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Madhuri M, Kulkarni S, Doshi D, Reddy S, Adepu S, Reddy S. Oral health status and self- assessment of oral health risk factors among South Indian diabetic patients. Indian J Dent Res 2021; 32:140-146. [PMID: 34810379 DOI: 10.4103/ijdr.ijdr_508_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The disease profile of the world is changing at an astonishingly fast rate. It is essential that the impending nature of chronic disease is recognized and acted on urgently. India leads the world with the largest number of diabetics earning the dubious distinction of being termed the "diabetic capital" of the world. Aim To assess and compare the oral health status and related oral health risk factors among diabetic patients in Hyderabad and Secunderabad. Settings A cross sectional study was carried out in various diagnostic centers among 801 patients aged 30 years and above. Methods and Materials Oral health status and self-assessed data on related oral risk factors were measured using modified World Health Organization (WHO) assessment form and oral health questionnaire for adults 2013. Statistical Analysis Comparison of mean scores of the variables based on gender was assessed using ANOVA. Statistical significance was set at p < 0.05. Results Females had higher proportion of untreated caries (362; 85%) and DMFT (Decayed, Missing and Filled Teeth; 375; 88%) compared to males. On the basis of loss of attachment, the mean number of sextants with no loss of attachment was mostly noted among female subjects. Conclusion In the present study, though gingivitis was seen in higher percentage (82%), the presence of periodontal disease was relatively low (68.3%). It can be concluded that diabetic subjects may have poor oral health.
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Affiliation(s)
- Mukkavilli Madhuri
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Suhas Kulkarni
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Dolar Doshi
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Srikanth Reddy
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Srilatha Adepu
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Sahithi Reddy
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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Sochaj-Gregorczyk A, Ksiazek M, Waligorska I, Straczek A, Benedyk M, Mizgalska D, Thøgersen IB, Enghild JJ, Potempa J. Plasmin inhibition by bacterial serpin: Implications in gum disease. FASEB J 2019; 34:619-630. [PMID: 31914706 DOI: 10.1096/fj.201901490rr] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022]
Abstract
Tannerella forsythia is a periodontopathogen that expresses miropin, a protease inhibitor in the serpin superfamily. In this study, we show that miropin is also a specific and efficient inhibitor of plasmin; thus, it represents the first proteinaceous plasmin inhibitor of prokaryotic origin described to date. Miropin inhibits plasmin through the formation of a stable covalent complex triggered by cleavage of the Lys368-Thr369 (P2-P1) reactive site bond with a stoichiometry of inhibition of 3.8 and an association rate constant (kass) of 3.3 × 105 M-1s-1. The inhibition of the fibrinolytic activity of plasmin was nearly as effective as that exerted by α2-antiplasmin. Miropin also acted in vivo by reducing blood loss in a mice tail bleeding assay. Importantly, intact T. forsythia cells or outer membrane vesicles, both of which carry surface-associated miropin, strongly inhibited plasmin. In intact bacterial cells, the antiplasmin activity of miropin protects envelope proteins from plasmin-mediated degradation. In summary, in the environment of periodontal pockets, which are bathed in gingival crevicular fluid consisting of 70% of blood plasma, an abundance of T. forsythia in the bacterial biofilm can cause local inhibition of fibrinolysis, which could have possible deleterious effects on the tooth-supporting structures of the periodontium.
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Affiliation(s)
| | - Miroslaw Ksiazek
- Malopolska Center of Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Irena Waligorska
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Anna Straczek
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Malgorzata Benedyk
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Danuta Mizgalska
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Ida B Thøgersen
- Interdisciplinary Nanoscience Center (iNANO), Department of Molecular Biology, Aarhus University, Aarhus, Denmark
| | - Jan J Enghild
- Interdisciplinary Nanoscience Center (iNANO), Department of Molecular Biology, Aarhus University, Aarhus, Denmark
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, USA
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Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
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4
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Chatzopoulos GS, Tsalikis L. Periodontal treatment needs and systemic diseases in an older population in Greece. J Clin Exp Dent 2016; 8:e32-7. [PMID: 26855703 PMCID: PMC4739365 DOI: 10.4317/jced.52763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/02/2015] [Indexed: 11/22/2022] Open
Abstract
Background To evaluate the relationship between systemic diseases, body mass index and periodontal treatment needs in an older population in Greece. Material and Methods A total of 262 older people were clinically examined about their periodontal status and medical histories were recorded using a health history questionnaire. Additionally, weight and height measurements as well as demographic data were obtained from the participants in the study. Results Older people exhibited mean age of 63.98 years, weight of 78.76 kg and height of 1.64 m. The mean CPITN score was 2.84. 31.7% of the study population were smokers and 53.8% females. No statistically significant difference was observed in seniors between periodontal treatment needs and systemic diseases. Females exhibited statistically significant more often osteoporosis, thyroid disorders (p<0.001) and hypercholesterolemia (p=0.014) than males. High CPTIN scores were not associated with higher levels of BMI. Conclusions Within the limitation of this study, older adults’ periodontal treatment needs are not associated significantly with a great number of systemic diseases and body mass index. Key words:Seniors, periodontitis, systemic diseases, body mass index (BMI), smoking, Greece.
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Affiliation(s)
- Georgios S Chatzopoulos
- DDS, Resident Advanced Education Program in Periodontology, School of Dentistry, University of Minnesota, USA
| | - Lazaros Tsalikis
- DDS, Dr med dent, Associate Professor, Department of Preventive Dentistry, Periodontology and Implant biology, School of Dentistry, Aristotle University of Thessaloniki, Greece
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Knight ET, Leichter JW, Tawse-Smith A, Thomson WM. Quantifying the Association Between Self-Reported Diabetes and Periodontitis in the New Zealand Population. J Periodontol 2015; 86:945-54. [DOI: 10.1902/jop.2015.150048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ramesh A, Soroushian S, Ganguly R. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs. Imaging Sci Dent 2013; 43:235-43. [PMID: 24380062 PMCID: PMC3873311 DOI: 10.5624/isd.2013.43.4.235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 07/27/2013] [Accepted: 08/10/2013] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. MATERIALS AND METHODS One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. RESULTS There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. CONCLUSION This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.
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Affiliation(s)
- Aruna Ramesh
- Division of Oral and Maxillofacial Radiology, Department of Diagnosis and Health Promotion, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Sheila Soroushian
- Department of Orthodontics, Howard University College of Dentistry, Washington, DC, USA
| | - Rumpa Ganguly
- Division of Oral and Maxillofacial Radiology, Department of Diagnosis and Health Promotion, Tufts University School of Dental Medicine, Boston, MA, USA
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Análisis de MMPs en fluidos orales en el diagnóstico complementario de las enfermedades periodontales. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s0718-5391(12)70111-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Silva JA, Ferrucci DL, Peroni LA, Abrahão PG, Salamene AF, Rossa-Junior C, Carvalho HF, Stach-Machado DR. Sequential IL-23 and IL-17 and increasedMmp8andMmp14expression characterize the progression of an experimental model of periodontal disease in type 1 diabetes. J Cell Physiol 2012; 227:2441-50. [DOI: 10.1002/jcp.22979] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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9
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Silva JAF, Lopes Ferrucci D, Peroni LA, de Paula Ishi E, Rossa-Junior C, Carvalho HF, Stach-Machado DR. Periodontal disease-associated compensatory expression of osteoprotegerin is lost in type 1 diabetes mellitus and correlates with alveolar bone destruction by regulating osteoclastogenesis. Cells Tissues Organs 2012; 196:137-50. [PMID: 22301390 DOI: 10.1159/000330879] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2011] [Indexed: 12/21/2022] Open
Abstract
Alveolar bone resorption results from the inflammatory response to periodontal pathogens. Systemic diseases that affect the host response, such as type 1 diabetes mellitus (DM1), can potentiate the severity of periodontal disease (PD) and accelerate bone resorption. However, the biological mechanisms by which DM1 modulates PD are not fully understood. The aim of this study was to determine the influence of DM1 on alveolar bone resorption and to evaluate the role of receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin (OPG) in osteoclastogenesis in rats. PD was induced by means of ligature in nondiabetic and in streptozotocyn-induced DM1 rats. Morphological and morphometric analyses, stereology and osteoclast counting were performed. RANKL and OPG mRNA levels, protein content, and location were determined. PD caused alveolar bone resorption, increased the number of osteoclasts in the alveolar bone crest and also promoted changes in RANKL/OPG mRNA expression. DM1 alone showed alveolar bone destruction and an increased number of osteoclasts at the periapical and furcal regions. DM1 exacerbated these characteristics, with a greater impact on bone structure, resulting in a low OPG content and a higher RANKL/OPG ratio, which correlated with prominent osteoclastogenesis. This work demonstrates that the effects of PD and DM1 enhance bone destruction, confirms the importance of the RANKL signaling pathway in bone destruction in DM1 in animal models and suggests the existence of alternative mechanisms potentiating bone degradation in PD.
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Affiliation(s)
- Juliete Aparecida F Silva
- Department of Anatomy, Cell Biology, Physiology and Biophysics, State University of Campinas, Campinas, Brazil
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Kardeşler L, Bıyıkoğlu B, Çetinkalp Ş, Pitkala M, Sorsa T, Buduneli N. Crevicular fluid matrix metalloproteinase-8, -13, and TIMP-1 levels in type 2 diabetics. Oral Dis 2010; 16:476-81. [DOI: 10.1111/j.1601-0825.2010.01659.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Kesić L, Petrović D, Obradović R, Gasić J, Todorović K. [Diabetes mellitus and periodontal disease]. MEDICINSKI PREGLED 2009; 62:534-538. [PMID: 20491379 DOI: 10.2298/mpns0912534k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION This review highlights the relations between diabetes mellitus and periodontal disease, as well as the pathogenic mechanisms which are still the subject of investigations. The possible pathogenic mechanisms important for developing periodontal disease in the diabetics are: vascular gingival changes, the disorders in the metabolism of the collagen, disorders in the function of the polimorphonuclear leukocytes and specific microbial flora in the parodontal pockets. CONCLUSION It is clear that adequate early recognition and good treatment are very important and significant for treatment of diabetic periodontal disease.
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Affiliation(s)
- Ljiljana Kesić
- Odeljenje za oralnu medicinu i parodontologiju, Medicinski fakultet, Klinika za stomatologiju, Nis
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12
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Hugoson A, Norderyd O. Has the prevalence of periodontitis changed during the last 30 years? J Clin Periodontol 2009; 35:338-45. [PMID: 18724861 DOI: 10.1111/j.1600-051x.2008.01279.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIM This paper reviews global trends in the change in prevalence of periodontitis over the last 30 years. MATERIAL AND METHODS The epidemiology of periodontal disease is briefly reviewed together with the current classification system and the clinical and radiographic diagnostic methodology in periodontal disease. RESULTS This review identifies the very limited number of studies that provide prevalence data over time, and this data is discussed in comparison with those stemming from a few corresponding studies from countries outside Europe. CONCLUSIONS The data indicate a possible trend of a lower prevalence of periodontitis in recent years.
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Affiliation(s)
- Anders Hugoson
- School of Health Science, Jönköping University, Jönköping, Sweden.
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13
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Persson GR, Persson RE. Cardiovascular disease and periodontitis: an update on the associations and risk. J Clin Periodontol 2009; 35:362-79. [PMID: 18724863 DOI: 10.1111/j.1600-051x.2008.01281.x] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Associations between periodontitis and cardiovascular diseases have been recognized. MATERIAL AND METHODS New literature since the last European Workshop on Periodontology has been reviewed. RESULTS The lack of reliable epidemiological data on disease prevalence makes an assessment of the associations and risks between periodontitis and cardiovascular diseases difficult. Two recent meta-analysis reports have identified associations between periodontitis and cardiovascular diseases (odds ratios: 1.1-2.2). Different surrogate markers for both disease entities, including serum biomarkers, have been investigated. Brachial artery flow-mediated dilatation, and carotid intima media thickness have in some studies been linked to periodontitis. Studies are needed to confirm early results of improvements of such surrogate markers following periodontal therapy. While intensive periodontal therapy may enhance inflammatory responses and impair vascular functions, studies are needed to assess the outcome of periodontal therapies in subjects with confirmed cardiovascular conditions. Tooth eradication may also reduce the systemic inflammatory burden of individuals with severe periodontitis. The role of confounders remain unclear. CONCLUSIONS Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case-control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.
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Hugoson A, Sjödin B, Norderyd O. Trends over 30 years, 1973–2003, in the prevalence and severity of periodontal disease. J Clin Periodontol 2008; 35:405-14. [PMID: 18433384 DOI: 10.1111/j.1600-051x.2008.01225.x] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anders Hugoson
- Department of Natural Science and Biomedicine, School of Health Science, Jönköping University, Jönköping, Sweden.
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15
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Kardeşler L, Buduneli N, Biyikoğlu B, Cetinkalp S, Kütükçüler N. Gingival crevicular fluid PGE2, IL-1beta, t-PA, PAI-2 levels in type 2 diabetes and relationship with periodontal disease. Clin Biochem 2008; 41:863-8. [PMID: 18472001 DOI: 10.1016/j.clinbiochem.2008.04.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 04/10/2008] [Accepted: 04/20/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate if type 2 diabetes mellitus increase gingival crevicular fluid (GCF) levels of prostaglandin E(2) (PGE(2)), interleukin-1beta (IL-1beta), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-2 (PAI-2). DESIGN AND METHODS Seventeen type 2 diabetic patients with periodontal disease (DM), 17 otherwise healthy periodontally diseased patients (PD) and 17 systemically and periodontally healthy control subjects (H) were enrolled. Clinical periodontal measurements were recorded at six sites/tooth. GCF samples were analyzed by ELISA. Data were tested by statistical tests. RESULTS DM group revealed lower IL-1beta levels than PD group (p<0.01). PGE(2), t-PA and PAI-2 levels were similar in DM and PD groups (p>0.05). PGE(2), t-PA levels were higher in DM and PD groups than H group (p<0.05). PAI-2 level was higher in DM group than H group (p<0.05). GCF total amount of PGE(2) in DM group exhibited significant correlations with all clinical periodontal measurements (p<0.05). CONCLUSION Type 2 diabetes in this study seems not to increase GCF levels of the evaluated inflammatory mediators.
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Affiliation(s)
- Levent Kardeşler
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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16
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Silva JAF, Lorencini M, Reis JRR, Carvalho HF, Cagnon VHA, Stach-Machado DR. The influence of type I diabetes mellitus in periodontal disease induced changes of the gingival epithelium and connective tissue. Tissue Cell 2008; 40:283-92. [PMID: 18439638 DOI: 10.1016/j.tice.2008.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 01/29/2008] [Accepted: 02/13/2008] [Indexed: 02/09/2023]
Abstract
Periodontal disease constitutes the most frequent chronic diseases in human dentition. Bacterial plaque is the main etiologic agent, although it is the host immune response that causes periodontal tissue destruction. Diabetes is considered an important risk factor, not only for the onset but also for progression of the disease. The aim of this study was to analyze structural changes in the rat gingival epithelium and connective tissue in response to the experimental periodontal disease induced by the ligature technique, under the influence of diabetes. The results showed that experimental periodontal disease is characterized by marked inflammation, affecting both the epithelial and connective tissues, causing degeneration of the dermal papilla, increase in the number of inflammatory cells, destruction of reticulin fibers, and accumulation of dense collagen fibers (fibrosis). These changes were worsened by diabetes, apparently by hampering the inflammatory response and affecting tissue repair of the affected tissues.
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Affiliation(s)
- J A F Silva
- Department of Microbiology and Immunology, State University of Campinas, Campinas, SP, Brazil
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Silva JAF, Lorencini M, Peroni LA, De La Hoz CLR, Carvalho HF, Stach-Machado DR. The influence of type I diabetes mellitus on the expression and activity of gelatinases (matrix metalloproteinases-2 and -9) in induced periodontal disease. J Periodontal Res 2008; 43:48-54. [PMID: 18230106 DOI: 10.1111/j.1600-0765.2007.00993.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontal disease corresponds to a group of lesions that affect the tooth-supporting tissues present in the dental follicle. Although bacterial plaque is important, the immune response also contributes to the destruction of periodontal tissues. Diabetes mellitus is closely associated with the development, progression and severity of periodontal disease because it not only affects extracellular matrix organization but also the tissue response to inflammation. The objective of the present investigation was to study the influence of diabetes on experimental periodontal disease by evaluating the degradation of extracellular matrix through the analysis of matrix metalloproteinase (MMP)-2 and MMP-9 expression and activity, using immunofluorescence, zymography and real-time reverse transcription-polymerase chain reaction. MATERIAL AND METHODS Wistar rats were divided into normal and diabetic groups and evaluated 0, 15 and 30 d after the induction of periodontal disease by ligature. RESULTS MMP-2 and -9 were detected in epithelial cells, in the blood vessel endothelium and in connective tissue cells. The same profile of enzymatic expression of MMP-2 and -9 was observed in normal and diabetic animals, with a peak in activity at day 15 of inflammation. However, in diabetic animals, MMP-2 gelatinolytic activity was reduced after the inflammatory stimulus, whereas that of MMP-9 was increased. MMP-2 gene expression decreased with inflammation in both normal groups and groups with diabetes. In contrast, MMP-9 expression increased in normal animals and decreased in diabetic animals after inflammation. CONCLUSION The results suggest the involvement of MMP-2 and -9 in the dynamics of periodontal disease and that variation in their expression levels results in differences in tissue organization and wound healing in normal and diabetic animals.
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Affiliation(s)
- J A F Silva
- Departmento de Microbiologia e Imunologia, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
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18
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Scardina GA, Messina P. Modifications of interdental papilla microcirculation: a possible cause of periodontal disease in Hashimoto's thyroiditis? Ann Anat 2008; 190:258-63. [PMID: 18407481 DOI: 10.1016/j.aanat.2007.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 12/22/2007] [Accepted: 12/23/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypothyroidism is defined by a decrease in thyroid hormone production and thyroid gland function. The aim of the present research has been to evaluate the morphologic interdental papilla microcirculation of patients suffering from Hashimoto thyroiditis (HT) and to evaluate a possible correlation with the associated periodontal disease. METHODS Fifteen healthy subjects and 15 patients suffering from HT were examined. The patients who showed conditions known to compromise microcirculation, such as diabetes, hypertension and pharmacological treatments, were not included in the group of healthy patients. All patients were non-smokers. Gingival capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. RESULTS An interdental papilla vascular modification results in HT. In patients suffering from HT, it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. CONCLUSIONS This study shows that capillary alterations in patients suffering from HT occur in gingival microcirculation.
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Affiliation(s)
- Giuseppe Alessandro Scardina
- Department of Oral Sciences G. Messina, University of Palermo, Dr. Scardina Giuseppe Alessandro via Del Vespro, 129-90127 Palermo, Italy.
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Borges-Yáñez SA, Irigoyen-Camacho ME, Maupomé G. Risk factors and prevalence of periodontitis in community-dwelling elders in Mexico. J Clin Periodontol 2006; 33:184-94. [PMID: 16489944 DOI: 10.1111/j.1600-051x.2006.00897.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The objective of this study was to determine whether an association existed between chronic systemic diseases/conditions, risk factors common in old age, and the extent and severity of chronic periodontal disease. MATERIALS AND METHODS Sociodemographic and lifestyle characteristics were examined by contrasting rural, urban-marginal, and urban social environments in Central Mexico. Data were analysed with Analysis of Variance, chi2 tests, and multivariable logistic regression. RESULTS A total of 473 adults 60 years old and over were interviewed; 315 were also examined and underwent laboratory assays (participation rate, 66%); women, 62%; mean age 73+/-8 years; 23% edentulous. The distribution of periodontitis by sociodemographic variables showed differences across locales (73% low-urban, 57% middle-urban, 29% rural). The regression model indicated that periodontitis was more frequently associated with low-urban locale, higher systolic blood pressure, higher body mass index, and worse calculus readings, with an interaction whereby being obese and having a high calculus index was associated with a high probability of having periodontitis. CONCLUSIONS Overall periodontal conditions were fair. While we identified oral, systemic, and social variables that modulated the experience of periodontitis, it would appear that urban, low social class elders appeared to have worse periodontal conditions.
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Affiliation(s)
- S Aída Borges-Yáñez
- Facultad de Odontología, Universidad Nacional Autónoma de México, México DF, México.
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Vitaliano PP, Persson R, Kiyak A, Saini H, Echeverria D. Caregiving and gingival symptom reports: psychophysiologic mediators. Psychosom Med 2005; 67:930-8. [PMID: 16314598 DOI: 10.1097/01.psy.0000188485.65153.7b] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We first assessed the association of caregiving with gingival symptom reports. We then assessed whether the observed relationship was mediated by psychophysiologic host factors. METHODS Caregivers of spouses with Alzheimer's disease (n = 123) were compared with demographically similar noncaregiver spouses (n = 117). RESULTS The percentage of caregivers (17%) who reported gingival symptoms was twice that of noncaregivers (8.5%) (p < .05), despite the fact that caregivers and noncaregivers did not differ in oral health care. The relationship between caregiving and gingival symptom reports was mediated by psychophysiologic variables. Caregivers were higher on hassles (p < .05), depressed mood (p < .05), and metabolic risk (insulin, glucose, obesity; p < .05) than were noncaregivers. Greater gingival symptom reports were also associated with greater hassles (p < .01), depressed mood (p < .001), and metabolic risk (p < .001). Measures of subcutaneous fat, inflammation, and frank diabetes were related to gingival symptom reports but not to caregiver status. CONCLUSIONS A higher percentage of caregivers reported gingival symptoms than noncaregivers. These results have implications for research on aging, psychophysiology, and chronic stress.
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Affiliation(s)
- Peter P Vitaliano
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington 98195-6560, USA.
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Heitz-Mayfield LJA. Disease progression: identification of high-risk groups and individuals for periodontitis. J Clin Periodontol 2005; 32 Suppl 6:196-209. [PMID: 16128838 DOI: 10.1111/j.1600-051x.2005.00803.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS While the role of bacteria in the initiation of periodontitis is primary, a range of host-related factors influence the onset, clinical presentation and rate of progression of disease. The objectives of this review are (1) to present evidence for individual predictive factors associated with a patient's susceptibility to progression of periodontitis and (2) to describe the use of prognostic models aimed at identifying high-risk groups and individuals in a clinical setting. METHODS Relevant publications in the English language were identified after Medline and PubMed database searches. Because of a paucity of longitudinal studies investigating factors including clinical, demographic, environmental, behavioural, psychosocial, genetic, systemic and microbiologic parameters to identify individuals at risk for disease progression, some association studies were also included in this review. FINDINGS AND CONCLUSIONS Cigarette smoking is a strong predictor of progressive periodontitis, the effect of which is dose related. High levels of specific bacteria have been predictive of progressive periodontitis in some studies but not all. Diabetics with poor glycaemic control have an increased risk for progression of periodontitis. The evidence for the effect of a number of putative factors including interleukin-1 genotype, osteoporosis and psychosocial factors is inconclusive and requires further investigation in prospective longitudinal studies. Specific and sensitive diagnostic tests for the identification of individuals susceptible to disease progression are not yet a reality. While factors assessed independently may not be valuable in predicting risk of future attachment loss, the combination of factors in a multifactorial model may be useful in identifying individuals at risk for disease progression. A number of multifactorial models for risk assessment, at a subject level have been developed but require validation in prospective longitudinal studies.
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Affiliation(s)
- L J A Heitz-Mayfield
- Centre for Rural and Remote Oral Health, The University of Western Australia, Nedlands, WA, Australia.
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Abstract
The increasing population of older subjects with dental care needs will become a major challenge to our society and its care providers. To manage the health care needs of the elderly, a coordination between medical and dental care providers will become necessary. From the dental perspective, it is important to develop skills in the risk assessment of older patients. Such risk assessment of older subjects should take an approach that is holistic and focused on the reduction of the infectious burden and the improvement of self-efficacy.
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Affiliation(s)
- Rigmor E Persson
- Department of Periodontology and Fixed Prosthodontics, University of Berne, Freiburgstrasse 7, CH 3010 Berne, Switzerland.
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Renvert S, Persson GR. Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss. J Clin Periodontol 2004; 31:208-13. [PMID: 15016025 DOI: 10.1111/j.0303-6979.2004.00469.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Limited subject-based information exists on the relationship between clinical and radiographic periodontal data. AIMS To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). MATERIAL AND METHODS Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic. RESULTS The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001). CONCLUSIONS The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.
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Affiliation(s)
- S Renvert
- Health Sciences, Kristianstad University, Sweden
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Omori K, Naruishi K, Nishimura F, Yamada-Naruishi H, Takashiba S. High glucose enhances interleukin-6-induced vascular endothelial growth factor 165 expression via activation of gp130-mediated p44/42 MAPK-CCAAT/enhancer binding protein signaling in gingival fibroblasts. J Biol Chem 2003; 279:6643-9. [PMID: 14676217 DOI: 10.1074/jbc.m311688200] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Diabetic patients are susceptible to severe inflammatory periodontitis manifesting as swollen gingiva with bleeding, but the underlying mechanism is not well understood. Our purpose was to determine the effect of a high glucose (HG) condition on the interleukin-6/soluble interleukin-6 receptor (IL-6/sIL-6R)-induced activation of signaling and vascular endothelial growth factor (VEGF) expression in human gingival fibroblasts (HGFs). In this study, HGFs were cultured for at least two passages under a normal glucose (NG; 5.5 mM) condition or high glucose (25 mM) condition. Importantly, the HG condition significantly induced expression of gp130 mRNA in HGFs compared with levels in control cells. Consistent with the expression of its mRNA, the HG condition also increased the expression of gp130 protein, and phosphorylation of the tyrosine residue by gp130 was enhanced significantly by IL-6/sIL-6R stimulation. Furthermore, the HG condition enhanced the IL-6/sIL-6R-induced phosphorylation of p44/42 MAPK and led to subsequent activation of CCAAT/enhancer binding protein in nuclei. In contrast, there was no significant difference in phosphorylation of JNK between the HG and NG condition. Interestingly, HGFs increased IL-6/sIL-6R-induced VEGF165 mRNA expression and VEGF165 secretion under the HG condition compared with levels under the NG condition. In contrast, the induction of VEGF165 secretion was partially inhibited by PD98059 (selective p44/42 MAPK inhibitor) under the HG condition. In addition, the VEGF165 secretion was completely inhibited by the combination of PD98059 and SP600125 (JNK inhibitor). Our findings suggest that the HG condition indirectly increases VEGF expression via activation of gp130-mediated p44/42 MAPK-CCAAT/enhancer binding protein signaling in HGFs. Thus, elevated VEGF secretion in HGFs under the HG condition may play a role in the development of the severe periodontitis observed in diabetic patients.
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Affiliation(s)
- Kazuhiro Omori
- Department of Pathophysiology, Periodontal Science, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8525, Japan
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Persson GR, Persson RE, MacEntee CI, Wyatt CCII, Hollender LG, Kiyak HA. Periodontitis and perceived risk for periodontitis in elders with evidence of depression. J Clin Periodontol 2003; 30:691-6. [PMID: 12887337 DOI: 10.1034/j.1600-051x.2003.00360.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression and periodontitis are common conditions in older adults. There is some evidence that these two conditions may be related. AIMS To study a population of dentate elders and assess the prevalence of depression, self-assessment of risk for periodontitis and tooth loss, in relation to periodontal disease status. MATERIAL AND METHODS Data were obtained from 701 older subjects (mean age 67.2 years (SD+/-4.6), of whom 59.5% were women. Self-reports of a diagnosis of depression, scores of the Geriatric Depression Scale (GDS), and self-assessment of risk for future tooth loss and periodontitis were compared with a diagnosis of periodontitis based on probing depth, and bone loss assessed from panoramic radiographs. Other systemic diseases and smoking habits were also determined and studied in relation to depression. RESULTS A history of depression was reported by 20% of the subjects. GDS scores >/=8 were reported by 9.8% of the elders. Periodontitis was identified in 48.5% of the subjects. Depression was associated with heart attack (p<0.05), stroke (p<0.01), high blood pressure (p<0.02), all combined cardiovascular diseases (p<0.001), chronic pain (p<0.01), osteoarthritis (p<0.001), and osteoporosis (p< 0.001) but not with periodontitis (p=0.73). Subjects with depression had a higher self-reported risk score for future tooth loss (p<0.02). No group difference emerged for self-perceived risk for periodontitis. Logistic regression analysis demonstrated that a past history of tooth loss (p<0.001), self-perceived risk for periodontitis (p<0.02), the number of years with a smoking habit (p<0.02), and male gender (p<0.02) were associated with a diagnosis of periodontitis but neither measure of depression could be included in an explanatory model for periodontitis. CONCLUSIONS Evidence of depression (self-report or by GDS) is not associated with risk for periodontitis in older subjects but is associated with tooth loss and chronic conditions associated with pain.
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Affiliation(s)
- G R Persson
- Department of Periodontics, University of Washington, Seattle, WA, USA.
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