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Malvicini G, Marruganti C, Abu Leil M, Martignoni M, Pasqui E, de Donato G, Grandini S, Gaeta C. Association between apical periodontitis and secondary outcomes of atherosclerotic cardiovascular disease: A case-control study. Int Endod J 2024; 57:281-296. [PMID: 38204179 DOI: 10.1111/iej.14018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
AIM To evaluate the association between apical periodontitis (AP) and atherosclerotic cardiovascular disease (ASCDV). METHODOLOGY A total of 65 periodontally and systemically healthy patients (age ≥ 40 years) were included in the study. Periapical status was assessed through dental examination and periapical radiographs; 33 subjects had AP (AP+), while 32 acted as control (AP-). Moreover, data regarding their periapical index (PAI) score and the Decayed, Missing, and Filled Teeth (DMFT) index were recorded. All subjects underwent echo-colour Doppler assessment of carotid intima-media thickness (CIMT), carotid plaques, degree of stenosis using the North American Symptomatic Carotid Surgery Trial (NASCET) method, maximum diameter of the abdominal aorta (maximum AA) and common iliac arteries (CIA) diameters. Furthermore, peripheral blood flow was also measured using the ankle-brachial index (ABI). Simple and multiple regression analyses were performed. RESULTS Among AP+ patients, 57.58% disclosed at least one sign of subclinical carotid atherosclerosis. Multiple regression analysis identified AP as a significant risk indicator for carotid plaques [OR = 4.87 (1.27, 18.98; p = .021)] and marked carotid intima-media thickenings (OR = 14.58 [1.22, 176.15], p = .035). A significant association was established between AP and other cardiovascular (CV) variables (CIMT, NASCET, and maximum AA). On the contrary, a higher PAI score does not correlate to increased odds of carotid alterations, and the presence of AP did not prove any significant change in CIA and ABI. No significant correlation was established between DMFT and other variables. CONCLUSIONS Results from the current study highlight that the presence of AP may be regarded as a risk indicator for ASCVD, with AP being associated with 5-fold increased odds of having carotid plaques and 15-fold increased odds of having marked carotid intima-media thickenings. Further studies should be conducted in order to verify whether AP treatment could be beneficial for ASCVD signs.
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Affiliation(s)
- Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Mustafa Abu Leil
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Marco Martignoni
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Edoardo Pasqui
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Gianmarco de Donato
- Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Simone Grandini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Huh Y, Yoo JE, Park S, Han K, Kim SM, Park HS, Cho KH, Ahn J, Jun SH, Nam GE. Association of Dental Diseases and Oral Hygiene Care With the Risk of Heart Failure in Patients With Type 2 Diabetes: A Nationwide Cohort Study. J Am Heart Assoc 2023; 12:e029207. [PMID: 37548156 PMCID: PMC10492939 DOI: 10.1161/jaha.122.029207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/27/2023] [Indexed: 08/08/2023]
Abstract
Background To evaluate the association of dental diseases and oral hygiene care with incidence of heart failure (HF) among patients with type 2 diabetes. Methods and Results This study included 173 927 patients with type 2 diabetes aged ≥40 years, who underwent Korean National Health Insurance Service health examinations in 2008 and were followed up until the end of 2017. Hazard ratios (HRs) and 95% CIs for HF were estimated using multivariable Cox proportional hazards regression analysis. During a median follow-up of 9.3 years, 1.94% of participants developed HF. An increased number of missing teeth was associated with a higher risk of HF (P<0.001). HRs of HF increased among individuals with ≥15 missing teeth (HR, 1.37 [95% CI, 1.14-1.64]) compared with those without missing teeth. Decreased risk of HF was observed in individuals with ≥1 time/year of professional dental cleaning (HR, 0.93 [95% CI, 0.87-0.99]) and in those with ≥2 times/d of toothbrushing (HR, 0.90 [95% CI, 0.82-0.98]) compared with those without these practices. While combined presence of missing teeth and periodontal disease (P=0.004) or dental caries (P=0.007) increased HF risk, combined oral hygiene care was associated with further HF risk reduction (P=0.024). Better oral hygiene care was associated with decreased HF risk, even as the number of missing teeth increased (P<0.001). Conclusions Among patients with type 2 diabetes, dental diseases and oral hygiene care are important determinants of HF development. Dental disease management and good oral care may prevent HF in patients with type 2 diabetes.
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Affiliation(s)
- Youn Huh
- Department of Family MedicineUijeongbu Eulji Medical CenterEulji UniversityUijeongbuGyeonggi‐doRepublic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam CenterSeoul National University HospitalSeoulRepublic of Korea
| | - Sang‐Hyun Park
- Department of Medical StatisticsCollege of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulRepublic of Korea
| | - Seon Mee Kim
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Hye Soon Park
- Department of Family MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Kyung Hwan Cho
- Department of Family MedicineKorea University Anam HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Jin‐Soo Ahn
- Department of Dental Biomaterials Science and Dental Research InstituteSchool of DentistrySeoul National UniversitySeoulRepublic of Korea
| | - Sang Ho Jun
- Department of Oral & Maxillofacial SurgeryKorea University Anam HospitalSeoulRepublic of Korea
| | - Ga Eun Nam
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
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Pu J, Song J, Pan S, Zhuang S, Gao R, Liang Y, Wu Z, Wang Y, Zhang Y, Yang L, Han F, Wu H, Tang J, Wang X. Predicting cardiovascular risk in a Chinese primary Sjögren's syndrome population: development and assessment of a predictive nomogram. Ther Adv Chronic Dis 2023; 14:20406223231181490. [PMID: 37485232 PMCID: PMC10357044 DOI: 10.1177/20406223231181490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 07/25/2023] Open
Abstract
Background Patients with primary Sjögren's syndrome (pSS) are at increased risk of cardiovascular morbidity as compared with the general population. Objectives A retrospective study on 349 Chinese patients with pSS was conducted to identify potential risk factors for cardiovascular events and develop a cardiovascular risk nomogram. Design This is a retrospective observational study. Methods The study included 349 patients who were diagnosed with pSS at Tongji Hospital, School of Medicine, Tongji University, China from January 2010 to March 2022. The least absolute shrinkage and selection operator (LASSO) was used to select features for the cardiovascular risk model. The features selected in LASSO were used to build the cardiovascular risk model in a multivariate logistic regression analysis. C-index, receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were used to assess the predictive model. Internal validation was performed by bootstrapping. Results Sex, joint pain as an initial symptom, dry mouth, oral ulcers, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated thyroid-stimulating hormone (TSH) level, and elevated systolic blood pressure were included in the nomogram for the prediction of cardiovascular risk. Our model had good discrimination (C-index: 0.824, 95% confidence interval: 0.712-0.936) and good calibration (C-index in the interval validation: 0.8). Decision curve analysis indicated that our nomogram demonstrated clinical usefulness for intervention in a cardiovascular disease possibility threshold of 3%. Conclusion The cardiovascular risk nomogram incorporating sex, initial joint pain, dry mouth, oral ulcer, dental caries, Raynaud's phenomenon, fatigue, diabetes, elevated TSH, and systolic blood pressure could be used in the prediction of cardiovascular risk in patients with pSS and the guidance of further treatment.
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Affiliation(s)
- Jincheng Pu
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiamin Song
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shengnan Pan
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuqi Zhuang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ronglin Gao
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yuanyuan Liang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhenzhen Wu
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yanqing Wang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Youwei Zhang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lufei Yang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fang Han
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huihong Wu
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jianping Tang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No.389 Xincun Road, Shanghai 200065, China
| | - Xuan Wang
- Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No.389 Xincun Road, Shanghai 200065, China
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Giordano-Kelhoffer B, Lorca C, March Llanes J, Rábano A, del Ser T, Serra A, Gallart-Palau X. Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review. Biomedicines 2022; 10:biomedicines10081803. [PMID: 36009350 PMCID: PMC9405223 DOI: 10.3390/biomedicines10081803] [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: 05/31/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 02/06/2023] Open
Abstract
Imbalances of the oral microbiota and dysbiosis have traditionally been linked to the occurrence of teeth and oral diseases. However, recent findings indicate that this microbiota exerts relevant influence in systemic health. Dysbiosis of the oral microbiota is implicated in the apparition and progression of cardiovascular, neurodegenerative and other major human diseases. In fact, the oral microbiota are the second most diverse and largely populated microbiota of the human body and its relationships with systemic health, although widely explored, they still lack of proper integration. The purpose of this systematic review is thus to widely examine the implications of oral microbiota in oral, cardiovascular and neurodegenerative diseases to offer integrative and up-to-date interpretations. To achieve that aim, we identified a total of 121 studies curated in PUBMED from the time interval January 2003–April 2022, which after careful screening resulted in 79 studies included. The reviewed scientific literature provides plausible vias of implication of dysbiotic oral microbiota in systemic human diseases, and encourages further research to continue elucidating the highly relevant and still poorly understood implications of this niche microbiota in systemic health. PROSPERO Registration Number: CRD42022299692. This systematic review follows relevant PRISMA guidelines.
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Affiliation(s)
- Barbara Giordano-Kelhoffer
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain;
- Bioengineering Institute of Technology, Faculty of Health Sciences, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
| | - Cristina Lorca
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
| | - Jaume March Llanes
- NeuroPGA Research Group—Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain;
| | - Alberto Rábano
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Teodoro del Ser
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Aida Serra
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
| | - Xavier Gallart-Palau
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
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Yin Y, Wang L, Chen G, You H. Effect of Fraxetin on Oxidative Damage Caused by Isoproterenol-Induced Myocardial Infarction in Rats. Appl Biochem Biotechnol 2022; 194:5666-5679. [PMID: 35802243 DOI: 10.1007/s12010-022-04019-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/02/2022]
Abstract
At present, cardiovascular disorders are the most prominent factors for the high morbidity rate globally. The occurrence of myocardial infarction followed by myocardial ischemia is the important cause of high death rates. Various medical treatments are available, yet the mortality and morbidity rate is high. In the present investigation, the cardioprotective property of fraxetin (Fx) is evaluated in myocardial infarction-induced experimental rats. Fraxetin, a phytochemical known as coumarin isolated from Fraxinus rhynchophylla. Fraxetin has numerous pharmacological activities including antioxidant, apoptosis inhibitor, anti-inflammatory, and antimicrobial agent. The experimental mice were split into 4 groups each comprising six animals. Group I was considered the control group; 0.1% NaCl solution was given as dosage. Group II received only Fx; group III was treated with ISO. Group IV was treated with Fx followed by ISO to induce myocardial infarction. In ISO administrated rats, there were changes in the heart weight, activities of cardiac markers, transmembrane protein activity, antioxidant enzymes, pro-inflammatory proteins, lipid profile, and myocardial structures. Pre-treatment of fraxetin in group IV experimental rats resulted in decreased cardiac weight, diminished level of cardiac markers (cardiac troponin T (cTnT), creatine kinase, creatine kinase-MB, and cardiac troponin I (cTnI)), reduced level of oxidative stress biomarkers (LOOH and TBARS) in the plasma and cardiac tissue, amplified level of enzymes in antioxidant defense system (catalase (CAT), superoxide dismutase (SOD), glutathione (GSH), and glutathione peroxidase (GPx)) in the plasma and heart tissue, and elevated level of ATPase activities. The histopathological studies also revealed the potent activity of fraxetin in protecting the cardiac tissues from inflammation and damage. ISO-administrated experimental rats treated with fraxetin exhibit increased antioxidants activity and decreased free radicals. Our study revealed that the administration of fraxetin significantly reduced the extent of myocardial damage during myocardial infarction in rats caused by isoproterenol. Thus, the results prove the cardioprotective effect of fraxetin in MI-induced rats.
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Affiliation(s)
- Yu Yin
- Department of Medical Insurance, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang Road, Jinan City, 250013, Shandong Province, China
| | - Lihui Wang
- Department of Internal Medicine, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang Road, Jinan City, 250013, Shandong Province, China
| | - Guifang Chen
- Department of Integrated Traditional Chinese and Western Medicine & Rheumatology and Immunology, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang Road, Jinan City, 250013, Shandong Province, China
| | - Hongwen You
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan City, 250021, Shandong Province, China.
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Leão TSS, Tomasi GH, Conzatti LP, Marrone LCP, Reynolds MA, Gomes MS. Oral inflammatory burden and carotid atherosclerosis among stroke patients. J Endod 2022; 48:597-605. [PMID: 35143813 DOI: 10.1016/j.joen.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This study aimed to test the hypothesis that oral inflammatory burden (OIB) is independently associated with the carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA). METHODS This cross-sectional observational study included 240 hospital patients with the diagnosis of IS or TIA. The main exposures were apical periodontitis (AP), root canal treatment (RCT), and crestal alveolar (periodontal) bone loss (BL), and the main outcome was the CAB. Exposure and outcome variables were measured through a head and neck multidetector computed tomography angiography and CAB was dichotomized in <50% and ≥50% vessel occlusion. OIB scored as a composite measure of the endodontic and periodontal disease exposure. Hospital health records provided information on socio-demographic and medical covariates. Prevalence ratios (PR) were calculated through Poisson regression models, estimating the relationship between the oral exposures and CAB, with =5%. RESULTS Mean age was 62.15 ± 13.1 years, with 56.7% males. Univariate analyses showed that AP≥2 (PR=1.83,95%CI=1.05-3.17) and endodontic burden (EB) (AP &/or RCT≥2) (PR=1.98,95%CI=1.13-3.47) were associated with CAB ≥50%. Multivariate models, adjusted for socio-demographic and medical covariates, revealed that pooled periodontal and endodontic parameters (OIB= BL ≥5mm & EB ≥2) was independently associated with CAB ≥50% (PR=2.47,95%CI= 1.04-5.87). CONCLUSION A higher OIB was independently associated with increased levels of CAB among IS or TIA hospital patients. The combination of endodontic and periodontal parameters strengthened the observed association and should be evaluated in future studies on the relationship between oral health and cardiovascular outcomes.
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Affiliation(s)
- T S S Leão
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil;; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - G H Tomasi
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L P Conzatti
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L C P Marrone
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M A Reynolds
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil;; Medical and Dental Center of the Military Police of Rio Grande do Sul, Brazil
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7
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Siqueira JF, Rôças IN. Present status and future directions - microbiology of endodontic infections. Int Endod J 2021; 55 Suppl 3:512-530. [PMID: 34958494 DOI: 10.1111/iej.13677] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.
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Affiliation(s)
- José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, and Department of Endodontics and Molecular Microbiology Laboratory, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, RJ, Brazil
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Yamanaka F, Tsujita K, Saito S. Periodontal Disease as a Potential Risk Factor of Cardiovascular Disease. Circ J 2021; 86:819-820. [PMID: 34955482 DOI: 10.1253/circj.cj-21-1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital.,Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Shigeru Saito
- Department of Cardiology, Shonan Kamakura General Hospital
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9
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Aloutaibi YA, Alkarim AS, Qumri EM, Almansour LA, Alghamdi FT. Chronic Endodontic Infections and Cardiovascular Diseases: Does the Evidence Support an Independent Association? Cureus 2021; 13:e19864. [PMID: 34976491 PMCID: PMC8712192 DOI: 10.7759/cureus.19864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 01/08/2023] Open
Abstract
Previous studies have shown that endodontic infections might increase the risk of cardiovascular diseases. However, there is no conclusive evidence that endodontic infections are associated with cardiovascular diseases among individuals with cardiac conditions. This systematic review aimed to collect and evaluate the current evidence on the relationship between chronic endodontic infections and cardiovascular diseases. The PubMed, Scopus, and Web of Science databases were searched, and Google Scholar was used to retrieve relevant clinical studies within the past 10 years (2011-2021). Observational studies (prospective cohort, retrospective cohort, cross-sectional, and case-control studies), which investigated the impact of endodontic infections and apical periodontitis in individuals with cardiac conditions at risk of cardiovascular disease, in English were considered. Review papers, duplicates, animal studies, and other irrelevant studies were excluded. Four investigators independently carried out the study selection and data collection processes. Quality assessment was performed in this review. Fourteen studies with 960,652 human subjects were included in this review. No association between endodontic infections and cardiovascular diseases among individuals with cardiac conditions was noted. Most of the studies showed a moderate overall risk of bias by 57.14% (n=8). There is weak evidence regarding the association between cardiovascular diseases and chronic endodontic infections. Further longitudinal clinical studies are required to determine the association between cardiovascular diseases and endodontic infections.
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Affiliation(s)
- Yaser A Aloutaibi
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Abdulaziz S Alkarim
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Esraa M Qumri
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Lolo A Almansour
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Faisal T Alghamdi
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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10
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Stys LPA, Böttcher DE, Scarparo RK, Gonçalves Waltrick SB, de Figueiredo JAP, Gomes MS, Campos MM. Serum levels of inflammatory markers and HbA1c in patients with type 2 diabetes and apical periodontitis: Preliminary findings. AUST ENDOD J 2021; 48:105-115. [PMID: 34608703 DOI: 10.1111/aej.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/03/2021] [Accepted: 09/19/2021] [Indexed: 12/15/2022]
Abstract
This pilot study assessed the glycaemic control and the serum levels of inflammatory mediators in type 2 diabetes (T2DM) patients with apical periodontitis (AP). Thirty individuals were divided into four groups: Healthy (H); with AP (AP); with T2DM (T2DM); and with T2DM and AP (T2DM-AP). Demographic and pharmacological data were registered. The body mass index (BMI) and the levels of glycated haemoglobin (HbA1c) and IL-1β, IL-6, IL-10, CCL3 and CCL4 were evaluated. AP areas were determined radiographically. Mean age was 64 ± 12 years, with 63% females. Most T2DM patients were under treatment with metformin and antihypertensives. BMI and H1bAc were significantly higher in T2DM patients in relation to H and AP groups. The AP areas were larger in the T2DM-AP group, compared with the AP group. These preliminary findings suggest no influence of AP on glycaemic control or inflammatory levels amongst T2DM patients, although T2DM increased the AP severity.
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Affiliation(s)
- Liliana Preto Agostini Stys
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Daiana Elisabeth Böttcher
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Silvana Beltrami Gonçalves Waltrick
- Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Maximiliano Schünke Gomes
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Centro Médico e Odontológico da Polícia Militar do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Martha Campos
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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11
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Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke. Stroke Res Treat 2021; 2021:5402764. [PMID: 34531969 PMCID: PMC8440111 DOI: 10.1155/2021/5402764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Methods Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology (p = 0.028). There was a trend (OR 7.122; p = 0.083) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.
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12
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Koletsi D, Iliadi A, Tzanetakis GN, Vavuranakis M, Eliades T. Cardiovascular Disease and Chronic Endodontic Infection. Is There an Association? A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9111. [PMID: 34501699 PMCID: PMC8430722 DOI: 10.3390/ijerph18179111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/09/2023]
Abstract
The aim of the present study was to systematically assess existing evidence on the possible association between chronic endodontic infections and cardiovascular disease (CVD). An electronic database search was implemented until 2 October 2020. The main outcome was risk of CVD diagnosis. Risk of bias was assessed through the ROBINS-I tool, while random effects meta-analyses were conducted. The quality of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation. Twenty-one studies were eligible for inclusion, while 10 were included in the quantitative synthesis. Risk for CVD diagnosis in patients with chronic endodontic infection was 1.38 times those without infection (RR = 1.38; 95% CIs: 1.06, 1.80; p = 0.008). Risk of bias ranged from moderate to serious, while the quality of the evidence was graded as very low. Indications for an identified association between chronic endodontic infection and CVDs do exist; however, they are not grounded on high-quality evidence at present. Further research for an establishment of an association based on temporal sequence of the two entities and on unbiased well-conducted cohort studies would be highly valued.
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Affiliation(s)
- Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland;
| | - Anna Iliadi
- Department of Dental Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 10679 Athens, Greece;
| | - Giorgos N. Tzanetakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, 10679 Athens, Greece;
| | - Manolis Vavuranakis
- First Cardiology Department, National and Kapodistrian University of Athens, Hippocration Hospital, 10679 Athens, Greece;
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland;
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13
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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14
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Milojevic Samanovic A, Jakovljevic V, Vasovic M, Mitrovic S, Rankovic M, Mihajlovic K, Bolevich S, Zivkovic V. Cardiac, biochemical and histopathological analysis reveals impaired heart function in hypertensive rats with apical periodontitis. Int Endod J 2021; 54:1581-1596. [PMID: 33987853 DOI: 10.1111/iej.13562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
AIM To investigate the association between experimentally induced apical periodontitis (AP) and heart function in hypertensive rats. METHODOLOGY Forty-eight normotensive Wistar albino and spontaneously hypertensive (SHR) rats were divided into four equal groups: control (C), normotensive with AP (AP), SHR and SHR with AP (SHR + AP). AP was induced on the first right mandibular molars by exposing the pulp chambers to the oral environment for four weeks and confirmed radiographically. Thereafter, the animals were sacrificed by cervical dislocation, whilst hearts were isolated and perfused according to the Langendorff technique gradually increasing coronary perfusion pressures 40-120 cmH2 O. The hemimandibles were analysed radiographically (mm2 and pixels) to verify the presence of AP. Biomarkers of cardiac oxidative stress (OS) were determined in coronary venous effluent and cardiac tissue homogenate. Cardiac tissue was analysed histopathologically for signs of heart damage (oedema, fibrosis and necrosis). All data were analysed by Kruskal-Wallis and one-way anova tests (p < .05). RESULTS The levels of the maximum left ventricular pressure development rate of the SHR + AP group were significantly increased compared to the AP and C groups, and of the SHR group compared with the C group (p < .05). The levels of the minimum left ventricular pressure development rate of the SHR + AP group were significantly decreased compared to the AP, SHR and C groups, and of the SHR group compared to the C group (p < .05). The radiographic AP area was significantly larger in the SHR + AP group than in the AP group (p < .01). The levels of superoxide anion were significantly higher in the SHR + AP group than in the AP, SHR and C groups (p < .05). The activities of superoxide dismutase in cardiac tissue homogenate were significantly lower in the SHR + AP and AP groups compared with the SHR and C groups (p < .05). CONCLUSIONS In rats, AP was associated with impaired cardiodynamics, disturbed cardiac OS, antioxidant defence and cardiac pathologic changes in hypertensive conditions. Hypertension was associated with an increase in the AP radiographic area. Further studies should confirm whether root canal treatment can have a cardioprotective effect and reduce cardiac OS in hypertensive conditions.
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Affiliation(s)
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Miroslav Vasovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Slobodanka Mitrovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marina Rankovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Mihajlovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Sergey Bolevich
- Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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15
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Cotti E, Mercuro G. Editorial to: The role of Saccharibacteria (TM7) in the oral microbiome as a predictor for secondary cardiovascular events. Int J Cardiol 2021; 332:202-203. [PMID: 33812949 DOI: 10.1016/j.ijcard.2021.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
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16
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Lin CW, Chen YT, Ho HH, Hsieh PS, Kuo YW, Lin JH, Liu CR, Huang YF, Chen CW, Hsu CH, Lin WY, Yang SF. Lozenges with probiotic strains enhance oral immune response and health. Oral Dis 2021; 28:1723-1732. [PMID: 33749084 DOI: 10.1111/odi.13854] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/22/2021] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Probiotics participate in regulating oral microbiota and reducing the prevalence of oral diseases; however, clinical research on probiotics is insufficient. Therefore, in this study, we performed in vitro screening of potential oral protective probiotic strains and then evaluated the clinical efficacy of the selected strains on maintaining oral health. MATERIALS AND METHODS Fifty healthy individuals were recruited and randomly assigned into the placebo group and probiotics group, which included three strains of probiotics, Lactobacillus salivarius subs. salicinius AP-32, Lactobacillus paracasei ET-66, and Lactobacillus plantarum LPL28. Each group was blindly administered placebo or probiotics for four weeks. RESULTS Next-generation sequencing results showed that the oral microbiota of Lactobacillus salivarius in the oral cavity were significantly increased in subjects supplemented with mixed probiotic lozenges. The anti-bacterial activities of viable probiotics were observed within two weeks. Both IgA levels and Lactobacillus and Bifidobacterium abundances in the oral cavity were significantly increased in the experimental groups, along with a reduced formation of plaque. Most participants reported that their oral health conditions and intestinal symptoms had improved. CONCLUSIONS Overall, our clinical study suggests that oral probiotic lozenges may enhance oral immunity, modulate oral microbiota, and improve oral health.
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Affiliation(s)
- Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Tzu Chen
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Hsieh-Hsun Ho
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Pei-Shan Hsieh
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Yi-Wei Kuo
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Jia-Hung Lin
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Cheng-Ruei Liu
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Yu-Fen Huang
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Ching-Wei Chen
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Chen-Hung Hsu
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Wen-Yang Lin
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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17
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Cho HJ, Shin MS, Song Y, Park SK, Park SM, Kim HD. Severe Periodontal Disease Increases Acute Myocardial Infarction and Stroke: A 10-Year Retrospective Follow-up Study. J Dent Res 2021; 100:706-713. [PMID: 33478309 DOI: 10.1177/0022034520986097] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study aimed to evaluate the causal association of periodontal disease with acute myocardial infarction (AMI) and stroke, after controlling for various confounders among the Korean population. A retrospective cohort study using the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) was performed during 2002 to 2015 (baseline: 2002 to 2005; follow-up: 2006 to 2015) in the Republic of Korea. A total of 298,128 participants with no history of AMI or stroke were followed up for 10 y. AMI and stroke were defined by a diagnosis using the International Classification of Diseases, 10th Revision (ICD-10) guideline. Periodontal condition was classified into 3 groups (healthy, moderate periodontal disease, severe periodontal disease [SPD]) using the combination of ICD codes, treatment codes in the NHIS, and recommendation of periodontal treatment by the dentists in HEALS. Various confounders, such as sociodemographic, behavioral, systemic, and oral health factors, including hypercholesterolemia, were considered. Multivariable Cox regression analysis was applied to estimate adjusted incidence rate ratio (adjusted hazard ratio [aHR]) based on person-year of periodontal condition for AMI, stroke, and nonfatal major adverse cardiovascular events (MACEs) encompassing AMI or stroke controlling for various confounders. Stratified analyses according to age group, sex, and toothbrushing frequency were also performed. After controlling for various confounders, participants with SPD compared with non-SPD participants had a higher incidence by 11% for AMI (aHR, 1.11; 95% confidence interval [CI], 1.02-1.20), by 3.5% for stroke (aHR, 1.035; 95% CI, 1.01-1.07), and by 4.1% for MACEs (aHR, 1.04; 95% CI, 1.01-1.07). The association of SPD with AMI and MACE was highly modified in females and adults aged 40 to 59 y. In the total Korean population, SPD increased total AMI events by 4.3%, total stroke events by 1.4%, and the total MACEs by 1.6%. Our data confirmed that SPD was causally associated with the new events of AMI and stroke.
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Affiliation(s)
- H J Cho
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - M S Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Y Song
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, South Australia, Australia
| | - S K Park
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - S M Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.,Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - H D Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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18
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Sadiq N, Probst JC, Merchant AT, Martin AB, Shrestha D, Khan MM. The role of dental insurance in mitigating mortality among working-age U.S. adults with periodontitis. J Clin Periodontol 2020; 47:1294-1303. [PMID: 32939782 DOI: 10.1111/jcpe.13366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 07/28/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
AIM To assess the relationship of dental insurance with all-cause mortality and mortality due to cardiovascular diseases (CVD), diabetes mellitus (DM), and cerebrovascular diseases (CBD) among those with periodontitis. MATERIALS AND METHODS NHANES III and its associated mortality data set were used in this study. The outcome variables were "all-cause mortality" and "combined mortality" due to CVD, DM, and CBD. The independent variable was dental insurance stratified over periodontitis status. Unweighted frequencies with weighted column percentages were used for descriptive statistics, and chi-square test was applied for significance. Cox proportional hazard models were used for stratified multivariable analyses. All analyses were performed in SAS v9.4 accounting for survey data complexities. Significance level was kept at 5%. RESULTS The mortality was 14.58% for all-cause mortality and 4.06% for combined mortality among those with periodontitis in this study. Dental insurance significantly reduced the hazard of all-cause mortality among those with periodontitis (HR: 0.75; 95% CI: 0.61 - 0.93), adjusted for covariates. However, no association of dental insurance with combined mortality was observed among periodontitis group. CONCLUSIONS Dental insurance reduces hazard of all-cause mortality among those with periodontitis. Dental insurance ensures access to dentists and improves oral and dental health. Longitudinal study is needed to establish causality.
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Affiliation(s)
- Naveed Sadiq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.,Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Janice C Probst
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Amy B Martin
- College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Deepika Shrestha
- Data Management and Analysis Division, Center for Policy, Planning and Evaluation, DC Department of Health, Washington, DC, USA
| | - M Mahmud Khan
- Department of Health Policy & Management, University of Georgia, Athens, GA, USA
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19
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Alim BA, Canturk E, Koksal C. The effect of treated apical periodontitis before heart valve surgery on C-reactive protein levels. Oral Dis 2020; 27:632-638. [PMID: 32710519 DOI: 10.1111/odi.13554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Dental infections produce significant increases in systemic inflammatory responses manifested by cytokines and acute-phase reactants. This study evaluated the postoperative C-reactive protein (CRP) levels according to patients having teeth treated or not treated for apical periodontitis (AP) before heart valve surgery. MATERIALS AND METHODS Preoperative, postoperative third- and fifth-day CRP levels, and the previous dental data of 91 patients were investigated. Whether the patients had been treated for AP and whether they used antibiotic prophylaxis for this treatment were determined by examining the previous data. The analysis of covariance (ANCOVA) was used for statistical analysis. RESULTS There were no statistically significant differences in the preoperative CRP levels and the third-day CRP levels between all patients treated and those not treated for AP (p > .05). The mean fifth-day CRP levels of the patients with teeth treated for AP were significantly lower than those of the patients with teeth not treated for AP (p < .05). Antibiotic prophylaxis had a significant effect on the fifth-day CRP levels. CONCLUSION The decrease in CRP levels after AP treatment may contribute to alleviating heart valve disease and maintaining cardiac health.
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Affiliation(s)
- Betul Aycan Alim
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Emir Canturk
- Department of Cardiovascular Surgery, Istanbul Medipol Kosuyolu Hospital, Istanbul, Turkey
| | - Cengiz Koksal
- Department of Cardiovascular Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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20
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Park SY, Kim SH, Kang SH, Yoon CH, Lee HJ, Yun PY, Youn TJ, Chae IH. Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea. Eur Heart J 2020; 40:1138-1145. [PMID: 30561631 DOI: 10.1093/eurheartj/ehy836] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/03/2018] [Accepted: 11/22/2018] [Indexed: 12/31/2022] Open
Abstract
AIMS Oral health problems such as periodontal disease, dental caries, and tooth loss have been suggested to have associations with cardiovascular disease. This study aimed to evaluate whether oral hygiene behaviour can alleviate cardiovascular risk associated with oral health status using a nationwide population-based cohort. METHODS AND RESULTS The data of 247 696 healthy adults aged 40 years or older who underwent an oral health screening programme and had no history of major cardiovascular events were extracted from the National Health Insurance System-National Health Screening Cohort. After a median follow-up of 9.5 years, 14 893 major cardiovascular events occurred including cardiac death, myocardial infarction, stroke, and heart failure. The risk of cardiovascular events was higher when a subject had periodontal disease, a higher number of dental caries, or more tooth loss. Performing one more tooth brushing a day was associated with a 9% significantly lower risk of cardiovascular events after multivariable adjustment. Regular dental visits (once a year or more) for professional cleaning were also shown to reduce cardiovascular risk by 14%. Improved oral hygiene behaviours were shown to attenuate the cardiovascular risk originating from periodontal disease, dental caries, and tooth loss. CONCLUSION Oral hygiene care such as frequent tooth brushing and regular dental visits for professional cleaning reduced the risk of future cardiovascular events in healthy adults. This study also suggests that improved oral hygiene behaviour may modify the association between oral health and cardiovascular diseases.
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Affiliation(s)
- Shin-Young Park
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-Do, Korea.,Clinical Dental Education, Department of Dentistry, Dental Research Institutes, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sun-Hwa Kim
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Korea
| | - Si-Hyuck Kang
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Korea.,Department of Internal Medicine, Seoul National University, 101 Daehak-ro, Chong No Gu, Seoul, Korea
| | - Chang-Hwan Yoon
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Korea.,Department of Internal Medicine, Seoul National University, 101 Daehak-ro, Chong No Gu, Seoul, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-Do, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-Do, Korea
| | - Tae-Jin Youn
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Korea.,Department of Internal Medicine, Seoul National University, 101 Daehak-ro, Chong No Gu, Seoul, Korea
| | - In-Ho Chae
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Korea.,Department of Internal Medicine, Seoul National University, 101 Daehak-ro, Chong No Gu, Seoul, Korea
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21
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Tooth loss is associated with atherosclerosis and a poorer functional outcome among stroke patients. Clin Oral Investig 2020; 24:4541-4548. [DOI: 10.1007/s00784-020-03319-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/30/2020] [Indexed: 12/28/2022]
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22
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The impact of oral health on physical fitness: A systematic review. Heliyon 2020; 6:e03774. [PMID: 32346633 PMCID: PMC7182722 DOI: 10.1016/j.heliyon.2020.e03774] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/07/2020] [Accepted: 04/08/2020] [Indexed: 12/20/2022] Open
Abstract
Background Oral health problems may have numerous effects on general health, including physical fitness and performance. In this review, we aimed to systematically review the available evidence to assess the effect of oral health on general physical fitness. Methods We systematically performed a literature search in two different databases (PUBMED and EMBASE) without restriction to the year of publication. Articles were included if the subjects were humans and the primary aim was to assess the effects of dental and/or oral health problems on physical activity using either objective physical measurements or physical performance tests. The quality of the studies was then assessed using a Joanna Briggs Institute (JBI) Critical Appraisal tool. Results A total of 2651 articles were initially retrieved from the systematic search of the literature. Of these, a final total of 11 articles following the inclusion criteria were included in the review. All of the 11 articles included in the review had good methodological quality. Of the 11 articles, ten articles suggested a correlation between dental and oral condition toward physical fitness, body balance, cardiorespiratory function, and also cognitive function. Only one article found contradictory results, which showed that periodontal conditions did not correlate with the cardiorespiratory function. Malocclusion, including the number of remaining teeth, was reported in five studies (45.4%), periodontal disease was evaluated in six studies (54.5%), along with slight evaluation of periapical inflammation. Conclusion This review suggests that there is a negative effect of poor dental and/or oral health on physical fitness and performance.
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Alim BA, Guneser MB, Dincer AN. Cardiologists' and cardiovascular surgeons' attitudes toward managing endodontic infections and oral health in patients with cardiovascular diseases. Postgrad Med 2020; 132:156-161. [PMID: 31933403 DOI: 10.1080/00325481.2020.1714205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: A relationship between dentists and medical doctors should be encouraged to reduce cardiovascular risk in cardiac patients with dental infection. The aim of this study was to evaluate the attitudes of cardiologists and cardiovascular surgeons (cardiac specialists) toward managing endodontic infections and oral health in patients with cardiovascular diseases (CVDs).Methods: A survey of 16 questions assessing knowledge of endodontic infection, dental examination, timing of endodontic treatment, and antibiotic prophylaxis was sent to cardiac specialists in Turkey. The participants' responses were compared by means of the chi-square test (p ≤ 0.05).Results: Responses were received from 444 (44.71%) participants. Of all participants, 91.4% agreed that endodontic infections are important diseases that should be treated. Cardiac patients were referred to a dentist by 66.6% of the cardiologists and 80.3% of the cardiovascular surgeons (p = 0.002). Almost all participants (97.3%) believed that the heart health of cardiac patients with endodontic infections could be negatively affected by this infection.Conclusion: Although there is not yet any conclusive evidence on whether the presence of an endodontic infection may have an impact on CVDs, this study showed that most cardiac specialists attached importance to endodontic infections.
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Affiliation(s)
- Betul Aycan Alim
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Burak Guneser
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Asiye Nur Dincer
- Faculty of Dentistry, Department of Endodontics, Bezmialem Vakif University, Istanbul, Turkey
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LC-MS/MS Analysis of Sugars, Alditols, and Humectants in Smokeless Tobacco Products. BEITRÄGE ZUR TABAKFORSCHUNG INTERNATIONAL 2019; 28:203-213. [PMID: 32327867 DOI: 10.2478/cttr-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Globally, smokeless tobacco (ST) includes a wide array of chemically diverse products generally used in the oral cavity. Although ST has been widely investigated, this study was undertaken to determine the levels of sugars (mono- and di-saccharides), alditols, and humectants present in major ST categories/subcategories by using high performance liquid chromatography coupled with a triple quadrupole mass spectrometer (HPLC-MS/MS). The products studied included chewing tobacco (loose leaf, plug, twist), US moist snuff, Swedish snus, creamy snuff, dry snuff, dissolvable tobacco products, and tobacco-coated toothpicks. The highest mean sugar level was detected in chewing tobacco (9.3-27.5%, w/w), followed by dissolvable tobacco (2.1%); all other products were lower than 1%. Creamy snuff had the highest mean alditol levels (22.6%), followed by dissolvable tobacco (15.4%); all others had levels lower than 1%. The detected mean humectant levels ranged from non-detectable to 5.9%. This study demonstrates the broad chemical diversity among ST. This research may aid researchers and public health advocates investigating the exposures and risks of ST. [Beitr. Tabakforsch. Int. 28 (2019) 203-213].
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25
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Swastini IGAAP, Mahadewa TGB, Widyadharma IPE. Alveolar Bone Osteoclast Profile in the Periodontitis Wistar Rats Model with the Snail Slime (Achatina Fulica) Application. Open Access Maced J Med Sci 2019; 7:1680-1684. [PMID: 31210823 PMCID: PMC6560295 DOI: 10.3889/oamjms.2019.451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Bone damage is a result of periodontal disease that occurs due to changes in osteoclast and osteoblast activity in response to local inflammation. The bacteria Aggregatibacter actinomycetemcomitans produces Lipopolysaccharide (LPS), which can increase osteoclast activity. AIM This study aimed to analyse the decrease in alveolar bone osteoclasts in periodontitis rats' model with the application of snail slime. METHODS Wistar rats (27) with periodontitis divided into three groups, namely the control group (debridement), P1 group (debridement and application of oral snail slime) 300 Mg/Kg Body weight, P2 group (debridement, application of topical snail slime) 0.1 Mg. Osteoclast profile analysis was carried out by HE staining procedure to determine the histological feature of osteoclasts. The statistical significance was determined using the Shapiro-Wilk Test, One Way ANOVA, and Post Hoc test (p < 0.05). RESULTS Osteoclast profile in rats with periodontitis applied with snail slime significantly decreased the number of osteoclasts with both oral and topical administration, there were significant differences in the number of osteoclasts between groups (one way ANOVA, p < 0.05) and there were no significant differences between groups P1 and P2 (Post Hoc, p > 0.05). CONCLUSION In this study, there was a decrease in the number of osteoclasts which were slipped by snail slime in Wistar rats with periodontitis; this indicates a periodontitis healing process.
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Davanian H, Gaiser RA, Silfverberg M, Hugerth LW, Sobkowiak MJ, Lu L, Healy K, Sandberg JK, Näsman P, Karlsson J, Jansson L, Engstrand L, Sällberg Chen M. Mucosal-associated invariant T cells and oral microbiome in persistent apical periodontitis. Int J Oral Sci 2019; 11:16. [PMID: 31068577 PMCID: PMC6506549 DOI: 10.1038/s41368-019-0049-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 02/07/2023] Open
Abstract
Opportunistic bacteria in apical periodontitis (AP) may pose a risk for systemic dissemination. Mucosal-associated invariant T (MAIT) cells are innate-like T cells with a broad and potent antimicrobial activity important for gut mucosal integrity. It was recently shown that MAIT cells are present in the oral mucosal tissue, but the involvement of MAIT cells in AP is unknown. Here, comparison of surgically resected AP and gingival tissues demonstrated that AP tissues express significantly higher levels of Vα7.2-Jα33, Vα7.2-Jα20, Vα7.2-Jα12, Cα and tumour necrosis factor (TNF), interferon (IFN)-γ and interleukin (IL)-17A transcripts, resembling a MAIT cell signature. Moreover, in AP tissues the MR1-restricted MAIT cells positive for MR1–5-OP-RU tetramer staining appeared to be of similar levels as in peripheral blood but consisted mainly of CD4+ subset. Unlike gingival tissues, the AP microbiome was quantitatively impacted by factors like fistula and high patient age and had a prominent riboflavin-expressing bacterial feature. When merged in an integrated view, the examined immune and microbiome data in the sparse partial least squares discriminant analysis could identify bacterial relative abundances that negatively correlated with Vα7.2-Jα33, Cα, and IL-17A transcript expressions in AP, implying that MAIT cells could play a role in the local defence at the oral tissue barrier. In conclusion, we describe the presence of MAIT cells at the oral site where translocation of oral microbiota could take place. These findings have implications for understanding the immune sensing of polymicrobial-related oral diseases.
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Affiliation(s)
- Haleh Davanian
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | | | - Luisa W Hugerth
- Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.,Clinical Genomics Facility, Science for Life Laboratory, Solna, Sweden
| | | | - Liyan Lu
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Katie Healy
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | - Peggy Näsman
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Jörgen Karlsson
- Clinic of Endodontics and Periodontology, Eastman Institute Stockholm, Stockholm, Sweden
| | - Leif Jansson
- Clinic of Endodontics and Periodontology, Eastman Institute Stockholm, Stockholm, Sweden
| | - Lars Engstrand
- Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.,Clinical Genomics Facility, Science for Life Laboratory, Solna, Sweden
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Bergandi L, Giuggia B, Alovisi M, Comba A, Silvagno F, Maule M, Aldieri E, Scotti N, Scacciatella P, Conrotto F, Berutti E, Pasqualini D. Endothelial Dysfunction Marker Variation in Young Adults with Chronic Apical Periodontitis before and after Endodontic Treatment. J Endod 2019; 45:500-506. [PMID: 30910354 DOI: 10.1016/j.joen.2019.01.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Cardiovascular diseases are the leading cause of mortality worldwide. Apical periodontitis (AP) has been associated with an increased risk of cardiovascular diseases. A correlation has been shown between chronic AP and endothelial dysfunction (ED), but there is no evidence to indicate ED improves after endodontic treatment in patients with periapical lesions. The aim of this study was to investigate vascular and molecular markers of early ED before and after root canal treatment in young adults with chronic AP. METHODS Twenty control subjects and 21 patients with AP were assessed at baseline. The AP patients were also evaluated 2 and 12 months post-treatment. Endothelial flow reserve was assessed via an endothelial function test, and enzyme-linked immunosorbent assays were used to evaluate plasma levels of proinflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor alpha; vasoconstrictor ED marker endothelin (ET)-1; circulating endothelial adhesion markers intercellular adhesion molecule 1 (ICAM-1)/CD54 and soluble vascular cellular adhesion molecule (sVCAM)-1/CD106; soluble CD14; and the endothelial leukocyte adhesion molecule (E-selectin). RESULTS AP was associated with increased serum levels of ET-1, ICAM-1, E-selectin, IL-1, and sCD14, suggesting early vascular ED, with no macroscopic evidence of a reduction in endothelial flow reserve. Root canal treatment ameliorated inflammation and early ED, lowering plasma levels of IL-1, sCD14, ET-1, ICAM-1/CD54, and E-selectin to those of control subjects. CONCLUSIONS Our findings suggest that AP may drive early vascular ED and that the endodontic therapy of AP ameliorates early ED.
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Affiliation(s)
| | - Beatrice Giuggia
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | | | - Milena Maule
- Department of Medical Sciences, Division of Cardiology, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Paolo Scacciatella
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Federico Conrotto
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Elio Berutti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy.
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Hatvani J, Horvath A, Michetti J, Basarab A, Kouame D, Gyongy M. Deep Learning-Based Super-Resolution Applied to Dental Computed Tomography. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2019. [DOI: 10.1109/trpms.2018.2827239] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Messing M, Souza LCD, Cavalla F, Kookal KK, Rizzo G, Walji M, Silva R, Letra A. Investigating Potential Correlations between Endodontic Pathology and Cardiovascular Diseases Using Epidemiological and Genetic Approaches. J Endod 2019; 45:104-110. [DOI: 10.1016/j.joen.2018.10.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/04/2018] [Accepted: 10/28/2018] [Indexed: 12/13/2022]
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30
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Bains R, Bains VK. Lesions of endodontic origin: An emerging risk factor for coronary heart diseases. Indian Heart J 2018; 70 Suppl 3:S431-S434. [PMID: 30595303 PMCID: PMC6309294 DOI: 10.1016/j.ihj.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/18/2023] Open
Abstract
A high inflammatory state, such as atherosclerosis, is a major underlying cause of coronary heart diseases (CHDs). Inflammatory mediators are known to lead to endothelial dysfunction and play a key role in initiation, progression, and rupture of atherothrombotic plaque. Chronic inflammatory dental infections such as periodontitis and lesions of endodontic origin or chronic apical periodontitis (CAP) may provide an environment conducive for such events. Atherosclerosis has shown to share a common spectrum of inflammatory markers with apical periodontitis. The possible correlation between CHD and CAP is emerging at microbiological, clinical, inflammatory, and molecular levels. This less recognized fact should be discussed more among the dental and medical fraternity so that more awareness and positive approach toward oral health can be created among patients and health-care providers.
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Affiliation(s)
- Rhythm Bains
- Department of Conservative Dentistry & Endodontics, King George's Medical University, Lucknow, India.
| | - Vivek K Bains
- Department of Periodontology, Saraswati Dental College, Lucknow, India
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Aminoshariae A, Kulild JC, Fouad AF. The Impact of Endodontic Infections on the Pathogenesis of Cardiovascular Disease(s): A Systematic Review with Meta-analysis Using GRADE. J Endod 2018; 44:1361-1366.e3. [DOI: 10.1016/j.joen.2018.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022]
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Preianò M, Maggisano G, Murfuni MS, Villella C, Pelaia C, Montalcini T, Lombardo N, Pelaia G, Savino R, Terracciano R. An Analytical Method for Assessing Optimal Storage Conditions of Gingival Crevicular Fluid and Disclosing a Peptide Biomarker Signature of Gingivitis by MALDI-TOF MS. Proteomics Clin Appl 2018; 12:e1800005. [DOI: 10.1002/prca.201800005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/27/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Mariaimmacolata Preianò
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Giuseppina Maggisano
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Maria Stella Murfuni
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Chiara Villella
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Tiziana Montalcini
- Department of Experimental and Clinical Medicine; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Nicola Lombardo
- Department of Medical and Surgical Sciences; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Girolamo Pelaia
- Department of Medical and Surgical Sciences; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Rocco Savino
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
| | - Rosa Terracciano
- Department of Health Sciences; Laboratory of Mass Spectrometry and Proteomics; University “Magna Graecia”; Catanzaro 88100 Italy
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Debnath S. Preliminary studies on the inhibition potential of Indian domestic curd against coliforms, an emerging periodontal pathogen. J Indian Soc Periodontol 2018; 21:357-365. [PMID: 29491580 PMCID: PMC5827501 DOI: 10.4103/jisp.jisp_223_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Coliforms colonize in dental plaques via oral route and may lead to systemic complications. Escherichia coli and its lipopolysaccharide-induced periodontitis is an emerging threat. Clinical management necessitates antibiotic regimens with risk of resistance and upsetting the gut. There is urgent need for better, sustainable, and economical alternative. Aim: To investigate the inhibition of coliforms, a potential periodontopathogen directly by Indian domestic curd (IDC) “in situ". Materials and Methods: Coliforms from natural habitat (Municipal sewage in Agartala, Tripura), a source of infection through food and water, were used as target organism. Domestically prepared curd without any fortification is used to explore its true inhibition potential. Assays of agar well diffusion performed with IDC (ultraviolet sterilized and pH adjusted 6.5) against isolated pure cultures of coliforms. The study protocol nullified effect of organic acids, volatile compounds, bacteriophages, and peroxides in IDC. Peptide nature of inhibitory ingredient was studied by Sodium Dodecyle Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE), urea treatment. Computational phylogenetics revealed structural features of inhibitory ingredient. Statistical comparisons were done by analysis of variance. Second-order polynomial regression was done to evaluate the effect of IDC dilution on coliform inhibition. Mann–Whitney U-test performed to analyze different sample treatments. Results: Agar well diffusion (sealed bottom wells) shows inhibition of catalase-negative coliforms (confirmed by Gram staining and triple sugar iron agar assay) in pure culture (MacConkey agar). Activity diminished in urea, potentiated in ethylene diamine tetra acetic acid, remains unchanged by heat treatment (121°C, 15 min). SDS-PAGE revealed three distinct peptides (>10–15KDa). Hence, thermostable inhibitory peptides attached to target cell lead to observed activity (titer up to 1204.82 AU/ml with minimum 8 mm inhibition). Conclusions: IDC adequately inhibits sewage coliforms and may prevent dental plaques coliform colonization and its associated risks.
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Affiliation(s)
- Surajit Debnath
- Head, Department of Medical Laboratory Technology, Women's Polytechnic, Agartala, Tripura, India
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Laputková G, Schwartzová V, Bánovčin J, Alexovič M, Sabo J. Salivary Protein Roles in Oral Health and as Predictors of Caries Risk. Open Life Sci 2018; 13:174-200. [PMID: 33817083 PMCID: PMC7874700 DOI: 10.1515/biol-2018-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
This work describes the current state of research on the potential relationship between protein content in human saliva and dental caries, which remains among the most common oral diseases and causes irreversible damage in the oral cavity. An understanding the whole saliva proteome in the oral cavity could serve as a prerequisite to obtaining insight into the etiology of tooth decay at early stages. To date, however, there is no comprehensive evidence showing that salivary proteins could serve as potential indicators for the early diagnosis of the risk factors causing dental caries. Therefore, proteomics indicates the promising direction of future investigations of such factors, including diagnosis and thus prevention in dental therapy.
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Affiliation(s)
- Galina Laputková
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P. J. Šafárik in Košice, Trieda SNP 1, Košice, 040 11, Slovakia
| | - Vladimíra Schwartzová
- 1st Department of Stomatology, Faculty of Medicine, University of P. J. Šafárik in Košice, Trieda SNP 1, Košice, 040 11, Slovakia
| | - Juraj Bánovčin
- Department of Stomatology and Maxillofacial Surgery, Faculty of Medicine, University of P. J. Šafárik in Košice, Rastislavova 43, Košice, 041 90, Slovakia
| | - Michal Alexovič
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P. J. Šafárik in Košice, Trieda SNP 1, Košice, 040 11, Slovakia
| | - Ján Sabo
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P. J. Šafárik in Košice, Trieda SNP 1, Košice, 040 11, Slovakia
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Michetti J, Basarab A, Diemer F, Kouame D. Comparison of an adaptive local thresholding method on CBCT and µCT endodontic images. ACTA ACUST UNITED AC 2017; 63:015020. [DOI: 10.1088/1361-6560/aa90ff] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Nanri H, Yamada Y, Itoi A, Yamagata E, Watanabe Y, Yoshida T, Miyake M, Date H, Ishikawa-Takata K, Yoshida M, Kikutani T, Kimura M. Frequency of Fruit and Vegetable Consumption and the Oral Health-Related Quality of Life among Japanese Elderly: A Cross-Sectional Study from the Kyoto-Kameoka Study. Nutrients 2017; 9:nu9121362. [PMID: 29244736 PMCID: PMC5748812 DOI: 10.3390/nu9121362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/10/2017] [Accepted: 12/13/2017] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Many previous studies have reported that fruit and vegetable consumption is associated with a reduced risk of various disease, but whether or not their consumption is associated with the oral health-related quality of life (OHRQoL) is unclear. The objective of this study was to examine the association between the frequency of fruit and vegetable consumption and the OHRQoL in elderly subjects by sex. METHODS We analyzed cross-sectional data from a population-based Kyoto-Kameoka Study in 2012 of 3112 men and 3439 women (age ≥ 65 years). The frequencies of fruit and vegetable consumption were assessed using a validated food frequency questionnaire. We evaluated the OHRQoL using the General Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems in old adults. RESULTS After adjusting for age, body mass index, alcohol, smoking, education, socioeconomic status, history of disease, medication use, mobility disability, and total energy intake, a higher frequency of combined fruit and vegetable consumption showed a significant positive association with the GOHAI score in both men and women (p-trend < 0.001 in both sexes). These associations remained significant after adjustment for poor mastication and denture use (p-trend all < 0.05 in both sexes). We observed a significant positive association even when the frequencies of fruit or vegetable consumption were analyzed separately (all p-trend < 0.05 in both sexes). CONCLUSIONS A higher frequency of fruit and/or vegetable consumption independently showed a strong positive association with the OHRQoL in both men and women. Further prospective studies are needed to confirm these findings.
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Affiliation(s)
- Hinako Nanri
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
| | - Yosuke Yamada
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
| | - Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo 650-0046, Japan.
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto 610-0395, Japan.
| | - Yuya Watanabe
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
- Faculty of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan.
| | - Tsukasa Yoshida
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Senior Citizens' Welfare Section, Kameoka City Government, Kyoto 621-8501, Japan.
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
| | - Heiwa Date
- Department of Data Science, Shiga University, Shiga 522-8522, Japan.
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima 734-8553, Japan.
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tokyo 184-0011, Japan.
| | - Misaka Kimura
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
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Hernández-Caldera A, Vernal R, Paredes R, Veloso-Matta P, Astorga J, Hernández M. Human periodontal ligament fibroblasts synthesize C-reactive protein and Th-related cytokines in response to interleukin (IL)-6 trans-signalling. Int Endod J 2017; 51:632-640. [PMID: 29106735 DOI: 10.1111/iej.12872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/31/2017] [Indexed: 12/23/2022]
Abstract
AIM To characterize the potential of human periodontal ligament fibroblasts (HPLF) to synthesize CRP and Th-related cytokines in response to IL-6 in periodontal health and apical inflammation. METHODOLOGY Primary HPLF stimulated with IL-6, soluble(s) IL-6 receptor (R) and controls were assayed for CRP, Th1, Th2, Th17 and Treg-related cytokines by quantitative real-time PCR and ELISA, respectively. IL-6R mRNA expression and its soluble protein levels were screened in HPLF cultures, and ex vivo samples of healthy periodontal ligaments (n = 5) and apical lesions (n = 13). Data were analysed with ANOVA or unpaired t-test. RESULTS 0.5 ng mL-1 IL-6 plus 1 ng mL-1 of its soluble receptor (sIL-6R) for 24 h was effective in inducing CRP production. IL-6 alone had a mild dose-dependent effect; co-stimulation with sIL-6R significantly enhanced this effect, whereas it was completely abolished by the addition of IL-6R blocking antibody (P < 0.05). Similarly, higher mRNA expression and protein levels of Th1, Th17 and partially Treg-related cytokines were found for IL-6 combined with its soluble receptor versus the nonstimulated group and IL-6R antibody (P < 0.05). IL-6R mRNA expression was slightly induced by IL-6 compared to THP-1 cells, but sILR-6 protein could not be detected in HPLF. High sIL-6R levels were detected in apical lesions and were immunolocalized to mononuclear inflammatory cells and proliferating epithelium. CONCLUSION IL-6 trans-signalling induced Th1 and Th17-related cytokines and represents an extra-hepatic mechanism for PCR synthesis in human periodontal ligament fibroblasts, contributing to explain the bone-destructive phenotype of apical lesions and eventually its systemic complications.
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Affiliation(s)
- A Hernández-Caldera
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - R Vernal
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - R Paredes
- Escuela Medicina Veterinaria, Facultad de Ecología y Recursos Naturales, Universidad Andrés Bello, Santiago, Chile
| | - P Veloso-Matta
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - J Astorga
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - M Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
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Hernández-Ríos P, Pussinen PJ, Vernal R, Hernández M. Oxidative Stress in the Local and Systemic Events of Apical Periodontitis. Front Physiol 2017; 8:869. [PMID: 29163211 PMCID: PMC5672116 DOI: 10.3389/fphys.2017.00869] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 10/17/2017] [Indexed: 12/13/2022] Open
Abstract
Oxidative stress is involved in the pathogenesis of a variety of inflammatory disorders. Apical periodontitis (AP) usually results in the formation of an osteolytic apical lesion (AL) caused by the immune response to endodontic infection. Reactive oxygen species (ROS) produced by phagocytic cells in response to bacterial challenge represent an important host defense mechanism, but disturbed redox balance results in tissue injury. This mini review focuses on the role of oxidative stress in the local and associated systemic events in chronic apical periodontitis. During endodontic infection, ligation of Toll-like receptors (TLRs) on phagocytes' surface triggers activation, phagocytosis, synthesis of ROS, activation of humoral and cellular responses, and production of inflammatory mediators, such as, cytokines and matrix metalloproteinases (MMPs). The increment in ROS perturbs the normal redox balance and shifts cells into a state of oxidative stress. ROS induce molecular damage and disturbed redox signaling, that result in the loss of bone homeostasis, increased pro-inflammatory mediators, and MMP overexpression and activation, leading to apical tissue breakdown. On the other hand, oxidative stress has been strongly involved in the pathogenesis of atherosclerosis, where a chronic inflammatory process develops in the arterial wall. Chronic AP is associated with an increased risk of cardiovascular diseases (CVD) and especially atherogenesis. The potential mechanisms linking these diseases are also discussed.
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Affiliation(s)
- Patricia Hernández-Ríos
- Department of Conservative Dentistry, School of Dentistry, Universidad de Chile, Santiago, Chile
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Rolando Vernal
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - Marcela Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
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Periodontal Diseases and Possible Future Cardiovascular Events, Are they Related? An Overview. JOURNAL OF PEDIATRICS REVIEW 2017. [DOI: 10.5812/jpr.11144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Paloma de Oliveira B, Câmara AC, Aguiar CM. Prevalence of Asymptomatic Apical Periodontitis and its Association with Coronary Artery Disease in a Brazilian Subpopulation. Acta Stomatol Croat 2017; 51:106-112. [PMID: 28827847 PMCID: PMC5548220 DOI: 10.15644/asc51/2/3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of the present study was to determine the prevalence of asymptomatic apical periodontitis (AAP) and its association with coronary artery disease (CAD) in a Brazilian subpopulation, and to examine the correlation of AAP with gender, age and most frequently affected dental elements. Methods The data were collected from medical records of the patients (n = 1346) treated at the Specialization in Endodontics Clinic of the Federal University of Pernambuco in the period between 2003 and 2010. From each patient, the following variables were recorded: gender, age, endodontically compromised teeth, endodontic diseases diagnosed and the history of CAD. The data were analyzed using Pearson's chi-square test adopting a significance level of 5%. Results AAP was diagnosed in 574 patients (42.6%), corresponding to 641 teeth (40.1%). Both genders (p = 0.082), and all age groups (p = 0.190) were affected similarly. The upper incisors (52.8%, p <0.001) had a higher prevalence of AAP. The patients with AAP showed 1.45 times more chance of exhibiting CAD (p = 0.307). Conclusions The results pointed out that the prevalence of AAP in this population was high and similar to that observed in other countries. A positive association, but not statistically significant, between AAP and CAD was found.
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Affiliation(s)
- Bruna Paloma de Oliveira
- Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Andréa Cruz Câmara
- Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Carlos Menezes Aguiar
- Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
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Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation - An observational study. PLoS One 2017; 12:e0176724. [PMID: 28464019 PMCID: PMC5413016 DOI: 10.1371/journal.pone.0176724] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 04/14/2017] [Indexed: 12/19/2022] Open
Abstract
Background/Objective Progress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation. Methodology One thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score. Results In all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration. Conclusion A high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers of unmet treatment needs. Periapical health was associated with adequate root canal obturation and high-grade postendodontic restorations, and quality regarding these latter aspects is considered mandatory to promote periapical health.
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Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Periodontal disease is a chronic inflammatory disease that results from the activity of altered oral microbiome, leading to altered immune reaction, destruction of tissues supporting the teeth, and oral bone loss. This disease is particularly associated with an expressed systemic inflammation, being considered nowadays an inflammatory disorder. At the same time, inflammation has been recognized to play a major role in the development of atherosclerotic lesions. Atheromatous plaque formation is triggered by alterations in the structure of the endothelium, which lead to the expression of adhesion molecules and recruitment of immune cells such as macrophages, in the arterial wall. While the association between periodontal disease, inflammation and cardiovascular diseases has been well established, the causality relation between these three entities has not been demonstrated so far. This review presents the most common advances in understanding the complex link between periodontal disease, inflammation and atherosclerosis, as a common pathway leading to increased cardiovascular risk.
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Dudko Y, Kruger E, Tennant M. National dental waitlists: what would it take to reset to zero? AUST HEALTH REV 2017; 40:277-281. [PMID: 26364244 DOI: 10.1071/ah15025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/17/2015] [Indexed: 11/23/2022]
Abstract
Objective Over the years, long public dental waitlists across Australia have received much attention from the media. The issue for eligible patients, namely a further deterioration of dental health because of not being able to address dental concerns relatively quickly, has been the subject of several state and Federal initiatives. The present study provides a cost model for eliminating public dental waitlists across Australia and compares these results with the cost of contracting out public dental care to private clinics. Methods Waitlist data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual State or Territory Dental Health body. Average costs associated with employing key dental personnel and performance figures were used from previously published data to estimate the potential financial commitment and probable public benefits. Results The cost model suggests that, on average, it would be more than twice as expensive to contract the work out to private dental clinics as to treat eligible patients within public dental clinics. It is estimated that the cost of eliminating the legacy dental waiting lists (over 12 months) would be between A$50 and A$100million depending on the method adopted. The effort would require some 360 dental teams. Conclusion The design of the Australian public dental care system that is targeted at meeting the needs of eligible patients into the future, in addition to being effective and sustainable, must also offer a level of protection to the taxpayer. The ability to address waitlist backlog identified in the present study clearly would require a mix of service models depending on service availability at different locations. Further research is needed to optimise the mix of service providers to address community needs. What is known about the topic? Long public dental waitlists across Australia have received much attention from the media. The topic has been the subject of debate at the government level and, over the years, has seen an increase in allocation of public funds in an effort to address the policy needs. What does this paper add? This study calculates the actual number of people on the public dental waitlist, provides a detailed analysis of the distribution of the demand for the services and offers a cost model for resetting public dental waitlists across Australia. What are the implications for practitioners? This study carries no implications for individual practitioners at the clinical level. However, at the state and national levels, this model offers direction to a more cost-effective allocation of public funds and human resources.
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Affiliation(s)
- Yevgeni Dudko
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia.
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia.
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Jurczak A, Kościelniak D, Skalniak A, Papież M, Vyhouskaya P, Krzyściak W. The role of the saliva antioxidant barrier to reactive oxygen species with regard to caries development. Redox Rep 2017; 22:524-533. [PMID: 28288542 DOI: 10.1080/13510002.2017.1301625] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the role of the antioxidant barrier in the saliva of children with caries, and its impact on the colonization of cariogenic bacteria. METHODS This is a cross-sectional study of 81 children aged 1-5 years. Antioxidant levels and salivary bacterial profiles were measured. Patients were divided into two groups as follows: initial stage decay, termed non-cavitated (1-2 in International Caries Detection and Assessment System (ICDAS)), and extensive decay, termed cavitated lesions (5-6 in ICDAS). The control group includes children without caries. RESULTS The linear regression model demonstrated that the GSH, GSSG, GSH/GSSG, and total antioxidant capacity levels are influenced (P < 0.05) by: the stage of caries and the dominant bacterial strain. Compared with the other groups (P < 0.001), the highest antioxidant parameters were recorded in the saliva of patients with cavitated lesions. DISCUSSION Our results indicate that the high levels of antioxidants in saliva increase significantly in children in line with the salivary cariogenic bacterial profiles and caries progression.
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Affiliation(s)
- A Jurczak
- a Department of Pediatric Dentistry, Institute of Dentistry , Jagiellonian University Medical College Krakow , Poland
| | - D Kościelniak
- a Department of Pediatric Dentistry, Institute of Dentistry , Jagiellonian University Medical College Krakow , Poland
| | - A Skalniak
- b Genetics Laboratory, Department of Endocrinology , Jagiellonian University Medical College Krakow , Poland
| | - M Papież
- c Department of Cytobiology, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
| | - P Vyhouskaya
- d Department of Medical Diagnostics, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
| | - W Krzyściak
- d Department of Medical Diagnostics, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
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Evidence summary: the relationship between oral and cardiovascular disease. Br Dent J 2017; 222:381-385. [DOI: 10.1038/sj.bdj.2017.224] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 01/25/2023]
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Does apical periodontitis have systemic consequences? The need for well-planned and carefully conducted clinical studies. Br Dent J 2016; 218:513-6. [PMID: 25952428 DOI: 10.1038/sj.bdj.2015.340] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 12/18/2022]
Abstract
Apical periodontitis, infection of the root canal system, may have systemic consequences. This proposal has been brought forward many times in dentistry literature but the general consensus is that there is no scientific basis for an association between endodontic infections and general health. This opinion paper argues that, in order to obtain such a scientific basis, or to rule out the issue all together, we need carefully designed longitudinal challenge model (that is, intervention) studies in which we follow specific biomarkers of inflammation. These biomarkers can be those that are currently being substantiated in chronic inflammation and low-grade inflammation studies in medicine and nutritional science, where the presence of these inflammatory disorders is linked to systemic outcomes. A list of suggested biomarkers has been included.
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Vlasa A, Biris C, Benedek T, Eremie L. Letter to the Editor, "Association of Endodontic Lesions with Coronary Artery Disease". J Dent Res 2016; 96:233. [PMID: 27927888 DOI: 10.1177/0022034516681953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- A Vlasa
- 1 Faculty of Dental Medicine, University of Medicine and Pharmacy Targu Mures, Romania
| | - C Biris
- 1 Faculty of Dental Medicine, University of Medicine and Pharmacy Targu Mures, Romania
| | - T Benedek
- 2 Department of Internal Medicine, Clinic of Cardiology, University of Medicine and Pharmacy Targu Mures, Romania
| | - L Eremie
- 1 Faculty of Dental Medicine, University of Medicine and Pharmacy Targu Mures, Romania
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Hoppe CB, Oliveira JAP, Grecca FS, Haas AN, Gomes MS. Association between chronic oral inflammatory burden and physical fitness in males: a cross-sectional observational study. Int Endod J 2016; 50:740-749. [DOI: 10.1111/iej.12686] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/29/2016] [Indexed: 12/17/2022]
Affiliation(s)
- C. B. Hoppe
- Department of Conservative Dentistry; School of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - J. A. P. Oliveira
- Department of Conservative Dentistry; School of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - F. S. Grecca
- Department of Conservative Dentistry; School of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - A. N. Haas
- Department of Conservative Dentistry; School of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - M. S. Gomes
- Clinical Department; School of Dentistry; Pontifical Catholic University of Rio Grande do Sul; Porto Alegre Brazil
- Medical and Dental Center of the Military Police of Rio Grande do Sul; Porto Alegre Brazil
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Garg P, Chaman C. Apical Periodontitis - Is It Accountable for Cardiovascular Diseases? J Clin Diagn Res 2016; 10:ZE08-12. [PMID: 27656588 DOI: 10.7860/jcdr/2016/19863.8253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/25/2016] [Indexed: 11/24/2022]
Abstract
The aim of this review was to assess the relationship between apical periodontitis and cardiovascular diseases and the predictive factors regarding this association. Cross sectional and observational studies have been included, which are mostly retrospective. A comprehensive search was performed in the Systematic Electronic Databases, PUBMED and MEDLINE from 1919 till September 2014. Articles were also hand searched. From 86 studies identified, all were read and 58 articles which were relevant were included in the text. Some articles were excluded because they were pertaining to periodontology and other systemic disorders. Some were solely animal studies and were thus excluded. Our results suggest an independent association between cardiovascular diseases and apical periodontitis. A causal relationship could not be established since weak parameters of risk have been assessed in the studies, population taken is difficult to compare and other confounding factors have not been ruled out. Only a more focused and better instituted scientific research can determine this association. Establishing a cause and effect relationship between apical periodontitis and cardiovascular diseases can affect the course of treatment of cardiovascular diseases. It is not only of interest from the scientific point of view but also from public health perspective.
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Affiliation(s)
- Paridhi Garg
- Senior Lecturer, Department of Consevative Dentistry and Endodontics, Inderprastha Dental College and Hospital , Sahibabad, Uttar Pradesh, India
| | - Chandrakar Chaman
- Reader, Department of Consevative Dentistry and Endodontics, Kothiwal Dental College and Research Centre , Moradabad, Uttar Pradesh. India
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Grønkjær LL, Holmstrup P, Schou S, Schwartz K, Kongstad J, Jepsen P, Vilstrup H. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis. Hepat Med 2016; 8:97-103. [PMID: 27695370 PMCID: PMC5027950 DOI: 10.2147/hmer.s113485] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications. Methods A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association with systemic inflammation markers and cirrhosis-related complications were explored by univariable and multivariable logistic regression analyses. Results Periapical radiolucency was present in one or more teeth in 46% of the patients. Strong predictors were gross caries (odds ratio [OR] 3.12, 95% confidence interval [CI] 1.43–6.79) and severe periodontitis (OR 3.98, 95% CI 1.04–15.20). Also old age (OR 1.10, 95% CI 1.01–1.19) and smoking (OR 3.24, 95% CI 1.02–17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors. The patients with periapical radiolucency had higher C-reactive protein (15.8 mg/L vs 8.1 mg/L, P=0.02) and lower albumin contents (25 g/L vs 28 g/L, P=0.04) than those without. Furthermore, the patients with periapical radiolucency had a higher prevalence of cirrhosis-related complications such as ascites, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05). Conclusion Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings.
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Affiliation(s)
| | - Palle Holmstrup
- Section of Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences
| | - Søren Schou
- Section for Oral and Maxillofacial Surgery, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | | | - Johanne Kongstad
- Section of Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hendrik Vilstrup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus
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