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Ikhar AS, Kolte RA, Kolte AP, Rathi PR, Ghoderao DG, Dahake RN. Comparative evaluation of semaphorin-4D, peptidylarginine deiminase-2, and matrix metalloproteinase-8 levels of gingival crevicular fluid in periodontally healthy and Stage III periodontitis smoker and non-smoker patients before and after non-surgical periodontal therapy. J Periodontol 2024; 95:563-570. [PMID: 37846733 DOI: 10.1002/jper.23-0324] [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: 05/19/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND This study was designed to assess the influence of non-surgical periodontal therapy (NSPT) on gingival crevicular fluid (GCF) levels of semaphorin-4D (SEMA-4D), peptidylarginine deiminase-2 (PAD-2), and matrix metalloproteinase-8 (MMP-8) levels in periodontally healthy, Stage III periodontitis non-smoker and smoker patients. METHODS Sixty patients were equally divided into three groups, Group I: Periodontally healthy, Group II: Non-smokers with Stage III periodontitis, and Group III: Smokers with Stage III periodontitis. The patients underwent NSPT with clinical and biochemical parameters examined at baseline and 3 months post therapy. GCF was collected for levels of SEMA-4D, PAD-2, and MMP-8 through enzyme-linked immunosorbent assay (ELISA). RESULTS Greater values of PPD (8.06 ± 0.19 mm), CAL (8.94 ± 0.19 mm), PI (2.58 ± 0.19) while lower PBI (1.39 ± 0.19%) and GI (1.72 ± 0.19) scores were seen in Group III as compared to Group II, which reduced significantly from baseline to 3 months in both the groups after NSPT. Minimum values of SEMA-4D, PAD-2, and MMP-8 levels in GCF were seen for Group I, which increased incrementally to Group II and III. Also, among Group II and III the SEMA-4D, PAD-2, and MMP-8 levels in GCF reduced from baseline to 3 months indicating a favorable response within the tissues. CONCLUSION Greater levels in GCF of Levels of SEMA-4D, PAD-2, and MMP-8 in Group II and III, which reduced significantly post NSPT, implied that these biomarkers play a pivotal role in the inflammatory process and can be utilized for early diagnosis.
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Affiliation(s)
- Aishwarya S Ikhar
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rajashri A Kolte
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Abhay P Kolte
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Prachi R Rathi
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Dhanashree G Ghoderao
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rahul N Dahake
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
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Huang YQ, Xu JN, Huang Y, Xu YD, Wang HL, Shi WT, Wang J, Wang H. Independent and combined effects of smoking, drinking and depression on periodontal disease. BMC Oral Health 2024; 24:535. [PMID: 38711116 DOI: 10.1186/s12903-024-04287-6] [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: 11/10/2023] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Periodontitis is a complex chronic inflammatory disease that is particularly associated with health-related conditions such as smoking, excessive drinking and depression. This research aimed to investigate the interaction between these lifestyles factors on periodontitis risk. METHODS This study included participants who participated in the National Health and Nutrition Examination Survey in the United States between 2009 and 2014. They had completed oral health-periodontal examination, Smoking-Cigarette Use Questionnaire, Alcohol Use Questionnaire, and Patient Health Questionnaire. Periodontal clinical attachment loss (CAL) of 3 mm or more and Patient Health Questionnaire-9 (PHQ-9) of 10 scores or more were used to identify periodontitis and depression, respectively. Daily alcohol consumption in the past year was classified into three levels: low (1 drink or less), moderate (between 1 and 3 drinks), and heavy drinking (4 drinks or more), while smoking was defined as having smoked at least 100 cigarettes in one's lifetime. Then, the logistic regression combined with interaction models were used to analyze the independent and combined effects of smoking, drinking and depression on periodontitis risk. RESULTS The results indicated a statistically significant multiplicative interaction between smoking and depression in relation to the development of periodontitis, both in the overall population (P = 0.03) and among male participants (P = 0.03). Furthermore, among individuals experiencing depression, smoking was found to significantly increase the prevalence of periodontitis by 129% in the younger age group compared to non-smokers (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.10 to 4.76). However, the interaction between smoking and alcohol consumption was only significant among females (P < 0.05). There was a dose-dependent relationship between drinking frequency and smoking on periodontitis prevalence. In the smoking population, occasional drinking (OR: 1.70; 95% CI: 1.22 to 2.37) and regular drinking (OR: 2.28; 95% CI: 1.68 to 3.11) significantly increased the prevalence of periodontitis compared to individuals without these two factors. CONCLUSION These results suggested that there were interactive effects between smoking, drinking and depression on periodontitis risk and policies aimed at healthy behaviours and mental health may be beneficial for our oral health.
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Affiliation(s)
- Y Q Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China
| | - J N Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Y Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China
| | - Y D Xu
- Nanjing Medical University, Nanjing, China
| | - H L Wang
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China
| | - W T Shi
- Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology College of Stomatology, Shanghai Jiao Tong University, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - H Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 Chongqing Road, Huangpu District, Shanghai, China.
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Shreya S, Annamalai M, Jirge VL, Sethi S. Utility of salivary biomarkers for diagnosis and monitoring the prognosis of nicotine addiction - A systematic review. J Oral Biol Craniofac Res 2023; 13:740-750. [PMID: 38028231 PMCID: PMC10630637 DOI: 10.1016/j.jobcr.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Tobacco and smoke associated with tobacco comprises of a mixture of more than 9500 chemical compounds, most of which have been identified as harmful. Two of the most potent carcinogens found in cigarette smoke are N'-nitrosonornicotine (NNN) and polycyclic aromatic hydrocarbons (PAHs). The most commonly used method to detect and monitor nicotine addiction is via serum cotinine levels. Though considered the gold standard, there is a decline in preventive screening and diagnostic testing due to the fear of pain from invasive testing. Data sources and study selection A structured literature search was performed using the search engines PubMed and Google scholar following the PRISMA guidelines for systematic reviews. The titles and abstracts were retrieved and analysed, followed by full-text relevant data extraction in addition to a risk-of-bias analysis. Data extraction and synthesis A total of 37 studies were included in the systematic review. Salivary cotinine levels were compared between smokers and non-smokers, cigarette smokers and water pipe smokers, water pipe smokers and non-smokers. Lactate dehydrogenase salivary levels were compared between smokers and non-smokers, and salivary thiocyanate were compared between smokers and non-smokers. Conclusions Identifying biomarkers with high performance in terms of sensitivity and specificity will contribute to accelerating future research in this domain.
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Affiliation(s)
- S. Shreya
- A B Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Manoj Annamalai
- KAHER’S KLE V.K. Institute of Dental Sciences, Belagavi, Karnataka, 590010, India
| | - Vasanti Lagali Jirge
- KAHER’S KLE V.K. Institute of Dental Sciences, Belagavi, Karnataka, 590010, India
| | - Sneha Sethi
- Adelaide Dental School, University of Adelaide, Adelaide, 5000, Australia
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Corridore D, Saccucci M, Zumbo G, Fontana E, Lamazza L, Stamegna C, Di Carlo G, Vozza I, Guerra F. Impact of Stress on Periodontal Health: Literature Revision. Healthcare (Basel) 2023; 11:healthcare11101516. [PMID: 37239803 DOI: 10.3390/healthcare11101516] [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: 03/08/2023] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Stress is a physiological response of the body to stressful life events but may not be when the individual is persistently exposed to the stress trigger, and it negatively affects certain physiological functions, thus triggering psychosomatic diseases. In literature, chronic stress and inadequate coping strategies are found to mediate the risk and development of periodontitis; mechanisms have therefore been proposed to explain the effects of stress on the periodontium. Since stress is a prevalent problem in modern life and given the importance of maintaining oral health, the present literature review aimed to estimate the association between stress and periodontal disease. The research question adopted is the following: "Are psychological stress and periodontal disease related?" The search was conducted in August 2022 and limited to articles in electronic databases from 2017 to 2022 in English, excluding reviews and literature reviews. From the electronic databases, a total of 532 articles were identified and became 306 after reviews and duplicates were removed. An additional bibliographic search was conducted through the same electronic databases, controlled terms and keywords including only systematic reviews, which were previously excluded. Through the bibliography cited in the systematic reviews, an additional 18 articles were identified, with a new total of 324. As a result of reading the title and abstract of these 324 articles, an additional 295 were excluded. Reading the full text of the remaining 29 studies, 2 articles were excluded due to non-adherence to the eligibility criteria. The remaining 27 results were included in our literature review. It has been suggested in the literature that adverse socioeconomic conditions elicit a stress response, which can trigger periodontal inflammation. Most of the 27 articles included in the study confirm and demonstrate a positive association between psychological stress and periodontal disease. Numerous studies have shown the mechanisms through which chronic stress negatively affects periodontal tissues. Therefore, in the light of the results obtained from this review, it is important that oral health professionals, also for general health purposes, consider stress factors among the risk factors of periodontal disease, its severity and decreased efficacy of treatments. It is therefore advisable to act preventively through the interception of chronic stress.
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Affiliation(s)
- Denise Corridore
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Saccucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giulia Zumbo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Erika Fontana
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Lamazza
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Stamegna
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Gabriele Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Iole Vozza
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Guerra
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
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Baumeister SE, Reckelkamm SL, Grabe HJ, Nauck M, Klinger-König J, Völzke H, Kocher T, Friedrich N, Holtfreter B. Cortisol and periodontitis: Prospective observational and Mendelian randomization studies. Front Endocrinol (Lausanne) 2023; 14:1100985. [PMID: 37008927 PMCID: PMC10050732 DOI: 10.3389/fendo.2023.1100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/01/2023] [Indexed: 03/17/2023] Open
Abstract
Purpose Cortisol has obesogenic, hyperglycemic and immunomodulating effects. Preclinical and observational research suggested that it is associated with periodontitis but the evidence for potential causality in humans is sparse. We triangulated results from prospective observational and Mendelian randomization (MR) analyses to further explore this. Methods Using pooled data from 3,388 participants of two population cohort studies embedded in the Study of Health in Pomerania (SHIP) project, we associated serum cortisol levels with periodontal outcomes measured after a median follow-up time of 6.9 years, adjusting for confounding and selection bias using propensity score weighting and multiple imputation. We further examined the effect of genetically proxied plasma morning cortisol levels on periodontitis using two-sample MR of 17,353 cases and 28,210 controls. Results In SHIP, we found that cortisol levels were positively associated with follow-up levels of mean clinical attachment level (CAL), deep interdental CAL and bleeding on probing but were unrelated to mean probing pocket depth and deep periodontal pockets. In MR analysis, cortisol was not associated with periodontitis. Conclusion The observational study revealed a prospective association of spot cortisol with makers of periodontitis. Contrary to observational studies, genetically instrumented, long-term cortisol was unrelated to periodontitis. Our results find no univocal evidence that cortisol plays a role in periodontitis pathology, casting doubt on cortisol-related pathways.
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Affiliation(s)
| | - Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Biomarkers common for inflammatory periodontal disease and depression: A systematic review. Brain Behav Immun Health 2022; 21:100450. [PMID: 35330865 PMCID: PMC8938251 DOI: 10.1016/j.bbih.2022.100450] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Dysregulated immune response arising in the periphery can induce depressive symptoms through neuroimmune interactions. Inflammatory oral pathology can be a potent inducer of chronic neuroimmune response relevant to depression. We aimed to synthesize available evidence for the association between inflammatory periodontal diseases (IPD) and major depression (MD) in relation to a broad range of biomarkers. Methods Medline, Embase, PsycInfo, Cochrane Library, Web of Science and Scopus databases were searched from inception until January 27, 2022. Search terms included subject headings and synonyms for inflammatory periodontal disease and depression. Studies that reported data on both depression and inflammatory periodontal disease as categories along with measurement of a biomarker were considered. Two reviewers independently selected the articles for inclusion, extracted data and assessed the quality of each study. The protocol for this study was registered with PROSPERO, CRD42021215524. Results Twenty-eight studies were included in the final review-eleven cross-sectional studies, seven case-control studies, and six prospective cohort studies conducted in humans; the remaining four were experimental animal studies. Eighteen studies including all animal studies reported a positive association between depression and periodontal disease; one study reported a negative association and another nine studies found no such associations. Twenty studies reported mixed associations between IPD and biomarkers (i.e, salivary, serum, urine or gingival crevicular fluid cortisol, C reactive protein, cytokines, etc.). Biomarkers related to depression were gingival crevicular fluid cortisol, interleukin 6 (IL-6), Il-1β, immunoglobulin G against Bacterioides forsythus; root canal lipopolysaccharides; blood IL-6, IL-1β, cortisol, advanced oxidation protein products, nitric oxide metabolites, lipid hydroperoxides and trapping antioxidant parameter; whereas five studies found no associations between depression and a biomarker. Although animal studies showed interaction of immune, inflammatory and neurotrophic biomarkers in the relationship between depression and periodontal disease, human studies showed mixed findings. In most studies, there were risks of bias due to the sample selection and assessment protocol. Study heterogeneity and limited number of comparable studies reporting on shared biomarkers precluded a meta-analysis. Conclusion Immune-inflammatory contribution to depression was evident in the context of inflammatory periodontal diseases, but whether biomarkers mediate the associations between IPD and MD needs to be tested through methodologically rigorous studies aiming specifically at this hypothesis.
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