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La Rosa GRM, Di Stefano A, Gangi D, Emma R, Fala V, Amaliya A, Yilmaz HG, Lo Giudice R, Pacino SA, Pedullà E, Górska R, Kowalski J, Polosa R. Dental plaque quantitation by light induced fluorescence technology in exclusive Electronic Nicotine Delivery Systems (ENDS) users. J Dent 2024; 147:105223. [PMID: 38987079 DOI: 10.1016/j.jdent.2024.105223] [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: 06/05/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVES In comparison to conventional combustible cigarettes, Electronic Nicotine Delivery Systems (ENDS) including both e-cigarettes (ECs) and heated tobacco products (HTPs) significantly reduce exposure to toxic chemical emissions. However, their impact on dental plaque remains unclear. This study measures dental plaque in ENDS (ECs and HTPs) users using quantitative light-induced fluorescence (QLF) technology, comparing them with current, former, and never smokers. METHODS This cross-sectional study compared dental plaque measurements using QLF technology (Q-ray cam™ Pro) among current smokers (≥10 cigarettes/day), former smokers (quit ≥6 months), never smokers, and exclusive ENDS users (quit ≥6 months). Dental plaque measurements were expressed as ΔR30 (total area of mature dental plaque) and ΔR120 (greater plaque thickness/maturation-calculus). The Simple Oral Hygiene (SOH) score was calculated by the QLF proprietary software. Statistical analyses including ANCOVA was performed by R version (4.2.3) with p < 0.05. RESULTS A total 30 smokers, 24 former smokers, 29 never smokers, and 53 ENDS users were included. Current smokers had significantly higher ΔR30 and ΔR120 values compared to other groups (p < 0.001). ENDS users showed plaque levels similar to never and former smokers (p > 0.05) but significantly lower than current smokers (p < 0.01). Although ENDS users showed a lower SOH score than smokers, this difference was not statistically significant. Daily toothbrushing and mouthwash usage were significant covariates. CONCLUSION ENDS users exhibited reduced accumulation of dental plaque and calculus compared with current smokers. CLINICAL SIGNIFICANCE Exclusive ENDS use could less impact dental plaque accumulation compared to cigarette smoking. Further research is needed to confirm these findings and fully understand ENDS impact on dental plaque formation.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy.
| | | | | | - Rosalia Emma
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
| | - Valeriu Fala
- Faladental, Chișinău, Republic of Moldova; "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Hasan Guney Yilmaz
- Near East University, Faculty of Dentistry. Department of Periodontology. Nicosia, Mersin10, Turkey
| | - Roberto Lo Giudice
- Department of Human Pathology of Adults and Developmental Age, University of Messina, Italy
| | - Sebastiano Antonio Pacino
- Addendo srl, Dental Clinic, Catania, Italy; ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Jan Kowalski
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
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Savran L, Sağlam M. Clinical effects of omega-3 fatty acids supplementation in the periodontal treatment of smokers and non-smokers with periodontitis: a retrospective study. Clin Oral Investig 2024; 28:437. [PMID: 39031219 PMCID: PMC11271343 DOI: 10.1007/s00784-024-05835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/17/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVES Omega-3 supplementation as an adjunct to nonsurgical periodontal treatment has been reported to have a positive effect on healing in periodontitis patients. However, there is a lack of information on the effects of periodontal healing in smokers with periodontitis. The aim of this retrospective study was to investigate the effect of omega-3 supplementation given as an adjunct to nonsurgical periodontal treatment on clinical parameters in smoker and non-smoker periodontitis patients. METHODS This study included a total of 80 periodontitis patients, 40 non-smokers and 40 smokers who were systemically healthy. In this study, patients were divided into 4 groups as follows: Group 1 (Subgingival instrumentation (SI) alone/nonsmoker), Group 2 (SI alone/smoker), Group 3 (SI + Omega-3/nonsmoker) and Group 4 (SI + Omega-3/smoker). Group 3 and 4 consumed 1320 mg Omega-3 capsule (640 mg EPA, 480 mg DHA) once a day for 3 months. Probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI) and bleeding on probing (BOP %) were recorded at baseline, 1 month and 3 months after treatment. RESULTS Significant improvement of all clinical parameters at 1 and 3 months was observed in all groups. Whole mouth CAL, GI and BOP% were significantly reduced in group 4 compared to group 2 at 1 and 3 months postoperatively (p < 0.05). For moderately deep pockets (4-6 mm) and deep pockets (7 mm≤), PD and CAL reductions were significantly greater in groups taking omega - 3 (group 3 and group 4) compared to groups not taking omega-3 (group 1 and group 2) between baseline and 1 month and between baseline and 3 months (p ˂ 0.05). CONCLUSION Omega-3 supplementation given as an adjunct to nonsurgical periodontal treatment provided significant benefit in the improvement of clinical parameters (especially for CAL and PD) in the short term in smokers and non-smokers with periodontitis. CLINICAL RELEVANCE Nonsurgical periodontal treatment with omega-3 supplementation resulted in significant improvements in clinical parameters in smokers and non-smokers with periodontitis.
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Affiliation(s)
- Levent Savran
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey.
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Thiem DGE, Donkiewicz P, Rejaey R, Wiesmann-Imilowski N, Deschner J, Al-Nawas B, Kämmerer PW. The impact of electronic and conventional cigarettes on periodontal health-a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4911-4928. [PMID: 37526741 PMCID: PMC10492702 DOI: 10.1007/s00784-023-05162-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of electronic cigarettes on periodontal health compared to conventional cigarette smoke and a non-smoking population. MATERIALS AND METHODS MEDLINE, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov were screened for literature. Eligibility criteria included clinical studies published between 2006 and 2022 that compare e-cigarettes and conventional cigarettes on periodontal health (bleeding on probing (BoP), plaque index (PI), probing depth (PD), attachment loss (AL), marginal bone loss (MBL), tooth loss, molecular inflammation markers, salivary flow rate). Meta-regression analysis was used to examine the influence of moderator variables. RESULTS Sixteen studies were found to be eligible for qualitative synthesis. Individual analyses showed that cigarette smokers had significantly higher PI, PD, AL, and MBL and increased concentrations of proinflammatory mediators than e-cigarette users and non-smokers. Meta-analysis revealed a 0.33-fold lower chance for BoP in e-cigarette users compared to smokers (p = 0.03), whereby meta-regression failed to detect any effects regarding the age of users and frequency of smoking. A 0.01-fold decreased chance for positive BoP in e-cigarette users compared with non-smokers was seen (p < 0.01). CONCLUSIONS The current findings suggest that that e-cigarette use might be considered a healthier alternative to cigarette smoking concerning periodontal health. Even so, harmful effects of electronic nicotine delivery system (ENDS) usage on periodontal health were seen as well. However, a definitive decision on this research question remains elusive due to the absence of randomized controlled trials. CLINICAL RELEVANCE Electronic cigarettes, marketed as a safer alternative to traditional cigarettes, are becoming increasingly popular. Evidence on the use of electronic cigarettes as a cessation aid and its beneficial impact compared to cigarette smoke remains inconclusive, so the analysis conducted in this review addresses a recent question of high clinical relevance.
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Affiliation(s)
- Daniel G. E. Thiem
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Phil Donkiewicz
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- BioHorizons Camlog, Maybachstr. 5, 71299 Wimsheim, Germany
| | - Raha Rejaey
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Nadine Wiesmann-Imilowski
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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Conte G, Amaliya A, Gupta S, Emma R, Gospodaru S, Bordeniuc G, Fala V, Pacino SA, Urso S, Zucchelli G, Polosa R. Repeatability of dental plaque quantitation by light induced fluorescence technology in current, former, and never smokers. BMC Oral Health 2023; 23:480. [PMID: 37443061 PMCID: PMC10347782 DOI: 10.1186/s12903-023-03154-0] [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: 01/20/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The effects of smoking on the accumulation of dental plaque have not been studied in depth. We compared dental plaque quantitation obtained with a novel light induced fluorescence technology among current, former, and never smokers and verified measurements' repeatability. METHODS Dental plaque quantitation was objectively assessed by quantitative light induced fluorescence (QLF) technology on three separate study visits in current, former, and never smokers: baseline (day 0), day 7, day 30. Increase in the fluorescence intensity of at least 30% (ΔR30) and 120% (ΔR120) together with the simple oral hygiene (SOH) scoring were considered for analysis. RESULTS The QLF parameters were highly repeatable in each study group (p < 0.0001, by regression analyses). All QLF parameters showed a significant difference between never smokers and current smokers (p = 0.041 for ΔR30; p = 0.027 for ΔR120; p = 0.04 for SOH). No significant differences were observed between never and former smokers and between current and former smokers except for ΔR120 (p = 0.033). CONCLUSION Dental plaque measurements by QLF technology were highly reproducible and showed greater plaque formation among current smokers compared to non-smokers. Objective and reproducible quantitation of dental plaque can be a valuable clinical and regulatory science endpoint to investigate the effect of smoking cessation medications, combustion-free tobacco products, and consumer care products on oral health. CLINICAL RELEVANCE There is a need to objectively evaluate the relationship between smoking and plaque build-up as well as maturation. Current smokers demonstrated greater and more mature plaque buildup when compared to never and former smokers. Differences in plaque build-up and maturation between current, former and non-smokers may be utilized as an effective tool for patient motivation, identifying therapeutic end-points, translational research as well as prognostication. TRIAL REGISTRATION The study is a pilot study parts of a larger project with registration ID: NCT04649645. As preliminary study, the pilot study referred into this paper started before the larger study registered in ClinicalTrials.gov.
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Affiliation(s)
- Gianluca Conte
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Addendo Srl, Dental Clinic, Catania, Italy
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rosalia Emma
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | - Gheorghe Bordeniuc
- Fala Dental, Chișinău, Republic of Moldova
- "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Valeriu Fala
- Fala Dental, Chișinău, Republic of Moldova
- "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Sebastiano Antonio Pacino
- Addendo Srl, Dental Clinic, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Salvatore Urso
- Department of Biological, Geological and Environmental Sciences, University of Catania, Catania, Italy
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Riccardo Polosa
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Omer-Cihangir R, Baser U, Kucukgergin C, Aykol-Sahin G, Huck O, Yalcin F. Impact of Smoking on Neutrophil Enzyme Levels in Gingivitis: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158075. [PMID: 34360367 PMCID: PMC8345369 DOI: 10.3390/ijerph18158075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023]
Abstract
Background: The determination of the impact of risk factors such as smoking in periodontal disease development is of importance to better characterize the disease. However, its impact on host response remains unclear. This study aimed to evaluate the effects of tobacco smoking on GCF levels of neutrophil enzymes (myeloperoxidase (MPO), beta-glucuronidase (BGD), neutrophil elastase (NE) and periodontal parameters in healthy young adults with dental plaque biofilm-induced gingivitis. Methods: The study population consisted of 60 systemically healthy young adults (39 smokers (Sm) and 21 non-smokers (n-Sm)) diagnosed with plaque-induced gingivitis. The periodontal examination consisted of a plaque index (PI); gingival index (GI); probing depth (PD); bleeding on probing (BoP), and clinical attachment level (CAL). GCF MPO, BGD, and NE levels were determined by means of an enzyme-linked immunosorbent assay (ELISA). Results: PI, GI, and BoP were significantly increased in the Sm group (p < 0.05). PD and CAL showed no significant difference between Sm and n-Sm groups (p > 0.05). In GCF, MPO, BGD, and NE levels were significantly increased in Sm group (p < 0.05). NE levels showed a significant correlation with GI and BoP (p < 0.05 for both). Moreover, a positive correlation between BGD and NE levels (p < 0.05) was measured. Conclusions: It may be concluded that, even in young patients, tobacco consumption affects the host’s immune response related to gingival inflammation. It is, therefore, mandatory to inform young patients about the risk related to tobacco consumption for their gingival health.
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Affiliation(s)
- Rumeysa Omer-Cihangir
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
- Correspondence: (R.O.-C.); (U.B.); Tel.: +90-505-369-8644 (U.B.)
| | - Ulku Baser
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
- Correspondence: (R.O.-C.); (U.B.); Tel.: +90-505-369-8644 (U.B.)
| | - Canan Kucukgergin
- Department of Medical Biochemistry, Istanbul Faculty of Medicine, University of Istanbul, Istanbul 34093, Turkey;
| | - Gokce Aykol-Sahin
- Periodontology Department, Faculty of Dentistry, Istanbul Okan University, Istanbul 34959, Turkey;
| | - Olivier Huck
- Department of Periodontology, Dental Faculty, University of Strasbourg, 67081 Strasbourg, France;
- INSERM, UMR 1260 Osteoarticular and Dental Regenerative Nanomedicine, 67000 Strasbourg, France
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France
| | - Funda Yalcin
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
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Haque M, Akter F. Smash of diabetes mellitus on smile. ADVANCES IN HUMAN BIOLOGY 2021. [DOI: 10.4103/aihb.aihb_68_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S46-S73. [PMID: 29926936 DOI: 10.1002/jper.17-0576] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. IMPORTANCE A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. FINDINGS Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Cléverson O Silva
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Rösing CK, Gomes SC, Carvajal P, Gómez M, Costa R, Toledo A, Solanes F, Romanelli H, Gamonal J, Oppermann RV. Impact of smoking on gingival inflammation in representative samples of three South American cities. Braz Oral Res 2019; 33:e090. [PMID: 31531553 DOI: 10.1590/1807-3107bor-2019.vol33.0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/22/2019] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.
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Affiliation(s)
- Cassiano Kuchenbecker Rösing
- Federal University of Rio Grande do Sul - UFRGS, Department of Conservative Dentistry, Faculty of Dentistry, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Federal University of Rio Grande do Sul - UFRGS, Department of Conservative Dentistry, Faculty of Dentistry, Porto Alegre, RS, Brazil
| | - Paola Carvajal
- University of Chile, Faculty of Dentistry, Laboratory of Periodontal Biology, Santiago, Chile
| | - Mariel Gómez
- Maimónides University, School of Dentistry, Career of Specialist in Periodontics, Buenos Aires, Argentine
| | - Ricardo Costa
- Federal University of Rio Grande do Sul - UFRGS, Department of Conservative Dentistry, Faculty of Dentistry, Porto Alegre, RS, Brazil
| | - Andres Toledo
- Maimónides University, School of Dentistry, Career of Specialist in Periodontics, Buenos Aires, Argentine
| | - Fernando Solanes
- University of Chile, Faculty of Dentistry, Laboratory of Periodontal Biology, Santiago, Chile
| | - Hugo Romanelli
- Maimónides University, School of Dentistry, Career of Specialist in Periodontics, Buenos Aires, Argentine
| | - Jorge Gamonal
- University of Chile, Faculty of Dentistry, Laboratory of Periodontal Biology, Santiago, Chile
| | - Rui Vicente Oppermann
- Federal University of Rio Grande do Sul - UFRGS, Department of Conservative Dentistry, Faculty of Dentistry, Porto Alegre, RS, Brazil
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S44-S67. [DOI: 10.1111/jcpe.12939] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | | | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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Tarnowski M, Duda-Sobczak A, Lipski J, Zozulinska-Ziolkiewicz D, Wyganowska-Swiatkowska M. Tobacco smoking decreases clinical symptoms of gingivitis in patients with type 1 diabetes-a cross-sectional study. Oral Dis 2018; 24:1336-1342. [PMID: 29757485 DOI: 10.1111/odi.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/23/2018] [Accepted: 04/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Periodontal disease may develop on the background of microvascular complications of diabetes. However, some modifying factors, such as tobacco smoking, should be taken into consideration when assessing risk of development of chronic complications. The aim of the study was the clinical assessment of the periodontal status in patients with type 1 diabetes according to tobacco smoking. SUBJECTS AND METHODS A total of 362 subjects aged 29 (IQR 22-35) years, type 1 diabetes duration 12 (8-18) years, hemoglobin A1c, HbA1c 8.0 (7.2-9.1)% were included. We used Gingival Index, Approximal Plaque Index, and Sulcus Bleeding Index to assess periodontal health. Patients were divided into two subgroups according to current cigarette smoking. RESULTS No differences in age, diabetes duration, and chronic complications were found between subgroups. A better metabolic control of diabetes expressed by lower HbA1c (p = 0.00001) and triglyceride levels (p = 0.004) was shown in nonsmokers. Smokers presented significantly lower gingival bleeding, p = 0.009. HbA1c correlated with API in study group (Rs = 0.16; p = 0.002) and in nonsmokers subgroup (Rs = 0.2;p = 0.004), however, not in smoker's subgroup. In multivariable regression analysis, smoking cigarettes (β = -0.26; p = 0.0002), hs-CRP (β = 0.15; p = 0.03) and age (β = -0.19; p = 0.007) occurred to be independent predictors of SBI after adjustment for confounding variables (R2 = 0.13; p = 0.001). CONCLUSIONS Patients with type 1 diabetes smoking cigarettes presented lower gingival sulcus bleeding and worse metabolic control of diabetes than nonsmoking patients.
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Affiliation(s)
- Mateusz Tarnowski
- Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jakub Lipski
- Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Poznan, Poland
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Park SY, Ahn S, Lee JT, Yun PY, Lee YJ, Lee JY, Song YW, Chang YS, Lee HJ. Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions. J Periodontal Implant Sci 2017; 47:328-338. [PMID: 29093989 PMCID: PMC5663669 DOI: 10.5051/jpis.2017.47.5.328] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/26/2017] [Indexed: 12/23/2022] Open
Abstract
Purpose A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis (P. gingivalis) expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.
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Affiliation(s)
- Shin-Young Park
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Tae Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Periodontology, Dankook University Jukjeon Dental Hospital, Yongin, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun Jong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Joo Youn Lee
- Department of Molecular Medicine and Biopharmaceutical Sciences, BK21 Plus Graduate School of Convergence Science and Technology, Medical Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yeong Wook Song
- Department of Molecular Medicine and Biopharmaceutical Sciences, BK21 Plus Graduate School of Convergence Science and Technology, Medical Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon-Seok Chang
- Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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Martinez-Herrera M, Silvestre FJ, Silvestre-Rangil J, Bañuls C, Rocha M, Hernández-Mijares A. Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross-sectional study. J Clin Periodontol 2017; 44:981-988. [DOI: 10.1111/jcpe.12773] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Mayte Martinez-Herrera
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | - Francisco Javier Silvestre
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | | | - Celia Bañuls
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Institute of Health Research INCLIVA; University of Valencia; Valencia Spain
| | - Milagros Rocha
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- CIBER CB06/04/0071 Research Group; CIBER Hepatic and Digestive Diseases; University of Valencia; Valencia Spain
| | - Antonio Hernández-Mijares
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Institute of Health Research INCLIVA; University of Valencia; Valencia Spain
- Department of Medicine; University of Valencia; Valencia Spain
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13
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De Wet LM, Slot DE, Van der Weijden GA. Supportive periodontal treatment: Pocket depth changes and tooth loss. Int J Dent Hyg 2017; 16:210-218. [DOI: 10.1111/idh.12290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 12/26/2022]
Affiliation(s)
- LM De Wet
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
- Clinic for Periodontology Utrecht; Utrecht The Netherlands
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Carvajal P, Gómez M, Gomes S, Costa R, Toledo A, Solanes F, Romanelli H, Oppermann R, Rösing C, Gamonal J. Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study. J Appl Oral Sci 2016; 24:524-534. [PMID: 27812624 PMCID: PMC5083031 DOI: 10.1590/1678-775720160178] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/27/2016] [Indexed: 01/22/2023] Open
Abstract
Objectives: The aim of this study is to investigate the prevalence and severity of gingival inflammation and associated risk indicators in South American adults. Material and Methods: Multi-stage samples totaling 1,650 adults from Porto Alegre (Brazil), Tucumán (Argentina), and Santiago (Chile) were assessed. The sampling procedure consisted of a 4-stage process. Examinations were performed in mobile dental units by calibrated examiners. A multivariable logistic regression model was utilized for associating variables as indicators of gingival inflammation (GI) (Gingival Index ≥0.5). Statistical significance was set at 0.05. Results: A total of 96.5% of the adults have GI. Regarding the severity of GI, 22.5% of participants examined have mild GI, 74.0% have moderate GI, and 3.6% have severe GI. The multivariate analyses identify the main risk indicators for GI as adults with higher mean of Calculus Index (OR=18.59); with a Visible Plaque Index ≥30% (OR=14.56); living in Santiago (OR=7.17); having ≤12 years of schooling (OR=2.18), and females (OR=1.93). Conclusions: This study shows a high prevalence and severity of gingival inflammation, being the first one performed in adult populations in three cities of South America.
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Affiliation(s)
- Paola Carvajal
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
| | - Mariel Gómez
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Sabrina Gomes
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Ricardo Costa
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Andres Toledo
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Fernando Solanes
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
| | - Hugo Romanelli
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Rui Oppermann
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Cassiano Rösing
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Jorge Gamonal
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
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Alves CR, Berlt FA, Mário TDG, Sfreddo CS, Maier J, Moreira CHC. Correlations between supra- and subgingival clinical parameters in smokers and individuals who have never smoked. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.1067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Smoking is a risk factor for prevalence, severity and progression of periodontal disease and appears to suppress marginal periodontium inflammatory response. Purpose To correlate Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) in smokers and never-smokers, as well as GBI and bleeding on probing (BOP ) in these groups. Material and method We used baseline data of one quasi-experimental study in which 11 smokers and 14 subjects who never smoked were submitted to clinical periodontal examinations between September 2010 and October 2011. Result The correlation between VPI and GBI was positive for both groups, it was strong and statistically significant in subjects who had never smoked and moderate in smokers. Regarding GBI and BOP correlations were moderate for smokers and weaker for individuals who had never smoked. Conclusion Smokers have lower strength correlation between VPI and GBI compared to individuals who had never smoked resulting in a less pronounced marginal gingival bleeding.
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Visvanathan R, Mahendra J, N A, Pandisuba, Chalini. Effect of smoking on periodontal health. J Clin Diagn Res 2014; 8:ZC46-9. [PMID: 25177637 PMCID: PMC4149143 DOI: 10.7860/jcdr/2014/8359.4597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 04/16/2014] [Indexed: 11/24/2022]
Abstract
AIMS AND OBJECTIVES The aim of the study was to assess and compare the effect of smoking on mRNA expression of MMP -8 and TIMP-1 in patients with untreated chronic periodontitis and in periodontally healthy subjects and to examine the correlation of MMP-8 and TIMP-1 levels with clinical parameters. MATERIALS AND METHODS Out of 60 subjects, 40 were selected subjects for the study, and were divided into Group I (periodontitis subject) and Group II (healthy subjects). Each group was further subdivided into subgroups I-A (chronic periodontitis smokers CPS), and I-B (chronic periodontitis non-smokers CPN), subgroup II-A (healthy smokers HS) and II B (healthy non-smokers HS). Both the groups underwent periodontal examination and clinical parameters were recorded. Tissue samples from both groups were subjected to the isolation of RNA which was then followed by qRT-PCR and the expression of the mRNA levels of MMP-8 and TIMP-1 were analyzed. RESULTS The mRNA expression of MMP-8 and TIMP-1 was further compared with the periodontal status of all the four groups. The mRNA expression of MMP-8 was compared between the groups and showed that Group I-A (CPS) had higher expression of MMP-8 compared to group I-B (CPN). Group I-B (CPN) vs Group I-A (CPS) showed statistically significant difference in MMP-8/TIMP-1 with higher values for Group I-A (CPS) than Group I-B (CPN). A positive correlation was found between MMP-8 expression and probing depth and clinical attachment level (CAL) among Group I-B (CPN) and Group I-A (CPS) subjects. A significant correlation was also found between MMP-8 and TIMP-1 expression with probing depth and CAL among Group II B(HN) group subjects. TIMP-1 also showed a positive correlation with gingival index (GI) among group II A (HS) subjects. CONCLUSION It is concluded that smoking has an impact on the periodontal status and mRNA expression of MMP-8 and TIMP-1 in chronic periodontitis patients. The earlier evaluation of MMP-8 and TIMP-1, can be used as a biomarker in predicting periodontal disease susceptibility.
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Affiliation(s)
- Rahul Visvanathan
- P.G Student, Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Jaideep Mahendra
- Professor, Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Ambalavanan N
- Professor & Hod , Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Pandisuba
- Lecturer and Biotechnologist, Central Research Laboratory, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Chalini
- Research Assistant, Central Research Laboratory, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
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Farina R, Tomasi C, Trombelli L. The bleeding site: a multi-level analysis of associated factors. J Clin Periodontol 2013; 40:735-42. [DOI: 10.1111/jcpe.12118] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
| | - Cristiano Tomasi
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
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18
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Lü D, Meng H, Xu L, Lu R, Zhang L, Chen Z, Feng X, Shi D, Tian Y, Wang X. New attempts to modify periodontal risk assessment for generalized aggressive periodontitis: a retrospective study. J Periodontol 2013; 84:1536-45. [PMID: 23305112 DOI: 10.1902/jop.2013.120427] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontal risk assessment (PRA) model was designed for risk evaluation of treated patients with periodontal disease. However, its use on generalized aggressive periodontitis (GAgP) had been scarcely reported. This study aims to investigate the association of original PRA/modified PRA (MPRA) and compliance of periodontal maintenance with long-term treatment outcomes of Chinese patients with GAgP. METHODS Eighty-eight patients from a GAgP cohort, who completed active periodontal treatment (APT) and accepted reevaluation 3 to 11 years (mean of 5.5 years) afterward, were enrolled. PRA was modified (three strategies involving replacement of bleeding on probing with bleeding index >2, counting sites with probing depth ≥6 mm and changing method of bone loss [BL] calculation) to classify patients into different risk groups based on data at the first recall after APT. PRA and three MPRA models were investigated regarding long-term association with tooth loss (TL) and alteration of bone level (∆BL). RESULTS Based on original PRA, 87 patients (98.8%) had a high-risk profile. According to three MPRA models, annual TL per patient values were greater in high-risk groups than in low-to-moderate risk groups (MPRA-1, 0.20 ± 0.33 versus 0.04 ± 0.14; MPRA-2, 0.18 ± 0.32 versus 0.05 ± 0.14; MPRA-3, 0.17 ± 0.32 versus 0.05 ± 0.15; P <0.05). By MPRA-1, irregular compliers with low-to-moderate risk profile had greater ∆BL (0.027 ± 0.031, indicating bone increment) than those with high risk (-0.012 ± 0.064, tendency for BL). For regular compliers, no significant differences of annual TL or ∆BL were found between risk groups. CONCLUSIONS MPRA models could be used for evaluating the long-term outcomes of Chinese patients with severe GAgP, especially irregular compliers. High-risk patients of MPRAs exhibited more TL and less bone fill than low-to-moderate risk ones.
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Affiliation(s)
- Da Lü
- Department of Periodontology, School and Hospital of Stomatology, Peking University, Beijing, China
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Sullivan AL, Bailey JH, Stokic DS. Predictors of oral health after spinal cord injury. Spinal Cord 2013; 51:300-5. [PMID: 23295469 DOI: 10.1038/sc.2012.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To examine predictors of oral health in people with spinal cord injury (SCI). METHODS Ninety-two people with SCI (> or =6 months, 44% cervical level) completed questionnaires and underwent oral examination. Socio-economic, injury-related and oral habits variables were used for predicting oral health score (OHS); Decayed, missing and filled teeth (DMFT) score; and periodontal screen and recording index (PSR). RESULTS Most people with SCI were able to bring at least one hand to the mouth (82%) and brush teeth independently (65%). Regarding daily oral habits, 84% reported brushing teeth, 48% rinsing mouth, 14% flossing, 33% tobacco use and 13% mouthstick use. Only 32% had teeth cleaned within the past year. Oral examination revealed three decayed and eight missing teeth on average, with prominent periodontal disease (64%). Employment before SCI and more risky oral habits were significant predictors of worse OHS (P=0.005 and P=0.014, respectively) and PSR score (P=0.010 and P=0.035, respectively). Older age was the only predictor of worse DMFT score (P<0.001). CONCLUSION Oral health appears compromised in people with SCI. Identification of modifiable risk factors warrants examination whether intervention with focus on behavioral changes may improve oral health in this population.
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Affiliation(s)
- A L Sullivan
- Dental Hygiene Program, School of Health Related Professions, University of Mississippi, Jackson, MS, USA
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Abstract
INTRODUCTION Smoking is an independent risk factor for periodontal disease and tooth loss. STATE OF THE ART Smoking impairs inflammatory and immune responses to periodontal pathogens, and exerts both systemic and local effects. Periodontal disease is increased both in prevalence and severity in smokers. Smoking is a predisposing factor to acute necrotizing ulcerative gingivitis and is associated with an increased rate of periodontal disease in terms of pocket formation and attachment loss, as well as alveolar bone loss. Cigar, pipe, water-pipe and cannabis smoking have similar adverse effects on periodontal health as cigarette smoking. Passive smoking is also an independent periodontal disease risk factor. Smokeless tobacco is associated with localized periodontal disease. Smokers respond less favourably to both non-surgical and surgical treatments and have higher failure rates and complications following dental implantation. Smoking cessation may halt the disease progression and improve the outcome of periodontal treatment. CONCLUSION Smoking cessation counselling should be an integral part of periodontal therapy and prevention.
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Affiliation(s)
- M Underner
- Unité de Tabacologie, Service de Pneumologie, Pavillon René Beauchant, CHU la Milétrie, BP 577, 86021 Poitiers cedex.
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Ghallab N, Shaker O. Salivary-Soluble CD44 Levels in Smokers and Non-Smokers With Chronic Periodontitis: A Pilot Study. J Periodontol 2010; 81:710-7. [DOI: 10.1902/jop.2010.090630] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hanes PJ, Krishna R. Characteristics of inflammation common to both diabetes and periodontitis: are predictive diagnosis and targeted preventive measures possible? EPMA J 2010; 1:101-16. [PMID: 23199045 PMCID: PMC3405308 DOI: 10.1007/s13167-010-0016-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 01/24/2010] [Indexed: 11/21/2022]
Abstract
Diabetes and periodontitis are chronic inflammatory disorders that contribute to each others' severity and worsen each others' prognosis. Studies have shown that patients with diabetes are at increased risk of developing periodontitis, and that diabetics with untreated periodontitis have more difficulty controlling serum glucose. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Periodontitis is accompanied by gingival bleeding and the production of an inflammatory exudate termed gingival crevicular fluid (GCF) that arises from the inflamed gingival tissues surrounding the teeth. GCF contains byproducts of connective tissue degradation, enzymes from host and bacterial cells, cytokines and other inflammatory mediators, and has been studied for screening blood glucose and for biomarkers of both diabetes and periodontitis. This review focuses on the inter-relationship between diabetes and periodontitis and the biomarkers common to both these diseases that may enable earlier detection, targeted preventive measures and individualized therapeutic intervention of these chronic conditions.
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Affiliation(s)
- Philip J. Hanes
- Department of Periodontics, Medical College of Georgia School of Dentistry, Augusta, GA 30912 USA
| | - Ranjitha Krishna
- Department of Periodontics, Medical College of Georgia School of Dentistry, Augusta, GA 30912 USA
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Immunoglobulin G (IgG) class, but Not IgA or IgM, antibodies to peptides of the Porphyromonas gingivalis chaperone HtpG predict health in subjects with periodontitis by a fluorescence enzyme-linked immunosorbent assay. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2009; 16:1766-73. [PMID: 19793900 DOI: 10.1128/cvi.00272-09] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Chaperones are molecules found in all cells and are critical in stabilization of synthesized proteins, in repair/removal of defective proteins, and as immunodominant antigens in innate and adaptive immunity. Subjects with gingivitis colonized by the oral pathogen Porphyromonas gingivalis previously demonstrated levels of anti-human chaperone Hsp90 that were highest in individuals with the best oral health. We hypothesized that similar antibodies to pathogen chaperones might be protective in periodontitis. This study examined the relationship between antibodies to P. gingivalis HtpG and clinical statuses of healthy and periodontitis-susceptible subjects. We measured the humoral responses (immunoglobulin G [IgG], IgA, and IgM) to peptides of a unique insert (P18) found in Bacteroidaceae HtpG by using a high-throughput, quantitative fluorescence enzyme-linked immunosorbent assay. Indeed, higher levels of IgG class anti-P. gingivalis HtpG P18 peptide (P < 0.05) and P18alpha, consisting of the N-terminal 16 amino acids of P18 (P < 0.05), were associated with better oral health; these results were opposite of those found with anti-P. gingivalis whole-cell antibodies and levels of the bacterium in the subgingival biofilm. When we examined the same sera for IgA and IgM class antibodies, we found no significant relationship to subject clinical status. The relationship between anti-P18 levels and clinical populations and individual subjects was found to be improved when we normalized the anti-P18alpha values to those for anti-P18gamma (the central 16 amino acids of P18). That same ratio correlated with the improvement in tissue attachment gain after treatment (P < 0.05). We suggest that anti-P. gingivalis HtpG P18alpha antibodies are protective in periodontal disease and may have prognostic value for guidance of individual patient treatment.
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Ayo-Yusuf OA, Reddy PS, van den Borne BW. Adolescents' sense of coherence and smoking as longitudinal predictors of self-reported gingivitis. J Clin Periodontol 2008; 35:931-7. [DOI: 10.1111/j.1600-051x.2008.01319.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosa GM, Lucas GQ, Lucas ON. Cigarette Smoking and Alveolar Bone in Young Adults: A Study Using Digitized Radiographs. J Periodontol 2008; 79:232-44. [DOI: 10.1902/jop.2008.060522] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gomes SC, Piccinin FB, Susin C, Oppermann RV, Marcantonio RAC. Effect of Supragingival Plaque Control in Smokers and Never-Smokers: 6-Month Evaluation of Patients With Periodontitis. J Periodontol 2007; 78:1515-21. [PMID: 17668970 DOI: 10.1902/jop.2007.060462] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The effect of supragingival plaque control on clinical signs of periodontitis is controversial, particularly when smoking habits are considered. This study evaluated the clinical effects of supragingival plaque control on clinical signs of periodontitis in smokers and never-smokers. METHODS The following data were collected for 25 never-smokers and 25 smokers at baseline and 30, 90, and 180 days: visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment loss (CAL). After baseline examinations, supragingival scaling was performed. Oral hygiene practices were reinforced and reevaluated weekly during the experimental period. Linear models adjusted for clustering of observations within individuals were used for statistical analysis. RESULTS Reductions in VPI were significant for both groups, with no intergroup differences. GBI at baseline was similar between groups, and at 30, 90, and 180 days, smokers had a lower GBI than never-smokers. Significant reductions were observed in PD for shallow (1 to 3 mm), moderate (4 to 5 mm), and deep sites (> or = 6 mm) in both groups. CAL was significantly greater in smokers throughout the study, but gains in attachment were similar for both groups (0.71 to 1.00 mm). BOP reductions were similar in both groups. CONCLUSIONS Supragingival plaque control resulted in significant changes in clinical parameters associated with gingivitis and periodontitis. Smoking did not affect results, regardless of initial PD.
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Guiglia R, Di Liberto C, Pizzo G, Picone L, Lo Muzio L, Gallo PD, Campisi G, D'Angelo M. A combined treatment regimen for desquamative gingivitis in patients with oral lichen planus. J Oral Pathol Med 2007; 36:110-6. [PMID: 17238974 DOI: 10.1111/j.1600-0714.2007.00478.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic desquamative gingivitis (DG) is a condition characterized by erythema, ulceration, and desquamation of the free and attached gingiva, usually expression of a district-systemic disease, such as oral lichen planus (OLP). METHODS A combined protocol of oral hygiene and topic corticosteroid therapy was applied in 30 patients with DG associated with OLP. Plaque index (PI) and bleeding on probing (BoP) were evaluated at baseline and after 3 months. RESULTS PI scoring was significantly lower after treatment in anterior, posterior, and all sites (P < 0.0001) as well as in vestibular and lingual ones (P < 0.0001 and P = 0.0001, respectively). BoP measures were found to be reduced significantly to 22.94% in a full-mouth evaluation (P < 0.0001; OR = 2.633; 95% CI: 2.2685-3.0561) as well as in each specific site (P < 0.0001). CONCLUSION This clinical trial validated the efficacy, in patients with DG associated with OLP, of a protocol based on professional oral hygiene and self-performed plaque control measures in improving of gingival health status.
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Affiliation(s)
- R Guiglia
- Department of Oral Sciences, Section of Periodontology, University of Palermo, Palermo, Italy
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Müller HP, Barrieshi-Nusair KM, Könönen E, Yang M. Effect of triclosan/copolymer-containing toothpaste on the association between plaque and gingival bleeding: a randomized controlled clinical trial. J Clin Periodontol 2006; 33:811-8. [PMID: 16965523 DOI: 10.1111/j.1600-051x.2006.00993.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To study longitudinal associations between plaque and gingival bleeding and multilevel variance/covariance structures after introducing triclosan-containing toothpaste. MATERIAL AND METHODS A 10-week, randomized, two-arm, double-masked, controlled clinical trial was conducted in 34 healthy, non-smoking females with plaque-induced gingivitis. Clinical periodontal examinations were repeated every other week. At week 4, test toothpaste containing 0.24% sodium monofluorophosphate, 0.3% triclosan, and 2% polyvinyl-methyl ether maleic acid; or control toothpaste containing 0.76% sodium monofluorophosphate and 0.1% sodium fluoride, were randomly distributed. RESULTS Multivariate multilevel models indicated that, after introducing experimental toothpastes, subject random error was reduced from 0.6 to below 0.2. The odds ratio (OR) of bleeding on probing (BOP) was about 30% less in the test than in the control group (p<0.01). At the end of the experiment, ORs for BOP and plaque index scores 1-3 (reference 0) were 2.1-2.4 in the control group, but 1.1-1.9 in the test group (p<0.05). No effects on plaque levels and calculus were observed. CONCLUSIONS Multivariate multilevel modelling allows the study of fixed and random effects of experimental toothpastes on gingival inflammation in small sample. Triclosan appears to attenuate the causal association between supragingival plaque and gingival bleeding in gingivitis.
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Affiliation(s)
- H P Müller
- Faculty of Dentistry, Kuwait University, Kuwait.
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Gomes SC, Piccinin FB, Oppermann RV, Susin C, Nonnenmacher CI, Mutters R, Marcantonio RAC. Periodontal Status in Smokers and Never-Smokers: Clinical Findings and Real-Time Polymerase Chain Reaction Quantification of Putative Periodontal Pathogens. J Periodontol 2006; 77:1483-90. [PMID: 16945023 DOI: 10.1902/jop.2006.060026] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smoking is a well-known risk factor for destructive periodontal disease, but its relationship with periodontal status and subgingival microbiota remains unclear. Inherent limitations of microbiological methods previously used may partly explain these mixed results, and real-time polymerase chain reaction (PCR) has been presented as a valid alternative. The aim of the present study was to investigate the clinical condition and microbiological profile of patients with chronic periodontitis as related to the habit of smoking. METHODS Fifty patients (33 to 59 years old), 25 smokers and 25 never-smokers, constituted the sample. The visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PD), clinical attachment loss (CAL), and gingival crevicular fluid (GCF) volume were recorded. Real-time PCR quantified Porphyromonas gingivalis, Micromonas micros, Dialister pneumosintes, Actinobacillus actinomycetemcomitans and total bacteria in subgingival samples. RESULTS Smokers and never-smokers showed similar values for VPI, GBI, and BOP. Smokers had deeper PD in buccal/lingual sites and higher CAL independently of the tooth surface. The GCF volume was smaller in smokers, independent of the PD. Similar amounts of total bacteria and P. gingivalis were observed for both groups. Significantly higher numbers of D. pneumosintes and M. micros were present in smokers and associated with moderate and deep pockets. When heavy smokers were considered, higher counts of total bacteria, M. micros, and D. pneumosintes were observed. CONCLUSIONS Smoking seems to have a detrimental impact on the periodontal status and microbiological profile of patients with periodontitis. Compared to never-smokers, smokers had deeper pockets, greater periodontal destruction, and higher counts of some putative periodontal pathogens.
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Affiliation(s)
- Sabrina C Gomes
- Department of Periodontology, São Paulo State University, Araraquara, São Paulo, Brazil
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Müller HP, Stadermann S. Multivariate multilevel models for repeated measures in the study of smoking effects on the association between plaque and gingival bleeding. Clin Oral Investig 2006; 10:311-6. [PMID: 16896834 DOI: 10.1007/s00784-006-0067-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 06/30/2006] [Indexed: 01/17/2023]
Abstract
Multivariate multilevel modeling was applied to analyze repeated measures data on the influence of heavy smoking on the association between the amount of supragingival plaque and gingival bleeding on probing (BOP) in a steady-state plaque environment. Data acquired in 65 systemically healthy young adults with mild plaque-induced gingivitis were analyzed. 33 heavy smokers consumed at least 20 cigarettes per day while 32 were non-smokers. Periodontal examinations at the outset consisted of periodontal probing depth, clinical attachment level, BOP, plaque index, and presence of calculus at 6 sites of every tooth present. They were repeated 3 times every 8 weeks. A multivariate 4-level variance component model revealed that the odds of BOP was twice as high in smokers. In addition, females had a lower likelihood for BOP but, with increasing bleeding scores during the course of the study, this effect attenuated. Low biserial correlations for BOP at the site level of between 0.11 and 0.2 were found. At the tooth level, correlations were moderate (0.2-0.5), and highest at the subject level (0.8-0.9). Variations at subject and tooth levels were very large at the outset but notably attenuated in the course of the study. Plaque consistently influenced the tendency for BOP with an odds ratio of about 1.7-1.8 for each increase in score in both smokers and non-smokers. The present study did not reveal evidence for attenuation of the plaque/gingival bleeding relationship in heavy smokers.
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Affiliation(s)
- H P Müller
- Faculty of Dentistry, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait.
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32
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Van der Velden U, Abbas F, Armand S, Loos BG, Timmerman MF, Van der Weijden GA, Van Winkelhoff AJ, Winkel EG. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants. J Clin Periodontol 2006; 33:540-8. [PMID: 16899096 DOI: 10.1111/j.1600-051x.2006.00953.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. MATERIAL AND METHODS For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were selected. Baseline examination was carried out in 1987 and follow-up examinations in 1994 and 2002. In 2002, 128 subjects could be retrieved from the original group of 255. Baseline examination included evaluation of plaque, bleeding on probing, calculus, pocket depth, attachment loss and presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, spirochetes and motile microorganisms. RESULTS The mean attachment loss increased from 0.33 mm in 1987 to 0.72 mm in 1994 and 1.97 mm in 2002. Analysis identified the amount of subgingival calculus and subgingival presence of A. actinomycetemcomitans as risk factors, and age as a risk determinant, for the onset of disease. Regarding disease progression, the number of sites with a probing depth > or = 5 mm and the number of sites with recession were identified as risk predictors and male gender as a risk determinant. CONCLUSION Screening of these parameters early in life could be helpful in the prevention of onset and progression of periodontal diseases.
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Affiliation(s)
- U Van der Velden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Abstract
OBJECTIVES Distinct periodontal phenotypes have been identified by cluster analysis, which is an explorative method with very low external validity. The aim of the present study was to investigate variance components of facial gingival thickness in young adults with mild gingivitis. MATERIAL AND METHODS Thirty-three non-smoking females, 18-23 years of age, with mild or moderate plaque-induced gingivitis participated. Gingival thickness was measured at every tooth present by use of ultrasound technology to the next 0.1 mm with a lowest measurement of 0.5 mm. Periodontal probing depth and clinical attachment level were measured with a pressure-controlled probe. Gingival bleeding index was assessed after probing on a 0-2 scale, where 1 was slight, and 2 was profuse bleeding on probing. The Silness-Loe plaque index was recorded. Multilevel variance components and random intercept models were built. RESULTS A 2-level (subject, tooth) variance component model of gingival thickness without any explanatory variable revealed an intercept (mean) of 0.93 +/- 0.02 mm. Subject variation of gingival thickness amounted to 4.2% of the total variance. Addition of tooth- and subject-related covariates to the model revealed, after adjusting for tooth type, an association with periodontal probing depth (estimated coefficient 0.067 +/- 0.025), and considerable association with average bleeding index (-0.395 +/- 0.149) and plaque index (0.125 +/- 0.048). Variation at the tooth level was drastically reduced; subject variation amounted to 5.2%. CONCLUSION Gingival thickness is mainly associated with tooth-related variables. Bleeding tendency is higher if gingiva is thin. Subject variability related to periodontal phenotype may add to the total variance, however, to a very low extent.
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Affiliation(s)
- H P Müller
- Faculty of Dentistry, Kuwait University, Safat, Kuwait.
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Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries Prevalence Measured with QLF after Treatment with Fixed Orthodontic Appliances: Influencing Factors. Caries Res 2004; 39:41-7. [PMID: 15591733 DOI: 10.1159/000081655] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2003] [Accepted: 03/26/2004] [Indexed: 11/19/2022] Open
Abstract
Caries prevalence on the buccal surfaces of teeth in orthodontic patients was determined with QLF and visual examination immediately after removal of fixed appliances. The number of lesions found by QLF far outnumbered that found by visual examination, but the distribution pattern was similar. 97% of all subjects and on average 30% of the buccal surfaces in a person were affected. On average, in males 40% of surfaces and in females 22% showed white spots (p < 0.01). Caries prevalence was lower (p < 0.01) in incisors and cuspids than in molars and premolars. A positive correlation with caries prevalence was found for the bleeding scores 6 weeks after debonding and lactobacillus counts before debonding. Mutans streptococci counts, age, treatment duration, socioeconomic status and dietary habits showed no correlation with caries prevalence.
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Affiliation(s)
- J G Boersma
- Department of Orthodontics, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Boschin F, Boutigny H, Delcourt-Debruyne E. Maladies gingivales induites par la plaque. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.emcden.2004.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
This paper reviews the evidence for cigarette smoking as a risk factor for the development of severe destructive periodontal disease in young adults. A high prevalence of cigarette smoking has been identified among young individuals with aggressive periodontitis and tobacco usage increases the risk of periodontal destruction most significantly in young populations. The effect appears to be dose related and is independent of levels of plaque accumulation. Young smokers have more alveolar bone loss and attachment loss than non smoking equivalents. Prolonged and heavy smoking can reduce gingival bleeding and therefore mask the clinical marker of bleeding on probing often used by dentists to monitor periodontal health. This has implications for potential misdiagnosis and failure to detect periodontitis at an early stage. Nicotine metabolites concentrate in the periodontal tissues and can have local effects as well as the potential to affect the systemic host response. Dentists are well placed to assess the smoking status of their young patients and have a role to play in the delivery of smoking cessation advice especially as it pertains to periodontal health. In this way the dental profession can also make a significant contribution to the general health and well being of our youth and future generations.
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Affiliation(s)
- Brian H Mullally
- Division of Restorative Dentistry (Periodontics), School of Clinical Dentistry, Queen's University of Belfast, Northern Ireland.
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Tatakis DN, Trombelli L. Modulation of clinical expression of plaque-induced gingivitis. I. Background review and rationale. J Clin Periodontol 2004; 31:229-38. [PMID: 15016250 DOI: 10.1111/j.1600-051x.2004.00477.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this article is to provide the necessary background and rationale for the accompanying studies, which are ultimately aimed at identifying genetic and environmental factors determining gingivitis susceptibility. MATERIALS AND METHODS The literature on factors reported to modify the clinical expression of gingivitis, i.e., factors that determine individual variability in gingival inflammatory response to plaque, is presented. RESULTS Clinical evidence suggests that the gingival inflammatory response to plaque accumulation may differ substantially among individuals. However, most of the available studies are of small scale and not purposely designed to address the issue. Systemic factors implicated in modulation of the clinical expression of gingivitis include metabolic, genetic, environmental and other factors. The significance of such factors in designing and conducting a large-scale experimental gingivitis trial and means to account for them are discussed. CONCLUSION Although several factors have been implicated, genetic or environmental factors underlying differences in gingivitis expression are not fully elucidated. The accompanying studies aim to identify and characterize, among participants in a specifically designed large-scale experimental gingivitis trial, subjects that differ significantly in their gingival inflammatory response to plaque. This is the first step in an effort to determine genetic or environmental factors underlying such differences.
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Affiliation(s)
- Dimitris N Tatakis
- Section of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH 43218-2357, USA.
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Abstract
BACKGROUND The purpose of this study was to investigate the dose-dependent effect of cigarette smoking upon gingival bleeding on probing (BOP) in a large representative sample of the United States population (National Health and Nutrition Examination Survey III). METHODS Weighted multiple logistic regression was used to model bleeding on probing of 141,967 mesio-buccal sites in 12,385 individuals with complete case records on all covariates. Adjustments were made for age, gender, race/ethnicity, number of missing teeth, tooth type/jaw, root caries, full crown coverage, socioeconomic status (poverty/income ratio), and survey characteristics. The model stratified by presence of calculus (CALC) and increased probing depth (PD > or = 4 mm). Generalized estimating equations were used to account for dependence of sites within subjects. RESULTS Smoking had a strong suppressive effect on gingival bleeding. The effect was strongest in heavier smokers (> 10 cigarettes/day) and smallest in former smokers. In healthy sites (no CALC, PD < or = 3 mm), the odds ratio (OR) of bleeding for sites in heavier smokers compared to never-smokers was 0.56 (95% CI: 0.45-0.70). Sites with CALC and/or PD > or = 4 mm were more likely to bleed in never-smokers (OR: 5.7; 95% CI: 4.3-7.6). This relationship was less evident among heavier smokers (OR: 1.3; 95% CI: 0.8-1.9). The effect of smoking did not differ between maxillary and mandibular molars, premolars, or incisors. CONCLUSION Smoking exerts a strong, chronic, and dose-dependent suppressive effect on gingival bleeding on probing.
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Affiliation(s)
- Thomas Dietrich
- Department of Periodontology, Charité, Humboldt University, Berlin, Germany.
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Müller HP, Stadermann S, Heinecke A. Gingival recession in smokers and non-smokers with minimal periodontal disease. J Clin Periodontol 2002; 29:129-36. [PMID: 11895540 DOI: 10.1034/j.1600-051x.2002.290207.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS Smoking is a major risk factor for destructive periodontal disease. There is limited information with regard to effects of smoking in subjects with minimal periodontal destruction. The aim of the present investigation was to assess the development of gingival recession in young adult smokers and non-smokers. METHODS 61 systemically healthy young adults, 19 to 30 years of age completed the final examination. 30 volunteers smoked at least 20 cigarettes per day, whereas 31 subjects were non-smokers. Clinical periodontal conditions were assessed 4x within a time period of 6 months. Site-specific analyses considering the correlated structure of data were performed. RESULTS At the outset, 50% of subjects presented with gingival recession at 1 or more sites. There was no significant difference in the prevalence of gingival recession between non-smokers and smokers. Severe recession in excess of 2 mm affected about 23% non-smokers but only 7% smokers. Some further gingival recession developed during the 6-month observation period. In a multivariate logistic regression analysis, the risk for recession development appeared not to be influenced by smoking status after adjusting for periodontal probing depth, recession at baseline, tooth brushing frequency, gender, jaw, tooth type and site. CONCLUSIONS Present data did not support the hypothesis that smokers are at an increased risk for the development of gingival recession.
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Affiliation(s)
- Hans-Peter Müller
- School of Dental Medicine, University of Heidelberg, Heidelberg, Germany.
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