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Martínez-García M, Hernández-Lemus E. Periodontal Inflammation and Systemic Diseases: An Overview. Front Physiol 2021; 12:709438. [PMID: 34776994 PMCID: PMC8578868 DOI: 10.3389/fphys.2021.709438] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
Periodontitis is a common inflammatory disease of infectious origins that often evolves into a chronic condition. Aside from its importance as a stomatologic ailment, chronic periodontitis has gained relevance since it has been shown that it can develop into a systemic condition characterized by unresolved hyper-inflammation, disruption of the innate and adaptive immune system, dysbiosis of the oral, gut and other location's microbiota and other system-wide alterations that may cause, coexist or aggravate other health issues associated to elevated morbi-mortality. The relationships between the infectious, immune, inflammatory, and systemic features of periodontitis and its many related diseases are far from being fully understood and are indeed still debated. However, to date, a large body of evidence on the different biological, clinical, and policy-enabling sources of information, is available. The aim of the present work is to summarize many of these sources of information and contextualize them under a systemic inflammation framework that may set the basis to an integral vision, useful for basic, clinical, and therapeutic goals.
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Affiliation(s)
- Mireya Martínez-García
- Sociomedical Research Unit, National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico.,Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de Mèxico, Mexico City, Mexico
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Coffey N, O' Leary F, Burke F, Roberts A, Hayes M. Periodontal and oral health status of people with Cystic Fibrosis: a systematic review. J Dent 2020; 103:103509. [PMID: 33129998 DOI: 10.1016/j.jdent.2020.103509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES People with Cystic Fibrosis (PWCF) may be presumed to be at lower risk of periodontal disease due to long term antibiotic use but this has not been comprehensively investigated. The oral hygiene and periodontal status of PWCF in comparison to the general population is not well established. The objective of this systematic review was to critically evaluate the literature on periodontal and oral hygiene status in PWCF to see if this group are at increased risk of periodontal disease (gingivitis or periodontitis). DATA SOURCES 5 databases were searched: Scopus, MEDLINE, Embase, Cochrane Library and Web of Science. STUDY SELECTION The search resulted in 614 publications from databases with one more publication identified by searching bibliographies. 13 studies were included in the qualitative analysis. CONCLUSIONS The majority of studies showed better oral hygiene, with lower levels of gingivitis and plaque among people with Cystic Fibrosis (PWCF) than controls. Interestingly, despite this, many studies showed that PWCF had higher levels of dental calculus. Three studies found there was no difference in Oral Hygiene between PWCF and controls. One study found that PWCF aged between 6 and 9.5 years had increased levels of clinical gingivitis, and one study showed that PWCF with gingivitis had more bleeding on probing than people without CF. The vast majority of PWCF examined were children- only five studies included people over 18 years, and only one looked exclusively at adults. There is a need for further study into the periodontal health of PWCF- particularly those over the age of 18. CLINICAL SIGNIFICANCE There are currently no guidelines referring to oral care in PWCF. Studies have suggested that the oral cavity acts as a reservoir of bacteria which may colonise the lungs. If PWCF are at increased risk of periodontal disease, they should attend for regular screenings to facilitate early detection.
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Affiliation(s)
- Niamh Coffey
- Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, T12 E8YV, Ireland.
| | - Fiona O' Leary
- Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, T12 E8YV, Ireland
| | - Francis Burke
- Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, T12 E8YV, Ireland
| | - Anthony Roberts
- Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, T12 E8YV, Ireland
| | - Martina Hayes
- Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, T12 E8YV, Ireland
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Venza N, Danesi C, Contò D, Fabi F, Mampieri G, Sangiuolo F, Laganà G. Periodontal condition in growing subjects with Marfan Syndrome: a case-control study. PeerJ 2019; 7:e6606. [PMID: 31065451 PMCID: PMC6485202 DOI: 10.7717/peerj.6606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/12/2019] [Indexed: 12/18/2022] Open
Abstract
Background Marfan's syndrome (MFS) is a systemic disorder of connective tissue caused by mutations in the extracellular matrix protein fibrillin-1. Orofacial characteristics may be useful in identification of the syndrome. Severe periodontitis is sometimes observed in MFS patients, but no in-depth information has been reported in Italian groups of growing subjects with MFS. The aim of this study was to analyze the periodontal condition on a group of growing subjects affected by MFS, in comparison with a typically developed control group. Methods A group of 16 subjects with diagnosed MFS were recruited from the Centre for Rare Diseases for Marfan Syndrome and Related Disorders of Tor Vergata University Hospital. The Marfan Group (MG) was compared with a Control Group (CG) composed by 20 nonsyndromic subjects. The periodontal clinical parameters like Marginal Gingival Thickness (GT), Plaque Index (PI), Bleeding On Probing (BOP) and Modified Periodontal Screening and Recording (PSR) were assessed. Results The mean value of PI in MG was 59%, instead in CG it reached 21%. Analysis showed a significant difference between MG and CG also for the BOP. In MG the mean value of BOP attained 36% and in CG it reached 16%. A statistical significant difference of distribution of PSR index between the two groups was found for all sextant examined. Discussion Patients with Marfan syndrome reveal a higher presence of plaque and consequently a generalized inflammation in the oral cavity when compared with a control group.
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Affiliation(s)
- Nicolò Venza
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Carlotta Danesi
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Diego Contò
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Francesco Fabi
- Laboratory of Medical Genetics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Gianluca Mampieri
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Federica Sangiuolo
- Laboratory of Medical Genetics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppina Laganà
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
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Ruff RR, Senthi S, Susser SR, Tsutsui A. Oral health, academic performance, and school absenteeism in children and adolescents: A systematic review and meta-analysis. J Am Dent Assoc 2018; 150:111-121.e4. [PMID: 30473200 DOI: 10.1016/j.adaj.2018.09.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The authors conducted a systematic review and meta-analysis to provide a summary estimate of the association between oral health and academic performance. TYPES OF STUDIES REVIEWED The authors conducted a systematic search of PubMed, Embase, and Google Scholar for studies on oral health, school absence, and academic achievement published in English from January 1945 through December 2017. Exposures included subjectively or objectively measured caries, oral pain, and periodontitis. Outcomes included school absence and school achievement. RESULTS The authors screened a total of 2,041 studies, from which they extracted data from 14 studies of 139,989 children (12 cross-sectional studies, 1 case-control study, and 1 longitudinal study). Five studies had school absence as the primary outcome, and 7 studies had student achievement as the primary outcome. Three studies included both outcomes. The authors found no studies for periodontitis. The average modified Newcastle-Ottawa Scale score was 3.93. The authors rated 10 studies as having a low risk of bias and 4 as having a high risk of bias. Qualitative synthesis suggested that poor oral health may have negative effects on student absenteeism and achievement, but study quality was highly variable. Results from meta-analyses indicated that poor oral health was significantly associated with increased odds of poor academic performance (pooled odds ratio, 1.52; 95% confidence interval, 1.20 to 1.83) and absenteeism (pooled odds ratio, 1.43; 95% confidence interval, 1.24 to 1.63). CONCLUSIONS AND PRACTICAL IMPLICATIONS Increased focus on the broader implications of improvements in oral health for children, such as educational or socioemotional development, is of further interest to practicing dentists owing to the greater connection between oral health and general health. The authors of this study found that caries or tooth pain had a negative association with academic achievement and school absenteeism. However, study quality was limited by inconsistent exposure and outcome definitions and a predominance of cross-sectional designs. Thus, causal conclusions are not supported.
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Nicolau B, Castonguay G, Madathil S, Vuong T, Almeida TDD. Periodontal Diseases and Traumatic Dental Injuries in the Pediatric Population. Pediatr Clin North Am 2018; 65:1051-1061. [PMID: 30213348 DOI: 10.1016/j.pcl.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article provides an overview of periodontal diseases and traumatic dental injuries (TDIs) in children and adolescents, which are serious public health problems worldwide. Periodontal diseases, including gingivitis and periodontitis, commonly affect the oral soft tissues and teeth and often co-occur with other chronic diseases. TDIs are prevalent from an early age and carry high treatment costs. Behavioral and environmental factors contribute to both TDIs and periodontal diseases, but their etiology varies according to population characteristics and case definition. Both conditions may lead to pain, function impairment, esthetic problems, and psychosocial effects, with major consequences on quality of life.
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Affiliation(s)
- Belinda Nicolau
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada.
| | - Geneviève Castonguay
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Sreenath Madathil
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Thien Vuong
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Tahyna Duda Deps Almeida
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada; Faculty of Dentistry, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627 Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Sampaio-Maia B, Caldas IM, Pereira ML, Pérez-Mongiovi D, Araujo R. The Oral Microbiome in Health and Its Implication in Oral and Systemic Diseases. ADVANCES IN APPLIED MICROBIOLOGY 2016; 97:171-210. [PMID: 27926431 DOI: 10.1016/bs.aambs.2016.08.002] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The oral microbiome can alter the balance between health and disease, locally and systemically. Within the oral cavity, bacteria, archaea, fungi, protozoa, and viruses may all be found, each having a particular role, but strongly interacting with each other and with the host, in sickness or in health. A description on how colonization occurs and how the oral microbiome dynamically evolves throughout the host's life is given. In this chapter the authors also address oral and nonoral conditions in which oral microorganisms may play a role in the etiology and progression, presenting the up-to-date knowledge on oral dysbiosis as well as the known underlying pathophysiologic mechanisms involving oral microorganisms in each condition. In oral pathology, oral microorganisms are associated with several diseases, namely dental caries, periodontal diseases, endodontic infections, and also oral cancer. In systemic diseases, nonoral infections, adverse pregnancy outcomes, cardiovascular diseases, and diabetes are among the most prevalent pathologies linked with oral cavity microorganisms. The knowledge on how colonization occurs, how oral microbiome coevolves with the host, and how oral microorganisms interact with each other may be a key factor to understand diseases etiology and progression.
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Affiliation(s)
| | - I M Caldas
- Universidade do Porto, Portugal; Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal; Universidade de Coimbra, Portugal
| | | | - D Pérez-Mongiovi
- Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal
| | - R Araujo
- Universidade do Porto, Portugal; Flinders University, Adelaide, SA, Australia
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Implant therapy for a patient with Down syndrome and oral habits: A clinical report. J Prosthet Dent 2016; 116:320-4. [DOI: 10.1016/j.prosdent.2016.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/15/2016] [Accepted: 01/19/2016] [Indexed: 11/24/2022]
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Fabri GMC, Savioli C, Siqueira JT, Campos LM, Bonfá E, Silva CA. [Periodontal disease in pediatric rheumatic diseases]. REVISTA BRASILEIRA DE REUMATOLOGIA 2014; 54:311-7. [PMID: 25627227 DOI: 10.1016/j.rbr.2013.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/23/2013] [Indexed: 12/15/2022] Open
Abstract
Gingivitis and periodontitis are immunoinflammatory periodontal diseases characterized by chronic localized infections usually associated with insidious inflammation This narrative review discusses periodontal diseases and mechanisms influencing the immune response and autoimmunity in pediatric rheumatic diseases (PRD), particularly juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (C-SLE) and juvenile dermatomyositis (JDM). Gingivitis was more frequently observed in these diseases compared to health controls, whereas periodontitis was a rare finding. In JIA patients, gingivitis and periodontitis were related to mechanical factors, chronic arthritis with functional disability, dysregulation of the immunoinflammatory response, diet and drugs, mainly corticosteroids and cyclosporine. In C-SLE, gingivitis was associated with longer disease period, high doses of corticosteroids, B-cell hyperactivation and immunoglobulin G elevation. There are scarce data on periodontal diseases in JDM population, and a unique gingival pattern, characterized by gingival erythema, capillary dilation and bush-loop formation, was observed in active patients. In conclusion, gingivitis was the most common periodontal disease in PRD. The observed association with disease activity reinforces the need for future studies to determine if resolution of this complication will influence disease course or severity.
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Affiliation(s)
- Gisele M C Fabri
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Faculdade de Odontologia, Universidade Federal de Juiz de Fora, MG, Brasil
| | - Cynthia Savioli
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - José T Siqueira
- Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Lucia M Campos
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Eloisa Bonfá
- Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Clovis A Silva
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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