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Schertel Cassiano L, Ribeiro AP, Peres MA, Lopez R, Fjældstad A, Marchini L, Nascimento GG. Self-reported periodontitis association with impaired smell and taste: A multicenter survey. Oral Dis 2024; 30:1516-1524. [PMID: 37114436 DOI: 10.1111/odi.14601] [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: 12/09/2022] [Revised: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. MATERIALS AND METHODS Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. RESULTS The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). CONCLUSION Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.
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Affiliation(s)
- Luisa Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ana Paula Ribeiro
- Department of Restorative Dentistry, College of Dentistry, University of Florida, Florida, Gainesville, USA
| | - Marco Anselmo Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
| | - Rodrigo Lopez
- School of Dentistry, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | | | - Leonardo Marchini
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Ohio, Cleveland, USA
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
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Matayoshi S, Tojo F, Suehiro Y, Okuda M, Takagi M, Ochiai M, Kadono M, Mikasa Y, Okawa R, Nomura R, Itoh Y, Itoh N, Nakano K. Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus. Sci Rep 2024; 14:2777. [PMID: 38307981 PMCID: PMC10837110 DOI: 10.1038/s41598-024-53213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
Periodontitis is known to be associated with type 2 diabetes mellitus (T2DM), and gargling with mouthwash is known to reduce the incidence of periodontitis by inhibiting periodontal pathogens. However, the effects of mouthwash on oral and systemic conditions in patients with T2DM remain unknown. In this study, we investigated the effects of gargling with mouthwash on the number of red complex species, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, and HbA1c levels in patients with T2DM. Patients were instructed to gargle with water for 6 months, followed by gargling with mouthwash containing chlorhexidine gluconate for the subsequent 6 months. At each clinic visit, saliva was collected and bacterial DNA was extracted to detect red complex species using the polymerase chain reaction technique. The HbA1c level was determined using a blood sample. The number of red complex species significantly decreased in younger or male patients who gargled with mouthwash. Furthermore, HbA1c levels significantly decreased in younger patients or patients with higher HbA1c levels who gargled with mouthwash. These results suggest that gargling with mouthwash reduces the number of red complex species and improves the hyperglycemic status in patients with T2DM, especially younger patients.
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Affiliation(s)
- Saaya Matayoshi
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan.
| | - Fumikazu Tojo
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Makoto Okuda
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Misato Takagi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Marin Ochiai
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Maika Kadono
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yusuke Mikasa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Rena Okawa
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshito Itoh
- Itoh Internal Medicine Clinic, Osaka, Japan
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Naoto Itoh
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Itoh Internal Medicine Clinic, Osaka, Japan
| | - Kazuhiko Nakano
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
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Naseer A, Mc Garrigle C, McLoughlin J, O'Connell B. Tooth loss is associated with prevalent diabetes and incident diabetes in a longitudinal study of adults in Ireland. Community Dent Oral Epidemiol 2024; 52:111-119. [PMID: 37723132 DOI: 10.1111/cdoe.12907] [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: 01/09/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
AIM The aim of this study was to explore the relationship between periodontal status, tooth loss and diabetes among community-dwelling adults aged 50 years and over in Ireland. METHODS From respondents who attended a health assessment in Wave 3 of the Irish Longitudinal Study on Ageing (TILDA), an opportunistic sample was selected for an oral health examination. The oral health examination criteria were used in previous Irish surveys and WHO recommendations. For diabetes, the self-reported and objectively measured data on diabetes for the same cohort from Wave 3 to Wave 5 of TILDA was used. Multinomial regression analysis was used to evaluate the relationship between diabetes and tooth loss and tooth loss and incident diabetes, controlling for other covariates. RESULTS Out of the 3111 people who were offered an oral health assessment 2539 were examined. For the purposes of analysis, the adults below 50 years of age (n = 31) and those with an incomplete oral health assessment (n = 4) were omitted from the sample. The final sample consisted of 2504 people, giving a response rate of 80.5%. Among the study sample, 9.9% (n = 249) were edentate; 35.7% (n = 895) had 1-19 teeth and 54.4% (n = 1360) had ≥20 teeth. From the sample of 2504 adults, 2358 had HbA1c results and 8.4% (n = 198) of these had diabetes according to the TILDA criteria. Multinomial regression analysis showed that diabetes was associated with tooth loss. Diabetes at Wave 3 was associated with a higher rate of being edentate (PR 2.12, 95% CI 1.27-3.52) relative to having ≥20 teeth while controlling for the effect of age, gender, education level, area of residence, body mass index (BMI) and smoking. Furthermore, having 1-19 teeth at Wave 3 was associated with incident diabetes over a 4-year follow-up (OR 1.94, 1.00-3.75). There was no evidence of an association between diabetes and periodontal status as measured in this sample. CONCLUSION The results suggested that diabetes was associated with tooth loss and that this relationship may be bi-directional among community-dwelling adults aged 50 years and over in Ireland, but they do not support a relationship between diabetes and periodontal status in this sample.
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Affiliation(s)
- Amara Naseer
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Christine Mc Garrigle
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Jacinta McLoughlin
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Brian O'Connell
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
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Ruggiero T, Carossa M, Camisassa D, Bezzi M, Rivetti G, Nobile V, Pol R. Hyaluronic Acid Treatment of Post-Extraction Tooth Socket Healing in Subjects with Diabetes Mellitus Type 2: A Randomized Split-Mouth Controlled Study. J Clin Med 2024; 13:452. [PMID: 38256586 PMCID: PMC10816872 DOI: 10.3390/jcm13020452] [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: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The present study aimed to investigate the effect of HA in improving post-extraction socket healing in subjects with diabetes mellitus (DM) type 2. DM patients requiring bilateral extraction of the homologous teeth were visited at the C.I.R. Dental School, University of Turin. After the extractions, one site was randomly assigned to the test (T) group (postoperative application of HA), while the other site was assigned to the control group (C, no treatment). Patients were then followed after 3, 7, 14, and 21 days. Primary outcomes were the healing index and socket closure. The Mann-Whitney test or the Student's t-test was used for nonparametric or parametric distributed variables. The chi-square test was used if the estimated data in any given cell were >5, otherwise the Fisher test was adopted. A p < 0.05 was considered statistically significant. In total, 36 patients (n = 36) were enrolled in this study for a total of 72 extractions (n = 72). Sockets treated with HA showed significantly (p < 0.05) better healing index values at day 7 (p = 0.01) and at day 14 (p = 0.02) and significantly (p < 0.05) better socket closure values at day 3 (p = 0.04), day 7 (p = 0.001) and day 14 (p = 0.001) compared to the C group. Based on the clinical results, HA seems to be promising in improving the timing and the quality of post-extractive wound healing in DM patients. Further clinical research, as well as histological investigations, are required to confirm the results.
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Affiliation(s)
- Tiziana Ruggiero
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
- Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Massimo Carossa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Davide Camisassa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Marta Bezzi
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Rivetti
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Vincenzo Nobile
- Complife Italia S.r.l., Via Mons. Angelini 21, 27028 San Martino Siccomario, Italy
| | - Renato Pol
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
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Lu J, Yu N, Liu Q, Xie Y, Zhen L. Periodontal Ligament Stem Cell Exosomes Key to Regulate Periodontal Regeneration by miR-31-5p in Mice Model. Int J Nanomedicine 2023; 18:5327-5342. [PMID: 37746047 PMCID: PMC10516219 DOI: 10.2147/ijn.s409664] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Periodontitis is a chronic inflammatory disease that causes alveolar bone loss. Diabetes is one of the most important factors contributing to periodontitis. Exosomes derived from mesenchymal stem cells (MSCs-Exo) have been reported to promote bone regeneration. This study aimed to examine the function and mechanism of exosomes derived from periodontal ligament stem cells (PDLSCs-Exo) in regulating periodontal regeneration in diabetic periodontitis. Methods Exosomes derived from normal-glucose-cultured PDLSCs (NG-PDLSCs-Exo) and high-glucose-preconditioned PDLSCs (HG-PDLSCs-Exo) were used. Their effects on RAW264.7 cells were investigated by TRAP staining and quantitative real time-polymerase chain reaction (qRT-PCR). The role of exosomal miR-31-5p in osteoclast differentiation was tested using qRT-PCR, double luciferase analysis, and Western blotting. We investigated the effects of these two types of PDLSCs-Exo on alveolar bone loss in vivo in mice with experimental periodontitis. Results PDLSCs-Exo were transferred to RAW264.7, and HG-PDLSCs-Exo inhibited osteoclast formation to a lesser extent than NG-PDLSCs-Exo. Further studies revealed the effect of PDLSCs-Exo on osteoclastogenesis via the miR-31-5p/eNOS signaling pathway. In mice with experimental periodontitis, PDLSCs-Exo reduced alveolar bone destruction and decreased the number of osteoclasts on the alveolar bone surface. Conclusion Our results suggest that exosomal miR-31-5p derived from PDLSCs regulates alveolar bone regeneration by targeting eNOS.
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Affiliation(s)
- Jiuqing Lu
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Stomatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Nijia Yu
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Qian Liu
- Department of Stomatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yajia Xie
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Lei Zhen
- Department of Stomatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
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Bukhary DM. Teeth Rehabilitation and Nutritional Influence on Diabetic Patients: A Review. Cureus 2023; 15:e46182. [PMID: 37790059 PMCID: PMC10544288 DOI: 10.7759/cureus.46182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
Diabetes mellitus (DM) is a globally prevalent endocrine and metabolic disorder characterized by hyperglycemia. Its complications significantly impact both the quality and longevity of the patient's life with a substantial burden on the healthcare system. Missing teeth make individuals more susceptible to malnutrition compared to those with functional teeth. This is especially true for people with diabetes, as the condition is closely linked to both oral health and food intake. Natural teeth loss can significantly reduce an individual's ability to chew food, leading to a decrease in the quality and quantity of their nutrition. Prosthodontics is a dental specialty that replaces missing teeth with artificial ones. Replacing missing teeth may prevent the risk of malnutrition due to decreased ability to chew. Good oral health is important for overall health, especially for those with conditions such as diabetes. Artificial teeth replacement may improve nutrition intake by improving chewing ability. Therefore, the ultimate objective of rehabilitating a patient's oral cavity is to replace the shape and function in terms of chewing performance to a degree that is as close to normal as feasible. The purpose of this review is to explore the literature showing the link between natural teeth loss and nutrition in individuals with DM, with a special focus on prosthodontic management. Several oral complications occur in diabetic patients specifically teeth loss, which in turn affects mastication function. This in turn cause malnutrition and affect glucose level. It is imperative for healthcare providers to take an interdisciplinary approach in order to improve the dental and nutritional status and overall well-being of DM patients.
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Affiliation(s)
- Dalea M Bukhary
- Department of Oral and Maxillofacial Prosthodontics, King Abdulaziz University, Jeddah, SAU
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7
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Seniya KM, Baiju KV, Ambili R. Evaluation of salivary glycated albumin in periodontitis patients with and without type 2 diabetes mellitus and its changes with non-surgical periodontal therapy. Niger J Clin Pract 2023; 26:1257-1263. [PMID: 37794537 DOI: 10.4103/njcp.njcp_503_22] [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] [Indexed: 10/06/2023]
Abstract
Background Bidirectional relationship exists between diabetes mellitus and periodontitis. Glycated albumin is an emerging biomarker to assess intermediate glycemic control. Salivary glycated albumin has not been evaluated in periodontitis. Aim The aim of the study was to compare salivary glycated albumin in periodontitis patients with and without diabetes mellitus before and after periodontal therapy. Materials and Methods This comparative cross-sectional study was conducted in the Department of Periodontics. Ninety subjects (mean age 41.8 ± 6.82) were categorized into three groups. Clinical examination and saliva sample collection were done at baseline and 4 weeks after scaling and root debridement. Salivary glycated albumin levels were estimated using an enzyme-linked immunosorbent assay. One-way analysis of variance with post hoc test and paired t-test was done for inter- and intra-group comparison. The optimal cut-off value was calculated using the receiver operating characteristic curve and by maximization of the Youden index. Results Mean salivary glycated albumin was the highest in diabetic patients followed by non-diabetic periodontitis patients and least in healthy controls. All the intergroup comparisons were significant. A cut-off value of 72.19 ng/ml of salivary glycated albumin could predict diabetic status with a sensitivity and specificity of 75%. Salivary glycated albumin was significantly reduced in a similar manner in both groups after periodontal therapy (19.4% and 18.5%). Conclusion Periodontitis patients with diabetes mellitus were presented with the highest salivary glycated albumin. Non-surgical periodontal therapy resulted in a similar reduction of salivary glycated albumin in periodontitis with and without diabetes mellitus.
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Affiliation(s)
- K M Seniya
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - K V Baiju
- Department of Statistics, Government college for women, Trivandrum, Kerala, India
| | - R Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
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Nabila S, Choi J, Kim JE, Hahn S, Hwang IK, Kim TI, Park HK, Choi JY. Bidirectional associations between periodontal disease and systemic diseases: a nationwide population-based study in Korea. Sci Rep 2023; 13:14078. [PMID: 37640779 PMCID: PMC10462734 DOI: 10.1038/s41598-023-41009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
To evaluate the associations of periodontal disease (PD) with systemic diseases, including diabetes mellitus (DM) and cardiovascular disease (CVD), as well as the reciprocal association. The CVD included the cases of coronary heart disease and heart failure. A prospective study was conducted from 2007 to 2019 using linked data from three databases in Korea. Three separate study groups were formed to individually determine the risks of PD (n = 10,533), DM (n = 14,523) and CVD (n = 14,315). All diseases were confirmed based on physicians' diagnoses using medical records and self-reports. Cox proportional hazard regression was applied with 95% confidence intervals (CIs) to obtain hazard ratios (HRs). PD was significantly associated with an elevated risk of DM (HR [95% CI]: 1.22 [1.07-1.39]) after full adjustment for age, sex, lifestyle factors, body mass index, dental behaviour and CVD. PD was also found to increase the risk of CVD (1.27 [1.03-1.57]), whereas CVD increased the risk of PD (1.20 [1.09-1.32]) after full adjustment for other covariates including DM. This study found a bidirectional association between PD and CVD, as well as a positive association of PD with DM.
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Affiliation(s)
- Salma Nabila
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea
| | - Jaesung Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ji-Eun Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea
| | - Seokyung Hahn
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - In-Kyung Hwang
- Department of Periodontology, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Korea
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, 101 Daehak-ro, Jongno-gu, Seoul, 110-749, Korea.
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.
- BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Korea.
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
- Cancer Research Institute, Seoul National University, Seoul, Korea.
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Alwithanani N. Periodontal Diseases and Diabetes Mellitus: A Systematic Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S54-S63. [PMID: 37654263 PMCID: PMC10466651 DOI: 10.4103/jpbs.jpbs_515_22] [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: 10/25/2022] [Revised: 01/02/2023] [Accepted: 03/03/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Although the fact that the association of the periodontitis and the diabetes mellitus is well accepted, the literature has inconsistent findings regarding this connection. The motive in conducting this systematic review was to define whether poorly controlled diabetes was linked to the development or progression of periodontitis. Materials and Methods Databases from PubMed, Scopus, and Embase were searched electronically. All included articles' reference lists were manually searched. Google Scholar was used to research gray literature. For this review, longitudinal studies (prospective) on the association between periodontitis and diabetes were taken into consideration. Studies have to have included at least two parameters of the evolution of health of the periodontium throughout time. The study's design, as well as unadjusted and adjusted estimates, was recorded. This study calculated the combined impact of diabetes-related hyperglycemia on the start or progression of periodontitis using meta-analysis. To look into possible sources of study heterogeneity, subgroup analyses and meta-regression were used. Results With 49,262 participants from 13 studies that met the inclusion criteria, 3197 of whom had been diagnosed with diabetes. Diabetes augmented the likelihood of developing or progressing into periodontitis by 86%, according to meta-analyses of adjusted estimates (RR 1.86; 95% CI 1.3-2.8). On the association between periodontitis and diabetes, there is little data, nonetheless. Conclusions This study provides proof that persons with diabetes have an increased risk of developing periodontitis. Methodological limitations mentioned in this study should be overcome in upcoming prospective longitudinal investigations.
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Affiliation(s)
- Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, Taif University, Taif, Saudi Arabia
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Kobayashi T, Iwaki M, Nogami A, Honda Y, Ogawa Y, Imajo K, Saito S, Nakajima A, Yoneda M. Involvement of Periodontal Disease in the Pathogenesis and Exacerbation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis: A Review. Nutrients 2023; 15:nu15051269. [PMID: 36904268 PMCID: PMC10004797 DOI: 10.3390/nu15051269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
The increasing incidence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), along with global lifestyle changes, requires further in-depth research to elucidate the mechanisms and develop new treatment strategies. In addition, the number of patients with periodontal disease has increased recently, suggesting that periodontal disease is sometimes associated with systemic conditions. In this review, we summarize recent studies linking periodontal disease and NAFLD, the concept of the mouth-gut-liver axis, oral and intestinal microbiota, and liver disease. We suggest new research directions toward a detailed mechanistic understanding and novel targets for treatment and prevention. Forty years have passed since the concepts of NAFLD and NASH were first proposed. however, no effective prevention or treatment has been established. We also found that the pathogenesis of NAFLD/NASH is not limited to liver-related diseases but has been reported to be associated with various systemic diseases and an increasing number of causes of death. In addition, changes in the intestinal microbiota have been shown to be a risk factor for periodontal diseases, such as atherosclerosis, diabetes, rheumatoid arthritis, nonalcoholic fatty liver disease, and obesity.
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Affiliation(s)
- Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Asako Nogami
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Yasushi Honda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Yuji Ogawa
- National Hospital Organization Yokohama Medical Center, Gastroenterology Division, 3-60-2 Harajyuku, Yokohama 245-8575, Japan
| | - Kento Imajo
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, 255 Tsuko, Furusawa, Kawasaki 215-0026, Japan
| | - Satoru Saito
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama 236-0004, Japan
- Correspondence: ; Tel.: +81-45-787-2640
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Fujishiro M, Tanaka S, Watanabe K, Imatake K, Suzuki Y, Ishihara H, Tani S. Association of Glycated Hemoglobin Level with Self-Reported Chewing Problems in Elderly Community-Dwelling Individuals in Japan. J Multidiscip Healthc 2023; 16:1231-1238. [PMID: 37159603 PMCID: PMC10163885 DOI: 10.2147/jmdh.s404028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023] Open
Abstract
Purpose Chewing problems are associated with increased mortality, geriatric syndromes and poor activities of daily living. Starting in 2018, in Japan, a self-reported questionnaire investigating chewing status was implemented in the annual health checkup program. Considering the bidirectional association between hyperglycemia and poor oral health, it is hypothesized that people with self-reported chewing problems will have relatively poor glycemic profiles. We investigated the metabolic characteristics of elderly community dwellers with self-reported chewing problems, as well as the association between the problems and HbA1c levels. Patients and Methods This was a retrospective, cross-sectional study. We reviewed the data of 1018 adults ≥ 65 years of age who had undergone an annual health checkup at Nihon University Hospital during the period from January 2019 through December 2019. The presence of chewing problems was investigated using a self-reported questionnaire constructed based on guidance provided by the Japanese government. Results In the 1018 participants, the overall prevalence of chewing problems was 10.4%. Participants with chewing problems showed significantly higher levels and worse categories of HbA1c than those without such problems (HbA1c < 6.0%, 42.5% vs 54.8%; HbA1c 6.0-6.9%, 41.5% vs 37.0%; HbA1c ≥ 7.0%, 16.0% vs 8.2%, p = 0.008). Participants with HbA1c ≥ 7.0% have a significantly increased risk of chewing problems as compared to those with HbA1c < 6.0% (odds ratio 2.76, p = 0.002), even after adjusting for the effects of age, sex, body mass index, eating behaviors, and history of diabetes mellitus. Conclusion HbA1c ≥ 7.0% is associated with self-reported chewing problems in elderly Japanese community-dwellers. We thus recommend a proactive assessment of oral conditions for this population.
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Affiliation(s)
- Midori Fujishiro
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Nihon University Hospital, Tokyo, Japan
| | - Sho Tanaka
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Amemiya Internal Medicine Clinic, Kanagawa, Japan
- Correspondence: Sho Tanaka, Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan, Tel +81-3-3972-8111, Fax +81-3-3959-9775, Email
| | - Kentaro Watanabe
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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12
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Hamamoto Y, Ouhara K, Miyagawa T, Shintani T, Komatsu N, Kajiya M, Matsuda S, Fujita T, Sasaki S, Iwata T, Ohno H, Yoneda M, Mizuno N, Kurihara H. Masticatory dysfunction in patients with diabetic neuropathy: A cross-sectional study. PLoS One 2022; 17:e0269594. [PMID: 35666758 PMCID: PMC9170089 DOI: 10.1371/journal.pone.0269594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Chewing well is essential for successful diet therapy and control of blood glucose level in patients with diabetes. In addition, long-term hyperglycemia is a risk factor for microvascular complications, which are the main cause of morbidity and mortality in these patients. Hence, it is plausible that masticatory disorder may be relevant to diabetic microvascular complications which is caused by long-term hyperglycemia. The aim of this study was to investigate whether masticatory disorders are relevant to diabetic microvascular complications. Methods This cross-sectional study included 172 patients with type 2 diabetes who underwent educational hospitalization in the Department of Endocrinology and Diabetic Medicine, Hiroshima University Hospital, from April 2016 to March 2020. Masticatory efficiency was determined quantitatively by using the GLUCO SENSOR GS-Ⅱ. Multivariable linear regression models were constructed to examine which factors were related to masticatory efficiency. Statistical significance was defined as a two-sided p value of < 0.05. Results According to the bivariable analysis, masticatory efficiency was significantly correlated with duration of diabetes (p = 0. 049), number of remaining teeth (p < 0.0001), the number of moving teeth (p = 0.007) and condition of diabetic neuropathy (p < 0.0001). Moreover, the number of remaining teeth (p < 0.0001) and diabetic neuropathy (p = 0.007) remained significantly correlated with masticatory efficiency in the multivariable analysis. Conclusions For the first time, we demonstrated that patients with type 2 diabetes who developed diabetic neuropathy had significantly reduced masticatory efficiency. Effective mastication is an important factor in successful diet therapy for diabetes. To prevent the progression of diabetic complications, especially in patients with diabetic neuropathy, it may be necessary to combine individualized therapies from dentists and nutritionists with consideration for the level of masticatory dysfunction.
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Affiliation(s)
- Yuta Hamamoto
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Kazuhisa Ouhara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Miyagawa
- Clinical Research Center in Hiroshima, Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoaki Shintani
- Central Clinical Divisions, Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Nao Komatsu
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mikihito Kajiya
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Matsuda
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Fujita
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinya Sasaki
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoyuki Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruya Ohno
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masayasu Yoneda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriyoshi Mizuno
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hidemi Kurihara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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13
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Impact of Impaired Glucose Metabolism on Periodontitis Progression over Three Years. Dent J (Basel) 2022; 10:dj10010010. [PMID: 35049608 PMCID: PMC8774522 DOI: 10.3390/dj10010010] [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] [Received: 07/09/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 02/05/2023] Open
Abstract
We evaluated the relationship between glucose abnormalities and periodontitis in overweight/obese individuals. Eight hundred and seventy (870) diabetes-free participants aged 40-65 years completed the three-year follow-up in the San Juan Overweight Adults Longitudinal Study. The ADA thresholds for fasting and 2-h post-load glucose and HbA1c were used to define prediabetes. The NHANES methods were used to assess periodontitis. Multivariable linear regression was used to evaluate the relationship between baseline glucose metabolism measures and periodontitis at follow-up, adjusting for potential confounders. There was no association between impaired glucose measures and mean pocket depth (PD), mean clinical attachment loss (CAL), or mean percent of sites ≥5 mm PD. Impaired glucose tolerance (IGT) was associated with a lower mean percent of sites ≥5 mm CAL (β = -1.6, p = 0.037). Prediabetes and impaired fasting glucose (IFG) were associated with improvement in mean percent of sites ≥5 mm PD (β = -1.4, p = 0.022; β = -1.6, p = 0.032; respectively). IFG and IGT were associated with improvement in mean percent of sites with ≥5 mm CAL (β = -1.6, p = 0.038; β = -1.9, p = 0.020; respectively). In conclusion, there were no consistent associations between baseline prediabetes or insulin resistance and periodontitis progression over a three-year period.
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14
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Grisi DC, Vieira IV, de Almeida Lima AK, de Oliveira Mattos MC, Damé-Teixeira N, Salles LP, de Oliveira LA, Stefani C, do Carmo Machado Guimarães M. The Complex Interrelationship between Diabetes Mellitus, Oral Diseases and General Health. Curr Diabetes Rev 2022; 18:e220321192408. [PMID: 34225632 DOI: 10.2174/1573399817666210322153210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/20/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
There is emerging evidence that several oral diseases and conditions can be associated with DM. Dental caries, hyposalivation, fungal diseases and endodontics lesions may represent potential oral complications that can be aggravated by chronic hyperglycemia. Individuals with DM have a low perception of oral diseases which can lead to clinically important oral and systemic complications. This review aims to provide data on the most common oral signs and symptoms related to DM and to explore the mechanisms that might explain associations between DM and oral diseases in order to clarify the risks posed by poor oral health in DM. Since the linkage between oral diseases and DM is part of multifactorial aspects related to chronic hyperglycemic status and several common conditions affecting the whole body, both require rigorous self-control from patients and attention from medical and dental professionals.
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Affiliation(s)
- Daniela Corrêa Grisi
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | | | | | | | - Nailê Damé-Teixeira
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | - Loise Pedrosa Salles
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | | | - Cristine Stefani
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
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15
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VALENTIM FB, BARBOSA JSDA, CARNEIRO VC, ARAÚJO AM, ROSETTI EP. Association between periodontitis and type 2 diabetes mellitus: study in a population attended by the Brazilian Health System. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.01022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Periodontitis control helps to prevent and control diabetes mellitus and understanding of this relationship can lead to changes in health policy. Objective The purpose of this study was to investigate the association between periodontitis, knowledge, and glycemic control. Material and method This is a cross-sectional analytical epidemiological survey with 216 Type 2 diabetic patients, non-smokers, who had current blood screenings with glycated hemoglobin (HbA1c). Result Overall, 93.51% of the patients reported brushing their teeth at least twice a day, 62.5% visited the dentist last year, 81.58% have already undergone treatment for periodontal disease, 43.52% reported having periodontitis and 59.72% had controlled diabetes. No significant (p=0.603) association between HbA1c control and the presence of periodontitis was found. Among the patients with periodontitis, no association between HbA1c control and information on the periodontal disease was found (p=0.996), and know/believe in its relationship with diabetes (p=0.659; p=0.973). Conclusion No relationship between periodontitis and diabetes was found in the sample, as well as in patients with periodontitis, those with knowledge on periodontal disease and knowledge/belief in its relationship with diabetes, which could be justified by the care by a multi-professional health team.
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16
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Yang S, Li Y, Liu C, Wu Y, Wan Z, Shen D. Pathogenesis and treatment of wound healing in patients with diabetes after tooth extraction. Front Endocrinol (Lausanne) 2022; 13:949535. [PMID: 36213270 PMCID: PMC9538860 DOI: 10.3389/fendo.2022.949535] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus is a common systematic chronic disease amongst dental patients. The elevated glucose microenvironment can prolong the healing of tooth extraction sockets. Therefore, the promotion of healing up tooth extraction sockets is of great clinical importance to the patients with diabetes mellitus. The current evidence indicates the mechanism of the recovery period of extraction sockets in hyperglycaemia conditions from physiological, inflammation, immune, endocrine and neural aspects. New advancements have been made in varied curative approaches and drugs in the management of wound healing of tooth extraction sockets in diabetes. However, most of the interventions are still in the stage of animal experiments, and whether it can be put into clinical application still needs further explorations. Specifically, our work showed topical administration of plasma-rich growth factor, advanced platelet-rich fibrin, leukocyte- and platelet-rich fibrin and hyaluronic acid as well as maxillary immediate complete denture is regarded as a promising approach for clinical management of diabetic patients requiring extractions. Overall, recent studies present a blueprint for new advances in novel and effective approaches for this worldwide health ailment and tooth extraction sockets healing.
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17
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Abstract
The long-term inflammatory impact of diet could potentially elevate the risk of periodontal disease through modification of systemic inflammation. The aim of the present study was to prospectively investigate the associations between a food-based, reduced rank regression (RRR)-derived, empirical dietary inflammatory pattern (EDIP) and incidence of periodontitis. The study population was composed of 34 940 men from the Health Professionals Follow-Up Study, who were free of periodontal disease and major illnesses at baseline (1986). Participants provided medical and dental history through mailed questionnaires every 2 years and dietary data through validated semi-quantitative FFQ every 4 years. We used Cox proportional hazard models to examine the associations between EDIP scores and validated self-reported incidence of periodontal disease over a 24-year follow-up period. No overall association between EDIP and the risk of periodontitis was observed; the hazard ratio comparing the highest EDIP quintile (most proinflammatory diet) with the lowest quintile was 0·99 (95 % CI 0·89, 1·10, P-value for trend = 0·97). A secondary analysis showed that among obese non-smokers (i.e. never and former smokers at baseline), the hazard ratio for periodontitis comparing the highest EDIP quintile with the lowest was 1·39 (95 % CI 0·98, 1·96, P-value for trend = 0·03). In conclusion, no overall association was detected between EDIP and incidence of self-reported periodontitis in the study population. From the subgroups evaluated, EDIP was significantly associated with increased risk of periodontitis only among non-smokers who were obese. Hence, this association must be interpreted with caution.
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18
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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19
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Gao S, Tian J, Li Y, Liu T, Li R, Yang L, Xing Z. Periodontitis and Number of Teeth in the Risk of Coronary Heart Disease: An Updated Meta-Analysis. Med Sci Monit 2021; 27:e930112. [PMID: 34421117 PMCID: PMC8394608 DOI: 10.12659/msm.930112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background A positive link between periodontitis and chronic systemic disease has been indicated. However, few studies focused on the loss of teeth. Our analysis aims to analyze the relationship of periodontitis and number of teeth with the risk of coronary heart disease (CHD). Material/Methods A meta-analysis was conducted on qualified data extracted from the PubMed, Embase, and Cochrane Library databases. Only cohort studies were included in this study. We screened articles that assessed the periodontal condition and teeth number as well as the incidence or mortality of CHD. Hazard ratio (HR) and relative risk (RR) were calculated by Stata SE software. Results A total of 11 prospective studies with over 200 000 total participants were analyzed. Ten studies reported on periodontitis and CHD, and 4 studies included data on number of teeth. After adjusting for multivariate factors, there was a significant association between periodontitis and the risk of CHD (RR, 1.18; 95% confidence interval [CI], 1.10–1.26); the RR of CHD in the edentulous population was 1.20 (95% CI, 1.08–1.34). Moreover, results on the RR values for number of teeth were as follows: 24–17 teeth (RR, 1.12; 95% CI, 1.05–1.19); 16–11 (RR, 1.28; 95% CI, 1.15–1.42); and ≤10 (RR, 1.55; 95% CI, 1.43–1.69). Conclusions Our study showed that periodontitis is a risk factor for CHD and that the number of removed teeth is positively correlated with the risk of CHD. During clinical assessment, both factors need to be considered as factors associated with cardiovascular risks.
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Affiliation(s)
- Shuting Gao
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Jinhui Tian
- Center of Evidence-Based Medicine, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Yiting Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Tingjie Liu
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Ruiping Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Lan Yang
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Zhankui Xing
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
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20
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Stöhr J, Barbaresko J, Neuenschwander M, Schlesinger S. Bidirectional association between periodontal disease and diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sci Rep 2021; 11:13686. [PMID: 34211029 PMCID: PMC8249442 DOI: 10.1038/s41598-021-93062-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/17/2021] [Indexed: 12/24/2022] Open
Abstract
Periodontal disease has been reported to be associated with diabetes mellitus. However, the direction of the association and the influence of bias are not clear. Thus, the aim of this systematic review and meta-analysis was to summarize the existing evidence on the bidirectional prospective association between periodontal disease and diabetes mellitus by accounting for the risk of bias of the original studies. The literature search was conducted on the electronic data sources PubMed and Web of Science up to February 9th, 2021. We included observational studies, which investigated the prospective association between diabetes mellitus and periodontal disease or vice versa. The risk of bias of the primary studies was evaluated by applying the Quality in Prognosis Studies (QUIPS) tool. Random effects models were used to calculate summary relative risk (SRR) with 95% CI. Subgroup analyses were applied to investigate heterogeneity and the robustness of the finding. In total, 15 studies were included . The SRR for incident diabetes mellitus was 1.26 (95% CI 1.12, 1.41; I2: 71%, n = 10; participants = 427,620; identified cases = 114,361), when comparing individuals with periodontitis to individuals without periodontitis. The SRR for incident periodontitis was 1.24 (95% CI 1.13, 1.37; I2: 92%, n = 7; participants = 295,804; identified cases: > 22,500), comparing individuals with diabetes to individuals without diabetes. There were no significant differences between subgroups after stratification for risk of bias. The findings show a positive bidirectional association between periodontal disease and diabetes mellitus, and thus, underline the need for screening of patients with periodontitis regarding diabetes mellitus and vice versa. The main limitation of the study is the high unexplained heterogeneity between the studies including the different assessment methods of the disease diagnosis.
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Affiliation(s)
- Julia Stöhr
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany. .,German Center for Diabetes Research, München-Neuherberg, Germany.
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21
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Weijdijk LPM, Ziukaite L, Van der Weijden GAF, Bakker EWP, Slot DE. The risk of tooth loss in patients with diabetes: A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:145-166. [PMID: 33973353 PMCID: PMC9291053 DOI: 10.1111/idh.12512] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/09/2021] [Accepted: 05/05/2021] [Indexed: 01/02/2023]
Abstract
Aim The aim of this systematic review was to comprehensively and critically summarize and synthesize the risk of losing teeth among with diabetes mellitus (DM) compared to those without DM, as established in observational studies. Materials and methods MEDLINE‐PubMed and Cochrane databases were searched through a period from their inception through October 2020 to identify eligible studies. Papers that primarily evaluate the number of teeth in DM patients compared to non‐DM individuals were included. A descriptive analysis of the selected studies was conducted, and when feasible, a meta‐analysis was performed. The quality of the studies was assessed. Results A total of 1087 references were generated, and screening of the papers resulted in 10 eligible publications. A descriptive analysis demonstrated that six of these studies indicate a significantly higher risk of tooth loss in DM patients. This was confirmed by the meta‐analysis risk ratio of 1.63 95% CI (1.33; 2.00, p < 0.00001). Subgroup analysis illustrates that this is irrespective of the risk‐of‐bias assessment. The higher risk of tooth loss in DM patients was also higher when only DM type II patients or studies with a cross‐sectional design were considered. Patients with a poor DM control status presented a significantly increased risk of tooth loss. When the data were separated by the world continent where the study was performed, Asia and South America had numerically higher risks and a 95% CI that did not overlap with Europe and North America. Conclusion There is moderate certainty for a small but significantly higher risk of tooth loss in DM patients as compared to those without DM.
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Affiliation(s)
- Lotte P M Weijdijk
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), ACTA is a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Dentistry, Dental Care Utrecht (DCU), Utrecht, The Netherlands.,Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), ACTA is a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura Ziukaite
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), ACTA is a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Fridus Van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), ACTA is a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eric W P Bakker
- Division Clinical Methods and Public Health Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), ACTA is a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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22
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Stoicescu M, Calniceanu H, Țig I, Nemeth S, Tent A, Popa A, Brisc C, Ignat-Romanul I. Significant aspects and correlation between glycemic control and generalized chronic periodontitis in type 2 diabetes mellitus patients. Exp Ther Med 2021; 22:671. [PMID: 33986836 DOI: 10.3892/etm.2021.10103] [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: 02/10/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
The purpose of this research was to assess the correlation between glycemic control and clinical periodontal characteristics in type 2 diabetics with generalized chronic periodontitis. A total of 182 patients with type 2 diabetes mellitus and generalized chronic periodontitis were included in our study. The clinical examination included full-mouth plaque accumulation, bleeding on probing (BoP), probing depth (PD), presence of suppuration (SUP), clinical attachment level (CAL) and number of remaining teeth. Blood analyses were conducted for glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG). The correlation between the extent of periodontitis, defined as the percentage of PD and CAL sites ≥5 mm, and glycemic control was also analyzed. In addition, clinical parameters were compared between two (<7 and ≥7%) glycemic subsets. The frequency of uncontrolled diabetic subjects (HbA1c ≥7%) was higher than that of the well-controlled subjects (HbA1c <7%), 57.15 vs. 42.85%. Among the clinical parameters evaluated, mean full-mouth plaque accumulation was significantly higher among patients without glucose control (74.2±25.2 vs. 62.5±28.7%, P<0.01), as well as mean PD (3.78±0.9 vs. 3.42±0.8 mm, P<0.01) and mean CAL (4.5±1.2 vs. 4.1±1.2 mm, P=0.02). The sites with PD ≥5 mm were statistically more prevalent among patients with HbA1c ≥7% compared with patients with HbA1c <7% (27.8±6.2 vs. 23.4±5.8%, P<0.01). The mean number of remaining teeth was statistically significantly lower in patients with HbA1c ≥7% compared with patients with HbA1c <7% (18.5±3.2 vs. 20.4±4.1, P<0.01). In conclusion, the severity and extension of generalized chronic periodontitis was higher in type 2 diabetes mellitus patients with poor glucose control compared with those with good glucose control.
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Affiliation(s)
- Manuela Stoicescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Horea Calniceanu
- Department of Periodontology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Ioan Țig
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Sebastian Nemeth
- Pharmacy Department, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Adriana Tent
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Adelina Popa
- Department of Orthodontics, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Ciprian Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ioana Ignat-Romanul
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Schroeder SM, Adamsen C, Besse R. The relationship between diabetes and oral health status, and dental visits among American Indian, Alaska Native, and Native Hawaiian elders. J Am Dent Assoc 2021; 152:293-301. [PMID: 33775287 DOI: 10.1016/j.adaj.2020.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND American Indian (AI), Alaska Native (AN), and Native Hawaiian (NH) populations report higher rates of diabetes, poorer oral health, and fewer dental visits than their peers. The authors aimed to identify relationships between oral health and dental visits and diabetes diagnosis among AI, AN, and NH elders. METHODS Data were obtained from a national survey of AI, AN, and NH elders 55 years and older (April 2014-2017) and included 16,136 respondents. Frequencies and χ2 tests were used to assess the relationship between oral health and dental visits, and diabetes. RESULTS Nearly one-half of the elders reported receiving a diagnosis of diabetes (49.2%). A significantly (P < .01) greater proportion of elders with diabetes reported a dental visit in the past year (57.8%) than those without. Differences (P < .01) were found between reported diabetes and need for extraction, denture work, and relief of dental pain. The authors found lower dental visit rates among elders with diabetes who were low income, older, unemployed, not enrolled in the tribe, lived on the reservation, and had only public insurance. CONCLUSIONS There is a need to increase oral health literacy and dental visits among elders with diabetes and, more urgently, a need to focus on providing care for subpopulations reporting lower visit rates. PRACTICAL IMPLICATIONS Dental providers must serve as a referral resource for at-risk elders and must work with and educate about the importance of oral health those who assist tribal elders with diabetes management, including primary care physicians, certified diabetes educators, nutritionists and dietitians, and public health care professionals.
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Kassab A, Ayed Y, Elsayed SA, Alqadi SF, Abdelgawad N, Mrag M, Ben Amor F. Glycated hemoglobin influence on periodontal status, pathogens and salivary interleukins in type II diabetic Tunisian subjects with chronic periodontitis. J Dent Sci 2021; 16:614-620. [PMID: 33854710 PMCID: PMC8025187 DOI: 10.1016/j.jds.2020.09.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/27/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND/PURPOSE Studies have shown that there is a possible correlation between the amount of glycated hemoglobin and the periodontal status. The goal of this study was to investigate the relationship between glycated hemoglobin (HbA1c) and the prevalence of gingival pathogens and circulating interleukin levels in type II diabetic Tunisian subjects. MATERIAL AND METHODS The research included four groups; 30 healthy subjects (H group), 30 non-diabetic subjects suffering from chronic periodontitis (CP group). Type-II diabetic patients were divided according to HbA1c level into 30 adequately-controlled type-II diabetes subjects (HbA1c ≤ 7 percent (ATIID&CP group)) and 30 inadequately-controlled type-II diabetes subjects and HbA1c > 7 percent (ITIID&CP group). Clinical periodontal condition parameters and assessment of salivary interleukin IL-1beta, IL-6 and IL-10 were assessed. Quantitative Polymerase Chain Reaction used for detection of Subgingival biofilm of periodontal pathogens. RESULTS Clinical parameters analyzed were positively associated with HbA1c levels (p < 0.05). A. Actinomycetemcomitans were found in 80 percent of ITIID&CP, 65 percent of CP and almost absent in H group. Porphyromonas gingivalis was present in 100 percent of CP, 85 percent of ITIID&CP, 50 percent of ATIID&CP and 3 percent of H group. T. Denticola had an equivalent occurrence. While Tannerella forsythia was scarce in ITIID&CP groups, but abundant in the H group. ITIID&CP had the highest IL-6 and IL-1beta/IL-10 ratios. CONCLUSION HBA1c levels affect periodontal status, pathogens and salivary interleukins in Type-II diabetic Tunisians with chronic periodontitis, compared with stable and chronic periodontitis groups and can interact with periodontal infections and increase the inflammatory state.
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Affiliation(s)
- Asma Kassab
- Research Laboratory of Oral Health and Bucco-Facial Rehabilitation, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Yosra Ayed
- Department of Oral Basic Science, Taibah University, Dental College & Hospital, Al-Madinah Al-Munawwrah, Saudi Arabia
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Shadia A. Elsayed
- Département of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
- Département of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al-Madinah Al-Munawwrah, Saudi Arabia
| | - Soha Fuad Alqadi
- Department of Orthodontics and Pediatric, Dental College & Hospital, Taibah University, Al-Madinah Al-Munawwrah, Saudi Arabia
| | - Nora Abdelgawad
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Marwa Mrag
- Research Laboratory of Oral Health and Bucco-Facial Rehabilitation, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
| | - Faten Ben Amor
- Research Laboratory of Oral Health and Bucco-Facial Rehabilitation, Faculty of Dental Medicine, University of Monastir, Monastir, Tunisia
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Fatima Del Carmen AD, Aída BYS, Javier DLFH. Risk Indicators of Tooth Loss Among Mexican Adult Population: A Cross-Sectional Study. Int Dent J 2021; 71:414-419. [PMID: 33642043 PMCID: PMC9275087 DOI: 10.1016/j.identj.2020.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to assess the factors associated with tooth loss in an adult population in Guanajuato, Mexico. Methods This cross-sectional study included individuals enrolled in a community program (2014-2016). Data were gathered through closed-ended questions about sociodemographic characteristics such as sex, age, and schooling. Oral hygiene practices, self-perceived oral health, dental visits during the last 12 months, smoking habits, and diabetes status of the participants were also recorded. A clinical evaluation was performed for each person to register decayed, missing, and filled teeth (DMF-t). Descriptive statistics, bivariate analysis, and negative binomial models were used to identify variables associated with the number of missing teeth. Results A total of 1640 persons were included in the study. The mean age was 41.6 (±15.4) years; 63.6% were female; and 52.7% had at least 1 missing tooth, with a mean of 2.9 (+4.6) missing teeth. The mean number of missing teeth increased by 5% per year relative to age. Females (relative ratio [RR] = 1.40), smokers (RR = 1.56), people with diabetes who smoke (RR = 3.62), and people who rated their oral health as fair or poor (RR = 1.2) had higher mean values of missing teeth. In contrast, individuals who achieved a high school degree (or above) (RR = 0.81), practiced daily toothbrushing (RR = 0.63), or practiced regular toothbrushing and flossing (RR = 0.65) had fewer missing teeth. Conclusions More than half of the population has at least 1 missing tooth. The number of missing teeth is higher in individuals with diabetes and unhealthy habits such as smoking. Good oral hygiene practices play an essential role in preventing tooth loss.
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Alqerban A. Levels of proinflammatory chemokines and advanced glycation end products in patients with type-2 diabetes mellitus undergoing fixed orthodontic treatment. Angle Orthod 2021; 91:105-110. [PMID: 33289806 PMCID: PMC8032277 DOI: 10.2319/051120-420.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To explore the effect of diabetic status on the proinflammatory chemokine profile and levels of advanced glycation end products (AGEs) in gingival crevicular fluid (GCF) derived from patients with type 2 diabetes mellitus (T2DM) undergoing fixed orthodontic treatment. MATERIALS AND METHODS Two groups, nondiabetic and T2DM, were included. Their demographics, biochemical parameters including hemoglobin A1c, fasting blood glucose, body mass index, and oral hygiene status were recorded. GCF sampling was performed after 2 months of placement of stainless steel archwires and chemokines (primary outcome) were quantified using Human Magnetic Luminex multiplex assay. Secondary outcomes were assessment of clinical periodontal status, unstimulated whole saliva flow rate, and GCF flow rate. RESULTS Twenty participants each in the nondiabetic (mean age: 26.4 years) and T2DM (mean age: 27.2 years) groups gave consent to participate. Biochemical analysis showed significantly increased values for hemoglobin A1c (P < .001), fasting blood glucose (P < .0001), body mass index(P = .047), and unstimulated whole saliva flow rate (P = .041) for the T2DM group. Bleeding on probing was significantly higher in participants with T2DM than nondiabetic participants (P = .039). Resistin (P = .034) and AGEs (P = .017) showed significantly higher values in participants with T2DM than nondiabetic participants. Pearson correlation analysis indicated a significant positive correlation between resistin (r = 0.1372; P = .022) and AGEs (r = 0.0194; P = .0186) against bleeding on probing in participants with T2DM. CONCLUSIONS The biochemical profile of GCF samples from participants with T2DM after alignment demonstrated higher levels of resistin and AGEs. The data suggest the presence of a proinflammatory response in patients with T2DM undergoing fixed orthodontic treatment.
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Alhassani AA, Hu FB, Li Y, Rosner BA, Willett WC, Joshipura KJ. The associations between major dietary patterns and risk of periodontitis. J Clin Periodontol 2020; 48:2-13. [PMID: 33020936 DOI: 10.1111/jcpe.13380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/19/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022]
Abstract
AIM To prospectively investigate the associations between major dietary patterns and incidence of periodontitis. METHODS We included 34,940 men from the Health Professionals Follow-Up Study, free of periodontal disease and major illnesses at baseline. Detailed medical and dental history was collected through biennial mailed questionnaires, and dietary information was provided through quadrennial food frequency questionnaires. Using principal component analysis, we identified two major dietary patterns ("prudent" and "Western"). We used Cox proportional hazard models to examine the associations between the two dietary patterns and self-reported incidence of periodontitis over a 24-year follow-up period. We investigated each pattern separately. RESULTS There was no overall association between Western or prudent dietary patterns and periodontitis. Among obese, however, the Western dietary pattern was significantly associated with incident periodontitis. The hazard ratio for those in the highest quintile of Western diet versus those in the lowest (reference) was 1.83 (95% confidence interval: 1.21-2.76). CONCLUSIONS There was no overall association between Western or prudent dietary patterns and periodontitis; however, in subgroups analysis, the Western diet was significantly associated with higher periodontitis risk only among obese men, a finding that requires replication and biological explication.
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Affiliation(s)
- Ahmed A Alhassani
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kaumudi J Joshipura
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
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Zhou T, Huang WK, Xu QY, Zhou X, Shao LQ, Song B. Nec-1 attenuates inflammation and cytotoxicity induced by high glucose on THP-1 derived macrophages through RIP1. Arch Oral Biol 2020; 118:104858. [PMID: 32805637 DOI: 10.1016/j.archoralbio.2020.104858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This research aimed to study whether necrostain-1 (Nec-1) could alleviate inflammatory injury induced by high glucose upon THP-1 derived macrophages through RIP1. DESIGN Firstly, THP-1 derived macrophages were incubated with 5.5 mM glucose (normal glucose, NG), 25 mM glucose (high glucose, HG), and mannitol as the high osmotic pressure group (5.5 mM glucose+19.5 mM mannitol) for 24, 48, and 72 h respectively. TNF-α, IL-1β, IL-6, and IL-8 levels were measured by ELISA. Secondly, macrophages were exposed to NG, HG, or HG plus 5 μM necrostatin-1 (Nec-1) for 72 h. mRNA expression of inflammatory cytokine was measured by RT-PCR, and protein levels of inflammatory cytokines and LDH leakage were determined by ELISA. RIP1 expression was determined by RT-PCR and WB. Thirdly, macrophages were transfected with si-RIP1 or negative control (si-NC). Wild type and RIP1-silenced macrophages were incubated with NG or HG, and TNF-α, IL-1β, IL-6, IL-8, and LDH levels were measured again by ELISA. RESULTS 1) TNF-α, IL-1β, IL-6, and IL-8 levels were elevated in the HG group, as compared with that the NG group. Inflammation remained unchanged in the mannitol group. 2) Inflammatory response and LDH levels in the HG plus Nec-1 group were remarkably lower than in the HG group. 3) Inflammatory injury in the si-NC group was more severe than in the si-RIP1 group. CONCLUSIONS Current results indicated that Nec-1 could alleviate HG-caused inflammatory injury on THP-1 derived macrophages by regulating RIP1. These findings could help cast light on the relationships between diabetes and periodontitis.
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Affiliation(s)
- Ting Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Wei-Kun Huang
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Qiu-Yan Xu
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Xue Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Long-Quan Shao
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Bin Song
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
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Saka-Herrán C, Jané-Salas E, González-Navarro B, Estrugo-Devesa A, López-López J. Validity of a self-reported questionnaire for periodontitis in a Spanish population. J Periodontol 2020; 91:1027-1038. [PMID: 31984491 DOI: 10.1002/jper.19-0604] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/28/2019] [Accepted: 12/29/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Clinical examination is the gold-standard approach for surveillance of periodontitis; however, it requires large resources. Several self-reported measures have been developed and tested in diverse scenarios with results suggesting that it may be a useful tool for screening periodontal disease in different populations; yet they have not being tested in Spanish population. We aimed to assess the validity of a self-reported questionnaire for periodontitis in a Spanish population from Barcelona during 2018. METHODS One hundred and twelve participants were enrolled in the study and, in one appointment; a dentist performed the self-reported questionnaire and a full-mouth periodontal examination. Periodontitis was defined as at least mild periodontitis according to three criterion of classification. Receiver-operating characteristics curve analyses were used to test the discriminatory capability, sensitivity and specificity of the self-reported questionnaire and logistic regression models were adjusted to estimate the minimal-set of questions associated with periodontitis. RESULTS The self-reported questionnaire had a useful discriminative capability for detecting individuals with periodontitis (area under the curve [AUC] = 0.85 95% CI 0.78-0.92) and its moderate/severe form (AUC = 0.86 95% CI 0.79-0.04) with sensitivity and specificity of 77% and 74% and 73% and 87%, respectively; representing moderate validity. The combination of four-specific questions had high accuracy (AUC = 0.88 95% CI 0.81-0.94) and validity (sensitivity = 92.2%) and was strongly associated with moderate/severe periodontitis after adjusting by socio-demographic factors. CONCLUSIONS The use of several self-reported questions proved to have a good performance for screening periodontitis in the population under study; specifically, those related with tooth mobility and gum migration. Large community-based studies are needed to test its validity and predictive capability.
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Affiliation(s)
- Constanza Saka-Herrán
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Beatriz González-Navarro
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Odontological Hospital University of Barcelona, University of Barcelona Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
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Aagaard KA, Al-Far HM, Piscator U, Krogh RA, Lauszus FF. Manifest diabetes after gestational diabetes: a double-cohort, long-term follow-up in a Danish population. Arch Gynecol Obstet 2020; 302:1271-1278. [PMID: 32656592 DOI: 10.1007/s00404-020-05669-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim was to follow-up two cohorts of women with GDM to investigate the incidence and time of diagnosis of manifest diabetes mellitus (DM) postpartum and identify the risk factors for diabetes in our population. METHODS A follow-up study on two independent cohorts having oral glucose tolerance test (OGTT) in 1991/1992 and 2011-2016: Cohort 1 consisted of 406 women including 54 with GDM and 352 with a non-GDM OGTT-test and cohort 2 had 433 women diagnosed with GDM. The first cohort had nearly 25 years of follow-up and gave information on magnitude, conversion rate and type of diabetes manifestation. The second cohort was started recently to evaluate whether newer diagnostic criteria and baseline information on the old cohort are still valid for prediction of diabetes risk. RESULTS The risk of manifest diabetes in cohort 1 at the end of follow-up was six times higher in women with previous GDM compared with non-GDM (RR = 6; 95% CI 4-11). We observed a 70% diabetes rate 25 years after pregnancy. Only family history of diabetes in cohort 2 was associated with conversion to manifest diabetes (p = 0.002), also after adjustment for age, BMI, non-Danish origin and smoking during pregnancy (p < 0.001) CONCLUSION: The incidence of diabetes after GDM is higher than that previously reported in Scandinavian populations and the rate of manifest diabetes rises steeply 15 years after pregnancy and after 40 years of age. The women of cohort 2 with recent GDM are at risk of DM at a higher rate. On this background our results are useful in identifying the time where GDM women may benefit from the effective implementation of evidence-based treatment to postpone and advert manifest DM.
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Affiliation(s)
- Kristina Aaskjær Aagaard
- Department of Gynecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400, Herning, Denmark
| | - Hanine Mustafa Al-Far
- Department of Gynecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400, Herning, Denmark
| | - Ulrika Piscator
- Department of Gynecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400, Herning, Denmark
| | - Rubab Agha Krogh
- Department of Gynecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400, Herning, Denmark
| | - Finn Friis Lauszus
- Department of Gynecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400, Herning, Denmark.
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Wu CZ, Yuan YH, Liu HH, Li SS, Zhang BW, Chen W, An ZJ, Chen SY, Wu YZ, Han B, Li CJ, Li LJ. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health 2020; 20:204. [PMID: 32652980 PMCID: PMC7353775 DOI: 10.1186/s12903-020-01180-w] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/29/2020] [Indexed: 02/05/2023] Open
Abstract
Background To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM). Methods Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA. Results A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust. Conclusions There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other’s incidence.
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Affiliation(s)
- Chen-Zhou Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Yi-Hang Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Hang-Hang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shen-Sui Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Bo-Wen Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Wen Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Zi-Jian An
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Si-Yu Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Yong-Zhi Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Bo Han
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Chun-Jie Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China
| | - Long-Jiang Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Number 14, Unit 3, Renmin Nan Road, Chengdu City, 610041, Sichuan, China.
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Marin S, Popovic-Pejicic S, Radosevic-Caric B, Trtić N, Tatic Z, Selakovic S. Hyaluronic acid treatment outcome on the post-extraction wound healing in patients with poorly controlled type 2 diabetes: A randomized controlled split-mouth study. Med Oral Patol Oral Cir Bucal 2020; 25:e154-e160. [PMID: 32040462 PMCID: PMC7103456 DOI: 10.4317/medoral.23061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background Hyaluronic acid is widely used in the medical field. However, there is a lack of research about its effect on patients with certain risks, such as compromised wound healing commonly found in patients with poorly controlled type 2 diabetes. The aim of this study is to investigate the efficacy of hyaluronic acid on the post-extraction wound healing and pain in patients with poorly controlled type 2 diabetes.
Material and Methods The randomized controlled split-mouth study was designed, which included 30 patients with poorly controlled type 2 diabetes with a bilaterally same teeth in the lower jaw for extraction. The sockets treated with 0.8% hyaluronic acid represented the study group, while the sockets where hyaluronic acid was not applied represented the control group. Wound closure rate (WCR), clinical scores in wound healing scale (WHS) and pain intensity in Visual analogue scale (VAS) were recorded. Patients were followed up on 5th, 10th, 15th, 20th, 25th day after tooth extraction.
Results The results showed a higher WCR at the extraction site where hyaluronic acid was applied. Also, statistically significant difference was found (p< 0.001). In regards to WHS, the sockets treated with hyaluronic acid showed better healing, especially on day 10 (p=0.006) and day 15 (p=0.021). However, there were no statistically significant differences in VAS scores between groups.
Conclusions Hyaluronic acid placed in post-extraction socket in patients with poorly controlled diabetes may improve wound healing, especially in the first days after application. Key words:Hyaluronic acid, type 2 diabetes mellitus, post-extraction wound healing, wound closure measurement.
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Affiliation(s)
- S Marin
- Department of Oral Surgery, Faculty of Medicine, University of Banja Luka Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
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Yue H, Xu X, Liu Q, Li X, Xiao Y, Hu B. Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis. BMC Oral Health 2020; 20:18. [PMID: 31969148 PMCID: PMC6977292 DOI: 10.1186/s12903-020-1004-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/10/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). METHODS Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration's risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. RESULTS Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: - 1.53, 95% confidence interval - 2.95 to - 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. CONCLUSIONS NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.
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Affiliation(s)
- Hui Yue
- Department of Stomatology Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinxin Xu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Chongqing, 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Qin Liu
- School of Public Health and Management, Chongqing Medical University Chongqing, Chongqing, China
| | - Xiaozhi Li
- Department of Stomatology Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yiting Xiao
- Department of Stomatology Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Hu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Chongqing, 401147, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Deeraksa S, Chaichit R. The association between functional oral health literacy and periodontal disease among adults with type 2 diabetes mellitus in the northeast region of Thailand. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_338_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Inhibition of HMGB1 Promotes Osseointegration under Hyperglycemic Condition through Improvement of BMSC Dysfunction. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1703709. [PMID: 31929852 PMCID: PMC6939424 DOI: 10.1155/2019/1703709] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 02/05/2023]
Abstract
High mobility group box 1 (HMGB1) participates actively in oxidative stress damage and the latter relates closely to diabetic complications, including poor implant osseointegration. This article is aimed at investigating the effects of HMGB1 on dysfunction of bone marrow stromal cells (BMSCs) and impaired osseointegration under diabetic environment. In vitro, BMSCs were treated with normal glucose (NG), high glucose (HG), and HG+glycyrrhizin (HMGB1 inhibitor, HG+GL). Cell proliferation, osteogenic behaviors, and oxidative stress were determined. In vivo, 8-week-old Sprague-Dawley rats were categorized to control, streptozotocin-induced diabetic, and diabetic-GL groups. Rats received GL (50 mg/kg, i.p.) or vehicle treatment daily after titanium implants were planted into the tibiae. After 4 and 8 weeks, plasma lipoperoxide detection, μCT analysis, and histomorphometric evaluation were conducted. By these approaches, we demonstrated that inhibiting HMGB1 by GL significantly attenuated HG-induced upregulation of HMGB1, HMGB1 ligand receptor for advanced glycation end products (RAGE) and their interaction, relieved oxidative stress, and reversed the downregulation of osteogenic markers, resulting in improved osteogenic differentiation. In diabetic rats, GL administration suppressed the upregulation of HMGB1, attenuated the lipoperoxide, and ameliorated the impaired trabecular structure and osseointegration. Taken together, inhibiting HMGB1 can be an effective approach to relieve BMSC dysfunction and enhance osseointegration under diabetic environment.
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El-Makaky Y, Shalaby HK. The effects of non-surgical periodontal therapy on glycemic control in diabetic patients: A randomized controlled trial. Oral Dis 2019; 26:822-829. [PMID: 31834660 DOI: 10.1111/odi.13256] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/12/2019] [Accepted: 12/07/2019] [Indexed: 12/16/2022]
Abstract
AIM The present study aimed to monitor the clinical outcomes and the metabolic response of periodontal therapy (non-surgical) in patients with periodontitis (chronic) and uncontrolled diabetes (type 2). METHODS Eighty-eight subjects with periodontitis (chronic) and uncontrolled diabetes (type 2) were enrolled in this controlled trial and allocated randomly to the test group (44 patients were received immediate periodontal therapy) or the control group (44 patients were received delayed periodontal therapy). The metabolic and clinical evaluations were conducted at baseline and 3 months. This included clinical attachment level, glycated hemoglobin (HbA1c), bleeding on probing, visible plaque, and pocket depth. The periodontal therapy in this study consists of one-stage scaling and root planning, a combination of systemic antibiotics (amoxicillin 500 mg and metronidazole 400 mg), and oral hygiene instructions. RESULTS Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at 3-month follow-up period the patients within the test group demonstrated significantly better clinical and metabolic outcomes than patients in the control group. CONCLUSION The non-surgical periodontal treatment using a combination of metronidazole and amoxicillin significantly improved the metabolic outcome in addition to periodontal health in diabetic subjects with chronic periodontitis.
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Affiliation(s)
- Yasser El-Makaky
- Department of Periodontology, Faculty of Dentistry, Tanta University, Tanta, Egypt.,Department of Periodontology, College of Dentistry, Taibah University, Saudi Arabia
| | - Hany K Shalaby
- Department of Periodontology, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Corrêa MG, Pimentel SP, Ribeiro FV, Cirano FR, Casati MZ. Host response and peri-implantitis. Braz Oral Res 2019; 33:e066. [PMID: 31576950 DOI: 10.1590/1807-3107bor-2019.vol33.0066] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022] Open
Abstract
Considering the absence of predictable and effective therapeutic interventions for the treatment of peri-implantitis, scientific evidence concerning the host response profile around dental implants could be important for providing in the future a wider preventive and/or therapeutic window for this peri-implant lesion, indicating biomarkers that provide quantifiable measure of response to peri-implant therapy. Moreover, a better knowledge of pattern of host osteo-immunoinflammatory modulation in the presence of peri-implantitis could either benefit the early diagnostic of the disease or to cooperate to prognostic information related to the status of the peri-implant breakdown. Finally, new evidences concerning the host profile of modulators of inflammation and of osseous tissue metabolism around dental implants could explain the individual susceptibility for developing peri-implant lesions, identifying individuals or sites with increased risk for peri-implantitis. The focus of this chapter was, based on a systematically searched and critically reviewed literature, summarizing the existing knowledge in the scientific research concerning the host osteo-immunoinflammatory response to the microbiological challenge related to periimplantitis.
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Affiliation(s)
- Monica Grazieli Corrêa
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Suzana Peres Pimentel
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fernanda Vieira Ribeiro
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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38
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YouTube information about diabetes and oral healthcare. Odontology 2019; 108:84-90. [DOI: 10.1007/s10266-019-00445-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 06/18/2019] [Indexed: 12/18/2022]
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Jia T, Wang YN, Zhang J, Hao X, Zhang D, Xu X. Cinaciguat in combination with insulin induces a favorable effect on implant osseointegration in type 2 diabetic rats. Biomed Pharmacother 2019; 118:109216. [PMID: 31319371 DOI: 10.1016/j.biopha.2019.109216] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 01/17/2023] Open
Abstract
The osseointegration process of implant is seriously impaired in type 2 diabetes mellitus (T2DM) that causes high failure rate, and insufficiency exists in current insulin therapy, creating a demand for new bone-synergistic agent. Cinaciguat, a novel type of soluble guanylate cyclase (sGC) activator, plays a vital role in glucose metabolism, inflammation control and bone regeneration. We hypothesized that the combined application of cinaciguat and insulin could reverse poor implant osseointegration in diabetes. To test this hypothesis, streptozotocin-induced diabetic rats were placed implants in the femur, and divided into five groups: control, T2DM, cinaciguat-treated T2DM (7 μg/kg), insulin-treated T2DM (12 IU/kg), cinaciguat plus insulin combination-treated T2DM (7 μg/kg and 12 IU/kg respectively), according to different treatment received. The weight and glucose levels of rats were evaluated at fixed times, and plasma level of cyclic guanosine monophosphate (cGMP) was determined before euthanasia. Three months after therapy, the femurs were isolated for pull-out test, environmental scanning electron microscope observation, microscopic computerized tomography evaluation and various histology analysis. Results revealed that diabetic rats showed the highest blood glucose level and lowest cGMP content, which led to the worst structural damage and least osseointegration. Combined treatment could attenuate the diabetes induced hyperglycemia to be normal, restore the cGMP content, protein kinase G II (PKG II) expression, phosphodiesterase-5 (PDE5) activity and ameliorate the mechanical strength, the impaired bone microarchitecture and osseointegration to the highest level. Meanwhile, monotreatment (insulin or cinaciguat) also showed restorative effect, but less. Our findings demonstrated that the cGMP/PKG II signaling pathway activated by cinaciguat mediated the favorable effects of the combined application on improving implant fixation under T2DM condition.
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Affiliation(s)
- Tingting Jia
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Implantology, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Ya-Nan Wang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Implantology, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Jiajia Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Implantology, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Xinyu Hao
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Pediatric Dentistry, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Dongjiao Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Implantology, School of Stomatology, Shandong University, Jinan, Shandong Province, China.
| | - Xin Xu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China; Department of Implantology, School of Stomatology, Shandong University, Jinan, Shandong Province, China.
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Yi X, Zhang L, Lu W, Tan X, Yue J, Wang P, Xu W, Ye L, Huang D. The effect of NLRP inflammasome on the regulation of AGEs-induced inflammatory response in human periodontal ligament cells. J Periodontal Res 2019; 54:681-689. [PMID: 31250434 DOI: 10.1111/jre.12677] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/18/2019] [Accepted: 06/01/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Diabetes influences the frequency and development of periodontitis. Inflammation of human periodontal ligament cells (HPDLCs) participates in this pathologic process. Hence, this study aims to explore whether advanced glycation end products (AGEs), by-products of diabetes, could exaggerate inflammation induced by muramyl dipeptide (MDP) in HPDLCs, and whether nucleotide-binding oligomerization domain-like receptors (NLRs) signaling pathway was involved. MATERIAL AND METHODS Human periodontal ligament cells were pre-treated with 100 μg/mL AGEs for 24 hours and stimulated with 10 μg/mL MDP for 24 hours. IL-6, IL-1β, and RAGE were detected, and the activation of NF-κB signaling pathway was observed. The expression of NLRs was evaluated with or without silencing RAGE or blocking NF-κB pathway under AGEs stimulation. Statistical analyses were performed by using independent sample t test. RESULTS Advanced glycation end products induced significant increase of inflammatory cytokines in HPDLCs (P < 0.05). Results of western blot (WB) showed that after 45 minutes stimulation of AGEs, p-p65/p65 ratio peaked; AGEs promoted the expression of NLRP1, NLRP3, and apoptosis-associated speck-like protein containing a CARD (ASC). After silencing RAGE or blocking NF-κB pathway, the up-regulation of NLRs protein caused by AGEs was attenuated. Additionally, AGEs pre-treatment could enhance the inflammatory response of MDP and the expression of NLRs, which were demonstrated by more expression of IL-6, IL-1β, NOD2, NLRP1, NLRP3, and ASC. CONCLUSION Advanced glycation end products induced inflammatory response in HPDLCs via NLRP1-inflammasome and NLRP3-inflammasome activation in which NF-κB signal pathway was involved. Besides, AGEs promoted the inflammatory response of MDP via NOD2, NLRP1-inflammasome, and NLRP3-inflammasome.
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Affiliation(s)
- Xiaowei Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wanlu Lu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
| | - Xuelian Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Junli Yue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Hospital of Stomatology Wuhan University, Wuhan, China
| | - Puyu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,The Affiliated Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Weizhe Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Lee CY, Kuan YH, Tsai YF, Tai CJ, Tsai TH, Huang KH. Correlation between diabetes mellitus and periodontitis in Taiwan: A nationwide cohort study. Diabetes Res Clin Pract 2019; 150:245-252. [PMID: 30880092 DOI: 10.1016/j.diabres.2019.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/01/2019] [Accepted: 03/07/2019] [Indexed: 12/15/2022]
Abstract
AIMS The mechanism underlying the association of diabetes mellitus (DM) and periodontitis is not clear. This study aimed to investigate the correlation between DM and periodontitis. METHODS This study was a retrospective cohort study, which conducted based on the Taiwan National Health Insurance Research Database. The study subjects were 39,384 new-onset DM patients who aged above 20 years old from 2005 to 2012. To avoid selection bias, we applied propensity score matching to obtain patients without DM, as the control group. Cox proportional hazard model was used to analyze the risk of periodontitis in patients with DM. RESULTS After controlling for related variables, Patients with DM had a higher risk for periodontitis compared with the patients without DM (adjusted hazard ratios [aHR] = 1.04, 95% confidence interval [CI]: 1.01-1.08). Patients with hypertension (HTN) had no higher risk for periodontitis (aHR = 0.96, 95% CI: 0.92-1.00). Patients with dyslipidemia and rheumatoid arthritis (RA) patients both had a higher risk for periodontitis (aHR = 1.26, 95% CI: 1.19-1.34; aHR = 1.41, 95% CI: 1.19-1.67). CONCLUSIONS There is a correlation between DM and periodontitis. Patients with DM may have a higher risk of incident periodontitis. Besides, age, HTN, dyslipidemia, and RA are also associated with incident periodontitis.
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Affiliation(s)
- Chien-Ying Lee
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ya-Fang Tsai
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Jaan Tai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan.
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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AlShwaimi E, Idrees M, Berri Z, El-Sakka H, Kujan O. Association between Diabetes Mellitus and Periodontal Diseases: A Survey of the Opinions of Dental Professionals. Med Princ Pract 2019; 28:141-149. [PMID: 30497082 PMCID: PMC6546030 DOI: 10.1159/000495881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 11/29/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This cross-sectional survey aimed to assess the knowledge of dentists and dental assistants practicing in Saudi Arabia regarding diabetes mellitus (DM) and periodontal diseases. SUBJECTS AND METHODS We used a pretested, closed-ended, multiple-choice questionnaire covering 2 principal sections: the assessment of previous educational training and practice, and the knowledge and scientific background regarding DM and periodontal diseases. The responses were grouped using the Likert-type scale. RESULTS The questionnaire showed a high reliability value of 0.805 as determined by a Cronbach's α. Out of 365 subjects who were initially interviewed, 239 subjects participated (response rate 65.5%): general dentists (45.6%) and dental hygienists and assistants (54.4%). Of the participating dentists, 70.4% were males; in contrast, 87.7% of dental assistants were female. Eighty-five percent of the participants strongly agreed that evidence supports the association between periodontal diseases and DM. Remarkably, dental assistants (78%) agreed more than dentists (68.5%) that diabetic patients with periodontal conditions would have worse glycemic control compared to diabetic patients with no periodontal diseases. Seventy-five percent of the respondents were confident about performing oral health screening for diabetic patients. Significantly more dental assistants showed their desire to expand their practice to include oral health screening (85%) and education compared to dentists (74%). CONCLUSIONS Both dentists and dental assistants in Saudi Arabia revealed a satisfactory knowledge level regarding the periodontal disease-diabetes interactions with no significant difference between the two groups. Further studies are recommended to assess the attitude of dental care providers while dealing with diabetic patients.
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Affiliation(s)
- Emad AlShwaimi
- Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University (University of Dammam), Dammam, Saudi Arabia
| | | | - Zeina Berri
- Department of Oral Medicine and Diagnostic Sciences, Al-Farabi College for Dentistry and Nursing, Al-Farabi Colleges, Riyadh, Saudi Arabia
| | - Haytham El-Sakka
- UWA Dental School, University of Western Australia, Nedlands, Washington, Australia
| | - Omar Kujan
- UWA Dental School, University of Western Australia, Nedlands, Washington, Australia,
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Enhanced Oxidative Damage and Nrf2 Downregulation Contribute to the Aggravation of Periodontitis by Diabetes Mellitus. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9421019. [PMID: 30622677 PMCID: PMC6304894 DOI: 10.1155/2018/9421019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/29/2018] [Indexed: 02/05/2023]
Abstract
Diabetes mellitus is a well-recognized risk factor for periodontitis. The goal of the present study was to elucidate whether oxidative stress and nuclear factor erythroid 2-related factor 2 (Nrf2) participate in the aggravation of periodontitis by diabetes. For this purpose, we assigned Wistar rats to control, periodontitis, diabetes, and diabetic periodontitis groups. Two weeks after induction of diabetes by streptozotocin, periodontitis was induced by ligation. Two weeks later, periodontal tissues and blood were harvested and analyzed by stereomicroscopy, immunohistochemistry, and real-time polymerase chain reaction. We found that ligation induced more severe bone loss and periodontal cell apoptosis in diabetic rats than in normal rats (p < 0.05). Compared with the control group, periodontitis significantly enhanced local oxidative damage (elevated expression of 3-nitrotyrosine, 4-hydroxy-2-nonenal, and 8-hydroxy-deoxyguanosine), whereas diabetes significantly increased systemic oxidative damage and suppressed antioxidant capacity (increased malondialdehyde expression and decreased superoxide dismutase activity) (p < 0.05). Simultaneous periodontitis and diabetes synergistically aggravated both local and systemic oxidative damage (p < 0.05); this finding was strongly correlated with the more severe periodontal destruction in diabetic periodontitis. Furthermore, gene and protein expression of Nrf2 was significantly downregulated in diabetic periodontitis (p < 0.05). Multiple regression analysis indicated that the reduced Nrf2 expression was strongly correlated with the aggravated periodontal destruction and oxidative damage in diabetic periodontitis. We conclude that enhanced local and systemic oxidative damage and Nrf2 downregulation contribute to the development and progression of diabetic periodontitis.
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de Miguel-Infante A, Martinez-Huedo MA, Mora-Zamorano E, Hernández-Barrera V, Jiménez-Trujillo I, de Burgos-Lunar C, Cardenas Valladolid J, Jiménez-García R, Lopez-de-Andrés A. Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study. Int J Clin Pract 2018; 73:e13294. [PMID: 30444571 DOI: 10.1111/ijcp.13294] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/24/2018] [Accepted: 11/11/2018] [Indexed: 12/12/2022] Open
Abstract
AIM We sought (a) to assess the association between periodontal disease and diabetes, controlling for socio-demographic characteristics, comorbidities, oral health status and lifestyle variables; (b) to identify which of these variables are independently associated with periodontal disease among diabetes sufferers. METHODS We conducted a case-control study using data from the National/European Health Interview Surveys, conducted from 2003 to 2014 in Spain. We included 65 295 subjects ≥40 years. Diabetes status was self-reported. One non-diabetic control was matched by the year-of-survey, age and sex for each diabetic patient. The presence of periodontal disease was defined using the answer "my teeth bleed spontaneously or while brushing" or/and "my teeth move" to the following question: "Do you suffer of any of these dental and oral disorders or disease?". Independent variables included demographic, socio-economic and healthcare related variables, oral health status and comorbidities. RESULTS The prevalence of periodontal disease was higher among those suffering from diabetes than their non-diabetes controls (23.8% vs 19.5%; P < 0.001). Adjusted OR of periodontal disease for subjects with diabetes was 1.22 (95% CI; 1.03-1.45). Among diabetes sufferers, missing teeth status (OR 2.08, 95% CI; 1.70-2.53), suffering osteoporosis (OR 1.41, 95% CI; 1.07-1.63) and suffering depression (OR 1.39, 95% CI; 1.12-1.71) were positively associated with higher risk of periodontal disease. Older ages, using private insurance and university education level were associated with lower rates of periodontitis. CONCLUSIONS Diabetes subjects have an increased likelihood of periodontal disease. Dentists and physicians should increase their awareness with their diabetic patients, especially those with lower educational level, with missing teeth, osteoporosis and depression.
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Affiliation(s)
- Ana de Miguel-Infante
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Maria A Martinez-Huedo
- Preventive Medicine and Public Health Teaching and Research Unit, La Paz Hospital University, Madrid, Spain
| | | | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Carmen de Burgos-Lunar
- Aging and Fragility in the Elderly Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Juan Cardenas Valladolid
- Dirección Técnica de Sistemas de Información, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ana Lopez-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Nascimento GG, Leite FRM, Vestergaard P, Scheutz F, López R. Does diabetes increase the risk of periodontitis? A systematic review and meta-regression analysis of longitudinal prospective studies. Acta Diabetol 2018; 55:653-667. [PMID: 29502214 DOI: 10.1007/s00592-018-1120-4] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/12/2018] [Indexed: 12/18/2022]
Abstract
AIM Even though the association between diabetes and periodontitis is taken for granted, results on this association are conflicting within the literature. This systematic review assessed whether poorly controlled diabetes was associated with periodontitis onset or progression. METHODS Electronic searches were performed in PubMed, Scopus and Embase databases. Hand search was carried out in the reference list of all articles included. Gray literature was investigated with a Google Scholar search. Prospective longitudinal studies on the association between diabetes and periodontitis were considered for this review. Studies should have presented at least two measurements of periodontal conditions over time. Data on study design, crude and adjusted estimates were collected. We used meta-analysis to estimate the pooled effect of hyperglycemia in people with diabetes on periodontitis onset or progression. Meta-regression and subgroup analyses were employed to investigate potential sources of heterogeneity between studies. RESULTS Thirteen studies matched the inclusion criteria, comprising 49,262 individuals, including 3197 diagnosed with diabetes. Meta-analyses of adjusted estimates showed that diabetes increased the risk of incidence or progression of periodontitis by 86% (RR 1.86 [95% CI 1.3-2.8]). However, there is scarce information on the association between diabetes and periodontal destruction. CONCLUSIONS This study provides evidence that diabetes is associated with increased risk of periodontitis onset and progression in adults. Upcoming prospective longitudinal studies ought to overcome methodological caveats identified in this review.
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Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark.
| | - Fábio R M Leite
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center, Aalborg University Hospital, Aalborg, Denmark
| | - Flemming Scheutz
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
| | - Rodrigo López
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
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Taboza ZA, Costa KL, Silveira VR, Furlaneto FA, Montenegro R, Russell S, Dasanayake A, Rego RO. Periodontitis, edentulism and glycemic control in patients with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2018; 6:e000453. [PMID: 29607049 PMCID: PMC5873546 DOI: 10.1136/bmjdrc-2017-000453] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/26/2017] [Accepted: 10/23/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To compare the glycemic control in non-smoking patients with type 2 diabetes according to their periodontal and dental status. RESEARCH DESIGN AND METHODS This cross-sectional study investigated patients previously diagnosed with type 2 diabetes and under antidiabetic medication. Clinical data and fasting blood glucose (FBG) levels were collected from medical and dental records. Patients were divided into three groups according to dental and periodontal diagnosis: no or mild periodontitis (NO/MILD, n=96), moderate or severe periodontitis (MOD/SEV, n=74) and edentulous (n=141). FBG levels were compared between groups. Logistic regression was also applied to estimate the OR of presenting hyperglycemia. RESULTS Edentulous patients had significantly higher FBG levels of 155.7±70.9 (mean±SD mg/dL) than those in the MOD/SEV (136.6±33.8) and the NO/MILD (123.1±36.7) groups. Differences between the latter two groups were also significant. Edentulous patients had adjusted ORs of 4.53, 4.27 and 3.95 of having FBG≥126, ≥150 and ≥180 mg/dL, respectively, in comparison with NO/MILD group. The MOD/SEV group also presented significant odds of having FBG≥126 mg/dL (OR=2.66) and ≥150 mg/dL (OR=2.45) than the NO/MILD group. CONCLUSIONS Patients in the MOD/SEV group had worse glycemic control than the ones in the NO/MILD group. However, edentulous patients presented higher glycemic levels than both dentate groups, and also presented with higher odds of having hyperglycemia.
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Affiliation(s)
- Zuila Albuquerque Taboza
- Department of Clinical Dentistry, Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | - Katia Linhares Costa
- Department of Clinical Dentistry, Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | - Virginia Régia Silveira
- Division of Periodontics, Department of Dentistry, School of Dentistry at Sobral, Federal University of Ceara, Sobral, Ceará, Brazil
| | - Flavia Aparecida Furlaneto
- Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology, School of Dentistry at Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renan Montenegro
- Department of Community Health, Faculty of Medicine, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | - Stefanie Russell
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York City, New York, USA
| | - Ananda Dasanayake
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York City, New York, USA
| | - Rodrigo O Rego
- Division of Periodontics, Department of Dentistry, School of Dentistry at Sobral, Federal University of Ceara, Sobral, Ceará, Brazil
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York City, New York, USA
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Zhang P, Zhang W, Zhang D, Wang M, Aprecio R, Ji N, Mohamed O, Li Y, Ding Y, Wang Q. 25-Hydroxyvitamin D 3 -enhanced PTPN2 positively regulates periodontal inflammation through the JAK/STAT pathway in human oral keratinocytes and a mouse model of type 2 diabetes mellitus. J Periodontal Res 2018. [PMID: 29516520 DOI: 10.1111/jre.12535] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis is an increasingly prevalent complication of diabetes mellitus (known as diabetes mellitus-associated periodontitis), and 25-hydroxyvitamin D3 (25VD3 ) was recently found to be a critical regulator of innate immunity in this disease, but the underlying mechanisms remain poorly understood. T-cell protein tyrosine phosphatase non-receptor type 2 (PTPN2) is a potential downstream protein of the 25VD3 /vitamin D receptor pathway. The aim of this study was to investigate the regulation of PTPN2 in periodontal inflammation in diabetes mellitus-associated periodontitis. MATERIAL AND METHODS Porphyromonas gingivalis-infected db/db mice were treated with 25VD3 . Their fasting blood glucose and body weight were monitored every other week, and the levels of alveolar bone loss and serum inflammatory cytokines (tumor necrosis factor-α, interferon-γ and interleukin-6) were determined at the time of killing. The effect of PTPN2 on human OKF6-TERT2 oral keratinocytes was examined through the knockout of PTPN2 using the CRISPR/Cas9 knockout plasmid. The expression levels of the PTPN2, vitamin D receptor and JAK1/STAT3 signaling proteins in the gingival epithelium and OKF6-TERT2 cells were determined through western blot and immunohistochemical analyses. RESULTS After 25VD3 treatment, db/db mice exhibited alleviated serum inflammatory cytokines and alveolar bone loss, and 25VD3 -enhanced PTPN2 expression decreased the expression of the JAK1/STAT3 signaling proteins in the gingival epithelium. Analyses of human oral keratinocytes showed that 25VD3 increased the expression of PTPN2, which dephosphorylates protein substrates in the JAK1/STAT3 signaling pathway. CONCLUSION PTPN2 contributed to a decrease in periodontal inflammation in type 2 diabetes mellitus via dephosphorylate protein substrates in the JAK1/STAT3 signaling pathway after 25VD3 treatment in human oral keratinocytes and a mouse model of type 2 diabetes mellitus. A thorough understanding of PTPN2 and its involvement in inhibiting inflammation might provide alternative therapeutic approaches for the pathogenesis and treatment of diabetes mellitus-associated periodontitis.
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Affiliation(s)
- P Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - W Zhang
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - D Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, China
| | - M Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - R Aprecio
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - N Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - O Mohamed
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - Y Li
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - Y Ding
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Grellmann AP, Sfreddo CS, Maier J, Lenzi TL, Zanatta FB. Systemic antimicrobials adjuvant to periodontal therapy in diabetic subjects: a meta-analysis. J Clin Periodontol 2017; 43:250-60. [PMID: 26790108 DOI: 10.1111/jcpe.12514] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Adjuvant antibiotics have been suggested to improve periodontal therapy in diabetic subjects. AIM The aim of this study was to systematically review randomized clinical trials assessing systemic antimicrobial use adjuvant to scaling and root planing (SRP) versus SRP alone in diabetic subjects. MATERIAL AND METHODS The PubMed, Cochrane Central Register of Controlled Trials, EMBASE, TRIP, Web of Science and LILACS databases and the grey literature were searched through May 2015. Of 2534 potentially eligible studies, 13 were included in the systematic review. Weighted mean differences (WMDs) in probing depth (PD) reduction and clinical attachment level (CAL) gain (primary outcomes), and plaque index (PI) and bleeding on probing (BOP) reductions, were estimated using a random effect model. RESULTS The WMD in PD reduction [-0.15 mm, n = 11, p = 0.001, 95% confidence interval (CI) -0.24, -0.06] favoured antibiotic use. WMDs in CAL gain, PI and BOP reductions (-0.14 mm, n = 9, p = 0.11, 95% CI -0.32, 0.03; 4.01%, n = 7, p = 0.05, 95% CI -0.04, 8.07; and -1.91%, n = 7, p = 0.39, 95% CI -6.32, 2.51 respectively) did not favour adjunctive antibiotic use. CONCLUSION Adjunctive therapy may improve the efficacy of SRP in reducing PD in diabetic subjects.
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Affiliation(s)
| | - Camila Silveira Sfreddo
- Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Juliana Maier
- Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Tathiane Larissa Lenzi
- Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
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50
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Yonekura S, Usui M, Murano S. Association between numbers of decayed teeth and HbA1c in Japanese patients with type 2 diabetes mellitus. Ups J Med Sci 2017; 122:108-113. [PMID: 28276781 PMCID: PMC5441370 DOI: 10.1080/03009734.2017.1285838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/03/2016] [Accepted: 01/19/2017] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Dental caries (DC) are more prevalent in individuals with diabetes than in healthy individuals. However, the association between glycaemic control and DC has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We therefore assessed the association between glycated haemoglobin (HbA1c) serum concentrations and the prevalence of DC in patients with T2DM. METHODS Retrospective analyses of data pertaining to 108 Japanese patients with T2DM hospitalized because of poor or worsened glycaemic control were included. We divided the patients based on HbA1c into two groups: HbA1c level ≥75 mmol/mol (9.0%) as poorly controlled T2DM, and HbA1c level <75 mmol/mol (9.0%) as a control group. We compared the association of lifestyle factors, dental caries, and periodontal health between patients with poorly controlled T2DM and controls. Stepwise multiple regression analyses were performed to evaluate the association between HbA1c, the absolute number of decayed teeth (DT), the sum of decayed, missing, and filled teeth, and the Met Need Index (MNI). RESULTS DT was higher and MNI was lower in patients with poorly controlled T2DM as compared to that in controls (P = 0.006 and P = 0.004, respectively). Multiple regression analyses revealed a significant association between HbA1c levels and DT (adjusted β = 0.039, 95% confidence interval [CI], 0.005 to 0.072, P = 0.025) and the MNI (adjusted β = -0.216, 95% CI -0.374 to -0.058, P = 0.008). CONCLUSIONS DT and MNI were associated with HbA1c in T2DM patients.
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Affiliation(s)
- Satoru Yonekura
- Department of Endocrinology, Tochigi Medical Center, Shimotsuga, Ohira-machi Kawatsure 420-1, Tochigi City, Tochigi, Japan
| | - Masato Usui
- Usui Dental Office, 12-14 Numawada-machi, Tochigi City, Tochigi, Japan
| | - Shunichi Murano
- Department of Endocrinology, Tochigi Medical Center, Shimotsuga, Ohira-machi Kawatsure 420-1, Tochigi City, Tochigi, Japan
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