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Arunyanak SP, Kungsadalpipob K, Wright KE, Subbalekha K, Dragan I, Mattheos N. The use of patient-related outcomes (PRO) and experience (PRE) in assessing the periodontal and implant patient. Periodontol 2000 2024. [PMID: 38927002 DOI: 10.1111/prd.12589] [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: 02/06/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
The purpose of this review was to summarize the evidence with regard to behavioral and psychosocial assessment of the periodontitis patient, the candidate for implant therapy, and the peri-implantitis patient. Periodontitis has an adverse effect on quality of life and its treatment can lead to significant improvements experienced by the patient. The latter is true for rehabilitation with dental implants, although patients harbor diverse expectations and perceptions of implant therapy, which can often interfere with satisfaction and/or influence long-term success. A thorough behavioral assessment of the candidate for implant therapy is essential, which should include, perceptions, expectations, as well as risk for behavioral disorders. Remedial action is essential to correct misperceptions and any identified risks. Finally, patients have limited awareness of limited ability to identify signs of peri-implantitis. The diagnosis of peri-implantitis can be a cause of significant distress, resentment, and loss of trust to the treatment and the caregivers. Despite documented value in clinical research, currently available instruments assessing patient-reported outcomes have little application in day-to-day clinical practice. Face-to-face patient to doctor open-ended communication remains the most effective way to comprehensively establish the long-term "therapeutic alliance" essential for the long journey for the periodontitis patient.
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Affiliation(s)
- Sirikarn P Arunyanak
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Kajorn Kungsadalpipob
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Kyle E Wright
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Irina Dragan
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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2
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Unlu O, Demirci M, Paksoy T, Eden AB, Tansuker HD, Dalmizrak A, Aktan C, Senel F, Sunter AV, Yigit O, Cakir BO, Kantarci A. Oral microbial dysbiosis in patients with oral cavity cancers. Clin Oral Investig 2024; 28:377. [PMID: 38884817 PMCID: PMC11182825 DOI: 10.1007/s00784-024-05770-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES The pathogenesis of oral cavity cancers is complex. We tested the hypothesis that oral microbiota dysbiosis is associated with oral cavity cancer. MATERIALS AND METHODS Patients with primary oral cavity cancer who met the inclusion and exclusion criteria were included in the study. Matching healthy individuals were recruited as controls. Data on socio-demographic and behavioral factors, self-reported periodontal measures and habits, and current dental status were collected using a structured questionnaire and periodontal chartings. In addition to self-reported oral health measures, each participant received a standard and detailed clinical examination. DNA was extracted from saliva samples from patients and healthy controls. Next-generation sequencing was performed by targeting V3-V4 gene regions of the 16 S rRNA with subsequent bioinformatic analyses. RESULTS Patients with oral cavity cancers had a lower quality of oral health than healthy controls. Proteobacteria, Aggregatibacter, Haemophilus, and Neisseria decreased, while Firmicutes, Bacteroidetes, Actinobacteria, Lactobacillus, Gemella, and Fusobacteria increased in oral cancer patients. At the species level, C. durum, L. umeaens, N. subflava, A. massiliensis, and V. dispar were significantly lower, while G. haemolysans was significantly increased (p < 0.05). Major periodontopathogens associated with periodontal disease (P. gingivalis and F.nucleatum) increased 6.5- and 2.8-fold, respectively. CONCLUSION These data suggested that patients with oral cancer had worse oral health conditions and a distinct oral microbiome composition that is affected by personal daily habits and may be associated with the pathogenicity of the disease and interspecies interactions. CLINICAL RELEVANCE This paper demonstrates the link between oral bacteria and oral cancers, identifying mechanistic interactions between species of oral microbiome.
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Affiliation(s)
- Ozge Unlu
- Faculty of Medicine, Department of Medical Microbiology, Istanbul Atlas University, Istanbul, Turkey.
- ADA Forsyth Institute, Cambridge, MA, USA.
| | - Mehmet Demirci
- Faculty of Medicine, Department of Medical Microbiology, Kırklareli University, Kırklareli, Turkey
| | - Tugce Paksoy
- Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - Arzu Baygul Eden
- Faculty of Medicine, Department of Biostatistics, Koc University, Istanbul, Turkey
| | - Hasan Deniz Tansuker
- Faculty of Medicine, Department of Otolaryngology, Yeditepe University, Istanbul, Turkey
| | - Aysegul Dalmizrak
- Faculty of Medicine, Department of Medical Biology, Balıkesir University, Balıkesir, Turkey
| | - Cagdas Aktan
- Faculty of Medicine, Department of Medical Biology, Bandirma University, Balıkesir, Turkey
| | - Firdevs Senel
- Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Beykent University, Istanbul, Turkey
| | - Ahmet Volkan Sunter
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Ozgur Yigit
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Burak Omur Cakir
- Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Istanbul Aydin University, Istanbul, Turkey
| | - Alpdogan Kantarci
- ADA Forsyth Institute, Cambridge, MA, USA
- School of Dental Medicine, Harvard University, Boston, MA, USA
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Aguiar FJN, Menezes FDS, Fagundes MDA, Fernandes GA, Alves FDA, Filho JG, Curado MP. Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis. Clinics (Sao Paulo) 2024; 79:100321. [PMID: 38301538 PMCID: PMC10847461 DOI: 10.1016/j.clinsp.2023.100321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). METHODS The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). RESULTS There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). CONCLUSIONS The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.
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Affiliation(s)
| | | | | | | | - Fabio de Abreu Alves
- Head of Service, Oral Medicine Department, A. C. Camargo Cancer Center, São Paulo, Brazil; Stomatology Department, Faculdade de Odontologia, Universidade São Paulo, São Paulo, SP, Brazil
| | - João Goncalves Filho
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Maria Paula Curado
- Nucleus of Epidemiology and Statistics in Cancer, A. C. Camargo Cancer Center, São Paulo, Brazil.
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Enevold C, Nielsen CH, Christensen LB, Kongstad J, Fiehn NE, Hansen PR, Holmstrup P, Havemose-Poulsen A, Damgaard C. Suitability of machine learning models for prediction of clinically defined Stage III/IV periodontitis from questionnaires and demographic data in Danish cohorts. J Clin Periodontol 2023. [PMID: 37691160 DOI: 10.1111/jcpe.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/14/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
AIM To evaluate if, and to what extent, machine learning models can capture clinically defined Stage III/IV periodontitis from self-report questionnaires and demographic data. MATERIALS AND METHODS Self-reported measures of periodontitis, demographic data and clinically established Stage III/IV periodontitis status were extracted from two Danish population-based cohorts (The Copenhagen Aging and Midlife Biobank [CAMB] and The Danish Health Examination Survey [DANHES]) and used to develop cross-validated machine learning models for the prediction of clinically established Stage III/IV periodontitis. Models were trained using 10-fold cross-validations repeated three times on the CAMB dataset (n = 1476), and the resulting models were validated in the DANHES dataset (n = 3585). RESULTS The prevalence of Stage III/IV periodontitis was 23.2% (n = 342) in the CAMB dataset and 9.3% (n = 335) in the DANHES dataset. For the prediction of clinically established Stage III/IV periodontitis in the CAMB cohort, models reached area under the receiver operating characteristics (AUROCs) of 0.67-0.69, sensitivities of 0.58-0.64 and specificities of 0.71-0.80. In the DANHES cohort, models derived from the CAMB cohort achieved AUROCs of 0.64-0.70, sensitivities of 0.44-0.63 and specificities of 0.75-0.84. CONCLUSIONS Applying cross-validated machine learning algorithms to demographic data and self-reported measures of periodontitis resulted in models with modest capabilities for the prediction of Stage III/IV periodontitis in two Danish cohorts.
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Affiliation(s)
- C Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - C H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L B Christensen
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Kongstad
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - N E Fiehn
- Costerton Biofilm Centre, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - P R Hansen
- Department of Cardiology, Herlev-Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Holmstrup
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A Havemose-Poulsen
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C Damgaard
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Saito M, Shimazaki Y, Yoshii S, Takeyama H. Association of self-rated chewing function and oral health status with metabolic syndrome. J Oral Sci 2023; 65:29-33. [PMID: 36529512 DOI: 10.2334/josnusd.22-0229] [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: 12/23/2022]
Abstract
PURPOSE The study aimed to examine the association of self-rated chewing function, the number of teeth and periodontal status with metabolic syndrome. METHODS The participants were 11,119 adults aged 40-74 years who underwent specific health checkups, including an oral health examination, in 2018 in Japan. This study used the standard questions of the specific health checkups to obtain information on self-rated chewing function. A multinomial logistic regression analysis was performed with metabolic syndrome status as the dependent variable, and age, sex, lifestyle questions, self-rated chewing function, number of teeth, and periodontal status as the independent variables. RESULTS Number of teeth and periodontal status were significantly associated with metabolic syndrome after adjusting for confounding variables. Self-rated chewing function was significantly associated with metabolic syndrome in the crude analysis, but not after adjustment for confounding variables. Both number of teeth and periodontal status were significantly associated with self-rated chewing function. CONCLUSION There was no significant direct association between self-rated chewing function and metabolic syndrome. Self-rated chewing function may be an indicator of poor oral condition that links to metabolic syndrome.
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Affiliation(s)
- Mizuki Saito
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University
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Talbert RD, Macy ED. Former Incarceration, Time Served, and Perceived Oral Health among African American Women and Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12906. [PMID: 36232206 PMCID: PMC9566785 DOI: 10.3390/ijerph191912906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
A large body of research has documented the far-reaching health consequences of mass incarceration in the United States. Yet, less scholarship has examined the relationship between former incarceration and oral health, a key reflection of health and disease occurring within the rest of the body. Using data extracted from the National Survey of American Life (n = 3343), this study examines associations among former incarceration status, duration of detention, and self-reported oral health among African American women and men. Results from gender-stratified ordered logistic models reveal that formerly incarcerated African American men and women experience significantly poorer oral health than their never incarcerated counterparts even after controlling for important social determinants of health. Furthermore, oral health is curvilinearly associated with the length of time that men are incarcerated such that odds of poor health decrease as detention duration increases up to approximately 15 years incarcerated. After 15 years of detainment, the odds of poor health tend to increase as duration increases. Findings extend research identifying gendered spillover health consequences of contact with the criminal legal system. Health professionals and policymakers should be conscious of incarceration as an important deleterious experience for the immediate and long-term condition of people's teeth, mouth, and gums.
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Affiliation(s)
- Ryan D. Talbert
- Department of Sociology, University of Connecticut, Storrs, CT 06269, USA
| | - Emma D. Macy
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269, USA
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Mohd-Said S, Mohd-Norwir NA, Ariffin AN, Teo HS, Nik-Azis NM, Rani H, Ramli H, Husain J, Mohd-Dom TN, Hamat A. Validation of a Simplified Digital Periodontal Health Screening Module for General Dental Practitioners. Healthcare (Basel) 2022; 10:1916. [PMID: 36292363 PMCID: PMC9601548 DOI: 10.3390/healthcare10101916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/04/2022] Open
Abstract
As a silent disease, individuals at risk of periodontitis are not easily identified until the disease has become severe. Early detection at the community level is essential, especially for general dental practitioners. The aim of this study was to design a comprehensive, user-friendly tool to screen patients' periodontal health at community level and to evaluate users' acceptance of its use. The periodontal health screening module was first developed by an expert panel of periodontists, public health specialists and general dentists. The developed module was tested for content acceptance on 156 graduating dental students from three public schools and later validated by 12 private general dental practitioners (GDPs) for reliability. Most of the students (64.1%) found the new module an easy assessment tool for periodontal health compared to the Basic Periodontal Examination (BPE). Most claimed that they understand the contents (80.8%) and accepted the designs (86.6%) and agreed (82.7%) that the new assessment module would allow them to screen patients anytime in the clinic. The interrater reliability as assessed between the GDPs and the investigators revealed acceptable agreement ranging from 62.5-100.0% (mean 89.6 ± 10.2%). The simplified digital periodontal health screening module showed promising acceptance for application in private general dental clinics.
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Affiliation(s)
- Shahida Mohd-Said
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | | | - Ahmad Najmi Ariffin
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Huey Shiuan Teo
- Klinik Pergigian Batu Pahat, Klinik Kesihatan Batu Pahat, Jalan Kluang, Batu Pahat 83000, Malaysia
| | - Nik Madihah Nik-Azis
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Haslina Rani
- Department of Family Oral Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Haslinda Ramli
- Department of Periodontology and Community Oral Health, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur 55100, Malaysia
| | - Juzaily Husain
- Department of Restorative Dentistry, Kulliyah of Dentistry, International Islamic University Malaysia, Kuantan 25200, Malaysia
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Afendi Hamat
- Center for Research in Language and Linguistics, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
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8
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Paksoy T, Peker K, Ustaoğlu G, Ural ÜM. Socio-demographic, Behavioral and Subjective Factors Affecting the Knowledge and Attitudes on Periodontal Health Among Turkish Pregnants. MEANDROS MEDICAL AND DENTAL JOURNAL 2022. [DOI: 10.4274/meandros.galenos.2021.98159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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9
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Does Smoking Explain the Association Between Use of E-Cigarettes and Self-Reported Periodontal Disease? J Dent 2022; 122:104164. [DOI: 10.1016/j.jdent.2022.104164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023] Open
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Sorunke ME, Onigbinde OO, Oyapero A, Coker OA. Self-Reported Periodontal Disease and its Association with Dental Anxiety in Lagos, Nigeria. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Deng K, Pelekos G, Jin L, Tonetti MS. Gingival bleeding on brushing as a sentinel sign of gingival inflammation: A diagnostic accuracy trial for the discrimination of periodontal health and disease. J Clin Periodontol 2021; 48:1537-1548. [PMID: 34494292 PMCID: PMC9293219 DOI: 10.1111/jcpe.13545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022]
Abstract
AIM To assess the accuracy of self-reported gingival bleeding on brushing (GBoB) for differentiating between periodontal health and disease and explore the optimal haemoglobin concentration that enables visual detection of GBoB. MATERIALS AND METHODS Self-assessment of GBoB was conducted in supervised sessions for 408 consecutive adults. The haemoglobin levels in saliva/toothpaste slurry (TPS) were analysed, followed by a full-mouth periodontal examination. Periodontal diagnoses were made based on the 2017 classification of periodontal diseases. Gingival inflammation was defined as presence of at least 10% of sites with bleeding on probing (BOP). Logistic regression and area under the receiver operating characteristic curve (AUROC) analyses were applied to assess the accuracy of GBoB. RESULTS Overall, 37.1% of the subjects claimed self-reported GBoB, and they had higher values of BOP (median: 25.0%; interquartile range (IQR): 16.0%-37.5%) than those without GBoB (median: 13.5%; IQR: 8.0%-24.8%, p < .001). The concentration/total amount of haemoglobin in TPS was positively correlated with the number of bleeding sites (r = .409/r = .520, p < .001). Haemoglobin concentration of 90.58 μg/ml or 0.51 μl blood volume enabled visual detection of GBoB with an AUROC of 0.848. Self-reported GBoB exhibited significantly increased values of diagnostic odds ratios (3-8) for varying degrees of gingival inflammation and periodontal disease (gingivitis and periodontitis). It showed low to moderate accuracy for discriminating periodontitis and gingivitis from periodontal health, with a sensitivity of 37.1% and 61.3% and a specificity of 84.8% and 84.4%, respectively. Absence of self-reported GBoB and low levels of haemoglobin had 93%-98% predictive values for periodontal health. CONCLUSIONS Despite its low sensitivity for the discrimination of periodontitis, self-reported GBoB is a promising sentinel sign for periodontal health and disease, and gingival inflammation in particular. It is visually detectable after minor blood loss. After validation in an independent population, identification of GBoB may promote earlier detection and better prevention and treatment of periodontal disease, thereby eventually reducing the global burden of the disease.
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Affiliation(s)
- Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,European Research Group on Periodontology, Genoa, Italy
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12
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Watanabe C, Wada J, Nagayama T, Uchida H, Mizutani K, Foxton RM, Shibata Y, Wakabayashi N. Long-term observation of periodontal condition following placement of removable partial dentures with rigid retainers and major connector in patients with/without diabetes: A retrospective study. J Prosthodont Res 2021; 66:117-123. [PMID: 34108298 DOI: 10.2186/jpr.jpr_d_20_00288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This retrospective study evaluated the periodontal tissues of the abutment teeth of removable partial dentures (RPDs) with rigid retainers and major connectors in patients with and without type 2 diabetes mellitus (T2D). METHODS A total of 313 patients who had been treated with RPDs, including rigid retainers and major connectors, were divided into two groups: T2D and non-T2D. The periodontal parameters and radiographic bone heights of the abutment teeth were evaluated at baseline and at a 5-year examination during supportive periodontal therapy (SPT). For patients with accessible standardized radiographs, bone density was analyzed based on the gray level (GL) using digital subtraction radiography (n = 83). RESULTS Overall, 739 abutment teeth (86 in the T2D group) of 235 patients (25 in the T2D group) were analyzed, and 95.0% (94.2% in the T2D group, and 95.2% in the non-T2D group) were maintained. The mean probing pocket depth significantly increased in both groups ( p < 0.001). There were significant changes in the radiographic bone height (p = 0.038) and GL on the side of the denture base area (p = 0.048) in the T2D group compared to those in the non-T2D group. CONCLUSIONS Regardless of T2D, RPDs with rigid retainers and major connectors could prevent the progression of periodontal disease and successfully maintain most of the abutment teeth during 5-years of SPT. However, T2D may be significantly associated with loss of bone height reduction and density on the side of the denture base area.
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Affiliation(s)
- Chie Watanabe
- Department of Conservative Dentistry, Division of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo
| | - Junichiro Wada
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Tomiharu Nagayama
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Hirofumi Uchida
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Koji Mizutani
- Department of Periodontology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Richard M Foxton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London (KCL), London
| | - Yo Shibata
- Department of Conservative Dentistry, Division of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo
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13
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Sekundo C, Bölk T, Kalmus O, Listl S. Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening. J Clin Med 2021; 10:E287. [PMID: 33466797 PMCID: PMC7830157 DOI: 10.3390/jcm10020287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76-0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82-132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.
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Affiliation(s)
- Caroline Sekundo
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Tobias Bölk
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Olivier Kalmus
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Stefan Listl
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 Nijmegen, The Netherlands
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14
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Romandini M, Lima C, Pedrinaci I, Araoz A, Costanza Soldini M, Sanz M. Clinical signs, symptoms, perceptions, and impact on quality of life in patients suffering from peri-implant diseases: a university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:100-111. [PMID: 33210787 DOI: 10.1111/clr.13683] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/22/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. MATERIAL AND METHODS Two hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. RESULTS Ninety-nine patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre-peri-implantitis/peri-implantitis than in healthy/mucositis implants (p < .01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p < .01). CONCLUSION Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-peri-implantitis/peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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15
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Micu IC, Bolboacă SD, Caracostea GV, Gligor D, Ciurea A, Iozon S, Soancă A, Mureșan D, Roman A. Self-reported and clinical periodontal conditions in a group of Eastern European postpartum women. PLoS One 2020; 15:e0237510. [PMID: 32810155 PMCID: PMC7433868 DOI: 10.1371/journal.pone.0237510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/28/2020] [Indexed: 12/02/2022] Open
Abstract
Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to “gum swelling”, “halitosis”, “previous periodontal diagnosis” and “previous periodontal treatment” with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.
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Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Gabriela V. Caracostea
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Diana Gligor
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sofia Iozon
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Daniel Mureșan
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
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16
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Ueno M, Shimazu T, Sawada N, Tsugane S, Kawaguchi Y. Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study. Asia Pac J Public Health 2020; 32:346-353. [PMID: 32741221 DOI: 10.1177/1010539520944721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.
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Affiliation(s)
- Masayuki Ueno
- Saitama Prefectural University, Koshigaya, Japan.,Tokyo Medical and Dental University, Tokyo, Japan
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17
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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