Association between alcohol dependence and both periodontal disease and tooth loss: a cross-sectional study

Personalizing dental screening and prevention protocols in dentulous patients with oropharyngeal cancer undergoing radiotherapy: A retrospective cohort study

Objectives

Patients with head and neck cancer are routinely screened for dental foci prior to radiotherapy (RT) to prevent post- RT tooth extractions associated with an increased risk of osteoradionecrosis. We evaluated the risk factors for post-RT tooth extraction to personalise dental screening and prevention protocols prior to RT.

Materials and methods

This retrospective cohort study included dentulous patients diagnosed with oropharyngeal cancer who had undergone radiation therapy at doses 60-70 Gy and achieved a disease-free survival of ≥ 1 year (N = 174). Risk factors were assessed using Cox regression models.

Results

The cumulative incidence of post-RT tooth extraction was 30.7 % at 5 years. Main indications for extraction (n = 62) were radiation caries (n = 20) and periodontal disease (n = 27). Risk factors associated (p < 0.05) with radiation caries-related extractions included active smoking, alcohol abuse, poor oral hygiene, parotid gland irradiation, and mandibular irradiation. A high-dose volume in the mandible was associated with periodontal disease events.

Conclusion

Post-RT extractions due to radiation caries were influenced by lifestyle factors and RT dose in the mandible and parotid glands. Periodontal disease-related extractions were primarily associated with the mandibular dose. During dental screening these post-RT risk factors should be taken into account to prevent osteoradionecrosis.

Ecological competition in the oral mycobiome of Hispanic adults living in Puerto Rico associates with periodontitis

Background: Fungi are a major component of the human microbiome that only recently received attention. The imbalance of indigenous fungal communities and environmental fungi present in the oral cavity may have a role in oral dysbiosis, which could exacerbate oral inflammatory diseases. Methods: We performed a cross-sectional study and recruited 88 participants aged 21 to 49 from sexually transmitted infection clinics in Puerto Rico. A full-mouth periodontal examination following the NHANES protocol defined periodontal severity (CDC/AAP). ITS2 (fungal) genes were amplified and sequenced for mycobiota characterization of yeast and environmental fungi. Environmental outdoor spore levels were measured daily by the American Academy of Allergy Asthma and Immunology San Juan station and defined by quartiles as spore scores. Results: Our data indicate polymicrobial colonization of yeast and environmental fungi in the oral cavity. Dominant taxa associated with periodontal disease included Saccharomyces cerevisiae, Rigidoporus vinctus, and Aspergillus penicilloides, while Candida albicans were found to be ubiquitous. Fungal aerosols were found to impact the oral cavity biofilm, likely due to competition and neutralization by inhaled outdoor and indoor fungal spores. Conclusion: To our knowledge, this is the first report showcasing the ecological competition of measured outdoor environmental fungi with the human oral mycobiota.

Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies

AIM

The aim of the study was to evaluate the prevalence of periodontitis in dentate people between 2011 and 2020.

MATERIALS AND METHODS

PUBMED, Web of Science, and LILACS were searched up to and including December 2021. Epidemiological studies reporting the prevalence of periodontitis conducted between 2011 and 2020 were eligible for inclusion in this review. Studies were grouped according to the case definition of confidence as confident (Centers for Disease Control [CDC] AAP 2012; CDC/AAP 2007; and Armitage 1999) and non-confident (community periodontal index of 3 or 4, periodontal pocket depth >4 mm, and clinical attachment level ≥1 mm). Random effects meta-analyses with double arcsine transformation were conducted. Sensitivity subgroup and meta-regression analyses explored the effect of confounding variables on the overall estimates.

RESULTS

A total 55 studies were included. The results showed a significant difference, with confident case definitions (61.6%) reporting nearly twice the prevalence as non-confident classifications (38.5%). Estimates using confident periodontal case definitions showed a pooled prevalence of periodontitis of 61.6%, comprising 17 different countries. Estimates reporting using the CDC/AAP 2012 case definition presented the highest estimate (68.1%) and the CDC/AAP 2007 presented the lowest (48.8%). Age was a relevant confounding variable, as older participants (≥65 years) had the highest pooled estimate (79.3%).

CONCLUSION

Between 2011 and 2020, periodontitis in dentate adults was estimated to be around 62% and severe periodontitis 23.6%. These results show an unusually high prevalence of periodontitis compared to the previous estimates from 1990 to 2010.

Resveratrol decreases local inflammatory markers and systemic endotoxin in patients with aggressive periodontitis

BACKGROUND

Inflammation is hypothesized to contribute to the pathogenesis of periodontitis. Resveratrol (RV) is known for its anti-inflammatory properties. The purpose of this study was to investigate the inhibitory effect of RV on local inflammatory markers and systemic endotoxin in patients with periodontitis.

METHODS

A total of 160 patients with periodontitis were enrolled in this study. The selected patients were randomly divided into four groups and received placebo, high-dose (500 mg/d) of RV (HRV, n = 40), middle-dose (250 mg/d) of RV (middle dose RV (MRV), n = 40) and low-dose (125 mg/d) of RV (low dose RV (LRV), n = 40) with orally administration. All patients received an 8-week treatment. The periodontal status of patients with periodontitis was recorded by using clinical attachment level (CAL), bleeding index (BI), oral hygiene index-simplified (OHI-S), and probing pocket depth (PPD). The levels of inflammatory markers in serum and gingival crevicular fluid (GCF), and systemic levels of endotoxin were evaluated using high sensitivity enzyme-linked immuno sorbent assay.

RESULTS

Outcomes showed that symptoms of periodontitis determined by CAL, BI OHI-S and PPD were improved by RV compared to placebo. RV treatment decreased inflammatory markers in serum and GCF compared to placebo in patient with periodontitis. Systemic endotoxin declined more in the RV group than the placebo-treated group.

CONCLUSION

In conclusion, data in the current study indicate that RV is an efficient drug for the treatment of patients with periodontitis. The findings of the present study find that RV inhibits systemic local inflammatory markers and systemic endotoxin and suggest that 500 mg/d RV is the ideal dose for patients with periodontitis.

Family and contextual factors associated with licit drug use in adolescence

OBJECTIVE:

TO evaluate the family and contextual factors associated with licit drug use among 15 to 19-year-old adolescents in the school context.

METHODS:

This is a representative, school-based, cross-sectional study conducted with 746 adolescents from 15 to 19 years old enrolled in public and private schools. Parents/guardians reported on the sociodemographic variables, while adolescents answered questionnaires on drug use, family cohesion and adaptability, oral health literacy and visits to the dentist. Information on school context was obtained at the institution and via municipal publications. Associations between variables were analyzed using unadjusted and adjusted multilevel Poisson regression models.

RESULTS:

Prevalence of licit drug use at least once and a pattern indicative of harmful drug use were 39.8% and 15.1%, respectively. After the adjusted analysis of licit drug use at least once, the variables gender (PR = 1.26; 95%CI: 1.01–1.59), family cohesion (PR = 9.81; 95%CI: 1.23–72.54), and average income of the school district (PR = 0.72; 95%CI: 0.57–0.91) remained in the final model. As for drug abuse, only the detached type (PR = 23.01; 95%CI: 2.46–214.87) and separated type (PR = 13.54; 95%CI: 1.40–130.97) of family cohesion remained in the final model.

CONCLUSION:

Experience with licit drug use was associated with family and contextual factors among the adolescents, while family cohesion was the main factor related to harmful drug use.

Serum 25-hydroxyvitamin D is negatively associated with severe periodontitis: a cross-sectional study

BACKGROUND

Periodontitis can lead to the destruction of periodontium and adversely influence the overall health, wellbeing, and quality of life. However, studies on the relationship between severe periodontitis and serum 25-hydroxyvitamin D [25(OH)D] are limited. This study is designed to explore the relationship between 25(OH)D and severe periodontitis.

METHODS

A cross-section study of 2928 participants enrolled from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2014 was conducted. The periodontal examination was performed using a total oral periodontal examination program, and probe measurements were collected at six sites per tooth in NHANES. Severe periodontitis was characterized as: ≥ 2 interproximal sites with attachment loss (AL) ≥ 6 mm (not on the same tooth) and ≥ 1 interproximal site with probing depth (PD) ≥ 5 mm. Severe periodontitis and serum 25(OH)D were the dependent and independent variables, respectively. Univariate, multivariate, and subgroup analyses were performed to explore the relationship between severe periodontitis and serum 25(OH)D.

RESULTS

Among the 2928 participants, the average age of the population was 50 ± 13.71 years old, with 1425 (48.67%) males, 316 (10.79%) exhibited severe periodontitis. Serum 25(OH)D showed a significantly negative association with severe periodontitis after adjusting all variables (OR 0.75, 95% CI 0.63-0.89). In addition, severe periodontitis has a nonlinear relationship with serum 25(OH)D, whoes inflection point was 102 (nmol/L). On the left side of the inflection point (25(OH)D ≤ 102 nmol/L), the effect size was 0.98 and 95%CI was 0.98-0.99 (25(OH)D per 1 nmol/L increments). On the right side of the inflection point (25(OH)D > 102 nmol/L), the effect size was 0.99 and 95% CI was 0.98-1.01. The subgroup analysis showed pronounced changes in non-Hispanic white, alcohol consumption, diabetes, and health insurance.

CONCLUSION

Serum 25 (OH) D in relation to severe periodontitis is nonlinear in our study.When serum 25 (OH) D is less than 102 nmol/L, serum 25 (OH) D is negatively associated with severe periodontitis.

Interventions to prevent periodontal disease in tobacco-, alcohol-, and drug-dependent individuals

Substance abuse affects more than one sixth of the world's population. More importantly, the nature of the abuse and the type of addictive substances available to individuals is increasing exponentially. All substances with abusive potential impact both the human immuno-inflammatory system and oral microbial communities, and therefore play a critical role in the etiopathogenesis of periodontal diseases. Evidence strongly supports the efficacy of professionally delivered cessation counseling. Dentists, dental therapists, and hygienists are ideally placed to deliver this therapy, and to spearhead efforts to provide behavioral and pharmacologic support for cessation. The purpose of this review is to examine the biologic mechanisms underlying their role in disease causation, to understand the pharmacologic and behavioral basis for their habituation, and to investigate the efficacy of population-based and personalized interventions in prevention of periodontal disease.