1
|
Tavajohi R, Sarbaz A, Honarmand H, Naser Moghadasi A. Chronic periodontitis in a patient with multiple sclerosis-A case report. Clin Case Rep 2024; 12:e9261. [PMID: 39114839 PMCID: PMC11303448 DOI: 10.1002/ccr3.9261] [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: 05/06/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
Multiple sclerosis (MS) is one of the common central nervous system diseases, but it can cause dysfunction in other organs such as periodontal tissues. However, it has not been as noticeable. This report aimed to present a 44-year-old patient with severe chronic periodontitis, and sudden teeth loss since the diagnosis of MS.
Collapse
Affiliation(s)
- Rayeheh Tavajohi
- Department of Clinical Pharmacy, School of PharmacyTehran University of Medical SciencesTehranIran
| | | | - Hooshyar Honarmand
- Department of Clinical Pharmacy, School of PharmacyTehran University of Medical SciencesTehranIran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research CenterNeuroscience InstituteTehran University of Medical SciencesTehranIran
| |
Collapse
|
2
|
Bartak H, Fareh T, Ben Othman N, Viard D, Cohen M, Rocher F, Ewig E, Drici MD, Lebrun-Frenay C. Dental Adverse Effects of Anti-CD20 Therapies. Neurol Ther 2024; 13:917-930. [PMID: 38668835 PMCID: PMC11136893 DOI: 10.1007/s40120-024-00616-7] [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: 01/17/2024] [Accepted: 04/03/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Over the past few years, anti-CD20 therapies like rituximab, ocrelizumab or ofatumumab have seen an increase in interest in the treatment of neurological autoimmune disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), or resistant forms of generalized myasthenia gravis (MG). They are generally well-tolerated, but recent reports have highlighted severe dental disorders in patients undergoing anti-CD20 therapies. The aim was to describe a series of cases and to compare with the available scientific literature. METHODS We reviewed 6 patient cases with dental disorders during anti-CD20 therapy that were reported to the pharmacovigilance center. A disproportionality analysis was also conducted on Vigibase® for each anti-CD20 and each adverse effect described in the cases. RESULTS Six cases of dental and gingival conditions in relatively young patients were reported (median age: 40.5 years old [min: 34; max: 79]). Oral conditions were developed in four patients with MS treated with ocrelizumab and in two patients receiving rituximab (one patient with MG and one with NMOSD). The onset of oral conditions ranged from 10 days to 2 years after treatment initiation. Notably, all patients treated with ocrelizumab experienced gingival recession. Various dental pathologies were observed, including tooth loss, dental pain, caries, brittle teeth, dental fractures, dental abscesses, and periodontitis. Analysis of Vigibase® revealed 284 worldwide cases of dental and gingival conditions under ocrelizumab, 386 cases under rituximab, and 80 under ofatumumab. Significant associations were found between these therapies and dental pathologies, particularly tooth abscesses and infections. CONCLUSION To our knowledge, this is the first case series reporting dental conditions developed in patients long-term treated with anti-CD20 treatments. This issue, literature data, and Vigilyze® analysis might be considered a safety signal that necessitates being confirmed with more robust data, such as a retrospective study with a control group. Meanwhile, proactive measures are essential like frequent dental checkups and dental hygienic measures to prevent oral health problems associated with anti-CD20 therapies.
Collapse
Affiliation(s)
- Hélène Bartak
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Tasnim Fareh
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Nouha Ben Othman
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Delphine Viard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Mikael Cohen
- Neurology MS Clinic, UMR2CA-URRIS, University Hospital of Nice, Nice, France
| | - Fanny Rocher
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Elliot Ewig
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France.
| | | |
Collapse
|
3
|
Arcas VC, Tig IA, Moga DFC, Vlad AL, Roman-Filip C, Fratila AM. A Systematic Literature Review on Inflammatory Markers in the Saliva of Patients with Multiple Sclerosis: A Cause or a Consequence of Periodontal Diseases. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:859. [PMID: 38929476 PMCID: PMC11205661 DOI: 10.3390/medicina60060859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Multiple sclerosis (MS) is a chronic neurodegenerative disease often linked with systemic conditions such as periodontal diseases (PDs). This systematic review aims to explore the association between inflammatory markers in saliva and PDs in MS patients, assessing the use of saliva as a non-invasive tool to monitor disease progression. Materials and Methods: 82 publications were examined after a thorough search of scholarly databases to determine whether inflammatory markers were present in MS patients and whether they were associated with periodontal disease (PD). Quality and bias were assessed using the Newcastle-Ottawa Scale, resulting in eight articles that were thoroughly analyzed. Results: The results point to a strong correlation between MS and periodontal disorders, which may point to the same pathophysiological mechanism. It does, however, underscore the necessity of additional study to determine a definitive causal association. Conclusions: The findings indicate a strong association between MS and PDs, likely mediated by systemic inflammatory responses detectable in saliva. The review highlights the importance of oral health in managing MS and supports the utility of saliva as a practical, non-invasive medium for monitoring systemic inflammation. Further research is necessary to confirm the causal relationships and to consider integrating salivary diagnostics into routine clinical management for MS patients.
Collapse
Affiliation(s)
- Vasile Calin Arcas
- Doctoral School of Biomedical Sciences, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Ioan Andrei Tig
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Doru Florian Cornel Moga
- Department of Dental Medicine and Nursing, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (C.R.-F.); (A.M.F.)
- Military Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| | - Alexandra Lavinia Vlad
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania;
| | - Corina Roman-Filip
- Department of Dental Medicine and Nursing, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (C.R.-F.); (A.M.F.)
- Neurology Department, Emergency County Clinical Hospital Sibiu, 550245 Sibiu, Romania
| | - Anca Maria Fratila
- Department of Dental Medicine and Nursing, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (C.R.-F.); (A.M.F.)
- Military Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| |
Collapse
|
4
|
Gedvilaite G, Pileckaite E, Ramanauskas I, Kriauciuniene L, Balnyte R, Liutkeviciene R. Investigating the Potential Influence of TAS2R16 Genetic Variants and Protein Levels on Multiple Sclerosis Development. J Pers Med 2024; 14:402. [PMID: 38673029 PMCID: PMC11051568 DOI: 10.3390/jpm14040402] [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: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The study aimed to investigate the association between the TAS2R16 gene (rs860170, rs978739, rs1357949), TAS2R16 serum levels, and multiple sclerosis (MS). A total of 265 healthy control subjects and 218 MS patients were included in the study. Single nucleotide polymorphisms (SNPs) were tested by real-time polymerase chain reaction (RT-PCR). The serum concentration of TAS2R16 was measured using the ELISA method. Analyses revealed that the TAS2R16 rs860170 TT genotype was statistically significantly less frequent in the MS group than in the control group (p = 0.041), and the CC genotype was statistically significantly more frequent in the MS group than in the control group (p < 0.001). In the most robust (codominant) model, the CC genotype was found to increase the odds of MS by ~27-fold (p = 0.002), and each C allele increased the odds of MS by 1.8-fold (p < 0.001). Haplotype analysis of the rs860170, rs978739, and rs1357949 polymorphisms showed that the C-C-A haplotype was associated with a ~12-fold increased odds of MS occurrence (p = 0.02). Serum TAS2R16 levels were elevated in the MS group compared to control subjects (p = 0.014). Conclusions: The rs860170, rs978739, and rs1357949 polymorphisms demonstrated that the C-C-A haplotype and elevated TAS2R16 serum levels can promote the development of MS. These preliminary findings underscore the importance of specific genetic variants, such as rs860170, rs978739, and rs1357949, in MS risk. Additionally, elevated TAS2R16 serum levels in MS patients suggest a potential role in MS pathogenesis. These findings provide insights into the genetic and molecular mechanisms underlying MS and pave the way for personalized diagnostic and therapeutic strategies. Integrating genetic and serum biomarker data in MS research offers promising avenues for improving clinical outcomes and advancing precision medicine approaches in the future.
Collapse
Affiliation(s)
- Greta Gedvilaite
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Enrika Pileckaite
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Ignas Ramanauskas
- Medical Faculty, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Loresa Kriauciuniene
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
| | - Renata Balnyte
- Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Rasa Liutkeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania; (G.G.); (L.K.); (R.L.)
| |
Collapse
|
5
|
Fehlhofer J, Ries J, Nickel FT, Rothhammer V, Schwab S, Kesting M, Buchbender M. Expression of Inflammatory Mediators in Biofilm Samples and Clinical Association in Multiple Sclerosis Patients in Remission-A Pilot Study. Life (Basel) 2024; 14:367. [PMID: 38541692 PMCID: PMC10971373 DOI: 10.3390/life14030367] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 08/24/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of unknown etiology that affects the central nervous system and can lead to neurological impairment. Our aim was to determine whether MS patients also show inflammatory changes in the oral cavity more frequently than healthy individuals. For this purpose, we examined plaque samples for various mediators and their correlation with clinical findings. A study group (MS) and a control group were examined and compared. The plaque samples were analyzed for the expression of interleukins (IL-2, -6, -10), matrix metalloproteinases (MMP-7, MMP-9), and a surface antigen CD90 by quantitative real-time PCR. The clinical parameters examined were the Mombelli plaque index; bleeding on probing (BOP) index; periodontal pocket depth; and decayed, missing, and filled tooth (DMFT) index. The expression of MMP9 was significantly (p = 0.035) higher in the control group. The expression of IL-2 was increased four-fold in the MS group; however, this difference was not statistically significant. The mean PD (p < 0.001) and BOP index (p = 0.029) values were increased in the study group. The clinical parameters of the BOP index and PD were significantly amplified in the MS patients. However, no causal relationship between the investigated inflammatory mediators and the clinical findings could be established in this case series.
Collapse
Affiliation(s)
- Jakob Fehlhofer
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.F.); (J.R.); (M.K.)
| | - Jutta Ries
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.F.); (J.R.); (M.K.)
| | - Florian Tobias Nickel
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.T.N.); (V.R.); (S.S.)
| | - Veit Rothhammer
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.T.N.); (V.R.); (S.S.)
| | - Stefan Schwab
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.T.N.); (V.R.); (S.S.)
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.F.); (J.R.); (M.K.)
| | - Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (J.F.); (J.R.); (M.K.)
| |
Collapse
|
6
|
Giovannoni G, Ford HL, Schmierer K, Middleton R, Stennett AM, Pomeroy I, Fisniku L, Scalfari A, Bannon C, Stross R, Hughes S, Williams A, Josephs S, Peel C, Straukiene A. MS care: integrating advanced therapies and holistic management. Front Neurol 2024; 14:1286122. [PMID: 38351950 PMCID: PMC10862341 DOI: 10.3389/fneur.2023.1286122] [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: 08/30/2023] [Accepted: 11/23/2023] [Indexed: 02/16/2024] Open
Abstract
Lifestyle and environmental factors are key determinants in disease causality and progression in neurological conditions, including multiple sclerosis (MS). Lack of exercise, poor diet, tobacco smoking, excessive alcohol intake, social determinants of health, concomitant medications, poor sleep and comorbidities can exacerbate MS pathological processes by impacting brain health and depleting neurological reserves, resulting in more rapid disease worsening. In addition to using disease-modifying therapies to alter the disease course, therapeutic strategies in MS should aim to preserve as much neurological reserve as possible by promoting the adoption of a "brain-healthy" and "metabolically-healthy" lifestyle. Here, we recommend self-regulated lifestyle modifications that have the potential to improve brain health, directly impact on disease progression and improve outcomes in people with MS. We emphasise the importance of self-management and adopting a multidisciplinary, collaborative and person-centred approach to care that encompasses the healthcare team, family members and community support groups.
Collapse
Affiliation(s)
- Gavin Giovannoni
- Centre for Neuroscience, Surgery and Trauma, Faculty of Medicine and Dentistry, The Blizard Institute, Queen Mary University of London, London, United Kingdom
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Helen L. Ford
- Leeds Teaching Hospitals, University of Leeds, Leeds, United Kingdom
| | - Klaus Schmierer
- Centre for Neuroscience, Surgery and Trauma, Faculty of Medicine and Dentistry, The Blizard Institute, Queen Mary University of London, London, United Kingdom
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Rod Middleton
- Disease Registers & Data Research in Health Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Andrea M. Stennett
- Centre for Neuroscience, Surgery and Trauma, Faculty of Medicine and Dentistry, The Blizard Institute, Queen Mary University of London, London, United Kingdom
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Ian Pomeroy
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- Department of Neurology, University of Liverpool, Liverpool, United Kingdom
| | - Leonora Fisniku
- Department of Neurosciences (Addenbrooke’s), Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Antonio Scalfari
- Centre of Neuroscience, Department of Medicine, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | | | - Ruth Stross
- Neurology Academy, Sheffield, United Kingdom
- Kingston Hospitals NHS Foundation Trust, Surrey, United Kingdom
| | - Sarah Hughes
- Torbay and South Devon NHS Foundation Trust, Torquay, United Kingdom
| | - Adam Williams
- Devon Partnership NHS Trust, Paignton, United Kingdom
| | | | | | - Agne Straukiene
- Torbay and South Devon NHS Foundation Trust, Torquay, United Kingdom
- University of Plymouth, Plymouth, United Kingdom
| |
Collapse
|
7
|
van der Putten GJ, de Baat C. An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People. J Clin Med 2023; 12:4306. [PMID: 37445340 DOI: 10.3390/jcm12134306] [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: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal caregivers. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
Collapse
Affiliation(s)
- Gert-Jan van der Putten
- Orpea Dagelijks Leven, 7327 AA Apeldoorn, The Netherlands
- Department of Dentistry, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Cees de Baat
- Fresh Unieke Mondzorg, 2411 NT Bodegraven, The Netherlands
| |
Collapse
|
8
|
Militi A, Bonanno M, Calabrò RS. It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders. J Clin Med 2023; 12:jcm12103528. [PMID: 37240633 DOI: 10.3390/jcm12103528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.
Collapse
Affiliation(s)
- Angela Militi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
| |
Collapse
|
9
|
Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Association between Periodontitis Extent, Severity, and Progression Rate with Systemic Diseases and Smoking: A Retrospective Study. J Pers Med 2023; 13:jpm13050814. [PMID: 37240984 DOI: 10.3390/jpm13050814] [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: 04/21/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The aim of this study was to analyze the relationship between extent, severity (stage), and rate of progression (grade) of periodontitis with systemic diseases as well as smoking using a large database. METHODS Patients' records identified in the BigMouth Dental Data Repository with a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions were evaluated. Patients were further categorized based on extent, severity, and rate of progression. Data were extracted from patients' electronic health records including demographic characteristics, dental procedural codes, and self-reported medical conditions, as well as the number of missing teeth. RESULTS A total of 2069 complete records were ultimately included in the analysis. Males were more likely to have generalized periodontitis and stage III or IV periodontitis. Older individuals were more likely diagnosed with grade B and stage III or IV periodontitis. Individuals with generalized disease, grade C, and stage IV demonstrated a significantly higher number of missing teeth. Higher numbers of tooth loss reported during supportive periodontal treatment were noted in generalized disease and stage IV periodontitis. Multiple sclerosis and smoking were significantly associated with grade C periodontitis. CONCLUSIONS Within the limitations of this retrospective study that utilized the BigMouth dental data repository, smokers were significantly associated with rapid progression of periodontitis (grade C). Gender, age, number of missing teeth, and number of tooth loss during supportive periodontal treatment were associated with disease characteristics.
Collapse
Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ziou Jiang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA
| | - Nicholas Marka
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA
| | - Larry F Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| |
Collapse
|
10
|
Rotstein I, Katz J. Increased Risk for Acute Periapical Abscesses in Multiple Sclerosis Patients and the Possible Association with Epstein-Barr Virus. J Endod 2023; 49:262-266. [PMID: 36526109 DOI: 10.1016/j.joen.2022.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a severe inflammatory neuroimmune degenerative condition affecting more than 2 million individuals worldwide. The purpose of this study was to assess the prevalence of acute periapical abscesses in patients with MS and to evaluate whether acute periapical abscesses (PAs) are more likely to affect patients who were previously infected by Epstein-Barr virus (EBV). METHODS Integrated data of hospital patients were used. Data from the corresponding diagnosis codes for MS and acute PA were retrieved by querying the appropriate International Classification of Diseases, Tenth Revision codes in the database. RESULTS Of the total hospital patient population, 0.18% were diagnosed with a history of MS. Females were more affected than males 3.25-fold. Whites were more affected than African Americans 6-fold. Whites were more affected than African Americans combined with other ethnicities 3.6-fold. The odds ratio (OR) for acute PAs in patients with a history of MS was 2.2 (P < .0001). After adjustment for diabetes mellitus comorbidity, the OR for acute PAs in patients with a history of MS was 2.6. After adjustment for cardiovascular disease comorbidity, the OR for acute PAs in patients with a history of MS was 1.27. Of the patients who presented with PAs, 0.2% were diagnosed with a history of EBV infection. The OR was 3.98, and the difference in prevalence was statistically significant (P < .0001). CONCLUSIONS Under the conditions of this cross-sectional study, it appears that the prevalence of acute PAs is higher in patients with MS and that EBV may play a role.
Collapse
Affiliation(s)
- Ilan Rotstein
- University of Southern California, Los Angeles, California.
| | | |
Collapse
|
11
|
Systemic Diseases with Oral Manifestations and Their Impact on Health-Related Quality of Life. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Abstract
Health-related quality of life is a multidimensional concept established to evaluate the physical, psychological, and social impacts of health conditions on individuals’ well-being. Various tools for measuring health-related quality of life can be categorized into two subsets: generic and disease–specific instruments. The oral cavity can be stricken by a broad range of local and systemic diseases and their systemic treatment modalities. The most common systemic illnesses associated with oral lesions are hematologic disorders, endocrinopathies, neurological disorders, gastrointestinal conditions, mucocutaneous and rheumatic diseases, and neoplastic processes. Their manifestations in the oral cavity are, in most cases, rather nonspecific but should not be overlooked. Oral health is one of the most important parts of overall health, thus it has been proposed that poor oral health may affect health–related quality of life. The presence of oral manifestations of systemic diseases has a negative impact on the daily functioning of patients, decreasing their overall well-being. This article will review the most common systemic diseases with oral manifestations and their impact on the health–related quality of life. Oral health researchers should put a stronger emphasis on the patient-reported quality of life as a primary outcome in future clinical trials. The significance of this area has still not been widely understood in the current dental literature even though it could help improve patients’ health-related quality of life.
Collapse
|
12
|
Costa C, Santiago H, Pereira S, Castro AR, Soares SC. Oral Health Status and Multiple Sclerosis: Classic and Non-Classic Manifestations—Case Report. Diseases 2022; 10:diseases10030062. [PMID: 36135218 PMCID: PMC9498041 DOI: 10.3390/diseases10030062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Multiple sclerosis is an autoimmune disease of the central nervous system with neurological and motor symptoms that affect the orofacial region. The aim of this work is to present a patient that lacks the three classic orofacial manifestations but has other less common clinical alterations. Case presentation: A 49-year-old female patient diagnosed with long-term relapsing–remitting multiple sclerosis visited the dentist complaining of mild but persistent orofacial pain including the temporomandibular joint and pain not specific to any tooth. She presented mucosal irritation, xerostomia, halitosis, and localized gingivitis. There was excessive wear of the upper and lower incisal edges and the occlusal faces of the upper canines and loss of six teeth due to caries. After a clinical oral examination, the diagnosis was temporomandibular joint disorder, gingivitis, dental hypersensitivity, bruxism, hyposalivation, xerostomia, and halitosis. Conclusions: Patients with multiple sclerosis present classic orofacial manifestations. Although these were not observed in this patient, she had others, such as gingivitis, tooth hypersensitivity, and bruxism. In addition, despite few studies associating a higher prevalence of caries with these patients, the number of carious and missing teeth in this patient highlight the evidence that multiple sclerosis has had a significant impact on the patient’s dental status over the years.
Collapse
Affiliation(s)
- Céu Costa
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Grupo de Patologia Experimental e Terapêutica, Centro de Investigação, Instituto Português de Oncologia do Porto, 4200-072 Porto, Portugal
- Correspondence:
| | - Hugo Santiago
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| | - Sofia Pereira
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Grupo de Patologia Experimental e Terapêutica, Centro de Investigação, Instituto Português de Oncologia do Porto, 4200-072 Porto, Portugal
| | - Ana Rita Castro
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| | - Sandra Clara Soares
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| |
Collapse
|
13
|
Cognitive function and oral health in relapsing-remitting multiple sclerosis. Clin Oral Investig 2021; 26:2899-2907. [PMID: 34773142 DOI: 10.1007/s00784-021-04272-1] [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: 08/11/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Multiple sclerosis (MS) is often associated with reduced cognitive function, and there is also emerging evidence of a heightened vulnerability to oral health problems. However, although links between cognitive function and oral health have been identified in other special populations, it remains to be established whether this relationship is also evident for people with MS. The aim of this study was to provide the first empirical test of whether there is a relationship between cognitive function and oral health in people diagnosed with relapsing-remitting multiple sclerosis (RRMS). METHODS One hundred and eleven individuals were evaluated: 56 people diagnosed with RRMS and 55 demographically matched healthy controls. All participants completed an objective oral health assessment as well as a standardized battery that assessed six distinct neurocognitive domains. RESULTS Relative to controls, people with RRMS presented with higher rates of decayed teeth and mild gingivitis, and also performed more poorly in three of the six neurocognitive domains assessed (language, complex attention, and executive function). However, for the RRMS group, no associations emerged between oral health with performance on any of the six neurocognitive domains. CONCLUSIONS These data cross-validate previous research which shows people with RRMS are more likely to present with both reduced cognitive function and poorer oral health, but also extends this literature in a meaningful way by additionally showing for the first time that these clinical features are unrelated in RRMS. CLINICAL RELEVANCE The findings emphasize the need for early assessment of both oral health and cognitive function in people with RRMS so that appropriate interventions and support can be put in place for each of these clinical symptoms.
Collapse
|
14
|
Covello F, Ruoppolo G, Carissimo C, Zumbo G, Ferrara C, Polimeni A, Vozza I. Multiple Sclerosis: Impact on Oral Hygiene, Dysphagia, and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3979. [PMID: 32512730 PMCID: PMC7312593 DOI: 10.3390/ijerph17113979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 01/19/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune disease in which the immune system reacts by damaging the central nervous system, specifically myelin and oligodendrocytes. It is the most debilitating neurological disease among young adults, causing personal, familiar, social, and professional limitations. Multiple sclerosis can cause disturbances in the orofacial district, due to a demyelination process on the nerves of the head and neck district. The aim of this study was to evaluate the oral health status, dysphagia, and quality of life of patients affected by MS. For this study, 101 patients aged between 12 and 70 (47 males, 54 females) affected by MS were selected, and three questionnaires were handed out and anonymously filled in by them: An oral hygiene test, DYMUS (DYsphagia in MUltiple Sclerosis), and IOHIP-14 (Italian version Oral Health Impact Profile). Through the analysis of the questionnaires it was possible to observe pathological conditions, such as gingival inflammation, xerostomia, dysphagia, neuralgia, and dysarthria. Through the analysis it was possible to outline how the roles of a medical team, composed of a dentist, otolaryngologist, and dental hygienist, are fundamental in coping with other medical figures, during the whole development of the diseases, as well as to prevent possible complications.
Collapse
Affiliation(s)
- Francesco Covello
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Giovanni Ruoppolo
- Sensorial Organs Department, Sapienza University of Rome, 00185 Rome, Italy;
| | - Camilla Carissimo
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Giulia Zumbo
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Carla Ferrara
- Public Health and Infectious Diseases Department, Section Health Statistics, Sapienza University of Rome, 00185 Rome, Italy;
| | - Antonella Polimeni
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Iole Vozza
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| |
Collapse
|