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de Mendonça GV, Junior CC, Feitosa ACR, de Mendonça BFS, Pimassoni LHS. Periodontitis and non-communicable diseases in a Brazilian population, a cross-sectional study, Vila Velha-ES, Brazil. Osong Public Health Res Perspect 2024; 15:212-220. [PMID: 38988024 PMCID: PMC11237320 DOI: 10.24171/j.phrp.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The objective of this study was to examine the hypothesis that periodontal disease is associated with chronic non-communicable diseases. METHODS In this cross-sectional study, we evaluated the periodontal health condition of the population, based on the community periodontal index, as well as the number of missing teeth and the presence of systemic health conditions. We quantified the association between oral health and the presence of chronic diseases using simple logistic regression, adjusting for confounding factors including age, smoking, and overweight. RESULTS The study population consisted of 334 volunteers, aged between 19 and 81 years. In patients over 45 years old, periodontal disease was found to be significantly associated with hypertension and diabetes. Furthermore, in female patients, periodontal disease was significantly associated with hypertension, diabetes, and cancer. CONCLUSION Our findings indicate that periodontal disease is positively and significantly associated with both arterial hypertension and diabetes, independent of potential confounding factors.
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Yakar N, Emingil G, Türedi A, Şahin Ç, Köse T, Bostanci N, Silbereisen A. Value of gingival crevicular fluid TREM-1, PGLYRP1, and IL-1β levels during menopause. J Periodontal Res 2023; 58:1052-1060. [PMID: 37529985 DOI: 10.1111/jre.13167] [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: 11/29/2022] [Revised: 06/06/2023] [Accepted: 07/20/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE This study aimed to investigate the association of GCF TREM-1, PGLYRP1, and IL-1β levels with periodontal health in pre- and postmenopausal women. BACKGROUND Triggering receptor expressed on myeloid cells 1 (TREM-1), activated through its ligand peptidoglycan recognition protein 1 (PGLYRP1), stimulates proinflammatory cytokine production, such as interleukin (IL)-1β, during periodontal inflammation. Postmenopausal changes may modulate these immune-inflammatory functions. No clinical study has yet investigated the effect of menopause on TREM-1, PGLYRP1, and IL-1β levels in gingival crevicular fluid (GCF). METHODS This cross-sectional study included 148 women (age range = 35-65 years), divided into postmenopausal women (PMW) (n = 76, mean age = 54 ± 5 years) and regularly menstruating premenopausal women (RMPW) (n = 72, mean age = 40 ± 4 years). Clinical periodontal parameters were recorded. TREM-1, PGLYRP1, and IL-1β levels were quantified with enzyme-linked immunosorbent assays. Pearson's Chi-squared test and Mann-Whitney-U test were used to compare categorical and numerical variables, respectively. Spearman's Rho correlation analysis was used to test the linear relationship between variables. Analyte level data were categorized based on the periodontal diagnosis and menopause status (2 × 2 nonparametric factorial ANOVA). RESULTS No significant differences in TREM-1, PGLYRP1, and IL-1β levels between PMW and RMPW were observed (p > .05). Mean values of periodontal indexes including probing depth did not differ significantly between PMW and RMPW groups (p = .474). TREM-1 levels were significantly higher in both PMW and RMPW with periodontitis, compared to gingivitis or health (p = .0021). CONCLUSION Menopause-related changes have no observable effect on GCF levels of TREM-1, PGLYRP1, and IL-1β. Higher GCF TREM-1 levels in women with periodontitis regardless of their menopausal status indicate that TREM-1 may be an indicator for periodontitis both in premenopausal and postmenopausal women.
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Affiliation(s)
- Nil Yakar
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Asena Türedi
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Çağdaş Şahin
- Department of Gynecology and Obstetrics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Angelika Silbereisen
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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The relationship between tooth loss and hypertension: a systematic review and meta-analysis. Sci Rep 2022; 12:13311. [PMID: 35922537 PMCID: PMC9349209 DOI: 10.1038/s41598-022-17363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
As tooth loss is the high end of periodontal problems and edentulous individuals are at higher risk of nutritional problems like obesity, understanding the association between tooth loss and hypertension is important for improving cardiovascular health. We searched for publications from the last two decades using three electronic databases (PubMed, Web of Science and Scopus) and conducted a systematic review and meta-analysis on the association between tooth loss and hypertension according to PRISMA-P guidelines. Quality assessments were performed using the Newcastle–Ottawa Scale and the GRADE approach. Twenty-four studies (20 cross-sectional, and 4 cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that subjects with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Meta-analyses revealed a statistically significant association between tooth loss and hypertension. The pooled odds ratios of hypertension for having tooth loss with no tooth loss and for edentulous with dentate were 2.22 (95% CI 2.00–2.45) and 4.94 (95% CI 4.04–6.05), respectively. In cohort studies, subjects with more tooth loss had a greater incidence of hypertension than those with less tooth loss during the follow-up period. The present systematic review and meta-analysis suggests that tooth loss is associated with an increased risk of hypertension and higher systolic blood pressure.
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Čolak D, Cmok Kučič A, Pintar T, Gašpirc B, Gašperšič R. Periodontal and systemic health of morbidly obese patients eligible for bariatric surgery: a cross-sectional study. BMC Oral Health 2022; 22:174. [PMID: 35562737 PMCID: PMC9107195 DOI: 10.1186/s12903-022-02207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background In obese patients, periodontitis might be associated with deprived systemic health. Edmonton obesity staging system (EOSS) is a new tool for classification of obesity that considers the metabolic, physical, and psychological health. The cross-sectional study aimed to evaluate the periodontal status of morbidly obese patients eligible for bariatric surgery and the association between periodontitis, obesity-related comorbidities, and EOSS. Methods Morbidly obese patients eligible for bariatric surgery underwent detailed periodontal examination and were divided into the periodontitis group (PG) and the non-periodontitis group (NPG). The medical and demographic data were obtained from medical files, while behavioural data were obtained by the interview. Descriptive statistics and simple statistical tests were used to summarise the characteristics of the sample and the differences between PG and NPG. The logistic regression models were used to calculate the association (odds ratio (OR)) between periodontitis and obesity-related diseases and EOSS. Results The study included 79 patients, with an average BMI of 44.6 kg/m2 (SD = 7.2). The prevalence of periodontitis was 65% (CI 95% 53%-75%). PG patients (n = 51) were older, more often smokers and were more often hypertensive than NPG patients (n = 28) (p < 0.05). Hypertension was positively associated with periodontitis with adjusted OR 3.98 (95% CI 1.23–12.8; p = 0.021)) and age with adjusted OR 1.06, (95% CI 1.01–1.13; p = 0.038)), while other tested conditions (diabetes, dyslipidaemia, and smoking habits) did not show significant association with periodontitis. Periodontitis did not correlate with EOSS or other obesity-related comorbidities (p > 0.05). Conclusion The morbidly obese patients eligible for bariatric surgery show a high prevalence of periodontitis and, therefore, are advised to be examined by a dentist before undergoing surgery. They have higher odds of hypertension but not of other obesity-related diseases or higher stages of EOSS. The medical personnel should raise awareness among obese patients on the potential association of poor periodontal health with hypertension. Trial registration NCT04653714. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02207-0.
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Affiliation(s)
- Dejana Čolak
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia. .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Alja Cmok Kučič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Boris Gašpirc
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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5
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Millen AE, Dahhan R, Freudenheim JL, Hovey KM, Li L, McSkimming DI, Andrews CA, Buck MJ, LaMonte MJ, Kirkwood KL, Sun Y, Murugaiyan V, Tsompana M, Wactawski-Wende J. Dietary carbohydrate intake is associated with the subgingival plaque oral microbiome abundance and diversity in a cohort of postmenopausal women. Sci Rep 2022; 12:2643. [PMID: 35173205 PMCID: PMC8850494 DOI: 10.1038/s41598-022-06421-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/20/2022] [Indexed: 12/12/2022] Open
Abstract
Limited research exists on carbohydrate intake and oral microbiome diversity and composition assessed with next-generation sequencing. We aimed to better understand the association between habitual carbohydrate intake and the oral microbiome, as the oral microbiome has been associated with caries, periodontal disease, and systemic diseases. We investigated if total carbohydrates, starch, monosaccharides, disaccharides, fiber, or glycemic load (GL) were associated with the diversity and composition of oral bacteria in subgingival plaque samples of 1204 post-menopausal women. Carbohydrate intake and GL were assessed from a food frequency questionnaire, and adjusted for energy intake. The V3-V4 region of the 16S rRNA gene from subgingival plaque samples were sequenced to identify the relative abundance of microbiome compositional data expressed as operational taxonomic units (OTUs). The abundance of OTUs were centered log(2)-ratio transformed to account for the compositional data structure. Associations between carbohydrate/GL intake and microbiome alpha-diversity measures were examined using linear regression. PERMANOVA analyses were conducted to examine microbiome beta-diversity measures across quartiles of carbohydrate/GL intake. Associations between intake of carbohydrates and GL and the abundance of the 245 identified OTUs were examined by using linear regression. Total carbohydrates, GL, starch, lactose, and sucrose intake were inversely associated with alpha-diversity measures. Beta-diversity across quartiles of total carbohydrates, fiber, GL, sucrose, and galactose, were all statistically significant (p for PERMANOVA p < 0.05). Positive associations were observed between total carbohydrates, GL, sucrose and Streptococcus mutans; GL and both Sphingomonas HOT 006 and Scardovia wiggsiae; and sucrose and Streptococcus lactarius. A negative association was observed between lactose and Aggregatibacter segnis, and between sucrose and both TM7_[G-1] HOT 346 and Leptotrichia HOT 223. Intake of total carbohydrate, GL, and sucrose were inversely associated with subgingival bacteria alpha-diversity, the microbial beta-diversity varied by their intake, and they were associated with the relative abundance of specific OTUs. Higher intake of sucrose, or high GL foods, may influence poor oral health outcomes (and perhaps systemic health outcomes) in older women via their influence on the oral microbiome.
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Affiliation(s)
- Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA.
| | - Runda Dahhan
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA
| | - Lu Li
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Daniel I McSkimming
- Division of Infectious Disease & International Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Chris A Andrews
- Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Michael J Buck
- Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA
| | - Keith L Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Yijun Sun
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Vijaya Murugaiyan
- Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Maria Tsompana
- Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, Buffalo, NY, 14214-8001, USA
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6
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Ollikainen E, Saxlin T, Tervonen T, Suominen AL, Knuuttila M, Jula A, Ylöstalo P. Association between periodontal condition and blood pressure is confounded by smoking. Acta Odontol Scand 2022; 80:457-464. [PMID: 35120431 DOI: 10.1080/00016357.2022.2035430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To investigate the role of smoking as a confounding factor in the association between periodontal pocketing and blood pressure. MATERIAL AND METHODS After restriction to 45-64-year-old subjects without hypertension, diabetes, rheumatic diseases, obesity and with no history of cardiovascular diseases or ongoing lipid-lowering medications, the study population consisted of 307 subjects of the Health 2000 Survey in Finland. Systolic and diastolic blood pressure and pulse pressure (mmHg) were used as outcome variables. Periodontal condition was measured by the number of teeth with ≥4 mm periodontal pockets. β-estimates and 95% confidence intervals (CI) were obtained from linear regression models. Analyses were made in the whole study population and stratified according to smoking habits/history. RESULTS The number of teeth with ≥4 mm periodontal pockets associated statistically significantly with systolic blood pressure and pulse pressure in the whole study population. Among never-smokers or daily smokers, there were no consistent nor statistically significant associations between the number of teeth with ≥4 mm periodontal pockets and systolic/diastolic blood pressure or pulse pressure. CONCLUSIONS Smoking appeared to confound the association between periodontal condition and blood pressure. Thorough control for the effect of smoking was not obtained using multivariate models.
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Affiliation(s)
- Emilia Ollikainen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Matti Knuuttila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti Jula
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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7
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The association of reproductive history with hypertension and obesity according to menopausal status: the J-MICC Study. Hypertens Res 2022; 45:708-714. [PMID: 35031776 DOI: 10.1038/s41440-021-00820-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/08/2021] [Indexed: 11/08/2022]
Abstract
Previous studies have reported that the number of pregnancies and childbirths affected the risk of cardiovascular diseases (CVDs). However, the influence of reproductive history on hypertension and obesity, which are important risk factors for CVDs, is still unclear. Moreover, this association may vary depending on menopausal status. We evaluated the association of reproductive history with hypertension and obesity using a large cross-sectional dataset from the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). At the baseline survey, physical data, blood samples, and self-reported health questionnaires were collected. Participants with insufficient data were excluded, and 24,558 women from eight study regions were included in this study. Logistic regression analysis was conducted to evaluate the association of reproductive history with hypertension and obesity using multivariable-adjusted odds ratios. In premenopausal women, childbirth showed a generally protective effect on hypertension but not on obesity. In postmenopausal women, childbirth was positively associated with obesity and hypertension but not with hypertension after adjusting for BMI. In conclusion, reproductive history was associated with hypertension and obesity in a large Japanese population, and this association differed between premenopausal and postmenopausal women.
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Mahendra J, Palathingal P, Mahendra L, Muralidharan J, Alzahrani KJ, Sayed M, Mugri MH, Almagbol M, Varadarajan S, Balaji TM, Bhandi S, Srinivasan S, Raj AT, Patil S. Isolated Systolic Blood Pressure and Red-Complex Bacteria-A Risk for Generalized Periodontitis and Chronic Kidney Disease. Microorganisms 2021; 10:50. [PMID: 35056499 PMCID: PMC8781149 DOI: 10.3390/microorganisms10010050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/13/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022] Open
Abstract
Hypertension is a risk factor for generalized periodontitis (GP) and chronic kidney diseases (CKD). However, the role of isolated systolic blood pressure as one of the major risks for these inflammatory diseases has not been explored. Very limited studies exist identifying the red-complex bacteria in association with the isolated systolic blood pressure. Hence, the main objective of this study was to assess the isolated systolic blood pressure and the red-complex bacteria along with the demographic variables, periodontal parameters, and renal parameters in patients with generalized periodontitis and chronic kidney disease. One hundred twenty participants (age 30-70 years) were divided into four groups-Group C: control (systemically and periodontally healthy subjects), Group GP: generalized periodontitis, Group CKD: subjects with CKD with good periodontal health, Group CKD + GP: subjects with both generalized periodontitis and CKD. Demographic variables and periodontal parameters were measured and recorded. Blood pressure measurements and a detailed history and renal parameters such as serum creatinine, eGFR, and fasting blood sugar were recorded. The red-complex bacteria (RCB) were assessed in the subgingival plaque samples of all four groups using RT-PCR. Older participants (above 50 years) showed worse periodontal scores in the CKD + GP group along with elevated isolated systolic blood pressure, higher serum creatinine, and fasting blood sugar. eGFR was significantly decreased compared to the other groups. Bacterial counts were higher in the GP + CKD group, suggesting that they may be at a higher risk for generalized periodontitis and chronic kidney disease. Isolated systolic blood pressure (ISBP) and RCB were significantly correlated with the renal and periodontal parameters. A log-linear relationship exists between periodontal disease, CKD, RCB, and isolated systolic hypertension levels.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - Plato Palathingal
- Department of Periodontics, Annoor Dental College, Ernakulam 686673, Kerala, India;
| | - Little Mahendra
- Research Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai 213620, United Arab Emirates;
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammad Almagbol
- Department of Community and Periodontics, Faculty of Dentistry, King Khalid University, Abha 62529, Saudi Arabia;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, Tamil Nandu, India; (S.V.); (A.T.R.)
| | | | - Shilpa Bhandi
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Sruthi Srinivasan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, Tamil Nandu, India; (S.V.); (A.T.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
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9
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How Periodontal Disease and Presence of Nitric Oxide Reducing Oral Bacteria Can Affect Blood Pressure. Int J Mol Sci 2020; 21:ijms21207538. [PMID: 33066082 PMCID: PMC7589924 DOI: 10.3390/ijms21207538] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
Nitric oxide (NO), a small gaseous and multifunctional signaling molecule, is involved in the maintenance of metabolic and cardiovascular homeostasis. It is endogenously produced in the vascular endothelium by specific enzymes known as NO synthases (NOSs). Subsequently, NO is readily oxidized to nitrite and nitrate. Nitrite is also derived from exogenous inorganic nitrate (NO3) contained in meat, vegetables, and drinking water, resulting in greater plasma NO2 concentration and major reduction in systemic blood pressure (BP). The recycling process of nitrate and nitrite to NO (nitrate-nitrite-NO pathway), known as the enterosalivary cycle of nitrate, is dependent upon oral commensal nitrate-reducing bacteria of the dorsal tongue. Veillonella, Actinomyces, Haemophilus, and Neisseria are the most copious among the nitrate-reducing bacteria. The use of chlorhexidine mouthwashes and tongue cleaning can mitigate the bacterial nitrate-related BP lowering effects. Imbalances in the oral reducing microbiota have been associated with a decrease of NO, promoting endothelial dysfunction, and increased cardiovascular risk. Although there is a relationship between periodontitis and hypertension (HT), the correlation between nitrate-reducing bacteria and HT has been poorly studied. Restoring the oral flora and NO activity by probiotics may be considered a potential therapeutic strategy to treat HT.
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Muñoz Aguilera E, Suvan J, Buti J, Czesnikiewicz-Guzik M, Barbosa Ribeiro A, Orlandi M, Guzik TJ, Hingorani AD, Nart J, D'Aiuto F. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovasc Res 2020; 116:28-39. [PMID: 31549149 DOI: 10.1093/cvr/cvz201] [Citation(s) in RCA: 184] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
Recent evidence suggests a link between periodontitis (PD) and hypertension, but the nature of this association remains unclear. The overall aim of this review was to critically appraise the evidence linking these two common disorders. Systematic search was conducted for studies published up to December 2018. Prevalence of hypertension in patients with PD (moderate/severe groups) vs. those without PD (non-PD) was the primary outcome. Additional outcomes included adjusted mean difference in systolic (SBP) and diastolic (DBP) blood pressure (BP) levels in PD vs. non-PD, assessment of biomarkers in PD and hypertension, and BP changes after periodontal therapy. From 81 studies selected, 40 were included in quantitative meta-analyses. Diagnoses of moderate-severe PD [odds ratio (OR) = 1.22; 95% confidence interval (CI): 1.10-1.35] and severe PD (OR = 1.49; 95% CI: 1.09-2.05) were associated with hypertension. Prospective studies confirmed PD diagnosis increased likelihood of hypertension occurrence (OR = 1.68; 95% CI: 0.85-3.35). Patients with PD exhibited higher mean SBP [weighted mean difference (WMD) of 4.49 mmHg; 95% CI: 2.88-6.11] and DBP (2.03 mmHg; 95% CI: 1.25-2.81) when compared with non-PD. Lastly, only 5 out of 12 interventional studies confirmed a reduction in BP following periodontal therapy, ranging from 3 to 12.5 mmHg of SBP and from 0 to 10 mmHg of DBP. PD is associated with increased odds of hypertension (SORT C) and higher SBP/DBP levels. The evidence suggesting that PD therapy could reduce BP is inconclusive. Although additional research is warranted on this association, these results suggest that oral health assessment and management of PD could not only improve oral/overall health and quality of life but also be of relevance in the management of patients with hypertension.
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Affiliation(s)
- Eva Muñoz Aguilera
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK.,Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Jean Suvan
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Jacopo Buti
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aline Barbosa Ribeiro
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Marco Orlandi
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Tomasz J Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aroon D Hingorani
- Genetic Epidemiology, Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK
| | - Jose Nart
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Francesco D'Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
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Wactawski-Wende J, LaMonte MJ, Hovey K, Banack H. The Buffalo OsteoPerio Studies: Summary of our findings and the unique contributions of Robert J. Genco, DDS, PhD. CURRENT ORAL HEALTH REPORTS 2020; 7:29-36. [PMID: 35591981 PMCID: PMC9116690 DOI: 10.1007/s40496-020-00257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Robert ("Bob") Genco was a member of the research team that established the Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study. Here we detail the scientific discoveries emanating from this enduring collaboration. STUDY COHORTS OsteoPerio is ancillary to the Women's Health Initiative Observational Study (WHI-OS). WHI-OS is a longitudinal study of 93,000 postmenopausal women aged 50-79 enrolled at 40 U.S. centers (enrolled 1993-1998). OsteoPerio enrolled 1342 women 3 years later (1997-2001) from the Buffalo WHI-OS participants to study the association of osteoporosis and periodontal disease. OsteoPerio has 5-year (N=1026) and 17-year (N=518) follow-up examinations. PARTICIPANTS In addition to information on health status from the WHI-OS, OsteoPerio further included comprehensive oral examinations assessing probing pocket depth, clinical attachment loss, gingival bleeding, alveolar crestal height, and DMFT. Systemic bone density (measured by DXA), blood, saliva and plaque also were collected at all three visits. SUMMARY Findings from these studies are summarized here.
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Affiliation(s)
- Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo
| | - Kathy Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo
| | - Hailey Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo
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Bazyar H, Adibmanesh A, Javid AZ, Maghsoumi-Norouzabad L, Gravand E, Alipour M, Sadeghi N. The relationship between metabolic factors and anthropometric indices with periodontal status in type 2 diabetes mellitus patients with chronic periodontitis. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.obmed.2019.100138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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LaMonte MJ, Genco RJ, Buck MJ, McSkimming DI, Li L, Hovey KM, Andrews CA, Zheng W, Sun Y, Millen AE, Tsompana M, Banack HR, Wactawski-Wende J. Composition and diversity of the subgingival microbiome and its relationship with age in postmenopausal women: an epidemiologic investigation. BMC Oral Health 2019; 19:246. [PMID: 31722703 PMCID: PMC6854792 DOI: 10.1186/s12903-019-0906-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/05/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The extent to which the composition and diversity of the oral microbiome varies with age is not clearly understood. METHODS The 16S rRNA gene of subgingival plaque in 1219 women, aged 53-81 years, was sequenced and its taxonomy annotated against the Human Oral Microbiome Database (v.14.5). Composition of the subgingival microbiome was described in terms of centered log(2)-ratio (CLR) transformed OTU values, relative abundance, and prevalence. Correlations between microbiota abundance and age were evelauted using Pearson Product Moment correlations. P-values were corrected for multiple testing using the Bonferroni method. RESULTS Of the 267 species identified overall, Veillonella dispar was the most abundant bacteria when described by CLR OTU (mean 8.3) or relative abundance (mean 8.9%); whereas Streptococcus oralis, Veillonella dispar and Veillonella parvula were most prevalent (100%, all) when described as being present at any amount. Linear correlations between age and several CLR OTUs (Pearson r = - 0.18 to 0.18), of which 82 (31%) achieved statistical significance (P < 0.05). The correlations lost significance following Bonferroni correction. Twelve species that differed across age groups (each corrected P < 0.05); 5 (42%) were higher in women ages 50-59 compared to ≥70 (corrected P < 0.05), and 7 (48%) were higher in women 70 years and older. CONCLUSIONS We identified associations between several bacterial species and age across the age range of postmenopausal women studied. Understanding the functions of these bacteria could identify intervention targets to enhance oral health in later life.
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Affiliation(s)
- Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214 USA
| | - Robert J. Genco
- Department of Oral Biology, School of Dental Medicine, UB Microbiome Center, University at Buffalo, Buffalo, NY USA
| | - Michael J. Buck
- Department of Biochemistry, School of Medicine and Biomedical Sciences, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY USA
| | - Daniel I. McSkimming
- Genome, Environment, and Microbiome Center of Excellence, University at Buffalo, Buffalo, NY USA
| | - Lu Li
- Department of Microbiology and Immunology and Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY USA
| | - Kathleen M. Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214 USA
| | - Christopher A. Andrews
- Department of Ophthalmology, School of Medicine, University of Michigan, Ann Arbor, MI USA
| | - Wei Zheng
- Department of Microbiology and Immunology and Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY USA
| | - Yijun Sun
- Department of Microbiology and Immunology and Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY USA
| | - Amy E. Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214 USA
| | - Maria Tsompana
- Department of Biochemistry, School of Medicine and Biomedical Sciences, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY USA
| | - Hailey R. Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214 USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214 USA
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Dar-Odeh N, Borzangy S, Babkair H, Farghal L, Shahin G, Fadhlalmawla S, Alhazmi W, Taher S, Abu-Hammad O. Association of Dental Caries, Retained Roots, and Missing Teeth with Physical Status, Diabetes Mellitus and Hypertension in Women of the Reproductive Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2565. [PMID: 31323793 PMCID: PMC6678296 DOI: 10.3390/ijerph16142565] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate in women of reproductive age a possible association between particular dental diseases-dental caries, retained roots, and missing teeth-with some systemic conditions-physical status score- ASA (American Society for Anesthesiologists), diabetes mellitus, and hypertension. METHODS Dental and medical history were retrieved from the electronic files of dental patients. Statistical analysis was performed using cross tabulation with the Chi-square test to explore the significance of an association between variables pertaining to dental diseases and the investigated systemic conditions. Logistic regression was further used to explore the significance of the above dental diseases as predictors for systemic conditions. RESULTS A total of 1768 female patients in the age range 18-55 were included, with a mean age of 31.2 ± 10.13 years. A total of 228 (12.9%) patients had a chronic systemic disease within the ASA II category, 66 (3.7%) were diabetic, and 76 (4.3%) were hypertensive. Missing teeth were significantly associated with the ASA II category, diabetes mellitus, and hypertension (p < 0.001, p = 0.009, p = 0.005 respectively), while retained roots were significantly associated with the ASA II category only (p = 0.023). Logistic regression showed a low predictive capacity of models describing the three systemic conditions. CONCLUSIONS Diabetes mellitus and hypertension were the most common systemic diseases among the study sample. While carious teeth had no significant association with the investigated systemic conditions, retained roots were significantly associated with the ASA II category only, and missing teeth were significantly associated with all investigated systemic conditions. However, oral diseases expressed a low predictive power of these systemic conditions.
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Affiliation(s)
- Najla Dar-Odeh
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia.
- School of Dentistry, University of Jordan, Amman 11942, Jordan.
| | - Sary Borzangy
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
| | - Hamzah Babkair
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
| | - Lamis Farghal
- Private Sector, Al Madinah Al Munawara 42313, Saudi Arabia
| | - Ghufran Shahin
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
| | - Sawsan Fadhlalmawla
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Walaa Alhazmi
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
| | - Sarah Taher
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
| | - Osama Abu-Hammad
- College of Dentistry, Taibah University, Al Madinah Al Munawara 43353, Saudi Arabia
- School of Dentistry, University of Jordan, Amman 11942, Jordan
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Gordon JH, LaMonte MJ, Genco RJ, Zhao J, Li L, Hovey KM, Tsompana M, Buck MJ, Andrews CA, Mcskimming DI, Zheng W, Sun Y, Wactawski-Wende J. Is the Oral Microbiome Associated with Blood Pressure in Older Women? High Blood Press Cardiovasc Prev 2019; 26:217-225. [PMID: 31236901 DOI: 10.1007/s40292-019-00322-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/14/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION A possible role of the oral microbiome, specifically oral nitrate reducing flora, in blood pressure (BP) homeostasis, if proven etiologic in nature, could lead to novel mechanism-based therapy to improve hypertension prevention and control. AIM This cross-sectional study characterized and compared the oral microbiome between four study groups based on BP status among 446 postmenopausal women aged 53-82 years. METHODS Three study groups were not taking hypertension medication and were separated based on BP, as follows: normal BP (systolic < 120 and diastolic < 80; N = 179), elevated BP/Stage I hypertension (systolic 120-139 or diastolic 80-90; N = 106), Stage II hypertension (systolic > 140 or diastolic > 90; N = 42). The forth group consisted of anyone taking hypertension medications, regardless of BP (N = 119). Subgingival microbiome composition was determined using 16S rRNA sequencing with the Illumina MiSeq platform. Kruskal-Wallis tests were used to compare species-level relative abundance of bacterial operational taxonomic units across the four groups. RESULTS Sixty-five bacterial species demonstrated significant differences in relative abundance in women with elevated BP or using hypertension medication as compared to those with normal BP. After correction for multiple testing, two species, Prevotella oral (species 317) and Streptococcus oralis, remained significant and were lower in abundance among women taking antihypertension medications compared to those with normal BP (corrected P < 0.05). CONCLUSIONS These data provide novel description of oral subgingival bacteria grouped according to BP status. Additional larger studies including functional analysis and prospective designs will help further assess the potential role of the oral microbiome in BP regulation and hypertension.
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Affiliation(s)
- Joshua H Gordon
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 273 Farber Hall, 3435 Main Street, Buffalo, NY, 14214, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 273 Farber Hall, 3435 Main Street, Buffalo, NY, 14214, USA.
| | - Robert J Genco
- Department of Oral Biology, School of Dental Medicine, UB Microbiome Center, University at Buffalo, Buffalo, NY, USA
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, USA
| | - Lu Li
- Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 273 Farber Hall, 3435 Main Street, Buffalo, NY, 14214, USA
| | - Maria Tsompana
- Department of Biochemistry, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY, USA
| | - Michael J Buck
- Department of Biochemistry, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY, USA
| | - Christopher A Andrews
- Department of Ophthalmology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel I Mcskimming
- Genome Environment, and Microbiome Center of Excellence, University at Buffalo, Buffalo, NY, USA
| | - Wei Zheng
- Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY, USA
| | - Yijun Sun
- Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo, Buffalo, NY, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 273 Farber Hall, 3435 Main Street, Buffalo, NY, 14214, USA
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Dyke TE. Robert J. Genco, DDS, PhD: Legacy of a renowned and visionary periodontal researcher who shaped our knowledge of periodontitis and systemic diseases. J Periodontol 2019; 90:563-564. [DOI: 10.1002/jper.19-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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