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Taccardi D, Chiesa A, Maiorani C, Pardo A, Lombardo G, Scribante A, Sabatini S, Butera A. Periodontitis and Depressive Disorders: The Effects of Antidepressant Drugs on the Periodontium in Clinical and Preclinical Models: A Narrative Review. J Clin Med 2024; 13:4524. [PMID: 39124790 PMCID: PMC11312867 DOI: 10.3390/jcm13154524] [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: 07/05/2024] [Revised: 07/26/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: Several psychological conditions, including stress and depression, can adversely affect oral health; in fact, antidepressants, commonly used to treat depressive disorders, may have conflicting effects on the periodontal status of individuals. The aim of this review was to determine the effects of antidepressants on the periodontium. Methods: A literature search was conducted using electronic databases, Pubmed/MEDLINE, Cochrane Library, focusing on the use of antidepressants and their effects on periodontal health in animals or humans. Results: Seventeen articles have been included with the use of amitriptyline (two studies), desipramine (one study), imipramine (two studies), desvenlafaxine (one study), fluoxetine (six studies), venlafaxine (three studies) and tianeptine (two studies). One study evaluated several categories of antidepressants, such as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), tricyclic, atypical and monoamine oxidase inhibitors (MAO). Most trials showed improvements in periodontal health, especially with fluoxetine, but also with imipramine, desipramine, desvenlafaxine and tianeptine; on the contrary, worsening of clinical periodontal indices and increased loss of alveolar bone were reported with venlafaxine. Conclusions: This review suggests that in the presence of comorbidity between periodontitis and depression, pharmacological treatment with SNRIs, SSRIs and mixed antidepressants is associated with improvement in periodontal parameters, except for venlafaxine. Healthcare professionals (especially oral and mental health professionals) should investigate proper adherence to medication therapy in patients with a history of periodontitis and depression. Further clinical trials are needed to confirm these results.
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Affiliation(s)
- Damiano Taccardi
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (D.T.); (A.C.); (A.S.); (A.B.)
| | - Alessandro Chiesa
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (D.T.); (A.C.); (A.S.); (A.B.)
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (D.T.); (A.C.); (A.S.); (A.B.)
| | - Alessia Pardo
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy;
| | - Giorgio Lombardo
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy;
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (D.T.); (A.C.); (A.S.); (A.B.)
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Silvia Sabatini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (D.T.); (A.C.); (A.S.); (A.B.)
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Batista-Cárdenas D, Araya-Castillo A, Arias-Campos MP, Solís-Rivera AP, Jiménez-Matarrita J, Piedra-Hernández L, Madriz-Montero L, Ramírez K. Association of the severity and progression rate of periodontitis with systemic medication intake. FRONTIERS IN ORAL HEALTH 2024; 5:1447019. [PMID: 39157205 PMCID: PMC11328918 DOI: 10.3389/froh.2024.1447019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Background/purpose Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.
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Affiliation(s)
| | | | | | | | | | | | | | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, San José, Costa Rica
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Özkal Eminoğlu D, Şahin BN, Biçer D, Dal G, Huseynlı I, Dadashov A, Betül Doğan D, Kaşali K. Using patients' oral photographs for oral hygiene motivation promotes periodontal health: a prospective randomized controlled trial. BMC Oral Health 2024; 24:786. [PMID: 38997684 PMCID: PMC11245847 DOI: 10.1186/s12903-024-04553-7] [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: 02/26/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVES The aim of this prospective, randomized, controlled, single-centered, examiner-blinded clinical trial was to evaluate the effectiveness of a personalized and visual oral health education program in addition to conventional oral hygiene education. MATERIALS AND METHODS Fifty-six non-smoker, right-handed participants (aged 30.34 ± 11.46 years) without clinical signs of periodontitis were randomly grouped: the intervention group (n = 28) received a personalized visualized oral health education combined with conventional oral hygiene education, and the control group (n = 28) received conventional oral hygiene education only. All participants were assessed for improved periodontal parameters (PI, GI, BOP, and PPD) at baseline, first month, and third month. RESULTS A significant reduction (p < 0.001) was observed in PI, GI, and BOP during two follow-up sessions compared to the baseline for the two groups. No differences were found for inter-group (p > 0.05) or intra-group (p = 1) comparison of PPD. PI (p = 0.012), GI (p = 0.032), and BOP (p = 0.024) scores were significantly reduced at the third-month follow-up assessment in the intervention group compared to the control group. CONCLUSIONS Clinical outcomes of periodontal health were significantly enhanced by the personalized and visual oral health education program applied in this study compared to the conventional oral hygiene education program. CLINICAL RELEVANCE Numerous studies reported additional interventions to the oral hygiene education program. However, we did not find any published studies investigating the role of patients' intra-oral photographs in oral care. This study's results demonstrated that a visually aided education program for oral hygiene motivation may help improve oral health. CLINICAL TRIAL REGISTRATION Registration number is "NCT06316505" and date of registration is 18/03/2024.
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Affiliation(s)
- Didem Özkal Eminoğlu
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey.
| | - Beyza Nur Şahin
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Dilek Biçer
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Gülsüm Dal
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Ismayıl Huseynlı
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Anvar Dadashov
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Didar Betül Doğan
- Faculty of Dentistry, Department of Periodontology, Atatürk University, Erzurum, Turkey
| | - Kamber Kaşali
- Faculty of Medicine, Department of Biostatistics, Atatürk University, Erzurum, Turkey
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Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Relationship of Medication Intake and Systemic Conditions with Periodontitis: A Retrospective Study. J Pers Med 2023; 13:1480. [PMID: 37888091 PMCID: PMC10608268 DOI: 10.3390/jpm13101480] [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: 09/18/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES To examine the potential relationship of medication intake and systemic conditions with periodontitis. METHODS AND MATERIALS A total of 1985 patient records with a diagnosis of periodontal health and stage III and IV periodontitis were included in the analysis. Demographic characteristics, the number of missing teeth, patient-reported medical conditions and medication intake as well as smoking habits were recorded. Regression models were performed to explore the outcomes. RESULTS Older individuals, Hispanic ethnic groups, Black and Hispanic or Latino racial groups and non-White individuals in general were significantly more frequently diagnosed with periodontitis than health. Hypertension, glaucoma, anxiety and depression were significantly associated with periodontitis, while cancer, alcohol use, kidney problems, asthma, sleep apnea and gastrointestinal disorders were associated with periodontal health. Patients who reported taking anticoagulants, statins and ACE inhibitors demonstrated 3.546 (95% CI: 1.982, 6.343), 2.771 (95% CI: 1.877, 4.09) and 4.847 (95% CI: 2.785, 8.434) times higher odds of having periodontitis, respectively. CONCLUSION Within the limitations of this retrospective study that utilized the BigMouth dental data repository, there is a possible relationship between systemic medications including anticoagulants, ACE inhibitors and statins as well as systemic medical conditions including hypertension, glaucoma, anxiety and depression with periodontitis.
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Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA;
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ziou Jiang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA; (Z.J.); (N.M.)
| | - Nicholas Marka
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA; (Z.J.); (N.M.)
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA;
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Frankenhaeuser F, Söder B, Källmén H, Korpi ER, Meurman JH. Periodontitis may predict the use of prescription medicines later in life, a database study. Front Pharmacol 2023; 14:1146475. [PMID: 36992840 PMCID: PMC10040546 DOI: 10.3389/fphar.2023.1146475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023] Open
Abstract
Medications used for the treatment of diseases also affect oral health. We investigated how having/not having periodontitis at baseline in 1985 was associated with purchases of medicines in the long term. The study paradigm is in the oral health-systemic health connections. We hypothesized that periodontitis links to purchases of medicines later in life. The study cohort consisted of 3,276 individuals from the greater Stockholm area, Sweden. Of them, 1,655 were clinically examined at baseline. Patients were followed-up for >35 years, using the national population and patient registers. The burden of systemic diseases and purchases of medicines were statistically analyzed comparing patients with (n = 285) and without (n = 1,370) periodontitis. The results showed that patients with periodontitis had purchased more of certain medications than non-periodontitis patients. Periodontitis patients purchased significantly more drugs used in diabetes (p = 0.035), calcium channel blockers (p = 0.016), drugs acting on the renin-angiotensin system (p = 0.024), and nervous system drugs (p = 0.001). Hence, patients with periodontitis indeed had purchased specific medications statistically significantly more than the periodontally healthy ones. This indicates that periodontitis, over time, might increase the risk for systemic diseases with the subsequent need for medication.
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Affiliation(s)
- Freja Frankenhaeuser
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Freja Frankenhaeuser,
| | - Birgitta Söder
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Esa R. Korpi
- Department of Pharmacology, University of Helsinki, Helsinki, Finland
| | - Jukka H. Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Yildirim BG, Aksit C, Mutlu M, Ainola M, Eklund KK, Leskelä J, Pussinen P, Beklen A. Severity and progression rate of periodontitis are associated with an increased risk of hypertension of patients attending a university clinic. BMC Oral Health 2022; 22:627. [PMID: 36550459 PMCID: PMC9784004 DOI: 10.1186/s12903-022-02637-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although periodontitis is associated with increased risk of hypertension, studies based on new periodontal disease classification is limited. We investigated whether periodontitis severity and progression rate are linked with self-reports on doctor-diagnosed hypertension in a large cohort of patients attending the periodontology clinic at the faculty of dentistry. METHODS Archived patient files, including radiographic image records and results from full-mouth clinical periodontal examination were screened for inclusion. Data on socioeconomic factors, smoking and oral hygiene habits, and medical history were collected with a questionnaire. RESULTS Diagnosis and background data were available for 7008 patients. The median (IQR) age was 31.0 (21.0) years; 60.1% (n = 4211) were female. Hypertension was diagnosed in 6.2% (n = 435) of patients. Both periodontitis stage and grade differed (p < 0.001) between patients with or without hypertension. Increased periodontal disease severity was associated with a 20% increasing risk for hypertension; the odds ratio (OR) was 2.63 (95% confidence interval [CI] 1.48-4.68, p < 0.001) in stage IV periodontitis. Increasing periodontitis progression rate was associated with a 35% increased risk for hypertension; the OR was 2.22 (95% CI 1.45-3.40, p < 0.001) in grade C periodontitis. CONCLUSION Severity and progression rate of periodontitis may be independent risk factors for hypertension in this large cohort of patients attending the university periodontal department.
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Affiliation(s)
- Burak G. Yildirim
- grid.164274.20000 0004 0596 2460Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Cemilenur Aksit
- grid.411739.90000 0001 2331 2603Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Mesut Mutlu
- grid.8302.90000 0001 1092 2592Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Mari Ainola
- grid.7737.40000 0004 0410 2071Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Translational Immunology Research Program (TRIMM), Research Program Unit (RPU), University of Helsinki, Helsinki, Finland
| | - Kari K. Eklund
- grid.7737.40000 0004 0410 2071Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Translational Immunology Research Program (TRIMM), Research Program Unit (RPU), University of Helsinki, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Inflammation Center, Division of Rheumatology, Helsinki University Hospital, Helsinki, Finland ,ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland
| | - Jaakko Leskelä
- grid.7737.40000 0004 0410 2071Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Pirkko Pussinen
- grid.7737.40000 0004 0410 2071Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland ,grid.9668.10000 0001 0726 2490Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Arzu Beklen
- grid.164274.20000 0004 0596 2460Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey ,grid.7737.40000 0004 0410 2071Translational Immunology Research Program (TRIMM), Research Program Unit (RPU), University of Helsinki, Helsinki, Finland
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Wang F, Peng L, Gu F, Huang P, Cheng B, Chen G, Meng L, Bian Z. Circulating small extracellular vesicles from patients with periodontitis contribute to development of insulin resistance. J Periodontol 2022; 93:1902-1915. [PMID: 35716108 DOI: 10.1002/jper.22-0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/24/2022] [Accepted: 05/26/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Epidemiological studies have identified the role of periodontitis in the pathogenesis of type 2 diabetes, but the underlying mechanism is poorly understood. It is well-known that small extracellular vesicles are lipid bilayer vesicles derived from cells with a diameter around 30 to 200 nm. The purpose of this study was to investigate whether periodontitis induced or exacerbated insulin resistance via circulating small extracellular vesicles. METHODS Plasma small extracellular vesicles from control and periodontitis rats were intravenously injected into type 2 diabetic rats. Insulin tolerance tests, glucose tolerance tests, and the activation of the insulin signaling pathway were measured to detect the effect of the plasma small extracellular vesicles on insulin sensitivity. In addition, circulating small extracellular vesicles from patients with periodontitis with or without diabetes were isolated and co-cultured with HepG2 cells. The ability of glucose uptake was assessed using the fluorescence of 2-NBDG via flow cytometry. The activation of insulin signaling pathway was examined via Western blotting. Real time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of enzyme related to glycolysis and gluconeogenesis. RESULTS Small extracellular vesicles derived from the plasma of periodontitis rats further impaired glucose tolerance and insulin tolerance in diabetic rats and significantly reduced the activation of the insulin signaling pathway in liver tissues, as evidenced by the decreased levels of p-AKT and p-GSK3β and the reduced hepatic glycogen content. For small extracellular vesicles isolated from human plasma, the concentration of small extracellular vesicles in patients with type 2 diabetes combined with periodontitis was higher than that of the healthy control and periodontitis alone. Moreover, circulating small extracellular vesicles from patients with periodontitis significantly inhibited the glucose uptake capacity and inhibited insulin signaling of HepG2 cells. CONCLUSION Periodontitis acted as a contributing factor to exacerbate insulin resistance of type 2 diabetic rats. Plasma small extracellular vesicles played a critical role in periodontitis aggravating insulin resistance.
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Affiliation(s)
- Fei Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Linlin Peng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fan Gu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Pei Huang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bo Cheng
- Departmant of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Gang Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Ju X, Harford J, Luzzi L, Jamieson LM. Prevalence, extent, and severity of periodontitis among Australian older adults: Comparison of two generations. J Periodontol 2022; 93:1387-1400. [PMID: 34957563 PMCID: PMC9786236 DOI: 10.1002/jper.21-0458] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Chronic periodontitis is highly prevalent among older adults. The study aimed to compare periodontal disease among Australian older adults in two generations. We hypothesized that the prevalence and severity of periodontitis would decrease from the previous generation to the recent generation. METHODS Data were obtained from the South Australian Dental Longitudinal Study (SADLS) in 1991 to 1992 (SADLS I) and 2013 to 2014 (SADLS II); population-based longitudinal surveys of Australian older adults aged ≥60 years. American Academy of Periodontology, the US Centers for Disease Control and Prevention (AAP/CDC), and the 2018 European Federation of Periodontology (EFP/AAP) classification case definitions were used to define and calculate prevalence of chronic periodontitis. Multivariable log-Poisson regression models were used to identify risk indicators for severe periodontitis after adjusting for other covariates. RESULTS There were a total of 801 and 355 participants that underwent a periodontal exam in SADLS I and II, respectively. The prevalence of severe periodontitis was higher in the recent generation (88% and 56%) than the previous generation (75% and 46.7%) under the CDC/AAP and EFP/AAP case definitions, respectively. The mean number of missing teeth was lower in the recent generation (6) than the previous generation (13). The prevalence ratio of severe periodontitis was around two times higher in the younger age group, men, those not born in Australia, and current smokers across both generations. CONCLUSIONS Our findings indicated that the recent generation of older adults has higher prevalence and severity of chronic periodontitis than the previous generation. Our findings indicated that aging, being male, born overseas, low household income, no dental insurance, and being a current smoker are significant risk factors associated with severe periodontitis among older Australians.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jane Harford
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
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da Silveira TM, Silva CFE, Vaucher RDA, Angst PDM, Casarin M, Pola NM. Higher frequency of specific periodontopathogens in hypertensive patients. A pilot study. Braz Dent J 2022; 33:64-73. [PMID: 36287500 PMCID: PMC9645173 DOI: 10.1590/0103-6440202204914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022] Open
Abstract
Periodontitis and arterial hypertension are two of the pathologies with the highest global prevalence; evidence reported so far has been favorable to an association between them. This cross-sectional study aimed to evaluate and compare the microbiological counts of hypertensive and normotensive patients with periodontitis. Sociodemographic, behavioral, systemic health data and periodontal clinical parameters were assessed. Counts of A. actinomycetemcomitans, P. intermedia, P. gingivalis and F. nucleatum were performed by real-time polymerase chain reaction using subgingival biofilm samples. Thirty-eight patients were included in this preliminary analysis, divided into two groups: Normotensive Group (NG) (n = 14) and Hypertensive Group (HG) (n = 24). Patients diagnosed with periodontitis composed both groups. Data analysis was performed with significance level of 5%. There was no significant difference between groups for clinical periodontitis diagnosis. In addition, hypertensive individuals had higher P. intermedia, P. gingivalis, and F. nucleatum counts when compared to normotensive individuals. The parameters probing pocket depth, bleeding on probing, and A. actinomycetemcomitans count did not presented statistical differences between groups. With these preliminary results, it can be concluded that the presence of arterial hypertension may be associated with a greater quantity of periodontopathogenic bacterial of some species in individuals with periodontitis.
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Affiliation(s)
| | | | - Rodrigo de Almeida Vaucher
- Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Maísa Casarin
- Division of Periodontics, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Natália Marcumini Pola
- Division of Periodontics, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Abstract
The emergence of the COVID-19 viral pandemic has generated a renewed interest in pharmacologic agents that target the renin angiotensin system (RAS). Angiotensin-converting enzyme 1 (ACE1) inhibitors decrease the synthesis of angiotensin II (Ang II) from its precursor angiotensin I and inhibit the breakdown of bradykinin, while Ang II receptor blockers antagonize the action of Ang II at the receptor level downstream. The actions of both classes of drugs lead to vasodilation, a blunting of sympathetic drive and a reduction in aldosterone release, all beneficial effects in hypertension and congestive heart failure. ACE2 cleaves the vasoconstrictor Ang II to produce the anti-inflammatory cytoprotective angiotensin 1-7 (Ang 1-7) peptide, which functions through the G protein-coupled receptor MAS to counteract the pathophysiologic effects induced by Ang II via its receptors, including vasoconstriction, inflammation, hypercoagulation, and fibrosis. SARS-CoV-2 enters human cells by binding ACE2 on the cell surface, decreases ACE2 activity, competes for ACE2 receptor-binding sites, and shifts the RAS toward an overexpression of Ang II, accounting for many of the deleterious effects of the virus. Thus, there is great interest in developing recombinant ACE2 as a therapeutic for prevention or treatment of COVID-19. Notably, ACE2 is highly expressed in the oral cavity, and saliva and dorsum of the tongue are major reservoirs of SARS-CoV-2. Cost-effective methods to debulk the virus in the oral cavity may aid in the prevention of viral spread. Here we review the pharmacology of targeted small molecule inhibitors of the RAS and discuss novel approaches to employing ACE2 as a therapeutic for COVID-19.
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Affiliation(s)
- E.V. Hersh
- Department of Oral Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M. Wolff
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P.A. Moore
- Departments of Dental Anesthesiology and Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - K.N. Theken
- Department of Oral Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - H. Daniell
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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