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Valverde A, George A, Nares S, Naqvi AR. Emerging therapeutic strategies targeting bone signaling pathways in periodontitis. J Periodontal Res 2024. [PMID: 39044454 DOI: 10.1111/jre.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/22/2024] [Accepted: 07/05/2024] [Indexed: 07/25/2024]
Abstract
Periodontitis is a multifactorial immune-mediated disease exacerbated by dysregulated alveolar bone homeostasis. Timely intervention is crucial for disease management to prevent tooth loss. To successfully manage periodontitis, it is imperative to understand the cellular and molecular mechanisms involved in its pathogenesis to develop novel treatment modalities. Non-surgical periodontal therapy (NSPT) such as subgingival instrumentation/debridement has been the underlying treatment strategy over the past decades. However, new NSPT approaches that target key signaling pathways regulating alveolar bone homeostasis have shown positive clinical outcomes. This narrative review aims to discuss endogenous bone homeostasis mechanisms impaired in periodontitis and highlight the clinical outcomes of preventive periodontal therapy to avoid invasive periodontal therapies. Although the anti-resorptive therapeutic adjuncts have demonstrated beneficial outcomes, adverse events have been reported. Diverse immunomodulatory therapies targeting the osteoblast/osteoclast (OB/OC) axis have shown promising outcomes in vivo. Future controlled randomized clinical trials (RCT) would help clinicians and patients in the selection of novel preventing therapies targeting key molecules to effectively treat or prevent periodontitis.
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Affiliation(s)
- Araceli Valverde
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Anne George
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Salvador Nares
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Afsar R Naqvi
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Microbiology and Immunology, University of Illinois Chicago, Chicago, Illinois, USA
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Meng R, Xu J, Fan C, Liao H, Wu Z, Zeng Q. Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis. BMC Oral Health 2024; 24:692. [PMID: 38877442 PMCID: PMC11177403 DOI: 10.1186/s12903-024-04433-0] [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: 02/01/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality in the world. Patients with periodontitis have a higher risk of CVD, although a causal relationship between these conditions remains unclear. Non-surgical periodontal therapy (NSPT) is able to control inflammation at local and systemic levels. This study aimed to analyze the effect of NSPT on CVD risk markers. METHODS Four electronic databases were searched from their inception to April 1, 2023, to identify and select articles without any language restrictions. Eleven CVD-related markers (e.g., C-reactive protein [CRP], Interleukin-6 [IL-6]) were selected. Meta-analyses were performed using random and fixed effect models. The differences were expressed as weighted mean differences (WMD) and 95% confidence interval (95% CI). RESULTS From 1353 studies, twenty-one randomized controlled clinical trials were included in the meta-analysis. Results showed a significant decrease in CRP, IL-6, and systolic blood pressure (SBP) after NSPT. CONCLUSION Moderate certainty evidence shows that NSPT has a positive effect on the reduction of IL-6 and SBP in patients with periodontitis, while low certainty evidence shows that NSPT is effective for reduction of CRP. Moderate certainty evidence showed that NSPT did not show a positive effect on low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG), and low certainty evidence showed that NSPT did not show a positive effect on Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), diastolic blood pressure (DBP), and flow-mediated dilatation (FMD). PROTOCOL REGISTRATION The protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews), number CRD42022377565.
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Affiliation(s)
- Rijing Meng
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Jialei Xu
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Chenrui Fan
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Haiqing Liao
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China.
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China.
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China.
| | - Zeni Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Qixin Zeng
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China.
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China.
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China.
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Wang AY, Lin GL, Keller JJ, Wang LH. Association between antihyperlipidemic agents and the risk of chronic periodontitis in patients with hyperlipidemia: A population-based retrospective cohort study in Taiwan. J Periodontol 2024; 95:483-493. [PMID: 37793052 DOI: 10.1002/jper.23-0166] [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: 03/19/2023] [Revised: 06/23/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The lipid-lowering and anti-inflammatory effects of statins and fibrates may ameliorate periodontitis. Patients with hyperlipidemia tend to have a worse periodontal status. This study assessed the association between the use of statins/fibrates and the incidence of chronic periodontitis in patients with hyperlipidemia in Taiwan. METHODS This retrospective cohort study enrolled patients newly diagnosed with hyperlipidemia between 2001 and 2012 from the 2000 Longitudinal Generation Tracking Database and followed them for 5 years. The study population was divided into four groups: statin monotherapy, fibrate monotherapy, combination therapy (both statins and fibrates), and control (neither statins nor fibrates). Each patient in the treatment group was matched at a ratio of 1:1 with a control. Chronic periodontitis risk was compared in the three study arms by using a Cox proportional hazard model. RESULTS Chronic periodontitis risk was reduced by 25.7% in the combination therapy group compared with the control group (adjusted hazard ratio [aHR], 0.743; 95% confidence interval (CI), 0.678-0.815). Low dose (<360 cumulative defined daily dose [cDDD]) and shorter duration (<2 years) of statin monotherapy seem to be associated with an increased risk of chronic periodontitis; high dose (≥720 cDDD/≥1080 cDDD) and longer duration (≥3 years) of statin/fibrate monotherapy may be correlated with a lower risk of periodontitis. Hydrophobic statin users had a lower chronic periodontitis risk than hydrophilic statin users. CONCLUSION Chronic periodontitis risk was lower in patients with hyperlipidemia on combination treatment with statins and fibrates, and the risk decreased when patients used statins or fibrates for >3 years.
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Affiliation(s)
- An-Yi Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Guan-Ling Lin
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Joseph Jordan Keller
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Li-Hsuan Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
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Ma W, Zou Z, Yang L, Lin D, Guo J, Shan Z, Hu Q, Wang Z, Li B, Fang J. Exploring the bi-directional relationship between periodontitis and dyslipidemia: a comprehensive systematic review and meta-analysis. BMC Oral Health 2024; 24:508. [PMID: 38684998 PMCID: PMC11059608 DOI: 10.1186/s12903-023-03668-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 11/14/2023] [Indexed: 05/02/2024] Open
Abstract
AIM As periodontitis and dyslipidemia are diseases that occur with high incidence, the relationship between them has attracted much attention. Previous studies on these diseases have tended to focus on lipid parameters and periodontitis, we aimed to investigate the relationship between dyslipidemia and periodontitis. MATERIALS AND METHODS A comprehensive search to identify the studies investigating the relationship between dyslipidemia and periodontitis was performed on PubMed, Web of Science and Cochrane Library before the date of August, 2023. Studies were considered eligible if they contained data on abnormal blood lipid parameters and periodontitis. Studies that reported mean differences and 95% confidence intervals or odds ratios were used. RESULTS A total of 73 publications were included in the meta-analysis. Hyper total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and lower high-density lipoprotein (HDL) levels are risk factors for periodontitis. Periodontal disease is a risk factor for high TG and low HDL levels. Three months after periodontal treatment, the levels of TC, TG and HDL were significantly improved, and statin treatment only improved gingival index (GI) levels compared to that of the dietary control. CONCLUSIONS The findings reported here suggest that the mutual promotion of periodontitis and dyslipidemia can be confirmed. Non-surgical periodontal therapy may improve lipid abnormalities. It can't be demonstrated whether systematic application of statins have a better effect on the improvement in periodontal status in patients with dyslipidemia compared to that of the control.
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Affiliation(s)
- Wanting Ma
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
- Central Laboratory, No. 1, Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Yunnan University of Traditional Chinese Medicine, Yunnan, 650021, Kunming, China
| | - Zhaolei Zou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Lisa Yang
- Department of Stomatology, Binzhou Medical University Hospital, Binzhou Medical University Hospital, 661 Huanghe Second Road, Shandong, 256603, Binzhou, China
| | - Dongjia Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Junyi Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Zhongyan Shan
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Qiannan Hu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Zhi Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Bin Li
- Clinical Trials Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, No. 58, Zhongshan Er Road, Guangzhou, Guangdong, 510080, People's Republic of China.
| | - Juan Fang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China.
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Ghanem AS, Németh O, Móré M, Nagy AC. Role of oral health in heart and vascular health: A population-based study. PLoS One 2024; 19:e0301466. [PMID: 38635852 PMCID: PMC11025934 DOI: 10.1371/journal.pone.0301466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/17/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND AND AIM Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors. MATERIALS AND METHODS Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings' validity. RESULTS Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01-2.77]); dental prosthetics had an OR of 1.45 [1.20-1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09-1.81]). CONCLUSIONS Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health's role in multidisciplinary disease management.
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Affiliation(s)
- Amr Sayed Ghanem
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Marianna Móré
- Institute of Social and Sociological Sciences, Faculty of Health Sciences, University of Debrecen, Nyíregyháza, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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Lee T, Han K, Yun KI. Association between dental scaling and metabolic syndrome and lifestyle. PLoS One 2024; 19:e0297545. [PMID: 38573898 PMCID: PMC10994476 DOI: 10.1371/journal.pone.0297545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/09/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Periodontal disease is a risk factor for diabetes and metabolic syndrome, and non-surgical periodontal treatment has been shown to help maintain stable blood sugar in diabetic patients. Determining the level of preventive scaling in patients with metabolic syndrome will help manage the disease. The purpose of this study was to investigate the extent to which people with metabolic syndrome or bad lifestyle performed scaling and the association between preventive scaling and metabolic syndrome or lifestyle in a large population. METHODS This study was conducted on adults aged 20 years or older from January 2014 to December 2017 in the National Health Insurance System (NHIS) database. Among 558,067 people who underwent health checkups, 555,929 people were included. A total of 543,791 people were investigated for preventive scaling. Metabolic syndrome components were abdominal obesity, lower high density lipoprotein cholesterol (HDL)-C, high triglycerides, high blood pressure and hyperglycemia. Unhealthy lifestyle score was calculated by assigning 1 point each for current smokers, drinkers, and no performing regular exercise. RESULTS When multiple logistic regression analysis was performed after adjusting for age, sex, income, body mass index (BMI), smoking, drinking and regular exercise, the Odds ratios (OR) and 95% confidence intervals (CI) of the group with 5 metabolic syndrome components were 0.741 (0.710, 0.773) (p<0.0001). After adjustment for age, sex, income, BMI, smoking, drinking, regular exercise, diabetes, hypertension and dyslipidemia, the OR (95% CI) of the group with unhealthy lifestyle score = 3 was 0.612 (0.586, 0.640) (p<0.0001). CONCLUSIONS The more metabolic syndrome components, and the higher unhealthy lifestyle score, the less scaling was performed.
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Affiliation(s)
- TaeYeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyoung-In Yun
- Department of Oral and Maxillofacial Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Isola G, Tartaglia GM, Santonocito S, Chaurasia A, Marya A, Lo Giudice A. Growth differentiation factor-15 and circulating biomarkers as predictors of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial. BMC Oral Health 2023; 23:582. [PMID: 37605193 PMCID: PMC10440880 DOI: 10.1186/s12903-023-03237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND During the last decades, in patients with periodontitis, periodontal treatment has been shown to reduce the potential release of local and systemic biomarkers linked to an early risk of systemic inflammatory disorders. This study evaluated the efficacy of non-surgical-periodontal treatment (NSPT) on growth differentiation factor 15 (GDF-15) and related circulating biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) in periodontal patients and explored whether subjects who had high GDF-15 levels at baseline showed increased clinical benefits following NSPT at 6-months follow-up. METHODS For this two-arm, parallel randomized clinical trial, patients with periodontitis were randomly allocated to receive quadrant scaling and root-planing (Q-SRP, n = 23, median age 51 years old) or full-mouth disinfection (FMD, n = 23, median age 50 years old) treatment. Clinical and periodontal parameters were recorded in all enrolled patients. The primary outcome was to analyse serum concentrations changes of GDF-15 and of GPx-1, hs-CRP, and SP-D at baseline and at 30, 90, and 180-days follow-up after NSPT through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques. RESULTS In comparison with FMD, patients of the Q-SRP group showed a significant improvement in clinical periodontal parameters (p < 0.05) and a reduction in the mean levels of GDF-15 (p = 0.005), hs-CRP (p < 0.001), and SP-D (p = 0.042) and an increase of GPx-1 (p = 0.025) concentrations after 6 months of treatment. At 6 months of treatment, there was a significant association between several periodontal parameters and the mean concentrations of GDF-15, GPx-1, hs-CRP, and SP-D (p < 0.05 for all parameters). Finally, the ANOVA analysis revealed that, at 6 months after treatment, the Q-SRP treatment significantly impacted the reduction of GDF-15 (p = 0.015), SP-D (p = 0.026) and the upregulation of GPx-1 (p = 0.045). CONCLUSION The results evidenced that, after 6 months of treatment, both NSPT protocols improved the periodontal parameters and analyzed biomarkers, but Q-SRP was more efficacious than the FMD approach. Moreover, patients who presented high baseline GDF-15 and SP-D levels benefited more from NSPT at 6-month follow-up. TRIAL REGISTRATION NCT05720481.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, 20100, Italy
- Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, 20100, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy.
| | - Akhilanand Chaurasia
- Department of Oral Medicine, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anand Marya
- Department of Orthodontics, University of Puthisastra Phnom Penh Combodia, Phnom Penh, 55180, Cambodia.
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, 600077, India.
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy
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Woelber JP, Reichenbächer K, Groß T, Vach K, Ratka-Krüger P, Bartha V. Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy-A Systematic Review. Nutrients 2023; 15:nu15061538. [PMID: 36986267 PMCID: PMC10052653 DOI: 10.3390/nu15061538] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane Library, and the Web of Science. Trial inclusion criteria included the application of a defined nutritional intervention (food, beverages, or supplements) adjunctive to NSPT compared to NSPT alone with at least one measured periodontal parameter (pocket probing depths (PPD) or clinical attachment level (CAL)). Of 462 search results, 20 clinical trials relating to periodontitis and nutritional interventions were identified, of which, in total, 14 studies could be included. Eleven studies examined supplements containing lycopene, folate, chicory extract, juice powder, micronutrients and plant extracts, omega-3 fatty acids, vitamin E, or vitamin D. Three studies examined food-based interventions (kiwifruit, green or oolong tea). Due to limited information on within-group differences in the studies, results were descriptively analyzed. A significant positive effect on periodontal parameters (PPD, bleeding on probing) was found for vitamin E, chicory extract, juice powder, green tea, and oolong tea. Heterogeneous effects were found for lycopene, folate, omega-3 fatty acids, and vitamin D. No effects on PPD were found for adjunct kiwifruit (in combination with NSPT). Risk of bias via RoB2 revealed a low risk of bias with some concerns. There was a high heterogeneity in the type of nutritional interventions. The adjunctive use of various supplements and green/oolong tea led to positive and significant effects of the nutritional interventions on clinical periodontal outcome parameters. In the context of non-surgical periodontal therapy, an adjunctive intake of micronutrients, omega-3 fatty acids, green/oolong tea, and polyphenols and flavonoids could be beneficial. Long-term clinical studies with full data reports (especially within-group differences) are needed for conducting a meta-analysis.
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Affiliation(s)
- Johan Peter Woelber
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Katharina Reichenbächer
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Tara Groß
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany
| | - Petra Ratka-Krüger
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Valentin Bartha
- Department for Conservative Dentistry, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Ruan Q, Guan P, Qi W, Li J, Xi M, Xiao L, Zhong S, Ma D, Ni J. Porphyromonas gingivalis regulates atherosclerosis through an immune pathway. Front Immunol 2023; 14:1103592. [PMID: 36999040 PMCID: PMC10043234 DOI: 10.3389/fimmu.2023.1103592] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/01/2023] [Indexed: 03/15/2023] Open
Abstract
Atherosclerosis (AS) is a chronic inflammatory disease, involving a pathological process of endothelial dysfunction, lipid deposition, plaque rupture, and arterial occlusion, and is one of the leading causes of death in the world population. The progression of AS is closely associated with several inflammatory diseases, among which periodontitis has been shown to increase the risk of AS. Porphyromonas gingivalis (P. gingivalis), presenting in large numbers in subgingival plaque biofilms, is the “dominant flora” in periodontitis, and its multiple virulence factors are important in stimulating host immunity. Therefore, it is significant to elucidate the potential mechanism and association between P. gingivalis and AS to prevent and treat AS. By summarizing the existing studies, we found that P. gingivalis promotes the progression of AS through multiple immune pathways. P. gingivalis can escape host immune clearance and, in various forms, circulate with blood and lymph and colonize arterial vessel walls, directly inducing local inflammation in blood vessels. It also induces the production of systemic inflammatory mediators and autoimmune antibodies, disrupts the serum lipid profile, and thus promotes the progression of AS. In this paper, we summarize the recent evidence (including clinical studies and animal studies) on the correlation between P. gingivalis and AS, and describe the specific immune mechanisms by which P. gingivalis promotes AS progression from three aspects (immune escape, blood circulation, and lymphatic circulation), providing new insights into the prevention and treatment of AS by suppressing periodontal pathogenic bacteria.
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Affiliation(s)
- Qijun Ruan
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Peng Guan
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Weijuan Qi
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Jiatong Li
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Mengying Xi
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Limin Xiao
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Sulan Zhong
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Dandan Ma
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- *Correspondence: Dandan Ma, ; Jia Ni,
| | - Jia Ni
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- *Correspondence: Dandan Ma, ; Jia Ni,
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Rahman B, Al-Marzooq F, Saad H, Benzina D, Al Kawas S. Dysbiosis of the Subgingival Microbiome and Relation to Periodontal Disease in Association with Obesity and Overweight. Nutrients 2023; 15:nu15040826. [PMID: 36839184 PMCID: PMC9965236 DOI: 10.3390/nu15040826] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Obesity causes gut dysbiosis; nevertheless, little is known about the oral microbiome. We aimed to identify differences in the subgingival microbiota influenced by body weight and periodontal status. Patients (n = 75) recruited at the University Dental Hospital Sharjah, United Arab Emirates, were distributed into three equal groups (healthy weight, overweight, and obese) sub-divided into having either no-mild (NM) or moderate-severe (MS) periodontitis. Subgingival plaques were collected. Microbiota were identified by 16S rRNA sequencing using nanopore technology. Linear discriminant analysis demonstrated significant bacterial biomarkers for body weight and periodontal health. Unique microbiota signatures were identified, with enrichment of periopathogens in patients with MS periodontitis (Aggregatibacter actinomycetemcomitans in obese, Tannerella forsythia and Treponema denticola in overweight, Porphyromonas gingivalis and Fusobacterium nucleatum in healthy weight), thus reflecting differences in the microbiota affected by body weight. Other pathogenic bacteria, such as Salmonella enterica and Klebsiella pneumoniae, were enriched in overweight subjects with NM periodontitis, suggesting an increase in the relative abundance of pathogens even in patients with good periodontal health if they were overweight. Alpha and beta diversities were significantly different among the groups. Dysbiosis of the subgingival microbiota in obese and overweight individuals was associated with increased prevalence and severity of periodontal disease, which was correlated with the body mass index. This study highlights the immense importance of the oral microbiome and the need for lifestyle and dental interventions to resolve oral dysbiosis and restore normal homeostasis.
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Affiliation(s)
- Betul Rahman
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Farah Al-Marzooq
- Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, UAE University, Al Ain 15551, United Arab Emirates
- Correspondence:
| | - Hiba Saad
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Dalenda Benzina
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
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11
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Tashiro A, Yonetsu T, Aoyama N, Shiheido-Watanabe Y, Niida T, Miyazaki S, Maejima Y, Goya M, Isobe M, Iwata T, Sasano T. Periodontitis was associated with worse clinical outcomes after catheter ablation for paroxysmal atrial fibrillation. Front Cardiovasc Med 2023; 9:1061243. [PMID: 36698924 PMCID: PMC9868319 DOI: 10.3389/fcvm.2022.1061243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Periodontitis (PD), a common chronic inflammatory disease, may be associated with the subsequent development of atrial fibrillation (AF) through a mechanism of systemic inflammation. However, little is known about the impact of PD on the recurrence of atrial fibrillation after catheter ablation (CA). Methods A total of 132 patients (age 62.2 ± 10.6 years; 72.7% male) who underwent periodontal examinations and the first CA for paroxysmal atrial fibrillation (PAF) were investigated. Clinical periodontal examination was performed by independent trained periodontists, and patients were diagnosed with PD when the maximum periodontal probing depth was equal to or greater than 4 mm and bleeding on probing was evident. Of these, 71 patients (54%) were categorized as those with PD (PD group) and the other 61 (46%) as those without PD (non-PD group). Pulmonary vein isolation was performed in a standard fashion. Results Kaplan-Meier curve analysis revealed worse atrial arrhythmia recurrence-free survival probabilities after CA for PAF in the PD group than in the non-PD group (64.8% versus 80.3%, respectively; p = 0.024) during a median follow-up period of 3.0 (interquartile range: 1.1-6.4) years. Cox regression analysis revealed PD as a significant predictor of arrhythmia recurrence (hazard ratio: 2.063, 95% confidence interval: 1.018-4.182), after adjusting for age and gender. Conclusion Periodontitis was independently associated with an increased risk of arrhythmia recurrence after the first CA for PAF. Our results may suggest that the periodontal status is potentially a modifiable determinant of the outcomes after PAF ablation, and further prospective studies are warranted.
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Affiliation(s)
- Akira Tashiro
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan,*Correspondence: Taishi Yonetsu, ; orcid.org/0000-0002-1798-5008
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, Yokosuka, Japan
| | - Yuka Shiheido-Watanabe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Niida
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinsuke Miyazaki
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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12
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Čolak D, Cmok Kučič A, Pintar T, Gašperšič R. Periodontal Therapy in Bariatric Surgery Patients with Periodontitis: Randomized Control Clinical Trial. J Clin Med 2022; 11:jcm11226837. [PMID: 36431314 PMCID: PMC9693218 DOI: 10.3390/jcm11226837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Bariatric surgery (BS) patients may experience the progression of periodontitis during recovery. We aimed to determine whether non-surgical periodontal therapy before BS improves the periodontal and systemic health parameters after the surgery. Methods: BS candidates with periodontitis were randomized into the test (TG) and control group (CG). One month before BS (pre-BS), patients in the TG (n = 15) received non-surgical periodontal therapy, while patients in the CG (n = 15) received only mechanical plaque removal. Patients were re-examined 3 and 6 months after BS. Differences between the TG and CG in clinical periodontal parameters, systemic health-related serum biomarkers, parameters of obesity, and prevalence of obesity-related diseases were evaluated. Results: From the 30 included patients, 26 were re-examined at 3 months and 20 patients at 6 months. Periodontal parameters bleeding on probing (p = 0.015), periodontal pocket dept (PPD, p = 0.0015), % PPD > 4 mm (p < 0.001), and full-mouth plaque levels (p = 0.002) were lower in the TG than in the CG at 6 months after BS. There is a general improvement in systemic health after BS without significant differences (p > 0.05) between the TG and CG at the 6-month follow-up. The TG shows a tendency for improvement in metabolic syndrome components at the 6-month follow-up compared to pre-BS (p < 0.05). Conclusions: Non-surgical periodontal therapy in periodontitis patients before the BS may improve periodontal health 3 and 6 months after the surgery. The possible benefits of periodontal therapy on the overall health of BS patients should be further explored.
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Affiliation(s)
- Dejana Čolak
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
| | - Alja Cmok Kučič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tadeja Pintar
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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13
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Zhu L, Zhou C, Chen S, Huang D, Jiang Y, Lan Y, Zou S, Li Y. Osteoporosis and Alveolar Bone Health in Periodontitis Niche: A Predisposing Factors-Centered Review. Cells 2022; 11:3380. [PMID: 36359775 PMCID: PMC9657655 DOI: 10.3390/cells11213380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/26/2023] Open
Abstract
Periodontitis is a periodontal inflammatory condition that results from disrupted periodontal host-microbe homeostasis, manifested by the destruction of tooth-supporting structures, especially inflammatory alveolar bone loss. Osteoporosis is characterized by systemic deterioration of bone mass and microarchitecture. The roles of many systemic factors have been identified in the pathogenesis of osteoporosis, including endocrine change, metabolic disorders, health-impaired behaviors and mental stress. The prevalence rate of osteoporotic fracture is in sustained elevation in the past decades. Recent studies suggest that individuals with concomitant osteoporosis are more vulnerable to periodontal impairment. Current reviews of worse periodontal status in the context of osteoporosis are limited, mainly centering on the impacts of menopausal and diabetic osteoporosis on periodontitis. Herein, this review article makes an effort to provide a comprehensive view of the relationship between osteoporosis and periodontitis, with a focus on clarifying how those risk factors in osteoporotic populations modify the alveolar bone homeostasis in the periodontitis niche.
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Affiliation(s)
| | | | | | | | | | | | | | - Yuyu Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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14
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Zhou M, Li C, Han X, Yu B, Yan XZ, Zhang Y, Yang XJ. Lipidomic analysis reveals altered lipid profiles of gingival tissues with periodontitis. J Clin Periodontol 2022; 49:1192-1202. [PMID: 35924763 DOI: 10.1111/jcpe.13710] [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: 09/23/2021] [Revised: 06/09/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
AIM The role of lipids in periodontitis has not been well studied. Thus, this study aimed to explore periodontitis-associated lipid profile changes and identify differentially expressed lipid metabolites in gingival tissues. MATERIALS AND METHODS Gingival tissues from 38 patients with periodontitis (periodontitis group) and 38 periodontally healthy individuals (control group) were collected. A UHPLC-QTOF-MS-based non-targeted metabolomics platform was used to identify and compare the lipid profiles of the two groups. The distribution and expression of related proteins were subsequently analyzed via immunohistochemistry to further validate the identified lipids. RESULTS Lipid profiles significantly differed between the two groups, and 20 differentially expressed lipid species were identified. Lysophosphatidylcholines (lysoPCs), diacylglycerols (DGs), and phosphatidylethanolamines (PEs) were significantly upregulated, while triacylglycerols (TGs) were downregulated in the periodontitis group. Moreover, the staining intensity of ABHD5/CGI-58, secretory phospholipase A2 (sPLA2), and sPLA2-IIA was significantly stronger in the gingival tissues of patients with periodontitis than in those of healthy controls. CONCLUSIONS LysoPCs, DGs, and PEs were significantly upregulated, whereas TGs were downregulated in gingival tissues of patients with periodontitis. Correspondingly, the immunohistochemical staining of ABHD5/CGI-58, sPLA2, and sPLA2-IIA in gingival tissues was consistent with the downstream production of lipid classes (lysoPCs, TGs, and DGs).
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Affiliation(s)
- Min Zhou
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Chen Li
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xue Han
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Bohan Yu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xiang-Zhen Yan
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yan Zhang
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xiao-Juan Yang
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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15
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Herrera D, Sanz M, Kebschull M, Jepsen S, Sculean A, Berglundh T, Papapanou PN, Chapple I, Tonetti MS. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol 2022; 49 Suppl 24:4-71. [PMID: 35688447 DOI: 10.1111/jcpe.13639] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND The recently published clinical practice guideline (CPG) for the treatment of periodontitis in stages I-III provided evidence-based recommendations for the treatment of periodontitis patients, defined according to the 2018 classification. Stage IV periodontitis shares the severity and complexity characteristics of stage III periodontitis, but includes the anatomical and functional sequelae of tooth and periodontal attachment loss (tooth flaring and drifting, bite collapse, etc.), which require additional interventions following completion of active periodontal therapy. AIM To develop an S3 Level CPG for the treatment of stage IV periodontitis, focusing on the implementation of inter-disciplinary treatment approaches required to treat/rehabilitate patients following associated sequelae and tooth loss. MATERIALS AND METHODS This S3 Level CPG was developed by the European Federation of Periodontology (EFP), following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and a structured consensus process with leading experts and a broad base of stakeholders. RESULTS The S3 Level CPG for the treatment of stage IV periodontitis culminated in recommendations for different interventions, including orthodontic tooth movement, tooth splinting, occlusal adjustment, tooth- or implant-supported fixed or removable dental prostheses and supportive periodontal care. Prior to treatment planning, it is critically important to undertake a definitive and comprehensive diagnosis and case evaluation, obtain relevant patient information, and engage in frequent re-evaluations during and after treatment. The periodontal component of therapy should follow the CPG for the treatment of periodontitis in stages I-III. CONCLUSIONS The present S3 Level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat patients with stage IV periodontitis and to maintain a healthy dentition over lifetime, according to the available evidence at the time of publication.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.,Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Centre for Oral Diseases, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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Czerniuk MR, Surma S, Romańczyk M, Nowak JM, Wojtowicz A, Filipiak KJ. Unexpected Relationships: Periodontal Diseases: Atherosclerosis-Plaque Destabilization? From the Teeth to a Coronary Event. BIOLOGY 2022; 11:biology11020272. [PMID: 35205138 PMCID: PMC8869674 DOI: 10.3390/biology11020272] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 02/06/2023]
Abstract
Simple Summary Periodontal disease and atherosclerotic cardiovascular disease are very common around the world. Coronary artery disease is the leading cause of death. The main factor involved in the pathogenesis of atherosclerosis is inflammation. Therefore, a number of studies have indicated that periodontal disease (causes chronic inflammation) is a risk factor for the progression of atherosclerosis. The presence of periodontal pathogens has been found in human atherosclerotic plaques. A number of pathomechanisms have been demonstrated, thanks to which periodontal pathogens, especially Porphyromonas gingivalis, can directly increase the progression of atherosclerosis and the risk of cardiovascular disease. Observational studies found that patients with periodontal disease were at higher risk of developing atherosclerotic cardiovascular disease. Moreover, periodontal treatment leads to a reduction in cardiovascular risk therefore taking care of oral hygiene should be an important cardiovascular disease preventive measure. Abstract Atherosclerotic cardiovascular disease (ASCVD) and periodontal disease (PD) are global health problems. High frequency of ASCVD is associated with the spread of many risk factors, including poor diet, sedentary lifestyle, diabetes, hyperlipidemia, obesity, smoking, hypertension, chronic kidney disease, hypertension, hyperhomocysteinemia, hyperuricemia, excessive stress, virus infection, genetic predisposition, etc. The pathogenesis of ASCVD is complex, while inflammation plays an important role. PD is a chronic, multifactorial inflammatory disease caused by dysbiosis of the oral microbiota, causing the progressive destruction of the bone and periodontal tissues surrounding the teeth. The main etiological factor of PD is the bacteria, which are capable of activating the immune response of the host inducing an inflammatory response. PD is associated with a mixed microbiota, with the evident predominance of anaerobic bacteria and microaerophilic. The “red complex” is an aggregate of three oral bacteria: Tannerella forsythia Treponema denticola and Porphyromonas gingivalis responsible for severe clinical manifestation of PD. ASCVD and PD share a number of risk factors, and it is difficult to establish a causal relationship between these diseases. The influence of PD on ASCVD should be treated as a factor increasing the risk of atherosclerotic plaque destabilization and cardiovascular events. The results of observational studies indicate that PD significantly increases the risk of ASCVD. In interventional studies, PD treatment was found to have a beneficial effect in the prevention and control of ASCVD. This comprehensive review summarizes the current knowledge of the relationship between PD and ASCVD.
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Affiliation(s)
- Maciej R. Czerniuk
- Department of Dental Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.R.C.); (J.M.N.); (A.W.)
| | - Stanisław Surma
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
- Correspondence: ; Tel.: +48-32-208-83-00
| | - Monika Romańczyk
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Jacek M. Nowak
- Department of Dental Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.R.C.); (J.M.N.); (A.W.)
| | - Andrzej Wojtowicz
- Department of Dental Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.R.C.); (J.M.N.); (A.W.)
| | - Krzysztof J. Filipiak
- Department of Clinical Sciences, Maria-Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland;
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17
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Zhou M, Dong J, Zha L, Liao Y. Causal Association between Periodontal Diseases and Cardiovascular Diseases. Genes (Basel) 2021; 13:genes13010013. [PMID: 35052354 PMCID: PMC8775300 DOI: 10.3390/genes13010013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 12/17/2022] Open
Abstract
Observational studies have revealed that dental diseases such as periodontitis and dental caries increase the risk of cardiovascular diseases (CVDs). However, the causality between periodontal disease (PD) and CVDs is still not clarified. In the present study, two-sample Mendelian randomization (MR) studies were carried out to assess the association between genetic liability for periodontal diseases (dental caries and periodontitis) and major CVDs, including coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke—including ischemic stroke as well as its three main subtypes—based on large-scale genome-wide association studies (GWASs). Our two-sample MR analyses did not provide evidence for dental caries and periodontitis as the causes of cardiovascular diseases; sensitivity analyses, including MR–Egger analysis and weighted median analysis, also supported this result. Gene functional annotation and pathway enrichment analyses indicated the common pathophysiology between cardiovascular diseases and periodontal diseases. The associations from observational studies may be explained by shared risk factors and comorbidities instead of direct consequences. This also suggests that addressing the common risk factors—such as reducing obesity and improving glucose tolerance—could benefit both conditions.
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Affiliation(s)
- Mengchen Zhou
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
| | - Jiangtao Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
| | - Lingfeng Zha
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
- Correspondence: (L.Z.); (Y.L.); Tel.: +86-27-85726011 (L.Z. & Y.L.)
| | - Yuhua Liao
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
- Key Lab of Molecular Biological Targeted Therapies of the Ministry of Education, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Correspondence: (L.Z.); (Y.L.); Tel.: +86-27-85726011 (L.Z. & Y.L.)
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18
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Orlandi M, Muñoz Aguilera E, Marletta D, Petrie A, Suvan J, D'Aiuto F. Impact of the treatment of periodontitis on systemic health and quality of life: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:314-327. [PMID: 34791686 DOI: 10.1111/jcpe.13554] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022]
Abstract
AIM To investigate the effect of treatment of periodontitis on systemic health outcomes, pregnancy complications, and associated quality of life. MATERIALS AND METHODS Systematic electronic searches were conducted to identify randomized controlled trials with minimum 6-month follow-up and reporting on the outcomes of interest. Qualitative and quantitative analyses were performed as deemed suitable. RESULTS Meta-analyses confirmed reductions of high-sensitivity C-reactive protein (hs-CRP) [0.56 mg/L, 95% confidence interval (CI) (-0.88, -0.25), p < .001]; interleukin (IL)-6 [0.48 pg/ml, 95% CI (-0.88, -0.08), p = .020], and plasma glucose [1.33 mmol/l, 95% CI (-2.41, -0.24), p = .016], and increase of flow-mediated dilation (FMD) [0.31%, 95% CI (0.07, 0.55), p = .012] and diastolic blood pressure [0.29 mmHg, 95% CI (0.10, 0.49), p = .003] 6 months after the treatment of periodontitis. A significant effect on preterm deliveries (<37 weeks) was observed [0.77 risk ratio, 95% CI (0.60, 0.98), p = .036]. Limited evidence was reported on quality-of-life (QoL) outcomes in the included studies. CONCLUSIONS Treatment of periodontitis results in systemic health improvements including improvement in cardiometabolic risk, reduction in systemic inflammation and the occurrence of preterm deliveries. Further research is however warranted to confirm whether these changes are sustained over time. Further, appropriate QoL outcomes should be included in the study designs of future clinical trials.
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Affiliation(s)
- Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | | | | | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - Jean Suvan
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
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19
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Periodontal and Peri-Implant Diseases and Systemically Administered Statins: A Systematic Review. Dent J (Basel) 2021; 9:dj9090100. [PMID: 34562974 PMCID: PMC8466038 DOI: 10.3390/dj9090100] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/29/2021] [Accepted: 09/02/2021] [Indexed: 12/14/2022] Open
Abstract
Hyperlipidemia is a well-recognized risk factor for cardiovascular disease, which, in turn, acts as a contributory factor in periodontitis development. Periodontitis has been associated with benign tumors and cancers and withseveral disorders, including hyperlipidemia. Correspondingly, periodontal treatment may exert a positive effect on lipid metabolism, although opposite evidence has also been reported. As a counterpart, the therapy for hyperlipidemia, conventionally based on statins, has been proposed to positively affect periodontal conditions, mainly due to statin pleiotropic effects, reducing periodontal inflammation and promoting osseointegration. Therefore, the present systematic review aimed to evaluate, in subjects with untreated periodontitis and peri-implant disease (Population), the effect of routine systemically administered statins (Intervention), compared to non-statin use (Comparison), on periodontal parameters around natural teeth and implants (Outcome). Discordant results were found in periodontal parameters, and the current lack of such data related to peri-implant tissues and to alveolar bone loss highlights the need for further studies on the topic, potentially paving the way for a more comprehensive approach to periodontitis and peri-implantitis management. Indeed, the validation of the beneficial effect provided by systemically delivered statins on periodontal and peri-implant tissues may direct recall scheduling, predict response to therapy and, therefore, guide treatment strategies of periodontal and peri-implant treatments in statin users.
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20
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Brun A, Nuzzo A, Prouvost B, Diallo D, Hamdan S, Meseguer E, Guidoux C, Lavallée P, Amarenco P, Lesèche G, Bouchard P, Michel JB, Rangé H. Oral microbiota and atherothrombotic carotid plaque vulnerability in periodontitis patients. A cross-sectional study. J Periodontal Res 2020; 56:339-350. [PMID: 33368263 DOI: 10.1111/jre.12826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 09/13/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND An increased risk of atherothrombotic vascular events has been reported in periodontitis patients. Periodontitis is associated with dysbiotic subgingival biofilms and bacteremia. OBJECTIVE We hypothesized (a) that the oral microbiome is associated with the carotid microbiome and (b) that periodontitis could contribute to plaque vulnerability. The aim of this study was to determine the associations between periodontitis, the carotid microbiome, and the local innate immune response in carotid atherothrombotic plaques vulnerable to rupture. METHODS In this cross-sectional study, 45 patients admitted for carotid endarterectomy underwent a preoperative periodontal examination. The volume of intraplaque hemorrhage reflected by the hemoglobin level released in carotid-conditioned media was considered as a criterion of carotid plaque vulnerability. Levels of antibodies against periodontal bacteria were determined in sera. The signature of the oral microbiota was assessed by microbial whole-genome sequencing, nested PCR, and immunostaining in carotid plaque samples. Markers of neutrophil recruitment (leukotriene B4), neutrophil activation (myeloperoxidase, defensins), and cytokines were measured in carotid-conditioned media and/or plasma. RESULTS All patients exhibited periodontitis. One hundred and forty-four bacterial genera were detected in the carotid microbiome. While Streptococcus was found in 84% of the carotid samples, periodontitis-associated genera were detected in 21%. P. gingivalis DNA and gingipains were also identified in carotid samples. There were significant inverse correlations between periodontal attachment loss/serum anti-P. gingivalis Immunoglobulin A and cytokine inhibiting neutrophils (all P < .01). There were also significant positive correlations between lipopolysaccharides, myeloperoxidase/human neutrophil peptides1-3, and hemoglobin levels (all P < .01). CONCLUSIONS In patients at risk of stroke, the carotid plaque microbiome was highly diverse and compatible with an oral origin. Periodontitis was significantly associated with neutrophil activation markers and plaque vulnerability to rupture.
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Affiliation(s)
- Adrian Brun
- Department of Periodontology, Faculty of Dental Surgery Montrouge, Université de Paris, Montrouge, France.,Division of Periodontology, Department of Oral Medicine, AP-HP, Henri Mondor Hospital, Créteil, France.,Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Alexandre Nuzzo
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Gastroenterology, Faculty of Medicine Xavier Bichat-Beaujon, Université de Paris, Clichy, France.,IBD and Intestinal Failure Unit, Department of Gastroenterology, APHP, Beaujon Hospital, Paris, France
| | - Bastien Prouvost
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France
| | - Devy Diallo
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Sandrella Hamdan
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Elena Meseguer
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Céline Guidoux
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Philippa Lavallée
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Pierre Amarenco
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Guy Lesèche
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Vascular Surgery, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Vascular Surgery, APHP, Bichat Hospital, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France.,Division of Periodontology, Department of Odontology, APHP, Rothschild Hospital, Paris, France.,Orofacial Pathologies, Imaging and Biotherapies laboratory, UR2496, Université de Paris, Montrouge, France
| | | | - Hélène Rangé
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France.,Division of Periodontology, Department of Odontology, APHP, Rothschild Hospital, Paris, France.,Orofacial Pathologies, Imaging and Biotherapies laboratory, UR2496, Université de Paris, Montrouge, France
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21
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Huang Y, Liao Y, Luo B, Li L, Zhang Y, Yan F. Non-surgical Periodontal Treatment Restored the Gut Microbiota and Intestinal Barrier in Apolipoprotein E -/- Mice With Periodontitis. Front Cell Infect Microbiol 2020; 10:498. [PMID: 33072621 PMCID: PMC7536370 DOI: 10.3389/fcimb.2020.00498] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Periodontitis has been associated with a variety of systematic diseases via affecting gut microbiota. However, the influence of periodontal treatment on intestinal microbiota is not known. Hyperlipidemia can significantly alter gut microbiota structure. It is proposed that the presence of hyperlipidemia can influence the impact of periodontitis on microbiota. This study was conducted to explore the influence of periodontitis and periodontal treatment on the gut microbiota on the basis of hyperlipidemia. Apolipoprotein E-/-(ApoE-/-) mice were ligatured to induced periodontitis and non-surgical periodontal treatment was performed for half of them after 4 weeks of ligation. Microbiota communities in the feces collected at 4, 5, 8 weeks after ligation were investigated using next-generation sequencing of 16S rDNA. Bone loss at periodontitis sites were analyzed using micro-computed tomography (Micro-CT). Morphology and mucosal architecture injury of ileum tissue were observed with hematoxylin-eosin staining. The serum lipid levels were assayed. The results showed that β-diversity index in experimental periodontitis group was differed significantly from that of the control group. Significant differences were found in β-diversity between the non-surgical periodontal treatment group and the ligation group. The samples of the non-surgical periodontal treatment group and the control group were clustered together 4 weeks after periodontal treatment. Intestinal villus height and ratio of villus height to crypt depth was found decreased after ligation and restored after non-surgical periodontal treatment. Non-surgical periodontal treatment induced the colonization and prosper of butyrate-producing bacteria Eubacterium, which was absent/not present in the ligation group. We confirmed that periodontitis led to gut microbiota dysbiosis in mice with hyperlipidemia. Non-surgical periodontal treatment had the trend to normalize the gut microbiota and improved the intestinal mucosal barrier impaired by periodontitis in apoE-/- mice.
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Affiliation(s)
- Yuezhen Huang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ying Liao
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Binyan Luo
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lili Li
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yangheng Zhang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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22
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Orlandi M, Graziani F, D'Aiuto F. Periodontal therapy and cardiovascular risk. Periodontol 2000 2020; 83:107-124. [PMID: 32385887 DOI: 10.1111/prd.12299] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are the worldwide leading cause of mortality. Cardiovascular diseases are noncommunicable conditions with a complex pathogenesis, and their clinical manifestations include major cardiovascular events such as myocardial infarction and stroke. Epidemiologic evidence suggests a consistent association between periodontitis and increased risk of cardiovascular diseases. Some evidence supports a beneficial effect of the treatment of periodontitis on both surrogate and hard cardiovascular outcomes. This narrative review has been conducted as an update of the most recent evidence on the effects of periodontitis treatment on cardiovascular outcomes since the last commissioned review of the European Federation of Periodontology-American Academy of Periodontology World Workshop in 2012. Newer evidence originating from published randomized controlled trials confirms a positive effect of periodontal treatment on surrogate measures of cardiovascular diseases, whereas there have been no randomized controlled trials investigating the effect of periodontal treatment on the incidence of cardiovascular disease events such as myocardial infarction and stroke. In conclusion, there is sufficient evidence from observational and experimental studies on surrogate cardiovascular measures to justify the design and conduct of appropriately powered randomized controlled trials investigating the effect of effective periodontal interventions on cardiovascular disease outcomes (ie, myocardial infarction and stroke) with adequate control of traditional cardiovascular risk factors.
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Affiliation(s)
- Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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23
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Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study. J Clin Med 2020; 9:jcm9072117. [PMID: 32635585 PMCID: PMC7408850 DOI: 10.3390/jcm9072117] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022] Open
Abstract
Aim: The primary objective of this pilot study was to evaluate the effect of non-surgical periodontal treatment. The secondary aim was to evaluate the effect of dietary therapy on both parameters of oxidative stress in leukocytes and leukocyte-endothelial cell interactions in an obese population. Methods: This was a pilot study with a before-and-after design. Forty-nine obese subjects with periodontitis were randomized by means of the minimization method and assigned to one of two groups, one of which underwent dietary therapy while the other did not. All the subjects underwent non-surgical periodontal treatment. We determined periodontal, inflammatory and oxidative stress parameters—total reactive oxygen species (ROS), superoxide production, intracellular Ca2+, mitochondrial membrane potential and superoxide dismutase (SOD) activity. We also evaluated interactions between leukocytes and endothelium cells—velocity, rolling flux and adhesion—at baseline and 12 weeks after intervention. Results: Periodontal treatment improved the periodontal health of all the patients, with a reduction in serum retinol-binding protein 4 (RBP4), total superoxide production and cytosolic Ca2+ in leukocytes. In the patients undergoing dietary therapy, there were less leukocyte adhesion to the endothelium, an effect that was accompanied by a decrease in TNFα, P-selectin and total ROS and an increase in SOD activity. Conclusions: Whereas non-surgical periodontal treatment induces an improvement in leukocyte homeostasis, dietary therapy as an adjuvant reduces systemic inflammation and increases antioxidant status which, in turn, modulates leukocyte-endothelium dynamics.
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24
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Shaqman M, Al-Abedalla K, Wagner J, Swede H, Gunsolley JC, Ioannidou E. Reporting quality and spin in abstracts of randomized clinical trials of periodontal therapy and cardiovascular disease outcomes. PLoS One 2020; 15:e0230843. [PMID: 32302309 PMCID: PMC7164582 DOI: 10.1371/journal.pone.0230843] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Poor reporting in randomized clinical trial (RCT) abstracts reduces quality and misinforms readers. Spin, a biased presentation of findings, could frequently mislead clinicians to accept a clinical intervention despite non-significant primary outcome. Therefore, good reporting practices and absence of spin enhances research quality. We aim to assess the reporting quality and spin in abstracts of RCTs evaluating the effect of periodontal therapy on cardiovascular (CVD) outcomes. METHODS PubMed, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and 17 trial registration platforms were searched. Cohort, non-randomized, non-English studies, and pediatric studies were excluded. RCT abstracts were reviewed by 2 authors using the CONSORT for abstracts and spin checklists for data extraction. Cohen's Kappa statistic was used to assess inter-rater agreement. Data on the selected RCT publication metrics were collected. Descriptive analysis was performed with non-parametric methods. Correlation analysis between quality, spin and bibliometric parameters was conducted. RESULTS 24 RCTs were selected for CONSORT analysis and 14 fulfilled the criteria for spin analysis. Several important RCT elements per CONSORT were neglected in the abstract including description of the study population (100%), explicitly stated primary outcome (87%), methods of randomization and blinding (100%), trial registration (87%). No RCT examined true outcomes (CVD events). A significant fraction of the abstracts appeared with at least one form of spin in the results and conclusions (86%) and claimed some treatment benefit in spite of non-significant primary outcome (64%). High-quality reporting had a significant positive correlation with reporting of trial registration (p = 0.04) and funding (p = 0.009). Spinning showed marginal negative correlation with reporting quality (p = 0.059). CONCLUSION Poor adherence to the CONSORT guidelines and high levels of data spin were found in abstracts of RCTs exploring the effects of periodontal therapy on CVD outcomes. Our findings indicate that journal editors and reviewers should consider strict adherence to proper reporting guidelines to improve reporting quality and reduce waste.
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Affiliation(s)
- Murad Shaqman
- Department of Oral Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Khadijeh Al-Abedalla
- Division of Periodontology, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
| | - Julie Wagner
- Division of Behavioral Science, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
| | - Helen Swede
- Department of Community Medicine, School of Medicine, UCONN Health, Farmington, CT, United States of America
| | - John Cart Gunsolley
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Effie Ioannidou
- Division of Periodontology, School of Dental Medicine, UCONN Health, Farmington, CT, United States of America
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25
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Sanz M, Marco del Castillo A, Jepsen S, Gonzalez‐Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel J, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol 2020; 47:268-288. [PMID: 32011025 PMCID: PMC7027895 DOI: 10.1111/jcpe.13189] [Citation(s) in RCA: 594] [Impact Index Per Article: 148.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. MATERIAL AND METHODS There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of BonnBonnGermany
| | - Jose R. Gonzalez‐Juanatey
- Cardiology DepartmentUniversity HospitalIDISCIBERCVUniverity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Francesco D’Aiuto
- Department of PeriodontologyEastman Dental Institute and HospitalUniversity College LondonLondonUK
| | - Philippe Bouchard
- U.F.R. d'odontologieUniversité Paris DiderotHôpital Rothschild AP‐HPParisFrance
| | - Iain Chapple
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Thomas Dietrich
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Israel Gotsman
- Heart InstituteHadassah University HospitalJerusalemIsrael
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
| | - David Herrera
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Phoebus Madianos
- Department of PeriodontologySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Jean‐Baptiste Michel
- Inserm Unit 1148Laboratory for Translational CV ScienceX. Bichat HospitalParisFrance
| | - Pablo Perel
- World Heart FederationGenevaSwitzerland
- Centre for Global Chronic ConditionsLondon School of Hygiene & Tropical MedicineLondonUK
| | - Burkert Pieske
- Department of Internal Medicin & CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- DZHK (German Center for Cardiovascular Research) Partnersite BerlinGerman Heart Institut BerlinBerlinGermany
| | - Lior Shapira
- Department of PeriodontologyHebrew University – Hadassah Faculty of Dental MedicineJerusalemIsrael
| | - Michael Shechter
- Leviev Heart CenterChaim Sheba Medical Centertel Hashomer and the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv‐YafoIsrael
| | - Maurizio Tonetti
- Department of PeriodontologyPrince Philip Dental HospitalThe University of Hong KongHong KongHong Kong
| | | | - Gernot Wimmer
- Department of Prosthetic DentistrySchool of Dental MedicineKarl‐Franzens University GrazGrazAustria
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26
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Sanz M, del Castillo AM, Jepsen S, Gonzalez-Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and Cardiovascular Diseases. Consensus Report. Glob Heart 2020; 15:1. [PMID: 32489774 PMCID: PMC7218770 DOI: 10.5334/gh.400] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. Material and Methods There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations. Results and Conclusions The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- M. Sanz
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | | | - S. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, DE
| | - J. R. Gonzalez-Juanatey
- Cardiology Department, University Hospital, University of Santiago de Compostela, IDIS, CIBERCV, ES
| | - F. D’Aiuto
- Department of Periodontology, Eastman Dental Institute and Hospital, University College London, London, UK
| | - P. Bouchard
- U.F.R. d’odontologie, Université Paris Diderot, Hôpital Rothschild AP-HP, Paris, FR
| | - I. Chapple
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - T. Dietrich
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - I. Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem, IL
| | - F. Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, IT
| | - D. Herrera
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | - B. Loos
- ACTA University, Amsterdam, NL
| | - P. Madianos
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, GR
| | - J. B. Michel
- Inserm Unit 1148, laboratory for translational CV science, X. Bichat hospital, Paris, FR
| | - P. Perel
- World Heart Federation, Geneva, CH
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, UK
| | - B. Pieske
- Charité Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Berlin, DE
- DZHK (German Center for Cardiovascular Research) Partnersite Berlin, German Heart Institut Berlin, DE
| | - L. Shapira
- Department of Periodontology, Hebrew University – Hadassah Faculty of Dental Medicine, Jerusalem, IL
| | - M. Shechter
- Leviev Heart Center, Chaim Sheba Medical Center, tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, IL
| | - M. Tonetti
- Department of Periodontology, The University of Hong Kong, Prince Philip Dental Hospital, HK
| | - C. Vlachopoulos
- Department of Cardiology, National and Kapodistrian University of Athens, GR
| | - G. Wimmer
- Department of Prosthetic Dentistry, School of Dental Medicine, Karl-Franzens University Graz, AT
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27
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Abraham S, Premnath A, Arunima PR, Kassim RM. Critical Appraisal of Bidirectional Relationship between Periodontitis and Hyperlipidemia. J Int Soc Prev Community Dent 2019; 9:112-118. [PMID: 31058060 PMCID: PMC6489519 DOI: 10.4103/jispcd.jispcd_316_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease and hyperlipidemia are both multifactorial disease with a high prevalence Worldwide. Cross-sectional and longitudinal prospective clinical studies show some evidence for a bidirectional relationship. Periodontitis and hyperlipidemia share some common risk factors and there exist a mechanistic link between both. Studies have found a positive response to periodontal therapy among hyperlipidemic patients, and statin use by hyperlipidemic patients has shown to influence the periodontal health. However, in spite of the rising prevalence of both diseases, many people remain unaware of their association with each other. Hence, this article summarizes the cyclic relationship between periodontal disease and hyperlipidemia.
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Affiliation(s)
- Seba Abraham
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Arya Premnath
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - P. R. Arunima
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Reejamol Mohammed Kassim
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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28
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Moeintaghavi A, Arab HR, Moghaddam MA, Shahmohammadi R, Bardan BY, Soroush Z. Evaluation of Effect of Surgical and Nonsurgical Periodontal Therapy on Serum C-Reactive Protein, Triglyceride, Cholesterol, Serum Lipoproteins and Fasting Blood Sugar in Patients with Severe Chronic Periodontitis. Open Dent J 2019. [DOI: 10.2174/1874210601913010015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background:Cardiovascular disease has been associated with multiple risk factors such as dyslipidemia. However, the focus has recently shifted towards some novel risk factorsi.e. infection from periodontitis.Given this background, we aimed to assess the effect of periodontal therapy on some CVD risk factors including Total Cholesterol (TC), Low-Density Lipoprotein(LDL), High-Density Lipoprotein(HDL), Triglycerides(TG) and C-Reactive Protein (CRP). Fasting Blood Sugar (FBS) level has also been measured.Methods:Thirty patients (12 male and 18 female) who had severe periodontitis were tested for different blood parameters; namely Total Cholesterol (TC), Low-Density Lipoprotein (LDL), High-Density Lipoprotein(HDL), Triglycerides (TGs), C-Reactive Protein (CRP) and Fasting Blood Sugar (FBS). Enzymatic colorimetric methods were applied to measure all the parameters’ values except for CRP. The first stage of periodontal treatment comprised oral hygiene instruction as well as scaling and root planing. After 1 month, at the next stage, open flap debridement surgery was performed on all 4 quadrants of the mouth. The blood parameters were reassessed and compared with the baseline values after 3 months. Two patients (female) failed to participate in the follow-ups. The Pearson's and Spearman's correlation coefficients were calculated to determine whether changes in laboratory variables are associated with age and average probing depth or not.Results:All the assessed parameters related to 28 patients showed mean reduction which proved to be significant for CRP (p=0.011) and cholesterol (p=0.035). Among all parameters, only CRP level was found to have a significant positive correlation with pocket depth. Other blood parameters' relationship with age and probing depth proved to be insignificant.Conclusion:Considering the results, periodontal treatment may significantly lower lipid profile serum levels and some inflammatory factors.
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29
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Lee JH, Jeong SN, Choi SH. Predictive data mining for diagnosing periodontal disease: the Korea National Health and Nutrition Examination Surveys (KNHANES V and VI) from 2010 to 2015. J Public Health Dent 2018; 79:44-52. [PMID: 30468241 DOI: 10.1111/jphd.12293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/17/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study aimed to identify patients with the highest risk of periodontal disease (PD), and to provide recommendations for the effective use and application of data mining (DM) techniques when establishing evidence-based dental-care policies for vulnerable groups at a high risk of PD. METHODS This study used the SEMMA (Sample, Explore, Modify, Model, and Assess) methodology to construct DM models based on data acquired from the fifth and sixth Korea National Health and Nutrition Examination Surveys (2000-2015). We analyzed the sociodemographic and comorbidity variables that influence PD by applying the popular DM techniques of decision-tree, neural-network, and regression models, and also attempted to improve the predictive power and reliability by comparing the results obtained by these three models. RESULTS Our comparisons of the three DM algorithms confirmed that the average squared error, misclassification rate, receiver operating characteristic index, Gini coefficient, and Kolmogorov-Smirnov test results were the most appropriate for the decision-tree model. The analysis of the decision-tree model revealed that age and smoking status exert major effects on the risk of PD, and that stress and education level exert effects in rural areas, whereas education level, sex, hyperlipidemia, and alcohol intake exert effects in urban areas. CONCLUSIONS We demonstrated that the decision-tree model is an effective DM technique for identifying the complex risk factors for PD. These results are expected to be helpful in improving the equality and efficacy of dental-care policies for vulnerable groups at a high risk of PD.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Hong R, Wang Z, Sui A, Liu X, Fan C, Lipkind S, Xu Q. Gingival mesenchymal stem cells attenuate pro-inflammatory macrophages stimulated with oxidized low-density lipoprotein and modulate lipid metabolism. Arch Oral Biol 2018; 98:92-98. [PMID: 30468993 DOI: 10.1016/j.archoralbio.2018.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the effects of gingival mesenchymal stem cells (GMSCs) on inflammatory macrophages upon oxidized low-density lipoprotein (ox-LDL) stimulation and evaluate therapeutic potential of GMSCs on mouse model of periodontitis associated with hyperlipidemia. METHODS in vitro, GMSCs were co-cultured with macrophages for 48 h in the absence or presence of M1 polarizing conditions and oxidized low-density lipoprotein in the transwell system. The supernatants were collected for ELISA. M1 and M2 markers of macrophages were analyzed by flow cytometry and PCR, and lipid accumulation was assessed by oil red O staining. in vivo, eighteen mice were divided into three groups (n = 6): Group A (periodontally healthy mice as control), Group B (periodontitis mice with hyperlipidemia), Group C (periodontitis mice with hyperlipidemia with the transplantation of GMSCs). The serum levels of cholesterol and inflammatory factors were measured by automatic analyzer. Bone regeneration was evaluated by Masson staining. RESULTS When co-cultured with GMSCs, the M1 markers of Tumor Necrosis Factor (TNF) -α, Interleukin (IL) -6, Interleukin (IL) -1β, CD86, and Human Leukocyte Antigen (HLA) -DR were significantly reduced. In contrast, M2 markers such as Interleukin(IL) -10 and CD206 were moderately increased. Similar results were obtained in the cell culture supernatants. In animal experiment, GMSCs suppressed the expression of sterol regulatory element binding transcription factor 1c (SREBP-1c) and elevated the levels of peroxisome proliferator-activated receptor alpha (PPARα) and peroxisome proliferator activator receptor- coactivator 1(PGC-1α) in the liver, attenuated cholesterol dysfunction via the downregulation of low-density lipoprotein (LDL) and total cholesterol (TC), and the upregulation of high-density lipoprotein (HDL), and decreased the levels of TNF-α and IL-6. Moreover, GMSC treatment improved bone regeneration. CONCLUSION GMSCs inhibit the activation of M1 macrophages, regulate lipid metabolism and reduce inflammatory response, and promote bone regeneration in mouse model of periodontitis associated with hyperlipidemia.
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Affiliation(s)
- Rundan Hong
- Department of Stomatology, Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Zhiguo Wang
- Department of Burn and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Aihua Sui
- Department of the Key Lab, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaoxuan Liu
- Department of Stomatology, Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong, China; Department of Stomatology, Yidu Central Hospital of Weifang, 4138 Linglong Mountain South Road, Qingzhou, 262500, Shandong, China
| | - Chun Fan
- Department of Stomatology, Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Sofya Lipkind
- Department of Molecular and Cellular Biology, University of California, Davis, California, United States
| | - Quanchen Xu
- Department of Stomatology, Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, 16 Jiangsu Road, Qingdao, 266003, Shandong, China.
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Naiff P, Carneiro V, Guimarães MDC. Importance of Mechanical Periodontal Therapy in Patients with Diabetes Type 2 and Periodontitis. Int J Dent 2018; 2018:6924631. [PMID: 30356347 PMCID: PMC6176290 DOI: 10.1155/2018/6924631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/29/2018] [Indexed: 11/17/2022] Open
Abstract
Periodontitis is an infectious and inflammatory disease of high prevalence worldwide and constitutes a significant oral health problem. It can lead to tooth loss. In addition, the local inflammatory process can cause the release of inflammatory mediators in the bloodstream and, consequently, contribute to the emergence of systemic effects as cardiovascular and diabetic complications. The purpose of this mini review is to alert health professionals about the risk that periodontitis represents for the onset or exacerbation of complications in individuals with type 2 diabetes mellitus and to emphasize that the mechanical treatment of periodontal disease and reestablishment of oral health are essential for the metabolic control of these patients. The periodontal therapy may help to reduce the risk of systemic complications in diabetes patients. Proper dental management should be suggested by health professionals, mainly from physicians to their patients, in order to improve the health conditions in these individuals.
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Affiliation(s)
- Priscilla Naiff
- Ph.D. Student, Faculty of Health Sciences, University of Brasilia, Distrito Federal, Brazil
| | - Valéria Carneiro
- Ph.D. Professor at Periodontics Division, University of Brasilia, Distrito Federal, Brazil
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Di Profio B, Villar CC, Saraiva L, Ortega KL, Pannuti CM. Is periodontitis a risk factor for infections in cirrhotic patients? Med Hypotheses 2017; 106:19-22. [PMID: 28818265 DOI: 10.1016/j.mehy.2017.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/09/2017] [Accepted: 06/26/2017] [Indexed: 02/08/2023]
Affiliation(s)
- B Di Profio
- Department of Estomatology, School of Dentistry, University of São Paulo, Brazil
| | - C C Villar
- Department of Estomatology, School of Dentistry, University of São Paulo, Brazil
| | - L Saraiva
- Department of Estomatology, School of Dentistry, University of São Paulo, Brazil
| | - K L Ortega
- Department of Estomatology, School of Dentistry, University of São Paulo, Brazil
| | - C M Pannuti
- Department of Estomatology, School of Dentistry, University of São Paulo, Brazil.
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França LFC, Vasconcelos ACCG, da Silva FRP, Alves EHP, Carvalho JS, Lenardo DD, de Souza LKM, Barbosa ALR, Medeiros JVR, de Oliveira JS, Vasconcelos DFP. Periodontitis changes renal structures by oxidative stress and lipid peroxidation. J Clin Periodontol 2017; 44:568-576. [DOI: 10.1111/jcpe.12729] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Luiz Felipe C. França
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Any Carolina C. G. Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
- Medicine School; Education Institute of Parnaiba Valley (IESVAP); Parnaiba PI Brazil
| | - Felipe R. P. da Silva
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Even H. P. Alves
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Joaquina S. Carvalho
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - David D. Lenardo
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Luan K. M. de Souza
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - André L. R. Barbosa
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - Jand-Venes R. Medeiros
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - Jefferson S. de Oliveira
- Laboratory of Biology and Biochemistry Plants (BIOqPLANT); Federal University of Piauí; Parnaíba PI Brazil
| | - Daniel F. P. Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
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dos Santos Carvalho J, Cardoso Guimarães Vasconcelos AC, Herlany Pereira Alves E, dos Santos Carvalho A, da Silva FRP, de Carvalho França LF, de Pádua Rocha Nóbrega Neto A, Di Lenardo D, de Souza LKM, Barbosa ALDR, Medeiros JVR, de Oliveira JS, Vasconcelos DFP. Steatosis caused by experimental periodontitis is reversible after removal of ligature in rats. J Periodontal Res 2017; 52:883-892. [DOI: 10.1111/jre.12459] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 12/20/2022]
Affiliation(s)
- J. dos Santos Carvalho
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | - A. C. Cardoso Guimarães Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
- Medicine School; Education Institute of Parnaiba Valley (IESVAP); Parnaiba PI Brazil
| | - E. Herlany Pereira Alves
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | - A. dos Santos Carvalho
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | - F. R. P. da Silva
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | - L. F. de Carvalho França
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | | | - D. Di Lenardo
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
| | - L. K. M. de Souza
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piaui; Parnaiba PI Brazil
| | - A. L. dos R. Barbosa
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piaui; Parnaiba PI Brazil
| | - J.-V. R. Medeiros
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piaui; Parnaiba PI Brazil
| | - J. S. de Oliveira
- Laboratory of Biology and Biochemistry Plants (BIOqPLANT); Federal University of Piaui; Parnaiba PI Brazil
| | - D. F. P. Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piaui; Parnaiba PI Brazil
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Arvanitidis E, Bizzarro S, Alvarez Rodriguez E, Loos BG, Nicu EA. Reduced platelet hyper-reactivity and platelet-leukocyte aggregation after periodontal therapy. Thromb J 2017; 15:5. [PMID: 28190975 PMCID: PMC5292810 DOI: 10.1186/s12959-016-0125-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/21/2016] [Indexed: 01/26/2023] Open
Abstract
Background Platelets from untreated periodontitis patients are hyper-reactive and form more platelet-leukocyte complexes compared to cells from individuals without periodontitis. It is not known whether the improvement of the periodontal condition achievable by therapy has beneficial effects on the platelet function. We aimed to assess the effects of periodontal therapy on platelet reactivity. Methods Patients with periodontitis (n = 25) but unaffected by any other medical condition or medication were included and donated blood before and after periodontal therapy. Reactivity to ADP or oral bacteria was assessed by flow cytometric analysis of membrane markers (binding of PAC-1, P-selectin, CD63) and platelet-leukocyte complex formation. Reactivity values were expressed as ratio between the stimulated and unstimulated sample. Plasma levels of soluble (s) P-selectin were determined by enzyme-linked immunosorbent assay (ELISA). Results Binding of PAC-1, the expression of P-selectin and CD63 in response to the oral bacterium P. gingivalis were lower at recall (1.4 ± 1.1, 1.5 ± 1.2, and 1.0 ± 0.1) than at baseline (2.7 ± 4.1, P = 0.026, 6.0 ± 12.5, P = 0.045, and 2.7 ± 6.7, P = 0.042, respectively). Formation of platelet-leukocyte complexes in response to P. gingivalis was also reduced at recall compared to baseline (1.2 ± 0.7 vs. 11.4 ± 50.5, P = 0.045). sP-selectin levels were significantly increased post-therapy. Conclusions In periodontitis patients, the improvement of the periodontal condition is paralleled by a reduction in platelet hyper-reactivity. We suggest that periodontal therapy, as an intervention for improved oral health, can facilitate the management of thrombotic risk, and on the long term can contribute to the prevention of cardiovascular events in patients at risk. Trial registration Current Controlled Trials identifier ISRCTN36043780. Retrospectively registered 25 September 2013. Electronic supplementary material The online version of this article (doi:10.1186/s12959-016-0125-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Efthymios Arvanitidis
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands
| | - Sergio Bizzarro
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands
| | - Elena Alvarez Rodriguez
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands
| | - Elena A Nicu
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands
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Gerber FA, Sahrmann P, Schmidlin OA, Heumann C, Beer JH, Schmidlin PR. Influence of obesity on the outcome of non-surgical periodontal therapy - a systematic review. BMC Oral Health 2016; 16:90. [PMID: 27590050 PMCID: PMC5010690 DOI: 10.1186/s12903-016-0272-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity and periodontitis are important chronic health problems. Obesity is associated with an increased prevalence of periodontitis. Whether obesity also affects the outcome of non-surgical periodontal therapy is to date still unclear. METHODS A systematic review of studies referenced in SCOPUS, MEDLINE, PubMed, Cochrane, CINAHL, Biosis and Web of Science was performed. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. Probing pocket depth reduction was analyzed as primary surrogate parameter for therapeutic success after non-surgical periodontal therapy. RESULTS One-hundred-and-fifty-nine potentially qualifying studies were screened. Eight studies fulfilled the inclusion criteria and were analyzed. Three of eight studies failed to show an influence of obesity on pocket depth reduction after non-surgical therapy. The remaining five studies documented a clear negative effect on the outcome of non-surgical periodontal therapy. The finally included studies did not correspond to the highest level of quality (RCTs). Due to the heterogeneity of the data a meta-analysis was not possible. CONCLUSION The literature on the effect of obesity on the treatment outcome of non-surgical periodontal therapy remains controversial. The data, however, support that obesity is not only a factor associated with poorer periodontal health but might also result in inferior response to non-surgical treatment of periodontitis.
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Affiliation(s)
- Fabienne A. Gerber
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Oliver A. Schmidlin
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürg Hans Beer
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
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