1
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Qu H, Zhang S. Association of cardiovascular health and periodontitis: a population-based study. BMC Public Health 2024; 24:438. [PMID: 38347510 PMCID: PMC10860246 DOI: 10.1186/s12889-024-18001-2] [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: 11/07/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND There is a strong association between cardiovascular disease (CVD) and periodontitis. This study utilized the Life Essentials 8 (LE8) score, a composite measure of cardiovascular health (CVH), to elucidate the relationship between CVH and periodontitis. METHODS Data from 8,649 nationally representative participants in the National Health and Nutrition Examination Survey (NHANES) were analyzed. The independent variable in our study was the CVH score (a higher CVH score indicates better cardiovascular health), and the dependent variable was the presence or absence of periodontitis. The association between CVH and periodontitis was investigated using weighted multivariable logistic regression models and restricted cubic spline (RCS). We controlled for potential confounders such as age, sex, race, education, and socioeconomic status to minimize bias. RESULTS There was a negative association between the total CVH score and the odds of periodontitis. After adjusting for all covariates, a 10-point increase in total CVH score was associated with a 10% lower in the odds of periodontitis [0.90 (0.87, 0.93)]. Participants with a higher CVH had 40% lower odds of periodontitis compared with those with a lower CVH. Socioeconomic status (education and income) modified this association (P for interaction < 0.05). CONCLUSION Our study suggests that better cardiovascular health, as indicated by higher CVH scores, is associated with a reduced likelihood of periodontitis among US adults. The relationship between CVH and periodontitis appears to be influenced by socioeconomic status, emphasizing the need for targeted interventions in populations with lower socioeconomic status.
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Affiliation(s)
- Haitao Qu
- Department of Oral and Maxillofacial Surgery, Jinan Stomatological Hospital, Jinan, 250001, China
| | - Shengnan Zhang
- Department of Oral and Maxillofacial Surgery, Jinan Stomatological Hospital, Jinan, 250001, China.
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2
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Ribeiro IM, de Souza Barroso ME, Kampke EH, Braga LTF, Campagnaro BP, Meyrelles SDS. Infrared laser therapy decreases systemic oxidative stress and inflammation in hypercholesterolemic mice with periodontitis. Lipids Health Dis 2023; 22:171. [PMID: 37817126 PMCID: PMC10566050 DOI: 10.1186/s12944-023-01934-9] [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: 07/31/2023] [Accepted: 10/02/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Near-infrared irradiation photobiomodulation (NIR-PBM) has been successfully used in periodontal treatment as an adjuvant tool to locally improve cell function and regeneration. Although the relationship between periodontitis and systemic disease constitutes an important aspect of periodontal clinical research, the systemic effects of NIR-PBM in periodontitis are not well known. In this study, we aimed to investigate the effects of NIR-PBM on systemic oxidative stress and inflammation in an apolipoprotein E (ApoE) knockout mouse model of periodontal disease (PD). METHODS We evaluated alveolar bone loss by measuring the distance from the cementoenamel junction (CEJ) to the alveolar bone crest (ABC), reactive oxygen species (ROS) production in blood cells, inflammatory activity, plasma cholesterol levels, and lipid peroxidation levels in three experimental groups: (1) ApoEC, control group without intervention; (2) ApoEP, first molar ligation-induced periodontitis for 4 weeks; and (3) ApoEP + PBM, exposed to 808 nm continuous wave, ø ~ 3 mm2, 100 mW, 60 s of NIR-PBM for 7 consecutive days after 4 weeks of periodontitis. At the end of the experimental protocols, ApoEP mice presented significantly increased alveolar bone loss, ROS production, inflammatory activity, plasma cholesterol, and lipid peroxidation levels compared to the ApoEC group (P < 0.05). NIR-PBM for 7 days in the ApoEP + PBM mice significantly decreased systemic ROS production, inflammatory response, plasma cholesterol, and lipid peroxidation levels, similar to those found in the ApoEC group (P > 0.05). However, it was not capable of preventing alveolar bone loss (P > 0.05 compared to ApoEP mice). CONCLUSION A 7-day treatment with NIR-PBM effectively reduces systemic oxidative stress and inflammatory parameters in hypercholesterolemic mice with PD. However, more studies with longer evaluation times are needed to confirm the systemic effects of locally applied NIR-PBM on PD associated with hypercholesterolemia.
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Affiliation(s)
- Isadora Martins Ribeiro
- Graduate Program in Dental Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | - Maria Eduarda de Souza Barroso
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | - Edgar Hell Kampke
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | | | - Bianca Prandi Campagnaro
- Graduate Program in Pharmaceutical Sciences, Vila Velha University (UVV), Vila Velha, 29102-920, ES, Brazil
| | - Silvana Dos Santos Meyrelles
- Graduate Program in Dental Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil.
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil.
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3
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Yu F, Wang H, Wang Q, Zhao B, Zhao Z, Bian W. Evaluation of bi-directional causal association between periodontal disease and erectile dysfunction: a two-sample Mendelian randomization study. Clin Oral Investig 2023; 27:5895-5903. [PMID: 37581767 DOI: 10.1007/s00784-023-05201-0] [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: 01/13/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The association between periodontal disease (PD) and erectile dysfunction (ED) has been well-documented in observational studies. However, observational studies are vulnerable to reverse causality and confounding factors, making the inference of causal-effect relationships challenging. Contrary to the current belief, Mendelian randomization (MR) can be applied to comprehensively assess the bi-directional causal effects between PD and ED. METHODS A two-sample MR analysis was performed using pooled statistics from genome-wide association studies involving European populations with PD (12,289 patients with PD and 22,326 controls) and ED (6,175 patients with clinically diagnosed ED and 217,630 controls). In this MR analysis, three methods--the inverse-variance weighted (IVW) average, weighted median, and MR-Egger regression methods--were used to evaluate the causal relationships between PD and ED. RESULTS According to the IVW analysis results, genetically predicted PD did not have a causal effect on ED (odds ratio 1.07, 95% confidence interval 0.96-1.20, p = 0.22). Furthermore, there was no clear indication of a significant causal effect of ED on PD in the reverse MR analysis (odds ratio 0.98, 95% confidence interval 0.90-1.08, p = 0.74). The results of the MR-Egger regression and weighted median methods were consistent with those of the IVW method. Based on the sensitivity analysis results, a major bias from genetic pleiotropy was unlikely to distort the causal estimates. CONCLUSION The present study does not support a causal effect between PD and ED. CLINICAL RELEVANCE From the perspective of genetics, PD does not appear to be a risk factor for the development of ED.
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Affiliation(s)
- Feiyan Yu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - He Wang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Qianqian Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Baoling Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Zhenni Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Wei Bian
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China.
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Shanxi Medical University, Taiyuan, China.
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4
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Wagner AK, D'Souza M, Bang CN, Holmstrup P, Blanche P, Fiehn NE, Gislason G, Pedersen CT, Damgaard C, Nielsen CH, Hansen PR. Treated periodontitis and recurrent events after first-time myocardial infarction: A Danish nationwide cohort study. J Clin Periodontol 2023; 50:1305-1314. [PMID: 37464548 DOI: 10.1111/jcpe.13853] [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: 09/05/2022] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/20/2023]
Abstract
AIM To investigate the association between previous periodontal treatment and recurrent events after first-time myocardial infarction (MI). MATERIALS AND METHODS From the Danish nationwide registries, patients with first-time MI between 2000 and 2015 were divided into three groups according to oral health care within 1 year prior to first-time MI. A multiple logistic regression model provided adjusted odds ratios (ORs) with 95% confidence intervals (CIs) to assess the 3-year risk of major adverse cardiovascular events (MACE). RESULTS A total of 103,949 patients were included. Patients with treated periodontitis (PD) prior to first-time MI had an adjusted 3-year risk of MACE similar to patients presumed periodontally healthy (OR 0.97 [95% CI 0.92-1.03]). Patients with no prior dental visits were significantly older, had more comorbidities and showed significantly increased adjusted 3-year risks of MACE (OR 1.47 [95% CI 1.42-1.52]), cardiovascular death (OR 1.71 [95% CI 1.64-1.78]) and heart failure (OR 1.13 [95% CI 1.07-1.20]) compared with patients presumed periodontally healthy. CONCLUSIONS Patients with treated PD 1 year prior to first-time MI had a similar risk of recurrent cardiovascular events as patients presumed periodontally healthy. No dental visit prior to first-time MI was an independent risk factor for recurrent events.
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Affiliation(s)
- Andrea Kjellström Wagner
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark
| | - Maria D'Souza
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark
| | - Casper N Bang
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Palle Holmstrup
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Paul Blanche
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Nils-Erik Fiehn
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- The Danish Heart Foundation, Copenhagen, Denmark
| | - Christian Torp Pedersen
- Department of Cardiology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
| | - Christian Damgaard
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Henrik Nielsen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Peter Riis Hansen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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5
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Shen MT, Shahin B, Chen Z, Adami GR. Unexpected lower level of oral periodontal pathogens in patients with high numbers of systemic diseases. PeerJ 2023; 11:e15502. [PMID: 37465146 PMCID: PMC10351517 DOI: 10.7717/peerj.15502] [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: 01/18/2023] [Accepted: 05/14/2023] [Indexed: 07/20/2023] Open
Abstract
Background Periodontal disease is associated with systemic conditions such as diabetes, arthritis, and cardiovascular disease, all diseases with large inflammatory components. Some, but not all, reports show periopathogens Porphyromonas gingivialis and Tannerella forsythia at higher levels orally in people with one of these chronic diseases and in people with more severe cases. These oral pathogens are thought to be positively associated with systemic inflammatory diseases through induction of oral inflammation that works to distort systemic inflammation or by directly inducing inflammation at distal sites in the body. This study aimed to determine if, among patients with severe periodontal disease, those with multi-morbidity (or many chronic diseases) showed higher levels of periodontal pathogens. Methods A total of 201 adult subjects, including 84 with severe periodontal disease were recruited between 1/2017 and 6/2019 at a city dental clinic. Electronic charts supplied self-reported diseases and conditions which informed a morbidity index based on the number of chronic diseases and conditions present. Salivary composition was determined by 16S rRNA gene sequencing. Results As expected, patients with severe periodontal disease showed higher levels of periodontal pathogens in their saliva. Also, those with severe periodontal disease showed higher levels of multiple chronic diseases (multimorbidity). An examination of the 84 patients with severe periodontal disease revealed some subjects despite being of advanced age were free or nearly free of systemic disease. Surprisingly, the salivary microbiota of the least healthy of these 84 subjects, defined here as those with maximal multimorbidity, showed significantly lower relative numbers of periodontal pathogens, including Porphyromonas gingivalis and Tannerella Forsythia, after controlling for active caries, tobacco usage, age, and gender. Analysis of a control group with none to moderate periodontal disease revealed no association of multimorbidity or numbers of medications used and specific oral bacteria, indicating the importance of severe periodontal disease as a variable of interest. Conclusion The hypothesis that periodontal disease patients with higher levels of multimorbidity would have higher levels of oral periodontal pathogens is false. Multimorbidity is associated with a reduced relative number of periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia.
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Affiliation(s)
- Michael T Shen
- Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois Chicago, Chicago, IL, United States of America
| | - Betti Shahin
- Restorative Dentistry, University of Illinois Chicago, Chicago, IL, United States of America
| | - Zhengjia Chen
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States of America
- Biostatistics Shared Resource Core, University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, United States of America
| | - Guy R Adami
- Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois Chicago, Chicago, IL, United States of America
- University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, United States of America
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6
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Aremu JB, Pérez CM, Joshipura KJ. Longitudinal Association between Periodontitis and the Risk of Hypertension. Int J Dent 2023; 2023:2644623. [PMID: 37361411 PMCID: PMC10290562 DOI: 10.1155/2023/2644623] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Objectives Hypertension poses a major public health challenge due to its association with increased risk of heart disease, chronic kidney disease, and death. The objective of this study is to evaluate the longitudinal association between periodontitis and the risk of hypertension. Methods Using a cohort study design, 540 participants free of diagnosed hypertension/prehypertension in the San Juan Overweight Adults Longitudinal Study and with complete 3-year follow-up data were included. Periodontitis was classified according to the 2012 Centers for Disease Control and Prevention/American Academy of Periodontology definition. Participants were considered to have developed hypertension if they reported physician-diagnosed hypertension over the follow-up period or had average systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg at follow-up. Participants free of diagnosed hypertension or prehypertension and with normal BP at baseline (SBP < 120 mm Hg and DBP < 80 mm Hg) were considered to develop prehypertension if they had SBP between 120 and 139 mm Hg or DBP between 80 and 89 mm Hg at follow-up. An additional (secondary) outcome was defined as the development of prehypertension/hypertension over the follow-up period among participants who had normal BP at baseline. We used Poisson regression, adjusting for age, sex, smoking status, physical activity, alcohol intake, diabetes, waist circumference, and family history of hypertension. Results One hundred and six (19.6%) participants developed hypertension, and 58 of the 221 with normal BP (26%) developed prehypertension/hypertension. There was no consistent association between periodontitis and the risk of developing hypertension. However, people with severe periodontitis had an increased incidence of prehypertension/hypertension (multivariate incidence rate ratios: 1.47; 95% confidence interval: 1.01, 2.17) than people without periodontitis after adjusting for confounders. Conclusion There was no association between periodontitis and hypertension in this cohort study. However, severe periodontitis was associated with an increased risk of prehypertension/hypertension.
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Affiliation(s)
- John B. Aremu
- College of Nursing and Health Professions, Arkansas State University, Jonesboro, AR, USA
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
- Department of General Dentistry, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
| | - Kaumudi J. Joshipura
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- School of Public Health, Ahmedabad University, Gujarat, India
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7
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Hix-Janssens T, Shinde S, Abouhany R, Davies J, Neilands J, Svensäter G, Sellergren B. Microcontact-Imprinted Optical Sensors for Virulence Factors of Periodontal Disease. ACS OMEGA 2023; 8:15259-15265. [PMID: 37151489 PMCID: PMC10157856 DOI: 10.1021/acsomega.3c00389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/28/2023] [Indexed: 05/09/2023]
Abstract
Periodontitis (gum disease) is a common biofilm-mediated oral condition, with around 7% of the adult population suffering from severe disease with risk for tooth loss. Moreover, periodontitis virulence markers have been found in atherosclerotic plaque and brain tissue, suggesting a link to cardiovascular and Alzheimer's diseases. The lack of accurate, fast, and sensitive clinical methods to identify patients at risk leads, on the one hand, to patients being undiagnosed until the onset of severe disease and, on the other hand, to overtreatment of individuals with mild disease, diverting resources from those patients most in need. The periodontitis-associated bacterium, Porphyromonas gingivalis, secrete gingipains which are highly active proteases recognized as key virulence factors during disease progression. This makes them interesting candidates as predictive biomarkers, but currently, there are no methods in clinical use for monitoring them. Quantifying the levels or proteolytic activity of gingipains in the periodontal pocket surrounding the teeth could enable early-stage disease diagnosis. Here, we report on a monitoring approach based on high-affinity microcontact imprinted polymer-based receptors for the Arg and Lys specific gingipains Rgp and Kgp and their combination with surface plasmon resonance (SPR)-based biosensor technology for quantifying gingipain levels in biofluids and patient samples. Therefore, Rgp and Kgp were immobilized on glass coverslips followed by microcontact imprinting of poly-acrylamide based films anchored to gold sensor chips. The monomers selected were N-isopropyl acrylamide (NIPAM), N-hydroxyethyl acrylamide (HEAA) and N-methacryloyl-4-aminobenzamidine hydrochloride (BAM), with N,N'-methylene bis(acrylamide) (BIS) as the crosslinker. This resulted in imprinted surfaces exhibiting selectivity towards their templates high affinity and selectivity for the templated proteins with dissociation constants (K d) of 159 and 299 nM for the Rgp- and Kgp-imprinted, surfaces respectively. The former surface displayed even higher affinity (K d = 71 nM) when tested in dilute cell culture supernatants. Calculated limits of detection for the sensors were 110 and 90 nM corresponding to levels below clinically relevant concentrations.
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Affiliation(s)
- Thomas Hix-Janssens
- Department
of Biomedical Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
| | - Sudhirkumar Shinde
- Department
of Biomedical Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
| | - Rahma Abouhany
- Department
of Biomedical Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
| | - Julia Davies
- Section
for Oral Biology and Pathology, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
| | - Jessica Neilands
- Section
for Oral Biology and Pathology, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
| | - Gunnel Svensäter
- Section
for Oral Biology and Pathology, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
| | - Börje Sellergren
- Department
of Biomedical Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
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8
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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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9
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Xiao X, Liu S, Deng H, Song Y, Zhang L, Song Z. Advances in the oral microbiota and rapid detection of oral infectious diseases. Front Microbiol 2023; 14:1121737. [PMID: 36814562 PMCID: PMC9939651 DOI: 10.3389/fmicb.2023.1121737] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
Several studies have shown that the dysregulation of the oral microbiota plays a crucial role in human health conditions, such as dental caries, periodontal disease, oral cancer, other oral infectious diseases, cardiovascular diseases, diabetes, bacteremia, and low birth weight. The use of traditional detection methods in conjunction with rapidly advancing molecular techniques in the diagnosis of harmful oral microorganisms has expanded our understanding of the diversity, location, and function of the microbiota associated with health and disease. This review aimed to highlight the latest knowledge in this field, including microbial colonization; the most modern detection methods; and interactions in disease progression. The next decade may achieve the rapid diagnosis and precise treatment of harmful oral microorganisms.
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Affiliation(s)
- Xuan Xiao
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Shangfeng Liu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Hua Deng
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuhan Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Liang Zhang
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China,Liang Zhang,
| | - Zhifeng Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,*Correspondence: Zhifeng Song,
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10
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Cardiovascular Diseases and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:261-280. [PMID: 35612803 DOI: 10.1007/978-3-030-96881-6_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the tooth-supporting connective tissue and alveolar bone that is initiated by a bacterial biofilm in periodontal pockets. It affects about half of adults in the Western world, and is associated with a range of systemic comorbidities, e.g., cardiovascular disease (CVD), diabetes and rheumatoid arthritis, and these diseases share overlapping systemic and target tissue inflammatory mechanisms. Indeed, mounting evidence has indicated that their association is causal and built on the presence of systemic low-grade inflammation (LGI). Prior research linking periodontitis to CVD has mainly been derived from experimental studies, observational data, and small interventional trials with surrogate markers of CVD, e.g., endothelial dysfunction. However, recent data from randomised studies have demonstrated that intensive treatment of periodontitis can reduce blood pressure in patients with hypertension in conjunction with reduction of systemic inflammatory markers. Furthermore, targeted anti-inflammatory therapy has been shown to reduce recurrent events in patients with established CVD and LGI. Along this line, the concept of residual inflammatory risk has emerged as an independent new risk factor for atherothrombotic CVD. The present review summarizes translational evidence indicating that periodontitis is a risk factor for CVD dependent on LGI, and we conclude that treatment of periodontitis is likely to contribute importantly to reduction of residual inflammatory risk.
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11
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Huang N, Li C, Sun W, Yang Y, Tang Q, Xiao F. Association Between Chronic Periodontal Disease and Erectile Dysfunction: A Case-Control Study. Am J Mens Health 2022; 16:15579883221084798. [PMID: 35319301 PMCID: PMC8949704 DOI: 10.1177/15579883221084798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Erectile dysfunction (ED) and chronic periodontal disease (CPD) share mutual risk factors, and the incidence of ED is increasing among young adults. The relation of CPD and ED remains obscure due to inconsistent clinical evidence. This study aimed to further assess the relationship between CPD and ED using the Community Periodontal Index of Treatment Need (CPITN) and the International Index of Erectile Function (IIEF). Totally, 202 adult men were included, with 100 subjects with ED in the case group and 102 subjects without ED undergoing routine dental examinations in the control group. The IIEF questionnaire was used to assess the severity of ED, and CPD was assessed through the Community Periodontal Index (CPI) score. Periodontal assessments were performed by one single calibrated examiner. Logistic regression analysis was performed for the association between CPD and ED. After adjustment for age, smoking status, tooth brushing time, education level, monthly income, tooth brushing frequency, and gum bleeding, higher CPI score was identified to be associated with a greater risk of ED (odds ratio [OR] = 2.755, 95% confidence interval [CI] = [1.400, 5.423], p = .003), suggesting that CPD was positively associated with the odds of ED. CPD was getting more severe with the progress of ED (p < .05). Men with ED could be encouraged to receive routine dental examinations and appropriate preventive dental measures to maintain oral and periodontal health.
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Affiliation(s)
- Nannan Huang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Chanxiu Li
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Wenjuan Sun
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Yuhong Yang
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen, Guangdong, P. R. China
| | - Qian Tang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Feng Xiao
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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12
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Hajek A, König HH, Buczak-Stec E, Rose LM, Kretzler B, Spinler K, Schiffner U, Aarabi G, Walther C. Regular childhood dental visits, health-related factors and quality of life in later life. Arch Gerontol Geriatr 2022; 99:104585. [DOI: 10.1016/j.archger.2021.104585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
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13
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Molecular Mechanisms Leading from Periodontal Disease to Cancer. Int J Mol Sci 2022; 23:ijms23020970. [PMID: 35055157 PMCID: PMC8778447 DOI: 10.3390/ijms23020970] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is prevalent in half of the adult population and raises critical health concerns as it has been recently associated with an increased risk of cancer. While information about the topic remains somewhat scarce, a deeper understanding of the underlying mechanistic pathways promoting neoplasia in periodontitis patients is of fundamental importance. This manuscript presents the literature as well as a panel of tables and figures on the molecular mechanisms of Porphyromonas gingivalis and Fusobacterium nucleatum, two main oral pathogens in periodontitis pathology, involved in instigating tumorigenesis. We also present evidence for potential links between the RANKL–RANK signaling axis as well as circulating cytokines/leukocytes and carcinogenesis. Due to the nonconclusive data associating periodontitis and cancer reported in the case and cohort studies, we examine clinical trials relevant to the topic and summarize their outcome.
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14
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Reissmann DR, Aarabi G, Härter M, Heydecke G, Kriston L. Measuring oral health: the Physical Oral Health Index: Physical Oral Health Index (PhOX). J Dent 2022; 118:103946. [PMID: 35017019 DOI: 10.1016/j.jdent.2022.103946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Oral health is an important component of a person's general health. Studies focusing on this issue need valid and reliable tools to assess oral health. Aim was to develop a comprehensive measure for physical oral health and to establish its measurement properties. METHODS The construct physical oral health was defined based on a systematic literature review and a modified Delphi technique in an expert panel (n=31). The preliminary tool was applied in a multicenter study (n=609) to gain empirical data on acceptance, item characteristics, reliability, and responsiveness. Validity was assessed as correlation of sores with patients' and experts' global oral health ratings and Oral Health Impact Profile (OHIP) summary score. Based on findings of field testing, the tool was modified to derive the final version of the Physical Oral Health Index (PhOX). Finally, measurement properties of the PhOX were determined. RESULTS The PhOX consists of 14 items covering all relevant oral health structures and conditions. For repeated measures, reliability of the summary score was high (ICC=0.87). The summary score was correlated in the expected direction to patients' (r=0.43) and examiners' (r=0.55) global oral health ratings and to OHIP summary scores (r=-0.41). Among patients receiving dental treatments between two assessments, PhOX summary scores increased from baseline to follow-up statistically significantly (p=0.002). CONCLUSIONS The newly developed PhOX is a methodologically sound and easy to apply tool for the comprehensive assessment of physical oral health.
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Affiliation(s)
- Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Oral hygiene and health-related quality of life in institutionalized older people. Eur Geriatr Med 2021; 13:213-220. [PMID: 34313976 PMCID: PMC8860786 DOI: 10.1007/s41999-021-00547-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
Aim We evaluated oral hygiene level and its association with oral health and general health-related quality of life (HRQoL) among older residents in long-term care facilities. Findings Only one-fifth of residents had good oral hygiene. Poor oral hygiene was associated with poor oral health and diminished HRQoL. Message Oral hygiene, oral health, and HRQoL may be improved with oral care education of caregivers, professional cooperation, and regular oral healthcare of older residents in long-term care facilities. Purpose We evaluated the level of oral hygiene and its association with oral health status and need for oral treatment among older residents in long-term care facilities. In addition, the association between oral hygiene level and health-related quality of life (HRQoL) was explored. Methods This cross-sectional study assessed 231 dentate residents in long-term care facilities (71% female, mean age 81 years, 70% had dementia). Nurses assessed residents and completed questionnaires on participants’ background information, diagnoses, oral healthcare habits, and HRQoL with the 15D instrument. Two qualified dentists performed clinical oral examinations (number of teeth, plaque index, periodontal condition, open caries lesions, and dry mouth). We used a modified plaque index (PI) to measure the level of oral hygiene (good, moderate, and poor) and calculated the clinical Asymptotic Dental Score (ADS) to determine the oral inflammation burden. Results Of the residents, 21% had good, 35% moderate, and 44% poor oral hygiene according to PI. Poor oral hygiene was associated with poorer cognitive status (P = 0.010) and higher oral inflammation burden (P < 0.001). Moreover, poor oral hygiene was associated with poorer HRQoL in a correlation analysis adjusted for age and gender. Conclusions Oral hygiene of older individuals in long-term care is insufficient. Poor oral hygiene is a marker for poor HRQoL. Residents also have a high burden of oral inflammatory diseases and a need for dental care. Older residents’ oral hygiene and HRQoL may be improved with oral care education of caregivers and regular dental check-ups.
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16
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Tsuboi A, Matsui H, Shiraishi N, Murakami T, Otsuki A, Kawashima J, Kiyama T, Tamahara T, Goto M, Koyama S, Sugawara J, Kodama EN, Metoki H, Hozawa A, Kuriyama S, Tomita H, Kikuya M, Minegishi N, Suzuki K, Koshiba S, Tamiya G, Fuse N, Aoki Y, Takai-Igarashi T, Ogishima S, Nakamura T, Sakurai-Yageta M, Nagami F, Kinoshita K, Kure S, Shimizu R, Sasaki K, Yamamoto M. Design and Progress of Oral Health Examinations in the Tohoku Medical Megabank Project. TOHOKU J EXP MED 2021; 251:97-115. [PMID: 32581193 DOI: 10.1620/tjem.251.97] [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] [Indexed: 11/18/2022]
Abstract
In order to assess the long-term impact of the Great East Japan Earthquake on the oral health of disaster victims and to evaluate gene-environmental interactions in the development of major oral diseases and oral-systemic associations, the oral part of two large-scale genome cohort studies by the Tohoku Medical Megabank Organization (ToMMo), including the Community-based cohort (CommCohort) study and the Birth and Three-Generation cohort (BirThree) study, have been conducted. The study population comprised 32,185 subjects, including 16,886 participants in the CommCohort study and 15,299 participants in the BirThree cohort study, recruited from 2013 to 2017. The oral studies consist of a questionnaire regarding oral hygiene behavior, clinical examinations by dentists, and oral plaque and saliva sampling for microbiome analyses, which were carried out at seven community support centers in Miyagi prefecture. The median age of all participants was 55.0 years, and 66.1% of participants were women. Almost all participants reported that they brushed their teeth more than once a day. The median number of present teeth was 27.0, and the decayed, missing and filled tooth number was 16.0, with a significant difference according to age and sex. The median periodontal pocket and clinical attachment level was 2.48 mm and 4.00 mm, respectively. Periodontal parameters increased significantly according to age, except for the accumulation of dental calculus. The oral part of these extensive cross-sectional studies provides a unique and important platform for future studies on oral health and diseases that elicit through interactions with systemic diseases, lifestyles, life events and genetic backgrounds, and contributes to researches clarifying the long-term effects of disasters on oral health.
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Affiliation(s)
- Akito Tsuboi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Hiroyuki Matsui
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University
| | | | - Takahisa Murakami
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University.,Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Akihito Otsuki
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | | | - Tomomi Kiyama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University
| | - Toru Tamahara
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University
| | - Maki Goto
- Tohoku Medical Megabank Organization, Tohoku University
| | | | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University.,Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Teikyo University School of Medicine
| | - Naoko Minegishi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Kichiya Suzuki
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Seizo Koshiba
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Gen Tamiya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Center for Advanced Intelligence Project, RIKEN
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Yuichi Aoki
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Information Sciences, Tohoku University
| | - Takako Takai-Igarashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | | | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Information Sciences, Tohoku University
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Ritsuko Shimizu
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | | | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
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17
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Bunte K, Kuhn C, Walther C, Peters U, Aarabi G, Smeets R, Beikler T. Clinical significance of ragA, ragB, and PG0982 genes in Porphyromonas gingivalis isolates from periodontitis patients. Eur J Oral Sci 2021; 129:e12776. [PMID: 33667038 DOI: 10.1111/eos.12776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/14/2022]
Abstract
Consistent detection of ragA, ragB, and PG0982 in the genome of Porphyromonas gingivalis (P. gingivalis) isolates from periodontitis patients suggests that genotypes containing these genes may influence virulence and P. gingivalis-associated periodontitis progression. This study evaluated the prevalence of these genes in P. gingivalis isolates from periodontitis patients (n = 28) and in isolates from periodontally healthy P. gingivalis carriers (n = 34). The association of these genes with progression of periodontitis, in vitro cell invasiveness, and bacterial survival following periodontal therapy was also assessed. Periodontal charting and microbiological sampling were done at baseline, and at 6, 12, and 24 months following subgingival debridement of the periodontitis patients. Healthy controls were assessed at baseline for comparison. P. gingivalis isolates were analysed by ragA, ragB, and PG0982 specific polymerase chain reaction (PCR) and Sanger sequencing. Primary human gingival fibroblasts were used for invasion experiments. Results showed that 25% of the tested isolates from the periodontitis group had ragB detected, whereas this gene was undetected in isolates from healthy participants. However, none of the selected genes was associated with an increased cell invasiveness in vitro, with bacterial survival, or with significant clinical periodontal parameter changes. Identification of genes that influence P.gingivalis virulence and therapeutic outcome may have a diagnostic or prognostic value.
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Affiliation(s)
- Kübra Bunte
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Carolin Walther
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Division of Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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18
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Noetzel N, Meyer AM, Siri G, Pickert L, Heeß A, Verleysdonk J, Benzing T, Pilotto A, Barbe AG, Polidori MC. The impact of oral health on prognosis of older multimorbid inpatients: the 6-month follow up MPI oral health study (MPIOH). Eur Geriatr Med 2020; 12:263-273. [PMID: 33206351 DOI: 10.1007/s41999-020-00427-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE There is clear evidence for an association between oral health and systemic illnesses, geriatric syndromes, and mortality. Frail and multimorbid older people often suffer from insufficient oral health care, but standardized dental examinations are not routinely performed in clinical settings. The aim of this study was to verify the practicability of in-hospital oral health examinations and to identify their association with patients' prognosis as assessed by means of the Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI). METHODS One hundred hospitalized patients aged 65 years and older (mean age 76.9 years (SD 6.4); 58.2% male, 41.8% female) underwent a CGA-based MPI calculation at discharge with subdivision into three mortality risk groups (MPI-1, low risk, score 0-0.33; MPI-2, moderate risk, score 0.34-0.66; MPI-3, high risk, score 0.67-1). To identify the current oral health status and the Oral Health-related Quality of Life (OHRQoL), three oral health examinations were performed. Information on survival, the incidence of oral diseases, dental appointments, and treatments up to 6 months after discharge were collected. RESULTS All oral health examinations were feasible during hospitalization and were associated with MPI prognosis, even though they were not associated with 6-month mortality. The MPI could not predict the use of dental health care or treatment, as, irrespective of MPI and oral health examinations, dental services were underutilized during follow up. CONCLUSION Besides MPI evaluation, oral health examinations should be implemented into an inhospital course to improve clinical decision-making as well as secondary and tertiary prevention of oral health- and related systemic diseases. TRIAL REGISTRATION NUMBER German Clinical Trials Register: DRKS00013607 (07.02.2019, retrospectively registered).
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Affiliation(s)
- Nicolas Noetzel
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Anna Maria Meyer
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Giacomo Siri
- Scientific Directorate-Biostatistics, E.O. Galliera Hospital, Genova, Italy
| | - Lena Pickert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Annika Heeß
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Joshua Verleysdonk
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Thomas Benzing
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Cologne Excellence Cluster On Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy.,Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Cologne Excellence Cluster On Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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19
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Tooth loss is associated with atherosclerosis and a poorer functional outcome among stroke patients. Clin Oral Investig 2020; 24:4541-4548. [DOI: 10.1007/s00784-020-03319-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/30/2020] [Indexed: 12/28/2022]
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20
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Valdez R, Aarabi G, Spinler K, Walther C, Seedorf U, Heydecke G, Buczak-Stec E, König HH, Hajek A. Association between Subjective Well-Being and Frequent Dental Visits in the German Ageing Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093207. [PMID: 32380743 PMCID: PMC7246676 DOI: 10.3390/ijerph17093207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022]
Abstract
The relationship between subjective well-being (SWB) and frequent attendance is understudied. This study used data from a large German sample of non-institutionalized individuals aged 40+ in 2014 (n = 7264). SWB was measured using the Satisfaction with Life Scale (SWLS) and the Positive and Negative Affect Schedule (PANAS). Number of self-reported dental visits in the past twelve months was used to measure the utilization frequency of dental services. Individuals with at least four dental visits in the preceding year (highest decile) were defined as frequent dental visits. Robustness checks were performed using alternative cut-offs to define frequent dental visits. Multiple logistic regressions showed that frequent dental visits (highest decile) were associated with less satisfaction with life [OR: 0.89, 95%-CI: 0.80–0.99] and higher negative affect [OR: 1.41, 95%-CI: 1.22–1.64], whereas it was not significantly associated with positive affect. Both associations depended on the cut-off chosen to define frequent dental visits. The present study highlights the association between SWB (particularly negative affect and low life satisfaction) and frequent dental visits. Further studies evaluating patients’ motivation for high dental service use are necessary to check the robustness of our findings.
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Affiliation(s)
- Richelle Valdez
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
- Institute of Medical Sociology, Center Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
| | - Kristin Spinler
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
- Institute of Medical Sociology, Center Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Carolin Walther
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.V.); (G.A.); (K.S.); (C.W.); (U.S.); (G.H.)
| | - Elzbieta Buczak-Stec
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.B.-S.); (H.-H.K.)
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.B.-S.); (H.-H.K.)
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.B.-S.); (H.-H.K.)
- Correspondence: ; Tel.: +49-40-7410-52877
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21
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Holtfreter B, Samietz S, Hertrampf K, Aarabi G, Hagenfeld D, Kim TS, Kocher T, Koos B, Schmitter M, Ahrens W, Alwers E, Becher H, Berger K, Brenner H, Damms-Machado A, Ebert N, Fischer B, Franzke CW, Frölich S, Greiser H, Gies A, Günther K, Hassan L, Hoffmann W, Jaeschke L, Keil T, Kemmling Y, Krause G, Krist L, Legath N, Lieb W, Leitzmann M, Linseisen J, Loeffler M, Meinke-Franze C, Michels KB, Mikolajczyk R, Obi N, Peters A, Pischon T, Schipf S, Schmidt B, Völzke H, Waniek S, Wigmann C, Wirkner K, Schmidt CO, Kühnisch J, Rupf S. Design und Qualitätskontrolle der zahnmedizinischen Untersuchung in der NAKO Gesundheitsstudie. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:426-438. [DOI: 10.1007/s00103-020-03107-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Zusammenfassung
Hintergrund
Karies und Parodontitis sind weltweit hoch prävalente Erkrankungen. Durch ihre Erfassung im Rahmen der NAKO Gesundheitsstudie können Assoziationen zwischen oralen und systemischen Erkrankungen untersucht werden.
Fragestellung
In einer ersten Qualitätsanalyse zur Halbzeit der NAKO-Basiserhebung wird die Plausibilität der zahnmedizinischen Ergebnisse überprüft. Es werden Maßnahmen zur Verbesserung der Datenqualität vorgeschlagen.
Material und Methoden
Ein zahnmedizinisches Interview, eine Speichelprobengewinnung und eine Befunderhebung wurden durchgeführt. Im Rahmen der Level-1-Untersuchung wurden Zahn- und Prothesenanzahl erfasst. In der Level-2-Untersuchung wurden detaillierte parodontologische, kariologische und funktionelle Befunde erhoben. Alle Untersuchungen wurden von geschultem nichtzahnmedizinischen Personal durchgeführt. Es wurden Plausibilitätsprüfungen durchgeführt sowie Verteilungen deskriptiv dargestellt.
Ergebnisse
In die Analysen gingen Daten von 57.967 Interviewteilnehmer*innen, 56.913 Level-1- und 6295 Level-2-Teilnehmer*innen ein. Der Anteil fehlender Werte lag für die einzelnen Parameter der Level-1- und Level-2-Untersuchungen zwischen 0,02 % und 3,9 %. Die Parameter zeigten eine plausible Verteilung; vereinzelt wurden unplausible Werte beobachtet, z. B. beim horizontalen und vertikalen Überbiss (Overjet und Overbite). Anhand der Intraklassenkorrelationskoeffizienten wurden für die einzelnen Parameter Unterschiede zwischen regionalen Clustern, den Studienzentren und verschiedenen Untersucher*innen nachgewiesen.
Diskussion
Die bisherigen Ergebnisse bestätigten die Umsetzbarkeit des Studienprotokolls durch nichtzahnmedizinisches Personal und die erfolgreiche Integration in das Untersuchungsprogramm der NAKO Gesundheitsstudie. Die Studienzentren benötigen eine intensive zahnmedizinische Betreuung für das Qualitätsmanagement.
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Cho DH, Song IS, Choi J, Gwon JG. Risk of peripheral arterial disease in patients with periodontitis: A nationwide, population-based, matched cohort study. Atherosclerosis 2020; 297:96-101. [DOI: 10.1016/j.atherosclerosis.2020.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/02/2020] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
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23
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Adachi N, Kobayashi Y. One-year follow-up study on associations between dental caries, periodontitis, and metabolic syndrome. J Oral Sci 2020; 62:52-56. [PMID: 31996523 DOI: 10.2334/josnusd.18-0251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
There have been few prospective studies on the relationship between oral health conditions and the development of metabolic syndrome (MetS). This prospective cohort study was performed at a Japanese company over one year. Routine medical health examinations, oral health examinations, and a questionnaire pertaining to education, job type, and health behaviors was administered. Participants aged ≥35 years who had no MetS components at baseline were re-examined after one year. Modified Poisson regression analyses were performed to calculate the relative risks (RRs) associated with oral health variables, including periodontitis, decayed and missing teeth, and decayed, missing, and filled teeth (DMFT) in relation to the development of MetS. Of 152 eligible participants, 136 were re-examined after one year; 30 exhibited one or more newly developed MetS components upon re-examination. Decayed teeth at baseline were significantly associated with development of at least one MetS component (adjusted RR 3.25, 95% confidence interval 1.59-6.63). There were no associations between periodontitis, missing teeth, or DMFT and the development of MetS. The association between decayed teeth and MetS was independent of other risk factors, including age and body mass index; therefore, decayed teeth may be associated with the development of MetS.
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Affiliation(s)
- Naoko Adachi
- Department of Preventive Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Public Health, Graduate School of Medicine, The University of Tokyo
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo
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24
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Periodontal Disease in Association with Systemic Diseases in the Dog. FOLIA VETERINARIA 2019. [DOI: 10.2478/fv-2019-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Periodontal disease (PD) is the second most common disease affecting dogs in UK veterinary practices. Veterinary and human literature suggests that periodontal disease may be associated with bacteraemia and a chronic, systemic release of inflammatory mediators which produce direct or immune-mediated changes elsewhere in the body. Thirty canine periodontal patient’s electronic medical histories were analysed for comorbidities. The findings were analysed overall to identify any possible associations. Seventy three percent of these dogs had comorbidities, most commonly haematopoietic, cardiovascular, musculoskeletal and hepatic systems were involved. The most prevalent comorbidities were: high liver enzymes, heart murmur, mitral valve disease, and monocytosis. Other interesting comorbidities were: endocarditis, neutrophilia, submandibular lymph node enlargement and arthritis. Periodontal disease patients had a higher prevalence of disease when compared to the disease prevalence data for UK pet dogs in general. Mitral valve disease was over 17 times more likely in the periodontal disease patients. Comorbidity disease prevalence also increased with more severe periodontal disease stages. This study supports an association between periodontal disease and systemic diseases in the dog. Further studies should focus on confirming a cause and effect relationship. Until then, these data may be useful for veterinarians to examine periodontal patients for concurrent diseases and can be used as a tool to promote dental disease prevention to pet owners.
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The expression of macrophage migration inhibitory factor and intercellular adhesion molecule-1 in rats with periodontitis and atherosclerosis. Arch Oral Biol 2019; 107:104513. [DOI: 10.1016/j.archoralbio.2019.104513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
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26
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Adams B, Nunes JM, Page MJ, Roberts T, Carr J, Nell TA, Kell DB, Pretorius E. Parkinson's Disease: A Systemic Inflammatory Disease Accompanied by Bacterial Inflammagens. Front Aging Neurosci 2019; 11:210. [PMID: 31507404 PMCID: PMC6718721 DOI: 10.3389/fnagi.2019.00210] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/26/2019] [Indexed: 01/08/2023] Open
Abstract
Parkinson’s disease (PD) is a well-known neurodegenerative disease with a strong association established with systemic inflammation. Recently, the role of the gingipain protease group from Porphyromonas gingivalis was implicated in Alzheimer’s disease and here we present evidence, using a fluorescent antibody to detect gingipain R1 (RgpA), of its presence in a PD population. To further elucidate the action of this gingipain, as well as the action of the lipopolysaccharide (LPS) from P. gingivalis, low concentrations of recombinant RgpA and LPS were added to purified fluorescent fibrinogen. We also substantiate previous findings regarding PD by emphasizing the presence of systemic inflammation via multiplex cytokine analysis, and demonstrate hypercoagulation using thromboelastography (TEG), confocal and electron microscopy. Biomarker analysis confirmed significantly increased levels of circulating proinflammatory cytokines. In our PD and control blood analysis, our results show increased hypercoagulation, the presence of amyloid formation in plasma, and profound ultrastructural changes to platelets. Our laboratory analysis of purified fibrinogen with added RgpA, and/or LPS, showed preliminary data with regards to the actions of the protease and the bacterial membrane inflammagen on plasma proteins, to better understand the nature of established PD.
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Affiliation(s)
- Büin Adams
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - J Massimo Nunes
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - Martin J Page
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - Timothy Roberts
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa.,Department of Biochemistry, Institute of Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan Carr
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Theo A Nell
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - Douglas B Kell
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa.,Department of Biochemistry, Institute of Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Etheresia Pretorius
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
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Spinler K, Aarabi G, Valdez R, Kofahl C, Heydecke G, König HH, Hajek A. Prevalence and determinants of dental visits among older adults: findings of a nationally representative longitudinal study. BMC Health Serv Res 2019; 19:590. [PMID: 31429740 PMCID: PMC6702718 DOI: 10.1186/s12913-019-4427-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/12/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The first aim was to present descriptive data on the frequency of dental visits among older adults in Germany. The second aim was to identify the determinants of the number of dental visits using a longitudinal approach. METHODS Longitudinal data were derived from the German Ageing Survey, which is a nationally representative sample of community-dwelling individuals ≥40 years in Germany. The frequency of dental visits in the past 12 months was recorded in the years 2002, 2008 and 2011. In order to control for time-constant unobserved heterogeneity, Poisson fixed effects regressions were used. RESULTS While the mean number of dental visits was 2.3 (SD: 2.0) in 2002, it was 2.0 (SD: 1.7) in 2008 and 2.1 (SD: 1.7) in 2011. The frequency of dental visits declined with age (total sample and women), transitions from normal weight to overweight (total sample), changes from divorced/widowed/single/married, living separated from spouse to 'married, living together with spouse' in women and with a decrease in the number of physical illnesses (total sample and men). CONCLUSIONS The frequency of dental visits declines with age in older adults. While some of the determinants of frequency are non-modifiable (e.g., ageing and worsening of general health), others are modifiable (e.g., change in weight category).
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Affiliation(s)
- K Spinler
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Sociology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Valdez
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Sociology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Kofahl
- Institute of Medical Sociology, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H-H König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Increased cortical infarction and neuroinflammation in ischemic stroke mice with experimental periodontitis. Neuroreport 2019; 30:428-433. [DOI: 10.1097/wnr.0000000000001220] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Kure K, Sato H, Aoyama N, Izumi Y. Accelerated inflammation in peripheral artery disease patients with periodontitis. J Periodontal Implant Sci 2018; 48:337-346. [PMID: 30619635 PMCID: PMC6312877 DOI: 10.5051/jpis.2018.48.6.337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022] Open
Abstract
Purpose Peripheral artery disease (PAD) is a form of arteriosclerosis that occurs in the extremities and involves ischemia. Previous studies have reported that patients with periodontitis are at high risk for PAD. However, the relationship between these 2 diseases has not yet been fully elucidated. In this cross-sectional study, we investigated this relationship by comparing patients with PAD to those with arrhythmia (ARR) as a control group. Methods A large-scale survey was conducted of patients with cardiovascular disease who visited Tokyo Medical and Dental University Hospital. We investigated their oral condition and dental clinical measurements, including probing pocket depth, bleeding on probing, clinical attachment level, and number of missing teeth; we also collected salivary and subgingival plaque samples and peripheral blood samples. All patients with PAD were extracted from the whole population (n=25), and a matching number of patients with ARR were extracted (n=25). Simultaneously, ARR patients were matched to PAD patients in terms of age, gender, prevalence of diabetes, hypertension, dyslipidemia, obesity, and the smoking rate (n=25 in both groups). Real-time polymerase chain reaction was performed to measure the bacterial counts, while the enzyme-linked immunosorbent assay method was used to measure anti-bacterial antibody titers and proinflammatory cytokine levels in serum. Results PAD patients had more missing teeth (18.4±2.0) and higher serum levels of C-reactive protein (1.57±0.85 mg/dL) and tumor necrosis factor-alpha (70.3±5.7 pg/mL) than ARR patients (12.0±1.7, 0.38±0.21 mg/dL, and 39.3±4.5 pg/mL, respectively). Meanwhile, no statistically significant differences were found in other dental clinical measurements, bacterial antibody titers, or bacterial counts between the 2 groups. Conclusions Our findings suggested that PAD patients had poorer oral and periodontal state with enhanced systemic inflammation.
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Affiliation(s)
- Keitetsu Kure
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroki Sato
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Kanagawa Dental University Graduate School of Dentistry, Yokosuka, Japan
| | - Yuichi Izumi
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo, Japan
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Roca-Millan E, González-Navarro B, Sabater-Recolons MM, Marí-Roig A, Jané-Salas E, López-López J. Periodontal treatment on patients with cardiovascular disease: Systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2018; 23:e681-e690. [PMID: 30341272 PMCID: PMC6261003 DOI: 10.4317/medoral.22725] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/21/2018] [Indexed: 12/12/2022] Open
Abstract
Background Atherosclerotic cardiovascular disease is the main cause of mortality in developed countries. It is a chronic and systemic inflammatory disease with a multifactorial etiology. Periodontal disease is one of the many factors that contribute to its development. Objective To analyze the effects of periodontal treatment on cardiovascular risk parameters in patients with atherosclerotic cardiovascular disease. Material and Methods A systematic research was conducted in the Pubmed/Medline databases for clinical trials published up to and including the year 2017. Results Ten articles were included for analysis. Periodontal treatment reduced C-reactive protein levels (77.8% of clinical trials), tumor necrosis factor-alpha (66.7%), interleukin-6 (100%) and leukocytes (50%). Fibrinogen levels also improved considerably (66.7%). Effects on lipid parameters were more limited, whereby only oxidized low density lipoprotein and very low density lipoprotein cholesterol decreased significantly. Meta-analysis showed a statistically significant decreased in C-reactive protein and leukocytes values when patients were submitted to non-surgical periodontal treatment in contrast to receiving no treatment at all (mean difference 1.199 mg/L, 95% confidence interval: 1.100-1.299, p<0.001; and mean difference 0,79 g/L, 95% confidence interval: 0.717-0.879, p<0.001, respectively). Conclusions Periodontal treatment has a beneficial effect on some of the biochemical parameters considered to represent cardiovascular risk. Further randomized clinical trials are necessary, with longer follow-up periods including regular periodic monitoring, in order to determine the extent of the impact of periodontal treatment. Key words:Periodontal disease, cardiovascular disease, atherosclerosis, periodontal therapy, periodontal treatment.
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Affiliation(s)
- E Roca-Millan
- University Campus of Bellvitge, Pabellón de Gobierno, 2nd floor, office 2:29, Feixa Llarga, s/n, 08907- L' Hospitalet de Llobregat, Barcelona, Spain,
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Aarabi G, Thomalla G, Heydecke G, Seedorf U. Chronic oral infection: An emerging risk factor of cerebral small vessel disease. Oral Dis 2018; 25:710-719. [DOI: 10.1111/odi.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Götz Thomalla
- Department of NeurologyHead‐ and NeurocenterUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Guido Heydecke
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Udo Seedorf
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
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Aarabi G, Reissmann DR, Seedorf U, Becher H, Heydecke G, Kofahl C. Oral health and access to dental care - a comparison of elderly migrants and non-migrants in Germany. ETHNICITY & HEALTH 2018; 23:703-717. [PMID: 28277023 DOI: 10.1080/13557858.2017.1294658] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To compare oral health, access barriers to dental care, oral health behavior and oral hygiene behavior of elderly German residents with and without immigration background. DESIGN In this cross-sectional explorative study, a convenience sample (N = 112, age ≥ 60 years, 54% immigrants) was recruited in four dental practices in Hamburg, Germany. Oral health was assessed with Decayed/Missing/Filled Teeth (DMFT), Papillary Bleeding Index (PBI), and Approximal Plaque Index (API). Dental health was operationalized as number of decayed teeth, and poor oral hygiene based on a PBI ≥ 40%. Access barriers and oral health behavior were assessed with a standardized questionnaire. RESULTS While caries experience was similar in migrants and non-migrants (DMFT mean: 24.8 vs. 23.4, n.s.), significantly more teeth were decayed (5.3 vs. 2.1, p < 0.001), and API (55.3% vs. 33.0%, p = 0.002) and PBI (46.3% vs. 30.5%, p = 0.016) were significantly higher in migrants. After adjusting for age, sex, income, education, and number of teeth, migrants still had on average 3 decayed teeth more than non-migrants. However, impact of migration background on poor oral health changed from OR = 3.61 (p = 0.007) to OR = 1.05 (n.s.) after adjusting for confounders, mainly due to lower income in migrants. Fewer migrants had visited a dentist within the past 12 months, and migrants were less likely to have a regular dentist that they visit and more often indicated language or cost barriers than non-migrants. CONCLUSION Elderly German migrants have higher treatment needs than non-migrants. Likely causes are poorer oral hygiene and lower utilization of dental care services. Specific prevention programs targeting migrants are warranted to improve oral health in this disadvantaged group.
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Affiliation(s)
- Ghazal Aarabi
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Daniel R Reissmann
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Udo Seedorf
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Heiko Becher
- b Department of Medical Biometry and Epidemiology, Center for Experimental Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Guido Heydecke
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Christopher Kofahl
- c Department of Medical Sociology, Center for Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Roles of Oral Infections in the Pathomechanism of Atherosclerosis. Int J Mol Sci 2018; 19:ijms19071978. [PMID: 29986441 PMCID: PMC6073301 DOI: 10.3390/ijms19071978] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 12/14/2022] Open
Abstract
Oral infections occur frequently in humans and often lead to chronic inflammations affecting the teeth (i.e., caries), the gingival tissues surrounding the teeth (i.e., gingivitis and endodontic lesions), and the tooth-supporting structures (i.e., periodontitis). At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. In this narrative review, we summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis.
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Bacterial DNA detected on pathologically changed heart valves using 16S rRNA gene amplification. Folia Microbiol (Praha) 2018; 63:707-711. [DOI: 10.1007/s12223-018-0611-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/11/2018] [Indexed: 12/19/2022]
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Radović N, Nikolić Jakoba N, Petrović N, Milosavljević A, Brković B, Roganović J. MicroRNA-146a and microRNA-155 as novel crevicular fluid biomarkers for periodontitis in non-diabetic and type 2 diabetic patients. J Clin Periodontol 2018. [PMID: 29517812 DOI: 10.1111/jcpe.12888] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM Recent studies point at the crucial role of epigenetic mechanisms in the development of multifactorial diseases such as periodontitis and diabetes mellitus (DM) type 2. In addition, circulatory microRNAs (miRs) have emerged as novel biomarkers for various diseases. Aim of this study was to investigate the levels of miR-146a and miR-155 and superoxide dismutase (SOD) activity in gingival crevicular fluid (GCF) of periodontitis patients with (CPDM) and without (CP) DM type 2 as well as in periodontally healthy, control groups (PHDM and PH, respectively). MATERIAL AND METHODS miR modulation was analysed using quantitative real-time PCR while SOD activity was measured spectrophotometrically. RESULTS The upregulation of miR-146a and miR-155 was observed in CP and CPDM patients' baseline, while the levels decreased after 6 weeks of the non-surgical therapy to the levels comparable to PH and PHDM, respectively. Expression levels of miRs positively correlated with SOD activity. Levels of miR-146a were higher in PHDM compared to PH patients. Multivariate analysis revealed that levels of miR-146a and miR-155 were significantly associated with periodontitis when adjusting for age and gender. CONCLUSIONS miR-146a and miR-155 may be considered as possible novel biomarkers for periodontitis in non-diabetic and type 2 diabetic patients.
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Affiliation(s)
- Nikola Radović
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nataša Nikolić Jakoba
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nina Petrović
- Department of Radiobiology and Molecular Genetics, Institute of Nuclear Sciences Vinca, University of Belgrade, Belgrade, Serbia.,Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Aleksandra Milosavljević
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Božidar Brković
- Department of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Chen TS, Kuo CH, Battsengel S, Pan LF, Day CH, Shen CY, Chung LC, Padma VV, Yao CK, Lin YM, Huang CY. Adipose-derived stem cells decrease cardiomyocyte damage induced by porphyromonas gingivalis endotoxin through suppressing hypertrophy, apoptosis, fibrosis, and MAPK markers. ENVIRONMENTAL TOXICOLOGY 2018; 33:508-513. [PMID: 29383833 DOI: 10.1002/tox.22536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 01/02/2018] [Accepted: 01/06/2018] [Indexed: 06/07/2023]
Abstract
Heart failure is one of the complications related to periodontal disease. In addition to drugs or herbal medicines, stem cell therapy shows potential in the treatment of cardiomyopathy. This study investigates if stem cells exhibit beneficial effects on cardiomyocyte damage induced by porphyromonas gingivalis endotoxin (Pg-LPS). From the experimental results we find that Pg-LPS reduce cardiomyocyte viability via the activation of apoptosis, hypertrophy, fibrosis and MAPK signaling. Pg-LPS damaged cardiomyocytes co-cultured with adipose-derived stem cells (ADSC) increases cardiomyocyte viability through suppressing the pathological markers described above. Further evidence implies that survival marker, IGF1, secreted from ADSC, may play an important role in the Pg-LPS induced protective effect on cardiomyocyte damage.
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Affiliation(s)
- Tung-Sheng Chen
- School of Life Science, National Taiwan Normal University, Taipei, Taiwan
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Chia-Hua Kuo
- Department of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Sarnai Battsengel
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Intermed Hospital, Chinggis Avenue 41, Khan-Uul district, 15th Khoroo, Uildver, Ulaanbaatar, 17040, Mongolia
| | - Lung-Fa Pan
- Division of Cardiology, Armed Force Taichung General Hospital, Taichung, Taiwan
- Department of Medical Imaging and Radiological Sciences of Central Taiwan, University of Science and Technology, Taichung, Taiwan
| | | | - Chia-Yao Shen
- Department of Nursing, MeiHo University, Pingtung, Taiwan
| | - Li-Chin Chung
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan County, Taiwan
| | - V Vijaya Padma
- Department of Biotechnology, Bharathiar University, Coimbatore, 641 046, India
| | | | - Yueh-Min Lin
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
- Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
- Faculty of Applied Sciences, Ton Duc Thang University, Tan Phong Ward, District 7, Ho Chi Minh City, 700000, Vietnam
- Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
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Chen T, Battsengel S, Kuo C, Pan L, Lin Y, Yao C, Chen Y, Lin F, Kuo W, Huang C. Stem cells rescue cardiomyopathy induced by
P. gingivalis
‐LPS via miR‐181b. J Cell Physiol 2018; 233:5869-5876. [DOI: 10.1002/jcp.26386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/04/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Tung‐Sheng Chen
- School of Life ScienceNational Taiwan Normal UniversityTaipeiTaiwan
- Graduate Institute of Basic Medical ScienceChina Medical UniversityTaichungTaiwan
| | - Sarnai Battsengel
- Graduate Institute of Basic Medical ScienceChina Medical UniversityTaichungTaiwan
- Intermed Hospital, Chinggis Avenue 41, Khan‐Uul district15th KhorooUildverUlaanbaatarMongolia
| | - Chia‐Hua Kuo
- Department of Sports SciencesUniversity of TaipeiTaipeiTaiwan
| | - Lung‐Fa Pan
- Division of CardiologyArmed Force Taichung General HospitalTaichungTaiwan
- Department of Medical Imaging and Radiological SciencesCentral Taiwan University of Science and TechnologyTaichungTaiwan
| | - Yueh‐Min Lin
- Department of PathologyChanghua Christian HospitalChanghuaTaiwan
- Jen‐Teh Junior College of MedicineNursing and ManagementMiaoliTaiwan
| | - Chun‐Hsu Yao
- School of Life ScienceNational Taiwan Normal UniversityTaipeiTaiwan
- Department of Biomedical Imaging and Radiological ScienceChina Medical UniversityTaichungTaiwan
- Graduate Institute of Chinese Medical ScienceChina Medical UniversityTaichungTaiwan
- Department of Biomedical InformaticsAsia UniversityTaichungTaiwan
| | - Yueh‐Sheng Chen
- School of Life ScienceNational Taiwan Normal UniversityTaipeiTaiwan
- Department of Biomedical Imaging and Radiological ScienceChina Medical UniversityTaichungTaiwan
- Graduate Institute of Chinese Medical ScienceChina Medical UniversityTaichungTaiwan
- Department of Cosmeceutics and Graduate Institute of CosmeceuticsChina Medical UniversityTaichungTaiwan
| | - Feng‐Huei Lin
- Institute of Biomedical Engineering and NanomedicineNational Health Research InstitutesMiaoli CountyTaiwan
- Institute of Biomedical EngineeringNational Taiwan UniversityTaipeiTaiwan
| | - Wei‐Wen Kuo
- Department of Biological Science and TechnologyChina Medical UniversityTaichungTaiwan
| | - Chih‐Yang Huang
- Graduate Institute of Basic Medical ScienceChina Medical UniversityTaichungTaiwan
- Graduate Institute of Chinese Medical ScienceChina Medical UniversityTaichungTaiwan
- Department of Health and Nutrition BiotechnologyAsia UniversityTaichungTaiwan
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39
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Relationship between atherosclerosis and occlusal support of natural teeth with mediating effect of atheroprotective nutrients: From the SONIC study. PLoS One 2017; 12:e0182563. [PMID: 28817589 PMCID: PMC5560638 DOI: 10.1371/journal.pone.0182563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/20/2017] [Indexed: 12/15/2022] Open
Abstract
Whereas most of studies investigating relationship between oral health and atherosclerosis have focused on periodontitis, very few of them were examined about occlusal status of natural teeth which possibly influence dietary habit. The primary aim of this cross-sectional study was to investigate the association between the occlusal support of posterior teeth and the prevalence of atherosclerosis in community-dwelling septuagenarians. Also, the second aim was to test the hypothesis that the intake of key nutrients for atherosclerosis prevention would have a mediating effect on the relationship between the occlusal status and atherosclerosis. The study population included 468 community-dwelling dentate persons aged 69–71 years recruited from the local residential registration in Japan. Participants were divided into three groups, according to the number of occlusal support zones (OSZ) in the posterior area: Complete (four OSZ), Moderate (three or two OSZ), and Collapsed (one or no OSZ). Dietary intakes were assessed using a brief-type self-administered diet history questionnaire. Atherosclerosis was defined as carotid intima-media thickness ≧1.10 mm by using carotid ultrasonography test. The logistic or linear regression model was used in multivariate analysis to assess relationship between occlusal status and atherosclerosis, and the mediating effect of key nutrients within the relationship. Multivariable analysis showed a significant association between occlusal status and atherosclerosis (odds ratio for Collapsed group to Complete group: 1.87; 95% CI: 1.45–2.41), independent of periodontal status (odds ratio: 2.01, 95%CI: 1.46–2.78). Fish and shellfish, vitamin B6 and n-3PUFAs were significantly related to both of occlusal status and atherosclerosis, and also was indicated a mediating effect on the association between occlusal status and atherosclerosis. This study implied that, within the limitation of the cross-sectional study design, the reduced posterior occlusion was related to the increased prevalence of atherosclerosis via the decline of key dietary intakes among Japanese community-dwelling dentate individuals.
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40
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Goldstein RL, Walia P, Teylan M, Lazzari AA, Tun CG, Hart JE, Garshick E. Clinical factors associated with C-reactive protein in chronic spinal cord injury. Spinal Cord 2017; 55:1088-1095. [PMID: 28762383 PMCID: PMC5794634 DOI: 10.1038/sc.2017.81] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 12/29/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES Determine clinical factors associated with plasma C-reactive protein (CRP) in persons with chronic spinal cord injury (SCI). SETTING Veterans Affairs Medical Center in Boston, MA, USA. METHODS Participants provided a blood sample, completed a respiratory health questionnaire and underwent dual X-ray absorptiometry (DXA) to assess total and regional body fat. Linear regression models were used to assess cross-sectional associations with plasma CRP. RESULTS In multivariable models, factors associated with a higher CRP included a greater BMI, urinary catheter use, a respiratory illness in the past week and non-white race. Mean CRP also increased with decreasing mobility (motorized wheelchair >hand-propelled wheelchair >walk with an assistive device >walk independently). Results were similar when adjusting for percentage android, gynoid, trunk or total fat mass in place of BMI. Level and completeness of SCI was not associated with CRP in multivariable models. CONCLUSIONS Clinical characteristics common in chronic SCI are associated with plasma CRP. These factors are more important than the level and completeness of SCI and some are potentially modifiable.
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Affiliation(s)
- R L Goldstein
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - P Walia
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - M Teylan
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - A A Lazzari
- Divison of Primary Care and Rheumatology Section, VA Boston Healthcare System, Boston, MA, Boston University School of Medicine, Boston, MA, USA
| | - C G Tun
- Department of Physical Medicine and Rehabilitation, VA Boston Healthcare System, Boston, MA, USA
| | - J E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - E Garshick
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA
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41
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Holmstrup P, Damgaard C, Olsen I, Klinge B, Flyvbjerg A, Nielsen CH, Hansen PR. Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician. J Oral Microbiol 2017; 9:1332710. [PMID: 28748036 PMCID: PMC5508374 DOI: 10.1080/20002297.2017.1332710] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/07/2017] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson’s disease, Alzheimer’s disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.
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Affiliation(s)
- Palle Holmstrup
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Damgaard
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Claus Henrik Nielsen
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Riis Hansen
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Cardiology Department, Herlev and Gentofte Hospital, Hellerup, Denmark
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42
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Association between periodontal disease and polycystic ovary syndrome: a systematic review. Int J Impot Res 2017; 29:89-95. [PMID: 28275229 DOI: 10.1038/ijir.2017.7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/07/2017] [Accepted: 02/02/2017] [Indexed: 12/27/2022]
Abstract
The purpose of the present study was to review systematically the association between periodontal diseases (PDs) and polycystic ovary syndrome (PCOS). To address the focused question, 'Is there a relationship between PD and PCOS?' indexed databases were searched up to October 2016 without time or language restrictions using different combinations of the following key words: PCOS, ovarian cysts, PD, periodontitis, gingival diseases and gingivitis. Letters to the Editor, commentaries, historic reviews, case-report, unpublished articles and animal/experimental studies were excluded. Seven case-control studies were included. The number of study participants ranged between 52 and 196 females aged between 15 and 45 years. In three and three studies, proinflammatory cytokines were assessed in gingival crevicular fluid and saliva samples, respectively. In one study, salivary microbes were investigated. All studies reported that a positive association exists between PD and PCOS. In conclusion, there is a positive association between PD and PCOS; however, further well-designed longitudinal controlled clinical trials are needed in this regard. It is recommended that physicians should refer patients with PCOS to oral health-care providers for comprehensive oral evaluation and treatment.
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Hansen GM, Belstrøm D, Nilsson M, Helqvist S, Nielsen CH, Holmstrup P, Tolker-Nielsen T, Givskov M, Hansen PR. Pseudomonas aeruginosa Microcolonies in Coronary Thrombi from Patients with ST-Segment Elevation Myocardial Infarction. PLoS One 2016; 11:e0168771. [PMID: 28030624 PMCID: PMC5193428 DOI: 10.1371/journal.pone.0168771] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/06/2016] [Indexed: 12/24/2022] Open
Abstract
Chronic infection is associated with an increased risk of atherothrombotic disease and direct bacterial infection of arteries has been suggested to contribute to the development of unstable atherosclerotic plaques. In this study, we examined coronary thrombi obtained in vivo from patients with ST-segment elevation myocardial infarction (STEMI) for the presence of bacterial DNA and bacteria. Aspirated coronary thrombi from 22 patients with STEMI were collected during primary percutaneous coronary intervention and arterial blood control samples were drawn from radial or femoral artery sheaths. Analyses were performed using 16S polymerase chain reaction and with next-generation sequencing to determine bacterial taxonomic classification. In selected thrombi with the highest relative abundance of Pseudomonas aeruginosa DNA, peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) with universal and species specific probes was performed to visualize bacteria within thrombi. From the taxonomic analysis we identified a total of 55 different bacterial species. DNA from Pseudomonas aeruginosa represented the only species that was significantly associated with either thrombi or blood and was >30 times more abundant in thrombi than in arterial blood (p<0.0001). Whole and intact bacteria present as biofilm microcolonies were detected in selected thrombi using universal and P. aeruginosa-specific PNA-FISH probes. P. aeruginosa and vascular biofilm infection in culprit lesions may play a role in STEMI, but causal relationships remain to be determined.
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Affiliation(s)
- Gorm Mørk Hansen
- Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
- Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- * E-mail:
| | - Daniel Belstrøm
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Martin Nilsson
- Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Steffen Helqvist
- Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Claus Henrik Nielsen
- Institute for Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Tim Tolker-Nielsen
- Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Michael Givskov
- Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- Singapore Center on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore
| | - Peter Riis Hansen
- Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
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Pepe S, Cheung MM. Gaps between the Teeth of Cardiovascular Health Strategy. Heart Lung Circ 2016; 26:1-5. [PMID: 27955764 DOI: 10.1016/j.hlc.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Salvatore Pepe
- Heart Research, Murdoch Childrens Research Institute; Department of Paediatrics, University of Melbourne; Department of Cardiology, Royal Children's Hospital, Melbourne, Australia.
| | - Michael M Cheung
- Heart Research, Murdoch Childrens Research Institute; Department of Paediatrics, University of Melbourne; Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
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45
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Hansen GM, Egeberg A, Holmstrup P, Hansen PR. Relation of Periodontitis to Risk of Cardiovascular and All-Cause Mortality (from a Danish Nationwide Cohort Study). Am J Cardiol 2016; 118:489-93. [PMID: 27372888 DOI: 10.1016/j.amjcard.2016.05.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
Abstract
Periodontitis and atherosclerosis are highly prevalent chronic inflammatory diseases, and it has been suggested that periodontitis is an independent risk factor of cardiovascular disease (CVD) and that a causal link may exist between the 2 diseases. Using Danish national registers, we identified a nationwide cohort of 17,691 patients who received a hospital diagnosis of periodontitis within a 15-year period and matched them with 83,003 controls from the general population. We performed Poisson regression analysis to determine crude and adjusted incidence rate ratios of myocardial infarction, ischemic stroke, cardiovascular death, major adverse cardiovascular events, and all-cause mortality. The results showed that patients with periodontitis were at higher risk of all examined end points. The findings remained significant after adjustment for increased baseline co-morbidity in periodontitis patients compared with controls, for example, with adjusted incidence rate ratio 2.02 (95% CI 1.87 to 2.18) for cardiovascular death and 2.70 (95% CI 2.60 to 2.81) for all-cause mortality. Patients with a hospital diagnosis of periodontitis have a high burden of co-morbidity and an increased risk of CVD and all-cause mortality. In conclusion, our results support that periodontitis may be an independent risk factor for CVD.
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Affiliation(s)
- Gorm Mørk Hansen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Alexander Egeberg
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Dermato-Allergology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Riis Hansen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Dumitrescu AL. Depression and Inflammatory Periodontal Disease Considerations-An Interdisciplinary Approach. Front Psychol 2016; 7:347. [PMID: 27047405 PMCID: PMC4804721 DOI: 10.3389/fpsyg.2016.00347] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/25/2016] [Indexed: 12/18/2022] Open
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47
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Periodontal disease and carotid atherosclerosis: A meta-analysis of 17,330 participants. Int J Cardiol 2016; 203:1044-51. [DOI: 10.1016/j.ijcard.2015.11.092] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 12/18/2022]
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