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Song Z, Li X, Xie J, Han F, Wang N, Hou Y, Yao J. Associations of inflammatory cytokines with inflammatory bowel disease: a Mendelian randomization study. Front Immunol 2024; 14:1327879. [PMID: 38288119 PMCID: PMC10822978 DOI: 10.3389/fimmu.2023.1327879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Objectives Previous studies have confirmed a link between specific inflammatory cytokines and inflammatory bowel disease (IBD), but the causal relationship between them is not completely clear. This Mendelian Randomization (MR) study aims to evaluate the causal relationship between 18 inflammatory cytokines and inflammatory bowel disease. Method Two-sample Mendelian randomization utilized genetic variances associated with IBD from two extensive publicly available genome-wide association studies (GWAS) (Crohn's Disease (CD): 12,194 cases and 28,072 controls; Ulcerative Colitis (UC): 12,336 cases and 33,609 controls). The data of inflammatory cytokines was acquired from a GWAS including 8,293 healthy participants. We used inverse variance weighted method, MR-Egger, weighted median, simple model and weighted model to evaluate the causal relationship between inflammatory cytokines and IBD. Sensitivity analysis includes heterogeneity and pleiotropy analysis to evaluate the robustness of the results. Results The findings indicated suggestive positive associations between Interleukin-13 (IL-13) and macrophage migration inhibitory factor (MIF) with CD (odds ratio, OR: 1.101, 95%CI: 1.021-1.188, p = 0.013; OR: 1.134, 95%CI: 1.024-1.255, p = 0.015). IL-13 also displayed a significant positive correlation with UC (OR: 1.099, 95%CI: 1.018-1.186, p = 0.016). Stem cell factor (SCF) was suggested to be associated with the development of both CD and UC (OR: 1.032, 95%CI: 0.973-1.058, p = 0.012; OR: 1.038, 95%CI: 1.005-1.072, p = 0.024). Conclusion This study proposes that IL-13 may be a factor correlated with the etiology of IBD (CD and UC), while MIF just be specifically associated with CD. Additionally, SCF appears more likely to be involved in the downstream development of IBD (CD and UC).
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Affiliation(s)
| | | | | | | | | | | | - Jianning Yao
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, ZhengZhou, China
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Xu J, Zhang Y, Fang XH, Liu Y, Huang YB, Ke ZL, Wang Y, Zhang YF, Zhang Y, Zhou JH, Su HT, Chen N, Liu YL. The oral bacterial microbiota facilitates the stratification for ulcerative colitis patients with oral ulcers. Ann Clin Microbiol Antimicrob 2023; 22:99. [PMID: 37946238 PMCID: PMC10633958 DOI: 10.1186/s12941-023-00646-3] [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: 07/13/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Clinically, a large part of inflammatory bowel disease (IBD) patients is complicated by oral lesions. Although previous studies proved oral microbial dysbiosis in IBD patients, the bacterial community in the gastrointestinal (GI) tract of those IBD patients combined with oral ulcers has not been profiled yet. METHODS In this study, we enrolled four groups of subjects, including healthy controls (CON), oral ulcer patients (OU), and ulcerative colitis patients with (UC_OU) and without (UC) oral ulcers. Bio-samples from three GI niches containing salivary, buccal, and fecal samples, were collected for 16S rRNA V3-V4 region sequencing. Bacterial abundance and related bio-functions were compared, and data showed that the fecal microbiota was more potent than salivary and buccal microbes in shaping the host immune system. ~ 22 UC and 10 UC_OU 5-aminosalicylate (5-ASA) routine treated patients were followed-up for six months; according to their treatment response (a decrease in the endoscopic Mayo score), they were further sub-grouped as responding and non-responding patients. RESULTS We found those UC patients complicated with oral ulcers presented weaker treatment response, and three oral bacterial genera, i.e., Fusobacterium, Oribacterium, and Campylobacter, might be connected with treatment responding. Additionally, the salivary microbiome could be an indicator of treatment responding in 5-ASA routine treatment rather than buccal or fecal ones. CONCLUSIONS The fecal microbiota had a strong effect on the host's immune indices, while the oral bacterial microbiota could help stratification for ulcerative colitis patients with oral ulcers. Additionally, the oral microbiota had the potential role in reflecting the treatment response of UC patients. Three oral bacteria genera (Fusobacterium, Oribacterium, and Campylobacter) might be involved in UC patients with oral ulcers lacking treatment responses, and monitoring oral microbiota may be meaningful in assessing the therapeutic response in UC patients.
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Affiliation(s)
- Jun Xu
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yu Zhang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Hui Fang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yun Liu
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yi-Bo Huang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Zi-Liang Ke
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yang Wang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yi-Fan Zhang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yang Zhang
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Jian-Hua Zhou
- Institute of Clinical Molecular Biology and Central Laboratory, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Hui-Ting Su
- Institute of Clinical Molecular Biology and Central Laboratory, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ning Chen
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yu-Lan Liu
- Department of Gastroenterology, Peking University People's Hospital, No.11, Xizhimen South Street, Xicheng District, Beijing, 100044, China.
- Clinical Center of Immune-Mediated Digestive Diseases, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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Lens C, Berne JV, Politis C. The impact of gastrointestinal diseases on oral and maxillofacial surgery outcomes. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:577-583. [PMID: 37658034 DOI: 10.1016/j.oooo.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/19/2023] [Accepted: 05/10/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE We analyzed the complication rates and outcomes in patients with gastrointestinal disorders who had undergone maxillofacial surgery. STUDY DESIGN We retrospectively analyzed 289 patients with inflammatory bowel disease (IBD), 142 with gastroesophageal reflux disease (GERD), and 42 with celiac disease (452 total) who had undergone oral and/or maxillofacial surgery. We examined their characteristics, medications they had taken, surgeries they had undergone, and complications they had experienced. Based on the results of univariate analysis, we selected variables for multivariable logistic regression to identify independent predictors of postoperative complications. RESULTS We found a complication rate of 10% in patients with IBD, 6.9% in patients with GERD, and 9.5% in patients with celiac disease. Dentoalveolar treatment was significantly associated with an increased risk of postoperative complications in patients with IBD and GERD. CONCLUSIONS Oral and/or maxillofacial surgery is safe in most patients with IBD, GERD, and celiac disease. Preventive measures for postoperative complications should be considered in patients with IBD and GERD undergoing dentoalveolar treatment.
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Affiliation(s)
- Charlotte Lens
- Oral and Maxillo-facial Surgery-Imaging and Pathology Research Group, Department of Imaging and Pathology, Group Biomedical Sciences, Catholic University Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Jonas Ver Berne
- Oral and Maxillo-facial Surgery-Imaging and Pathology Research Group, Department of Imaging and Pathology, Group Biomedical Sciences, Catholic University Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- Oral and Maxillo-facial Surgery-Imaging and Pathology Research Group, Department of Imaging and Pathology, Group Biomedical Sciences, Catholic University Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Sun K, Xia RH. Oral epithelial dysplasia and aphthous ulceration in a patient with ulcerative colitis: a case report. BMC Oral Health 2023; 23:143. [PMID: 36906558 PMCID: PMC10007854 DOI: 10.1186/s12903-023-02851-0] [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: 06/28/2022] [Accepted: 03/01/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Ulcerative colitis is a chronic inflammatory disease with apparent extraintestinal manifestations, including in the oral cavity. Oral epithelial dysplasia, an exclusive histopathological diagnosis that is used to predict malignant transformation, has never been reported with ulcerative colitis. Herein, we report a case with ulcerative colitis that was diagnosed via extraintestinal manifestations of oral epithelial dysplasia and aphthous ulceration. CASE PRESENTATION A 52-year-old male suffering from ulcerative colitis came to our hospital complaining of pain on his tongue with a history of 1 week. Clinical examination revealed multiple painful oval ulcers on the ventral surfaces of the tongue. Histopathological examination indicated ulcerative lesion and mild dysplasia in the adjacent epithelium. Direct immunofluorescence demonstrated negative staining along the junction of the epithelium and lamina propria. Immunohistochemical staining with Ki-67, p16, p53 and podoplanin was used to rule out the reactive cellular atypia to inflammation and ulceration of the mucosa. A diagnosis of aphthous ulceration and oral epithelial dysplasia was made. The patient was treated with mouthwash (composed of lidocaine, gentamicin and dexamethasone) and triamcinolone acetonide oral ointment. Oral ulceration healed after one week of treatment. At the 12-month follow-up, minor scarring was observed on the right ventral surface of the tongue, and the patient felt no discomfort in the oral mucosa. CONCLUSION Oral epithelial dysplasia might also occur in patients with ulcerative colitis despite the low incidence, which should broaden the understanding of oral manifestations of ulcerative colitis.
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Affiliation(s)
- Kai Sun
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Rong-Hui Xia
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China. .,National Center for Stomatology, Shanghai, China. .,National Clinical Research Center for Oral Diseases, Shanghai, China. .,Shanghai Key Laboratory of Stomatology, Shanghai, China. .,Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Men with Crohn's disease may have an increased risk for head and neck squamous cell carcinoma - a nationwide register study. Clin Oral Investig 2023; 27:625-630. [PMID: 36308560 PMCID: PMC9889498 DOI: 10.1007/s00784-022-04762-w] [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: 03/11/2022] [Accepted: 10/19/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Our goal was to study inflammatory bowel disease (IBD) patients' risk of head and neck squamous cell carcinoma (HNSCC), compared to general population. MATERIALS AND METHODS We performed a retrospective nationwide register-based study of Finnish individuals diagnosed with IBD between the years 1995 and 2015. The standardized incidence ratio (SIR) of HNSCC was calculated by comparing the cohort's complementary age-year-sex-person-year incidence to that of the whole Finnish population. RESULTS About 70,567 patients were diagnosed with IBD (Crohn's disease or ulcerative colitis). Later, 89 of them were diagnosed with HNSCC with mean time of 6.82 years. The incidence of HNSCC was increased in IBD patients compared to the Finnish population expectation (SIR 1.3, 95% CI 1.065-1.614, P = 0.062). When calculating Crohn's disease and ulcerative colitis separately as well as men and women separately, the incidence was particularly increased for men with Crohn's disease (SIR 1.951, 95% CI 1.216-2.935, P = 0.025). CONCLUSION An increased risk for HNSCC was found in men with Crohn's disease compared to the Finnish population expectations. CLINICAL RELEVANCE This study provides information that would improve follow-up protocols and treatment guidelines of IBD.
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Alvarado-Julio A, Chumacero-Palma K, Buenahora MR, Parra-Izquierdo V, Monsalve M, Torres AM, Chila-Moreno L, Flórez-Sarmiento C, Ramos-Casallas A, De Avila J, Bello-Gualtero JM, Jaimes D, Beltrán-Ostos A, Chalem-Choueka P, Pacheco-Tena C, Bautista-Molano W, Romero-Sánchez C. Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis. BMC Oral Health 2022; 22:477. [PMID: 36348398 PMCID: PMC9644594 DOI: 10.1186/s12903-022-02497-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/06/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND AIMS Spondyloarthritis (SpA) is a group of autoinflammatory disorders, of which the primary extra-articular manifestation is inflammatory bowel disease (IBD). The oral cavity being a part of gastrointestinal tract, is significantly compromised in IBD, and in many cases, it is the first site of clinical manifestations of IBD. This study aimed to identify changes in the oral mucosa associated with the onset of IBD and their association with endoscopic/histological findings. MATERIALS AND METHODS The study assessed 80 patients with SpA and 52 healthy controls. Oral, rheumatological, and gastroenterological assessments were performed. The ileocolonoscopy was performed via digital magnification chromoendoscopy. The statistical analysis consisted of Chi-square, Fisher's exact, and multiple correspondence discriminant analysis tests. RESULTS From the disease cohort, 63.0% patients showed oral lesions (p = 0.050). These manifestations ranged from gingivitis (55.0%, p = 0.001), aphthous stomatitis (3.8%, p = 0.091), angular cheilitis (2.6%, p = 0.200), and perioral erythema with scaling (1.3%, p = 0.300). All patients who presented with alterations in colonic mucosa also had oral lesions associated with IBD (p = 0.039), specifically gingivitis/aphthous stomatitis (p = 0.029). CONCLUSION The patients with SpA without IBD present significant oral signs and symptoms. Gingivitis seems to be the most relevant because of its associations with early endoscopic and histological findings. CLINICAL RELEVANCE An integral approach to the diagnostic tests that includes evaluations of oral, rheumatological and gastroenterological tissues may favor timely attention and improve patients' quality of life.
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Affiliation(s)
- Andrés Alvarado-Julio
- Oral Pathology and Diagnostic Media, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Katherin Chumacero-Palma
- Oral Pathology and Diagnostic Media, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - María Rosa Buenahora
- Oral Pathology and Diagnostic Media, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
- Clinical Epidemiology Unit/UNIECLO, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Viviana Parra-Izquierdo
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
- Gastroadvanced SAS IPS, Carrera 23 #45C-31, Bogotá, Colombia
| | - Mónica Monsalve
- Oral Pathology and Diagnostic Media, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Ana María Torres
- Oral Pathology and Diagnostic Media, School of Dentistry, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Lorena Chila-Moreno
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
- School of Medicine, Clinical Immunology Group, Universidad Militar Nueva Granada/Hospital Militar Central, Transversal 3ª #49-00, Bogotá, Colombia
| | - Cristian Flórez-Sarmiento
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
- Gastroadvanced SAS IPS, Carrera 23 #45C-31, Bogotá, Colombia
| | - Alejandro Ramos-Casallas
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Juliette De Avila
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | - Juan Manuel Bello-Gualtero
- Rheumatology and Immunology Department/Clinical Immunology Group, Hospital Militar Central, Transversal 3ª #49-00, Bogotá, Colombia
- School of Medicine, Clinical Immunology Group, Universidad Militar Nueva Granada/Hospital Militar Central, Transversal 3ª #49-00, Bogotá, Colombia
| | - Diego Jaimes
- Clínicos IPS, Carrera 15 #98-29, Bogotá, Colombia
| | - Adriana Beltrán-Ostos
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
| | | | - César Pacheco-Tena
- Investigación Y Biomedicina De Chihuahua S.C., Calle 16 #1600, Chihuahua, CHIH, México
| | - Wilson Bautista-Molano
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia
- School of Medicine, Clinical Immunology Group, Universidad Militar Nueva Granada/Hospital Militar Central, Transversal 3ª #49-00, Bogotá, Colombia
| | - Consuelo Romero-Sánchez
- School of Dentistry, Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Av. Carrera 9 #131A-02, Bogotá, Colombia.
- School of Medicine, Clinical Immunology Group, Universidad Militar Nueva Granada/Hospital Militar Central, Transversal 3ª #49-00, Bogotá, Colombia.
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Domokos Z, Uhrin E, Szabó B, Czumbel ML, Dembrovszky F, Kerémi B, Varga G, Hegyi P, Hermann P, Németh O. Patients with inflammatory bowel disease have a higher chance of developing periodontitis: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1020126. [PMID: 36425101 PMCID: PMC9679143 DOI: 10.3389/fmed.2022.1020126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/21/2022] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Periodontitis affects up to one billion people worldwide, and has been proven to be associated with several systemic inflammatory conditions. This study investigates the specific relationship between two multifactorial diseases: Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue, we investigated separately whether IBD patients have a higher chance of developing periodontitis, and equally, whether patients with periodontitis have a higher chance of developing IBD. METHODS The systematic search was performed in three databases: MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered in PROSPERO. All eligible studies investigating the association between IBD and periodontitis from either direction were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. As a primary outcome, we investigated the prevalence of IBD and periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients. RESULTS The systematic search resulted in 1,715 records, 14 of which were eligible for qualitative synthesis and 8 for quantitative synthesis. On the basis of the results of the primary outcome, IBD diagnosis was associated with significantly higher odds of periodontitis: OR = 2.65 (CI: 2.09-3.36, I 2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated separately the odds in Crohn's disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I 2 = 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56 to 4.83, I 2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two studies investigated whether patients with periodontitis were more susceptible to IBD, and both found that periodontitis was significantly associated with the risk of subsequent UC, but not with subsequent CD. However, more studies are needed to prove an association. CONCLUSION Our analysis confirmed that IBD patients have a higher chance of developing periodontitis, and are a higher risk population in dentistry. Both dentists and gastroenterologists should be aware of this relationship and should emphasize the importance of prevention even more than in the healthy population. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021286161].
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Affiliation(s)
- Zsuzsanna Domokos
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Uhrin
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Márk László Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Fanni Dembrovszky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Beáta Kerémi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Yuan G, Chen J, Wang X, Hu F, Zhang X, Chen X. Serum metabolomics provides clues in understanding colitis exacerbating experimental periodontitis in female mice. Arch Oral Biol 2022; 145:105583. [DOI: 10.1016/j.archoralbio.2022.105583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022]
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Lingua Plicata Associated with Increased Level of Proinflammatory Cytokines in Gingival Cervical Fluid: Possible New Sign in Ulcerative Colitis. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Ulcerative colitis (UC) is a complex disease in which the interaction of genetic, environmental, and microbial factors drives chronic intestinal inflammation. Gastrointestinal symptoms are predominant including pathological manifestations in the oral cavity, as well as extra-intestinal complications.
Lingua plicata (LP) is a condition characterized by an increased number of fissures and grooves at the central and lateral aspects of the dorsal surface of the tongue. LP is usually asymptomatic and discovered incidentally, but the accumulation of food in the fissures and grooves can lead to focal glossitis and halitosis.
In this study, we analyzed the level of proinflammatory cytokines in gingival crevicular fluid (GCF) and demonstrated that proinflammatory cytokines IFN-γ, IL-12, and IL-1β were significantly increased in the group of UC patients when compared with healthy controls. Obtained results have shown that 35% of UC patients have lingua plicata. The GCF levels of IFN-γ and IL-12 were higher in UC patients with LP compared with UC patients without lingua plicata.
In conclusion, increased GCF values of IFN-γ and IL-12, in UC patients with LP may be considered as a sign of the disease progression and, consequently, of a poor prognosis for patients.
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Tan CXW, Brand HS, Qaddour O, van der Bijl PML, De Boer NKH, Forouzanfar T, de Visscher JGAM. Knowledge and Interdisciplinary Communication of Gastroenterologists and Dentists in the Netherlands About Gastrointestinal Diseases With Oral Manifestations. CROHN'S & COLITIS 360 2022; 4:otac006. [PMID: 36777554 PMCID: PMC9802256 DOI: 10.1093/crocol/otac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background Gastrointestinal diseases can have oral manifestations. The aim of this study was to investigate the knowledge of gastroenterologists and dentists about gastrointestinal diseases with oral manifestations and to assess the frequency, extent and content of communication between gastroenterologists and oral healthcare professionals. Methods Separate questionnaires were developed and sent to all 523 gastroenterologists and a random selection of 500 dentists in the Netherlands. Both questionnaires contained questions about demographic characteristics of the participants, 10 statements about gastrointestinal diseases with possible oral manifestations and questions about the communication between gastroenterologists and oral healthcare professionals. Additionally, the questionnaire for gastroenterologists contained 9 statements about general dentistry and the questionnaire for dentist had 9 questions about gastrointestinal diseases. Results Gastroenterologists answered 47.6% ± 31.9% of the questions correct about gastrointestinal diseases with possible oral manifestations and 57.5% ± 27.9% of the questions correct about general dentistry. Dentists answered 26.6% ± 20.5% of the questions correct about possible oral manifestations of gastrointestinal diseases and 50.3% ± 18.7% of the questions correct about gastrointestinal diseases. Gastroenterologists and dentists valued interdisciplinary consultation as very useful with scores of 4.07 ± 0.70 and 4.67 ± 0.49 on a 5-point Likert scale, respectively, but the frequency of consultation was considered insufficiently with a mean score of 2.88 ± 1.01 and 2.24 ± 1.05 on a 5-point Likert scale, respectively. Conclusions This study suggests that the knowledge of gastroenterologists and dentists about gastrointestinal diseases with oral manifestations could be improved. Interdisciplinary consultation was considered valuable for the optimal treatment of their patients but was assessed as insufficient.
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Affiliation(s)
- Christopher X W Tan
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands,Address correspondence to: Christopher X.W. Tan, DDS, MD, Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre, location VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands ()
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Oumaima Qaddour
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Paulette M L van der Bijl
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AGEM Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Porphyromonas gingivalis exacerbates ulcerative colitis via Porphyromonas gingivalis peptidylarginine deiminase. Int J Oral Sci 2021; 13:31. [PMID: 34593756 PMCID: PMC8484350 DOI: 10.1038/s41368-021-00136-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 11/09/2022] Open
Abstract
Ulcerative Colitis (UC) has been reported to be related to Porphyromonas gingivalis (P. gingivalis). Porphyromonas gingivalis peptidylarginine deiminase (PPAD), a virulence factor released by P. gingivalis, is known to induce inflammatory responses. To explore the pathological relationships between PPAD and UC, we used homologous recombination technology to construct a P. gingivalis strain in which the PPAD gene was deleted (Δppad) and a Δppad strain in which the PPAD gene was restored (comΔppad). C57BL/6 mice were orally gavaged with saline, P. gingivalis, Δppad, or comΔppad twice a week for the entire 40 days (days 0-40), and then, UC was induced by dextran sodium sulfate (DSS) solution for 10 days (days 31-40). P. gingivalis and comΔppad exacerbated DDS-induced colitis, which was determined by assessing the parameters of colon length, disease activity index, and histological activity index, but Δppad failed to exacerbate DDS-induced colitis. Flow cytometry and ELISA revealed that compared with Δppad, P. gingivalis, and comΔppad increased T helper 17 (Th17) cell numbers and interleukin (IL)-17 production but decreased regulatory T cells (Tregs) numbers and IL-10 production in the spleens of mice with UC. We also cocultured P. gingivalis, Δppad, or comΔppad with T lymphocytes in vitro and found that P. gingivalis and comΔppad significantly increased Th17 cell numbers and decreased Treg cell numbers. Immunofluorescence staining of colon tissue paraffin sections also confirmed these results. The results suggested that P. gingivalis exacerbated the severity of UC in part via PPAD.
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Buchbender M, Fehlhofer J, Proff P, Möst T, Ries J, Hannig M, Neurath MF, Gund M, Atreya R, Kesting M. Expression of inflammatory mediators in biofilm samples and clinical association in inflammatory bowel disease patients-a preliminary study. Clin Oral Investig 2021; 26:1217-1228. [PMID: 34383142 PMCID: PMC8816497 DOI: 10.1007/s00784-021-04093-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/19/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Inflammatory bowel disease (IBD) has multiple impacts on soft and hard tissues in the oral cavity. The aim of this study was to analyze the expression of cytokines in biofilm samples from patients suffering from IBD and compare them to healthy patients. It was hypothesized that different cytokine expression levels and clinical associations might be drawn. MATERIAL AND METHODS A total of 56 biofilm samples from three different patient cohorts (group 0 = healthy, HC n = 30; group 1 = Crohn's disease, CD, n = 19; group 2 = ulcerative colitis, UC, n = 7) were examined for the expression levels of the cytokine interleukins IL-2, -6, and -10; matrix metalloproteinases 7 and 9; and surface antigens CD90/CD11a by quantitative real-time PCR and according to clinical parameters (plaque index, BOP, PD, DMFT, CAL). Relative gene expression was determined using the ∆∆CT method. RESULTS The mean BOP values (p = 0.001) and PD (p = 0.000) were significantly higher in the CD group compared to controls. Expression of IL-10 was significantly higher in the CD (p = 0.004) and UC groups (p = 0.022). Expression of MMP-7 was significantly higher in the CD group (p = 0.032). IBD patients treated with TNF inhibitors (p = 0.007) or other immunosuppressants (p = 0.014) showed significant overexpression of IL-10 compared to controls. CONCLUSION Different expression levels of IL-10 and MMP-7 were detected in plaque samples from IBD patients. As only BOP was significantly increased, we conclude that no clinical impairment of periodontal tissue occurred in IBD patients. CLINICAL RELEVANCE With the worldwide increasing incidence of IBD, it is important to obtain insights into the effects of the disease on the oral cavity. The study was registered (01.09.2020) at the German clinical trial registry (DRKS00022956). CLINICAL TRIAL REGISTRATION The study is registered at the German clinical trial registry (DRKS00022956).
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Affiliation(s)
- Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany.
| | - Jakob Fehlhofer
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany
| | - Peter Proff
- Head of the Department of Orthodontics, University of Regensburg, Regensburg, Germany
| | - Tobias Möst
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany
| | - Jutta Ries
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany
| | - Matthias Hannig
- Head of Department of Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Markus F Neurath
- Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.,Deutsches Zentrum Immuntherapie DZI, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Madline Gund
- Department of Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Raja Atreya
- Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.,Deutsches Zentrum Immuntherapie DZI, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany
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Tan CXW, Brand HS, Kalender B, De Boer NKH, Forouzanfar T, de Visscher JGAM. Dental and periodontal disease in patients with inflammatory bowel disease. Clin Oral Investig 2021; 25:5273-5280. [PMID: 33619633 PMCID: PMC8370899 DOI: 10.1007/s00784-021-03835-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/08/2021] [Indexed: 02/07/2023]
Abstract
Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.
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Affiliation(s)
- Christopher X W Tan
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Bilgin Kalender
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AGEM Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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Shakerin H, Khozeimeh F, Daghaghzadeh H, Najarzadegan F, Golestannejad Z, Adibi P. Oral manifestations in inflammatory bowel disease: A cross-sectional study in Isfahan. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.310033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Alawsi F, Sawbridge D, Fitzgerald R. Orthodontics in patients with significant medical co-morbidities. J Orthod 2020; 47:4-24. [PMID: 32985344 DOI: 10.1177/1465312520949881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A wide variety of patients with medical co-morbidities may present to general orthodontic practice. It is important for the treating clinician to have a general understanding of key medical conditions that may impact upon the treatment and management options. This clinical supplement provides a treatment-focused summative update for the orthodontist regarding significant medical co-morbidities, their general prevalence and an exploration of potential impacts upon orthodontic treatment. This review also discusses the significance of key medications and provides suggestions for the safe provision of orthodontic treatment.
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Affiliation(s)
- Fahad Alawsi
- Orthodontic Department, Royal Preston Hospital, Preston, UK
| | - David Sawbridge
- Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rhian Fitzgerald
- Orthodontic Department, Royal Preston Hospital, Preston, UK.,Alder Hey Children's Hospital, Liverpool, UK
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Kang EA, Chun J, Kim JH, Han K, Soh H, Park S, Hong SW, Moon JM, Lee J, Lee HJ, Park JB, Im JP, Kim JS. Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study. World J Gastroenterol 2020; 26:5661-5672. [PMID: 33088159 PMCID: PMC7545388 DOI: 10.3748/wjg.v26.i37.5661] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/07/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease (IBD) remains unclear.
AIM To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis.
METHODS A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn’s disease (CD), ulcerative colitis (UC)] using the International Classification of Disease 10th revision and rare intractable disease codes, was compared between the periodontitis and non-periodontitis groups until 2017.
RESULTS A total of 1092825 individuals (11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the non-periodontitis group (P < 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively (P < 0.01). Men were 604307 (55.3%) and 4844383 (54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval (CI): 1.008-1.182], but not CD (adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis.
CONCLUSION Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.
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Affiliation(s)
- Eun Ae Kang
- Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Jaeyoung Chun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06229, South Korea
| | - Jee Hyun Kim
- Department of Internal Medicine, Bundang CHA Medical Center, CHA University School of Medicine, Seoul 13496, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
| | - Hosim Soh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Seona Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Seung Wook Hong
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Jung Min Moon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Jooyoung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Hyun Jung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Jun-Beom Park
- Department of Periodontics, the Catholic University of Korea College of Medicine, Seoul 06591, South Korea
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
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Goldinova A, Tan CX, Bouma G, Duijvestein M, Brand HS, de Boer NK. Oral health and salivary function in ulcerative colitis patients. United European Gastroenterol J 2020; 8:1067-1075. [PMID: 32878578 PMCID: PMC7724544 DOI: 10.1177/2050640620957138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Although ulcerative colitis primarily involves the colon, extra-intestinal
manifestations are common and oral and dental complaints are no
exception. Objective This study aims at evaluating oral and dental health problems and salivary
function and composition in ulcerative colitis patients and its correlation
with disease activity. Methods Xerostomia Inventory score, (unstimulated/stimulated) salivary flow rates,
salivary amylase and mucin/ Mucin 5B levels, self-reported oral and dental
complaints, the oral health related quality of life, Simple Clinical Colitis
Activity Index and inflammatory bowel disease-specific health related
quality of life were determined. Results The cohort consisted of 51 ulcerative colitis patients. Hyposalivation was
experienced by 16% of patients under resting conditions and 24% under
chewing-stimulated conditions. Xerostomia was not correlated with salivary
flow rates. Disease activity did not influence salivary amylase and Mucin 5B
concentrations. The Xerostomia Inventory score was correlated with the
Simple Clinical Colitis Activity Index (p = 0.042) and
inflammatory bowel disease-specific health related quality of life
(p = 0.001). Most reported oral health problems were
halitosis (29%) and aphthae (28%). Frequently reported dental problems were
cavities (35%) and gum problems (31%). Patients with active disease
experienced significantly more oral and dental complaints. The number of
oral problems was positively correlated with the Simple Clinical Colitis
Activity Index (p = 0.045) and negatively correlated with
the inflammatory bowel disease-specific health related quality of life
(p = 0.005). Conclusion The subjective feeling of a dry mouth (xerostomia) is related to disease
activity and disease activity-associated quality of life in ulcerative
colitis patients, whereas the objective saliva secretion rate is not. Oral
and dental health problems are frequently observed in patients with
ulcerative colitis, especially during active disease.
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Affiliation(s)
- Ariana Goldinova
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Christopher Xw Tan
- Departments of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC/Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Gerd Bouma
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Marjolijn Duijvestein
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Nanne K de Boer
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
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Pyostomatitis vegetans in a pediatric patient with ulcerative colitis: case report of a rare pediatric inflammatory bowel disease extraintestinal manifestation and review of the literature. Eur J Gastroenterol Hepatol 2020; 32:889-892. [PMID: 32282544 DOI: 10.1097/meg.0000000000001723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Inflammatory bowel diseases can occur with a wide range of extraintestinal symptoms, among which pyostomatitis vegetans, that is a rare but almost pathognomonic finding. We report the case of a 9-year-old female patient affected by ulcerative colitis and recently treated for an oral candidiasis, who experienced a relapse in her ulcerative colitis (PUCAI 50), preceded by the return of whitish lesions in the oral cavity, initially misdiagnosed and unsuccessfully treated as candidiasis and then recognized as pyostomatitis vegetans. Bloody diarrhea was treated with oral beclomethasone, with rapid remission of ulcerative colitis and disappearance of pyostomatitis vegetans. After 2 years, ulcerative colitis is in sustained remission with oral mesalamine and pyostomatitis vegetans has not recurred. Pyostomatitis vegetans is considered a marker of ulcerative colitis relapse among adult population, and although very few pediatric cases are described, it is very important to remember it in the differential diagnosis of the oral manifestations and comorbidities of inflammatory bowel diseases.
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杜 芹, 马 歆. [Research progress of correlation between periodontal pathogens and systemic diseases]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:759-764. [PMID: 32897213 PMCID: PMC7277321 DOI: 10.12122/j.issn.1673-4254.2020.05.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 11/24/2022]
Abstract
Periodontal pathogens are the main pathogenic factor of periodontitis. Periodontal pathogens have a large variety of virulence factors such as lipopolysaccharide, fimbriae and proteases, which enables the pathogens to infect periodontal tissues and stimulate the secretion of inflammatory cytokines, causing chronic systemic inflammation. Periodontal pathogens may invade multiple systems such as the circulatory system, immune system, respiratory system and digestive system to cause systematic diseases. Recent studies have shown that periodontal pathogens may have close relations with systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and cancer. Among the periodontal pathogens, Porphyromonas gingivalis can be found in atherosclerotic plaques to impairing the function of the vascular endothelium; Porphyromonas gingivalis may also increase the level of inflammatory factors such as TNF-α to promote insulin resistance and diabetes. Many of the periodontal pathogens such as Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia can be detected in the synovial fluid of rheumatoid arthritis patients, suggesting their involvement in the pathogenesis of rheumatoid arthritis. Fusobacterium nucleatum may cause alterations in the intestinal microbiome in mice and promote the occurrence of intestinal tumors. Herein we review the recent progresses in the relationship between periodontal pathogens and systemic diseases.
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Affiliation(s)
- 芹 杜
- 四川省医学科学院//四川省人民医院口腔科,四川 成都 610072Department of Stomatlogy, Sichuan Academy of Medical Science & Sichuan People's Hospital, Chengdu 610072, China
- 电子科技大学附属医学院,四川 成都 610054School of Medicine, University of Electronic Science and Technology, Chengdu 610054, China
- 中国科学院成都生物研究所,四川 成都 610041Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, China
| | - 歆茹 马
- 四川省医学科学院//四川省人民医院口腔科,四川 成都 610072Department of Stomatlogy, Sichuan Academy of Medical Science & Sichuan People's Hospital, Chengdu 610072, China
- 遵义医科大学口腔医学院,贵州 遵义 563000School of Stomatology, Zunyi Medicial University, Zunyi 563000, China
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Tan CXW, Brand HS, Iqbal S, De Boer NKH, Forouzanfar T, de Visscher JGAM. A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e80-e86. [PMID: 32601008 DOI: 10.1016/j.oooo.2020.04.816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with inflammatory bowel disease have an increased risk of developing oral health problems. The aim of this study was to investigate whether oral diseases in these patients are related to inflammation of the intestine and if there is a correlation between inflammatory bowel disease-specific health-related quality of life (IBD-HR-QOL) and oral health problems. STUDY DESIGN The study was a cross-sectional survey and analysis of self-reported oral health of individuals with a stoma for Crohn's disease (CD), ulcerative colitis (UC), and treated colon cancer (CC). Validated international questionnaires were sent to members of the Stoma Federation of The Netherlands. Because there was an unequal distribution of male and female patients with CD and CC, data of 169 age-matched female patients with CD, UC, and CC with a stoma were analyzed. RESULTS Patients with CD had significantly more oral health problems compared with those with UC or CC. Patients with CD and UC both had significantly more gingival-related problems compared with patients with CC. There was a significant negative correlation between IBD-HR-QOL and oral health problems. CONCLUSIONS In the 3 distinguishable groups of patients with a stoma, patients with CD had an increased risk for oral health problems, independently from surgical removal of (a part of) the inflamed intestine, suggesting a general increased susceptibility of patients with CD for oral health problems.
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Affiliation(s)
- Christopher X W Tan
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Sumaira Iqbal
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AG&M Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Abi Doumeth S, Abbas O, Hashash JG. Ustekinumab Successfully Treats and Maintains Remission of Pyostomatitis Vegetans Associated with Crohn's Disease. CROHN'S & COLITIS 360 2020; 2:otaa014. [PMID: 36777963 PMCID: PMC9802229 DOI: 10.1093/crocol/otaa014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Indexed: 11/13/2022] Open
Abstract
Pyostomatitis vegetans (PV) is a rare inflammatory stomatitis often associated with inflammatory bowel diseases (IBD). Treatment of PV depends on the presence of coexisting IBD. To date, there have been no reports on the use of ustekinumab for PV. There have been recent cases on the use of ustekinumab for treatment of pyoderma gangrenosum and uveitis. We report the case of a 26-year-old female with moderately severe Crohn's disease (CD) and PV who was successfully treated with ustekinumab monotherapy. Since initiation of ustekinumab, she has been in clinical and biochemical remission from a CD and PV standpoint for the last 12 months.
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Affiliation(s)
- Sarah Abi Doumeth
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon,Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Jana G Hashash
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon,Address correspondence to: Jana G. Hashash, MD, MSc, Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon ()
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22
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Zhang L, Gao X, Zhou J, Chen S, Zhang J, Zhang Y, Chen B, Yang J. Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease. Int Dent J 2020; 70:227-236. [PMID: 31998967 DOI: 10.1111/idj.12542] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/26/2019] [Accepted: 11/02/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls. MATERIALS AND METHODS In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn's disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data. RESULTS After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63-6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24-3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50-7.95, P < 0.001; OR = 4.66, 95% CI: 2.49-8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients. CONCLUSIONS Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.
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Affiliation(s)
- Limin Zhang
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Gastroenterology, The Center for Inflammatory Bowel Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiamin Zhou
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shan Chen
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jinxin Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingfan Zhang
- Department of Gastroenterology, the Center for Inflammatory Bowel Disease, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Baili Chen
- Department of Gastroenterology, the Center for Inflammatory Bowel Disease, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Junying Yang
- Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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23
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Barta Z. Apical Periodontitis in Patients With Inflammatory Bowel Disease: A Puppet Master? Inflamm Bowel Dis 2020; 26:280-282. [PMID: 31247090 DOI: 10.1093/ibd/izz129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Indexed: 12/09/2022]
Abstract
Focal infection theory posits that periodontal pathobionts play a causal role in initiating or exacerbating diseases. Periodontal disease is a common inflammatory, multifactorial disease of the periodontal tissues. The main factor for inflammation is mature dental plaque with the presence of pathogens in the microbial biofilm. Disturbances of the systemic and/or mucosal immune system, antibiotic treatments, immunosuppressants, and biologic therapies all increase the chance of infections and inflammatory processes (ie, apical periodontitis). The pathogenesis of Crohn's disease and ulcerative colitis, the 2 main forms of inflammatory bowel disease (IBD), is still unclear, but both autoimmune and immune-mediated phenomena are involved. It is a global disease with a prevalence of 0.3% and an incidence of 280-320 per 100,000 people in North America. According to the literature, there is a negative association between poor oral health and risk of IBD, and this protective effect increases with the severity of poor dental hygiene. On the other hand, existing IBD seems to be associated with an increased risk of periodontal disease and worse oral health compared with other diseases. The nature of these associations is unclear, but it is unquestionable that all have an effect on the others. Additional studies are needed to confirm if there is a causal relationship between dental status and IBD. Apical periodontitis in patients affected by Crohn's disease or ulcerative colitis needs to be considered carefully, and it is important to treat the disease.
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Affiliation(s)
- Zsolt Barta
- Department of Gastroenterology, Institute of Medicine, and Department of Infectology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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24
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Rodrigues E, Laranjeira N, Nunes G, Roque-Ramos L, Vieira A, Fonseca J. ARE CARIOGENIC BACTERIA THE MAJOR RISK FACTOR TO DENTAL CARIES IN PATIENTS WITH ULCERATIVE COLITIS? ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:118-123. [PMID: 31460573 DOI: 10.1590/s0004-2803.201900000-25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND High prevalence of dental caries in ulcerative colitis (UC) has been attributed to diet and changes in salivary environment. OBJECTIVE We aimed to characterize the prevalence of dental caries, salivary flow rates, salivary buffering capacity and cariogenic bacteria counts of Mutans streptococci and Lactobacillus spp and to evaluate their relationship with drug therapy, disease activity and duration. METHODS A cross-sectional study was performed with UC patients followed in a tertiary center. Participants were submitted to a questionnaire (including demographic data, oral hygiene, eating habits) and a clinical observation with assessment of plaque index and Decayed, Missing and Filled Teeth index. Unstimulated/stimulated saliva was collected. Medical records, disease activity (Partial Mayo Score) and disease duration were collected. Laboratory data included salivary flow rates, salivary buffering capacity (CRT® buffer) and cariogenic bacteria count (Mutans streptococci and Lactobacillus spp) in saliva using the CRT® bacteria test (results: high or low counts). RESULTS Thirty UC patients were recruited. Oral hygiene routines were daily teeth brushing once or more (96.7%) and fluoride toothpaste (73.3%). Decayed, Missing and Filled Teeth index (mean 16.17±6.428) was not affected by the frequency of soft drinks, cakes, sweets and sugars between meals (P>0.2). Long-term disease showed a trend towards higher prevalence of caries (P=0.06). Most presented normal salivary flow rates, unstimulated (73.3%) and stimulated (60.0%), and high salivary buffering capacity (66.7%). Any association was found with age, gender, disease activity, disease duration and drug therapy. High Mutans streptococci and low Lactobacillus spp count were observed in 73.3% and 60% of patients, respectively. Patients with active disease (100%) and longer duration (88.9%) displayed higher Mutans streptococci count. CONCLUSION The prevalence of dental caries observed in UC patients was significant and did not seem to be influenced by their eating habits. The high prevalence of Mutans streptococci count may be a major risk factor for dental caries and may be looked as part of the UC dysbiosis. Dental care of UC patients should be planned according with this microbiota variation.
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Affiliation(s)
- Eduardo Rodrigues
- CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal
| | - Nuno Laranjeira
- CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal
| | - Gonçalo Nunes
- Hospital Garcia de Orta, Departamento de Gastroenterologia, Almada, Portugal
| | - Lídia Roque-Ramos
- Hospital Garcia de Orta, Departamento de Gastroenterologia, Almada, Portugal
| | - Ana Vieira
- Hospital Garcia de Orta, Departamento de Gastroenterologia, Almada, Portugal
| | - Jorge Fonseca
- CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal.,Hospital Garcia de Orta, Departamento de Gastroenterologia, Almada, Portugal
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25
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Fitzpatrick SG, Cohen DM, Clark AN. Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head Neck Pathol 2019; 13:91-102. [PMID: 30701449 PMCID: PMC6405793 DOI: 10.1007/s12105-018-0981-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.
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Affiliation(s)
- Sarah G Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Ashley N Clark
- Department of Diagnostic and Biomedical Sciences, University of Texas at Houston Health Science Center School of Dentistry, Houston, TX, USA
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26
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Lin CY, Tseng KS, Liu JM, Chuang HC, Lien CH, Chen YC, Lai CY, Yu CP, Hsu RJ. Increased Risk of Ulcerative Colitis in Patients with Periodontal Disease: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2602. [PMID: 30469385 PMCID: PMC6265883 DOI: 10.3390/ijerph15112602] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/01/2018] [Accepted: 11/16/2018] [Indexed: 12/12/2022]
Abstract
Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94⁻1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13⁻2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC.
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Affiliation(s)
- Chien-Yu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu city 300, Taiwan.
| | - Kuo-Sen Tseng
- Division of Rheumatology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan.
| | - Jui-Ming Liu
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan.
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan.
| | - Heng-Chang Chuang
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan.
| | - Chi-Hone Lien
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu city 300, Taiwan.
| | - Yi-Chih Chen
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu city 300, Taiwan.
| | - Chun-Ying Lai
- Division of Gastroenterology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan.
| | - Cheng-Ping Yu
- Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
- Department of Pathology and Graduate Institute of Pathology and Parasitology, The Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
| | - Ren-Jun Hsu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan.
- Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
- Department of Pathology and Graduate Institute of Pathology and Parasitology, The Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
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