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Zeng X, Wang X, Guan X, Feng X, Lu R, Meng H. The long-term effect of periodontitis treatment on changes in blood inflammatory markers in patients with generalized aggressive periodontitis. J Periodontal Res 2024; 59:689-697. [PMID: 38501229 DOI: 10.1111/jre.13251] [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: 07/25/2023] [Revised: 12/20/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long-term effects of periodontal inflammation control on systemic inflammatory markers are unclear. OBJECTIVE This study aimed to investigate the long-term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. METHODS Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow-ups were conducted over a 3- to 5-year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. RESULTS A total of 49 patients with GAgP completed APT and follow-ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1-mm reduction in PD after treatment, the neutrophil count, neutrophil-lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109/L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. CONCLUSION This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long-term observation.
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Affiliation(s)
- Xiancheng Zeng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiane Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiaoyuan Guan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ruifang Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Ren Z, Xue Y, Zhang H, Guo T, Yi W, Li L, Wang M, Xie J, Li Y. Systemic Immune-Inflammation Index and Systemic Inflammation Response Index are Associated With Periodontitis: Evidence From NHANES 2009 to 2014. Int Dent J 2024:S0020-6539(24)00104-7. [PMID: 38688802 DOI: 10.1016/j.identj.2024.03.019] [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: 01/03/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION AND AIMS Periodontitis, a chronic inflammatory condition affecting the supporting structures of the teeth, is a substantial public health burrden whilst impacting the life quality of those affected. Elevated levels of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have been implicated in various inflammatory conditions. This study aimed to investigate the relationship between SII and SIRI with periodontitis. METHODS The study examined a total of 8666 participants in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES). The study compared the weighted prevalence of periodontitis among various groups. The association between SII, SIRI levels, and periodontitis was analyzed using binary logistic regression. Additionally, we explored nonlinear relationships between SII, SIRI, and the prevalence of periodontitis using restricted cubic spline (RCS) plots. RESULTS Among participants in the fourth quartile (Q4) of SII and SIRI, the highest prevalence of periodontitis was observed, with rates of 44.87% and 48.41%, respectively. After adjusting for all covariates, the odds ratio (OR) for periodontitis associated with SII Q4 was 1.19 (95% CI 1.02, 1.39, P = .03), while for SIRI Q4, it was 1.18 (95% CI 1.01, 1.39, P = .04). In addition, the results of sensitivity analysis revealed consistent findings, indicating that after adjusting for all covariates, the OR for periodontitis associated with SII Q4 and SIRI Q4 remained statistically significant. Specifically, the OR for periodontitis associated with SII Q4 was 1.19 (95% CI 1.02, 1.39, P = .03), while for SIRI Q4, it was 1.19 (95% CI 1.01, 1.40, P = .04). CONCLUSIONS These results indicate that elevated SII and SIRI levels are associated with an increased prevalence of periodontitis. CLINICAL RELEVANCE These findings suggest a potential connection between systemic inflammation and periodontitis, highlighting the importance of periodontitis patients being aware of their systemic diseases that are inflammatory in nature such as chronic cardiovascular afflictions.
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Affiliation(s)
- Zhengyun Ren
- Department of General Surgery, Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China; Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Yan Xue
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Hui Zhang
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Tailin Guo
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Wei Yi
- Department of General Surgery, Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China; Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Linke Li
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Mengyuan Wang
- Department of stomatology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Jiang Xie
- Department of pediatrics, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China.
| | - Yi Li
- Department of Radiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China.
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Cao R, Li C, Geng F, Pan Y. J-shaped association between systemic immune-inflammation index and periodontitis: Results from NHANES 2009-2014. J Periodontol 2024; 95:397-406. [PMID: 37713193 DOI: 10.1002/jper.23-0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND To examine the relationship between the systemic immune-inflammation index (SII) and periodontitis and to investigate possible effect modifiers. METHODS Data used in the present cross-sectional study are from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 (N = 10,301). The SII was calculated using the following formula: (neutrophils count × platelet count)/lymphocytes count. The category of periodontitis was defined by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP) classification. We employed natural cubic spline and multivariable logistic regression analyses to evaluate the associations of the SII with periodontitis. RESULTS The associations between SII and periodontal health followed a J-shape (p < 0.001). The risk of periodontitis tended to reduce with the increment of log2(SII) in participants with log2(SII) ≤ 8.66 (odds radio [OR] = 0.83; 95% CI: 0.69-0.999), especially among non-Hispanic Whites (OR = 0.70; 95% CI: 0.52-0.95), and increased with the increment of log2(SII) in participants with log2(SII) > 8.66 (OR = 1.19; 95% CI: 1.02-1.38). A similar trend was also observed between the SII and the number of sites with probing pocket depth (PPD) ≥4 mm and clinical attachment loss (CAL) ≥ 3 or 5 mm. Furthermore, we found a significantly stronger correlation between lymphocytes and either neutrophils or platelets in individuals with log2(SII) > 8.66, as opposed to those with log2(SII) ≤ 8.66. CONCLUSIONS There is a J-shaped association between SII and periodontitis in US adults, with an inflection point of log2(SII) at 8.66, which may provide potential adjunctive treatment strategies for periodontitis with different immune response states. Further prospective trials are still required to confirm our findings.
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Affiliation(s)
- Ruoyan Cao
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Chen Li
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yaping Pan
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
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Xu X, Lu H, Huo P, Jin D, Zhu Y, Meng H. Effects of amoxicillin and metronidazole as an adjunct to scaling and root planing on glycemic control in patients with periodontitis and type 2 diabetes: A short-term randomized controlled trial. J Periodontal Res 2024; 59:249-258. [PMID: 38115631 DOI: 10.1111/jre.13225] [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: 06/19/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To assess the effects of amoxicillin and metronidazole with scaling and root planing (SRP) on periodontal parameters and glycemic control in patients with severe periodontitis and diabetes mellitus. BACKGROUND Adjunctive antibiotics use is advantageous for treating periodontitis in patients with severe periodontitis and diabetes. However, the effects of adjunctive antibiotic use on hemoglobin A1c (HbA1c) levels remain unclear. METHODS This short-term, randomized controlled trial enrolled patients with severe periodontitis and type 2 diabetes. The patients were randomly allocated to SPR only (i.e., control) or SPR + antibiotics (500 mg of amoxicillin and 200 mg of metronidazole, three times daily for 7 days) groups. Periodontal and hematological parameters were assessed at baseline and 3 months after treatment. Inter- and intra-group analyses were performed using Student's t-tests, Mann-Whitney U tests, and the binary logistic regression models. p-values of <.05 were considered statistically significant. RESULTS This study enrolled 49 patients, with 23 and 26 patients in the SRP-only and SRP + antibiotics groups, respectively. The periodontal parameters improved significantly and similarly in both groups after treatment (p < .05). The SRP + antibiotics group had more sites of improvement than the SRP-only group when the initial probing depth was >6 mm. (698 [78.96%] vs. 545 [73.35%], p = .008). The HbA1c levels decreased in the SRP-only and SRP + antibiotics groups after treatment (0.39% and 0.53%, respectively). The multivariable binary logistic regression model demonstrated that antibiotics administration and a high baseline HbA1c level were associated with a greater reduction in the HbA1c level (odds ratio = 4.551, 95% confidence interval: 1.012-20.463; odds ratio = 7.162, 95% confidence interval: 1.359-37.753, respectively). CONCLUSIONS SRP and SRP plus systemic antibiotics were beneficial for glycemic control. Adjunctive antibiotic use slightly improved the outcome for patients with severe periodontitis and poorly controlled diabetes.
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Affiliation(s)
- Xinran Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - He Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Pengcheng Huo
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dongsiqi Jin
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunxuan Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Guo J, Xu R, Liu R, Lai W, Hu C, He H, Zhang G, Li G, Zheng W, Zhang R. Association between the systemic immune inflammation index and periodontitis: a cross-sectional study. J Transl Med 2024; 22:96. [PMID: 38263194 PMCID: PMC10804475 DOI: 10.1186/s12967-024-04888-3] [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: 06/30/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Periodontitis is a chronic oral inflammatory disease that seriously affects people's quality of life. The purpose of our study was to investigate the correlation between the systemic immune inflammation index (SII) and periodontitis by utilizing a large national survey. This will establish a reference for the early identification and management of periodontitis. METHODS This study comprised the adult US population who participated in a national periodontitis surveillance project during the six years from 2009 to 2014. Through the utilization of univariate and multivariate weighted logistic regression, we investigated the correlation between the systemic immune inflammation index and periodontitis. Additionally, we employed sensitivity analyses to evaluate the robustness of our findings. RESULTS The study involved 10,366 participants with an average age of 51.00 years, of whom 49.45% were male (N = 5126) and 50.55% were female (N = 5240). The prevalence of periodontitis is estimated to be about 38.43% in the US adults aged 30 or older population. Our logistic regression models indicated a positive association between a SII higher than 978 × 109/L and periodontitis. The elder group (aged 50 or older) with SII higher than 978 × 109/L demonstrated a significant correlation with periodontitis in the fully adjusted model (Odds Ratio [OR] = 1.409, 95% Confidence Interval [CI] 1.037, 1.915, P = 0.022). However, there is no statistical difference among adults aged 30 to 50. The robustness of our findings was confirmed through sensitivity analyses. CONCLUSIONS Our study highlights that SII is associated with periodontitis in a nationally representative sample of US adults. And the SII is significantly associated with a high risk of periodontitis in individuals aged 50 or older.
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Affiliation(s)
- Junfeng Guo
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
- Department of Stomatology, The 970th Hospital of the Joint Logistics Support Force, Yantai, China.
| | - Rufu Xu
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Rongxing Liu
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Wenjing Lai
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Changpeng Hu
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Haitao He
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Gang Zhang
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Guobing Li
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Weiwei Zheng
- Department of Stomatology, The 970th Hospital of the Joint Logistics Support Force, Yantai, China.
| | - Rong Zhang
- Department of Pharmacy, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
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Özdemir EÇ, Bozkurt E, Yazar FM, Bozan MB. Can delta neutrophil index values predict the success of periodontal treatment in patients with periodontitis? Clin Oral Investig 2024; 28:82. [PMID: 38195732 PMCID: PMC10776715 DOI: 10.1007/s00784-023-05478-1] [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: 06/30/2023] [Accepted: 12/23/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of delta neutrophil index (DNI) on non-surgical periodontal therapy (NSPT), whose role has been documented in the pathogenesis and follow-up of periodontal disease. METHODS AND MATERIALS The study included 35 patients with stage 3, grade A periodontitis (test group) and 35 patients without periodontal disease (control group). Initially, periodontal parameters were recorded and blood samples were taken from all patients. For patients with periodontitis, periodontal parameter measurements and blood sample analyses were repeated 3 months after NSPT. RESULTS After NSPT, DNI, CRP (C-reactive protein), neutrophil count, WBC (white blood cell), and neutrophil-lymphocyte ratio (NLR) values decreased in the test group, but did not reach a statistically significant level (p > 0.05). When the inflammatory variables were examined, significantly higher CRP, IG (immature granulocytes), DNI, neutrophil count, and WBC were observed in the test group compared to the control group (p < 0.05). In the test group, periodontal parameters were lower 3 months after NSPT than at baseline (p < 0.05). CONCLUSION Consistent with previous findings in the literature, the patients with periodontitis were determined to have higher levels of DNI, CRP, neutrophils, and WBC, compared to the individuals without periodontitis. Although a decrease was seen in DNI after NSPT, this was not at a significant level. CLINICAL RELEVANCE DNI is a guide in the evaluation of inflammation at the onset of periodontal disease, but studies with a larger number of cases are needed to use these parameters in the evaluation of treatment success. TRIAL REGISTRATION This study was retrospectively registered on December 27, 2022, with the number NCT05666622 at http://www. CLINICALTRIALS gov .
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Affiliation(s)
- Eda Çetin Özdemir
- Department of Periodontology, Faculty of Dentistry, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, 46000, Turkey
| | - Esra Bozkurt
- Department of Periodontology, Faculty of Dentistry, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, 46000, Turkey.
| | - Fatih Mehmet Yazar
- Department of General Surgery, Private Sular Akademi Hospital, Kahramanmaraş, Turkey
| | - Mehmet Buğra Bozan
- Department of General Surgery, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Mishra S, Johnson L, Gazala MP, Dahiya S, Rahman W, Sreeraj VS. Systemic immune-inflammation index in patients with generalized stage III grade C periodontitis. Oral Dis 2023; 29:3599-3609. [PMID: 35913425 DOI: 10.1111/odi.14328] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/15/2022] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Systemic immune-inflammation index (SII) is a novel, inflammatory biomarker whose role in predicting several chronic systemic diseases has been recently identified. However, its association with generalized stage III grade C periodontitis in young adults remains unknown. MATERIAL AND METHODS The study is a multicentered, double-blind, hospital-based case-control clinical study. Periodontal examination comprised of recording plaque index, sites with bleeding on probing, pocket depth and clinical attachment loss for patients with generalized stage III grade C periodontitis and periodontally healthy group. Complete blood counts were obtained and used for calculating SII, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio. Collected data were then subjected to statistical analyses. RESULTS SII was significantly higher in patients with generalized stage III grade C periodontitis compared to periodontally healthy individuals (723.87 vs. 537.74 × 109 /L, p < 0.0001). SII is associated with severe periodontitis in young adults (odds ratio [OR]:11.86, 95% CI 9.61-20.76, p < 0.0001) after adjusting for factors found significant in univariate analysis. Receiver operative curve analysis demonstrated a fair predictive validity of SII in detecting generalized stage III grade C periodontitis in young adults (AUC: 0.766, 95%CI 0.731-0.799, p < 0.0001, sensitivity 81.27%, specificity 76.50% and diagnostic accuracy 78.89%). SII did not exhibit superior predictive validity when compared with NLR in the context of generalized stage III grade C periodontitis (AUC for SII: 0.766, 95%CI 0.731-0.799, AUC for NLR: 0.788, 95% CI 0.754-0.819; p = 0.28). CONCLUSION SII is associated with generalized stage III grade C periodontitis in young adults.
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Affiliation(s)
- Supriya Mishra
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Lynn Johnson
- Department of Periodontics, Rama Dental College, Kanpur, India
- Maitri College of Dentistry and Research Centre, Durg, India
| | - M P Gazala
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Sheetal Dahiya
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Waheda Rahman
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - V S Sreeraj
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
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Almășan O, Leucuța DC, Hedeșiu M. Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis. J Pers Med 2022; 12:jpm12060992. [PMID: 35743775 PMCID: PMC9225277 DOI: 10.3390/jpm12060992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Our study aimed to assess the association between the neutrophil to lymphocyte ratio (NLR), platelet to leukocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), red cell distribution width (RDW), and systemic immune inflammation index (SII) and periodontitis. (2) Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS databases, identifying observational studies. The Newcastle Ottawa scale was used to evaluate the quality of the included studies. The principal summary outcome measure in our random effects meta-analysis was the mean difference (MD). (3) Results: After screening 682 search results, a total of 10 studies including 3164 subjects were selected for quantitative assessment. We found a higher mean NLR, PLR, and LMR in the periodontitis group compared to the control group (0.41 (95% CI 0.12–0.7), p = 0.006; 7.43 (95% CI 0.31–14.54), p = 0.04; 2.05 (95% CI 0.27–3.83), p = 0.024). No differences were observed for RDW. (4) Conclusions: We found an association between NLR, LMR, and PLR and periodontitis, which might be thought of as emerging blood cell count inflammatory biomarkers that could shed light on the link between periodontitis and systemic disbalances, as well as for periodontitis prognosis and grading.
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Affiliation(s)
- Oana Almășan
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Daniel-Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Correspondence:
| | - Mihaela Hedeșiu
- Department of Oral and Maxillofacial Surgery and Radiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
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Mishra S, M. P. G, Rahman W. Clinical and diagnostic significance of blood leukocyte ratios in young patients with stage III grade C periodontitis. Acta Odontol Scand 2022; 80:161-168. [PMID: 34436974 DOI: 10.1080/00016357.2021.1969035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Blood leukocyte ratios have been recently proposed as simple, rapid, cheap and easily accessible biomarkers of systemic inflammation. However, little is known about the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with periodontitis, which might not only serve as the potential biomarkers of systemic inflammation but also aid in diagnosis/screening of severe periodontitis. Hence, the purpose of this study was to evaluate the differences in the serum levels of these leukocyte ratios in healthy subjects and patients with generalized stage III Grade C periodontitis, and their applicability in identifying patients with the risk of developing severe periodontitis. MATERIAL AND METHODS The subjects were categorized into case and control group. Clinical parameters including Plaque index (PI), modified Gingival Index (mGI), Mean ratio of bleeding sites, Probing Pocket depth (PPD) and the clinical attachment loss (CAL) were assessed in both the groups. Venous blood samples were collected from subjects from both groups for the biochemical analysis and blood leukocyte ratios- NLR, PLR and LMR were calculated. The values were then subjected to statistical analysis. RESULTS The results showed significantly higher NLR and lower LMR values in patients with generalized stage III grade C periodontitis. Both the blood leukocyte ratios were moderately associated with increasing clinical parameters of periodontal disease. However, the values of PLR, although found to be higher in the periodontitis group, did not make a significant difference when compared with periodontally healthy subjects. The cut-off value of >2.15 for NLR and <7.16 for LMR fairly predicted the risk of severe periodontitis in young adults. CONCLUSIONS NLR and LMR can provide a new insight into the relationship between periodontitis and systemic diseases and can be of potential diagnostic value in identifying patients with severe periodontitis of younger age group.
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Affiliation(s)
- Supriya Mishra
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Gazala M. P.
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Waheda Rahman
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
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Çetin Özdemir E, Bilen E, Yazar FM. Can the delta neutrophil ındex be used as a preliminary biomarker ın the evaluation of periodontal disease: a pilot study. J Appl Oral Sci 2022; 30:e20210555. [PMID: 35319605 PMCID: PMC8963392 DOI: 10.1590/1678-7757-2021-0555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Tissue destruction in periodontal diseases is related to inflammatory mediators in the host. However, it is unknown whether a relationship between delta neutrophil index (DNI) and neutrophil-lymphocyte ratio (NLR) in Stage 3 Grade A patients occurs. This cross-sectional study aimed to investigate the relationship between periodontal disease and DNI and NLR. METHODOLOGY The study included 74 systemically healthy, non-smoking adults separated into 3 groups. Group 1: 26 subjects with good periodontal health, Group 2: 26 subjects with gingivitis, and Group 3: 22 subjects with Stage 3 Grade A periodontitis. After determining which group the patient will be included in, a clinical periodontal examination was made of each patient and pocket depth (PD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and plaque index (PI) parameters were measured. Venous blood samples were taken and examined with an automatic hematology analyzer for DNI, immature granulocytes (IG), NLR, C-reactive protein (CRP), procalcitonin, neutrophil count and lymphocyte count. RESULTS DNI, IG, CRP, and neutrophil count were observed to be highest in Group 3, followed by Group 2, and the difference between the groups in these parameters was determined to be statistically significant (p<0.001, p<0.001, p=0.046, p=0.016). DNI, IG, CRP and neutrophil count were observed to be positively correlated with periodontal parameters. CONCLUSION The findings of this study support the role of DNI as a new biomarker for periodontal diseases. DNI may better reflect the systemic level of stage 3 grade A periodontitis than traditional inflammatory markers.
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Affiliation(s)
- Eda Çetin Özdemir
- Kahramanmaraş Sütçü İmam University, Faculty of Dentistry, Department of Periodontology, Kahramanmaraş, Turkey
| | - Emrah Bilen
- Afyonkarahisar Health Sciences University, Faculty of Dentistry, Department of Periodontology, Afyonkarahisar, Turkey
| | - Fatih M Yazar
- Private Sular Akademi Hospital, Department of General Surgery, Kahramanmaraş, Turkey
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McBurney MI, Tintle NL, Harris WS. The omega-3 index is inversely associated with the neutrophil-lymphocyte ratio in adults'. Prostaglandins Leukot Essent Fatty Acids 2022; 177:102397. [PMID: 35033882 DOI: 10.1016/j.plefa.2022.102397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
The neutrophil-lymphocyte ratio (NLR) is a biomarker of systemic inflammation and measures innate-adaptive immune system balance. The omega-3-index (O3I) measures the amount of EPA+DHA in blood. Both a low O3I and an elevated NLR are associated with increased risk for chronic disease and mortality, including cardiovascular diseases and cancer. Hypothesizing that low O3I may partly contribute to systemic chronic inflammation, we asked if a relationship existed between O3I and NLR in healthy adults (≥18 y, n = 28,871, 51% female) without inflammation [C-reactive protein (CRP) <3 mg/mL)] who underwent a routine clinical assessment. NLR was inversely associated with O3I before (p < 0.0001) and after adjusting for age, sex, BMI, and CRP (p < 0.0001). Pearson correlations of other variables with NLR were r = 0.06 (CRP), r = 0.14 (age), and r = 0.01(BMI). In this healthy population, an O3I < 6.6% was associated with increasing NLR whereas NLR remained relatively constant (low) when O3I > 6.6%, suggestive of a quiescent, balanced immune system.
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Affiliation(s)
- Michael I McBurney
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; Division of Biochemical and Molecular Biology, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, United States of America.
| | - Nathan L Tintle
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Department of Population Health Nursing Science, College of Nursing, University of Illinois - Chicago, Chicago, IL 60612, United States of America
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD 57106, United States of America; Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, United States of America
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12
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Yilmaz B, Somay E, Selek U, Topkan E. Pretreatment Systemic Immune-Inflammation Index Predict Needs for Teeth Extractions for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy. Ther Clin Risk Manag 2021; 17:1113-1121. [PMID: 34703240 PMCID: PMC8536877 DOI: 10.2147/tcrm.s334556] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/10/2021] [Indexed: 12/13/2022] Open
Abstract
Background To evaluate the utility of pretreatment systemic immune-inflammation index (SII) in predicting the teeth caries and need for tooth extraction after concurrent chemoradiotherapy (C-CRT) for locally advanced squamous-cell head and neck cancer (LA-SCHNC) patients. Methods The records of LA-SCHNC patients who underwent formal dental evaluations at pre- and post-C-CRT periods were retrospectively analyzed. The pretreatment SII values were calculated using the platelet, neutrophil, and lymphocyte measures acquired on the first day of C-CRT: SII=Platelets×neutrophils/lymphocytes. Receiver operating characteristic (ROC) curve analysis was employed to identify the ideal pre-C-CRT SII cutoff that may predict the teeth caries and the need for tooth extraction after the C-CRT. The primary endpoint was the link between the pre-C-CRT SII and the need for tooth extraction during the follow-up period. Results A sum of 126 patients were included. Median follow-up was 4.9 years (range: 2.7–7.8). Nasopharyngeal and laryngeal cancers comprised the majority (75.4%) study cohort. Post-treatment teeth extractions were reported in 62.7% patients. The optimal cutoff was 558 [Area under the curve (AUC): %76.8 sensitivity: 72.3%; and specificity: 70.9%] that grouped the patients into two subgroups with significantly different post-C-CRT tooth extraction rates: Group 1: SII≤558 (n = 70) and SII>558 (n = 56), respectively. Correlation analysis revealed a significant relationship between the pretreatment SII and the tooth extraction rates after the C-CRT (rs:0.89: P = 0.001). The comparative analysis displayed that the teeth extractions rates were significantly higher in the SII>558 group (77.1% versus 51.4% for SII≤558; Hazard ratio: 1.68; P = 0.001). Further analyses showed that the pre-C-CRT SII>558 was the unique factor associated with meaningfully higher necessities for post-C-CRT teeth extractions. Conclusion The present outcomes intimated that high pretreatment SII levels were linked to significantly increased post-treatment teeth extractions in LA-SCHNC patients undergoing definitive C-CRT.
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Affiliation(s)
- Busra Yilmaz
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Efsun Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.,Department of Radiation Oncology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Erkan Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
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Gupta S, Mohindra R, Singla M, Khera S, Sahni V, Kanta P, Soni RK, Kumar A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Bhalla A, Sorsa T, Räisänen I. The clinical association between Periodontitis and COVID-19. Clin Oral Investig 2021; 26:1361-1374. [PMID: 34448073 PMCID: PMC8390180 DOI: 10.1007/s00784-021-04111-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes. MATERIAL AND METHODS Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed. RESULTS Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests. CONCLUSIONS Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner. CLINICAL RELEVANCE The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.
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Affiliation(s)
- Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Ritin Mohindra
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mohita Singla
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Sagar Khera
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | | | - Poonam Kanta
- Department of Virology, PGIMER, Chandigarh, India
| | | | - Amit Kumar
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, PGIMER, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Varun Mahajan
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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