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Silva DS, Laranjeira P, Silva A, Silva I, Kaminska M, Mydel P, de Vries C, Lundberg K, da Silva JAP, Baptista IP, Paiva A. Impaired Periodontitis-Induced Cytokine Production by Peripheral Blood Monocytes and Myeloid Dendritic Cells in Patients with Rheumatoid Arthritis: A Case-Control Study. J Clin Med 2024; 13:5297. [PMID: 39274511 PMCID: PMC11395796 DOI: 10.3390/jcm13175297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/04/2024] [Accepted: 09/05/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Immune cells from rheumatoid arthritis (RA) patients display a reduced in vitro response to Porphyromonas gingivalis (P. gingivalis), which may have functional immune consequences. The aim of this study was to characterize, by flow cytometry, the frequency/activity of monocytes and naturally occurring myeloid dendritic cells (mDCs) in peripheral blood samples from patients with periodontitis and patients with periodontitis and RA. Methods: The relative frequency of monocytes and mDCs in the whole blood, the frequency of these cells producing TNFα or IL-6 and the protein expression levels for each cytokine, before and after stimulation with lipopolysaccharide (LPS) from Escherichia coli plus interferon-γ (IFN-γ), were assessed by flow cytometry, in peripheral blood samples from 10 healthy individuals (HEALTHY), 10 patients with periodontitis (PERIO) and 17 patients with periodontitis and RA (PERIO+RA). Results: The frequency of monocytes and mDCs producing IL-6 or TNF-α and the expression of IL-6 and TNF-α in the PERIO group were generally higher. Within the PERIO+RA group, P. gingivalis and related antibodies were negatively correlated with the monocyte and mDC expression of IL-6. A subgroup of the PERIO+RA patients that displayed statistically significantly lower frequencies of monocytes producing IL-6 after activation presented statistically significantly higher peptidylarginine deiminase (PAD)2/4 activity, anti-arg-gingipain (RgpB) IgG levels, mean probing depth (PD), periodontal inflamed surface area (PISA) and bleeding on probing (BoP). Conclusions: In the patients with PERIO+RA, innate immune cells seemed to produce lower amounts of pro-inflammatory cytokines, which are correlated with worse periodontitis-related clinical and microbiological parameters.
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Affiliation(s)
- Daniela S Silva
- Periodontology Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Group of Environmental Genetics of Coimbra Oncobiology (CIMAGO), Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Paula Laranjeira
- Group of Environmental Genetics of Coimbra Oncobiology (CIMAGO), Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Flow Cytometry Unit, Department of Clinical Pathology, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra (ULS), 3004-561 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotchnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-504 Coimbra, Portugal
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
| | - Ana Silva
- Flow Cytometry Unit, Department of Clinical Pathology, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra (ULS), 3004-561 Coimbra, Portugal
| | - Isabel Silva
- Flow Cytometry Unit, Department of Clinical Pathology, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra (ULS), 3004-561 Coimbra, Portugal
| | - Marta Kaminska
- Broegelmann Research Laboratory, Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, 5021 Bergen, Norway
- Department of Microbiology, Faculty of Biochemistry Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Piotr Mydel
- Broegelmann Research Laboratory, Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, 5021 Bergen, Norway
- Department of Microbiology, Faculty of Biochemistry Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland
| | - Charlotte de Vries
- Department of Medicine Solna, Division of Rheumatology, Karolinska Institute, 17164 Solna, Sweden
| | - Karin Lundberg
- Department of Medicine Solna, Division of Rheumatology, Karolinska Institute, 17164 Solna, Sweden
| | - José António P da Silva
- Group of Environmental Genetics of Coimbra Oncobiology (CIMAGO), Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Rheumatology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra (ULS), 3004-561 Coimbra, Portugal
| | - Isabel P Baptista
- Periodontology Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Group of Environmental Genetics of Coimbra Oncobiology (CIMAGO), Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Artur Paiva
- Group of Environmental Genetics of Coimbra Oncobiology (CIMAGO), Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Flow Cytometry Unit, Department of Clinical Pathology, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra (ULS), 3004-561 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotchnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-504 Coimbra, Portugal
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
- Ciências Biomédicas Laboratoriais, Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, 3046-854 Coimbra, Portugal
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Liu F, Zhu B, An Y, Zhou Z, Xiong P, Li X, Mi Y, He T, Chen F, Wu B. Gingipain from Porphyromonas gingivalis causes insulin resistance by degrading insulin receptors through direct proteolytic effects. Int J Oral Sci 2024; 16:53. [PMID: 39085196 PMCID: PMC11291925 DOI: 10.1038/s41368-024-00313-z] [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: 10/26/2023] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 08/02/2024] Open
Abstract
Periodontitis is a critical risk factor for the occurrence and development of diabetes. Porphyromonas gingivalis may participate in insulin resistance (IR) caused by periodontal inflammation, but the functional role and specific mechanisms of P. gingivalis in IR remain unclear. In the present study, clinical samples were analysed to determine the statistical correlation between P. gingivalis and IR occurrence. Through culturing of hepatocytes, myocytes, and adipocytes, and feeding mice P. gingivalis orally, the functional correlation between P. gingivalis and IR occurrence was further studied both in vitro and in vivo. Clinical data suggested that the amount of P. gingivalis isolated was correlated with the Homeostatic Model Assessment for IR score. In vitro studies suggested that coculture with P. gingivalis decreased glucose uptake and insulin receptor (INSR) protein expression in hepatocytes, myocytes, and adipocytes. Mice fed P. gingivalis tended to undergo IR. P. gingivalis was detectable in the liver, skeletal muscle, and adipose tissue of experimental mice. The distribution sites of gingipain coincided with the downregulation of INSR. Gingipain proteolysed the functional insulin-binding region of INSR. Coculture with P. gingivalis significantly decreased the INSR-insulin binding ability. Knocking out gingipain from P. gingivalis alleviated the negative effects of P. gingivalis on IR in vivo. Taken together, these findings indicate that distantly migrated P. gingivalis may directly proteolytically degrade INSR through gingipain, thereby leading to IR. The results provide a new strategy for preventing diabetes by targeting periodontal pathogens and provide new ideas for exploring novel mechanisms by which periodontal inflammation affects the systemic metabolic state.
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Affiliation(s)
- Fen Liu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Laboratory Center of Stomatology, Department of Paediatric Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Bofeng Zhu
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, China
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ying An
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Zhifei Zhou
- Department of Stomatology, General Hospital of Tibetan Military Command, Lhasa, China
| | - Peiying Xiong
- Department of Stomatology Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Xuan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yang Mi
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, China
| | - Tongqiang He
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, China
| | - Faming Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
| | - Buling Wu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, China.
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Arunyanak SP, Kungsadalpipob K, Wright KE, Subbalekha K, Dragan I, Mattheos N. The use of patient-related outcomes (PRO) and experience (PRE) in assessing the periodontal and implant patient. Periodontol 2000 2024; 95:40-50. [PMID: 38927002 DOI: 10.1111/prd.12589] [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: 02/06/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
The purpose of this review was to summarize the evidence with regard to behavioral and psychosocial assessment of the periodontitis patient, the candidate for implant therapy, and the peri-implantitis patient. Periodontitis has an adverse effect on quality of life and its treatment can lead to significant improvements experienced by the patient. The latter is true for rehabilitation with dental implants, although patients harbor diverse expectations and perceptions of implant therapy, which can often interfere with satisfaction and/or influence long-term success. A thorough behavioral assessment of the candidate for implant therapy is essential, which should include, perceptions, expectations, as well as risk for behavioral disorders. Remedial action is essential to correct misperceptions and any identified risks. Finally, patients have limited awareness of limited ability to identify signs of peri-implantitis. The diagnosis of peri-implantitis can be a cause of significant distress, resentment, and loss of trust to the treatment and the caregivers. Despite documented value in clinical research, currently available instruments assessing patient-reported outcomes have little application in day-to-day clinical practice. Face-to-face patient to doctor open-ended communication remains the most effective way to comprehensively establish the long-term "therapeutic alliance" essential for the long journey for the periodontitis patient.
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Affiliation(s)
- Sirikarn P Arunyanak
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Kajorn Kungsadalpipob
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Kyle E Wright
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Irina Dragan
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Zhang L, Tsai IC, Ni Z, Chen B, Zhang S, Cai L, Xu Q. Copper Chelation Therapy Attenuates Periodontitis Inflammation through the Cuproptosis/Autophagy/Lysosome Axis. Int J Mol Sci 2024; 25:5890. [PMID: 38892077 PMCID: PMC11172687 DOI: 10.3390/ijms25115890] [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: 04/02/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Periodontitis development arises from the intricate interplay between bacterial biofilms and the host's immune response, where macrophages serve pivotal roles in defense and tissue homeostasis. Here, we uncover the mitigative effect of copper chelator Tetrathiomolybdate (TTM) on periodontitis through inhibiting cuproptosis, a newly identified form of cell death which is dependent on copper. Our study reveals concurrent cuproptosis and a macrophage marker within murine models. In response to lipopolysaccharide (LPS) stimulation, macrophages exhibit elevated cuproptosis-associated markers, which are mitigated by the administration of TTM. TTM treatment enhances autophagosome expression and mitophagy-related gene expression, countering the LPS-induced inhibition of autophagy flux. TTM also attenuates the LPS-induced fusion of autophagosomes and lysosomes, the degradation of lysosomal acidic environments, lysosomal membrane permeability increase, and cathepsin B secretion. In mice with periodontitis, TTM reduces cuproptosis, enhances autophagy flux, and decreases Ctsb levels. Our findings underscore the crucial role of copper-chelating agent TTM in regulating the cuproptosis/mitophagy/lysosome pathway during periodontitis inflammation, suggesting TTM as a promising approach to alleviate macrophage dysfunction. Modulating cuproptosis through TTM treatment holds potential for periodontitis intervention.
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Affiliation(s)
| | | | | | | | | | | | - Qiong Xu
- Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; (L.Z.); (I.-C.T.); (Z.N.); (B.C.); (S.Z.); (L.C.)
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Saleh MHA, Dias DR, Kumar P. The economic and societal impact of periodontal and peri-implant diseases. Periodontol 2000 2024. [PMID: 38693603 DOI: 10.1111/prd.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Periodontal and peri-implant diseases result from a chronic inflammatory response to dysbiotic microbial communities and are characterized by inflammation in the soft tissue and the ensuing progressive destruction of supporting bone, resulting in tooth or implant loss. These diseases' high prevalence, multifactorial etiology, extensive treatment costs, and significant detriment to patients' quality-of-life underscore their status as a critical public health burden. This review delineates the economic and sociocultural ramifications of periodontal and peri-implant diseases on patient welfare and healthcare economics. We delve into the implications of diagnosis, treatment, supportive care, and managing destructive tissue consequences, contrasting these aspects with healthy patients.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Anuwar AHK, Ng CW, Safii SH, Saub R, Ab-Murat N. Modelling the national economic burden of non-surgical periodontal management in specialist clinics in Malaysia using a markov model. BMC Oral Health 2024; 24:346. [PMID: 38500175 PMCID: PMC10949624 DOI: 10.1186/s12903-024-04094-z] [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: 07/06/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Non-surgical periodontal treatment is the mainstay of periodontal treatment. In Malaysia, the prevalence of periodontal disease is substantial among adults with almost half of them having periodontitis. Therefore, we estimated the economic burden of non-surgical periodontal treatment in specialist clinics in Malaysia. METHODS Relevant data from multiple data sources which include national oral health and health surveys, national census, extensive systematic literature reviews, as well as discussion with experts, were used to estimate the economic burden of non-surgical periodontal management in specialist clinics in Malaysia in 2020. This estimation was done from the oral healthcare provider's perspective in both public and private sectors using an irreducible Markov model of 3-month cycle length over a time horizon of one year. RESULTS In 2020, the national economic burden of non-surgical periodontal treatment during the first year of periodontal management in specialist clinics in Malaysia was MYR 696 million (USD 166 million), ranging from MYR 471 million (USD 112 million) to MYR 922 million (USD 220 million). Of these, a total of MYR 485 million (USD 115 million) and MYR 211 million (USD 50 million) were the direct oral healthcare cost in public and private dental clinics, respectively. CONCLUSION The findings of this study demonstrated substantial economic burden of non-surgical periodontal management in specialist clinics in Malaysia. Being a life-long disease, these findings highlight the importance of enforcing primary and secondary preventive measures. On the strength and reliability of this economic evidence, this study provides vital information to inform policy- and decision-making regarding the future direction of managing periodontitis in Malaysia.
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Affiliation(s)
- Ainol Haniza Kherul Anuwar
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Chiu Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Norintan Ab-Murat
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
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Piedra-Hernández L, Batista-Cárdenas D, Gómez-Fernández A, Ramírez K. Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment. Clin Oral Investig 2023; 27:5459-5474. [PMID: 37488334 DOI: 10.1007/s00784-023-05165-1] [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: 02/02/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. MATERIALS AND METHODS Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. RESULTS Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. CONCLUSIONS Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. CLINICAL RELEVANCE Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.
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Affiliation(s)
- Lucía Piedra-Hernández
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica
| | - Daniela Batista-Cárdenas
- School of Statistics, University of Costa Rica, Rodrigo Facio Campus, San Pedro, Montes de Oca, San José, 11801, Costa Rica
| | - Adrián Gómez-Fernández
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica
| | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, Finca 3 "Instalaciones Deportivas", Sabanilla, Montes de Oca, San José, 11502, Costa Rica.
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Jaumet L, Hamdi Z, Julia C, Hercberg S, Touvier M, Bouchard P, Carra MC, Andreeva VA. Periodontitis assessed with a new screening tool and oral health-related quality of life: cross-sectional findings among general-population adults. Qual Life Res 2023; 32:259-272. [PMID: 35948787 PMCID: PMC9365217 DOI: 10.1007/s11136-022-03215-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Periodontitis, as a chronic, multifactorial inflammatory disease, has complex relationships with other diseases and ultimately with well-being. The aim of this cross-sectional study was to investigate the association between self-report periodontitis, as measured with the recently developed and validated modified Periodontal Screening Score (mPESS), and oral health-related quality of life (OHRQol) in a large population-based sample derived from the French NutriNet-Santé e-cohort. METHODS The sample was composed of 32,714 adults (75.5% women) with a mean age of 48.8 ± 13.9 years. Periodontitis was assessed based on age, smoking, and oral health status data obtained in 2011-2012, which allowed calculating the mPESS. An mPESS ≥ 5 was used to identify individuals at risk of severe periodontitis (main exposure). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) (main outcome) and the total score was dichotomized for analysis. Multivariable logistic regression analyses, considering physical health status, dietary and lifestyle confounding variables, were performed. RESULTS Overall, 6407 participants (19.6%) were at a high risk of severe periodontitis. A total of 7383 participants (22.6%) presented a relatively poor OHRQoL (OHIP-14 > 8, highest quartile). In the multivariable model, each of the following variables was independently and significantly associated with lower OHRQoL: older age (50-64 years), female sex, obesity, snacking between meals, frequent consumption of soft drinks and sweets/chocolate, risk of severe periodontitis, and having < 20 natural teeth were significantly. An mPESS ≥ 5 showed the highest odds for relatively poor OHRQoL (OR = 3.45; 95% CI 3.21-3.72). CONCLUSION The results support the association between periodontitis and OHRQoL in non-clinical samples. The use of mPESS could be tested in future prevention programs aiming at improving OHRQoL.
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Affiliation(s)
- Lauranne Jaumet
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Zeineb Hamdi
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Chantal Julia
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Serge Hercberg
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Mathilde Touvier
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Laboratory URP 2496 Orofacial Pathologies, Imaging and Biotherapies, University of Paris Cité, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Population-Based Epidemiologic Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Valentina A. Andreeva
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
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Čolak D, Cmok Kučič A, Pintar T, Gašperšič R. Periodontal Therapy in Bariatric Surgery Patients with Periodontitis: Randomized Control Clinical Trial. J Clin Med 2022; 11:6837. [PMID: 36431314 PMCID: PMC9693218 DOI: 10.3390/jcm11226837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Bariatric surgery (BS) patients may experience the progression of periodontitis during recovery. We aimed to determine whether non-surgical periodontal therapy before BS improves the periodontal and systemic health parameters after the surgery. Methods: BS candidates with periodontitis were randomized into the test (TG) and control group (CG). One month before BS (pre-BS), patients in the TG (n = 15) received non-surgical periodontal therapy, while patients in the CG (n = 15) received only mechanical plaque removal. Patients were re-examined 3 and 6 months after BS. Differences between the TG and CG in clinical periodontal parameters, systemic health-related serum biomarkers, parameters of obesity, and prevalence of obesity-related diseases were evaluated. Results: From the 30 included patients, 26 were re-examined at 3 months and 20 patients at 6 months. Periodontal parameters bleeding on probing (p = 0.015), periodontal pocket dept (PPD, p = 0.0015), % PPD > 4 mm (p < 0.001), and full-mouth plaque levels (p = 0.002) were lower in the TG than in the CG at 6 months after BS. There is a general improvement in systemic health after BS without significant differences (p > 0.05) between the TG and CG at the 6-month follow-up. The TG shows a tendency for improvement in metabolic syndrome components at the 6-month follow-up compared to pre-BS (p < 0.05). Conclusions: Non-surgical periodontal therapy in periodontitis patients before the BS may improve periodontal health 3 and 6 months after the surgery. The possible benefits of periodontal therapy on the overall health of BS patients should be further explored.
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Affiliation(s)
- Dejana Čolak
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Alja Cmok Kučič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tadeja Pintar
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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10
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Zhang R, Wu Z, Li M, Yang J, Cheng R, Hu T. Canonical and noncanonical pyroptosis are both activated in periodontal inflammation and bone resorption. J Periodontal Res 2022; 57:1183-1197. [PMID: 36146901 DOI: 10.1111/jre.13055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 08/04/2022] [Accepted: 09/07/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Pyroptosis has both a caspase-1-dependent canonical pathway and a caspase-4/-5/-11-dependent noncanonical pathway. They play an important role in inflammatory damage and related diseases. Canonical pyroptosis was reported to be involved in periodontitis. However, knowledge of caspase-4/-5/-11-dependent noncanonical pathway involvement remains limited. The aim of this study was to investigate the outcomes of pyroptosis inhibition on periodontitis as well as the possible mechanism, in order to provide a potential target for alleviating periodontitis. METHODS Human and rat periodontitis tissues were collected for immunohistochemistry (IHC). Micro-computed tomography was used to assess alveolar bone loss in experimental periodontitis model. Pyroptosis-related proteins were tested by western blot. propidium iodide staining and lactate dehydrogenase release were used to verify pyroptosis activation. RNA sequencing was applied to investigate the preliminary mechanism of the reduced periodontal inflammation induced by YVAD-CHO. RESULTS Both canonical- and noncanonical-related proteins were detected in human and rat periodontitis tissue. The pyroptosis-inhibited group demonstrated less inflammatory response and bone absorption. In vitro, pyroptosis was activated by lipopolysaccharide and inhibited by YVAD-CHO. RNA sequencing demonstrated that the expression of A20 and IκB-ζ was increased and verified by western blot in vitro and IHC in vivo. CONCLUSION These results suggest that inhibition of pyroptosis-reduced inflammation and alveolar bone resorption in periodontitis.
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Affiliation(s)
- Rui Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Preventive Dentistry, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhiwu Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Preventive Dentistry, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mingming Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Preventive Dentistry, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ran Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Preventive Dentistry, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Preventive Dentistry, National Center of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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11
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Irwandi RA, Chiesa ST, Hajishengallis G, Papayannopoulos V, Deanfield JE, D’Aiuto F. The Roles of Neutrophils Linking Periodontitis and Atherosclerotic Cardiovascular Diseases. Front Immunol 2022; 13:915081. [PMID: 35874771 PMCID: PMC9300828 DOI: 10.3389/fimmu.2022.915081] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/13/2022] [Indexed: 01/02/2023] Open
Abstract
Inflammation plays a crucial role in the onset and development of atherosclerosis. Periodontitis is a common chronic disease linked to other chronic inflammatory diseases such as atherosclerotic cardiovascular disease (ASCVD). The mechanistic pathways underlying this association are yet to be fully understood. This critical review aims at discuss the role of neutrophils in mediating the relationship between periodontitis and ASCVD. Systemic inflammation triggered by periodontitis could lead to adaptations in hematopoietic stem and progenitor cells (HSPCs) resulting in trained granulopoiesis in the bone marrow, thereby increasing the production of neutrophils and driving the hyper-responsiveness of these abundant innate-immune cells. These alterations may contribute to the onset, progression, and complications of atherosclerosis. Despite the emerging evidence suggesting that the treatment of periodontitis improves surrogate markers of cardiovascular disease, the resolution of periodontitis may not necessarily reverse neutrophil hyper-responsiveness since the hyper-inflammatory re-programming of granulopoiesis can persist long after the inflammatory inducers are removed. Novel and targeted approaches to manipulate neutrophil numbers and functions are warranted within the context of the treatment of periodontitis and also to mitigate its potential impact on ASCVD.
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Affiliation(s)
- Rizky A. Irwandi
- Periodontology Unit, UCL Eastman Dental Institute, University College London, London, United Kingdom
| | - Scott T. Chiesa
- UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - George Hajishengallis
- Department of Basic & Translational Sciences, Laboratory of Innate Immunity & Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - John E. Deanfield
- UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Francesco D’Aiuto
- Periodontology Unit, UCL Eastman Dental Institute, University College London, London, United Kingdom
- *Correspondence: Francesco D’Aiuto,
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12
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Irwandi RA, Kuswandani SO, Harden S, Marletta D, D'Aiuto F. Circulating inflammatory cell profiling and periodontitis: A systematic review and meta-analysis. J Leukoc Biol 2022; 111:1069-1096. [PMID: 35199874 DOI: 10.1002/jlb.5ru1021-524r] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 01/14/2022] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Inflammation is a key driver of common noncommunicable diseases. Among common triggers of inflammation, chronic gingival inflammation (periodontitis) triggers a consistent humoral host inflammatory response, but little is known on its impact on circulating inflammatory cell profiles. We aimed to systematically appraise all the evidence linking periodontitis and its treatment to circulating inflammatory cell profiles. From 6 databases, 157 studies were eligible for qualitative synthesis and 29 studies for meta-analysis. Our meta-analysis showed that participants with periodontitis exhibited a significant mean increase in circulating CD4+ , CD4+ CD45RO+ , IFNγ-expressing CD4+ and CD8+ T cells, CD19+ CD27+ and CD5+ B cells, CD14+ CD16+ monocytes, and CD16+ neutrophils but decrease in CD8+ T and CD14++ CD16- monocytes. Our qualitative synthesis revealed that peripheral blood neutrophils of patients with periodontitis consistently showed elevated production of reactive oxygen species (ROS) when compared with those of healthy controls. Some evidence suggested that the treatment of periodontitis reversed the exaggerated ROS production, but limited and inconclusive data were found on several circulating inflammatory cell profiling. We conclude that periodontitis and its treatment are associated with minor but consistent alterations in circulating inflammatory cell profiles. These changes could represent key mechanisms explaining the association of periodontitis with other comorbidities such as cardiovascular disease, diabetes, and rheumatoid arthritis.
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Affiliation(s)
- Rizky A Irwandi
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
| | - Sandra O Kuswandani
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom.,Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Simon Harden
- Department of Statistical Science, University College London, London, United Kingdom
| | - Debora Marletta
- Cruciform Hub, University College London, London, United Kingdom
| | - Francesco D'Aiuto
- Periodontology Unit, Eastman Dental Institute, University College London, London, United Kingdom
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13
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Abstract
Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.
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Affiliation(s)
| | - Ira B Lamster
- Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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14
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Al-Omiri MK, Al-Shayyab MH, Alahmari NM, Aldosari LI, Alzoubi IA, Al Nazeh AA, Majdalawi F, Alsafadi L, Lynch E. Impacts of the Triple bristles three-sided sonic powered toothbrush on tooth shade, plaque control and gingival health. Int J Dent Hyg 2021; 19:382-397. [PMID: 34529340 DOI: 10.1111/idh.12552] [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: 06/06/2021] [Revised: 08/14/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the efficacy of the Triple bristles three-sided sonic powered toothbrush in plaque removal and its impact on tooth shade and gingival health, and to compare this with a conventional manual toothbrush. METHODS Fifty two participants (26 males and 26 females; mean age [SD] = 22.48 [1.52], SE = 0.210, 95% CI = 22.06-22.90) were recruited into this controlled within-subject, randomized, two-treatment, 1-month crossover and examiner-blinded observational study between October 2020 and January 2021 in the School of Dentistry, University of Jordan. Within each participant, the upper and lower jaws were randomized to receive a brushing protocol either with the Triple bristles three-sided sonic brush or with a soft manual standard toothbrush with flat trimmed bristles. Tooth shades were recorded for upper and lower anterior and premolar teeth. The Turesky-Modified Quigley-Hein Plaque Index (TMQHPI) and bleeding on probing (BOP) were evaluated at study baseline, 1 week and 1 month after applying the brushing protocol. RESULTS Both tested brushes were associated with significant reduction in plaque scores and BOP (p < 0.05). The Triple bristles brush was more effective in reduction in plaque and BOP in the lower jaw and among females than the manual brush (p < 0.05). CONCLUSIONS The Triple bristles brush was more superior for reduction in plaque and probing on bleeding in the lower jaw and among females.
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Affiliation(s)
- Mahmoud K Al-Omiri
- Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman, Jordan.,Department of Prosthodontics, The City of London Dental School, London, UK
| | - Mohammad H Al-Shayyab
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Nasser M Alahmari
- Department of Prosthodontics, College of Dentistry, King Khalid University, Asir-Abha, Saudi Arabia
| | - Lujain I Aldosari
- Department of Prosthodontics, College of Dentistry, King Khalid University, Asir-Abha, Saudi Arabia
| | - Ibrahim A Alzoubi
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Abdullah A Al Nazeh
- Department of Pediatric Dentistry and Orthodontics Sciences, College of Dentistry, King Khalid University, Asir-Abha, Saudi Arabia
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15
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Zhang S, Zhu J, Zhu Y, Zhang X, Wu R, Li S, Su Y. Oral manifestations of patients with systemic sclerosis: a meta-analysis for case-controlled studies. BMC Oral Health 2021; 21:250. [PMID: 33971854 PMCID: PMC8108335 DOI: 10.1186/s12903-021-01603-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background Systemic sclerosis (SSc) is a multisystem rheumatic disease. Orofacial manifestations are commonly in SSc but maybe usually ignored and overshadowed by other systemic complications. Multiple comparative studies have been conducted to investigate the possible links between SSc and oral manifestations. The present study aimed to investigate the oral health status in patients with SSc.
Methods Pubmed, Embase, Web of Science, and Scopus were searched up to July 2020. Following outcomes were evaluated: Probing depth (PD), Attachment loss (AL), Bleeding on probing (BOP), Number or percentage of Sites with PD ≥ 4 mm, Prevalence of periodontitis, Number of teeth, Decayed Teeth, Missing teeth, Filled teeth, DMFT index, and the interincisal distance. Newcastle-Ottawa Scale (NOS) were applied for quality assessment. The statistical analysis was processed using the software STATA. Results 11 eligible studies were included. The maximum interincisor distance was significantly restricted in SSc patients (SMD − 1.061; 95 %CI [− 1.546, − 0.576]; Z = 4.29, P = 0.000).The prevalence of Periodontitis (OR 7.007; 95 %CI [3.529, 13.915]; Z = 5.56, P = 0.000), PD (SMD 3.101; 95 %CI [1.374, 4.829]; Z = 3.52, P = 0.000), AL(SMD 2.584; 95 %CI [0.321, 4.846]; Z = 2.24, P = 0.025), sites with PD ≥ 4mm (SMD 2.071 ; 95 %CI [0.267, 3.875]; Z = 2.25, P = 0.024) and the number of decayed teeth (SMD, 0.186; 95 %CI [0.007, 0.365]; Z = 2.04, P = 0.041) were increased significantly in SSc population in comparison with the controls. Conclusions SSc patients have limited mouth opening, higher periodontitis prevalence, and worse periodontal status, as well as an increased number of decayed teeth. Routinely oral hygiene instruction and initial periodontal treatment is recommended for SSc patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01603-2.
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Affiliation(s)
- Suhan Zhang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China
| | - Junfei Zhu
- Stomatology Center of China Japan Friendship Hospital, Beijing, China
| | - Yanshan Zhu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China
| | - Xiaochao Zhang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China
| | - Ruifang Wu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China
| | - Siying Li
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China.
| | - Yuwen Su
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin road, Changsha, China.
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16
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Jain A, Chawla M, Kumar A, Chawla R, Grover V, Ghosh S, Pandit N, Chawla P. Management of periodontal disease in patients with diabetes- good clinical practice guidelines: A joint statement by Indian Society of Periodontology and Research Society for the Study of Diabetes in India. J Indian Soc Periodontol 2020; 24:498-524. [PMID: 33424167 PMCID: PMC7781257 DOI: 10.4103/jisp.jisp_688_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
There is a huge body of literature suggesting an association and a bidirectional relationship between periodontal disease and diabetes. Diabetes and periodontal diseases are both chronic diseases with a high prevalence. Dentists/periodontists, in their daily clinical practice, very often attend to diabetes patients with diverse oral health conditions and cater to their dental treatment needs. Safe and effective periodontal therapy in this population requires a broad understanding of diabetes, medical management of diabetes, and essential modifications to dental/periodontal therapy that may be required. This paper describes a joint statement put forth by the Indian Society of Periodontology and the Research Society for the Study of Diabetes in India aiming to provide expert consensus and evidence-based guidelines for optimal clinical management of periodontal conditions in diabetes patients or patients at risk for diabetes. Although this paper is not envisioned to be a comprehensive review of this topic, it intends to provide the guidelines for dental professionals and periodontists.
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Affiliation(s)
- Ashish Jain
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Manoj Chawla
- Lina Diabetes Care Centre, Mumbai, Maharashtra, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Rajeev Chawla
- North Delhi Diabetes Centre, Rohini, New Delhi, India
| | - Vishakha Grover
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Nymphea Pandit
- Department of Periodontology, D. A. V. Dental College and Hospital, Yamunanagar, Haryana, India
| | - Purvi Chawla
- Lina Diabetes Care Centre, Mumbai, Maharashtra, India
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17
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He SL, Hou HJ, Wang JH. Determining the minimal important difference of the Oral Health Impact Profile for Chronic Periodontitis. J Clin Periodontol 2020; 47:1201-1208. [PMID: 32767566 DOI: 10.1111/jcpe.13355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/08/2020] [Accepted: 07/31/2020] [Indexed: 12/25/2022]
Abstract
AIM Building on previous psychometric work, we aimed to further assess the minimally important difference (MID) of the Oral Health Impact Profile for Chronic Periodontitis (OHIP-CP). METHODS In total, 240 consecutive patients with chronic periodontitis were recruited in the study. The OHIP-CP was completed at baseline and after six weeks. Methodology testing included the confirmatory factor analysis (CFA) and MID. Confirmatory factor analysis (CFA) was performed to assess the fit of the previously proposed three-factor model. The MID of this questionnaire was determined by applying anchor-based and distribution-based approaches. RESULTS The CFA supported a three-factor model for the OHIP-CP with acceptable fit to the data. The fit indices were χ2 /df = 2.231, GFI = 0.935, TLI = 0.969 and CFI = 0.976, RMSEA = 0.076. The OHIP-CP scores showed significant improvements after treatment (p < .001). The anchor-based MIDs of OHIP-CP for "oral function restriction," "oral pain" and "psychological and social impact," and total score were 2, 1, 4 and 7 points, respectively. The effect sizes (ES) and standardized response mean (SRM) for the OHIP-CP were moderate to large. CONCLUSIONS The MID of the OHIP-CP is recommended for interpreting clinically meaningful change in oral health-related quality of life (OHRQoL) over time.
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Affiliation(s)
- Song-Lin He
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hai-Juan Hou
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jin-Hua Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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18
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Grender J, Ram Goyal C, Qaqish J, Adam R. An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a manual toothbrush on plaque and gingivitis. Int Dent J 2020; 70 Suppl 1:S7-S15. [PMID: 32243573 DOI: 10.1111/idj.12571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. METHODS Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status ('healthy'/'not healthy') was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. RESULTS One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as 'healthy' (<10% bleeding sites), versus 24% of subjects using the manual brush (P < 0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P < 0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1 week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P < 0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. CONCLUSIONS The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.
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Affiliation(s)
| | - C Ram Goyal
- All Sum Research Center Ltd, Mississauga, ON, Canada
| | - Jimmy Qaqish
- All Sum Research Center Ltd, Mississauga, ON, Canada
| | - Ralf Adam
- Procter & Gamble Service GmbH, Kronberg, Germany
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19
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Abstract
This article reviews the key aspects of reducing the litigation aspects of the management of periodontal diseases and in particular periodontitis. Litigation arising from gingivitis, the other type of periodontal disease, is very rare and is therefore not considered in this article. This paper considers diagnosis, record keeping, communication, management of periodontitis including non-engaging patients and referrals. It provides guidance to reduce risks and improve the care for patients.
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20
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Botelho J, Machado V, Proença L, Bellini DH, Chambrone L, Alcoforado G, Mendes JJ. The impact of nonsurgical periodontal treatment on oral health-related quality of life: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:585-596. [PMID: 31901977 DOI: 10.1007/s00784-019-03188-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/23/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To estimate the impact of nonsurgical periodontal treatment (NSPT) on patients' oral health-related quality of life (OHRQoL). The focused question for this systematic review was: in adults patients with periodontitis, does NSPT improve oral health-related quality of life? MATERIAL AND METHODS Five databases (PubMed, CIHNL, EMBASE, LILACS and CENTRAL) were searched up to April 2019 (PROSPERO CRD42018103393). Intervention trials and cohort studies assessing the OHRQoL data of adults with periodontitis, enduring non-surgical periodontal treatment (NSPT) were eligible for inclusion. Subgroup random-effects meta-analysis was conducted methodically. RESULTS Overall, 491 studies were retrieved, out of which 19 met the inclusion criteria. Two randomized clinical trials (RCTs) and ten cohort studies were further analysed. Seven cohort studies were included in the statistical analysis. Subgroup meta-analyses of cohort studies revealed that NSPT improves in average 2.49 (95% CI 0.95-4.02), 8.94 (95% CI 6.89-10.99) and 6.49 (95% CI 5.11-7.88) OHRQoL levels at 1-2 weeks, 3-4 weeks and 6-12 weeks of post-treatment, respectively. CONCLUSIONS NSPT procedures greatly improve the oral health-related quality of life within a short time, remaining stable after 3 months of treatment. CLINICAL RELEVANCE This systematic review brings forward summary evidence that NSPT improves the OHRQoL in adults with periodontitis from a patient-centred perception and remain stable in the short term.
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Affiliation(s)
- João Botelho
- Periodontology Department, Egas Moniz Dental Clinic, Egas Moniz, CRL, Monte de Caparica, Portugal.,Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic, Egas Moniz, CRL, Monte de Caparica, Portugal.,Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, Egas Moniz, CRL, Monte de Caparica, Portugal
| | | | - Leandro Chambrone
- School of Dentistry, Ibirapuera University, São Paulo, SP, Brazil. .,Unit of Basic Oral Investigation (UIBO), El Bosque University, Bogota, Colombia.
| | - Gil Alcoforado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
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