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Effect of Subgingival Instrumentation on Neutrophil Elastase and C-Reactive Protein in Grade B and C Periodontitis: Exploratory Analysis of a Prospective Cohort Study. J Clin Med 2022; 11:jcm11113189. [PMID: 35683571 PMCID: PMC9181606 DOI: 10.3390/jcm11113189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Assessment of the effect of subgingival instrumentation (SI) on systemic inflammation in periodontitis grades B (BP) and C (CP). Methods: In this prospective cohort study, eight BP and 46 CP patients received SI. Data were collected prior to and 12 weeks after SI. Blood was sampled prior to, one day, 6, and 12 weeks after SI. Neutrophil elastase (NE), C-reactive protein (CRP), leukocyte count, lipopolysaccharide binding protein, interleukin 6 (IL-6) and IL-8 were assessed. Results: Both groups showed significant clinical improvement. NE was lower in BP than CP at baseline and 1 day after SI, while CRP was lower in BP than CP at baseline (p < 0.05). NE and CRP had a peak 1 day after SI (p < 0.05). Between-subjects effects due to CP (p = 0.042) and PISA (p = 0.005) occurred. Within-subjects NE change was confirmed and modulated by grade (p = 0.017), smoking (p = 0.029), number of teeth (p = 0.033), and PISA (p = 0.002). For CRP between-subjects effects due to BMI (p = 0.008) were seen. Within-subjects PISA modulated the change of CRP over time (p = 0.017). Conclusions: In untreated CP, NE and CRP were higher than in BP. SI results in better PPD and PISA reduction in BP than CP. Trial registration: Deutsches Register Klinischer Studien DRKS00026952 28 October 2021 registered retrospectively.
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Seidel CL, Gerlach RG, Weider M, Wölfel T, Schwarz V, Ströbel A, Schmetzer H, Bogdan C, Gölz L. Influence of probiotics on the periodontium, the oral microbiota and the immune response during orthodontic treatment in adolescent and adult patients (ProMB Trial): study protocol for a prospective, double-blind, controlled, randomized clinical trial. BMC Oral Health 2022; 22:148. [PMID: 35477563 PMCID: PMC9044659 DOI: 10.1186/s12903-022-02180-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Orthodontic treatment with fixed appliances is often necessary to correct malocclusions in adolescence or adulthood. However, oral hygiene is complicated by appliances, and prior studies indicate that they may trigger oral inflammation and dysbiosis of the oral microbiota, especially during the first 3 months after insertion, and, thus, may present a risk for inflammatory oral diseases. In recent periodontal therapeutic studies, probiotics have been applied to improve clinical parameters and reduce local inflammation. However, limited knowledge exists concerning the effects of probiotics in orthodontics. Therefore, the aim of our study is to evaluate the impact of probiotics during orthodontic treatment. METHODS This study is a monocentric, randomized, double blind, controlled clinical study to investigate the effectiveness of daily adjuvant use of Limosilactobacillus reuteri (Prodentis®-lozenges, DSM 17938, ATCC PTA 5289) versus control lozenges during the first three months of orthodontic treatment with fixed appliances. Following power analysis, a total of 34 adolescent patients (age 12-17) and 34 adult patients (18 years and older) undergoing orthodontic treatment at the University Hospital Erlangen will be assigned into 2 parallel groups using a randomization plan for each age group. The primary outcome measure is the change of the gingival index after 4 weeks. Secondary outcomes include the probing pocket depth, the modified plaque index, the composition of the oral microbiota, the local cytokine expression and-only for adults-serum cytokine levels and the frequencies of cells of the innate and adaptive immune system in peripheral blood. DISCUSSION Preventive strategies in everyday orthodontic practice include oral hygiene instructions and regular dental cleaning. Innovative methods, like adjuvant use of oral probiotics, are missing. The aim of this study is to analyse, whether probiotics can improve clinical parameters, reduce inflammation and prevent dysbiosis of the oral microbiota during orthodontic treatment. If successful, this study will provide the basis for a new strategy of prophylaxis of oral dysbiosis-related diseases during treatment with fixed appliances. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov in two parts under the number NCT04598633 (Adolescents, registration date 10/22/2020), and NCT04606186 (Adults, registration date 10/28/2020).
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Affiliation(s)
- Corinna L Seidel
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054, Erlangen, Germany.
| | - Roman G Gerlach
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, 91054, Erlangen, Germany
| | - Matthias Weider
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054, Erlangen, Germany
| | - Theresa Wölfel
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054, Erlangen, Germany
| | - Vincent Schwarz
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054, Erlangen, Germany
| | - Armin Ströbel
- Center for Clinical Studies (CCS), Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Germany
| | - Helga Schmetzer
- Med III, University Hospital of Munich, Workgroup: Immune Modulation, Marchioninistraße 15, 81377, Munich, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, 91054, Erlangen, Germany
- Medical Immunology Campus Erlangen, Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054, Erlangen, Germany
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Pussinen PJ, Kopra E, Pietiäinen M, Lehto M, Zaric S, Paju S, Salminen A. Periodontitis and cardiometabolic disorders: The role of lipopolysaccharide and endotoxemia. Periodontol 2000 2022; 89:19-40. [PMID: 35244966 PMCID: PMC9314839 DOI: 10.1111/prd.12433] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lipopolysaccharide is a virulence factor of gram-negative bacteria with a crucial importance to the bacterial surface integrity. From the host's perspective, lipopolysaccharide plays a role in both local and systemic inflammation, activates both innate and adaptive immunity, and can trigger inflammation either directly (as a microbe-associated molecular pattern) or indirectly (by inducing the generation of nonmicrobial, danger-associated molecular patterns). Translocation of lipopolysaccharide into the circulation causes endotoxemia, which is typically measured as the biological activity of lipopolysaccharide to induce coagulation of an aqueous extract of blood cells of the assay. Apparently healthy subjects have a low circulating lipopolysaccharide activity, since it is neutralized and cleared rapidly. However, chronic endotoxemia is involved in the pathogenesis of many inflammation-driven conditions, especially cardiometabolic disorders. These include atherosclerotic cardiovascular diseases, obesity, liver diseases, diabetes, and metabolic syndrome, where endotoxemia has been recognized as a risk factor. The main source of endotoxemia is thought to be the gut microbiota. However, the oral dysbiosis in periodontitis, which is typically enriched with gram-negative bacterial species, may also contribute to endotoxemia. As endotoxemia is associated with an increased risk of cardiometabolic disorders, lipopolysaccharide could be considered as a molecular link between periodontal microbiota and cardiometabolic diseases.
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Affiliation(s)
- Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical and Molecular Metabolism, Faculty of Medicine Research Programs, University of Helsinki, Helsinki, Finland
| | - Svetislav Zaric
- Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Susanna Paju
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Salminen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Machado V, Botelho J, Escalda C, Hussain SB, Luthra S, Mascarenhas P, Orlandi M, Mendes JJ, D’Aiuto F. Serum C-Reactive Protein and Periodontitis: A Systematic Review and Meta-Analysis. Front Immunol 2021; 12:706432. [PMID: 34394107 PMCID: PMC8355591 DOI: 10.3389/fimmu.2021.706432] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis has been associated with low-grade inflammation as assessed by C-reactive protein (CRP) levels and its treatment can decrease CRP serum levels. The aim of this systematic review was to critically appraise the evidence comparing CRP serum levels (standard and high-sensitivity [hs]) of otherwise healthy patients suffering from periodontitis when compared to controls. The impact of intensive and non-intensive nonsurgical periodontal treatment (NSPT) on hs-CRP was also investigated. Four electronic databases (Pubmed, The Cochrane Central Register of Controlled Trials [CENTRAL], EMBASE and Web of Science) were searched up to February 2021 and the review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No. CRD42020167454). Observational and intervention studies that: 1) evaluated CRP and hs-CRP serum levels in patients with and without periodontitis, and; 2) hs- CRP levels after NSPT were included. Following risk of bias appraisal, both qualitative and quantitative analyses were performed. Pooled estimates were rendered through ratio of means (RoM) random-effects meta-analyses. After screening 485 studies, 77 case-control studies and 67 intervention trials were included. Chronic and aggressive periodontitis diagnoses were consistently associated with higher levels of CRP and hs-CRP (p<0.001). Patients with aggressive periodontitis exhibited on average more than 50% higher levels of CRP (RoM [95% confidence interval [CI]]: 1.56 [1.15; 2.12], p=0.0039) than patients with chronic periodontitis. Intensive NSPT induced an immediate increase of hs-CRP followed by a progressive decrease whilst non-intensive NSPT consistently decreased hs-CRP after treatment up to 180 days (p<0.001). These findings provide robust evidence that periodontitis is associated with systemic inflammation as measured by serum CRP levels. Periodontitis treatment induces a short-term acute inflammatory increase when performed in an intensive session, whilst a progressive reduction up to 6 months was demonstrated when performed in multiple visits.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
- Evidence Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - João Botelho
- Periodontology Department, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
- Evidence Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Cláudia Escalda
- Evidence Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Syed Basit Hussain
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, London, United Kingdom
| | - Shailly Luthra
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, London, United Kingdom
| | - Paulo Mascarenhas
- Evidence Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Marco Orlandi
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, London, United Kingdom
| | - José João Mendes
- Evidence Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Francesco D’Aiuto
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, London, United Kingdom
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Plemmenos G, Evangeliou E, Polizogopoulos N, Chalazias A, Deligianni M, Piperi C. Central Regulatory Role of Cytokines in Periodontitis and Targeting Options. Curr Med Chem 2021; 28:3032-3058. [PMID: 32838709 DOI: 10.2174/0929867327666200824112732] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Periodontitis is an immune-inflammatory disease that leads to the progressive destruction of bone and connective tissue in the periodontal area. The cytokine network plays a primary role in tissue homeostasis, the recruitment of immune cells to control the pathogenic impact and the regulation of osteoclastic function, thus modulating the intensity and duration of the immune response. This review provides an update on the main cytokines implicated in the pathogenesis and progression of periodontitis and their targeting potential in order to enrich current treatment options. METHODS A structured search of bibliographic databases (PubMed, MEDLINE, Scopus) was performed for peer-reviewed cytokine studies focused on periodontitis the last ten years. A qualitative content analysis was performed in screened papers and a critical discussion of main findings is provided. RESULTS An altered cytokine profile has been detected in periodontitis patients and the interplay of pro-inflammatory and/or anti-inflammatory cytokines has been associated with disease pathogenesis. Among the most prominent pro-inflammatory cytokines, TNF-α, IL-1β, IL-17, IL-6 and the chemokines CXCL-6, CXCL-8 are overexpressed in periodontitis patients and correlate with disease progression. On the other hand, the anti-inflammatory IL-4 and IL- 11 levels are reduced while IL-12 and IFN-γ expression play a dual role in periodontal disease. Current periodontitis treatment strategies include selective antibiotics, antimicrobial photodynamic therapy and probiotics, which can modulate the cytokine network and when applied in combination with specific anti-cytokine agents can exert additional beneficial effects. CONCLUSION It is evident that cytokines play a central regulatory role in the inflammatory process and immune cell response that underlies bone destruction in periodontitis. Specific cytokine targeting should be considered as a complementary therapeutic scheme to current periodontal management.
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Affiliation(s)
- Grigorios Plemmenos
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Evangelos Evangeliou
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Nikolaos Polizogopoulos
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Andreas Chalazias
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Marianthi Deligianni
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Christina Piperi
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
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Stanisic D, Jeremic N, Majumder S, Pushpakumar S, George A, Singh M, Tyagi SC. High Fat Diet Dysbiotic Mechanism of Decreased Gingival Blood Flow. Front Physiol 2021; 12:625780. [PMID: 33746772 PMCID: PMC7965981 DOI: 10.3389/fphys.2021.625780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/09/2021] [Indexed: 01/14/2023] Open
Abstract
The gut microbiome has a very important role in human health and its influence on the development of numerous diseases is well known. In this study, we investigated the effect of high fat diet (HFD) on the onset of dysbiosis, gingival blood flow decreases, and the periodontal matrix remodeling. We established a dysbiosis model (HFD group) and probiotic model by Lactobacillus rhamnosus GG (LGG) treatment for 12weeks. Fecal samples were collected 24h before mice sacrificing, while short chain fatty acids (SCFA) analysis, DNA extraction, and sequencing for metagenomic analysis were performed afterwards. After sacrificing the animals, we collected periodontal tissues and conducted comprehensive morphological and genetic analyses. While HFD reduced Bacteroidetes, SCFA, and gingival blood flow, this type of diet increased Firmicutes, lipopolysaccharide (LPS) binding protein, TLR4, pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), matrix metalloproteinases (MMP-2 and MMP-9) expression, and also altered markers of bone resorption (OPG and RANKL). However, LGG treatment mitigated these effects. Thus, it was observed that HFD increased molecular remodeling via inflammation, matrix degradation, and functional remodeling and consequently cause reduced gingival blood flow. All of these changes may lead to the alveolar bone loss and the development of periodontal disease.
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Affiliation(s)
- Dragana Stanisic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Nevena Jeremic
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Suravi Majumder
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Sathnur Pushpakumar
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Akash George
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Mahavir Singh
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Suresh C. Tyagi
- Department of Physiology, School of Medicine, University of Louisville, Louisville, KY, United States
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Botelho J, Machado V, Hussain SB, Zehra SA, Proença L, Orlandi M, Mendes JJ, D'Aiuto F. Periodontitis and circulating blood cell profiles: a systematic review and meta-analysis. Exp Hematol 2020; 93:1-13. [PMID: 33068648 DOI: 10.1016/j.exphem.2020.10.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022]
Abstract
Periodontitis is a chronic inflammatory disease with local and systemic implications. Evidence suggests consistent hematologic changes associated with periodontitis. Our aim was to critically appraise the available evidence on hemogram, leukogram, and thrombogram alterations in otherwise healthy patients suffering from periodontitis when compared with controls. For this systematic review (SR), we searched MEDLINE, Web of Science, EMBASE, and the Cochrane Library (CENTRAL) for studies published up to June 2020. Both observational and interventional studies with baseline standard hematologic levels were included. Outcomes of interest were baseline hemogram, leukogram, and thrombogram values and the impact of periodontitis treatment on these outcomes. Upon risk of bias assessment, data extraction and both qualitative and quantitative (standardized mean differences) analyses were performed. Random-effects meta-analyses were performed to provide pooled estimates. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed (PROSPERO Reg. No. CRD42020164531). A total of 45 studies, eight intervention and 37 case-control studies, were identified after the final search of 3,012 titles. Following quality assessment, 43 articles were deemed to have low risk of bias, and two articles moderate risk. Meta-analyses confirmed that periodontitis was associated with both white and red cell lineages. Severe chronic periodontitis was associated with greater white blood cell counts (mean difference [MD] = 0.53, 95% confidence interval [CI]: 0.26-0.79) when compared with controls. Periodontitis was associated with a larger number of neutrophils (MD = 7.16%, 95% CI: 5.96-8.37) and lower mean platelet volume (MD = 0.30 fL, 95% CI: 0.49 to -0.10) compared with healthy participants. Nonsurgical periodontal treatment was associated with a decrease in white blood cell (WBC) levels (MD = 0.28 109/L, 95% CI: -0.47 to -0.08) in patients with chronic periodontitis. Periodontitis is associated with hematologic changes (Strength of Recommendation Taxonomy [SORT] A recommendation). Higher WBC levels, higher neutrophil levels, higher erythrocyte sedimentation rate, and lower mean platelet volumes are the most common blood count findings. The association between periodontitis and WBC could be causal in nature. Further assessment to determine whether periodontitis causes changes in circulating blood cells and to identify the molecular mechanisms underlying these associations is warranted.
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Affiliation(s)
- João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal; Evidence-Based Hub, CRU, CiiEM, IUEM, Almada, Portugal.
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal; Evidence-Based Hub, CRU, CiiEM, IUEM, Almada, Portugal
| | - Syed Basit Hussain
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | | | - Luís Proença
- Quantitative Methods for Health Research, CiiEM, IUEM, Monte de Caparica, Portugal
| | - Marco Orlandi
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | | | - Francesco D'Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
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Eickholz P, Schröder M, Asendorf A, Schacher B, Oremek GM, Kaiser F, Wohlfeil M, Nibali L. Effect of nonsurgical periodontal therapy on haematological parameters in grades B and C periodontitis: an exploratory analysis. Clin Oral Investig 2020; 24:4291-4299. [PMID: 32385656 PMCID: PMC7666670 DOI: 10.1007/s00784-020-03292-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Aim Assessment of the effect of nonsurgical periodontal therapy on haematological parameters in patients with grades B (BP) and C periodontitis (CP). Methods Eight BP and 46 CP patients received full-mouth periodontal debridement within 48 h, if positive for Aggregatibacter actinomycetemcomitans with adjunctive systemic antibiotics (4 BP, 17 CP). Clinical data were collected prior and 12 weeks after periodontal therapy. Blood was sampled prior to and 1 day as well as 6 and 12 weeks after the first SD visit. Erythrocyte count, haemoglobin value, haematocrit (HCT), mean erythrocyte volume (MCV), mean corpuscular haemoglobin (MCH), MCH concentration (MCHC), platelets (PLT) and heat shock protein 27 (Hsp27) were assessed. Results Both groups showed significant clinical improvement (p < 0.05). Using univariate analysis, MCV was noticeably lower in CP than BP at all examinations, HCT only at baseline. For CP, MCHC was noticeably higher 12 weeks after SD than at baseline and 1 day (p ≤ 0.005) and Hsp27 increased noticeably at 1 day (p < 0.05). Repeated measures analysis of variance revealed African origin to be associated with lower MCV and female sex with lower MCHC. Conclusion Based on multivariate analysis, periodontal diagnosis (BP/CP) was not associated with haematological parameters measured in this study or serum Hsp27. In CP, nonsurgical periodontal therapy improved MCHC 12 weeks after SD. Also in CP Hsp27 was increased 1 day after SD.
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Affiliation(s)
- Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7 (Haus 29), 60596, Frankfurt am Main, Germany.
| | - Mario Schröder
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7 (Haus 29), 60596, Frankfurt am Main, Germany
| | - Anne Asendorf
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7 (Haus 29), 60596, Frankfurt am Main, Germany
| | - Beate Schacher
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7 (Haus 29), 60596, Frankfurt am Main, Germany
| | - Gerhard M Oremek
- Department of Laboratory Medicine, Centre for Internal Medicine, Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Frank Kaiser
- Centre for Host-Microbiome Interactions, Kings College London, Guy's Hospital, Great Maze Pond, SE1 9RT, London, UK
| | - Martin Wohlfeil
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7 (Haus 29), 60596, Frankfurt am Main, Germany
| | - Luigi Nibali
- Centre for Host-Microbiome Interactions, Kings College London, Guy's Hospital, Great Maze Pond, SE1 9RT, London, UK
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Yu L, Zhou C, Wei Z, Shi Z. Effect of combined periodontal-orthodontic treatment on NOD-like receptor protein 3 and high mobility group box-1 expressions in patients with periodontitis and its clinical significance. Medicine (Baltimore) 2019; 98:e17724. [PMID: 31689812 PMCID: PMC6946199 DOI: 10.1097/md.0000000000017724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/26/2019] [Accepted: 09/29/2019] [Indexed: 12/13/2022] Open
Abstract
To investigate the effect of combined periodontal-orthodontic treatment on the gingival crevicular fluid (GCF) levels of high mobility group box-1 (HMGB1) and NOD-like receptor protein 3 (NLRP3) in chronic periodontitis.A total of 60 patients with periodontitis who received combined periodontal-orthodontic treatment and 32 healthy individuals as normal controls were recruited in this study. Periodontal parameters were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to examine GCF levels of HMGB1 and NLRP3.The periodontal parameters and GCF levels of HMGB1 and NLRP3 in periodontitis patients were significantly higher before treatment, and observably decreased after 6 months of treatment as compared with the healthy group. However, significant positive correlations were observed between HMGB1, NLRP3, and periodontal parameters in chronic periodontitis patients.Patients with chronic periodontitis showed higher levels of HMGB1 and NLRP3 in GCF.
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Affiliation(s)
- Lihua Yu
- Department of Stomatology, Hospital of Nanjing University of Science and Technology, Nanjing
| | - Chen Zhou
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, Jiangsu, China
| | - Zicheng Wei
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, Jiangsu, China
| | - Zhanai Shi
- Department of Stomatology, Hospital of Nanjing University of Science and Technology, Nanjing
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10
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Hiyoshi T, Domon H, Maekawa T, Nagai K, Tamura H, Takahashi N, Yonezawa D, Miyoshi T, Yoshida A, Tabeta K, Terao Y. Aggregatibacter actinomycetemcomitans induces detachment and death of human gingival epithelial cells and fibroblasts via elastase release following leukotoxin-dependent neutrophil lysis. Microbiol Immunol 2019; 63:100-110. [PMID: 30817027 DOI: 10.1111/1348-0421.12672] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 12/13/2022]
Abstract
Aggregatibacter actinomycetemcomitans is considered to be associated with periodontitis. Leukotoxin (LtxA), which destroys leukocytes in humans, is one of this bacterium's major virulence factors. Amounts of neutrophil elastase (NE), which is normally localized in the cytoplasm of neutrophils, are reportedly increased in the saliva of patients with periodontitis. However, the mechanism by which NE is released from human neutrophils and the role of NE in periodontitis is unclear. In the present study, it was hypothesized that LtxA induces NE release from human neutrophils, which subsequently causes the breakdown of periodontal tissues. LtxA-treatment did not induce significant cytotoxicity against human gingival epithelial cells (HGECs) or human gingival fibroblasts (HGFs). However, it did induce significant cytotoxicity against human neutrophils, leading to NE release. Furthermore, NE and the supernatant from LtxA-treated human neutrophils induced detachment and death of HGECs and HGFs, these effects being inhibited by administration of an NE inhibitor, sivelestat. The present results suggest that LtxA mediates human neutrophil lysis and induces the subsequent release of NE, which eventually results in detachment and death of HGECs and HGFs. Thus, LtxA-induced release of NE could cause breakdown of periodontal tissue and thereby exacerbate periodontitis.
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Affiliation(s)
- Takumi Hiyoshi
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hisanori Domon
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomoki Maekawa
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kosuke Nagai
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hikaru Tamura
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Takahashi
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Daisuke Yonezawa
- Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomohiro Miyoshi
- Department of Oral Microbiology, Matsumoto Dental University, Shiojiri, Japan
| | - Akihiro Yoshida
- Department of Oral Microbiology, Matsumoto Dental University, Shiojiri, Japan
| | - Koichi Tabeta
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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11
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Inflammatory serum markers up to 5 years after comprehensive periodontal therapy of aggressive and chronic periodontitis. Clin Oral Investig 2018; 22:3079-3089. [PMID: 29484548 PMCID: PMC6224024 DOI: 10.1007/s00784-018-2398-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/16/2018] [Indexed: 12/12/2022]
Abstract
Aim The aim of the study is to assess the long-term effect of active periodontal therapy on serum inflammatory parameters in patients with aggressive (AgP) and chronic (ChP) periodontitis in a non-randomised clinical study. Methods Twenty-five ChP and 17 AgP were examined clinically prior to (baseline), 12 weeks and 60 months after subgingival debridement of all pockets within 2 days. Systemic antibiotics were prescribed if Aggregatibacter actinomycetemcomitans was detected (10 AgP, 8 ChP), flap surgery was rendered if required. Neutrophil elastase (NE), C-reactive protein (CRP), lipopolysaccharide binding protein, interleukin 6, 8, and leukocyte counts were assessed at baseline, 12 weeks and 60 months. Results Clinical parameters improved significantly in both groups from 12 weeks to 60 months. Eleven AgP and 18 ChP patients received surgical treatment after the 12 weeks examination. Only 3 patients in each group attended ≥ 2 supportive maintenance visits per year. NE and CRP were significantly higher in AgP than ChP at baseline and 60 months (p < 0.01). For leukocyte counts in ChP, significant changes were observed (baseline: 6.11 ± 1.44 nl−1; 12 weeks: 5.34 ± 1.40 nl−1; 60 months: 7.73 ± 2.89 nl−1; p < 0.05). Multiple regression analysis identified African origin, surgical treatment and female sex to correlate with better clinical improvement. Conclusion Despite comprehensive periodontal treatment, AgP patients exhibit higher NE and CRP levels than ChP patients up to 5 years after therapy. Clinical relevance Systemic inflammatory burden in AgP patients is higher than in ChP patients even 5 years after periodontal treatment. Electronic supplementary material The online version of this article (10.1007/s00784-018-2398-x) contains supplementary material, which is available to authorized users.
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12
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Mysak J, Podzimek S, Vasakova J, Mazanek J, Vinsu A, Duskova J. C-reactive protein in patients with aggressive periodontitis. J Dent Sci 2017; 12:368-374. [PMID: 30895077 PMCID: PMC6395364 DOI: 10.1016/j.jds.2017.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/06/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP) in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. MATERIALS AND METHODS All patients (N = 45) were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23) and group LAgP (Localised form of aggressive periodontitis, N = 22). Control group (CON) included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. RESULTS CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP) in a similar way as bleeding on probing (BOP) and probing pocket depth (PPD) indices. CONCLUSION Our study results showed that CRP levels, as well as bleeding on probing (BOP) and probing pocket depth (PPD), indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis.
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Affiliation(s)
- Jaroslav Mysak
- Department of Periodontology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Stepan Podzimek
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Vasakova
- Department of Paediatric Dentistry, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jiri Mazanek
- Department of Maxillofacial Surgery, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Alex Vinsu
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Duskova
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
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13
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Zhou J, Yao Y, Jiao K, Zhang J, Zheng X, Wu F, Hu X, Li J, Yu Z, Zhang G, Jiang N, Li Z. Relationship between Gingival Crevicular Fluid Microbiota and Cytokine Profile in Periodontal Host Homeostasis. Front Microbiol 2017; 8:2144. [PMID: 29163429 PMCID: PMC5672786 DOI: 10.3389/fmicb.2017.02144] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/19/2017] [Indexed: 12/27/2022] Open
Abstract
As potential biomarkers in periodontitis, microbiome, and cytokines have recently been extensively investigated, but combined analyses of the variations between the microbial structure and cytokine composition are rare. The present study aimed to investigate whether there are differences in the combined profile of microbiome and cytokines in individuals with or without periodontitis. The microbiome and cytokine composition in gingival crevicular fluid (GCF) from 16 patients and 15 controls from Jishi Shan (Gansu, China) were analyzed using 454 pyrosequencing and RayBio Quantibody Arrays. The results showed that a higher co-occurrence of genera in periodontitis group compared with the healthy group, as evaluated by Schoener's abundance-based co-occurrence index. C-reactive protein (CRP) was significantly (P < 0.05) higher in the GCF of the periodontitis group while interleukin (IL)-8 was significantly (P < 0.01) higher in the GCF of the healthy group. The Mantel test revealed a significant concordance between cytokines and microbiota, in the healthy group (Mantel statistic r = 0.36, P ≤ 0.05) but not in the periodontitis group (Mantel statistic r = 0.013, P = 0.434). The results were further confirmed by the Procrustes test. Matrix metalloproteinase (MMP)-9, osteoactivin, IL-8, and macrophage inflammatory protein (MIP)-1a were significantly associated with bacterial composition at the phylum, class, order, family, and genus levels. CRP was also associated with bacterial composition at the species level. In conclusion, alterations in the polymicrobial community structure leads to disruption in the healthy correlation between cytokines and microbiomes. This dysbiosis between the microbiota and the immune response could be one of the major etiological mechanisms underlying periodontitis.
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Affiliation(s)
- Jianye Zhou
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
| | - Yiqing Yao
- Department of Biological Systems Engineering, Washington State University, Pullman, WA, United States
| | - Kangli Jiao
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
| | - Jumei Zhang
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
| | - Xin Zheng
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
| | - Fang Wu
- Yinchuan Stomatology Hospital, Yinchuan, China
| | - Xiaopan Hu
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
| | | | - Zhanhai Yu
- Department of Prosthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Gaosen Zhang
- Department of Soil Research, Cold and Arid Regions Environmental and Engineering Research Institute, Chinese Academy of Sciences, Lanzhou, China
| | - Nan Jiang
- Department of Applied Soil Biochemistry, Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang, China
| | - Zhiqiang Li
- Department of Prosthodontics, Key Laboratory of Oral Diseases of Gansu Province, Northwest University for Nationalities, Lanzhou, China
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14
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Efficacy of combined orthodontic-periodontic treatment for patients with periodontitis and its effect on inflammatory cytokines: A comparative study. Am J Orthod Dentofacial Orthop 2017; 152:494-500. [DOI: 10.1016/j.ajodo.2017.01.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 01/01/2017] [Accepted: 01/01/2017] [Indexed: 11/17/2022]
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15
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Turkoglu O, Emingil G, Eren G, Atmaca H, Kutukculer N, Atilla G. Gingival crevicular fluid and serum hCAP18/LL-37 levels in generalized aggressive periodontitis. Clin Oral Investig 2016; 21:763-769. [DOI: 10.1007/s00784-016-1834-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 04/20/2016] [Indexed: 12/14/2022]
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16
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Links between atherosclerotic and periodontal disease. Exp Mol Pathol 2016; 100:220-35. [DOI: 10.1016/j.yexmp.2016.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 02/06/2023]
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17
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Alfakry H, Malle E, Koyani CN, Pussinen PJ, Sorsa T. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease. Innate Immun 2016; 22:85-99. [PMID: 26608308 DOI: 10.1177/1753425915617521] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/13/2015] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.
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Affiliation(s)
- Hatem Alfakry
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ernst Malle
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Chintan N Koyani
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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18
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Yang SE, Park YG, Han K, Min JA, Kim SY. Dental pain related to quality of life and mental health in South Korean adults. PSYCHOL HEALTH MED 2015; 21:981-92. [PMID: 26456324 DOI: 10.1080/13548506.2015.1098781] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
High levels of stress, anxiety and depression have been reported in patients with orofacial pain. Dental pain has the potential to reduce quality of life (QOL), and pain relief is important aspect of QOL. The purpose of this study was to assess the relationships of dental pain with QOL and mental health using a nationally representative, population-based study. This study analyzed data from the 2012 Korea National Health and Nutrition Examination Survey (N = 5469). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Health-related QOL (HRQOL) was evaluated using EQ-5D and EQ-VAS, and mental health was evaluated by questionnaires. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Among 5469 adults, 1992 (36.42%) presented self-reported dental pain. Participants with anxiety/depression or pain/discomfort, and participants with stress, melancholy, suicidal thought or depression showed significantly higher prevalence of dental pain. After adjusting for covariates, five aspects of QOL and five aspects of mental health were related with dental pain. The AORs (95% CI) for dental pain were 1.39 (1.06-1.81) for mobility, 1.77 (1.19-2.63) for self-care, 1.38 (1.02-1.85) for usual activities, 1.73 (1.43-2.09) for pain/discomfort and 1.50 (1.13-1.98) for anxiety/depression. For mental health status factors, the AORs (95% CI) for dental pain were 1.29 (1.11-1.51) for stress, 1.37 (1.09-1.74) for melancholy, 1.26 (1.01-1.58) for suicidal thoughts, 1.43 (.93-2.19) for consultation to psychiatrist and 1.53 (1.07-2.19) for depression. This study showed that dental pain has an association with lower HRQOL and worse mental health status in South Korean adults.
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Affiliation(s)
- Sung-Eun Yang
- a Department of Conservative Dentistry , Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Yong-Gyu Park
- b Department of Biostatistics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Kyungdo Han
- b Department of Biostatistics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Jung-Ah Min
- c Department of Psychiatry , Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
| | - Sin-Young Kim
- a Department of Conservative Dentistry , Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
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19
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C-Reactive Protein in Peripheral Blood of Patients with Chronic and Aggressive Periodontitis, Gingivitis, and Gingival Recessions. Mediators Inflamm 2015; 2015:564858. [PMID: 26346216 PMCID: PMC4539496 DOI: 10.1155/2015/564858] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/18/2015] [Accepted: 06/02/2015] [Indexed: 02/01/2023] Open
Abstract
CRP is a plasma protein that reflects a measure of the acute phase response to inflammation and is one of the markers of choice in monitoring this response. CRP can be used for the prediction and early detection of periodontal disease. The aim of this study was to compare and evaluate the systemic levels of CRP in the peripheral blood samples of patients with chronic and aggressive periodontitis, gingivitis, and gingival recessions and compare them with periodontal clinical parameters. All patients (N = 158) were examined prior to the initiation of periodontal treatment. Patients were divided into four groups. Group A consisted of 26 patients with aggressive periodontitis, Group B consisted of 111 patients with chronic periodontitis, Group C consisted of 13 patients with gingivitis, and Group D consisted of 8 patients with gingival recessions. Our study results indicate that CRP levels increase subsequently with the severity of the periodontal disease and that the bleeding on probing index showed much better positive correlation with the CRP levels compared to the pocket depth index in both periodontitis patients groups, especially in aggressive periodontitis patients.
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20
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Serum and salivary matrix metalloproteinases, neutrophil elastase, myeloperoxidase in patients with chronic or aggressive periodontitis. Inflammation 2015; 37:1771-8. [PMID: 24799321 DOI: 10.1007/s10753-014-9907-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Salivary, serum matrix metalloproteinase-8 (MMP-8), tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), neutrophil elastase (NE), and myeloperoxidase (MPO) levels were investigated in generalized chronic periodontitis (GCP), generalized aggressive periodontitis (GAgP), and healthy groups. Whole-mouth clinical periodontal measurements were recorded. Salivary, serum concentrations of MMP-8, MPO, TIMP-1, and NE were determined by immunofluorometric assay or ELISA in 18 patients with GCP, 23 patients with GAgP, 18 individuals with healthy periodontium. Patients in the GAgP group were younger than the other groups (p<0.05). The study groups were similar in gender, smoking status. Plaque index was higher in GCP than GAgP group (p<0.05). Biochemical data were similar in periodontitis groups. Salivary, serum MPO, and salivary NE concentrations were higher; TIMP-1 concentrations were lower in the periodontitis groups than the controls (p<0.05). The present data support a close relationship between salivary, serum protease content and clinical periodontal parameters in patients with generalized periodontitis.
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21
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Goyal L, Bey A, Gupta ND, Sharma VK. Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patients and association with periodontal disease severity. Contemp Clin Dent 2014; 5:484-8. [PMID: 25395764 PMCID: PMC4229757 DOI: 10.4103/0976-237x.142816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE C-reactive protein (CRP) is an acute-phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, most of the studies have focused on chronic periodontitis and very few studies are done in patients with aggressive periodontitis. The aim of this study was to determine and compare the relative levels of serum CRP in aggressive and chronic periodontitis patients. MATERIALS AND METHODS A total of 75 systemically healthy subjects were divided into three groups: Group I, nonperiodontitis subjects; group II, chronic generalized periodontitis patients and group III, generalized aggressive periodontitis patients. All participants were subjected to quantitative CRP analysis using enzyme-linked immunosorbent assay. RESULTS Mean CRP levels were significantly greater in both group II and III as compared to group I and group III having greater level than group II. Furthermore, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss. CONCLUSION The present study indicates a positive correlation between CRP and periodontal disease severity with particular concern in younger individuals that could be a possible underlying pathway in the association between periodontal disease and the observed higher risk for cardiovascular disease in periodontitis patients.
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Affiliation(s)
- Lata Goyal
- Departments of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Afshan Bey
- Departments of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - N D Gupta
- Departments of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Vivek Kumar Sharma
- Departments of Periodontics and Community Dentistry, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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22
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Clinical results after nonsurgical therapy in aggressive and chronic periodontitis. Clin Oral Investig 2013; 18:453-60. [PMID: 23749245 DOI: 10.1007/s00784-013-1013-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 05/28/2013] [Indexed: 12/12/2022]
Abstract
AIM This study aims to analyze factors influencing treatment results in aggressive (AgP) and chronic (ChP) periodontitis. METHODS ChP [probing pocket depth (PPD) ≥ 3.5 mm, attachment loss ≥ 5 mm at >30 % of sites; age > 35 years] and AgP (clinically healthy; PPD ≥ 3.5 mm at >30 % of sites, radiographic bone loss ≥ 50 % at 2 teeth; age ≤ 35 years) were examined prior and 3 months after nonsurgical therapy according to the full-mouth disinfection concept. Adjunctive systemic antibiotics were used if Aggregatibacter actinomycetemcomitans had been detected at baseline. RESULTS In 31 ChP (12 female, 10 smokers; 4,808 sites) and 28 AgP (16 female, 9 smokers; 4,769 sites), overall mean PPD reductions were less favorable in AgP (0.9 ± 0.5 mm) than in ChP (1.3 ± 0.4 mm; p = 0.033). PPD reductions and relative vertical probing attachment level gain were more favorable at sites with initial PPD ≥ 6 mm, bleeding on probing, and for adjunctive systemic antibiotics. Furthermore, PPD reductions were more favorable for increased baseline tooth mobility and maxillary teeth, whereas AgP, female sex, and multirooted teeth were associated with less favorable PPD reduction. CONCLUSION Regarding PPD reduction, AgP responded less favorably to nonsurgical treatment than ChP.
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23
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Eickholz P, Siegelin Y, Scharf S, Schacher B, Oremek GM, Sauer-Eppel H, Schubert R, Wohlfeil M. Non-surgical periodontal therapy decreases serum elastase levels in aggressive but not in chronic periodontitis. J Clin Periodontol 2013; 40:327-33. [DOI: 10.1111/jcpe.12076] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Peter Eickholz
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Yasemin Siegelin
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Susanne Scharf
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Beate Schacher
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Gerhard M. Oremek
- Department of Laboratory Medicine; Centre for Internal Medicine; Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Hildegund Sauer-Eppel
- Department of Laboratory Medicine; Centre for Internal Medicine; Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Ralf Schubert
- Pneumology, Allergology and Cystic Fibrosis, Children's Hospital; Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Martin Wohlfeil
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
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Physiologie der Mundhöhle. Hautarzt 2012; 63:678-86. [DOI: 10.1007/s00105-012-2350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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