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Tung HJ, Ford R. Incident edentulism and number of comorbidities among middle-aged and older Americans. Gerodontology 2023; 40:484-490. [PMID: 36708102 DOI: 10.1111/ger.12675] [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: 07/31/2022] [Revised: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUNDS Certain chronic non-communicable diseases have been associated with the loss of all natural permanent teeth, referred to as edentulism. It has been suggested that edentulism, a chronic dental state, involving the loss of all teeth and poorer masticatory efficiency, could be associated with multiple chronic conditions as people age. In this study, we describe the association between the number of comorbidities and incident edentulism in a representative sample of older Americans. METHODS We took data from the Health and Retirement Study (HRS). Dentate participants aged 50 or older at the baseline of 2006 (N = 13 221) and 2012 (N = 13 938) were linked to their dentate and survival status at the follow-up interviews in 2012 and 2018, respectively. The association between the number of comorbidities and incident edentulism was investigated by using multinomial logistic regression models. RESULTS Over the two observation periods, the number of selected chronic conditions was predictive of edentulism 6 years later. A 10% higher chance of becoming edentulous by 2012 (OR = 1.10, 95% CI = 1.01, 1.20) was found for every additional comorbid condition to those who remained dentate in 2012. A similar association was identified for the 2012-2018 period. CONCLUSION Among older adults, the number of comorbidities was predictive of incident edentulism, and the same association pattern was found across two longitudinal study periods. Older adults with an increase in the number of comorbidities may experience a higher chance of tooth loss later in time.
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Affiliation(s)
- Ho-Jui Tung
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Randall Ford
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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He I, Poirier B, Jensen E, Kaur S, Hedges J, Jesudason S, Jamieson L, Sethi S. Demystifying the connection between periodontal disease and chronic kidney disease - An umbrella review. J Periodontal Res 2023; 58:874-892. [PMID: 37477165 DOI: 10.1111/jre.13161] [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: 02/21/2023] [Revised: 06/07/2023] [Accepted: 06/30/2023] [Indexed: 07/22/2023]
Abstract
Chronic kidney disease (CKD) and poor oral health are inter-related and their significant impact on each other is well established in the literature. Many systematic reviews and meta-analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation. The aim of this umbrella review was to review the quality of the current systematic reviews on the relationship between CKD and oral health with an emphasis on periodontal disease and to generate clinically relevant guidelines to maintain periodontal health in patients with CKD. This umbrella review was conducted and reported in alignment with the Joanna Briggs Institute and the PRISMA 2020 guidelines. The review protocol was established prior to commencing the review and registered on JBI and PROSPERO (CRD42022335209). Search strings were established for PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Dentistry & Oral Science Source up to April 2022. All systematic reviews and meta-analyses that considered the relationship between CKD and periodontitis or periodontal treatment were included. Of 371 studies identified through the systematic search, 18 systematic reviews met the inclusion criteria. Ten studies assessed the relationship between oral health status and CKD with a focus on periodontitis and CKD, five reviewed the impact of periodontal treatment on CKD outcomes, two included both relationship and effectiveness of periodontal treatment and one qualitatively reviewed oral health-related quality of life in patients with kidney failure. Findings indicate there is a bidirectional relationship between CKD and periodontal disease. In view of the heterogeneity of the existing literature on CKD and periodontal disease, specific recommendations for the management of periodontitis among patients with CKD are proposed for medical professionals, dental professionals, and aged care workers based on the evidence collated in this review.
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Affiliation(s)
- Isaac He
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Emilija Jensen
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sushil Kaur
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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Devi OM, Gupta J, Chahal GS, Jain A. Is periodontal infection a risk factor for thromboembolic disease? A systematic review. J Indian Soc Periodontol 2023; 27:238-250. [PMID: 37346852 PMCID: PMC10281308 DOI: 10.4103/jisp.jisp_576_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 06/11/2022] [Accepted: 07/10/2022] [Indexed: 06/23/2023] Open
Abstract
Background Venous thromboembolism (VTE) is a rising major health problem comprising pulmonary embolism (PE) and deep vein thrombosis. It is of concern due to premature mortality, increased morbidity, and associated healthcare costs and hospitalization. Periodontitis can increase the risk of VTE by way of systemic inflammation induced by infection that can contribute to hypercoagulability and platelet aggregation. This systematic review aims to synthesize all the evidence concerning periodontal infection as a risk factor for thromboembolic disease. Materials and Methods A search for articles published from 1967 till December 2020 was conducted in the PubMed (MEDLINE), Scopus, and EMBASE data bases. Results Five hundred and five articles were retrieved after running search strategies in PubMed, Scopus, and EMBASE search databases. Based on the inclusion criteria, three clinical studies, two case series, and ten case reports were included for qualitative analysis. The presence of periodontal disease was reported to influence the occurrence of venous thromboembolic disease with a statistical significance of <0.010. Case series and case reports of septic PE due to periodontal disease showed complete resolution of lung lesions and subsiding of symptoms after dental treatment and antimicrobial therapy. Conclusions The results of this systematic review suggested for an association between periodontal disease and the incidence of thromboembolic disease. As most of the included/available studies are case series and case reports, the strength of evidence is weak. Evidence generated from well-designed longitudinal controlled clinical trials may be helpful to further assess the strength of the association.
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Affiliation(s)
- Oinam Monica Devi
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Jyoti Gupta
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
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Kuraji R, Shiba T, Dong TS, Numabe Y, Kapila YL. Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J Gastroenterol 2023; 29:967-996. [PMID: 36844143 PMCID: PMC9950865 DOI: 10.3748/wjg.v29.i6.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/14/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
A growing body of evidence from multiple areas proposes that periodontal disease, accompanied by oral inflammation and pathological changes in the microbiome, induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). A subgroup of NAFLD patients have a severely progressive form, namely nonalcoholic steatohepatitis (NASH), which is characterized by histological findings that include inflammatory cell infiltration and fibrosis. NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma. The oral microbiota may serve as an endogenous reservoir for gut microbiota, and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis. Gut dysbiosis increases the production of potential hepatotoxins, including lipopolysaccharide, ethanol, and other volatile organic compounds such as acetone, phenol and cyclopentane. Moreover, gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall, leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation. In particular, many animal studies support that oral administration of Porphyromonas gingivalis, a typical periodontopathic bacterium, induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis. NAFLD, also known as the hepatic phenotype of metabolic syndrome, is strongly associated with metabolic complications, such as obesity and diabetes. Periodontal disease also has a bidirectional relationship with metabolic syndrome, and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively. In this review, we will describe the link between periodontal disease and NAFLD with a focus on basic, epidemiological, and clinical studies, and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome. In conclusion, it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease, gut microbiota, and metabolic syndrome. Thus, the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics, prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-0071, Japan
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Takahiko Shiba
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontology, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tien S Dong
- The Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Department of Medicine, University of California David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo 102-8159, Japan
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States
- Sections of Biosystems and Function and Periodontics, Professor and Associate Dean of Research, Felix and Mildred Yip Endowed Chair in Dentistry, University of California Los Angeles, Los Angeles, CA 90095, United States
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Baciu SF, Mesaroș AȘ, Kacso IM. Chronic Kidney Disease and Periodontitis Interplay-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1298. [PMID: 36674052 PMCID: PMC9859404 DOI: 10.3390/ijerph20021298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Periodontitis (PO), a chronic microbially-induced inflammation of the supporting tissues of the tooth, is linked to various systemic diseases. We analyze its bidirectional relationship to chronic kidney disease (CKD), a major health-care problem with impressive excess mortality. Overwhelming associative relationship between CKD and PO are analyzed. Major pathophysiologic mechanisms that link CKD to PO are then presented: systemic inflammation, endothelial dysfunction, and imbalance of oxidative stress characteristic of CKD have a role in PO development and might influence escape mechanisms of oral microbiota. Subclinical local and systemic inflammation induced by PO might influence in turn CKD outcomes. Homeostatic changes induced by CKD such as mineral bone disorders, acidosis, uremic milieu, or poor salivary flow are also relevant for the occurrence of PO. There is insufficient evidence to recommend a standardized diagnostic and therapeutic approach regarding association of PO to CKD.
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Affiliation(s)
- Sorana Florica Baciu
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Anca-Ștefania Mesaroș
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Ina Maria Kacso
- Department of Nephrology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Babes Street, 400012 Cluj-Napoca, Romania
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Kristensen CB, Ide M, Forbes A, Asimakopoulou K. Psychologically informed oral health interventions in pregnancy and type 2 diabetes: A scoping review. FRONTIERS IN ORAL HEALTH 2022; 3:1068905. [PMID: 36620123 PMCID: PMC9811123 DOI: 10.3389/froh.2022.1068905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Oral health is a critical aspect of gestational diabetes management. Gestational diabetes is high blood glucose levels during pregnancy and is managed like type 2 diabetes with diet and physical activity interventions. This scoping review sets out to discuss why oral health support should also become part of gestational diabetes management. Objectives The primary objective was to synthesise the existing psychologically informed oral health interventions for pregnant women and individuals with type 2 diabetes, and the extent to which these interventions map on to the COM-B Model. No literature exists on oral health interventions in gestational diabetes, why studies with type 2 diabetes populations were selected instead. The secondary objective was to identify the precise outcomes targeted in the interventions. Methodology The Joanna Briggs Institute's Methodology for Scoping Reviews was used to conduct this review. The populations of interest were pregnant women and individuals with type 2 diabetes, and eligible concepts were psychologically informed oral health interventions. Quasi-experimental and experimental designs were considered. The Ovid Interface including Embase, Medline, Global Health, APA PsychInfo, Health Management Information, Maternity, Infant Care Database, the Cochrane Library, and CINAHL was used as information sources. The study selection followed the PRISMA guidelines. The first search was conducted on the week commencing the 25th of July 2022, with a follow-up search conducted on the 10th of October 2022. Results 28 records were included for synthesis. The most frequently assessed psychological outcome was oral health knowledge and the most frequently assessed oral clinical outcome was Plaque Index. All studies used an educational intervention approach, while psychological capability in the COM-B Model was targeted in all interventions by increasing oral health knowledge among the participants. The Health Belief Model was the most frequently used theory in the interventions. Conclusion The results demonstrate that oral health is a recognised aspect of pregnancy and type 2 diabetes. The findings from this review and a qualitative interview study which is under development will inform the first oral health intervention for women with gestational diabetes in the United Kingdom.
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Affiliation(s)
- Camilla Böhme Kristensen
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom,Correspondence: Camilla Böhme Kristensen
| | - Mark Ide
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Angus Forbes
- Care in Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Koula Asimakopoulou
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
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Chaudhry A, Kassim NK, Zainuddin SLA, Taib H, Ibrahim HA, Ahmad B, Hanafi MH, Adnan AS. Potential Effects of Non-Surgical Periodontal Therapy on Periodontal Parameters, Inflammatory Markers, and Kidney Function Indicators in Chronic Kidney Disease Patients with Chronic Periodontitis. Biomedicines 2022; 10:biomedicines10112752. [PMID: 36359271 PMCID: PMC9687126 DOI: 10.3390/biomedicines10112752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) and chronic periodontitis (CP) contribute to the increased level of inflammatory biomarkers in the blood. This study hypothesized that successful periodontal treatment would reduce the level of inflammatory biomarkers in CKD patients. This prospective study recruited two groups of CP patients: 33 pre-dialysis CKD patients and 33 non-CKD patients. All patients underwent non-surgical periodontal therapy (NSPT). Their blood samples and periodontal parameters were taken before and after six weeks of NSPT. The serum level of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and periodontal parameters were compared between groups. On the other hand, kidney function indicators such as serum urea and estimated glomerular filtration rate (eGFR) were only measured in CKD patients. Clinical periodontal parameters and inflammatory markers levels at baseline were significantly higher (p < 0.05) in the CKD group than in the non-CKD group and showed significant reduction (p < 0.05) after six weeks of NSPT. CKD patients demonstrated a greater periodontitis severity and higher inflammatory burden than non-CKD patients. Additionally, CKD patients with CP showed a good response to NSPT. Therefore, CKD patients’ periodontal health needs to be screened for early dental interventions and monitored accordingly.
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Affiliation(s)
- Ahmed Chaudhry
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nur Karyatee Kassim
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Basic Sciences and Medical Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Chemical Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: ; Tel.: +60-199-822-305
| | - Siti Lailatul Akmar Zainuddin
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Haslina Taib
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Hanim Afzan Ibrahim
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Basic Sciences and Medical Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Chemical Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Basaruddin Ahmad
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Biostatics Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Muhammad Hafiz Hanafi
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Azreen Syazril Adnan
- Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, Jalan Tun Hamdan Sheikh Tahir, Pulau Pinang 13200, Malaysia
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Nair DK, Shanthi B, Nandu Baby P. Comparison of Microalbuminuria Status in Type 2 Diabetes Mellitus Patients With Chronic Periodontitis: A Cross-Sectional Study. Cureus 2022; 14:e27383. [PMID: 36046275 PMCID: PMC9419016 DOI: 10.7759/cureus.27383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background Diabetes has increased the risk for various other ailments in various organs of the body. This can be contributing to periodontitis also as it is the sixth complication related to diabetes mellitus. There is a bidirectional relationship between both. Given the high global prevalence of type-2 diabetes mellitus (T2DM) with periodontitis, it is of great importance to determine the link between periodontitis and microalbuminuria in T2DM patients, which shows early renal disease. Methodology In the present study, a total of 500 patients having T2DM were assessed for periodontitis using Community Periodontal Index (CPI). Anthropometric and biochemical measurements were obtained. Blood samples were estimated for glycemic control tests such as fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and lipid profile. The subjects who participated in the study were categorized into three groups depending on the albuminuria level. The data were tabulated and analyzed using SPSS Statistics software (IBM Corp., Armonk, USA). Results Out of 500 T2DM subjects, 342 subjects had periodontitis. A statistically significant difference was found in FPG, HbA1c, total cholesterol (TC), triglycerides, and low-density lipoprotein (LDL) between subjects with periodontitis and without periodontitis using a t-test (p = <0.001). The prevalence of normoalbuminuria, micro-, and macroalbuminuria among periodontitis patients was 24.6%, 72.8%, and 2.6% respectively, and the Chi-square analysis revealed that was highly significant. In terms of albuminuria, one-way analysis of variance (ANOVA) revealed statistically significant differences among the periodontitis subjects for the following variables: inputs such as the number of teeth, diabetes mellitus (DM) duration, the level of LDL, and also the depth of the pocket. Intergroup comparison of variables among subjects with albuminuria using the statistical test of Tukey Post Hoc found that there is a significant difference between normoalbuminuria and microalbuminuria. CPI score, tooth mobility, smoking, education level, family income, tooth brushing duration, along with the use of other dental hygiene aids was also found to be statistically significant among subjects with periodontitis. Conclusion The study concluded that T2DM patients had a higher incidence of microalbuminuria among individuals with periodontitis. These subjects also had significantly higher HbA1c and FPG levels than subjects with normoalbuminuria. In addition, subjects with periodontitis exhibited a significant reduction in the total teeth numbers present in the case of albuminuria. The longitudinal correlation between DM, microalbuminuria, and periodontitis could be further investigated in detail to explore possible pathways.
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Mariño R, Priede A, King M, Adams GG, Sicari M, Morgan M. Oral health professionals screening for undiagnosed type-2 diabetes and prediabetes: the iDENTify study. BMC Endocr Disord 2022; 22:183. [PMID: 35850674 PMCID: PMC9294826 DOI: 10.1186/s12902-022-01100-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As part of an evaluation of an oral healthcare practice-based model that identifies patients with prediabetes or type-2 diabetes, this study reports on the proportion of patients identified with clinically confirmed type-2 diabetes (T2D)/prediabetes and barriers of implementation of the model. METHODOLOGY Urban and rural oral healthcare practices were invited to participate. Participating practices invited eligible patients to participate in the screening program using the Australian Type-2 Diabetes Risk Assessment Tool (AUSDRISK). Participants were categorised as low, intermediate, or high-risk for prediabetes/T2D. Patients in the intermediate or high-risk category were referred to their General Medical Practitioner (GP) for further investigation. RESULTS Fifty-one oral healthcare practices and 76 Oral Health Professionals (OHP) participated (60 Dentists, 8 Dental Hygienists, 8 Oral Health Therapists). 797 patients were screened; 102 were low-risk; 331 intermediate-risk; and 364 high-risk for T2D. Of the 695 participants in the intermediate or high-risk groups, 386 (55.5%) were referred to their GP for T2D assessment. Of them, 96 (25.0%) results were returned to OHPs. Of the returned results, six were (6.3%) diagnosed with pre-T2D. CONCLUSION Patients found to have undiagnosed T2D/prediabetes (6.3%) were within the expected range reported in the literature. Findings indicate that identifying individuals at an elevated risk of having or developing T2D is effective, feasible and could be incorporated into oral healthcare settings. However, this integration may require additional OHPs training and education to ensure that patients at elevated risk of T2D are referred for further assessment.
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Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Andre Priede
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Michelle King
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Geoffrey G. Adams
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Maria Sicari
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
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Interconnectedness between periodontitis stage, oral hygiene habits, adherence to the Mediterranean diet and nutritional status in Dalmatian kidney transplant recipients: a cross-sectional study. Sci Rep 2022; 12:11614. [PMID: 35803958 PMCID: PMC9270487 DOI: 10.1038/s41598-022-15589-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this cross-sectional study was to determine the associations between the Mediterranean diet (MeDi), nutritional status parameters, muscle strength, and periodontal status in Dalmatian kidney transplant recipients (KTRs). 89 KTRs were included in this analysis, 40 (45%) women, with a mean age of 61 years (IQR = 13) and a mean time since kidney transplantation of 5 years (IQR = 6.6). An OHIP-14 questionnaire and questionnaire-based periodontal history were obtained from all participants, a comprehensive periodontal examination was performed. Body composition data, anthropometric and clinical parameters were collected for each study participant. The Mediterranean Diet Serving Score (MDSS) was used to assess MeDi adherence, and handgrip strength was measured with a hand dynamometer. Our results showed low adherence to MeDi in KTRs (28%) and almost 50% of KTRs suffer from severe forms of periodontitis. We also found a low OHIP-14 score and poor oral hygiene habits. KTRs with a less severe form of periodontitis had higher muscle mass and handgrip strength. MDSS score was associated with a higher number of teeth, and everyday cereal intake was inversely associated with the periodontitis stage. Our results demonstrate the associations between nutritional status, muscle strength, dietary habits, and periodontal health in Dalmatian KTRs.
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Antioxidant Effects of Curcumin Gel in Experimental Induced Diabetes and Periodontitis in Rats. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7278064. [PMID: 35592526 PMCID: PMC9113860 DOI: 10.1155/2022/7278064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 12/17/2022]
Abstract
This study aimed to evaluate the effect of curcumin gel on antioxidant marker level in experimental induced diabetes and periodontitis (EDP) in rats. Adult Wistar rats were randomized into five groups (20 each): (1) EDP treated with scaling and root planing (SRP) + curcumin gel (CU), (2) EDP treated with CU, (3) EDP treated with SRP, (4) EDP without treatment, and (5) systemically healthy and without ligature (control). Each group was subdivided equally into 4 subgroups of 5 rats. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ), and periodontitis was induced by a ligature. Blood samples were collected by cardiac puncture at 0, 7, 14, and 21 days to assess oxidative stress of malondialdehyde (MDA) and antioxidant enzymes of glutathione peroxidase (GPx), catalase (CAT), and suproxidase dismutase (SOD) levels. The results showed a significant increase in serum MDA and antioxidant enzyme levels in the untreated EDP group compared to the control group (
). The adjuvant use of CU to SRP resulted in a significant reduction of MDA and CAT levels as compared to the SRP group (
); however, significant reduction of GPX and SOD levels can be found only at day 7. It can be concluded that the decreased level of antioxidant enzymes can be construed as a result of decreased oxidative stress by curcumin therapy.
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Lazureanu PC, Popescu FG, Stef L, Focsa M, Vaida MA, Mihaila R. The Influence of Periodontal Disease on Oral Health Quality of Life in Patients with Cardiovascular Disease: A Cross-Sectional Observational Single-Center Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050584. [PMID: 35630001 PMCID: PMC9144554 DOI: 10.3390/medicina58050584] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/17/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Cardiovascular disease is a leading cause of global death with a rising prevalence and a heavy economic burden. Periodontal disease has been associated with cardiovascular diseases—including incident coronary heart disease, peripheral artery disease and ischemic stroke. The study evaluates the quality of life of patients with cardiovascular and periodontal disease from the point of view of oral health by using the short version of the Oral Health Impact Profile (OHIP-14) questionnaire. Materials and Methods: This study included a total of 221 patients (61.86 ± 15.03 years old) selected from the Emergency Hospital of Sibiu, Romania. The participants self-completed the OHIP-14 questionnaire and they benefited from an oral health examination conducted to assess the presence and the severity of periodontal disease. Results: Out of the 147 patients with cardiovascular disease, 77.5% had periodontal disease (32.6% stage I, 29.2% stage II, and 15.6% stage III and IV). The presence of periodontal disease was associated with a lower oral-health-related quality of life (p < 0.001, ANOVA) and with a higher OHIP-14 score in patients with cardiovascular disease (18.67 ± 8.17, p < 0.001 ANOVA). No significant difference was observed concerning patient sex and background; however, age, body mass index and the lack of an appropriate oral hygiene routine had a strong association with the individual quality of life. The general OHIP-14 score was higher in patients with periodontal disease and associated cardiovascular disease, the presence of both cardiovascular and periodontal disease being associated with a lower quality of life. Conclusions: By increasing the patients’ awareness to oral healthcare measures, better outcomes and improved oral-health-related quality of life could be observed.
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Affiliation(s)
- Pompilia Camelia Lazureanu
- Department of Physiology, Faculty of Medicine, “Lucian Blaga” University, 10, Victoriei Boulevard, 550024 Sibiu, Romania;
| | - Florina Georgeta Popescu
- Department of Occupational Health, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
- Correspondence:
| | - Laura Stef
- Department of Oral Health, Faculty of Medicine, “Lucian Blaga” University, 10, Victoriei Boulevard, 550024 Sibiu, Romania;
| | - Mircea Focsa
- Department of Medical Informatics and Biostatistics, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Monica Adriana Vaida
- Department of Anatomy and Embryology, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Romeo Mihaila
- Department of Internal Medicine, Faculty of Medicine, “Lucian Blaga” University, 10, Victoriei Boulevard, 550024 Sibiu, Romania;
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Hu S, Yu F, Jiang H, Shang W, Miao H, Li S, Zhao J, Xiao H. Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China. Front Cardiovasc Med 2022; 9:830732. [PMID: 35299983 PMCID: PMC8921456 DOI: 10.3389/fcvm.2022.830732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Periodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy. Methods Three hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications, multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables. Results The median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95% CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001). Conclusion Higher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.
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Affiliation(s)
- Shaonan Hu
- Innovation Center Computer Assisted Surgery, Leipzig University, Leipzig, Germany
| | - Feifan Yu
- School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Hong Jiang
- Department of Obstetrics and Gynecology, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, Chengdu, China
| | - Wei Shang
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Hui Miao
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Simin Li
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen, China
- Jianjiang Zhao
| | - Hui Xiao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- Hui Xiao
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14
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TNF-α, IL-1β, MMP-8 Crevicular Profile in Patients with Chronic Kidney Disease and Periodontitis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Increasing evidence sustains the potential of periodontitis as a risk factor for chronic kidney disease (CKD). Our study aimed to analyze several periodontal specific inflammatory biomarkers within the gingival crevicular fluid (GCF) of patients with CKD, compared to patients with normal kidney function, providing an inflammatory profile of the dialysis patient. The study comprised 79 patients divided into: group 1 (59 subjects with periodontitis and CKD) and group 2 (20 patients with periodontitis, without other systemic conditions). Clinical diagnosis was performed via dental and periodontal examination. GCF samples were collected from each patient, and the levels of TNF-α, IL-1β and MMP-8 were determined by using ELISA assay. In group 1, the average values were: 22.85 ± 5.87 pg/mL for TNF-α, 33.00 ± 39.68 pg/mL for IL-1β and 18.80 ± 27.75 ng/mL for MMP-8. In group 2, the mean values were: 2.10 ± 1.34 pg/mL for TNF-α, 0.71 ± 2.42 pg/mL for IL-1β and 5.35 ± 0.37 ng/mL for MMP-8. Statistical analysis revealed significant differences between groups as referring to all three biomarkers and, TNF-α and MMP-8, in certain stages of periodontitis. The level of TNF-α, IL-1β and MMP-8 points out the increased inflammatory status of the dialysis patient with PD, supporting the mutual connection of the two pathologies.
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15
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Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Antioxidants (Basel) 2021; 10:antiox10081304. [PMID: 34439554 PMCID: PMC8389262 DOI: 10.3390/antiox10081304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 01/22/2023] Open
Abstract
This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated.
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16
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Li L, Zhang YL, Liu XY, Meng X, Zhao RQ, Ou LL, Li BZ, Xing T. Periodontitis Exacerbates and Promotes the Progression of Chronic Kidney Disease Through Oral Flora, Cytokines, and Oxidative Stress. Front Microbiol 2021; 12:656372. [PMID: 34211440 PMCID: PMC8238692 DOI: 10.3389/fmicb.2021.656372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/01/2021] [Indexed: 12/25/2022] Open
Abstract
Periodontitis is a type of systemic immune inflammation that is caused by the complex infection of a variety of microorganisms in the subgingival plaque and the imbalance of the microbial ecological environment in the mouth. Periodontitis and chronic kidney disease (CKD) share many risk factors, such as obesity, smoking, and age. A growing body of data supports a strong correlation between periodontitis and kidney disease. Evidence supports the role of periodontal inflammation and elevated serum inflammatory mediators in renal atherosclerosis, renal deterioration, and end-stage renal disease (ESRD) development. Periodontitis is a risk factor for kidney disease. However, to our knowledge, there are few studies detailing the possible link between periodontitis and CKD. This review summarizes the possible mechanisms underlying periodontitis and CKD. More importantly, it highlights novel and potential pathogenic factors for CKD, including bacteria, pro-inflammatory mediators and oxidative stress. However, most research on the relationship between periodontitis and systemic disease has not determined causality, and these diseases are largely linked by bidirectional associations. Future research will focus on exploring these links to contribute to new treatments for CKD.
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Affiliation(s)
- Ling Li
- School of Stomatology, Anhui Medical University, Hefei, China
| | - Ya-Li Zhang
- School of Stomatology, Anhui Medical University, Hefei, China
| | - Xing-Yu Liu
- School of Stomatology, Anhui Medical University, Hefei, China
| | - Xiang Meng
- Key Laboratory of Oral Diseases Research of Anhui Province, College and Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Rong-Quan Zhao
- School of Stomatology, Anhui Medical University, Hefei, China
| | - Lin-Lin Ou
- School of Stomatology, Anhui Medical University, Hefei, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Tian Xing
- School of Stomatology, Anhui Medical University, Hefei, China.,Key Laboratory of Oral Diseases Research of Anhui Province, College and Hospital of Stomatology, Anhui Medical University, Hefei, China
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17
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Casanova-Rosado AJ, Casanova-Rosado JF, Minaya-Sánchez M, Robles-Minaya JL, Casanova-Sarmiento JA, Márquez-Corona MDL, Pontigo-Loyola AP, Isla-Granillo H, Mora-Acosta M, Márquez-Rodríguez S, Medina-Solís CE, Maupomé G. Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey. Healthcare (Basel) 2021; 9:healthcare9040404. [PMID: 33916223 PMCID: PMC8066655 DOI: 10.3390/healthcare9040404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.
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Affiliation(s)
- Alejandro José Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - Juan Fernando Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Mirna Minaya-Sánchez
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - José Luís Robles-Minaya
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | | | - María de Lourdes Márquez-Corona
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - América Patricia Pontigo-Loyola
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Horacio Isla-Granillo
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Mariana Mora-Acosta
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, School of Dentistry, Autonomous University of State of Mexico, Toluca 50000, Mexico
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, IN 46202, USA;
- Indiana University Network Science Institute, Bloomington, IN 47408, USA
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Sharma P, Fenton A, Dias IHK, Heaton B, Brown CLR, Sidhu A, Rahman M, Griffiths HR, Cockwell P, Ferro CJ, Chapple IL, Dietrich T. Oxidative stress links periodontal inflammation and renal function. J Clin Periodontol 2021; 48:357-367. [PMID: 33368493 PMCID: PMC7986430 DOI: 10.1111/jcpe.13414] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/06/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
Aims Patients with chronic kidney disease (CKD) are also susceptible to periodontitis. The causal link between periodontitis and CKD may be mediated via systemic inflammation/oxidative stress. Using structural equation modelling (SEM), this cross‐sectional study aimed to explore the causal relationship between periodontal inflammation (PI) and renal function. Materials and methods Baseline data on 770 patients with stage 3–5 (pre‐dialysis) CKD from an ongoing cohort study were used. Detailed, bioclinical data on PI and renal function, as well as potential confounders and mediators of the relationship between the two, were collected. SEMs of increasing complexity were created to test the causal assumption that PI affects renal function and vice versa. Results Structural equation modelling confirmed the assumption that PI and renal function are causally linked, mediated by systemic oxidative stress. The magnitude of this effect was such that a 10% increase in PI resulted in a 3.0% decrease in renal function and a 10% decrease in renal function resulted in a 25% increase in PI. Conclusions Periodontal inflammation represents an occult source of oxidative stress in patients with CKD. Further clinical studies are needed to confirm whether periodontal therapy, as a non‐pharmacological approach to reducing systemic inflammatory/oxidative stress burden, can improve outcomes in CKD.
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Affiliation(s)
- Praveen Sharma
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Anthony Fenton
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | | | - Brenda Heaton
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | | | - Amneet Sidhu
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Mutahir Rahman
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | | | - Paul Cockwell
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | - Charles J Ferro
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | - Iain L Chapple
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
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Effect of periodontal treatment on the glomerular filtration rate, reduction of inflammatory markers and mortality in patients with chronic kidney disease: A systematic review. PLoS One 2021; 16:e0245619. [PMID: 33481920 PMCID: PMC7822280 DOI: 10.1371/journal.pone.0245619] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Aim To assess the effect of periodontal treatment (PT) on glomerular filtration rate (GFR), systemic inflammation, or mortality in patients with chronic kidney disease (CKD). Methods A literature search was performed on PubMed and Web of Science databases on articles published until December 2019. The PRISMA guidelines were used throughout the manuscript. Results Of the total studies found, only 18 met the inclusion criteria; four retrospective and 14 prospective studies (including 3 randomized controlled trials–RCT). After PT, 3 studies investigated GFR, 2 found significant improvement; 11 (including 2 RCTs) investigated C-reactive protein levels, 9 found a significant improvement (including the 2 RCTs); 5 (including 3 RCTs) investigated Interleukine-6 level, 4 found a significant improvement (including 2 RCTs) and 2 studies evaluated mortality, one (retrospective study) found a significant difference. Conclusions Within the limitations of the present study, PT seems to improve CKD status, especially by reducing the systemic inflammation. Further RCTs are needed to confirm the results and specifically assess the influence of different types of PT in CKD patients. Taking into consideration the ability of PT to prevent further tooth loss and denutrition, early management of periodontitis is extremely important in patients with impaired renal function.
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20
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Poor oral hygiene and dental caries predict high mortality rate in hemodialysis: a 3-year cohort study. Sci Rep 2020; 10:21872. [PMID: 33318507 PMCID: PMC7736314 DOI: 10.1038/s41598-020-78724-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to investigate the impact of oral hygiene, periodontal diseases, and dental caries on all-cause mortality in hemodialysis. This prospective cohort study included 266 patients with end-stage renal disease who were undergoing hemodialysis. Medical interviews, blood biochemical tests, and comprehensive dental examinations including periodontal pocket examination on all teeth and dental plaque accumulation by debris index-simplified (DI-S), were performed. Survival rates were assessed at a 3-year follow-up. Overall, 207 patients were included in the longitudinal analysis, and 38 subjects died during the follow-up period. Cox proportional hazards analysis of the multivariate model demonstrated that the highest tertile of DI-S had a significantly higher risk of all-cause mortality than the lowest two tertiles after adjustment for age, sex, smoking habit, body mass index, diabetes, prior cardiovascular disease, hemodialysis vintage, high sensitivity C-reactive protein, albumin, and number of remaining teeth (hazard ratio, 3.04; 95% confidence interval, 1.50–6.17; p = 0.002). Moreover, the number of decayed teeth significantly increased the hazard ratio to 1.21 (95% confidence interval, 1.06.1.37; p = 0.003). This study suggests that accumulated dental plaque and untreated decay, but not periodontal disease, may be independently associated with all-cause mortality in patients undergoing hemodialysis.
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21
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Association between Uremic Toxin Concentrations and Bone Mineral Density after Kidney Transplantation. Toxins (Basel) 2020; 12:toxins12110715. [PMID: 33202788 PMCID: PMC7696468 DOI: 10.3390/toxins12110715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
Although uremic osteoporosis is a component of mineral and bone disorder in chronic kidney disease, uremic toxin (UT) concentrations in patients with end-stage kidney disease and bone mineral density (BMD) changes after kidney transplantation have not previously been described. We hypothesized that elevated UT concentrations at the time of transplantation could have a negative impact on bone during the early post-transplantation period. Hence, we sought to determine whether concentrations of UTs (trimethylamine-N-oxide, indoxylsulfate, p-cresylsulfate, p-cresylglucuronide, indole-3-acetic acid, hippuric acid, and 3-carboxy-4-methyl-5-propyl-furanpropionic acid) upon transplantation are predictive markers for (i) osteoporosis one month after transplantation, and (ii) a BMD decrease and the occurrence of fractures 12 and 24 months after kidney transplantation. Between 2012 and 2018, 310 kidney transplant recipients were included, and dual-energy X-ray absorptiometry was performed 1, 12, and 24 months after transplantation. The UT concentrations upon transplantation were determined by reverse-phase high-performance liquid chromatography. Indoxylsulfate concentrations upon transplantation were positively correlated with BMD one month after transplantation for the femoral neck but were not associated with osteoporosis status upon transplantation. Concentrations of the other UTs upon transplantation were not associated with osteoporosis or BMD one month after transplantation. None of the UT concentrations were associated with BMD changes and the occurrence of osteoporotic fractures 12 and 24 months after transplantation. Hence, UT concentrations at the time of kidney transplantation were not predictive markers of osteoporosis or fractures.
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22
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Machado V, Botelho J, Proença L, Alves R, Oliveira MJ, Amaro L, Águas A, Mendes JJ. Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis. BMC Oral Health 2020; 20:229. [PMID: 32819351 PMCID: PMC7441730 DOI: 10.1186/s12903-020-01219-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 08/13/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To determine if periodontal risk assessment (PRA), the number of missing teeth, diabetes mellitus (DM), perceived stress and interproximal cleaning are associated with oral health-related quality of life (OHRQoL), using Andersen's behavioral modelling (ABM). MATERIAL AND METHODS Data derived from 472 adults derived from a representative population of the Study of Periodontal Health in Almada-Seixal (SoPHiAS) was used. Socioeconomic status, perceived stress scale (PSS-10), oral health behaviors and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal conditions were assessed with a full-mouth periodontal examination. PRA was computed through behavioral and clinical information. Variables were grouped into Predisposing Factors, Enabling, Need, Oral Health Behaviors and Perceived Health Outcome latent variables. Confirmatory factor analysis, structural ABM and model fitness were conducted. RESULTS ABM applied to OHIP-14 showed acceptable model fit (χ2 = 2.75, CFI = 0.92, TLI = 0.90, RMSEA = 0.05, CI 90% [0.04-0.07]). The average of OHRQoL was 9.5 ± 11.3. Patient with periodontitis and with a high number of missing teeth experienced worse OHRQoL. Uncontrolled DM participants had more periodontal treatment necessity and poorer OHRQoL. Characteristic like aging and lower levels of education were directly associated with better OHRQoL, but in indirect path the OHRQoL was diminishes. Good oral hygiene and preventative measures were associated to lower periodontal treatment necessity. Lower periodontal treatment necessity was associated to higher OHRQoL. Age, tooth loss and interproximal cleaning were the most associated items to Predisposing, Need and Oral Health Behaviors, respectively. CONCLUSION ABM confirmed age, number of missing teeth, DM, interproximal cleaning and perceived stress as associated factors for OHRQoL. Uncontrolled DM was associated to higher Need and poorer OHRQoL. Good oral hygiene habits promote a healthy periodontium and, consequently, increases OHRQoL.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal.
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Almada, Portugal
| | - Ricardo Alves
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Maria João Oliveira
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
| | - Artur Águas
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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Oyetola EO, Adesina OM, Ogunbameru K, Egunjobi S, Adejobi AF. Distribution of Medical Conditions among Dental Patients. Niger Med J 2020; 61:129-135. [PMID: 33100463 PMCID: PMC7547757 DOI: 10.4103/nmj.nmj_80_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/04/2019] [Accepted: 02/13/2020] [Indexed: 11/04/2022] Open
Abstract
Aims The aim of the study was to determine the distribution of medical conditions among dental patients in our local environment. Settings and Design This is a descriptive cross-sectional study conducted at the Oral Diagnosis (OD) Clinic of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State. Materials and Methods Participants were selected using a simple random method from the pool of dental patients who presented at the OD Clinic of OAUTHC during the study period. Information was obtained from each participant using a structured questionnaire organized into sections. Section 1 collected information on participants' biodata such as age, sex, and weight. Section 2 recorded data on the history of the presence of relevant oral and systemic symptoms, while section 3 collected information on findings from intraoral and extraoral examination. Statistical Analysis Used The results were analyzed using STATA 13 statistical software. Results Of the 1503 patients who visited dental hospital during the study period, 176 (11.7%) had medical problems. The mean age of patients with medical problems was 48.5 ± 21.0 years. The mean age was higher in men compared to women (P = 0.013). More than one-fifth (21.6%) of the patients were first diagnosed in the dental clinic. Hypertension was the most frequently seen medical condition, closely followed by peptic ulcer and diabetes mellitus. Patients whose medical problems were first diagnosed following dental consultation were significantly older than those with known medical conditions. Conclusions Prevalence of medical conditions in dental patients is high. Hypertension is the most frequently associated systemic conditions among dental patients. Medical conditions were common among older age group (>50 years), males, and those with gum problems.
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Affiliation(s)
- Elijah Olufemi Oyetola
- Department of Preventive and Community Dentistry, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
| | - Olufunlola Motunrayo Adesina
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
| | - Kayode Ogunbameru
- Department of Preventive and Community Dentistry, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
| | - Shola Egunjobi
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
| | - Adewale Francis Adejobi
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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Dental problems and chronic diseases in mentally ill homeless adults: a cross-sectional study. BMC Public Health 2020; 20:419. [PMID: 32228526 PMCID: PMC7106680 DOI: 10.1186/s12889-020-08499-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/10/2020] [Indexed: 12/24/2022] Open
Abstract
Background Dental problems (DPs) and physical chronic diseases (CDs) are highly prevalent and incident in people with low socioeconomic status such as homeless individuals. Yet, evidence on the association between DPs and physical CDs in this population is limited. In the present study, we assessed the association between DPs and type and number of CDs in individuals experienced chronic homelessness and serious mental health problems. Methods We analyzed cross-sectional baseline data from 575 homeless adults with serious mental health problems participating in the Toronto site of the At Home/Chez Soi randomized controlled trial. Chronic DPs (lasting at least 6 months) were the primary exposure variable. Presence of self-reported CDs, including heart disease, effect of stroke, hypertension, diabetes, asthma, chronic bronchitis/emphysema, stomach or intestinal ulcer, inflammatory bowel disease, migraine, thyroid problems, arthritis, kidney/bladder problems, liver disease (other than hepatitis), and iron-deficiency anemia, were the primary outcomes. The total number of CDs was also analyzed as a secondary outcome. Logistic regression models were used to assess the association between DPs with each of the studied CDs, and negative binomial regression was used to test the association between DPs with the number of CDs. Results In our 575 homeless participants (68.5% males) with mean age 40.3 (11.8) years, a high proportion had DPs (42.5%). The presence of DPs was positively associated with heart disease (adjusted odds ratio (AOR):4.19,1.67–10.52), diabetes (AOR:2.17,1.13–4.17), chronic bronchitis (AOR:2.34,1.28–4.29), stomach or intestinal ulcer (AOR:3.48,1.80–6.73), inflammatory bowel disease (AOR:2.52,1.38–4.60), migraine (AOR:1.80,1.20–2.72), arthritis (AOR:2.71,1.71–4.29), kidney/bladder problems (AOR:2.43,1.30–4.54), and iron-deficiency anemia (AOR:3.28,1.90–5.65). DPs were also associated with a higher number of CDs (IRR: 1.62,1.38–1.90). Conclusion Dental health problems in homeless individuals with serious mental disorders are associated with several CDs. Dental care should be better integrated into existing social and health programs serving this population to improve their overall health status. The AH/CS study is registered with the International Standard Randomized Control Trial Number Register (ISRCTN42520374).
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25
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Association of urinary albumin excretion with periodontal parameters in patients with type 2 diabetes mellitus: a cross-sectional study. Diabetol Int 2020; 11:121-128. [PMID: 32206482 DOI: 10.1007/s13340-019-00413-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
Background Our previous pilot study using patients with type 2 diabetes mellitus in one medical clinic showed an association of urinary albumin excretion, a marker of generalized vascular dysfunction and kidney damage, with periodontitis. The purpose of this study was to confirm the association by increasing the number of patients and medical clinics. Methods Participants were 2302 patients (59.9% males, aged 29-93 years) with type 2 diabetes mellitus from 25 medical clinics. Their medical records and information about socioeconomic status and health behavior were collected. Periodontal status was assessed in a nearby dental office. Multiple linear regression analyses were conducted to examine the association of log-transformed urinary albumin-to-creatinine ratio with periodontal parameters after adjusting for sociodemographic status, general health conditions, and health behaviors. The analyses were performed in all subjects and subjects with normoalbuminuria only. Results Multiple linear regression analysis showed that mean probing pocket depth (beta: 0.062), percentage of sites with probing pocket depth of 4 mm or deeper (beta: 0.068), percentage of mobile teeth (beta: 0.055), and severity of periodontitis (beta: 0.049) were significantly (p < 0.05) correlated with log-transformed urinary albumin-to-creatinine ratio after adjusting for possible confounders in all subjects. However, no significant associations between urinary albumin-to-creatinine ratio and periodontal parameters were observed in subjects with normoalbuminuria only. Conclusions These results suggest that periodontitis is associated with urinary albumin excretion in patients with type 2 diabetes mellitus. Collaboration between medical and dental healthcare providers is needed for treatment of diabetes and periodontitis.
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26
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Hickey NA, Shalamanova L, Whitehead KA, Dempsey-Hibbert N, van der Gast C, Taylor RL. Exploring the putative interactions between chronic kidney disease and chronic periodontitis. Crit Rev Microbiol 2020; 46:61-77. [PMID: 32046541 DOI: 10.1080/1040841x.2020.1724872] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) and chronic periodontitis (CP) are both common diseases, which are found disproportionately comorbid with each other and have been reported to have a detrimental effect on the progression of each respective disease. They have an overlap in risk factors and both are a source of systemic inflammation along with a wide selection of immunological and non-specific effects that can affect the body over the lifespan of the conditions. Previous studies have investigated the directionality of the relationship between these two diseases; however, there is a lack of literature that has examined how these diseases may be interacting at the localized and systemic level. This review discusses how oral microorganisms have the ability to translocate and have distal effects and provides evidence for microbial involvement in a systemic disease. Furthermore, it summarizes the reported local and systemic effects of CKD and CP and discusses how the interaction of these effects may be responsible for directionality associations reported.
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Affiliation(s)
- Niall A Hickey
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Liliana Shalamanova
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kathryn A Whitehead
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Nina Dempsey-Hibbert
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Christopher van der Gast
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Rebecca L Taylor
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
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27
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Yoshioka M, Okamoto Y, Murata M, Fukui M, Yanagisawa S, Shirayama Y, Nagai K, Hinode D. Association between Oral Health Status and Diabetic Nephropathy-Related Indices in Japanese Middle-Aged Men. J Diabetes Res 2020; 2020:4042129. [PMID: 32587866 PMCID: PMC7303739 DOI: 10.1155/2020/4042129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/07/2020] [Accepted: 05/25/2020] [Indexed: 11/17/2022] Open
Abstract
Oral health status is known to be associated with lifestyle-related diseases such as diabetes and chronic kidney disease. In Japan, around 40% of hemodialysis cases are patients with diabetic nephropathy. The aim of this study was to clarify the association between oral health status and diabetic nephropathy-related indices in Japanese middle-aged men. Sixty-six men (age range: 55-64 years) with ≥20 remaining teeth and who received public medical checkups and oral examinations were enrolled. We examined correlations of age, body mass index, HbA1c, HDL-C, LDL-C, neutral fat, serum creatinine, and the estimated glomerular filtration rate (eGFR) with the number of remaining teeth or the community periodontal index (CPI) score (periodontal pocket < 4 mm: 0, 4-6 mm: 1, ≥6 mm: 2). A positive correlation between the CPI score and serum creatinine and a negative correlation between CPI score and eGFR (Spearman's rank correlation coefficient, r = 0.459, p < 0.01, and r = -0.460, p < 0.01, respectively) were observed. The mean eGFR in the CPI score 0 group was significantly higher than that in the CPI score 1/2 group (82.6 vs. 70.7, Student's t-test, p < 0.01). Logistic regression analysis using eGFR as a dependent variable and age, CPI score, body mass index, HbA1c, and neutral fat as independent variables suggested that low eGFR (<60) could be attributed to CPI score (OR = 3.169, 95% CI: 1.031-9.742, p = 0.044). These results suggest a possible association between periodontal status and renal function in Japanese middle-aged men. Periodontal condition is controlled by oral prophylaxis, and periodontal disease and chronic kidney disease have some common risk factors. Thus, periodontal management can contribute to the prevention of severe chronic kidney disease.
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Affiliation(s)
- Masami Yoshioka
- Department of Oral Health Sciences, Faculty of Health and Welfare, Tokushima Bunri University, 180 Nishihamaboji Yamashirocho Tokushima, 770-8514, Japan
| | - Yoshifumi Okamoto
- Tokushima Dental Association, 1-8-65 Kitatamiya, Tokushima 770-0003, Japan
| | - Masahiro Murata
- Tokushima Dental Association, 1-8-65 Kitatamiya, Tokushima 770-0003, Japan
| | - Makoto Fukui
- Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramotocho, Tokushima 770-8504, Japan
| | - Shizuko Yanagisawa
- Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramotocho, Tokushima 770-8504, Japan
| | - Yasuhiko Shirayama
- Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramotocho, Tokushima 770-8504, Japan
| | - Kojiro Nagai
- Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramotocho, Tokushima 770-8504, Japan
| | - Daisuke Hinode
- Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramotocho, Tokushima 770-8504, Japan
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Lertpimonchai A, Rattanasiri S, Tamsailom S, Champaiboon C, Ingsathit A, Kitiyakara C, Limpianunchai A, Attia J, Sritara P, Thakkinstian A. Periodontitis as the risk factor of chronic kidney disease: Mediation analysis. J Clin Periodontol 2019; 46:631-639. [PMID: 30993705 PMCID: PMC6593715 DOI: 10.1111/jcpe.13114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 01/29/2023]
Abstract
AIM To determine sequences and magnitude of causality among periodontitis, diabetes and chronic kidney disease (CKD) by mediation analysis. METHODS Ten-year-data were retrieved from the Electric Generation Authority of Thailand (EGAT) study. A cohort of 2,635 subjects was identified with no CKD at baseline. The interested outcome was CKD incidence defined as glomerular filtration rate <60 ml/min/1.73 m2 . The percentage of proximal sites with clinical attachment loss ≥5 mm was used to represent periodontitis. Mediation analysis with 1,000-replication bootstrapping was applied to two causal diagrams, diagram A (Periodontitis → Diabetes → CKD) and diagram B (Diabetes → Periodontitis → CKD). RESULTS The cumulative incidence of CKD was 10.3 cases per 100 persons during 10-year period. In diagram A, each increasing percentage of proximal sites with severe periodontitis increased the adjusted odds ratio of CKD 1.010 (95% CI: 1.005, 1.015) and 1.007 (95% CI: 1.004, 1.013), by direct and indirect effect through diabetes, respectively. In diagram B, diabetes increased the odds of CKD twofold, with 6.5% of this effect mediated via periodontitis. CONCLUSIONS Periodontitis had significant direct effect, and indirect effect through diabetes, on the incidence of CKD. Awareness about systemic morbidities from periodontitis should be emphasized.
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Affiliation(s)
- Attawood Lertpimonchai
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suphot Tamsailom
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chantrakorn Champaiboon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiporn Ingsathit
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chagriya Kitiyakara
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anusorn Limpianunchai
- Medical and Health Division, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Piyamitr Sritara
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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29
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Systemic inflammation linking chronic periodontitis to cognitive decline. Brain Behav Immun 2019; 81:63-73. [PMID: 31279681 DOI: 10.1016/j.bbi.2019.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022] Open
Abstract
Persistent inflammation in the systemic immune system can impose detrimental effects on the central nervous system (CNS). Neuroinflammation might be a result of this to accelerate the progressive deterioration of neuronal functions during aging. In this regard, controlling inflammation through delaying and/or preventing chronic inflammatory diseases may be a potential strategy to prevent or modify the progression of Alzheimer's Disease (AD). Periodontitis is a chronic inflammatory disease of the oral cavity that is common among the elderly, especially for those who have decline in cognitive functions. While epidemiological findings support the association of chronic periodontitis and cognitive decline, whether they have causal relationship remains unclear. Nonetheless, the possibility that periodontopathogens, systemic immune cells and inflammatory cytokines could reach the CNS should not be overlooked. The impacts of periodontitis on CNS homeostasis and inflammation as a pathophysiological factor concerning the association between periodontitis and AD will be discussed in this review. Future work should elucidate the pathological pathways involved in periodontitis-induced cerebral infections and inflammation, and define the role of the latter in AD progression.
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30
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Thanakun S, Pawaputanon Na Mahasarakham C, Pornprasertsuk-Damrongsri S, Izumi Y. Correlation of plasma osteopontin and osteocalcin with lower renal function in dental patients with carotid artery calcification and tooth loss. J Oral Biosci 2019; 61:183-189. [PMID: 31400547 DOI: 10.1016/j.job.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/23/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate plasma osteopontin (OPN) and osteocalcin (OCN) levels in dental patients with carotid artery calcification (CAC) and determine the correlations between these proteins and renal function and tooth loss. METHODS The health parameters and number of teeth of 99 participants were recorded. Panoramic radiographs were taken for CAC evaluation, and OPN and OCN levels were measured. RESULTS None of the participants had overt kidney disease, and 14 (14.14%) had CAC. The age, sex, and health profiles of patients with CAC were not different from those without CAC. The OPN and OCN levels in participants with CAC were higher than in those without (p = 0.026 and p = 0.025, respectively). The OPN levels were correlated with the estimated glomerular filtration rate (eGFR) (p = 0.021) and tooth loss (p = 0.027). The OCN levels were correlated with the eGFR (p = 0.002), tooth loss (p = 0.023), blood urea nitrogen (p = 0.040), and creatinine levels (p = 0.031). The median tooth loss in individuals with an eGFR <60 mL/min/1.73 m2 was higher than that of individuals with an eGFR ≥60 mL/min/1.73 m2 (p = 0.033). In individuals with CAC, tooth loss correlated more strongly with the eGFR, and the correlation between OPN and OCN levels was more apparent. CONCLUSION Dental patients with CAC and increased tooth loss have a greater tendency for decreased renal function, which may be associated with OPN and OCN; thus, these patients should be referred for investigation.
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Affiliation(s)
- Supanee Thanakun
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; Oral Diagnosis and Oral Medicine Clinic, Dental Hospital, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
| | | | | | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan.
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31
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Kitamura M, Mochizuki Y, Miyata Y, Obata Y, Mitsunari K, Matsuo T, Ohba K, Mukae H, Yoshimura A, Nishino T, Sakai H. Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation. Int J Mol Sci 2019; 20:ijms20143413. [PMID: 31336777 PMCID: PMC6678374 DOI: 10.3390/ijms20143413] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.
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Affiliation(s)
- Mineaki Kitamura
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yasushi Mochizuki
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
| | - Yoko Obata
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hideki Sakai
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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Kapellas K, Singh A, Bertotti M, Nascimento GG, Jamieson LM. Periodontal and chronic kidney disease association: A systematic review and meta-analysis. Nephrology (Carlton) 2019; 24:202-212. [PMID: 29359889 DOI: 10.1111/nep.13225] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 12/19/2022]
Abstract
AIM Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. METHODS Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta-analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. RESULTS A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44-1.79, I2 35.2%, P = 0.11) compared to those without. Conversely, a similar magnitude but non-significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I2 = 89.8%, P < 0.00) versus non-CKD. Meta-regression revealed study quality based on the Newcastle-Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis. CONCLUSIONS Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maitê Bertotti
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo G Nascimento
- Department of Dentistry and Oral Health, Aarhus Universitet Institut for Odontologi, Aarhus, Denmark
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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33
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Zhang D, Liu W, Miao R, Wang L, Zhou X, Wang H, Li Y, Wang Z. Chronic Periodontitis is a Risk Factor of Renal Dysfunction in Patients with Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2019; 129:407-412. [PMID: 31049901 DOI: 10.1055/a-0895-5275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND This study explores the association between chronic periodontitis and renal dysfunction in type 2 diabetic mellitus (T2DM) patients. METHODS An observational study was conducted in 169 T2DM patients with chronic periodontitis. Patients were divided into 2 groups according to presence of normal renal function (n=111) and renal dysfunction (n=58), and oral health behavior-related variables were obtained by questionnaire. Periodontal status was examined, and pocket probing depth (PD), clinical attachment level (CAL), and bleeding index (BI) were measured. RESULTS The severe periodontitis group had a significant higher HbA1c level (8.53 ± 1.61%) as compared with the mild and moderate periodontitis groups (7.68±1.58%) and (7.35±1.45%), P=0.001. Compared with patients with normal renal function, patients with renal dysfunction had a higher PD value, higher CAL value, fewer remaining teeth, and were less likely to have remaining teeth ≥20. The percentage of sites with PD ≥4 mm (52.8% vs. 41.67%) was significantly greater in patients with renal dysfunction. There was no difference in the scores of oral health knowledge assessment between the 2 groups. After adjustment by gender, age, BMI, smoking, hypertension, and HbA1c, the percentage of the sites with PD≥4 mm was an independent risk factor of renal dysfunction in T2DM patients. CONCLUSION In patients with T2DM, those with periodontitis may be more susceptible to decreased kidney function.
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Affiliation(s)
- Dongxue Zhang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wenyan Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ran Miao
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lei Wang
- Department of Stomatology, Chuiyangliu Hospital, Tsinghua University, Beijing, China
| | - Xuan Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Haiyan Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Wangerin C, Pink C, Endlich K, Rettig R, Stracke S, Nauck M, Völzke H, Kocher T, Holtfreter B. Long-term Association of Periodontitis With Decreased Kidney Function. Am J Kidney Dis 2019; 73:513-524. [DOI: 10.1053/j.ajkd.2018.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 10/21/2018] [Indexed: 12/14/2022]
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Iwasaki M, Taylor GW, Sato M, Minagawa K, Ansai T, Yoshihara A. Effect of chronic kidney disease on progression of clinical attachment loss in older adults: A 4‐year cohort study. J Periodontol 2019; 90:826-833. [DOI: 10.1002/jper.18-0464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/09/2019] [Accepted: 01/27/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Masanori Iwasaki
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - George W. Taylor
- Department of Preventive and Restorative Dental SciencesUniversity of California San Francisco San Francisco CA USA
| | - Misuzu Sato
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
| | - Kumiko Minagawa
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
| | - Toshihiro Ansai
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health PromotionDepartment of Oral Health and WelfareGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
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Chopra A, Sivaraman K. An update on possible pathogenic mechanisms of periodontal pathogens on renal dysfunction. Crit Rev Microbiol 2019; 45:514-538. [PMID: 30729832 DOI: 10.1080/1040841x.2018.1553847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontitis is a potential source of permanent systemic inflammation that initiates renal dysfunction and contributes to the development of chronic kidney diseases (CKDs). Although numerous studies have confirmed the bidirectional role of periodontal infection and renal inflammation, no literature has yet highlighted the sophisticated pathogenic mechanisms by which periodontal pathogens, particularly Porphynomonas Gingivalis, induce renal dysfunction and contributed in the development of CKDs. The present review aims to critically analyze and highlight the novel pathogenesis of periodontitis induced CKDs.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Islas-Granillo H, Borges-Yañez SA, Navarrete-Hernández JDJ, Veras-Hernández MA, Casanova-Rosado JF, Minaya-Sánchez M, Casanova-Rosado AJ, Fernández-Barrera MÁ, Medina-Solís CE. Indicators of oral health in older adults with and without the presence of multimorbidity: a cross-sectional study. Clin Interv Aging 2019; 14:219-224. [PMID: 30787597 PMCID: PMC6363395 DOI: 10.2147/cia.s170470] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim of this study was to determine whether there are differences in the distribution of various indicators of oral health among elderly people with and without multimorbidity (ie, two or more chronic diseases). Subjects and methods A cross-sectional, comparative study was conducted using a sample of Mexican elderly individuals aged ≥60 years. The average age of the cohort was 79.06±9.78 years, and 69.1% were women. The variables indicating oral health were as follows: functional dentition, edentulism, hyposalivation, xerostomia, root caries and periodontitis. The multimorbidity variable was operationally categorized as follows: 0= subjects with no chronic disease or one chronic disease and 1= subjects with two or more chronic diseases. Questionnaires were used to collect information on various variables regarding general health. Likewise, the participants underwent a clinical oral examination. The analysis was performed using Stata 11.0. Results The overall prevalence of multimorbidity was 27.3%. The prevalences of various oral health indicators were as follows: without functional dentition 89.9%; hyposalivation 59.7%; edentulism 38.9% and self-reported xerostomia 25.2%. Dental caries were observed in 95.3% of the subjects, and the prevalence of severe periodontitis was 80%. We found a significant difference only in edentulism; its prevalence was higher among subjects with multimorbidity (55.3% vs 32.7%, P=0.015) than among those without multimorbidity. Conclusion The presence of edentulism in this sample of Mexican older adults was higher in subjects with multimorbidity. Multimorbidity and oral diseases constitute a true challenge in elderly people, because they affect quality of life and are associated with high health care costs.
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Affiliation(s)
- Horacio Islas-Granillo
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Mexico,
| | | | | | | | | | | | | | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Mexico, .,Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata", Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
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Yaussy SL, DeWitte SN. Calculus and survivorship in medieval London: The association between dental disease and a demographic measure of general health. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 168:552-565. [PMID: 30613949 DOI: 10.1002/ajpa.23772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Dental plaque is associated with a variety of systemic diseases and mortality risks in living populations. However, bioarchaeologists have not fully investigated the mortality risks associated with plaque (or its mineralized form, calculus) in the past. This study examines the relationship between survivorship and calculus in a medieval skeletal sample. MATERIALS AND METHODS Our sample (n = 1,098) from four medieval London cemeteries, c. 1000-1540 CE, includes people who died under attritional (normal) and catastrophic (famine and plague) conditions. The associations between age and the presence of dental calculus on the permanent left first mandibular molar are assessed using binary logistic regression and Kaplan-Meier survival analysis. RESULTS The regression results indicate a significant negative relationship between age and calculus presence for individuals of all ages who died under normal mortality conditions and for adults who died under both normal and catastrophic conditions. Survival analysis reveals decreased survivorship for people of all ages with calculus under normal mortality conditions. Similarly, during conditions of catastrophic mortality, adult males with calculus suffered reduced survivorship compared to males without it, though there was no difference in survivorship between adult females with and without calculus. CONCLUSIONS These results suggest that, as in modern populations, calculus accumulation in the inhabitants of medieval London reflects a greater risk of premature death. The evaluation of calculus, a potential measure of underlying frailty, in the context of a demographic measure of general health suggests that it might provide insights into health in past populations.
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Affiliation(s)
- Samantha L Yaussy
- Department of Anthropology, University of South Carolina, Columbia, South Carolina
| | - Sharon N DeWitte
- Department of Anthropology, University of South Carolina, Columbia, South Carolina
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Holde GE, Baker SR, Jönsson B. Periodontitis and quality of life: What is the role of socioeconomic status, sense of coherence, dental service use and oral health practices? An exploratory theory-guided analysis on a Norwegian population. J Clin Periodontol 2018; 45:768-779. [DOI: 10.1111/jcpe.12906] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/28/2018] [Accepted: 04/16/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Gro Eirin Holde
- Department of Clinical Dentistry; Faculty of Health Sciences; UiT the Arctic University of Norway; Tromsø Norway
- The Public Dental Health Service Competence Centre of Northern Norway; Tromsø Norway
| | - Sarah R. Baker
- Academic Unit of Oral Health, Dentistry and Society; School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway; Tromsø Norway
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Zhao D, Khawaja AT, Jin L, Li KY, Tonetti M, Pelekos G. The directional and non-directional associations of periodontitis with chronic kidney disease: A systematic review and meta-analysis of observational studies. J Periodontal Res 2018; 53:682-704. [PMID: 29777531 DOI: 10.1111/jre.12565] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
This systematic review aimed to assess the current evidence on the directional and non-directional associations of periodontitis with chronic kidney disease (CKD). Electronic search for observational studies on the association of periodontitis with CKD was performed in MEDLINE, EMBASE, PubMed, Open GREY and Cochrane library up to June 5, 2017. Two reviewers conducted study selection, data collection and assessment of methodological quality using the original and modified Newcastle-Ottawa Scale. Cohort, case-control and cross-sectional studies were included, which clearly defined periodontitis and CKD or reported acceptable clinical parameters of these 2 diseases in adults. Meta-analysis was employed to estimate the pooled odds ratio on the non-directional association and the incidence rate ratio (IRR) for the directional association. Among 2530 potential eligible articles, 47 were finally included. Most of them investigated a non-directional association of periodontitis with CKD, including 7 case-control studies and 38 cross-sectional studies; 24 studies had statistical analysis on the non-directional association and 75% of them reported significant results, which were supported further by the meta-analysis (random: odds ratio = 2.12, P < .001; χ2 = 25.74, I2 = 88.3%). None of the studies focused on the directional association of CKD (as the exposure) with periodontitis (as the outcome), whereas 2 retrospective cohort studies explored a directional association of periodontitis (as the exposure) with CKD (as the outcome) (random: IRR=2.10, P > .05; fixed: IRR=1.76, P < .05; χ2 = 4.65, I2 = 78.3%). Overall, the high heterogeneity of studies limits the significance of these results. There is substantial evidence on the non-directional association of periodontitis with CKD, while there are limited studies on the directional association. Well-designed prospective studies with longer follow-ups in representative communities are needed to clarify the directional association and enhance the quality of the evidence on this topic.
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Affiliation(s)
- D Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - A T Khawaja
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - L Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - K-Y Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - M Tonetti
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - G Pelekos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Yoshihara A, Kaneko N, Iwasaki M, Nohno K, Miyazaki H. Relationship between vitamin D receptor gene polymorphism and susceptibility to chronic kidney disease and periodontal disease in community-dwelling elderly. J Clin Periodontol 2018; 45:672-679. [DOI: 10.1111/jcpe.12896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Noboru Kaneko
- Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Masanori Iwasaki
- Department of Community Oral Health Development; Kyushu Dental University; Kitakyushu Fukuoka Japan
| | - Kaname Nohno
- Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Hideo Miyazaki
- Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Deschamps-Lenhardt S, Martin-Cabezas R, Hannedouche T, Huck O. Association between periodontitis and chronic kidney disease: Systematic review and meta-analysis. Oral Dis 2018; 25:385-402. [DOI: 10.1111/odi.12834] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 01/07/2017] [Accepted: 01/22/2018] [Indexed: 12/18/2022]
Affiliation(s)
- S Deschamps-Lenhardt
- Faculté de chirurgie-dentaire; Periodontology; Université de Strasbourg; Strasbourg France
- Pôle de médecine et chirurgie bucco-dentaire; Hôpitaux universitaires de Strasbourg; Strasbourg France
| | - R Martin-Cabezas
- Faculté de chirurgie-dentaire; Periodontology; Université de Strasbourg; Strasbourg France
- Pôle de médecine et chirurgie bucco-dentaire; Hôpitaux universitaires de Strasbourg; Strasbourg France
| | - T Hannedouche
- Faculté de Médecine; Université de Strasbourg et Service de néphrologie; Hôpitaux Universitaires de Strasbourg; Strasbourg France
| | - O Huck
- Faculté de chirurgie-dentaire; Periodontology; Université de Strasbourg; Strasbourg France
- Pôle de médecine et chirurgie bucco-dentaire; Hôpitaux universitaires de Strasbourg; Strasbourg France
- INSERM (French National Institute of Health and Medical Research); Regenerative Nanomedicine; UMR 1260; Fédération de Médecine Translationnelle de Strasbourg (FMTS); Strasbourg France
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Understanding the direction of the relationship between white matter hyperintensities of vascular origin, sleep quality, and chronic kidney disease-Results from the Atahualpa Project. Clin Neurol Neurosurg 2017; 165:10-14. [PMID: 29288961 DOI: 10.1016/j.clineuro.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The burden of cerebral small vessel disease, sleep disorders, and chronic kidney disease is on the rise in remote rural settings. However, information on potential links between these conditions is limited. We aimed to assess the relationships between these conditions in community-dwelling older adults living in rural Ecuador. PATIENTS AND METHODS Atahualpa residents aged ≥60 years were offered a brain MRI. A venous blood sample was obtained for serum creatinine determination. Baseline interviews and procedures were directed to assess demographics, cardiovascular risk factors, and sleep quality. Using generalized structural equation modeling (GSEM), we assessed the associations between white matter hyperintensities (WMH) of vascular origin, sleep quality and kidney function, as well as the directions of the relationships between these variables. RESULTS Of 423 candidates, 314 (74%) were enrolled. Moderate-to-severe WMH were noticed in 74 (24%) individuals, poor sleep quality in 101 (31%), and moderate-to-severe chronic kidney disease in 28 (9%). GSEM showed that the direction of the effect was from kidney function to WMH and from the latter to sleep quality. Of independent variables investigated, worse kidney function was associated with age, high glucose levels and male sex. WMH was associated with cholesterol blood levels, blood pressure, level of education and severe edentulism. Poor sleep quality was associated with poor physical activity. CONCLUSION This population based study shows that chronic kidney disease is associated with increased severity of WMH, which, in turn, is associated with a poor sleep quality.
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Iwasaki M, Taylor GW, Awano S, Yoshida A, Kataoka S, Ansai T, Nakamura H. Periodontal disease and pneumonia mortality in haemodialysis patients: A 7-year cohort study. J Clin Periodontol 2017; 45:38-45. [DOI: 10.1111/jcpe.12828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Masanori Iwasaki
- Division of Community Oral Health Development; Kyushu Dental University; Kitakyushu Japan
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences; University of California San Francisco; San Francisco CA USA
| | - Shuji Awano
- Department of Comprehensive Education; Kyushu Dental University; Kitakyushu Japan
| | - Akihiro Yoshida
- Department of Oral Microbiology; Matsumoto Dental University; Shiojiri Japan
| | - Shota Kataoka
- Division of Community Oral Health Development; Kyushu Dental University; Kitakyushu Japan
| | - Toshihiro Ansai
- Division of Community Oral Health Development; Kyushu Dental University; Kitakyushu Japan
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Parente IT, Lima ZR, Teixeira LH, Lisboa MR, de Melo IM, Santos PR, Goes P. Gingivitis, increased probing depth, clinical attachment loss and tooth loss among patients with end-stage chronic kidney disease: a case-control study. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0833-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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46
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Zhang J, Jiang H, Sun M, Chen J. Association between periodontal disease and mortality in people with CKD: a meta-analysis of cohort studies. BMC Nephrol 2017; 18:269. [PMID: 28814274 PMCID: PMC5558661 DOI: 10.1186/s12882-017-0680-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Periodontal disease occurs relatively prevalently in people with chronic kidney disease (CKD), but it remains indeterminate whether periodontal disease is an independent risk factor for premature death in this population. Interventions to reduce mortality in CKD population consistently yield to unsatisfactory results and new targets are necessitated. So this meta-analysis aimed to evaluate the association between periodontal disease and mortality in the CKD population. METHODS Pubmed, Embase, Web of Science, Scopus and abstracts from recent relevant meeting were searched by two authors independently. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was explored by chi-square test and quantified by the I2 statistic. RESULTS Eight cohort studies comprising 5477 individuals with CKD were incorporated. The overall pooled data demonstrated that periodontal disease was associated with all-cause death in CKD population (RR, 1.254; 95% CI 1.046-1.503; P = 0.005), with a moderate heterogeneity, I2 = 52.2%. However, no evident association was observed between periodontal disease and cardiovascular mortality (RR, 1.30, 95% CI, 0.82-2.06; P = 0.259). Besides, statistical heterogeneity was substantial (I2 = 72.5%; P = 0.012). Associations for mortality were similar between subgroups, such as the different stages of CKD, adjustment for confounding factors. Specific to all-cause death, sensitivity and cumulative analyses both suggested that our results were robust. As for cardiovascular mortality, the association with periodontal disease needs to be further strengthened. CONCLUSIONS We demonstrated that periodontal disease was associated with an increased risk of all-cause death in CKD people. Yet no adequate evidence suggested periodontal disease was also at elevated risk for cardiovascular death.
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Affiliation(s)
- Jian Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China
| | - Hong Jiang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Min Sun
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, People's Republic of China
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
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Panny A, Glurich I, Haws RM, Acharya A. Oral and Craniofacial Anomalies of Bardet-Biedl Syndrome: Dental Management in the Context of a Rare Disease. J Dent Res 2017; 96:1361-1369. [PMID: 28662344 DOI: 10.1177/0022034517716913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Standardized guidelines for the oral health management of patients with rare diseases exhibiting morphologic anomalies are currently lacking. This review considers Bardet-Biedl syndrome (BBS), a monogenic autosomal recessive nonmotile ciliopathy, as an archetypal condition. Dental anomalies are present in a majority of individuals affected by BBS due to abnormal embryonic orofacial and tooth development. Genetically encoded intrinsic oral structural anomalies and heterogeneous BBS clinical phenotypes and consequent oral comorbidities confound oral health management. Since the comorbid spectrum of BBS phenotypes spans diabetes, renal disease, obesity, sleep apnea, cardiovascular disease, and cognitive disorders, a broad spectrum of collateral oral disease may be encountered. The genetic impact of BBS on the anatomic development of oral components and oral pathology encountered in the context of various BBS phenotypes and their associated comorbidities are reviewed herein. Challenges encountered in managing patients with BBS are highlighted, emphasizing the spectrum of oral pathology associated with heterogeneous clinical phenotypic expression. Guidelines for provision of care across the spectrum of BBS clinical phenotypes are considered. Establishment of integrated medical-dental delivery models of oral care in the context of rare diseases is emphasized, including involvement of caregivers in the context of managing these patients with special needs.
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Affiliation(s)
- A Panny
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - I Glurich
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - R M Haws
- 2 Center for Clinical Research, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - A Acharya
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
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Kang SH, Park JW, Cho KH, Do JY. Association Between Periodontitis and Low-Grade Albuminuria in Non-Diabetic Adults. Kidney Blood Press Res 2017; 42:338-346. [PMID: 28578341 DOI: 10.1159/000477784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/21/2017] [Indexed: 11/19/2022] Open
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Yoshihara A, Sugita N, Iwasaki M, Wang Y, Miyazaki H, Yoshie H, Nakamura K. Relationship between renal function and periodontal disease in community-dwelling elderly women with different genotypes. J Clin Periodontol 2017; 44:484-489. [PMID: 28207944 DOI: 10.1111/jcpe.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine the association between periodontal disease and renal function in elderly women with different genotypes. MATERIAL AND METHODS A total of 332 postmenopausal never-smoking women were analysed. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers such as periodontal inflamed surface area (PISA) were evaluated. Selected variables, including PISA quartile, body mass index (BMI), HbA1C and age in Arg allele carriers and non-carriers based on the beta-3 adrenergic receptor, or between Ala allele carriers and non-carriers based on peroxisome proliferator-activated receptor gamma, were analysed using multiple logistic regression analysis. RESULTS The odds ratios of serum cystatin C level and PISA (fourth quartile) were significantly positive for both Arg (2.52; p = 0.035) and Ala allele non-carriers (2.36; p = 0.021). A significant association was also found between serum cystatin C level and BMI for both Arg (1.18; p = 0.001) and Ala allele non-carriers (1.12; p = 0.003). CONCLUSION The results of this study suggest that periodontal inflammation might be associated with renal function. Furthermore, in both the Arg and Ala allele non-carriers, the associations between BMI and PISA for renal function became stronger.
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Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Noriko Sugita
- Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masanori Iwasaki
- Department of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Yanming Wang
- Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hideo Miyazaki
- Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiromasa Yoshie
- Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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50
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Iwasaki M, Borgnakke WS, Awano S, Yoshida A, Hamasaki T, Teratani G, Kataoka S, Kakuta S, Soh I, Ansai T, Nakamura H. Periodontitis and health-related quality of life in hemodialysis patients. Clin Exp Dent Res 2017; 3:13-18. [PMID: 29744174 PMCID: PMC5839240 DOI: 10.1002/cre2.50] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 12/25/2022] Open
Abstract
Periodontitis is common among dialysis patients. The current cross-sectional study aimed to explore associations between periodontitis and health-related quality of life (HRQoL) among hemodialysis patients. Data from 188 dentate patients undergoing hemodialysis between May and July 2008 at a medical center in Kitakyushu city, Japan, were analyzed while applying modified Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions to categorize the participants into the following three groups: severe, moderate, and no/mild periodontitis, respectively. HRQoL was assessed by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) where a higher score indicates better health status. Associations between periodontitis groups and the eight health domains of SF-36 were evaluated using general linear models that were adjusted for age, sex, underlying cause of dialysis, duration of dialysis, comorbidities, serum biomarkers, body mass index, smoking status, and alcohol use. Among the 188 participants, 18 (9.6%) had severe periodontitis, 100 (53.2%) had moderate periodontitis, and the remaining 70 (37.2%) had no/mild periodontitis. Compared with the participants with no/mild periodontitis, those with severe periodontitis had worse scores in the following five of eight SF-36 health scales: physical functioning, role physical, vitality, social functioning, and mental health (P < 0.05). The findings suggest an independent relationship between severe periodontitis and decreased HRQoL among dialysis patients.
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Affiliation(s)
- Masanori Iwasaki
- Division of Community Oral Health DevelopmentKyushu Dental UniversityKitakyushuJapan
| | - Wenche S. Borgnakke
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Shuji Awano
- Department of Comprehensive EducationKyushu Dental UniversityKitakyushuJapan
| | - Akihiro Yoshida
- Department of Oral MicrobiologyMatsumoto Dental UniversityShiojiriJapan
| | - Tomoko Hamasaki
- Department of Nutrition Faculty of Home EconomicsKyushu Women's UniversityKitakyushuJapan
| | | | - Shota Kataoka
- Division of Community Oral Health DevelopmentKyushu Dental UniversityKitakyushuJapan
| | - Satoko Kakuta
- Division of Community Oral Health DevelopmentKyushu Dental UniversityKitakyushuJapan
| | - Inho Soh
- Division of Community Oral Health DevelopmentKyushu Dental UniversityKitakyushuJapan
| | - Toshihiro Ansai
- Division of Community Oral Health DevelopmentKyushu Dental UniversityKitakyushuJapan
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