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Jardini MAN, Pedroso JF, Ferreira CL, Nunes CMM, Reichert CO, Aldin MN, Figueiredo Neto AM, Levy D, Damasceno NRT. Effect of adjuvant probiotic therapy (Lactobacillus reuteri) in the treatment of periodontitis associated with diabetes mellitus: clinical, controlled, and randomized study. Clin Oral Investig 2024; 28:80. [PMID: 38183505 DOI: 10.1007/s00784-023-05441-0] [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: 08/30/2023] [Accepted: 12/16/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Subgingival instrumentation (SI) with probiotics may be a proposal for the treatment of periodontitis (P), for patients with type 2 diabetes mellitus (T2DM). The Lactobacillus reuteri probiotic as an adjunctive therapy in the treatment of P associated with T2DM was evaluated. MATERIALS AND METHODS Forty diabetic participants diagnosed with P (stage III and IV, grade B) were randomized into SI + Placebo (n = 20): subgingival instrumentation plus placebo lozenges and SI + Probi (n = 20): subgingival instrumentation plus probiotics. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque index (PI), bleeding on probing (BoP), and PISA index were performed at baseline and 30, 90, and 180 days. Cytokine concentration in the gingival crevicular fluid, subgingival biofilm sample, and LDL and HDL subfractions were evaluated. RESULTS In the deep pockets, PD in SI + Probi showed increased values (p = 0.02) compared to SI + Placebo at 90 days. For CAL, SI + Probi showed increased values compared to SI + Placebo, with a significant difference at 30 days (p = 0.03), 90 days (p = 0.02), and 180 days (p = 0.04). At #PD ≥ 7 mm, SI + Probi had a more frequent number of sites (p = 0.03) compared to SI + Placebo only at baseline. For the PISA, SI + Probi showed a significant difference (p = 0.04) compared to SI + Placebo at 90 days. For cytokines, SI + Probi showed higher quantification than SI + Placebo for IL-10 (p < 0.001) at 90 days, IL-12 (p = 0.010) at 90 days, IL-1β (p = 0.035) at 90 days, and IL-8 (p = 0.003) at baseline. SI + Placebo showed higher quantification of IL-1β (p = 0.041) compared to SI + Probi only at 30 days. There was a reduction in all microbial complexes. SI + Probi improved LDL size (246.7 nm vs 260.4 nm; p < 0.001), while large HDL subfractions were reduced aft 180 days of treatment (24.0% vs 20.3%; p = 0.022) when compared with SI + Placebo; this response was dependent of probiotics (1.0 mg/dL vs - 6.2 mg/dL; p = 0.002). CONCLUSION Subgingival instrumentation improved the clinical periodontal parameters in patients with T2DM. The use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction. CLINICAL RELEVANCE Scientific rationale for study: subgingival instrumentation with probiotics may be a proposal for the treatment of periodontitis (P), especially for patients with type 2 diabetes mellitus (T2DM). PRINCIPAL FINDINGS the use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction. Practical implications: L. reuteri as an adjunct to subgingival instrumentation may have significant therapeutic implications in dyslipidemia.
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Affiliation(s)
- Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil.
| | - Juliana Fatima Pedroso
- Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil
| | | | - Camilla Magnoni Moretto Nunes
- Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil
| | - Cadiele Oliana Reichert
- Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Marlene Nunez Aldin
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Debora Levy
- Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
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2
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Gil-Montoya JA, Rivero-Blanco T, Leon-Rios X, Exposito-Ruiz M, Pérez-Castillo I, Aguilar-Cordero MJ. Oral and general health conditions involved in periodontal status during pregnancy: a prospective cohort study. Arch Gynecol Obstet 2023; 308:1765-1773. [PMID: 36512113 PMCID: PMC10579146 DOI: 10.1007/s00404-022-06843-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Pregnancy is a period in a woman's life that has important consequences on oral health, particularly for gingival health. Present study aims to identify women at higher risk of developing periodontal disease (gingivitis and periodontitis) during late pregnancy and evaluate how this condition evolves during this period. METHODS Prospective cohort study was designed with pregnant women who were assessed during the first and third trimesters of gestation in a southern Spanish public hospital. Data regarding gingival and periodontal health, oral hygiene, and overall health status (obesity and diabetes mellitus) were collected. Reporting followed STROBE checklist. RESULTS Significantly higher number of women had the periodontal and gingival disease in the third trimester of gestation compared with in early pregnancy. In the third trimester of gestation, 42 (28.6%) and 63 (42.9%) of women presented symptoms of periodontal disease and gingival disease, respectively. Obesity (OR 2.834; 95%CI 0.919-8.741), worse oral hygiene during the first trimester of gestation (OR: 4.031; 95%CI 2.12-7.65), and periodontal disease during early pregnancy (OR: 15.104; 95%CI 3.60-63.36) most effectively predicted periodontal disease during late pregnancy. CONCLUSIONS Pregnancy is associated with exacerbated periodontal and gingival disease symptoms throughout the different trimesters of gestation. Obesity and oral hygiene during early pregnancy were the risk factors that most contributed to the aforementioned changes in periodontal disease.
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Affiliation(s)
- J A Gil-Montoya
- Granada School of Dentistry, Institute of Biomedical Research of Granada, University of Granada, c/ Paseo de Cartuja S/N, 18071, Granada, Spain.
| | - T Rivero-Blanco
- Granada School of Dentistry, Institute of Biomedical Research of Granada, University of Granada, c/ Paseo de Cartuja S/N, 18071, Granada, Spain
| | - X Leon-Rios
- Granada School of Dentistry, University of Granada, Granada, Spain
- School of Dentistry, Universidad Peruana de Ciencias Aplicadas, Santiago de Surco, Perú
| | - M Exposito-Ruiz
- Faculty of Health Sciences, University of Granada, Granada, Spain
| | - I Pérez-Castillo
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Andalusian Plan for Research Development and Innovation, University of Granada, CTS 367, Granada, Spain
| | - M J Aguilar-Cordero
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Andalusian Plan for Research Development and Innovation, University of Granada, CTS 367, Granada, Spain
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3
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Tominaga K, Abe T, Ando Y, Hamano T, Isomura M, Nabika T, Yano S. Changes in masticatory performance and the new onset of diabetes mellitus in older adults: a 5-year longitudinal study. Diabetol Int 2023; 14:165-171. [PMID: 37090125 PMCID: PMC10113411 DOI: 10.1007/s13340-022-00613-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Objective Although masticatory performance is affected by age-related reduction in number of teeth (or treatment), the relationship between longitudinal changes in masticatory performance and diabetes mellitus is unknown. This longitudinal study investigated the association between changes in masticatory performance and new-onset diabetes mellitus among community-dwelling Japanese older adults. Methods The data of 214 older adults living in Ohnan Town, Shimane, Japan, who participated in two surveys conducted between 2012 and 2017 were analyzed. Diabetes mellitus was defined as a hemoglobin A1c level ≥ 6.5% or self-reported diabetes mellitus. The masticatory performance (measured by number of gummy jelly pieces collected after chewing) was evaluated by dental hygienists. Masticatory performance was categorized into two groups (high or low) based on the median in each survey; further, four groups (Group A: remained consistently high, Group B: changed from low to high, Group C: remained consistently low, Group D: changed from high to low) were used to determine longitudinal changes in masticatory performance. Logistic regression was used to analyze the association between changes in masticatory performance and new-onset diabetes mellitus. Results Overall, 10.3% of participants had diabetes mellitus at the follow-up survey. Multivariate analysis showed that Group D (odds ratio 8.69, 95% confidence interval 1.98-38.22) was positively associated with the development of diabetes mellitus compared with Group A after adjusting for sex, age, body mass index, alcohol consumption, physical activity, and eating speed. Conclusions Deteriorating masticatory performance for 5 years may cause diabetes mellitus among older adults.
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Affiliation(s)
- Kazumichi Tominaga
- Tominaga Dental Office, Ochi District, Shimane Japan
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Yuichi Ando
- Department of Health Promotion, National Institute of Public Health, Wako, Saitama Japan
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto, Kyoto Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Faculty of Human Sciences, Shimane University, Matsue, Shimane Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Izumo, Shimane Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Laboratory Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane Japan
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4
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Zimmermann T, Koenig A, Porzelt S, Schmage P, Konnopka C, Schellhammer S, Behrens-Potratz A, Ijeoma Okoro E, Henken E, Stratmeyer P, Beikler T, König HH, Scherer M, Konnopka A. Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany. BMJ Open 2023; 13:e063685. [PMID: 36914197 PMCID: PMC10016254 DOI: 10.1136/bmjopen-2022-063685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Older people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people. METHODS AND ANALYSIS InSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist's visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Review Board of the Hamburg Medical Chamber (approval number: 2021-100715-BO-ff). The results of this study will be disseminated through conference presentations and publications in peer-reviewed journals. An expert advisory board to support the InSEMaP study group will be established. TRIAL REGISTRATION NUMBER German Clinical Trials Register: DRKS00027020.
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Affiliation(s)
- Thomas Zimmermann
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Alena Koenig
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Sarah Porzelt
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Center for Dental and Oral Medicine, Hamburg, Germany
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Stefanie Schellhammer
- Department of Health Care Research and Innovation, Deutsche Angestellten-Krankenkasse (DAK), Hamburg, Germany
| | - Anja Behrens-Potratz
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Edelqueen Ijeoma Okoro
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Espen Henken
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Peter Stratmeyer
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Center for Dental and Oral Medicine, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
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5
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The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus-A Review. Diagnostics (Basel) 2023; 13:diagnostics13040681. [PMID: 36832168 PMCID: PMC9954907 DOI: 10.3390/diagnostics13040681] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Periodontitis is a chronic inflammatory disease caused by the presence of a bacterial biofilm known as dental plaque. This biofilm affects the supporting apparatus of the teeth, especially the periodontal ligaments and the bone surrounding the teeth. Periodontal disease and diabetes seem to be interrelated and in a bidirectional relationship, and have been increasingly studied in recent decades. For example, diabetes mellitus has a detrimental effect on periodontal disease, increasing its prevalence, extent, and severity. In turn, periodontitis negatively affects glycemic control and the course of diabetes. This review aims to present the most recently discovered factors that contribute to the pathogenesis, therapy, and prophylaxis of these two diseases. Specifically, the article focuses on microvascular complications, oral microbiota, pro- and anti-inflammatory factors in diabetes, and periodontal disease. As presented in this review, these two diseases require specific/ complementary therapeutic solutions when they occur in association, with new clinical trials and epidemiological research being necessary for better control of this interdependent pathogenic topic.
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6
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Haluszka D, Aminmansour S, Tóth P, Aminmansour S, Kellermayer M. Nanomechanical and Nonlinear Optical Properties of Glycated Dental Collagen. J Dent Res 2022; 101:1510-1516. [PMID: 35722958 DOI: 10.1177/00220345221100404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Nonenzymatic glycation is a multistep, slow reaction between reducing sugars and free amino groups of long-lived proteins, which affects the structural and mechanical properties of collagen-rich tissues via accumulation of advanced glycation end products (AGEs). Dental collagen is exposed to glycation as part of the natural aging process. However, in case of chronically high blood glucose, the process can be accelerated, resulting in premature stiffening of dentin, leading to tooth fragility. The molecular mechanisms whereby collagen glycation evokes the loss of mechanical stability in teeth are currently unknown. In this study, we used 2-photon and atomic force microscopies to correlate structural and mechanical changes in dental collagen induced by in vitro glycation. Young tooth samples were demineralized and cut longitudinally into 30-µm sections, then artificially glycated in 0.5 M ribose solution for 10 wk. Two-photon microscopy analysis showed that both the autofluorescence and second harmonic-generated (SHG) signal intensities of glycated samples were significantly greater than those of the controls. Regarding the structural alteration of individual collagen fibers, a remarkable increase could be measured in fiber length of ribose-treated sections. Furthermore, nanoindentation of intertubular dentin regions revealed significantly higher stiffness in the ribose-treated samples, which points at a significant accumulation of AGEs. Thus, collagen glycation occurring during sustained exposure to reducing sugars leads to profound structural and mechanical changes in dentin. Besides the numerous oral complications associated with type 2 diabetes, the premature structural and mechanical deterioration of dentin may also play an important role in dental pathology.
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Affiliation(s)
- D Haluszka
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - S Aminmansour
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - P Tóth
- Department of Biophysics, University of Pécs, Faculty of Medicine, Pécs, Hungary
| | - S Aminmansour
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - M Kellermayer
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
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7
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Takeda M, Abe T, Toyama Y, Tominaga K, Yano S, Nabika T, Yamasaki M. Combined association of oral and skeletal muscle health with type 2 diabetes mellitus among community-dwelling older adults in Japan: a cross-sectional study. J Rural Med 2022; 17:67-72. [PMID: 35432640 PMCID: PMC8984617 DOI: 10.2185/jrm.2021-042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: Although oral health and skeletal muscle status are known to be
risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their
combined effects among community-dwelling older adults. The purpose of this study was to
investigate the association between oral health and skeletal muscle status among older
adults with T2DM in Japan. Participants and Methods: This cross-sectional study included data from
individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48
mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental
hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal
muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength
(HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral
health status (each of the three categories in NT and MF) and skeletal status (each of the
three categories in SMI and HGS). Results: T2DM was prevalent in 83 participants (16.4%) and was significantly
associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]:
1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI
and high MF and SMI, respectively. Conclusion: Our findings indicate that low muscle mass with tooth loss or
masticatory dysfunction is associated with T2DM among community-dwelling older adults.
This suggests that maintaining oral health and muscle mass may be an effective strategy
for the prevention of T2DM.
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Affiliation(s)
- Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
| | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
| | - Yuta Toyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
| | | | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
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8
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Balmasova IP, Tsarev VN, Unanyan KG, Ippolitov EV, Tsareva TV, Kharakh YN, Akhmedov GD, Stepanova SY, Katkov II, Arutyunov SD. Diagnostic value of microbiome biomarkers of the periodonite microbiome in patients with the association of chronic periodontitis and diabetes mellitus type 2. Klin Lab Diagn 2021; 66:678-683. [PMID: 34882353 DOI: 10.51620/0869-2084-2021-66-11-678-683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The place of high-tech methods of molecular biology in clinical laboratory diagnostics of various diseases and the development of a system of biomarkers as an important component of diagnostic research is currently attracting the closest attention of the scientific community. In this paper, an attempt is made to use high-tech metagenomic analysis to solve problems that arise due to the high frequency of association of periodontal diseases with systemic pathology, in particular, with type 2 diabetes mellitus. The aim of the study was to determine the taxonomic and metabolic features of the microbiome of periodontal tissues in periodontal diseases associated with type 2 diabetes mellitus, as a model of the ratio of local and systemic effects of periodontal pathogenic bacteria. The study included 16S shotgun sequencing of bacterial DNA as part of biological material from periodontal pockets/dentoalveolar furrows of 46 people - 15 patients with chronic periodontitis associated with type 2 diabetes mellitus, 15 patients with chronic periodontitis unrelated to systemic pathology, as well as 16 healthy people in the control group, followed by bioinformatic processing of the data obtained. The obtained data allowed us to establish the taxonomic features of the periodontal microbiome in the association of chronic periodontitis with type 2 diabetes mellitus, which included the predominance of representatives of the families Prevotellaceae and Spirochaetaceae in its composition. The features of metabolic processes in periodontal tissues with the participation of the microbiome were also revealed, which consisted in an increase in the exchange of cysteine and methionine against the background of a decrease in the metabolism of pyrimidine, methane, sphingolipids, and the synthesis of fatty acids, which are of diagnostic value in assessing the condition of patients with type 2 diabetes mellitus.
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Affiliation(s)
| | - V N Tsarev
- Moscow State University of Medicine and Dentistry
| | - K G Unanyan
- Moscow State University of Medicine and Dentistry
| | | | - T V Tsareva
- Moscow State University of Medicine and Dentistry
| | - Y N Kharakh
- Moscow State University of Medicine and Dentistry
| | - G D Akhmedov
- Moscow State University of Medicine and Dentistry
| | | | - I I Katkov
- Moscow State University of Medicine and Dentistry
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9
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Bof de Andrade F, de Oliveira C, de Oliveira Duarte YA, Sabbah W, Bernabé E. Tooth loss, dental prostheses use and cognitive performance in older Brazilian adults: The SABE cohort study. Geriatr Gerontol Int 2021; 21:1093-1098. [PMID: 34626081 DOI: 10.1111/ggi.14290] [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: 05/24/2021] [Revised: 08/12/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
AIM To investigate the within- and between-person longitudinal effects of tooth loss and the use of dentures, clinically assessed by dentists, on cognitive decline in a representative sample of community-dwelling older Brazilian adults. METHODS Data came from 1265, 1112 and 1021 individuals aged ≥60 years who participated in the second (2006), third (2010) and fourth (2015) waves, respectively, of the Health, Well-being and Aging study (SABE). Cognitive performance was evaluated with the abbreviated version of the Mini-Mental State Examination (MMSE). The number of natural teeth was classified according to three categories: none, 1-19 and ≥20 teeth. The presence of removable full or partial dentures in each dental arch (yes/no) was recorded. Hybrid regression models, adjusted for sociodemographic, behavior and health-related covariates, were used to estimate the between- and within-person effects of the longitudinal association between cognitive performance and oral health. RESULTS Participants with 1-19 and no teeth had, respectively, 1.15 (95% CI 0.65-1.66) and 1.54 (95% CI 0.99-2.09) units lower MMSE score than those with ≥20 teeth. Denture wearers had 1.54 (95% CI 1.13-1.95) units greater MMSE score than non-denture wearers, and those who started wearing dentures during the follow up had 0.83 (95% CI 0.21-1.45) units greater MMSE score after the transition. CONCLUSION Our main findings showed that the use of dental prostheses might be a protective factor for cognitive decline. Geriatr Gerontol Int 2021; 21: 1093-1098.
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Affiliation(s)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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10
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Basso L, Chacun D, Sy K, Grosgogeat B, Gritsch K. Periodontal Diseases and COVID-19: A Scoping Review. Eur J Dent 2021; 15:768-775. [PMID: 34500484 PMCID: PMC8630939 DOI: 10.1055/s-0041-1729139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of this scoping review was to present the existing literature regarding the relationship between periodontal diseases and coronavirus disease 2019 (COVID-19). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines was followed. Articles were retrieved from PubMed/MEDLINE and Scopus databases and screened to include studies relating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 to periodontal cells and/or tissues and/or diseases. Twenty-five papers were included; consisting of six reviews, seven original articles, six short reports, four letters to the editor, one commentary, and one case report. The articles were allocated to three different topics: (i) hypotheses on the relationship between periodontal diseases and COVID-19; (ii) risk factors and comorbidities common to periodontitis and COVID-19; (iii) periodontal manifestations of COVID-19. Certain molecules (angiotensin-converting enzyme-2, furin, cathepsin, TMPRSS2...) that are found at a high level in periodontal tissues, particularly in patients with periodontitis, are involved in the mechanism of entry of SARS-CoV-2 into cells. Periodontopathic bacteria could also play a direct role in the mechanism of entry of SARS-CoV-2 by cleaving the S-protein, and the cytokines produced during periodontitis could add to the cytokine storm found in the severe forms of COVID-19. It thus appears that the treatment of periodontitis, which allows a reduction in periodontopathic bacteria and of the local and systemic inflammation state, could be part of a strategy to prevent the development of severe forms of COVID-19.
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Affiliation(s)
- Lisa Basso
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France
| | - Doriane Chacun
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France
| | - Kadiatou Sy
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France.,Univ Lille, INSERM, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Brigitte Grosgogeat
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité de Recherche Clinique, Lyon, France
| | - Kerstin Gritsch
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France
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11
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Abe T, Tominaga K, Ando Y, Toyama Y, Takeda M, Yamasaki M, Okuyama K, Hamano T, Isomura M, Nabika T, Yano S. Number of teeth and masticatory function are associated with sarcopenia and diabetes mellitus status among community-dwelling older adults: A Shimane CoHRE study. PLoS One 2021; 16:e0252625. [PMID: 34077486 PMCID: PMC8172058 DOI: 10.1371/journal.pone.0252625] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 01/13/2023] Open
Abstract
Objectives We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults. Subjects and methods This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders. Results After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932–0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907–0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941–0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904–0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957–0.999; OR, 0.976; 95% CI, 0.960–0.992, respectively). Conclusion Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Kazumichi Tominaga
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Tominaga Dental Office, Ochi-gun, Shimane, Japan
| | - Yuichi Ando
- Department of Health Promotion, National Institute of Public Health, Wako City, Saitama, Japan
| | - Yuta Toyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Masayuki Yamasaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Sociology, Department of Sports Sociology and Health Sciences, Kyoto Sangyo University, Kita-ku, Kyoto, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Medicine, Department of Functional Pathology, Shimane University, Izumo City, Shimane, Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Medicine, Department of Laboratory Medicine, Shimane University, Izumo City, Shimane, Japan
- * E-mail:
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12
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Al-Momani MM. Indocyanine-mediated antimicrobial photodynamic therapy promotes superior clinical effects in stage III and grade C chronic periodontitis among controlled and uncontrolled diabetes mellitus: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2021; 35:102379. [PMID: 34087466 DOI: 10.1016/j.pdpdt.2021.102379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/20/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of this randomized controlled clinical trial was to evaluate the efficacy of indocyanine-green mediated antimicrobial photodynamic therapy (ICG-aPDT) in the treatment of stage III grade C periodontitis in terms of clinical, microbiological, and immune-inflammatory parameters in patients with well-controlled and poorly-controlled form of type-2 diabetes mellitus (T2DM). MATERIALS AND METHODS Subjects with a diagnosis of chronic periodontitis according to the new classification and case definition of periodontitis [probing depth (PD): ≥6 mm, interdental clinical attachment loss (CAL): ≥5 mm and bone loss extending to mid-third of root and beyond (≥3 mm)] were recruited. Subjects were grouped on the basis of well-controlled and poorly-controlled diabetic status. Two subgroups were made according to the treatment modality (RSD versus ICG-aPDT/RSD) in each group. A split-mouth design was used in which one site was designated for control (RSD alone treatment) while the other contralateral site was chosen for test treatment (ICG-aPDT/RSD) in all the patients. Periodontal parameters included the measurement of plaque score (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and alveolar bone levels (ABL). Identification of Porphyromonas gingivalis and Tannarella forsythia through PCR was executed using species specific primers. Gingival crevicular fluid samples were then analyzed using enzyme-linked immunosorbent assay for the quantification of interleukin (IL)-17 and interferon (IFN)-γ. All the clinical, microbiological, and immunological parameters were assessed using repeated measure ANOVA for intra and inter-group comparisons. The p-value significance was set at 0.05. RESULTS The mean age of the 50 patients was 44.7 ± 7.4 years. Systemic parameters suggest no significant change between the times in either HbA1c or serum CRP levels in any of the groups. A statistically significant reduction for BOP was noted for ICG-aPDT group for non-diabetic subjects at 3 months follow up only, while a significant reduction was seen at both 3 months and 6 months among well-controlled and poorly-controlled T2DM subjects (p<0.05). For PD and CAL, a significant improvement was seen for ICG-aPDT group among non-diabetic and well-controlled T2DM subjects at both 3- and 6-months follow up, while a significant reduction was seen at only 3 months among poorly-controlled T2DM subjects. A significant reduction was seen for ICG-aPDT group compared to RSD group for both bacteria in all the three groups at 6 months follow up (p<0.05). CONCLUSION ICG-aPDT significantly improved clinical and antimicrobial parameters in well-controlled and poorly-controlled T2DM having stage III and grade C periodontitis. Glycemic status did not have negative impact in the reduction of periodontal parameters in either types of T2DM. TRIAL REGISTRATION The present RCT was registered in the clinicaltrials.gov under the identifier: NCT04857346.
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Affiliation(s)
- Mohammed Mahmoud Al-Momani
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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13
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Glurich I, Berg R, Panny A, Shimpi N, Steinmetz A, Nycz G, Acharya A. Longitudinal Observation of Outcomes and Patient Access to Integrated Care Following Point-of-Care Glycemic Screening in Community Health Center Dental Safety Net Clinics. FRONTIERS IN ORAL HEALTH 2021; 2:670355. [PMID: 35048014 PMCID: PMC8757706 DOI: 10.3389/froh.2021.670355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Rates of diabetes/prediabetes continue to increase, with disparity populations disproportionately affected. Previous field trials promoted point-of-care (POC) glycemic screening in dental settings as an additional primary care setting to identify potentially at-risk individuals requiring integrated care intervention. The present study observed outcomes of POC hemoglobin A1c (HbA1c) screening at community health center (CHC) dental clinics (DC) and compliance with longitudinal integrated care management among at-risk patients attending dental appointments. Materials and Methods: POC HbA1c screening utilizing Food and Drug Administration (FDA)-approved instrumentation in DC settings and periodontal evaluation of at-risk dental patients with no prior diagnosis of diabetes/prediabetes and no glycemic testing in the preceding 6 months were undertaken. Screening of patients attending dental appointments from October 24, 2017, through September 24, 2018, was implemented at four Wisconsin CHC-DCs serving populations with a high representation of disparity. Subjects meeting at-risk profiles underwent POC HbA1c screening. Individuals with measures in the diabetic/prediabetic ranges were advised to seek further medical evaluation and were re-contacted after 3 months to document compliance. Longitudinal capture of glycemic measures in electronic health records for up to 2 years was undertaken for a subset (n = 44) of subjects with available clinical, medical, and dental data. Longitudinal glycemic status and frequency of medical and dental access for follow-up care were monitored. Results: Risk assessment identified 224/915 (24.5%) patients who met inclusion criteria following two levels of risk screening, with 127/224 (57%) qualifying for POC HbA1c screening. Among those tested, 62/127 (49%) exhibited hyperglycemic measures: 55 in the prediabetic range and seven in the diabetic range. Moderate-to-severe periodontitis was more prevalent in patients with prediabetes/diabetes than in individuals with measures in the normal range. Participant follow-up compliance at 3 months was 90%. Longitudinal follow-up documented high rates of consistent access (100 and 89%, respectively), to the integrated medical/DC environment over 24 months for individuals with hyperglycemic screening measures. Conclusion: POC glycemic screening revealed elevated HbA1c measures in nearly half of at-risk CHC-DC patients. Strong compliance with integrated medical/dental management over a 24-month interval was observed, documenting good patient receptivity to POC screening in the dental setting and compliance with integrated care follow-up by at-risk patients.
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Affiliation(s)
- Ingrid Glurich
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Richard Berg
- Office of Research Computing and Analytics, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Aloksagar Panny
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Neel Shimpi
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Annie Steinmetz
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Greg Nycz
- Family Health Center of Marshfield, Inc., Marshfield Clinic Health System, Marshfield, WI, United States
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, United States
- Family Health Center of Marshfield, Inc., Marshfield Clinic Health System, Marshfield, WI, United States
- Advocate Aurora Research Institute, LLC, Advocate Aurora Health, Inc., Downers Grove, IL, United States
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14
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Shi S, Ding F, Liu X, Wang L, Wang X, Zhang S, Zhao G, Song Y. Clinical and radiographic variables related to implants with simultaneous grafts among type 2 diabetic patients treated with different hypoglycemic medications: a retrospective study. BMC Oral Health 2021; 21:214. [PMID: 33906655 PMCID: PMC8080327 DOI: 10.1186/s12903-021-01583-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
Background The influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents. Methods In this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal–Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons. Results After a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P < 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P < 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P < 0.05) and GLP-1 group (P < 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P > 0.05). Conclusions The radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone. Clinical trial registration number ChiCTR2000034211 (retrospectively registered).
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Affiliation(s)
- Shaojie Shi
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Feng Ding
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Xiangdong Liu
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Lei Wang
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Xingxing Wang
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Sijia Zhang
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
| | - Guoqiang Zhao
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yingliang Song
- State key Laboratory of military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
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Drift of the Subgingival Periodontal Microbiome during Chronic Periodontitis in Type 2 Diabetes Mellitus Patients. Pathogens 2021; 10:pathogens10050504. [PMID: 33922308 PMCID: PMC8145315 DOI: 10.3390/pathogens10050504] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
Since periodontitis and type 2 diabetes mellitus are complex diseases, a thorough understanding of their pathogenesis requires knowing the relationship of these pathologies with other disorders and environmental factors. In this study, the representability of the subgingival periodontal microbiome of 46 subjects was studied by 16S rRNA gene sequencing and shotgun sequencing of pooled samples. We examined 15 patients with chronic periodontitis (CP), 15 patients with chronic periodontitis associated with type 2 diabetes mellitus (CPT2DM), and 16 healthy subjects (Control). The severity of generalized chronic periodontitis in both periodontitis groups of patients (CP and CPT2DM) was moderate (stage II). The male to female ratios were approximately equal in each group (22 males and 24 females); the average age of the subjects was 53.9 ± 7.3 and 54.3 ± 7.2 years, respectively. The presence of overweight patients (Body Mass Index (BMI) 30–34.9 kg/m2) and patients with class 1–2 obesity (BMI 35–45.9 kg/m2) was significantly higher in the CPT2DM group than in patients having only chronic periodontitis or in the Control group. However, there was no statistically significant difference in all clinical indices between the CP and CPT2DM groups. An analysis of the metagenomic data revealed that the alpha diversity in the CPT2DM group was increased compared to that in the CP and Control groups. The microbiome biomarkers associated with experimental groups were evaluated. In both groups of patients with periodontitis, the relative abundance of Porphyromonadaceae was increased compared to that in the Control group. The CPT2DM group was characterized by a lower relative abundance of Streptococcaceae/Pasteurellaceae and a higher abundance of Leptotrichiaceae compared to those in the CP and Control groups. Furthermore, the CP and CPT2DM groups differed in terms of the relative abundance of Veillonellaceae (which was decreased in the CPT2DM group compared to CP) and Neisseriaceae (which was increased in the CPT2DM group compared to CP). In addition, differences in bacterial content were identified by a combination of shotgun sequencing of pooled samples and genome-resolved metagenomics. The results indicate that there are subgingival microbiome-specific features in patients with chronic periodontitis associated with type 2 diabetes mellitus.
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Zhang H, Zhang Y, Chen X, Li J, Zhang Z, Yu H. Effects of statins on cytokines levels in gingival crevicular fluid and saliva and on clinical periodontal parameters of middle-aged and elderly patients with type 2 diabetes mellitus. PLoS One 2021; 16:e0244806. [PMID: 33417619 PMCID: PMC7793287 DOI: 10.1371/journal.pone.0244806] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/16/2020] [Indexed: 02/05/2023] Open
Abstract
Objective To analyze the effect of statins on cytokines levels in gingival crevicular fluid (GCF) and saliva and on clinical periodontal parameters of middle-aged and elderly patients with type 2 diabetes mellitus (T2DM). Methods Systemically healthy controls (C group, n = 62), T2DM patients not taking statins (D group, n = 57) and T2DM patients taking statins (S group, n = 24) were recruited. In each group, subjects (40–85 years) were subclassified into the h (periodontal health)group, the g (gingivitis)group or the p (periodontitis) group according to different periodontal conditions. 17 cytokines in gingival crevicular fluid (GCF) and saliva samples of each subject were measured utilizing the Luminex technology kit. Further, HbA1c (glycated hemoglobin), FPG (fasting plasma glucose), PD (probing depth), CAL (clinical attachment level), BOP (bleeding on probing), GI (gingival index) and PI (periodontal index) were recorded. Data distribution was tested through the Shapiro-Wilk test, upon which the Kruskal-Wallis test was applied followed by Mann-Whitney U test and Bonferroni’s correction. Results Levels of IFN-γ, IL-5, IL-10 and IL-13 in the saliva of the Dh group were significantly lower than those in the Ch group, while factor IL-4 was higher (p<0.05). Levels of MIP-3α, IL-7 and IL-2 in GCF of the Dh group were considerably higher than those in the Ch group (p<0.05), while that of IL-23 was considerably lower. Compared with the Cg group, levels of IFN-γ, IL-4, IL-5, IL-6, IL-10 and IL-13 were significantly lower in the saliva of the Dg group (p<0.05). Lower levels of IFN-γ, IL-5 and IL-10 were detected in the Sg group than those in the Cg group (p<0.05). At the same time, levels of IL-1β, IL-6, IL-7, IL-13, IL-17, IL-21 and MIP-3α in the gingival crevicular fluid of the Sg group were lower in comparison with the Dg group. In addition, lower levels of IL-4 and higher levels of IL-7 in GCF were identified in the Dg group than those in the Cg group, while in the Sg group, lower levels of IL-4, MIP-1αand MIP-3αwere observed than those in the Cg group (p<0.05). Lower levels of IFN-γ, IL-6, IL-10, IL-13 and I-TAC were found in the Sp group compared with those in the Cp group. The IFN-γ, IL-6 and IL-10 levels were lower in the Dp group than those in the Cp group (p<0.05). Meanwhile, in the Sp group, lower levels of pro-inflammatory factors IFN-γ, IL-1β, IL-2, IL-6, IL-7, IL-21 and TNF-α, in addition to higher levels of anti-inflammatory factors IL-4 and IL-5 in gingival crevicular fluid, were identified than those in the Dp group. Higher levels of IFN-γ,IL-1β,IL-2,IL-7,IL-21 and TNF-α and a lower level of IL-5 in the Dp group were identified than those in the Cp group (p<0.05). Moreover, statins were able to substantially reduce PD in T2DM patients with periodontitis, indicating an obvious influence on the levels of cytokines secreted by Th1 cells, Th2 cells and Th17 cells, as revealed by PCA (principal component analysis). Conclusion Statins are associated with reduced PD and cytokines levels in the GCF and saliva of T2DM patients with periodontitis.
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Affiliation(s)
- Huiyuan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yameng Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaochun Chen
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Juhong Li
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Ziyang Zhang
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail:
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