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Qaiser M, Asmatullah M, Shahwar D, Aqeel M, Ameer N, Mahmood K, Hanif M, Sajid Chughtai FR, Usman Abid HM, Bukhari SW. A yeast-malic acid crosslinker/polyacrylic acid hydrogel containing doxycycline for the treatment of periodontitis. RSC Adv 2024; 14:25174-25189. [PMID: 39139228 PMCID: PMC11318522 DOI: 10.1039/d4ra02638a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/15/2024] [Indexed: 08/15/2024] Open
Abstract
Doxycycline (DX) is a drug of choice for the treatment of periodontitis, with the limitation of requiring a high dose, which may be overcome by the preparation of a targeted controlled-release hydrogel containing a newly synthesized yeast-malic acid crosslinker (YMC). YMC was synthesized via thermochemical modification of yeast with malic acid at 100-140 °C and compared with glutaraldehyde-saturated toluene (GST). Swelling capacity, acid and carboxyl content, scanning electron microscopy (SEM) imaging, Brunauer-Emmett-Teller (BET) analysis, viscosity, cross-linking density, DX loading and release behavior at pH 6.5, mucoadhesion, and antimicrobial and periodontal efficacy of the glutaraldehyde hydrogel (HGG) and YMC hydrogel (HGY) were compared. Changes from C-O (1421 cm-1) to C[double bond, length as m-dash]OOR (1702 cm-1) in the infrared spectroscopy, along with changes in the degree of substitution from 0 to 0.39, degree of esterification from 0 to 40 ± 1.5 and COOH content from 129 ± 0.5 to 290 ± 0.5 (meq. per 100 g), were found between yeast to YMC, respectively. The results revealed 1.5 times more dynamic swelling, 0.25-fold decrease in acid content, 2.3-fold increase in carboxyl content, and 1.2- and 2.1-fold increases in cross-linking density and viscosity of HGY as compared to HGG, respectively. The SEM and BET results revealed that HGY had a 2 times greater porous surface than HGG. HGY/DX was 35 ± 2% more effective in controlling periodontitis bacteria, decreased periodontal depth from 4 to 3.2 mm, and gingival index from 3 to 1 as compared to HGG/DX in patients suffering from periodontitis. HGY/DX not only serves as a tool for the controlled release of DX in periodontal pockets but also contributes to the treatment of gingival periodontitis.
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Affiliation(s)
- Muhammad Qaiser
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
- Drugs Testing Laboratory Punjab Multan Pakistan
| | - Muhammad Asmatullah
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan Pakistan +923327638243
| | - Dure Shahwar
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
| | - Muhammad Aqeel
- Nishtar Institute of Dentistry Jail Road, Jinnah Town Multan Punjab Pakistan
| | - Nabeela Ameer
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
| | - Khalid Mahmood
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan Pakistan +923327638243
| | - Muhammad Hanif
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
| | - Fazal Rahman Sajid Chughtai
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
| | - Hafiz Muhammad Usman Abid
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University Multan 76800 Pakistan +923336103668
| | - Syed Waqas Bukhari
- Drugs Testing Laboratory Punjab Multan Pakistan
- Institute of Chemical Sciences, Bahauddin Zakariya University Multan Pakistan +923327638243
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Hwang SM, Kim TY, Kim A, Kim YG, Park JW, Lee JM, Kim JY, Suh JY. Resveratrol facilitates bone formation in high-glucose conditions. Front Physiol 2024; 15:1347756. [PMID: 38706943 PMCID: PMC11066205 DOI: 10.3389/fphys.2024.1347756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Periodontitis is known to be affected by high-glucose conditions, which poses a challenge to periodontal tissue regeneration, particularly in bone formation. In this study, the potential effects of resveratrol (3,5,4'-trihydroxystilbene, RSV) in facilitating bone formation under high-glucose conditions after periodontitis has been investigated. We focused on the analysis of osteoblasts and periodontal ligament cells, which are essential for bone formation including cell proliferation and differentiation. And we aimed to investigate the impact of RSV on bone healing, employed diabetic mouse model induced by streptozotocin and confirmed through histological observation. High-glucose conditions adversely affected cell proliferation and ALP activity in both MC3T3-E1 and hPDLF in vitro, with more significant impact on MC3T3-E1 cells. RSV under high-glucose conditions had positive effects on both, showing early-stage effects for MC3T3-E1 cells and later-stage effects for hPDLF cells. RSV seemed to have a more pronounced rescuing role in MC3T3-E1 cells. Increased ALP activity was observed and the expression levels of significant genes, such as Col 1, TGF-β1, ALP, and OC, in osteogenic differentiation were exhibited stage-specific expression patterns. Upregulated Col 1 and TGF-β1 were detected in the early stage, and then ALP and OC expressions became more pronounced in the later stages. Similarly, stronger positive reactions against RUNX2 were detected in the RSV-treated group compared to the control. Furthermore, in in vivo experiment, RSV stimulates the growth and differentiation of osteoblasts, thereby promoting bone formation. High-glucose levels have the potential to impair cellular functions and the regenerative capacity to facilitate bone formation with MC3T3-E1 rather than hPDLF cells. Resveratrol appears to facilitate the inherent abilities of MC3T3-E1 cells compared with hPDLF cells, indicating its potential capacity to restore functionality during periodontal regeneration.
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Affiliation(s)
- Sung-Min Hwang
- Department of Periodontology, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Tae-Young Kim
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Anna Kim
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Yong-Gun Kim
- Department of Periodontology, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Jin-Woo Park
- Department of Periodontology, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Young Kim
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Jo-Young Suh
- Department of Periodontology, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
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Feng Q, Zhang M, Zhang G, Mei H, Su C, Liu L, Wang X, Wan Z, Xu Z, Hu L, Nie Y, Li J. A whole-course-repair system based on ROS/glucose stimuli-responsive EGCG release and tunable mechanical property for efficient treatment of chronic periodontitis in diabetic rats. J Mater Chem B 2024; 12:3719-3740. [PMID: 38529844 DOI: 10.1039/d3tb02898d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Elevated glucose levels, multiple pro-inflammatory cytokines and the generation of excessive reactive oxygen species (ROS) are pivotal characteristics within the microenvironments of chronic periodontitis with diabetes mellitus (CPDM). Control of inflammation and modulation of immune system are required in the initial phase of CPDM treatment, while late severe periodontitis requires a suitable scaffold to promote osteogenesis, rebuild periodontal tissue and reduce alveolar bone resorption. Herein, a whole-course-repair system is introduced by an injectable hydrogel using phenylboronic acid functionalized oxidized sodium alginate (OSA-PBA) and carboxymethyl chitosan (CMC). Epigallocatechin-3-gallate (EGCG) was loaded to simultaneously adjust the mechanical property of the OSA-PBA/CMC + EGCG hydrogel (OPCE). This hydrogel has distinctive adaptability, injectability, and ROS/glucose-triggered release of EGCG, making it an ideal drug delivery carrier. As expected, OPCE hydrogel shows favourable antioxidant and anti-inflammatory properties, along with a regulatory influence on the phenotypic transition of macrophages, providing a favourable immune microenvironment. Apart from that, it provides a favourable mechanical support for osteoblast/osteoclast differentiation regulation at the late proliferation stage of periodontal regeneration. The practical therapeutic effects of OPCE hydrogels were also confirmed when applied for treating periodontitis in diabetic rats. In summary, OPCE hydrogel may be a promising whole-course-repair system for the treatment of CPDM.
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Affiliation(s)
- Qingchen Feng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Mei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Guanning Zhang
- Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Hongxiang Mei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Chongying Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Lisa Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Xiaoxia Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Ziqianhong Wan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Zhengyi Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Liangkui Hu
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Yu Nie
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
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Aliberti SM, Funk RHW, De Stefano M, Hoffmann T, Capunzo M. An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study. Clin Exp Dent Res 2024; 10:e2836. [PMID: 38450945 PMCID: PMC10918715 DOI: 10.1002/cre2.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure. MATERIALS AND METHODS The study used the hybrid method of SWOT-AHP. RESULTS Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight. CONCLUSIONS This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.
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Affiliation(s)
- Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Richard H. W. Funk
- Institute of AnatomyTechnische Universität (TU) DresdenDresdenGermany
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Marco De Stefano
- Department of Industrial EngineeringUniversity of SalernoSalernoItaly
| | - Thomas Hoffmann
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
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Steigmann L, Gunaratnam S, Giannobile WV, Van Til M, Daignault-Newton S, Herman WH, Gunaratnam N, Katulanda P, Sarma AV. Poor Glycemic Control Increases Dental Risk in a Sri Lankan Population. Healthcare (Basel) 2024; 12:358. [PMID: 38338243 PMCID: PMC10855197 DOI: 10.3390/healthcare12030358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Introduction: The aim of our study was to investigate the impact of diabetes-related factors on the dental disease outcomes of diabetes patients in Trincomalee, Sri Lanka. Materials and Methods: Dental data were collected from 80 type-2-diabetic individuals. A dental risk score was calculated based on the frequency of dental outcomes observed and categorized as low risk (≤3 dental outcomes) and high risk (>3 dental outcomes). Results: In this cohort of men and women with type 2 diabetes, there was a high frequency of periodontal related outcomes, including missing teeth (70%), gingival recessions (40%), tooth mobility (41%), and bleeding (20%). Thirty-nine (39%) of participants had high dental risk, while forty-nine (61%) had low risk. Conclusions: After controlling for age, participants with higher capillary blood glucose levels had 3-fold greater odds of a high dental risk score (OR = 2.93, 95%CI = 1.13, 7.61). We found that poor glycemic control indicated by elevated capillary blood glucose was associated with increased dental risk.
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Affiliation(s)
- Larissa Steigmann
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Sejal Gunaratnam
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - William V. Giannobile
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Monica Van Til
- Department of Urology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | | | - William H. Herman
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | | | - Prasad Katulanda
- Faculty of Medicine, University of Colombo, Colombo 00300, Sri Lanka
| | - Aruna V. Sarma
- Department of Urology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
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Xu HM, Shen XJ, Liu J. Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus. World J Diabetes 2023; 14:1793-1802. [PMID: 38222787 PMCID: PMC10784791 DOI: 10.4239/wjd.v14.i12.1793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/20/2023] [Accepted: 11/27/2023] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with periodontitis. Currently, there are few studies proposing predictive models for periodontitis in patients with T2DM. AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models. METHODS In this a retrospective study, 300 patients with T2DM who were hospitalized at the First People's Hospital of Wenling from January 2022 to June 2022 were selected for inclusion, and their data were collected from hospital records. We used logistic regression to analyze factors associated with periodontitis in patients with T2DM, and random forest and logistic regression prediction models were established. The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve (AUC). RESULTS Of 300 patients with T2DM, 224 had periodontitis, with an incidence of 74.67%. Logistic regression analysis showed that age [odds ratio (OR) = 1.047, 95% confidence interval (CI): 1.017-1.078], teeth brushing frequency (OR = 4.303, 95%CI: 2.154-8.599), education level (OR = 0.528, 95%CI: 0.348-0.800), glycosylated hemoglobin (HbA1c) (OR = 2.545, 95%CI: 1.770-3.661), total cholesterol (TC) (OR = 2.872, 95%CI: 1.725-4.781), and triglyceride (TG) (OR = 3.306, 95%CI: 1.019-10.723) influenced the occurrence of periodontitis (P < 0.05). The random forest model showed that the most influential variable was HbA1c followed by age, TC, TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showed that in the training dataset, the AUC of the random forest model was higher than that of the logistic regression model (AUC = 1.000 vs AUC = 0.851; P < 0.05). In the validation dataset, there was no significant difference in AUC between the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915; P > 0.05). CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the risk of periodontitis in patients with T2DM.
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Affiliation(s)
- Hong-Miao Xu
- Department of Stomatology, The First People’s Hospital of Wenling, Taizhou 317500, Zhejiang Province, China
| | - Xuan-Jiang Shen
- Department of Stomatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Jia Liu
- Department of Stomatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
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Ekşi C. Two Cases Demonstrating the Role of Creeping Attachment in the Treatment of Keratinized Gingival Deficiency With Free Gingival Graft: A 12-Month Follow-Up. Cureus 2023; 15:e49537. [PMID: 38156128 PMCID: PMC10753146 DOI: 10.7759/cureus.49537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
After free gingival graft procedure, partial or complete coverage of exposed root surfaces due to coronal migration of the gingival margin is called "creeping attachment." This case report aimed to evaluate the results of the free gingival graft procedure performed on two patients with keratinized gingival deficiency in the mandibular anterior region and to present the creeping attachment formation process with a 12-month follow-up in light of current literature. Free gingival graft treatment was applied after the initial periodontal treatments were completed for two patients who visited the periodontology clinic complaining of gingival recession. Although the postoperative recovery was completed without any problems, it was observed that there were still root exposures in the relevant areas. Patient motivation was provided by giving oral hygiene training to the patients. After the 12-month follow-up, it was reported that denuded root surfaces were completely covered with creeping attachment formation. Complete coverage of denuded root surfaces is possible through the formation of creeping attachment, with the help of oral care and follow-up procedures, without requiring repeated surgical procedures. So, after relevant procedures, dentists must provide patients with sufficient information and awareness on this issue.
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Affiliation(s)
- Cemre Ekşi
- Periodontology, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, TUR
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Oral Health Professionals’ and Patients’ Opinions of Type-2 Diabetes Screenings in an Oral Healthcare Setting. ENDOCRINES 2023. [DOI: 10.3390/endocrines4010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objectives: As part of an evaluation of an oral healthcare practice-based model that identifies patients with prediabetes or type-2 diabetes (T2D), this study reports on the experiences and opinions of oral health professionals and patients on the screening program. Methodology: Urban and rural oral healthcare practices were invited to participate. Participating practices invited eligible patients to participate in the screening program. Patients were categorised as low, intermediate, or high-risk for prediabetes/T2D. Patients in the intermediate or high-risk category were referred to their general practitioner (GP) for further investigation. Post-screening surveys were used to assess acceptability, barriers and facilitators of the screening program among participating oral health professionals (OHP) and patients. Results: The post-screening survey was completed by 135 patient, and 38 OHPs (i.e., dentists, dental hygienists, oral health therapists). the majority of OHPs (94.6%) who delivered the protocol were satisfied with the approach. Most patients reported satisfaction with the approach (73.2%) and would recommend it to others. Several barriers for implementation were identified by OHPs and patients. Conclusion: OHPs feedback indicated that the screening model was generally acceptable. The feedback from patients following their participation in this study was overwhelmingly positive, indicating that the screening protocols were accepted by patients.
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Aljofi FE, Alesawy A, Alzaben B, Alshaikh M, Alotaibi N, Aldulaijan HA, Alshehri S, Aljoghaiman E, Al-Dulaijan YA, AlSharief M. Impact of Metformin on Periodontal and Peri-Implant Soft and Hard Tissue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1095. [PMID: 36673851 PMCID: PMC9859401 DOI: 10.3390/ijerph20021095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords 'metformin', 'diabetes', 'periodontitis', 'implant', and 'peri-implantitis' via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.
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Affiliation(s)
- Faisal E. Aljofi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Aminah Alesawy
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Bader Alzaben
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Marwa Alshaikh
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Norah Alotaibi
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Hajer A. Aldulaijan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh P.O. Box 60169, Saudi Arabia
| | - Sami Alshehri
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Eman Aljoghaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Yousif A. Al-Dulaijan
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Mishali AlSharief
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Cost-Effectiveness of Screening to Identify Pre-Diabetes and Diabetes in the Oral Healthcare Setting. ENDOCRINES 2022. [DOI: 10.3390/endocrines3040062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: This study assesses the long-term cost-effectiveness of this screening protocol from a healthcare system perspective. Methods: Australians presenting to private oral healthcare practices recruited to the iDENTify study were included as the study population. A Markov model preceded by a decision tree was developed to assess the intervention’s long-term cost-effectiveness when rolled out to all eligible Australians, and measured against ‘no-intervention’ current practice. The model consisted of four health states: normoglycaemia; pre-diabetes; type 2 diabetes and death. Intervention reach of various levels (10%, 20%, 30%, and 40%) were assessed. The model adopted a 30-year lifetime horizon and a 2020 reference year. Costs and benefits were discounted at 5% per annum. Results: If the intervention reached a minimum of 10% of the target population, over the lifetime time horizon, each screened participant would incur a cost of $38,462 and a gain of 10.564 QALYs, compared to $38,469 and 10.561 QALYs for each participant under current practice. Screening was associated with lower costs and higher benefits (a saving of $8 per person and 0.003 QALYs gained), compared to current standard practice without such screening. Between 8 and 34 type 2 diabetes cases would be avoided per 10,000 patients screened if the intervention were taken up by 10% to 40% of private oral healthcare practices. Sensitivity analyses showed consistent results. Conclusions: Implementing type 2 diabetes screening in the private oral healthcare setting using a simple risk assessment tool was demonstrated to be cost-saving. The wider adoption of such screening is recommended.
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Mehriz BM, Atteya MA, Skipina TM, Mostafa MA, Soliman EZ. Association between Periodontitis and Diabetes Mellitus in the General Population. J Diabetes Metab Disord 2022; 21:1249-1254. [PMID: 36404812 PMCID: PMC9672178 DOI: 10.1007/s40200-022-01010-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 10/14/2022]
Abstract
Purpose- This study aimed to examine the association between periodontitis and diabetes mellitus. Methods Participants with natural teeth in one jaw from the Third United States National Health and Nutrition Examination Survey (1988-1994) were included in this analysis. Participants with moderate (> 4mm attachment loss in ≥ 2 mesial sites or 5mm pocket depth in ≥ 2 mesial sites) or severe (> 6mm attachment loss in ≥ 2 mesial sites and > 5mm pocket depth in ≥ 1 mesial site) periodontitis were classified as having periodontal disease. The rest of the participants were considered without periodontal disease. Diabetes mellitus was defined as fasting glucose ≥ 126mg/dL, hemoglobin A1c ≥ 6.5% or the use of antihyperglycemic medications. Multivariable logistic regression was used to examine the association between periodontitis and diabetes mellitus in all study population and subgroups stratified by demographics and comorbidities. Results This analysis included 13,000 participants [mean age 43.8 ± 19.1 years, 47.5% male, 30% whites]. About 12.7% (n = 1,656) of the study population had periodontitis, and 9.2% (n = 1,200) had diabetes. In a multivariable-adjusted model, presence (vs. absence) of periodontitis was associated with 66% increased odds of diabetes (OR (95% CI):1.66 (1.43-1.94); p < 0.001). Compared to those without periodontitis, the odds of diabetes among those with severe periodontitis was much higher (OR (95% CI): 2.31(1.72-3.11); p < 0.001) than in those with moderate periodontitis (OR (95% CI): 1.54(1.30-1.82); p < 0.001). Conclusions Periodontitis is associated with prevalent diabetes in a dose-response fashion, suggesting a bidirectional relationship between those two diseases. Patients with periodontal disease should be counseled regarding their elevated risk of diabetes. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01010-6.
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Affiliation(s)
- Basant M. Mehriz
- Institute of Global Health and Human Ecology, School of Sciences and Engineering, American University in Cairo, New Cairo, Cairo, Egypt
| | - Mirna A. Atteya
- Institute of Global Health and Human Ecology, School of Sciences and Engineering, American University in Cairo, New Cairo, Cairo, Egypt
| | - Travis M. Skipina
- Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
| | - Mohamed A. Mostafa
- Epidemiological Cardiology Research Center, Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center, Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
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12
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Ateeq H, Zia A, Husain Q, Khan MS, Ahmad M. Effect of inflammation on bones in diabetic patients with periodontitis via RANKL/OPG system-A review. J Diabetes Metab Disord 2022; 21:1003-1009. [PMID: 35673491 PMCID: PMC9167386 DOI: 10.1007/s40200-021-00960-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/14/2021] [Indexed: 01/31/2023]
Abstract
Purpose Diabetes mellitus and periodontitis are inflammatory diseases, the severity of inflammation results in the progression and persistence of both the disorders and affects bones. Diabetic complications aggravate in diabetic subjects having periodontitis; similarly, diabetic patients are more prone to developing gingivitis and periodontitis. Periodontal and diabetic inflammation disturbs bone homeostasis, which possibly involves both innate and adaptive immune responses. The pathogenic processes that link the two diseases are the focus of much research and it is likely that upregulated inflammation arising from each condition adversely affects the other. RANKL/OPG pathway plays a prominent role in periodontal and diabetic inflammation and bone resorption. Method This review article summarises the literature on the link between inflammatory cytokines and the prevalence of disturbed bone homeostasis in diabetic patients with periodontitis. An extensive search was done in PubMed, Scopus, Medline and Google Scholar databases between April 2003 and May 2021. Result A total of 27 articles, including pilot studies, case-control studies, cross-sectional studies, cohort studies, randomized control trials, longitudinal studies, descriptive studies and experimental studies, were included in our literature review. Conclusion Since RANKL/OPG are cytokines and have immune responses, regulating these cytokines expression will help control diabetes, periodontitis and bone homeostasis. The growing evidence of bone loss and increased fracture risk in diabetic patients with periodontitis makes it imperative that health professionals carry out planned treatment focusing on monitoring oral health in diabetic patients; bone markers should also be evaluated in patients with chronic periodontitis with an impaired glycemic state.
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Affiliation(s)
- Hira Ateeq
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh-202002, India
- Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh-202002, India
| | - Afaf Zia
- Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh-202002, India
| | - Qayyum Husain
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh-202002, India
| | - Mohd Sajid Khan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh-202002, India
| | - Mohd Ahmad
- Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh-202002, India
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13
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Alsamahi S, Milne TM, Hussaini H, Rich AM, Friedlander LT. Type 2 diabetes and the clinically normal pulp - An in-vitro study. Int Endod J 2022; 55:660-671. [PMID: 35322881 PMCID: PMC9324782 DOI: 10.1111/iej.13732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/15/2022]
Abstract
Aim The aim of this study was to investigate the effect of type 2 diabetes (T2D) on clinically normal dental pulp tissue by using special stains and immunohistochemistry (IHC) to determine the morphology of the coronal pulp and distribution of immune markers in non‐T2D and T2D groups. Methodology Ethics approval for this in vitro pilot study was obtained from the University of Otago Human Ethics Committee (16/069). Twenty extracted permanent molar teeth diagnosed as having clinically normal pulp status were collected. Ten teeth were from participants with well‐controlled T2D and ten from participants without diabetes (non‐T2D). Each tooth was sectioned transversely at the cemento‐enamel junction before the crowns were decalcified and embedded in paraffin. Sections were stained with haematoxylin and eosin, Massons trichrome, and van Gieson stains for histological and morphological evaluation. IHC using anti‐CD4, anti‐CD68 and anti‐CD83 and anti‐IL1β, anti‐IL6, anti‐IL17, anti‐TNF‐α, anti‐TLR2, anti‐TLR4 and anti‐FOXP3 identified proteins of interest. Qualitative and semi‐quantitative analyses evaluated the morphology of the dental pulp and protein expression. Data analyses were performed with GraphPad Prism, using Student's t‐test and multiple regression using SPSS at p < .05. Results Special stains demonstrated morphological differences in the T2D dental pulp compared with non‐T2D. Qualitative analysis indicated that the pulp in the T2D samples was consistently less cellular, less vascular, showed evidence of thickened blood vessel walls, increased pulp calcification and collagen deposition. Semi‐quantitative analysis of IHC samples showed the T2D pulp had significantly increased expression of macrophage and dendritic cell markers CD68 (p < .001) and CD83 (p = .04), and there was significantly greater expression of inflammatory cytokines IL1β (p = .01), IL6 (p < .0001), IL17 (p < .0001) and TNF‐α (p = .01). T2D samples showed a significant increase in markers of innate inflammation, TLR2 (p < .001) and TLR4 (p < .001) and decreased expression of regulatory T‐cell marker, FOXP3 (p = .01). Multiple regression showed that age‐corrected differences were statistically significant. Conclusion Preliminary findings suggest that T2D may exert a similar response in the pulp to complications in other body sites. Hyperglycaemia is associated with changes in the morphology of the clinically normal dental pulp with altered immune cell and cytokine expression.
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Affiliation(s)
- S Alsamahi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - T M Milne
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - H Hussaini
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - A M Rich
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
| | - L T Friedlander
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago
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14
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Shim H, Koo J, Ahn J. Association between Rheumatoid Arthritis and Poor Self-Perceived Oral Health in Korean Adults. Healthcare (Basel) 2022; 10:healthcare10030427. [PMID: 35326903 PMCID: PMC8954365 DOI: 10.3390/healthcare10030427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objective: Rheumatoid arthritis (RA) and oral health problems have been reported as specific disease units; however, this study was conducted to evaluate the association between RA and comprehensive oral health status. Therefore, this study aimed to assess the association between RA and oral health using self-perceived oral health (SPOH) variables that can determine the oral health status in Korean adults using representative national data. Methods: Data from 40,186 selected participants were collected from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2018. The prevalence relative risk (PRR) was estimated using Poisson regression analysis to obtain the risk ratio of the SPOH according to RA. Results: The risk of SPOH depending on the RA status was statistically significant (odds ratio [OR] = 1.108, 95% confidence interval [CI] 1.005–1.222). In addition, the risk of SPOH depending on the RA status was higher in the group with diabetes mellitus (DM) (OR = 1.205, 95% CI 0.966–1.503) than in the group without DM (OR = 1.088, 95% CI 0.976–1.214). Conclusions: In this study, a significant association was identified between RA and SPOH. Oral health experts should identify the factors affecting the oral health of patients with RA and provide correct oral health care; however, additional research is needed.
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Affiliation(s)
- Hana Shim
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jungwan Koo
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: (J.K.); (J.A.); Tel.: +82-2-2258-6268 (J.K.); +82-2-2258-6701 (J.A.); Fax: +82-2-2258-6678 (J.K. & J.A.)
| | - Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: (J.K.); (J.A.); Tel.: +82-2-2258-6268 (J.K.); +82-2-2258-6701 (J.A.); Fax: +82-2-2258-6678 (J.K. & J.A.)
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15
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Salhi L, Reners M. Update on the Bidirectional Link Between Diabetes and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:231-240. [DOI: 10.1007/978-3-030-96881-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Wang Y, Chu T, Gong Y, Li S, Wu L, Jin L, Hu R, Deng H. Mendelian randomization supports the causal role of fasting glucose on periodontitis. Front Endocrinol (Lausanne) 2022; 13:860274. [PMID: 35992145 PMCID: PMC9388749 DOI: 10.3389/fendo.2022.860274] [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: 01/22/2022] [Accepted: 07/07/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The effect of hyperglycemia on periodontitis is mainly based on observational studies, and inconsistent results were found whether periodontal treatment favors glycemic control. The two-way relationship between periodontitis and hyperglycemia needs to be further elucidated. This study aims to evaluate the causal association of periodontitis with glycemic traits using bi-directional Mendelian randomization (MR) approach. METHODS Summary statistics were sourced from large-scale genome-wide association study conducted for fasting glucose (N = 133,010), HbA1c (N = 123,665), type 2 diabetes (T2D, N = 659,316), and periodontitis (N = 506,594) among European ancestry. The causal relationship was estimated using the inverse-variance weighted (IVW) model and further validated through extensive complementary and sensitivity analyses. RESULTS Overall, IVW showed that a genetically higher level of fasting glucose was significantly associated with periodontitis (OR = 1.119; 95% CI = 1.045-1.197; PFDR= 0.007) after removing the outlying instruments. Such association was robust and consistent through other MR models. Limited evidence was found suggesting the association of HbA1C with periodontitis after excluding the outliers (IVW OR = 1.123; 95% CI = 1.026-1.229; PFDR= 0.048). These linkages remained statistically significant in multivariate MR analyses, after adjusting for body mass index. The reverse direction MR analyses did not exhibit the causal association of genetic liability to periodontitis with any of the glycemic trait tested. CONCLUSIONS Our MR study reaffirms previous findings and extends evidence to substantiate the causal effect of hyperglycemia on periodontitis. Future studies with robust genetic instruments are needed to confirm the causal association of periodontitis with glycemic traits.
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Affiliation(s)
- Yi Wang
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Hui Deng, ; Yi Wang,
| | - Tengda Chu
- Department of Periodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yixuan Gong
- Department of Periodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Sisi Li
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Lixia Wu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rongdang Hu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Hui Deng
- Department of Periodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Hui Deng, ; Yi Wang,
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17
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Eliezer M, Sculean A, Miron RJ, Nemcovsky C, Bosshardt DD, Fujioka-Kobayashi M, Weinreb M, Moses O. Cross-linked hyaluronic acid slows down collagen membrane resorption in diabetic rats through reducing the number of macrophages. Clin Oral Investig 2021; 26:2401-2411. [PMID: 34608575 DOI: 10.1007/s00784-021-04206-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/26/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We previously showed that accelerated degradation of collagen membranes (CMs) in diabetic rats is associated with increased infiltration of macrophages and blood vessels. Since pre-implantation immersion of CMs in cross-linked high molecular weight hyaluronic acid (CLHA) delays membrane degradation, we evaluated here its effect on the number of macrophages and endothelial cells (ECs) within the CM as a possible mechanism for inhibition of CM resorption. MATERIALS AND METHODS Diabetes was induced with streptozotocin in 16 rats, while 16 healthy rats served as control. CM discs were labeled with biotin, soaked in CLHA or PBS, and implanted under the scalp. Fourteen days later, CMs were embedded in paraffin and the number of macrophages and ECs within the CMs was determined using antibodies against CD68 and transglutaminase II, respectively. RESULTS Diabetes increased the number of macrophages and ECs within the CMs (∼2.5-fold and fourfold, respectively). Immersion of CMs in CLHA statistically significantly reduced the number of macrophages (p < 0.0001) in diabetic rats, but not that of ECs. In the healthy group, CLHA had no significant effect on the number of either cells. Higher residual collagen area and membrane thickness in CLHA-treated CMs in diabetic animals were significantly correlated with reduced number of macrophages but not ECs. CONCLUSIONS Immersion of CM in CLHA inhibits macrophage infiltration and reduces CM degradation in diabetic animals. CLINICAL RELEVANCE The combination of CLHA and CM may represent a valuable approach when guided tissue regeneration or guided bone regeneration procedures are performed in diabetic patients.
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Affiliation(s)
- Meizi Eliezer
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Carlos Nemcovsky
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Miron Weinreb
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Moses
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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18
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Aziz J, Rahman MT, Vaithilingam RD. Dysregulation of metallothionein and zinc aggravates periodontal diseases. J Trace Elem Med Biol 2021; 66:126754. [PMID: 33831799 DOI: 10.1016/j.jtemb.2021.126754] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 03/29/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Periodontitis (PD) is a multifaceted inflammatory disease connected to bacterial infection that results in the destruction of tooth supporting structures and eventually tooth loss. Given their involvement in infection and inflammation, both metallothionein (MT) and zinc (Zn) might play vital roles in the development and progression of PD. More specifically, both MT and Zn are heavily involved in regulating immune functions, controlling bacterial infection, balancing inflammatory responses, and reducing oxidative stress, all of which are associated with the pathogenesis of PD. OBJECTIVE This review paper will explore the physiological functions of MT and Zn and hypothesise how dysregulation could negatively affect periodontal health, leading to PD. FINDINGS Bacterial lipopolysaccharide (LPS) derived from periodontal pathogens, namely P. gingivalis initiates the acute phase response, thus upregulating the expression of MT which leads to the subsequent deficiency of Zn, a hallmark of periodontal disease. This deficiency leads to ineffective NETosis, increases the permeability of the gingival epithelium, and disrupts the humoral immune response, collectively contributing to PD. In addition, the presence of LPS in Zn deficient conditions favours M1 macrophage polarisation and maturation of dendritic cells, and also inhibits the anti-inflammatory activity of regulatory T cells. Collectively, these observations could theoretically give rise to the chronic inflammation seen in PD. CONCLUSION A disrupted MT and Zn homeostasis is expected to exert an adverse impact on periodontal health and contribute to the development and progression of PD.
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Affiliation(s)
- Jazli Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia; Dept. of Oral & Craniofacial Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | | | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
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19
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Zhang B, Yang Y, Yi J, Zhao Z, Ye R. Hyperglycemia modulates M1/M2 macrophage polarization via reactive oxygen species overproduction in ligature-induced periodontitis. J Periodontal Res 2021; 56:991-1005. [PMID: 34190354 DOI: 10.1111/jre.12912] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis in diabetic patients is characterized by enhanced inflammation and aggravated tissue damage in comparison with that in non-diabetic counterparts. The progression of periodontal damage under diabetic condition can be partly ascribed to hyperglycemia-induced disturbance between immune activation and inflammation resolution, where macrophages are capable of participating given their plasticity in response to different stimuli. Herein, we aimed to investigate the changes of macrophage polarization in periodontitis under diabetic condition and the underlying mechanism. MATERIALS AND METHODS Type-1 diabetes was induced by the injection of streptozotocin (STZ, 60 mg/kg) in Sprague-Dawley rats. Rats in N-acetyl cysteine (NAC)-treated groups received NAC dissolved in drinking water (200 mg/kg/day). Experimental periodontitis was induced by ligating 3-0 silk around left maxillary second molars for 4 weeks. Alveolar bone destruction was tested by micro-computed tomography and tartrate-resistant acid phosphatase (TRAP) staining. M1/M2 macrophage polarization in periodontal tissue was detected by immunohistochemistry staining. RAW264.7 were cultured in normal glucose (5.5 mM) or high glucose environment (25 mM) with or without NAC (8 mmol/L). LPS (100 ng/ml) and IL-4 (20 ng/ml) were used to induce M1 macrophages and M2 macrophages, respectively. M1/M2 macrophage polarization was detected by qRT-PCR, immunofluorescent staining, and flow cytometry. Reactive oxygen species (ROS) accumulation was detected by fluorogenic probes. RANKL (100 ng/ml) were applied to induce osteoclastogenic differentiation of RAW264.7, and osteoclast formation was examined by TRAP staining. RESULTS Rats with diabetes displayed enhanced macrophages infiltration and M1 macrophage polarization in periodontal lesions compared with vehicle-treated rats. Under LPS or IL-4 stimulation, high glucose culture of RAW264.7 elevated ROS level and increased the expression of M1 macrophage markers (iNOS, TNF-α, and IL-6) whereas decreased the expression of M2 macrophage markers (Arg-1 and CD206). Supernatants of high glucose-treated M1/M2 macrophages enhanced osteoclast formation compared to normal glucose-cultured cells. Decreasing ROS level via NAC partially reversed the effect of high glucose on M1/M2 macrophage polarization. Meanwhile, daily intake of NAC in rodent models inhibited M1 macrophage polarization, which subsequently ameliorated alveolar bone loss and decreased osteoclast numbers in periodontitis in diabetic rats. CONCLUSION These findings demonstrated that hyperglycemia could polarize macrophage toward M1 macrophages via overproducing ROS under inflammatory condition, which might take responsibility for aggravated periodontal damage in periodontitis under diabetic condition. Inhibiting M1 macrophages and restoring M2 macrophages by ROS scavenger is hopefully a potential adjunct treatment strategy for diabetic periodontitis.
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Affiliation(s)
- Bo 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 Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jianru Yi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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20
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Bostanci N, Krog MC, Hugerth LW, Bashir Z, Fransson E, Boulund F, Belibasakis GN, Wannerberger K, Engstrand L, Nielsen HS, Schuppe-Koistinen I. Dysbiosis of the Human Oral Microbiome During the Menstrual Cycle and Vulnerability to the External Exposures of Smoking and Dietary Sugar. Front Cell Infect Microbiol 2021; 11:625229. [PMID: 33816334 PMCID: PMC8018275 DOI: 10.3389/fcimb.2021.625229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/11/2021] [Indexed: 12/18/2022] Open
Abstract
Physiological hormonal fluctuations exert endogenous pressures on the structure and function of the human microbiome. As such, the menstrual cycle may selectively disrupt the homeostasis of the resident oral microbiome, thus compromising oral health. Hence, the aim of the present study was to structurally and functionally profile the salivary microbiome of 103 women in reproductive age with regular menstrual cycle, while evaluating the modifying influences of hormonal contraceptives, sex hormones, diet, and smoking. Whole saliva was sampled during the menstrual, follicular, and luteal phases (n = 309) of the cycle, and the participants reported questionnaire-based data concerning their life habits and oral or systemic health. No significant differences in alpha-diversity or phase-specific clustering of the overall microbiome were observed. Nevertheless, the salivary abundances of genera Campylobacter, Haemophilus, Prevotella, and Oribacterium varied throughout the cycle, and a higher species-richness was observed during the luteal phase. While the overall community structure maintained relatively intact, its functional properties were drastically affected. In particular, 11 functional modules were differentially abundant throughout the menstrual cycle, including pentose phosphate metabolism, and biosynthesis of cobalamin and neurotransmitter gamma-aminobutyric acid. The menstrual cycle phase, but not oral contraceptive usage, was accountable for greater variations in the metabolic pathways of the salivary microbiome. Further co-risk factor analysis demonstrated that Prevotella and Veillonella were increased in current smokers, whereas high dietary sugar consumption modified the richness and diversity of the microbiome during the cycle. This is the first large study to systematically address dysbiotic variations of the oral microbiome during the course of menstrual cycle, and document the additive effect of smoking and sugar consumption as environmental risk factors. It reveals the structural resilience and functional adaptability of the oral microbiome to the endogenous hormonal pressures of the menstrual cycle, while revealing its vulnerability to the exogenous exposures of diet and smoking.
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Affiliation(s)
- Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Christine Krog
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Luisa W Hugerth
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Zahra Bashir
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Holbæk Hospital, Holbæk, Denmark
| | - Emma Fransson
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Fredrik Boulund
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Lars Engstrand
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Henriette Svarre Nielsen
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ina Schuppe-Koistinen
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
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Obeng IS, Ogamba IK. Service integration for improved diabetic and dental care: exploring an effective model for optimising health outcomes. JOURNAL OF INTEGRATED CARE 2020. [DOI: 10.1108/jica-07-2020-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study identifies and synthesizes existing literature on the integration of diabetic and dental services and explores a service integration model for optimising diabetic patient health outcomes and improving healthcare systems in low and middle-income countries.Design/methodology/approachPeer-reviewed literature that analysed the integration of health services regarding dental and medical services were reviewed. The articles were identified using the Academic Search Complete, Business Source Complete, CINAHL Complete, Google Scholar and MEDLINE databases and screened using the PRISMA guidelines.FindingsA total of 40 full-text articles were examined for eligibility out of which 26 were selected for analysis. Diabetes was shown to contribute significantly to the global disease burden and this is also reflected in most low and middle-income countries. It is found that the integration of medical and dental services could help alleviate this burden. Hence, locally adapted Rainbow-Modified Integrated Care model is proposed to fill this integration gap.OriginalityThe integration of dental and medical services has been proven to be useful in improving diabetic patient outcomes. Hence, the need to facilitate cross-professional collaboration between dentists and physicians cannot be overemphasised and this can be extended and locally adapted by different health systems across the world.Practice ImplicationsThe integration of dental and diabetic services using models such as the Rainbow Model of Integrated Care is recommended to optimise health outcomes of diabetic patients and enhancing service delivery, especially in resource-poor healthcare systems.
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Snipes M, Sun C, Yu H. Inhibition of sphingosine-1-phosphate receptor 2 attenuated ligature-induced periodontitis in mice. Oral Dis 2020; 27:1283-1291. [PMID: 32945579 PMCID: PMC7969475 DOI: 10.1111/odi.13645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/25/2020] [Accepted: 09/07/2020] [Indexed: 01/22/2023]
Abstract
Objectives Periodontitis is an inflammatory bone loss disease initiated by oral bacterial inflammation. Herein, we determined whether inhibition of sphingosine‐1‐phosphate receptor 2 (S1PR2, a G protein‐coupled receptor) by its specific antagonist, JTE013, could alleviate ligature‐induced periodontitis in mice. Materials and Methods C57BL/6 mice were placed with silk ligatures at the left maxillary second molar to induce experimental periodontitis. Mice were treated with JTE013 or control vehicle (dimethyl sulfoxide, DMSO) oral topically on the ligatures once daily. After 15 days of treatment, RNA was extracted from the lingual mucosal tissues to quantify IL‐1β, IL‐6, and TNF mRNA levels in the tissues. Alveolar bone loss was determined by micro‐computed tomography. Sagittal periodontal tissue sections were cut and stained by hematoxylin and eosin (H&E) for general histology, or stained by tartrate‐resistant acid phosphatase (TRAP) for osteoclasts. Results Treatment with JTE013 attenuated ligature‐induced alveolar bone loss compared with DMSO treatment. Treatment with JTE013 reduced IL‐1β, IL‐6, and TNF mRNA levels in murine gingival mucosal tissues, inhibited leukocyte infiltration in the periodontal tissues, and decreased the number of osteoclasts in the periodontal tissues compared with controls. Conclusion Oral topical administration of JTE013 alleviated periodontal inflammatory bone loss induced by ligature placement in mice.
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Affiliation(s)
- Marquise Snipes
- Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Chao Sun
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Hong Yu
- Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC, 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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Porphyromonas gingivalis lipopolysaccharide and glycated serum albumin increase the production of several pro-inflammatory molecules in human gingival fibroblasts via NFκB. Arch Oral Biol 2020; 116:104766. [DOI: 10.1016/j.archoralbio.2020.104766] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/01/2020] [Accepted: 05/10/2020] [Indexed: 12/12/2022]
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25
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Zoabi H, Nemcovsky CE, Bender O, Moses O, Weinreb M. Accelerated degradation of collagen membranes in type 1 diabetic rats is associated with increased expression and production of several inflammatory molecules. J Periodontol 2020; 91:1348-1356. [PMID: 32056217 DOI: 10.1002/jper.19-0503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Membrane durability is critical for regenerative procedures. We reported previously that type 1-like diabetes in rats accelerates the degradation of collagen membranes and we tested here whether this is associated with increased local production of inflammatory molecules as part of a diabetes-induced chronic inflammation around and within the membranes. METHODS Collagen membrane discs were implanted under the scalp in diabetic (streptozotocin-induced) and control rats, which were sacrificed after 2 or 3 weeks. Total RNA and proteins were isolated from the membrane and its surrounding tissues and the expression and production of six inflammatory molecules (interleukin-6 [IL-6], tumor necrosis factor alpha [TNFα], matrix metalloproteinase [MMP]-9, macrophage migration inhibitory factor [MIF], MIP-1α, and MIP-2α) was measured using real-time PCR and western blotting, respectively. Minimal histological analysis of the membranes was conducted to conform to previous studies. RESULTS Hyperglycemia resulted in reduced membrane thickness (by 10% to 25%) and increased mononuclear infiltrate inside the membrane. mRNA and protein levels of IL-6, TNFα, and MMP-9 were elevated in diabetic rats both 2 and 3 weeks post-surgery. The levels (both mRNA and protein) of MIF were increased at 2 weeks post-surgery and those of MIP-1α and MIP-2α at 3 weeks. There was a very good match in the temporal changes of all examined genes between the mRNA and protein levels. CONCLUSIONS Elevated local production of inflammatory cytokines and MMPs, together with apparent mononuclear infiltrate and increased collagenolysis confirm that hyperglycemia leads to a chronic inflammation in and around the implanted collagen membranes, which reduces membrane longevity.
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Affiliation(s)
- Hasan Zoabi
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Carlos E Nemcovsky
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer Bender
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ofer Moses
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Miron Weinreb
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Gingimaps: Protein Localization in the Oral Pathogen Porphyromonas gingivalis. Microbiol Mol Biol Rev 2020; 84:84/1/e00032-19. [PMID: 31896547 DOI: 10.1128/mmbr.00032-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Porphyromonas gingivalis is an oral pathogen involved in the widespread disease periodontitis. In recent years, however, this bacterium has been implicated in the etiology of another common disorder, the autoimmune disease rheumatoid arthritis. Periodontitis and rheumatoid arthritis were known to correlate for decades, but only recently a possible molecular connection underlying this association has been unveiled. P. gingivalis possesses an enzyme that citrullinates certain host proteins and, potentially, elicits autoimmune antibodies against such citrullinated proteins. These autoantibodies are highly specific for rheumatoid arthritis and have been purported both as a symptom and a potential cause of the disease. The citrullinating enzyme and other major virulence factors of P. gingivalis, including some that were implicated in the etiology of rheumatoid arthritis, are targeted to the host tissue as secreted or outer-membrane-bound proteins. These targeting events play pivotal roles in the interactions between the pathogen and its human host. Accordingly, the overall protein sorting and secretion events in P. gingivalis are of prime relevance for understanding its full disease-causing potential and for developing preventive and therapeutic approaches. The aim of this review is therefore to offer a comprehensive overview of the subcellular and extracellular localization of all proteins in three reference strains and four clinical isolates of P. gingivalis, as well as the mechanisms employed to reach these destinations.
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Kumar S, Hirani T, Patel V, Hirani S, Mohammed I, Shishoo D. Expression of apelin among the individuals of chronic periodontitis, with and without type ii diabetes mellitus: A study using enzyme-linked immunosorbent assay. ADVANCES IN HUMAN BIOLOGY 2020. [DOI: 10.4103/aihb.aihb_84_20] [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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Santos RCD, Pinho RCM, Cimões R. Chronic Periodontitis in Patients with Type 2 Diabetes: Analysis of the FokI Polymorphism and Perception of Quality of Life. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Minty M, Canceil T, Serino M, Burcelin R, Tercé F, Blasco-Baque V. Oral microbiota-induced periodontitis: a new risk factor of metabolic diseases. Rev Endocr Metab Disord 2019; 20:449-459. [PMID: 31741266 DOI: 10.1007/s11154-019-09526-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It has recently become evident that the periodontium (gingiva, desmodontal ligament, cementum and alveolar bone) and the associated microbiota play a pivotal role in regulating human health and diseases. The oral cavity is the second largest microbiota in the body with around 500 different bacterial species identified today. When disruption of oral cavity and dysbiosis occur, the proportion of strict anaerobic Gram-negative bacteria is then increased. Patients with periodontitis present 27 to 53% more risk to develop diabetes than the control population suggesting that periodontitis is an aggravating factor in the incidence of diabetes. Moreover, dysbiosis of oral microbiota is involved in both periodontal and metabolic disorders (cardiovascular diseases, dyslipidaemia …). The oral diabetic dysbiosis is characterized by a specific bacteria Porphyromonas, which is highly expressed in periodontal diseases and could exacerbate insulin resistance. In this review, we will address the nature of the oral microbiota and how it affects systemic pathologies with a bidirectional interaction. We also propose that using prebiotics like Akkermansia muciniphila may influence oral microbiota as novel therapeutic strategies. The discovery of the implication of oral microbiota for the control of metabolic diseases could be a new way for personalized medicine.
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Affiliation(s)
- Matthieu Minty
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Thibault Canceil
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Matteo Serino
- INSERM, INRA, ENVT, UPS, IRSD, Université de Toulouse, 31024, Toulouse, France
| | - Remy Burcelin
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - François Tercé
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Vincent Blasco-Baque
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France.
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France.
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France.
- INSERM UMR1048-I2MC Team 2 « Intestinal Risk Factors, Diabetes and Dyslipidemia » Building L4, 1st floor, Hospital of Rangueil 1, Avenue Jean Poulhès, 84225 31432, Toulouse Cedex 4 Lab, BP, France.
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Xu Y, Zheng B, He J, Cui Z, Liu Y. Silver nanoparticles promote osteogenic differentiation of human periodontal ligament fibroblasts by regulating the RhoA–TAZ axis. Cell Biol Int 2019; 43:910-920. [DOI: 10.1002/cbin.11180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 05/14/2019] [Accepted: 05/18/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Yunhe Xu
- Department of Orthodontics, School of StomatologyChina Medical University 110002 Shenyang People's Republic of China
| | - Bowen Zheng
- Department of Orthodontics, School of StomatologyChina Medical University 110002 Shenyang People's Republic of China
| | - Jia He
- Department of Orthodontics, School of StomatologyChina Medical University 110002 Shenyang People's Republic of China
| | - Zhao Cui
- Department of General SurgeryChangchun Children's Hospital 130061 Changchun People's Republic of China
| | - Yi Liu
- Department of Orthodontics, School of StomatologyChina Medical University 110002 Shenyang People's Republic of China
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Mourão L, Carillo Jr R, Linares SM, Canabarro A, Fischer RG. Homeopathy and Periodontal Treatment in Type II Diabetic Patients: a 1-Year Randomized Clinical Trial. Braz Dent J 2019; 30:139-145. [DOI: 10.1590/0103-6440201902124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/24/2018] [Indexed: 01/22/2023] Open
Abstract
Abstract Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.
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Affiliation(s)
- Leila Mourão
- Universidade Veiga de Almeida Rio de Janeiro, Brazil
| | | | | | - Antonio Canabarro
- Universidade Veiga de Almeida Rio de Janeiro, Brazil; UERJ - Universidade do Estado do Rio de Janeiro, Brazil
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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: 127] [Impact Index Per Article: 25.4] [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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Pang Y, Yuan X, Guo J, Wang X, Yang M, Zhu J, Wang J. The effect of liraglutide on the proliferation, migration, and osteogenic differentiation of human periodontal ligament cells. J Periodontal Res 2018; 54:106-114. [DOI: 10.1111/jre.12607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Yunqing Pang
- School of StomatologyLanzhou University Lanzhou China
| | - Xuemin Yuan
- School of StomatologyLanzhou University Lanzhou China
| | - Jia Guo
- School of StomatologyLanzhou University Lanzhou China
| | - Xuemei Wang
- School of StomatologyLanzhou University Lanzhou China
| | - Man Yang
- School of StomatologyLanzhou University Lanzhou China
| | - Jingli Zhu
- School of StomatologyLanzhou University Lanzhou China
| | - Jing Wang
- School of StomatologyLanzhou University Lanzhou China
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Stunted childhood growth is associated with decompartmentalization of the gastrointestinal tract and overgrowth of oropharyngeal taxa. Proc Natl Acad Sci U S A 2018; 115:E8489-E8498. [PMID: 30126990 DOI: 10.1073/pnas.1806573115] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Linear growth delay (stunting) affects roughly 155 million children under the age of 5 years worldwide. Treatment has been limited by a lack of understanding of the underlying pathophysiological mechanisms. Stunting is most likely associated with changes in the microbial community of the small intestine, a compartment vital for digestion and nutrient absorption. Efforts to better understand the pathophysiology have been hampered by difficulty of access to small intestinal fluids. Here, we describe the microbial community found in the upper gastrointestinal tract of stunted children aged 2-5 y living in sub-Saharan Africa. We studied 46 duodenal and 57 gastric samples from stunted children, as well as 404 fecal samples from stunted and nonstunted children living in Bangui, Central African Republic, and in Antananarivo, Madagascar, using 16S Illumina Amplicon sequencing and semiquantitative culture methods. The vast majority of the stunted children showed small intestinal bacterial overgrowth dominated by bacteria that normally reside in the oropharyngeal cavity. There was an overrepresentation of oral bacteria in fecal samples of stunted children, opening the way for developing noninvasive diagnostic markers. In addition, Escherichia coli/Shigella sp. and Campylobacter sp. were found to be more prevalent in stunted children, while Clostridia, well-known butyrate producers, were reduced. Our data suggest that stunting is associated with a microbiome "decompartmentalization" of the gastrointestinal tract characterized by an increased presence of oropharyngeal bacteria from the stomach to the colon, hence challenging the current view of stunting arising solely as a consequence of small intestine overstimulation through recurrent infections by enteric pathogens.
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Zeidán-Chuliá F, Yilmaz D, Häkkinen L, Könönen E, Neves de Oliveira BH, Güncü G, Uitto VJ, Caglayan F, Gürsoy UK. Matrix metalloproteinase-7 in periodontitis with type 2 diabetes mellitus. J Periodontal Res 2018; 53:916-923. [DOI: 10.1111/jre.12583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 12/24/2022]
Affiliation(s)
- F. Zeidán-Chuliá
- Programa de Pós-Graduação em Ciências Biológicas, Bioquímica; Departamento de Bioquímica; Instituto de Ciências Básicas da Saúde; Universidade Federal do Rio Grande do Sul (UFRGS); Porto Alegre RS Brazil
- Department of Periodontology; Institute of Dentistry; University of Turku; Turku Finland
- Departamento de Ciencias Biomédicas Básicas; Facultad de Ciencias Biomédicas y de la Salud; Universidad Europea de Madrid; Villaviciosa de Odón Spain
| | - D. Yilmaz
- Department of Periodontology; Institute of Dentistry; University of Turku; Turku Finland
- Department of Periodontology; Faculty of Dentistry; University of Sakarya; Sakarya Turkey
| | - L. Häkkinen
- Laboratory of Periodontal Biology; Faculty of Dentistry; University of British Columbia; Vancouver BC Canada
| | - E. Könönen
- Department of Periodontology; Institute of Dentistry; University of Turku; Turku Finland
- Oral Health Care; Welfare Division; City of Turku; Turku Finland
| | - B.-H. Neves de Oliveira
- Programa de Pós-Graduação em Ciências Biológicas, Bioquímica; Departamento de Bioquímica; Instituto de Ciências Básicas da Saúde; Universidade Federal do Rio Grande do Sul (UFRGS); Porto Alegre RS Brazil
| | - G. Güncü
- Department of Periodontology; Faculty of Dentistry; University of Hacettepe; Ankara Turkey
| | - V.-J. Uitto
- Department of Oral Biology; Institute of Dentistry; University of Helsinki; Helsinki Finland
| | - F. Caglayan
- Department of Periodontology; Faculty of Dentistry; University of Hacettepe; Ankara Turkey
| | - U. K. Gürsoy
- Department of Periodontology; Institute of Dentistry; University of Turku; Turku Finland
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Han K, Park JB. Clinical implications of age and sex in the prevalence of periodontitis in Korean adults with diabetes. Exp Ther Med 2018; 15:3865-3873. [PMID: 29556264 PMCID: PMC5844085 DOI: 10.3892/etm.2018.5880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/21/2017] [Indexed: 01/12/2023] Open
Abstract
The present study was performed to assess the risk factors for periodontitis in Korean adults with diabetes. Data from the Korean National Health and Nutrition Examination Survey of the Korean population, conducted between January 2012 and December 2014 were used in the investigation. The presence of periodontitis in participants with diabetes in association with demographic variables and the anthropometric characteristics of the participants was investigated. Multiple logistic regression analyses were used to assess the associations between periodontitis and age, sex, diabetic control and duration of diabetes, following adjustment for confounding factors. The odds ratio of periodontitis was higher in individuals ≥65 years old compared with individuals <65 years old (1.152). The odds ratio of periodontitis was significantly higher in males compared with females (1.774). The number of patients with moderate and severe periodontitis differed significantly between different age groups. The present study revealed that age, sex and oral health behavior are risk indicators for periodontitis in patients with diabetes. The present study suggests that that an increased age, being male and engaging in poor oral health behavior increases the risk of periodontitis in participants with diabetes.
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Affiliation(s)
- Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Bakshi D, Kaur G, Singh D, Sahota J, Thakur A, Grover S. Estimation of Plasma Levels of Tumor Necrosis Factor-a, Interleukin-4 and 6 in Patients with Chronic Periodontitis and Type II Diabetes Mellitus. J Contemp Dent Pract 2018; 19:166-169. [PMID: 29422465 DOI: 10.5005/jp-journals-10024-2231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Both periodontitis and type II diabetes mellitus (T2DM) are common diseases with a multifactorial etiology and have influence of cytokines in their pathogenesis and thus may also influence each other. In recent times, more attention has been given to understanding the influences of these inflammatory cytokines which are a main part of oral chronic inflammation on systemic health of the individuals. Therefore, the aim of this study was to evaluate the plasma cytokine levels, specifically tumor necrosis factor-a (TNF-a), interleukin (IL)-6, and IL-4, in chronic periodontitis patients and T2DM patients, so as to investigate the influence of chronic periodontitis in systemic inflammation associated with diabetes mellitus. MATERIALS AND METHODS The present study comprised a total sample size of 60 patients. A detailed history along with complete periodontal examination were done for each person. These patients were subdivided into four study groups with 15 subjects (n = 15) in each group: group I: healthy individuals, group II: chronic periodontitis, group III: diabetes mellitus without chronic periodontitis, and group IV: diabetes mellitus with chronic periodontitis. Venous blood was withdrawn for obtaining serum samples from the subjects. Hemoglobin A1c (HbAlc) levels were measured from the automated chromatography. Using enzyme-linked immunosorbent assay kit, TNF-a, IL-4, and IL-6 were measured. RESULTS It was observed that the difference between almost all the results showed statistical significance. Not much of a difference was seen when TNF-a and IL-6 findings of group II were compared with group III. Furthermore, IL-4 also did not differ when group II was compared with group IV. CONCLUSION The inflammatory cytokines together control the inflammation process and a balance is maintained. However, in patients with diabetes mellitus, this balance is interrupted, which affects the final development and progression of the disease. Thus, hyperglycemia may be partly associated with the severity of the periodontal status in diabetic patients. CLINICAL SIGNIFICANCE Hyperglycemia thus may play a role in increasing the severity of the periodontal status in diabetic patients. Keeping such relationship in mind, better treatment modalities can be provided to the patients.
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Affiliation(s)
- Dipanshu Bakshi
- Department of Dentistry, Chintpurni Medical College & Hospital, Pathankot, Punjab, India
| | - Guneet Kaur
- Private Practitioner, Department of Periodontology, Ludhiana Punjab, India
| | - Deepinder Singh
- Private Practitioner, Department of Oral and Maxillofacial Surgery, Ludhiana, Punjab, India
| | - Jasjit Sahota
- Department of Periodontics, Institute of Dental Sciences Jammu, Jammu and Kashmir, India
| | - Ambika Thakur
- Department of Dentistry, Chintpurni Medical College & Hospital, Pathankot, Punjab, India
| | - Shekhar Grover
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India, Phone: +919501544877, e-mail:
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Degasperi GR, Etchegaray A, Marcelino L, Sicard A, Villalpando K, Pinheiro SL. Periodontal Disease: General Aspects from Biofilm to the Immune Response Driven by Periodontal Pathogens. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/aim.2018.81001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chen H, Fu T, Ma Y, Wu X, Li X, Li X, Shen J, Wang H. Intermittent administration of parathyroid hormone ameliorated alveolar bone loss in experimental periodontitis in streptozotocin-induced diabetic rats. Arch Oral Biol 2017; 83:76-84. [DOI: 10.1016/j.archoralbio.2017.06.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 06/25/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022]
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Holmstrup P, Damgaard C, Olsen I, Klinge B, Flyvbjerg A, Nielsen CH, Hansen PR. Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician. J Oral Microbiol 2017; 9:1332710. [PMID: 28748036 PMCID: PMC5508374 DOI: 10.1080/20002297.2017.1332710] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/07/2017] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson’s disease, Alzheimer’s disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.
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Affiliation(s)
- Palle Holmstrup
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Damgaard
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Claus Henrik Nielsen
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Riis Hansen
- Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Cardiology Department, Herlev and Gentofte Hospital, Hellerup, Denmark
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Mullin JM, Diguilio KM, Valenzano MC, Deis R, Thomas S, Zurbach EP, Abdulhaqq S, Montaner LJ. Zinc reduces epithelial barrier compromise induced by human seminal plasma. PLoS One 2017; 12:e0170306. [PMID: 28278250 PMCID: PMC5344308 DOI: 10.1371/journal.pone.0170306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 01/03/2017] [Indexed: 01/11/2023] Open
Abstract
Human semen has the potential to modulate the epithelial mucosal tissues it contacts, as seminal plasma (SP) is recognized to contain both pro- and anti-barrier components, yet its effects on epithelial barrier function are largely unknown. We addressed the role of human SP when exposed to the basal-lateral epithelial surface, a situation that would occur clinically with prior mechanical or disease-related injury of the human epithelial mucosal cell layers in contact with semen. The action of SP on claudins-2, -4, -5, and -7 expression, as well as on a target epithelium whose basolateral surface has been made accessible to SP, showed upregulation of claudins-4 and -5 in CACO-2 human epithelial cell layers, despite broad variance in SP-induced modulation of transepithelial electrical resistance and mannitol permeability. Upregulation of claudin-2 by SP also exhibited such variance by SP sample. We characterize individual effects on CACO-2 barrier function of nine factors known to be present abundantly in seminal plasma (zinc, EGF, citrate, spermine, fructose, urea, TGF, histone, inflammatory cytokines) to establish that zinc, spermine and fructose had significant potential to raise CACO-2 transepithelial resistance, whereas inflammatory cytokines and EGF decreased this measure of barrier function. The role of zinc as a dominant factor in determining higher levels of transepithelial resistance and lower levels of paracellular leak were confirmed by zinc chelation and exogenous zinc addition. As expected, SP presentation to the basolateral cell surface also caused a very dramatic yet transient elevation of pErk levels. Results suggest that increased zinc content in SP can compete against the barrier-compromising effect of negative modulators in SP when SP gains access to that epithelium's basolateral surface. Prophylactic elevation of zinc in an epithelial cell layer prior to contact by SP may help to protect an epithelial barrier from invasion by SP-containing STD microbial pathogens such as HPV or HIV.
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Affiliation(s)
- James M. Mullin
- Lankenau Institute for Medical Research, Wynnewood, PA, United States of America
- * E-mail:
| | | | - Mary C. Valenzano
- Lankenau Institute for Medical Research, Wynnewood, PA, United States of America
| | - Rachael Deis
- Department of Biology, Drexel University, Philadelphia, PA, United States of America
| | - Sunil Thomas
- Lankenau Institute for Medical Research, Wynnewood, PA, United States of America
| | - E. Peter Zurbach
- Department of Chemistry, Saint Joseph’s University, Philadelphia, PA, United States of America
| | | | - Luis J. Montaner
- The Wistar Institute, Philadelphia, PA, United States of America
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Kuo HC, Chang LC, Chen TC, Lee KC, Lee KF, Chen CN, Yu HR. Sterol Regulatory Element-Binding Protein-1c Regulates Inflammasome Activation in Gingival Fibroblasts Infected with High-Glucose-Treated Porphyromonas gingivalis. Front Cell Infect Microbiol 2016; 6:195. [PMID: 28083517 PMCID: PMC5183582 DOI: 10.3389/fcimb.2016.00195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 12/12/2016] [Indexed: 12/12/2022] Open
Abstract
Background:Porphyromonas gingivalis is a major bacterial species implicated in the progression of periodontal disease, which is recognized as a common complication of diabetes. The interleukin (IL)-1β, processed by the NLR family pyrin domain containing 3 (NLRP3) inflammasome, has been identified as a target for pathogenic infection of the inflammatory response. However, the effect of P. gingivalis in a high-glucose situation in the modulation of inflammasome activation in human gingival fibroblasts (HGFs) is not well-understood. Methods:P. gingivalis strain CCUG25226 was used to study the mechanisms underlying the regulation of HGF NLRP3 expression by the infection of high-glucose-treated P. gingivalis (HGPg). Results: HGF infection with HGPg increases the expression of IL-1β and NLRP3. We further demonstrated that the upregulation of sterol regulatory element-binding protein (SREBP)-1c by activation of the Akt and p70S6K pathways is critical for HGPg-induced NLRP3 expression. We showed that the inhibition of Janus kinase 2 (JAK2) blocks the Akt- and p70S6K-mediated SREBP-1c, NLRP3, and IL-1β expression. The effect of HGPg on HGF signaling and NLRP3 expression is mediated by β1 integrin. In addition, gingival tissues from diabetic patients with periodontal disease exhibited higher NLRP3 and SREBP-1c expression. Conclusions: Our findings identify the molecular pathways underlying HGPg-dependent NLRP3 inflammasome expression in HGFs, providing insight into the effect of P. gingivalis invasion in HGFs.
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Affiliation(s)
- Hsing-Chun Kuo
- Department of Nursing, Chang Gung University of Science and Technology (CGUST)Chiayi, Taiwan; Research Center for Industry of Human Ecology and Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology (CGUST)Taoyuan, Taiwan; Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST)Chiayi, Taiwan
| | - Li-Ching Chang
- Department of Dentistry, Chang Gung Memorial Hospital Chiayi, Taiwan
| | - Te-Chuan Chen
- Division of Nephrology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Ko-Chao Lee
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital - Kaohsiung Medical Center Kaohsiung, Taiwan
| | - Kam-Fai Lee
- Department of Pathology, Chang Gung Memorial Hospital Chiayi, Taiwan
| | - Cheng-Nan Chen
- Department of Biochemical Science and Technology, National Chiayi University Chiayi, Taiwan
| | - Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital - Kaohsiung Medical CenterKaohsiung, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University College of MedicineKaohsiung, Taiwan
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Naruishi K, Oishi K, Inagaki Y, Horibe M, Bando M, Ninomiya M, Kawahara K, Minakuchi J, Kawashima S, Shima K, Kido J, Nagata T. Association between periodontal condition and kidney dysfunction in Japanese adults: A cross-sectional study. Clin Exp Dent Res 2016; 2:200-207. [PMID: 29744168 PMCID: PMC5839219 DOI: 10.1002/cre2.39] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/06/2016] [Accepted: 06/10/2016] [Indexed: 12/25/2022] Open
Abstract
Recent studies have demonstrated that chronic kidney disease (CKD) may be associated with the progression of periodontal disease. Diabetes mellitus (DM) is a major risk factor for CKD. The objective of this study was to clarify the relationship between periodontal condition and kidney dysfunction in patients who had kidney failure with or without DM. One hundred sixty-four patients with kidney dysfunction were enrolled (male: N = 105; female: N = 59), and the relationship between periodontal condition and kidney dysfunction was analyzed in a cross-sectional study. The subjects were divided into three groups: (a) patients with DM, (b) dialysis patients with nephropathy due to various kidney diseases, and (c) dialysis patient with nephropathy due to DM (diabetic nephropathy). Then, the effect of DM on the periodontal condition was analyzed. The patients were also stratified by CKD stage (into G1-G5) using the estimated glomerular filtration rate (eGFR), and the G5 group was divided in patients with or without DM. Correlations between eGFR and parameters of periodontal condition were calculated in patients from G1 to G4. The number of missing teeth was significantly higher in dialysis patients with diabetic nephropathy than in patients with DM, whereas alveolar bone loss did not show a significant difference among the three groups. In addition, the G5 patients with DM had a significantly higher number of missing teeth than the other CKD groups, whereas alveolar bone loss did not show a significant difference. In G5 patients with DM, Community Periodontal Index and Oral Hygiene Index scores were significantly higher than in G1-4 patients with DM. There was a significant negative correlation between eGFR and the number of missing teeth. Patients with diabetic nephropathy have a higher rate of periodontal problems such as missing teeth in Japanese adults.
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Affiliation(s)
- Koji Naruishi
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Keiji Oishi
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Yuji Inagaki
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Masumi Horibe
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Mika Bando
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Masami Ninomiya
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Kazuhiko Kawahara
- Kawashima HospitalKitasako IchibanchoTokushimaTokushima PrefectureJapan
| | - Jun Minakuchi
- Kawashima HospitalKitasako IchibanchoTokushimaTokushima PrefectureJapan
| | - Shu Kawashima
- Kawashima HospitalKitasako IchibanchoTokushimaTokushima PrefectureJapan
| | - Kenji Shima
- Kawashima HospitalKitasako IchibanchoTokushimaTokushima PrefectureJapan
| | - Jun‐ichi Kido
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
| | - Toshihiko Nagata
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaTokushima PrefectureJapan
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Aguirre JI, Akhter MP, Neuville KG, Trcalek CR, Leeper AM, Williams AA, Rivera M, Kesavalu L, Ke HZ, Liu M, Kimmel DB. Age-related periodontitis and alveolar bone loss in rice rats. Arch Oral Biol 2016; 73:193-205. [PMID: 27771588 DOI: 10.1016/j.archoralbio.2016.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 08/18/2016] [Accepted: 10/15/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To characterize in rice rats: (a) periodontitis (PD) progress with feeding of standard laboratory rat chow (STD) during ages 4-80 weeks; and (b) PD progress with feeding of a high sucrose-casein (H-SC) diet during young adulthood. METHODS One group (N=12) was euthanized at age 4 weeks (Baseline). Four groups (N=8-16) consumed a STD diet from baseline and were necropsied at ages 22, 30, 52, and 80 weeks. Three groups (N=10-16) consumed an H-SC diet from baseline. Two were necropsied at ages 22 and 30 weeks, respectively. The third switched to the STD diet at age 22 weeks and was necropsied at age 30 weeks. All mandibles/maxillae were assessed by histometry for degree of periodontal inflammation (PD Score), alveolar crest height (ACH, mm), and horizontal alveolar bone height (hABH, mm2). RESULTS In STD diet rats aged ≥30 weeks, all endpoints were worse (P<0.05) than at Baseline. In H-SC diet rats aged ≥22 weeks, all endpoints were worse than at Baseline (P<0.05). At age 22 weeks, all endpoints were worse in the H-SC group than in the STD group (P<0.05). By age 30 weeks, the STD and H-SC groups did not differ. CONCLUSIONS 1) STD diet fed rice rats develop moderate/severe PD by age 30 weeks; 2) an H-SC diet accelerates moderate/severe PD development; and 3) switching to a STD diet does not halt/reverse PD that was accelerated by an H-SC diet. These data further clarify use of the rice rat as a PD model.
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Affiliation(s)
- J I Aguirre
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - M P Akhter
- Osteoporosis Research Center, School of Medicine, Creighton University, Omaha, NE 68131, United States.
| | - K G Neuville
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - C R Trcalek
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - A M Leeper
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - A A Williams
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - M Rivera
- Department of Periodontology and Oral Biology, College of Dentistry, UF, United States.
| | - L Kesavalu
- Department of Periodontology and Oral Biology, College of Dentistry, UF, United States; Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - H Z Ke
- Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - M Liu
- Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - D B Kimmel
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
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Hong M, Kim HY, Seok H, Yeo CD, Kim YS, Song JY, Lee YB, Lee DH, Lee JI, Lee TK, Ahn HS, Ko YH, Jeong SC, Chae HS, Sohn TS. Prevalence and risk factors of periodontitis among adults with or without diabetes mellitus. Korean J Intern Med 2016; 31:910-9. [PMID: 27604799 PMCID: PMC5016291 DOI: 10.3904/kjim.2016.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 06/13/2016] [Accepted: 07/28/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/AIMS This study examined prevalence and risk factors of periodontitis in representative samples of Korean adults, with and without diabetes mellitus (DM). METHODS Data from the 2012 Korean National Health and Nutritional Examination Survey were analyzed. A total of 4,477 adults (≥ 30 years old) were selected from 8,057 individuals who completed a nutrition survey, a self-reported general health behavior questionnaire, an oral examination, an oral hygiene behaviors survey, and laboratory tests. DM was defined as a fasting plasma glucose ≥ 126 mg/dL, or self-reported diagnosed diabetes, or current use of oral hypoglycemic agents and/or insulin. The community periodontal index was used to assess periodontitis status and comparisons between the periodontitis and the non-periodontitis group, were performed, according to the presence of DM. Risk factors for periodontitis in adults with DM and without DM were evaluated by multiple logistic regression analysis. RESULTS The prevalence of periodontitis was significantly higher in adults with DM (43.7%) than in those without DM (25%, p < 0.001). In adults without DM, risk factors for periodontitis were older age, male, urban habitation, waist circumference, smoking, oral pain, and less frequent tooth brushing. Significant risk factors for periodontitis in adults with DM were the smoking, oral pain, and not-using an oral hygiene product. CONCLUSIONS Adults with DM have an increased risk of periodontitis than those without DM. Current smoking and oral pain increase this risk. Using an oral hygiene product can reduce risk of periodontal disease in adults with DM.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tae Seo Sohn
- Correspondence to Tae Seo Sohn, M.D. Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: +82-31-820-3652 Fax: +82-31-847-2719 E-mail:
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Distinct interacting core taxa in co-occurrence networks enable discrimination of polymicrobial oral diseases with similar symptoms. Sci Rep 2016; 6:30997. [PMID: 27499042 PMCID: PMC4976368 DOI: 10.1038/srep30997] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/12/2016] [Indexed: 12/30/2022] Open
Abstract
Polymicrobial diseases, which can be life threatening, are caused by the presence and interactions of multiple microbes. Peri-implantitis and periodontitis are representative polymicrobial diseases that show similar clinical symptoms. To establish a means of differentiating between them, we compared microbial species and functional genes in situ by performing metatranscriptomic analyses of peri-implantitis and periodontitis samples obtained from the same subjects (n = 12 each). Although the two diseases differed in terms of 16S rRNA-based taxonomic profiles, they showed similarities with respect to functional genes and taxonomic and virulence factor mRNA profiles. The latter—defined as microbial virulence types—differed from those of healthy periodontal sites. We also showed that networks based on co-occurrence relationships of taxonomic mRNA abundance (co-occurrence networks) were dissimilar between the two diseases. Remarkably, these networks consisted mainly of taxa with a high relative mRNA-to-rRNA ratio, with some showing significant co-occurrence defined as interacting core taxa, highlighting differences between the two groups. Thus, peri-implantitis and periodontitis have shared as well as distinct microbiological characteristics. Our findings provide insight into microbial interactions in polymicrobial diseases with unknown etiologies.
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Menegat JSB, Lira-Junior R, Siqueira MA, Brito F, Carvalho AT, Fischer RG, Figueredo CM. Cytokine expression in gingival and intestinal tissues of patients with periodontitis and inflammatory bowel disease: An exploratory study. Arch Oral Biol 2016; 66:141-6. [DOI: 10.1016/j.archoralbio.2016.02.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/05/2015] [Accepted: 02/26/2016] [Indexed: 12/26/2022]
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Comparison of independent and dependent culture methods for the detection of transient bacteremia in diabetic subjects with chronic periodontitis. BIOMEDICA 2016; 36:156-61. [PMID: 27622449 DOI: 10.7705/biomedica.v36i1.2674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 07/17/2015] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Oral-derived bacteremia may occur after several dental procedures and routine daily activities. Some conditions of the oral cavity may favor episodes of bacteremia. This would be the case of patients with diabetes mellitus and periodontitis, who exhibit exacerbated gingival inflammation and may be more prone to developing oral-derived bacteremia. OBJECTIVE To compare the effectiveness of an independent culture method (quantitative real-time PCR- qCR) and the most commonly used method (BacT-ALERT 3D®) for the diagnosis of bacteremia. MATERIALS AND METHODS Blood samples were drawn from subjects with type 2 diabetes mellitus and chronic periodontitis before and after apple chewing. Samples were processed by an automated blood culture system (BacT-ALERT 3D®) monitored for 15 days with suitable subculture of positive cultures. In parallel, whole DNA from blood samples was purified using a commercial kit and screened by qPCR using a universal primer set of16S rDNA for bacteria detection. RESULTS Blood cultures taken before apple chewing were shown to be negative by the two diagnostic methods. After chewing, two samples (11%) showed bacterial growth by BacT-ALERT 3D® whereas qPCR did not detect the presence of bacteria in any sample. CONCLUSIONS qPCR did not show greater effectiveness than the BacT-ALERT 3D® in the detection of bacteremia of oral origin.
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Botero JE, Rodríguez C, Agudelo-Suarez AA. Periodontal treatment and glycaemic control in patients with diabetes and periodontitis: an umbrella review. Aust Dent J 2016; 61:134-48. [DOI: 10.1111/adj.12413] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2016] [Indexed: 12/28/2022]
Affiliation(s)
- JE Botero
- Faculty of Dentistry; Universidad de Antioquia; Medellín Colombia
| | - C Rodríguez
- Faculty of Dentistry; Universidad de Antioquia; Medellín Colombia
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Neutrophil Functions in Periodontal Homeostasis. J Immunol Res 2016; 2016:1396106. [PMID: 27019855 PMCID: PMC4785262 DOI: 10.1155/2016/1396106] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/07/2016] [Indexed: 12/13/2022] Open
Abstract
Oral tissues are constantly exposed to damage from the mechanical effort of eating and to microorganisms, mostly bacteria. In healthy gingiva tissue remodeling and a balance between bacteria and innate immune cells are maintained. However, excess of bacteria biofilm (plaque) creates an inflammation state that recruits more immune cells, mainly neutrophils to the gingiva. Neutrophils create a barrier for bacteria to reach inside tissues. When neutrophils are insufficient, bacteria thrive causing more inflammation that has been associated with systemic effects on other conditions such as atherosclerosis, diabetes, and cancer. But paradoxically when neutrophils persist, they can also promote a chronic inflammatory state that leads to periodontitis, a condition that leads to damage of the bone-supporting tissues. In periodontitis, bone loss is a serious complication. How a neutrophil balance is needed for maintaining healthy oral tissues is the focus of this review. We present recent evidence on how alterations in neutrophil number and function can lead to inflammatory bone loss, and how some oral bacteria signal neutrophils to block their antimicrobial functions and promote an inflammatory state. Also, based on this new information, novel therapeutic approaches are discussed.
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