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Breivik TJ, Gjermo P, Gundersen Y, Opstad PK, Murison R, Hugoson A, von Hörsten S, Fristad I. Microbiota-immune-brain interactions: A new vision in the understanding of periodontal health and disease. Periodontol 2000 2024. [PMID: 39233381 DOI: 10.1111/prd.12610] [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: 04/11/2024] [Revised: 08/01/2024] [Accepted: 08/19/2024] [Indexed: 09/06/2024]
Abstract
This review highlights the significance of interactions between the microbiota, immune system, nervous and hormonal systems, and the brain on periodontal health and disease. Microorganisms in the microbiota, immune cells, and neurons communicate via homeostatic nervous and hormonal systems, regulating vital body functions. By modulating pro-inflammatory and anti-inflammatory adaptive immune responses, these systems control the composition and number of microorganisms in the microbiota. The strength of these brain-controlled responses is genetically determined but is sensitive to early childhood stressors, which can permanently alter their responsiveness via epigenetic mechanisms, and to adult stressors, causing temporary changes. Clinical evidence and research with humans and animal models indicate that factors linked to severe periodontitis enhance the responsiveness of these homeostatic systems, leading to persistent hyperactivation. This weakens the immune defense against invasive symbiotic microorganisms (pathobionts) while strengthening the defense against non-invasive symbionts at the gingival margin. The result is an increased gingival tissue load of pathobionts, including Gram-negative bacteria, followed by an excessive innate immune response, which prevents infection but simultaneously destroys gingival and periodontal tissues. Thus, the balance between pro-inflammatory and anti-inflammatory adaptive immunity is crucial in controlling the microbiota, and the responsiveness of brain-controlled homeostatic systems determines periodontal health.
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Affiliation(s)
- Torbjørn Jarle Breivik
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Odontology, University of Oslo, Oslo, Norway
- Division for Protection, Norwegian Defence Research Establishment, Kjeller, Norway
| | - Per Gjermo
- Department of Periodontology, Faculty of Dentistry, Institute of Clinical Odontology, University of Oslo, Oslo, Norway
| | - Yngvar Gundersen
- Division for Protection, Norwegian Defence Research Establishment, Kjeller, Norway
| | - Per Kristian Opstad
- Division for Protection, Norwegian Defence Research Establishment, Kjeller, Norway
| | - Robert Murison
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anders Hugoson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg and School of Health and Welfare, Gothenburg, Sweden
| | - Stephan von Hörsten
- Department for Experimental Therapy, University Hospital Erlangen, Preclinical Experimental Center, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Inge Fristad
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
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Psychological stress: neuroimmune roles in periodontal disease. Odontology 2022:10.1007/s10266-022-00768-8. [DOI: 10.1007/s10266-022-00768-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022]
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Correlation Analysis of miR-1246 Expression in Saliva of Patients with Chronic Periodontitis and Periodontal Indexes, Inflammatory Cytokines, and Protease Molecules. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1949159. [PMID: 35942384 PMCID: PMC9356776 DOI: 10.1155/2022/1949159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/25/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Objective. The study aimed to investigate the correlation of miR-1246 in saliva with periodontal indicators, inflammatory cytokines, and protease molecules in patients with chronic periodontitis. Methods. Thirty-five patients with chronic periodontitis were included as the chronic periodontitis group, and 35 healthy individuals were selected as the healthy control group during the same period. The miR-1246 levels, inflammatory cytokine interleukin (IL)-1β, IL-6, IL-17, tumor necrosis factor-α (TNF-α), matrix metalloproteinase (MMP-1), MMP-8, and MMP tissue inhibitor (TIMP-1) in saliva were determined, and periodontal indexes, including the plaque index (PLI), bleeding index (BI), periodontal probing depth (PD), and attachment loss (AL) were examined. Results. The salivary levels of miR-1246, IL-1β, IL-6, IL-17, TNF-α, MMP-1, MMP-8, and TIMP-1 and the periodontal indexes PLI, GI, PD, and AL in the chronic periodontitis group were significantly higher than those in the healthy control (
). Salivary levels of miR-1246 in patients with chronic periodontitis were positively correlated with the levels of IL-1β, IL-6, IL-17, TNF-α, MMP-1, MMP-8, TIMP-1, PLI, GI, PD, and AL (
). Conclusion. Abnormally elevated levels of miR-1246 in saliva of patients with chronic periodontitis correlate with levels of periodontal indices, inflammatory cytokines, and protease molecules.
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D’Ambrosio F, Caggiano M, Schiavo L, Savarese G, Carpinelli L, Amato A, Iandolo A. Chronic Stress and Depression in Periodontitis and Peri-Implantitis: A Narrative Review on Neurobiological, Neurobehavioral and Immune-Microbiome Interplays and Clinical Management Implications. Dent J (Basel) 2022; 10:49. [PMID: 35323251 PMCID: PMC8947556 DOI: 10.3390/dj10030049] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023] Open
Abstract
Besides the well-known systemic factors for periodontal and peri-implant diseases, additional co-factors, such as chronic stress and depression, may also affect disease onset and progression as well as treatment responsiveness. Neurobiological and neurobehavioral pathogenic links between chronic stress and depression, on the one side, and periodontitis and peri-implantitis, on the other side, which have been little investigated and principally related to necrotizing periodontal disease, have been reviewed, along with their putative interconnections with periodontal immune-microbiome balance. Rising evidence suggest that dysregulated neurobiological and neurobehavioral factors, as well as periodontal immune-microbiome unbalance, all related to chronic stress and depression, may crucially interact and thus represent contributing factors in the genesis and worsening not only of necrotizing periodontal lesions, but also of chronic periodontitis and peri-implantitis. Such potential interconnections may be even more relevant in recurrent and aggressive cases of periodontal and peri-implant disease, which are frequently refractory to therapy, and may, if corroborated, coherently pave the way for personalized prevention and treatment strategies, possibly targeting immune-microbiome unbalance and neurobehavioral factors and focusing on neurobiological ones, especially in chronically stressed and depressed subjects with periodontitis and peri-implantitis.
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Affiliation(s)
- Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (M.C.); (L.S.); (G.S.); (L.C.); (A.A.); (A.I.)
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Agarwal M, Agarwal P, Bhattacharya H, Rastogi P, Agarwal A. Evaluation of association between potential stress markers and periodontal health in medical and dental students: A questionnaire-based study. Natl J Maxillofac Surg 2022; 13:90-94. [PMID: 35911810 PMCID: PMC9326195 DOI: 10.4103/njms.njms_101_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/13/2020] [Accepted: 03/12/2021] [Indexed: 11/11/2022] Open
Abstract
Aims and Objectives: Psychological conditions, particularly psychosocial stress, have been implicated as risk indicators for periodontal disease. The aim of the present study was to explore the role of psychosocial stress on periodontium through questionnaire and serum cortisol level. Subjects and Methods: Two hundred medical and dental undergraduates were recruited for the study. Case group included 82 examination going and control group had 79 nonexam going students. Their stress level was evaluated using a standard questionnaire (perceived stress scale). Gingival index, periodontal disease index, bleeding on probing index, serum cortisol level, and serum alpha-amylase level were also measured. Statistical Analysis Used: Bivariate correlations and multiple regression tests were done. Results: A positive correlation was found among stress scores, salivary cortisol, alpha-amylase, and periodontal disease measures. Conclusion: Periodontitis can be related to immunologic changes related to psychological states
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Mady M, ALOtaibi RA, ALJohani RA, Almutair SH, Msaud JM, AlBarakati JA, ALMakhalas AF, AlSakhin FZ, AlNajem SA, AlAshjai AM, Houmady RA, Barnawi NI. The Effect of Periodontal Disease on Quality of Life: Literature Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/lyo7bismil] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Rodrigues MO, Moraes AB, de Paula MP, Pereira VA, Leão ATT, Vieira Neto L. Adrenal incidentaloma as a novel independent predictive factor for periodontitis. J Endocrinol Invest 2021; 44:2455-2463. [PMID: 33788166 DOI: 10.1007/s40618-021-01557-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/22/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE There are no data regarding periodontal derangements in patients with adrenal incidentalomas (AI). We assessed the frequency and severity of periodontitis in patients with AI [non-functioning adrenal incidentaloma (NFAI) and possible autonomous cortisol secretion (ACS)] and compared with individuals with normal adrenal. METHODS A cross-sectional study evaluated thirty-five individuals with AI and 26 controls. NFAI and possible ACS diagnosis was based on the current guidelines: NFAI [cortisol levels after 1 mg dexamethasone suppression test (1 mg-DST) ≤ 1.8 µg/dL (≤ 50 nmol/L)]; possible ACS [cortisol levels after 1 mg-DST 1.9-5.0 µg/dL (51-138 nmol/L)]. Sociodemographic data were collected, and a full-mouth periodontal evaluation was performed. RESULTS There was no significant difference between groups regarding age, sex, income, ethnicity, education level, smoking, body mass index, dysglycemia, and arterial hypertension. Patients with AI exhibited worse periodontal conditions than controls for the following periodontal clinical parameters: mean percentage of probing pocket depth (PPD) and clinical attachment level (CAL) ≥ 5 mm (p < 0.001 and p = 0.006, respectively). Patients with NFAI and possible ACS showed higher gingival bleeding index (p = 0.014), bleeding on probing (p < 0.001), and CAL (p < 0.001) means compared to controls. The frequencies of periodontitis were 72.7% in patients with NFAI, 84.6% in possible ACS, and 30.8% in controls (p = 0.001). Periodontitis was more severe in patients with possible ACS than NFAI and controls. Patients with NFAI and possible ACS exhibited odds ratio for periodontitis of 4.9 (p = 0.016) and 8.6 (p = 0.02), respectively. CONCLUSION Patients with AI have higher frequency and severity of periodontitis than controls. The presence of AI was an independent predictive factor for periodontitis.
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Affiliation(s)
- M O Rodrigues
- Department of Dental Clinic, Division of Periodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A B Moraes
- Department of Internal Medicine and Endocrine Unit, School of Medicine, Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Professor Rodolpho Paulo Rocco Street, 255. 9th floor-Endocrinology Unit Rio de Janeiro, Rio de Janeiro, RJ, 21941-913, Brazil
| | - M P de Paula
- Department of Internal Medicine and Endocrine Unit, School of Medicine, Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Professor Rodolpho Paulo Rocco Street, 255. 9th floor-Endocrinology Unit Rio de Janeiro, Rio de Janeiro, RJ, 21941-913, Brazil
| | - V A Pereira
- Department of Dental Clinic, Division of Periodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A T T Leão
- Department of Dental Clinic, Division of Periodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Vieira Neto
- Department of Internal Medicine and Endocrine Unit, School of Medicine, Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Professor Rodolpho Paulo Rocco Street, 255. 9th floor-Endocrinology Unit Rio de Janeiro, Rio de Janeiro, RJ, 21941-913, Brazil.
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Azzi DV, de Jesus Pereira AN, de Oliveira Silva V, de Carvalho Foureaux R, Lima ARV, Barducci RS, Albuquerque AS, Reis GL, de Oliveira RR, Andrade EF, Zangeronimo MG, Chalfun-Júnior A, Pereira LJ. Dose-response effect of prebiotic ingestion (β-glucans isolated from Saccharomyces cerevisiae) in diabetic rats with periodontal disease. Diabetol Metab Syndr 2021; 13:111. [PMID: 34663444 PMCID: PMC8524835 DOI: 10.1186/s13098-021-00729-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/05/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Periodontal disease is one of the most frequent comorbidities in diabetic patients and can contribute to poor blood glucose control. OBJECTIVE To evaluate the effects of ingesting different doses of beta-glucans (BG) isolated from Saccharomyces cerevisiae on alveolar bone loss (ABL) and inflammatory/metabolic parameters in normal and diabetic rats with ligature-induced periodontal disease (PD). DESIGN Sixty male rats were assigned into two groups: non-diabetic or diabetic (i.p. 70 mg/kg streptozotocin) with PD. Then, groups were subdivided into five subgroups according BG doses: 0 mg/Kg; 10 mg/Kg; 20 mg/Kg; 40 mg/Kg or 80 mg/Kg. Animals received BG for 28 days and ligatures were placed on lower first molars during the last 14 days. RESULTS ABL of diabetic and non-diabetic animals receiving BG 40 mg/kg (1.33 ± 0.03 mm and 0.77 ± 0.07 mm, respectively) and 80 mg/kg (1.26 ± 0.07 mm and 0.78 ± 0.05 mm, respectively) doses was lower (p < 0.05) in comparison to respective controls (1.59 ± 0.11 mm and 0.90 mm ±0.08). COX-2 (Control: 1.66 ± 0.12; 40 mg/kg: 1.13 ± 0.07; 80 mg/kg: 0.92 ± 0.18) and RANKL expressions (Control: 1.74 ± 0.34; 40 mg/kg: 1.03 ± 0.29 ;80 mg/kg: 0.75 ± 0.21), together with the RANKL/OPG ratio (Control: 1.17 ± 0.08; 40 mg/kg: 0.67 ± 0.09; 80 mg/kg: 0.63 ± 0.28) were attenuated above the same dose (p < 0.05). BG did not influence (p > 0.05) metabolic parameters in non-diabetic rats. In diabetic animals, doses above 40 mg/kg reduced IL-1β (Control: 387 ± 66; 40 mg/kg: 309 ± 27; 80 mg/kg: 300 ± 14) and TNF-α (Control: 229 ± 19; 40 mg/kg: 128 ± 53; 80 mg/kg: 71 ± 25), blood glucose levels (Control: 402 ± 49; 40 mg/kg: 334 ± 32; 80 mg/kg: 287 ± 56), total cholesterol (Control: 124 ± 8; 40 mg/kg: 120 ± 10; 80 mg/kg: 108 ± 9), LDL-c + VLDL-c (Control: 106 ± 8; 40 mg/kg: 103 ± 10; 80 mg/kg: 87 ± 10) and triacylglycerols (Control: 508 ± 90; 40 mg/kg: 301 ± 40; 80 mg/kg: 208 ± 61), whereas increased HDL-c (Control: 18 ± 0.5; 40 mg/kg: 19 ± 1; 80 mg/kg: 21 ± 1) (p < 0.05). Optimal dose needed to reduce ABL was higher in diabetic animals with PD. CONCLUSIONS BG ingestion reduced ABL and improved inflammatory profile in a dose-dependent manner. Best effects were achieved with doses above 40 mg/kg.
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Affiliation(s)
- Diana Vilela Azzi
- Department of Veterinary Medicine, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | | | - Viviam de Oliveira Silva
- Department of Veterinary Medicine, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | | | - Andressa Ribeiro Veiga Lima
- Department of Health Sciences, Universidade Federal de Lavras (UFLA), 3037, Lavras, Minas Gerais, 37200-900, Brazil
| | | | - Adriana Silva Albuquerque
- Department of Veterinary Medicine, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Gabriel Lasmar Reis
- Department of Biology, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | | | - Eric Francelino Andrade
- Institute of Agrarian Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Unaí, Minas Gerais, Brazil
| | | | - Antonio Chalfun-Júnior
- Department of Biology, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Luciano José Pereira
- Department of Veterinary Medicine, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil.
- Department of Health Sciences, Universidade Federal de Lavras (UFLA), 3037, Lavras, Minas Gerais, 37200-900, Brazil.
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Zhang H, Chen B, Pan C, Zhang A. To evaluate the serum cortisol, salivary cortisol, and serum interleukin-1 B level in patients of chronic periodontitis with smoking and stress and without smoking and stress. Medicine (Baltimore) 2021; 100:e26757. [PMID: 34397819 PMCID: PMC8341332 DOI: 10.1097/md.0000000000026757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
The role of cognitive, social and biological factors in the etiology of chronic periodontitis has been reported.The aim of this study was to evaluate the salivary cortisol level and interleukin-1 B level in patients of Chronic periodontitis in smokers and stress and nonsmokers without stress.The design of study randomized, prospective, double-blinded, and prospective study.The total sample size was comprised of 600 subjects between the ages of 20 and 50 years. The sample size was divided into 300 males and 300 females. Out of 600 subjects, 200 subjects comprised of subjects with chronic periodontitis with positive depression level with a history of smoking (Group I), 200 subjects comprised of subjects with chronic periodontitis without depression and without smoking (Group II), and 200 subjects who were taken as the control group comprised of healthy subjects without chronic periodontitis, without depression level, and no smoking history (Group III). Salivary cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA).The result showed that there was a positive correlation between morning and evening salivary cortisol level in all the groups with correlation coefficient. There was significant higher value of salivary cortisol in Group I patients when compared with Group II and Group III. However, when the comparison of salivary cortisol levels was done between the Group II and Control group, the result showed nonsignificant P value.It is suggested that stress is positively correlated with the salivary cortisol levels in smokers and nonsmokers.
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Affiliation(s)
- Haiou Zhang
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Bocheng Chen
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Chenyu Pan
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Ansheng Zhang
- Department of Stomatology, XI’AN International Medical Center Hospital, Xi’an, ShaanXi, China
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Silva GC, Costa ED, Lemos VS, Queiroz-Junior CM, Pereira LJ. Experimental Periodontal Disease Triggers Coronary Endothelial Dysfunction in Middle-Aged Rats: Preventive Effect of a Prebiotic β-Glucan. J Gerontol A Biol Sci Med Sci 2021; 76:1398-1406. [PMID: 33677586 DOI: 10.1093/gerona/glab066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Indexed: 12/11/2022] Open
Abstract
This study was aimed to verify the hypothesis that periodontal disease contributes to endothelial dysfunction in the coronary arteries of middle-aged rats. Besides we evaluated the effects of a prebiotic (β-glucan isolated from Saccharomyces cerevisiae) in preventing vascular dysfunction. The sample comprised young (sham and induced to periodontal disease) and middle-aged rats (sham, periodontal disease, sham-treated and periodontal disease-treated), at 12 and 57 weeks, respectively. The treated-groups received daily doses of β-glucan (50 mg/kg) orally (gavage) for 4 weeks, and periodontal disease was induced in the last 2 weeks by ligature. A myograph system assessed vascular reactivity. The expression of endothelial nitric oxide synthase (eNOS), cyclooxygenase 1 (COX-1), COX-2, p47phox, gp91phox, NF-KB p65, p53, p21, and p16 was quantified by western blotting. Serum hydroperoxide production was measured by the ferrous oxidation-xylenol orange (FOX-2) assay method. Interleukin-1 beta (IL-1β), IL-10, and tumor necrosis factor-alpha (TNF-α) levels were evaluated by spectroscopic ultraviolet-visible analysis. Periodontal disease in middle-aged rats was associated with reduced acetylcholine-induced relaxations of coronary artery rings affecting the endothelium-dependent hyperpolarization- and the nitric oxide-mediated relaxations. The endothelial dysfunction was related to eNOS downregulation, pronounced impairment of the EDH-mediated relaxation, increased IL-1β and TNF-α proinflammatory cytokines, and also upregulation of NADPH oxidase and COXs, starting accumulate aging markers such as p53/p21 and the p16. Treatment with β-glucan effectively reduced bone loss in periodontal disease and delayed endothelial dysfunction in the coronary artery. Our data show that yeast β-glucan ingestion prevented oxidative stress and synthesis of proinflammatory marker and prevented eNOS reduction induced by periodontal disease in middle-aged rats. These results suggest that β-glucan has a beneficial effect on the coronary vascular bed.
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Affiliation(s)
- Grazielle Caroline Silva
- Faculty of Health, Centro Universitário de Lavras (UNILAVRAS), Lavras, Minas Gerais, Brazil.,Department of Health Sciences, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Eduardo Damasceno Costa
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Virgínia Soares Lemos
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Celso Martins Queiroz-Junior
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Luciano José Pereira
- Department of Health Sciences, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
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Discepoli N, Marruganti C, Mirra R, Pettinari G, Ferrari Cagidiaco E, Ferrari M. Patients' illness perception before and after non-surgical periodontal therapy. A pre-post quasi-experimental study. J Periodontol 2021; 93:123-134. [PMID: 33997985 DOI: 10.1002/jper.21-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patient's illness perception, assessed through the Brief-Illness Perception Questionnaire (Brief-IPQ), plays a decisive role in the treatment effectiveness of a wide range of chronic diseases; nonetheless, evidence is still lacking regarding periodontitis. The aim of the present pre-post quasi-experimental study was to evaluate the change in the Brief-IPQ before and after non-surgical periodontal treatment (NST) and to evaluate its ability to foresee the efficacy of NST. METHODS A total of 126 periodontitis participants starting NST were asked to participate in the study. The nine-item Brief-IPQ together with a full periodontal chart were recorded at baseline and at the 3-month follow up (reevaluation) after NST. Pre-post comparisons of psychometric and periodontal variables were carried out through the Wilcoxon signed-rank test (α = 0.05). A predictive model was built to test the ability of the Brief-IPQ items to foresee the efficacy of NST. RESULTS NST led to a significant reduction in all periodontal parameters (P < 0.001); the proportion of pockets closed was 64.18%. Although the overall sum score of the Brief-IPQ remained fairly stable (P = 0.0673), significant changes occurred for items seven ("understanding") (P < 0.001) and 8 ("emotional response") (P < 0.05). The best model (R2 = 0.068, F = 2.15, P = 0.033) obtained from the multivariate linear regression analysis demonstrated that item five ("identity") (β = 2.340, P = 0.017) and item eight ("emotional response") (β = -2.569, P = 0.008) significantly predict the efficacy of NST (i.e., the proportion of pockets closed at reevaluation). CONCLUSIONS NST significantly ameliorates patient's understanding and emotional burden related to periodontitis. Baseline values of perceived symptoms and emotional response are predictive for the short-term efficacy of NST.
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Affiliation(s)
- Nicola Discepoli
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Raffaele Mirra
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gessica Pettinari
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Marco Ferrari
- Unit of Dental Material and Fixed Prosthodontics, University of Siena, Siena, Italy
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Costa PD, Canaan JCR, Midori Castelo P, Campideli Fonseca D, Márcia Pereira-Dourado S, Mendonça Murata R, Pardi V, José Pereira L. Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis. Nutrients 2021; 13:973. [PMID: 33802889 PMCID: PMC8002608 DOI: 10.3390/nu13030973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
The lack of access to a balanced diet, rich in vitamins and minerals, can predispose people to inflammatory diseases such as obesity, diabetes mellitus, and periodontitis. We aimed to evaluate the relationship between micronutrient intake, sociodemographic behavioral characteristics, and periodontal health in adults assisted by a public health care system. Participants (n = 450) answered a food frequency questionnaire and were submitted to anthropometric and oral clinical examinations. Principal component analysis was used to summarize the number of components emerging from 17-micronutrient intake. Subsequently, cluster analysis was employed. The prevalence of at least one periodontal pocket ≥ 4 mm was 67.4%. Three clusters were identified according to periodontal status. Cluster 1 "poor periodontal status" was characterized by older individuals (n = 202; 85% females) with poor periodontal status, lower education level, mainly smokers with non-transmissible chronic diseases (NTCD), with lower energy, omega-3, fiber, Zn, K, Cu, and vitamin C intake. Cluster 3 "healthy periodontal status" included younger individuals (n = 54) with the healthiest periodontal status, a higher education level, without NTCD, and with higher energy, omega-3, fiber, Zn, calcium, retinol, and riboflavin intake. Cluster 2 was labeled as "intermediate periodontal status". Micronutrient ingestion was associated with periodontal status and may be considered in health promotion actions for low-income populations.
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Affiliation(s)
- Patrícia Daniela Costa
- Health Sciences Faculty, Universidade Federal de Lavras (UFLA), 37200-900 Lavras, Minas Gerais, Brazil; (P.D.C.); (J.C.R.C.); (S.M.P.-D.)
| | - Juliana Cristina Reis Canaan
- Health Sciences Faculty, Universidade Federal de Lavras (UFLA), 37200-900 Lavras, Minas Gerais, Brazil; (P.D.C.); (J.C.R.C.); (S.M.P.-D.)
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), 09913-030 Diadema, São Paulo, Brazil;
| | | | - Stela Márcia Pereira-Dourado
- Health Sciences Faculty, Universidade Federal de Lavras (UFLA), 37200-900 Lavras, Minas Gerais, Brazil; (P.D.C.); (J.C.R.C.); (S.M.P.-D.)
| | - Ramiro Mendonça Murata
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University (ECU), Greenville, NC 27834, USA;
| | - Vanessa Pardi
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University (ECU), Greenville, NC 27834, USA;
| | - Luciano José Pereira
- Health Sciences Faculty, Universidade Federal de Lavras (UFLA), 37200-900 Lavras, Minas Gerais, Brazil; (P.D.C.); (J.C.R.C.); (S.M.P.-D.)
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13
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Martínez M, Martín-Hernández D, Virto L, MacDowell KS, Montero E, González-Bris Á, Marín MJ, Ambrosio N, Herrera D, Leza JC, Sanz M, García-Bueno B, Figuero E. Periodontal diseases and depression: A pre-clinical in vivo study. J Clin Periodontol 2021; 48:503-527. [PMID: 33432590 DOI: 10.1111/jcpe.13420] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/10/2020] [Accepted: 01/07/2021] [Indexed: 12/17/2022]
Abstract
AIM To analyse, through a pre-clinical in vivo model, the possible mechanisms linking depression and periodontitis at behavioural, microbiological and molecular levels. MATERIALS AND METHODS Periodontitis (P) was induced in Wistar:Han rats (oral gavages with Porphyromonas gingivalis and Fusobacterium nucleatum) during 12 weeks, followed by a 3-week period of Chronic Mild Stress (CMS) induction. Four groups (n = 12 rats/group) were obtained: periodontitis and CMS (P+CMS+); periodontitis without CMS; CMS without periodontitis; and control. Periodontal clinical variables, alveolar bone levels (ABL), depressive-like behaviour, microbial counts and expression of inflammatory mediators in plasma and brain frontal cortex (FC), were measured. ANOVA tests were applied. RESULTS The highest values for ABL occurred in the P+CMS+ group, which also presented the highest expression of pro-inflammatory mediators (TNF-α, IL-1β and NF-kB) in frontal cortex, related to the lipoprotein APOA1-mediated transport of bacterial lipopolysaccharide to the brain and the detection of F. nucleatum in the brain parenchyma. A dysregulation of the hypothalamic-pituitary-adrenal stress axis, reflected by the increase in plasma corticosterone and glucocorticoid receptor levels in FC, was also found in this group. CONCLUSIONS Neuroinflammation induced by F. nucleatum (through a leaky mouth) might act as the linking mechanism between periodontal diseases and depression.
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Affiliation(s)
- María Martínez
- Postgraduate program in Periodontology, Faculty of Dentistry, Complutense University, Madrid (UCM), Madrid, Spain
| | - David Martín-Hernández
- Department of Child and Adolescent Psychiatry, Hospital Gregorio Marañón Research Institute (IiSGM), Madrid, Spain.,Department of Pharmacology and Toxicology, Faculty of Medicine UCM, Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM, IUIN, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Leire Virto
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - Karina S MacDowell
- Department of Pharmacology and Toxicology, Faculty of Medicine UCM, Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM, IUIN, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - Álvaro González-Bris
- Department of Pharmacology and Toxicology, Faculty of Medicine UCM, Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM, IUIN, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - María José Marín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - Nagore Ambrosio
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - Juan Carlos Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine UCM, Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM, IUIN, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
| | - Borja García-Bueno
- Department of Pharmacology and Toxicology, Faculty of Medicine UCM, Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM, IUIN, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group (UCM), Madrid, Spain
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14
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Dent SC, Berger SM, Griffin JS. Biocultural pathways linking periodontal disease expression to food insecurity, immune dysregulation, and nutrition. Am J Hum Biol 2020; 33:e23549. [PMID: 33300640 DOI: 10.1002/ajhb.23549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES In this article, we test theoretical pathways leading to and resulting from periodontal disease to better understand how periodontal disease, which is measurable in both past and present populations, integrates biocultural context and affects whole-body physiology. METHODS We use data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and logistic and linear regressions to test pathways linking psychosocial stress to periodontal disease, and periodontal disease to serum vitamin C levels. We then use causal mediation analysis to test the role of mediating variables in these pathways (n = 1853 individuals). RESULTS Food insecurity was positively associated with periodontal disease and negatively associated with serum counts of C-reactive protein (CRP) and neutrophils. Neither CRP nor neutrophils significantly mediated the relationship between food insecurity and periodontal disease. Periodontal disease was negatively associated with serum vitamin C levels and positively associated with neutrophil counts. Neutrophils may mediate the relationship between periodontal disease and vitamin C. CONCLUSIONS We identify two main findings: (a) periodontal disease contributes to and may result from immune dysregulation, particularly of neutrophils, and (b) an immune response to chronic infection such as periodontal disease is metabolically expensive for the body to maintain and likely depletes serum micronutrient levels. Both micronutrient status and serum neutrophil counts affect multiple skeletal and physiological phenotypes and thus position periodontal disease in whole-body context.
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Affiliation(s)
- Sophia C Dent
- Department of Anthropology, Appalachian State University, Boone, NC, USA
| | - Steph M Berger
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacob S Griffin
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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15
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Veynachter T, Orti V, Moulis E, Rousseau H, Thilly N, Anagnostou F, Jeanne S, Bisson C. Prevalence and Associated Factors of Self-Reported Gingival Bleeding: A Multicenter Study in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228563. [PMID: 33218143 PMCID: PMC7698919 DOI: 10.3390/ijerph17228563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 12/11/2022]
Abstract
Gingival bleeding (GB) is a common sign of gingival inflammation which indicates the presence of periodontal diseases. This cross-sectional multicenter survey aimed to assess the prevalence of self-reported gingival bleeding (SRGB) in French adults and identify the main associated factors. A questionnaire-based interview was randomly proposed to 794 individuals in four French cities (Nancy, Montpellier, Paris, and Rennes). Subjects were recruited in preventive medicine centers (50%), railway stations, and malls (50%). The questionnaire comprised 25 items: SRGB characteristics, socioeconomic variables, oral hygiene habits, use of drugs, and anxiety level. The overall prevalence of SRGB was 63.2% [59.8%; 66.6%], with 58.7% bleeding after toothbrushing and 4.5% spontaneous bleeding. Males reported significantly lower SRGB prevalence than females (p = 0.04). The distribution of SRGB frequency was inversely proportional to age (p < 0.0001). No association between drug use and SRGB was found. The people interviewed in the preventive medicine centers reported the highest frequency of SRGB (p < 0.0001). In the multivariate logistic model, SRGB was significantly related to occupation, smoking status, brushing frequency, and anxiety level. In conclusion, SRGB was prevalent in more than half of the sample and was mainly associated with age, toothbrushing frequency, and anxiety level. Thus, providing information to patients about the importance of this oral manifestation may play an important role in preventing periodontal diseases.
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Affiliation(s)
- Thomas Veynachter
- Faculty of Dentistry, University of Lorraine, 54505 Vandœuvre-lès-Nancy, France;
- Department of Periodontology, University Hospital, 54000 Nancy, France
- SIMPA, Stress Immunity Pathogens Unit, Brabois Santé Campus, EA 7300, F-54000 Nancy, France
- Correspondence:
| | - Valérie Orti
- Department of Dentistry, University of Montpellier, 34193 Montpellier, France; (V.O.); (E.M.)
| | - Estelle Moulis
- Department of Dentistry, University of Montpellier, 34193 Montpellier, France; (V.O.); (E.M.)
| | - Hélène Rousseau
- Platform Support for Clinical Research, University Hospital, 54505 Vandoeuvre-Lès-Nancy, France; (H.R.); (N.T.)
| | - Nathalie Thilly
- Platform Support for Clinical Research, University Hospital, 54505 Vandoeuvre-Lès-Nancy, France; (H.R.); (N.T.)
| | - Fani Anagnostou
- Department of Dentistry, Garancière, University of Paris Diderot, 75006 Paris, France;
| | - Sylvie Jeanne
- Department of Periodontology, University of Rennes, 35043 Rennes, France;
| | - Catherine Bisson
- Faculty of Dentistry, University of Lorraine, 54505 Vandœuvre-lès-Nancy, France;
- Department of Periodontology, University Hospital, 54000 Nancy, France
- SIMPA, Stress Immunity Pathogens Unit, Brabois Santé Campus, EA 7300, F-54000 Nancy, France
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16
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ÖZCAN M, ÖZCAN G. Stresin cerrahi olmayan periodontal tedavi üzerine etkisi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.745326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Kim HJ, Kim EH, Park AK, Shin Y, Kang J, Lim J, Bhak J, Lee JY, Kim BC, Joo JY. Detection of association between periodontitis and polymorphisms of IL-1β + 3954 and TNF-α -863 in the Korean population after controlling for confounding risk factors. J Periodontal Res 2020; 55:905-917. [PMID: 32618013 PMCID: PMC7689763 DOI: 10.1111/jre.12783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 01/05/2023]
Abstract
Background and Objective Interleukin (IL)‐1 and tumor necrosis factor (TNF)‐α are inflammatory cytokines that play an important role in periodontitis, and their genetic variations have been suggested to be associated with increased risk of periodontitis. Focusing on three single nucleotide polymorphisms (SNPs) of IL‐1α + 4845, IL‐1β + 3954, and TNF‐α −863, we aimed to investigate the relationship between periodontitis risk and the polymorphisms of IL‐1 α/β and TNF‐α in Koreans. Material and Methods Mouthwash samples from 548 subjects (135 controls without periodontitis, 387 generalized chronic periodontitis patients, and 26 generalized aggressive periodontitis patients) were collected for isolation of genomic DNA. Genotyping of selected SNPs was performed using real‐time PCR. Univariable associations between the polymorphisms and periodontitis were assessed by chi‐squared test or Fisher's exact test. To evaluate the association after controlling for confounding effects of various risk factors, we stratified the subjects according to the presence or absence of self‐reported diseases and employed multiple logistic regression model to adjust for age, smoking status, and oral hygiene indices and behaviors. Results Significant association of IL‐1β + 3954 and TNF‐α −863 polymorphisms with periodontitis was observed after adjusting for the confounding risk factors, but not in univariable association analysis. The significant association between genotype CT of IL‐1β + 3954 and increased risk of advanced periodontitis was consistently detected regardless of the status of self‐reported diseases. In the polymorphism of TNF‐α −863, the genotype with minor allele (CA + AA) was significantly associated with periodontitis susceptibility, which was observed only in the subjects with self‐reported diseases. Conclusion The results suggest that genetic variations of IL‐1β + 3954 and TNF‐α −863 are associated with increased risk of periodontitis in Koreans. In addition, our findings underscore the importance of controlling for confounding risk factors to detect significant association between genetic factors and risk of periodontitis. A further well‐designed large‐scale study is needed to warrant our results.
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Affiliation(s)
- Hyun-Joo Kim
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | | | - Ae Kyung Park
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | | | | | | | - Jong Bhak
- Korean Genomics Industrialization and Commercialization Center, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea.,Clinomics Inc, Ulsan, Republic of Korea
| | - Ju-Youn Lee
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | | | - Ji-Young Joo
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
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18
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Castro MML, Ferreira RDO, Fagundes NCF, Almeida APCPSC, Maia LC, Lima RR. Association between Psychological Stress and Periodontitis: A Systematic Review. Eur J Dent 2020; 14:171-179. [PMID: 32069501 PMCID: PMC7069755 DOI: 10.1055/s-0039-1693507] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This systematic review aims to investigate the association between psychological stress and periodontitis through analysis of cortisol levels and periodontal clinical parameters. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide and based on PECO (Participants, Exposure, Comparators, Outcomes) question and registered at PROSPERO under the code CRD42017076670. As eligibility criteria, observational studies performed in adult humans presenting periodontitis (P), which evaluated patients exposed (E) and nonexposed to psychological stress (C) and to verify the association between this type of stress and periodontitis (O) were included. The searches were performed until March 2018. The following databases were used: PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar. After searches, the duplicate results were removed. The remaining citations were selected according to eligibility criteria in two phases. In the first phase, the title/abstract was evaluated. In the second phase, the articles were chosen previously were assessed by full text. After selection, the studies were submitted to data extraction and risk of bias evaluation by Fowkes and Fulton. A total of 1,386 citations were retrieved. After duplicates removal and selection process, three articles were selected by full text. Among them, two articles reported a positive association between psychological stress and periodontitis. All articles were classified as low risk of bias. Even though two articles highlighted an association between psychological stress and the presence of a possible modulatory pattern of cortisol levels in clinical parameters of periodontitis, more studies are necessary to elucidate this question.
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Affiliation(s)
- Micaele M L Castro
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, University Federal do Pará, Rua Augusto Corrêa 1, Guamá, Belém, PA, Brazil
| | - Railson de O Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, University Federal do Pará, Rua Augusto Corrêa 1, Guamá, Belém, PA, Brazil
| | - Nathalia C F Fagundes
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta. 5528 Edmonton Clinic Health Academy, Edmonton, Canada
| | - Anna P C P S C Almeida
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, University Federal do Pará, Rua Augusto Corrêa 1, Guamá, Belém, PA, Brazil
| | - Lucianne C Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael R Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, University Federal do Pará, Rua Augusto Corrêa 1, Guamá, Belém, PA, Brazil
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19
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Haririan H, Andrukhov O, Böttcher M, Pablik E, Wimmer G, Moritz A, Rausch-Fan X. Salivary neuropeptides, stress, and periodontitis. J Periodontol 2019; 89:9-18. [PMID: 28914594 DOI: 10.1902/jop.2017.170249] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/20/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Scientific evidence for psychologic stress as a risk factor for periodontitis is fragmentary and relies mostly on either questionnaire-based or biomarker studies. The aim of this study is to investigate brain-derived neurotrophic factor, substance P, vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), calcitonin gene-related peptide, and adrenomedullin as well as cortisol in saliva and serum in periodontal health and disease combined with different aspects of stress and possible associations with clinical parameters. METHODS In total, 56 patients with aggressive and chronic periodontitis and 44 healthy controls were screened by enzyme-linked immunosorbent assay and mass spectrometry for presence of neuropeptides and cortisol in saliva and serum. Psychologic stress was evaluated by validated questionnaires. All substances were explored for a possible relationship to periodontitis, clinical parameters, and stress. RESULTS VIP and NPY showed significantly higher levels in saliva but not in serum of patients with periodontitis. These neuropeptides correlated with the extent, severity, and bleeding on probing scores in patients with periodontitis. Females had significantly lower salivary VIP levels. There were no differences among participants regarding psychologic stress. CONCLUSION VIP and NPY in saliva could be potential sex-specific salivary biomarkers for periodontitis regardless of psychologic stress.
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Affiliation(s)
- Hady Haririan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, Division of Conservative Dentistry and Periodontology, Medical University of Vienna
| | | | - Eleonore Pablik
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna
| | - Gernot Wimmer
- Division of Prosthodontics, Restorative Dentistry, Periodontology, and Implantology, School of Dentistry, Medical University of Graz, Graz, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.,Competence Center for Periodontal Research, Division of Conservative Dentistry and Periodontology, Medical University of Vienna
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20
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An Evaluation of the Academic Stress’ Affect on Periodontal Tissues. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: It has been discussed over the years whether emotional stress might be a risk factor for periodontal diseases. The correlation between periodontal disease and stress can still not be explained. Our aim was to evaluate the effects of academic stress on gingival tissues in a prospective design.
Material and Methods: The study population consisted of randomly selected 40 dental students. Clinical examinations of plaque (PI), gingival (GI) and sulcus bleeding (SBI) indices, probing pocket depth (PPD) and gingival crevicular fluid flow rate were performed along with State-Trait Anxiety Inventory at three different periods of the school year. Measurements were recorded one month before the finals (1st period), during the final exams (2nd period), and two months after the final exams (3rd period).
Results: The changes in mean values of all parameters except plaque and pocket depth between the final and control terms were statistically significant. There was a significant correlation between gingival index and stress, plaque, pocket depth, and sulcus bleeding indices at 1st period. There was a significant correlation between gingival index and crevicular fluid at 2nd period. There was a significant correlation between gingival index and plaque, and sulcus bleeding indices at 3rd period.
Conclusions: The present results support the hypothesis that academic stress is a significant risk factor for gingival and periodontal inflammation.
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21
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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22
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Bawankar PV, Kolte AP, Kolte RA. Evaluation of stress, serum and salivary cortisol, and interleukin‐1β levels in smokers and non‐smokers with chronic periodontitis. J Periodontol 2018; 89:1061-1068. [DOI: 10.1002/jper.18-0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/27/2018] [Accepted: 03/04/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Pranjali V. Bawankar
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
| | - Abhay P. Kolte
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
| | - Rajashri A. Kolte
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
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23
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Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis. Clin Oral Investig 2018; 25:1677-1684. [PMID: 30066030 DOI: 10.1007/s00784-018-2569-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis. MATERIALS AND METHODS This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay. RESULTS The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups. CONCLUSIONS Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings. CLINICAL RELEVANCE Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.
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24
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Chatzistavrianou D, Blair F. Diagnosis and management of chronic and aggressive periodontitis part 1: periodontal assessment and diagnosis. ACTA ACUST UNITED AC 2017; 44:306-8, 310, 313-5. [DOI: 10.12968/denu.2017.44.4.306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Despoina Chatzistavrianou
- Specialist in Prosthodontics, Specialty Registrar in Restorative Dentistry, Birmingham Dental Hospital and University of Birmingham School of Dentistry, Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Fiona Blair
- Consultant and Senior Clinical Lecturer in Restorative Dentistry, Birmingham Dental Hospital and University of Birmingham School of Dentistry, Birmingham Community Healthcare NHS Trust, Birmingham, UK
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25
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Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, Cortisol, and Periodontitis in a Population Aged 50 Years and Over. J Dent Res 2016; 85:324-8. [PMID: 16567552 DOI: 10.1177/154405910608500408] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Periodontitis and its relationship with psycho-neuro-immunological variables, such as psychological stress and cortisol, have been little explored. The objective of this study was to evaluate the extent and severity of chronic periodontitis and its association with the levels of salivary cortisol and the scores obtained with a stress questionnaire in a population aged 50 years and over. We studied 235 individuals in a cross-sectional study. They answered the Lipp’s Inventory of Stress Symptoms for Adults, were instructed to collect three saliva samples for cortisol analysis, and were examined for evaluation for periodontitis. Based on logistic regression, cortisol levels were positively associated with the following outcomes: means of clinical attachment level (CAL) > = 4 mm [OR = 5.1, 95%CI (1.2, 20.7)]; 30% of sites with CAL > = 5 mm [OR = 6.9, 95%CI (1.7, 27.1)]; and 26% of sites with probing depth > = 4 mm [OR = 10.7, 95%CI (1.9, 54.1)] after adjustment for confounding variables. The results suggest that cortisol levels were positively associated with the extent and severity of periodontitis.
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Affiliation(s)
- J B Hilgert
- Post-graduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, 2600/414 Porto Alegre, RS 90035-003, Brazil.
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Crespo FA, Klaes CK, Switala AE, DeWitte SN. Do leprosy and tuberculosis generate a systemic inflammatory shift? Setting the ground for a new dialogue between experimental immunology and bioarchaeology. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 162:143-156. [PMID: 27704524 DOI: 10.1002/ajpa.23104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 11/10/2022]
Abstract
It is possible that during long lasting chronic infections such as tuberculosis (TB) and leprosy individuals who generate a stronger immune response will produce a chronic shift in the systemic levels of inflammatory proteins. Consequently, the systemic immunological shift could affect inflammatory responses against other persistent pathogens such as Porphyromonas gingivalis associated with periodontal disease (PD). OBJECTIVE To determine if in vitro exposure to Mycobacterium tuberculosis or M. leprae lysates impacts subsequent immune responses to P. gingivalis; and to propose a new dialogue between experimental immunology and paleopathology. MATERIAL AND METHODS We sequentially (2 days protocol) exposed peripheral blood mononuclear cells (PBMCs) from healthy donors to bacterial lysates either from M. tuberculosis, or M. leprae, or P. gingivalis. After collecting all supernatants, we measured the expression of immune proteins TNFα and IFNγ using an enzyme-linked immunosorbent assay. RESULTS Early exposure (day 1) of PBMCs to M. leprae or M. tuberculosis lysates induces an inflammatory shift detected by the increase of TNFα and IFNγ when the same cells are subsequently (day 2) exposed to oral pathogen P. gingivalis. DISCUSSION By extrapolating these results, we suggest that chronic infections, such as TB and leprosy, could generate a systemic immunological shift that can affect other inflammatory processes such the one present in PD. We propose that the presence and severity of PD should be explored as a proxy for inflammatory status or competence when reconstructing the health profile in past populations.
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Affiliation(s)
- Fabian A Crespo
- Department of Anthropology, University of Louisville, Louisville, Kentucky
| | | | - Andrew E Switala
- Department of Bioengineering, University of Louisville, Louisville, Kentucky
| | - Sharon N DeWitte
- Departments of Anthropology and Biological Sciences, University of South Carolina, Columbia, South Carolina
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Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
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Social-Biological Interactions in Oral Disease: A 'Cells to Society' View. PLoS One 2016; 11:e0146218. [PMID: 26751953 PMCID: PMC4709106 DOI: 10.1371/journal.pone.0146218] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 11/09/2015] [Indexed: 11/01/2022] Open
Abstract
Oral diseases constitute a major worldwide public health problem, with their burden concentrating in socially disadvantaged and less affluent groups of the population, resulting in significant oral health inequalities. Biomedical and behavioural approaches have proven relatively ineffective in reducing these inequalities, and have potentially increased the health gap between social groups. Some suggest this stems from a lack of understanding of how the social and psychosocial contexts in which behavioural and biological changes occur influence oral disease. To unravel the pathways through which social factors affect oral health outcomes, a better understanding is thus needed of how the social 'gets under the skin,' or becomes embodied, to alter the biological. In this paper, we present the current knowledge on the interplay between social and biological factors in oral disease. We first provide an overview of the process of embodiment in chronic disease and then evaluate the evidence on embodiment in oral disease by reviewing published studies in this area. Results show that, in periodontal disease, income, education and perceived stress are correlated with elevated levels of stress hormones, disrupted immune biomarkers and increased allostatic load. Similarly, socioeconomic position and increased financial stress are related to increased stress hormones and cariogenic bacterial counts in dental caries. Based on these results, we propose a dynamic model depicting social-biological interactions that illustrates potential interdependencies between social and biological factors that lead to poor oral health. This work and the proposed model may aid in developing a better understanding of the causes of oral health inequalities and implicate the importance of addressing the social determinants of oral health in innovating public health interventions.
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Rohini G, Kalaivani S, Kumar V, Rajasekar SA, Tuckaram J, Pandey V. Estimation and comparison of serum cortisol levels in periodontally diseased patients and periodontally healthy individuals: A clinical-biochemical study. J Pharm Bioallied Sci 2015; 7:S457-60. [PMID: 26538897 PMCID: PMC4606639 DOI: 10.4103/0975-7406.163501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: Psychological conditions, particularly psychosocial stress have been implicated as risk indicators of periodontal disease. Stress increases cortisol production from the adrenal cortex by stimulating an increase in the release of ACTH from the pituitary gland. Increased cortisol production suppresses the immune response and increases the potential of periodontal tissue destruction. Aim: The aim of the present study was to estimate and compare the serum cortisol levels in periodontally diseased patients and periodontally healthy individuals. Materials and Methods: Total of 45 subjects were recruited for this study and were categorized into three groups. Group I - Comprised of aggressive periodontitis patients (n = 15), Group II - Chronic periodontitis patients (n = 15), and Group III - Healthy controls (n = 15). Serum samples were collected from each of the groups and cortisol levels were determined using cortisol immunoassay kit. Clinical examination covered probing depth, gingival index (GI), gingival recession, plaque index, and clinical attachment level. The statistical analysis was done using nonparameteric t-test and Spearman's rank correlation coefficient. Results: With respect to cortisol, the levels were higher in Group-I compared to the other groups. On comparison of mean cortisol levels among the groups, the values were statistically significant between Group-I and Group-III. Group-I showed a significant negative correlation between cortisol levels and GI. Conclusion: Within the limits of the study serum cortisol levels was higher in the chronic periodontitis group compared to the other groups. Positive correlation was found between the cortisol levels and other clinical parameters except for the GI.
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Affiliation(s)
- G Rohini
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, India
| | - S Kalaivani
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, India
| | - Vipin Kumar
- Consultant Periodontist and Implantologist, Delhi, India
| | - S A Rajasekar
- Consultant Oral and Maxillofacial surgeon, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaishree Tuckaram
- Department of Periodontics, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Vinisha Pandey
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Kanpur, Uttar Pradesh, India
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Siqueira CRBD, Semenoff TADV, Palma VC, Borges ÁH, Silva NFD, Segundo AS. Effect of chronic stress on implant osseointegration into rat's mandible. Acta Cir Bras 2015; 30:598-603. [PMID: 26465103 DOI: 10.1590/s0102-865020150090000003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/11/2015] [Indexed: 11/22/2022] Open
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Zhuang D, Han J, Bi L, Wang Y, Hao Y, Zhou Q, Cao W. Sonodynamic effect of hematoporphyrin monomethyl ether on ligature-induced periodontitis in rats. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:2545-51. [PMID: 26005331 PMCID: PMC4427595 DOI: 10.2147/dddt.s82347] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives The aim of this study was to perform a histological evaluation of sonodynamic therapy (SDT) of hematoporphyrin monomethyl ether (HMME) on artificially induced periodontal disease in rats. Methods Submerging ligatures were placed at the subgingival region of the first maxillary molar in rats. Eighty rats were randomly assigned into four groups: group 1 received no treatment; group 2 was subjected to 50 μg/mL HMME alone; group 3 was treated with low-intensity ultrasound alone (1 W/cm2); and group 4 was treated with 50 μg/mL HMME plus ultrasound irradiation (1 MHz, 30 minutes). Ten rats in each group were euthanized at 7 and 15 days, and periodontal tissue samples were taken for histological examination. Results The animals treated by SDT showed less bone loss (P<0.05) at all experimental periods than the other three groups. No significant differences were found between the control and HMME groups (P>0.05). Conclusion Our results suggest that HMME-mediated SDT can effectively alleviate the periodontal tissue destruction in artificially induced periodontitis in rats. Hence, SDT may have good clinic potential as a noninvasive treatment of periodontal diseases.
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Affiliation(s)
- Deshu Zhuang
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, People's Republic of China
| | - Jialong Han
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, People's Republic of China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, People's Republic of China
| | - Yueping Wang
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, People's Republic of China
| | - Yanru Hao
- Department of Stomatology, The First Affiliated Hospital, Harbin Medical University, Harbin, People's Republic of China
| | - Qi Zhou
- Condensed Matter Science and Technology Institute, Harbin Institute of Technology, Harbin, People's Republic of China
| | - Wenwu Cao
- Condensed Matter Science and Technology Institute, Harbin Institute of Technology, Harbin, People's Republic of China ; Department of Mathematics and Materials Research Institute, The Pennsylvania State University, University Park, PA, USA
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Takeda O, Toyama T, Watanabe K, Sato T, Sasaguri K, Akimoto S, Sato S, Kawata T, Hamada N. Ameliorating effects of Juzentaihoto on restraint stress and P. gingivalis-induced alveolar bone loss. Arch Oral Biol 2014; 59:1130-8. [DOI: 10.1016/j.archoralbio.2014.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 04/04/2014] [Accepted: 06/28/2014] [Indexed: 12/18/2022]
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Peeran SW, Kumar NP, Azaruk FAA, Alsaid FM, Abdalla KA, Mugrabi MH, Peeran SA. Association between mental well-being, depression, and periodontal attachment level among young adults of the postwar Sebha city, Libya: A pilot study. J Nat Sci Biol Med 2014; 5:308-12. [PMID: 25097404 PMCID: PMC4121904 DOI: 10.4103/0976-9668.136172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The present study was aimed to investigate the association of mental well-being and depression with periodontal clinical attachment loss among young adults in postwar urban population of Sebha city, Libya. MATERIALS AND METHODS Mental well-being and depression were assessed using Arabic versions of World Health Organization (WHO) five well-being index and major depression inventory (ICD-10), respectively. Random sample of 149 subjects were studied. Degree of periodontal attachment was measured at six sites per tooth using a rigid manual periodontal probe. RESULT AND CONCLUSION A total of 59.11% of the studied samples had healthy mental well-being state, whereas 40.81% had poor mental well-being. The severity of depression was stronger in males than in females. In the present study mental well-being, depression, and all its categories did not have any significant effect on periodontal attachment loss. Further studies and health interventions can be planned based on this data.
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Affiliation(s)
- Syed Wali Peeran
- Department of Periodontology and Oral Implantology, Sebha University, Sebha, Libya
| | - Naveen P.G. Kumar
- Department of Community and Preventive Dentistry, College of Dental Sciences, Davengere, India
| | | | | | - Khaled Awidat Abdalla
- Department of Oral Biology and Orthodontics, Faculty of Dentistry, Sebha University, Sebha, Libya
| | - Marei Hamed Mugrabi
- Department of Periodontics, Faculty of Dentistry, Arab Medical University, Benghazi, Libya
| | - Syed Ali Peeran
- Department of Oral and Maxillofacial Prothodontics, Faculty of Dentistry, Jazan University, KSA
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Abstract
UNLABELLED The relationship of a sound mind to the maintenance of a healthy body has been recognized throughout most of recorded history. The term 'stress' is used to describe adverse emotions or reactions to unpleasant experiences. Individuals with high levels of stress and poor coping skills experience twice as much periodontal disease as compared to those with minimal stress and good coping skills. Although stress may predispose an individual to more destruction from periodontitis, the presence of periodontal pathogens remains the essential aetiologic factor. This review presents a summary of stress, discussing how it can predispose an individual to periodontal disease. CLINICAL RELEVANCE Stress, which is a universal phenomenon, is implicated to have various systemic effects besides being a risk factor for periodontal disease. This article elucidates the relationship between psycho-social stress and destructive periodontal disease.
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Abstract
Risk factors play an important role in an individual's response to periodontal infection. Identification of these risk factors helps to target patients for prevention and treatment, with modification of risk factors critical to the control of periodontal disease. Shifts in our understanding of periodontal disease prevalence, and advances in scientific methodology and statistical analysis in the last few decades, have allowed identification of several major systemic risk factors for periodontal disease. The first change in our thinking was the understanding that periodontal disease is not universal, but that severe forms are found only in a portion of the adult population who show abnormal susceptibility. Analysis of risk factors and the ability to statistically adjust and stratify populations to eliminate the effects of confounding factors have allowed identification of independent risk factors. These independent but modifiable, risk factors for periodontal disease include lifestyle factors, such as smoking and alcohol consumption. They also include diseases and unhealthy conditions such as diabetes mellitus, obesity, metabolic syndrome, osteoporosis, and low dietary calcium and vitamin D. These risk factors are modifiable and their management is a major component of the contemporary care of many periodontal patients. Genetic factors also play a role in periodontal disease and allow one to target individuals for prevention and early detection. The role of genetic factors in aggressive periodontitis is clear. However, although genetic factors (i.e., specific genes) are strongly suspected to have an association with chronic adult periodontitis, there is as yet no clear evidence for this in the general population. It is important to pursue efforts to identify genetic factors associated with chronic periodontitis because such factors have potential in identifying patients who have a high susceptibility for development of this disease. Many of the systemic risk factors for periodontal disease, such as smoking, diabetes and obesity, and osteoporosis in postmenopausal women, are relatively common and can be expected to affect most patients with periodontal disease seen in clinics and dental practices. Hence, risk factor identification and management has become a key component of care for periodontal patients.
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Movva LR, Ho DK, Corbet EF, Leung WK. Type-2 diabetes mellitus, metabolic control, serum inflammatory factors, lifestyle, and periodontal status. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Bansal J, Bansal A, Shahi M, Kedige S, Narula R. Periodontal Emotional Stress Syndrome: Review of Basic Concepts, Mechanism and Management. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojmp.2014.33026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Foureaux RDC, Messora MR, de Oliveira LFF, Napimoga MH, Pereira ANJ, Ferreira MS, Pereira LJ. Effects of probiotic therapy on metabolic and inflammatory parameters of rats with ligature-induced periodontitis associated with restraint stress. J Periodontol 2013; 85:975-83. [PMID: 24171503 DOI: 10.1902/jop.2013.130356] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study evaluates the effects of probiotic therapy (PT) in rats with ligature-induced periodontitis associated with restraint stress. METHODS Sixty-four rats were divided into control, stress (STR), probiotic (PROB), periodontal disease (PD), STR-PROB, STR-PD, STR-PROB-PD, and PROB-PD groups. The probiotic was added to the drinking water for 44 days. PD was induced by a ligature. In STR groups, the animals were subjected to restraint stress for 2.5 hours per day for 30 days. RESULTS Rats with PD exhibited increased alveolar bone loss (P <0.05), as well as increased levels of cyclooxygenase-2, serum C-terminal telopeptide (CTX), p38 mitogen-activated protein kinase (p38), and receptor activator of nuclear factor-κB ligand and decreased levels of osteoprotegerin (OPG). Stressed rats presented high levels of C-peptide, corticosterone, and glucose (P <0.05). In general, the presence of stress reduced the expression of CTX and p38 (P <0.05). PT reduced alveolar bone loss in unstressed animals. It also decreased expression of CTX and induced increased expression of OPG in unstressed animals with PD. However, PT was not effective in preventing bone loss or altering the expression of inflammatory markers in stressed animals. PT decreased the number of inflammatory cells in the periodontal tissue (P <0.05). Groups with stress and PD showed decreased villous height and crypt depth. Stress seemed to prevent part of the probiotic beneficial effects on the small intestine. CONCLUSIONS Based on the methodology used, PT may reduce tissue breakdown resulting from PD in unstressed rats. The protocol used for restraint stress influenced the immunomodulatory effects of PT in intestinal and periodontal tissues.
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Affiliation(s)
- Renata de C Foureaux
- Department of Physiology and Pharmacology, Federal University of Lavras (UFLA), Lavras, MG, Brazil
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Graetz C, Ehrenthal JC, Senf D, Semar K, Herzog W, Dörfer CE. Influence of psychological attachment patterns on periodontal disease - a pilot study with 310 compliant patients. J Clin Periodontol 2013; 40:1087-94. [PMID: 24111819 DOI: 10.1111/jcpe.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Psychosocial variables have received increased attention in periodontology. Attachment theory adds to known risk factors by linking early interactional experiences with adult tendencies of stress-regulation, health behaviour, symptom reporting, and healthcare utilization. The study investigates associations between attachment patterns and periodontal parameters. METHODS Within the context of a longitudinal study on periodontal diseases, 310 patients with aggressive (AgP) and chronic periodontitis (CP) filled out questionnaires on psychological attachment patterns. The influence of attachment style on health behaviour, treatment attendance and utilization, and periodontal variables was tested. RESULTS We found associations between psychological attachment anxiety on smoking and higher number of session use, independent of disease severity, which was more pronounced for women. Patients with higher attachment avoidance attended periodontal treatment later when diagnosed with CP and earlier with AgP. For men, we found differential associations for attachment avoidance and anxiety and number of teeth at beginning of treatment. CONCLUSION Psychological attachment patterns are a promising target for understanding periodontal disease in addition to known psychosocial risk factors.
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Affiliation(s)
- Christian Graetz
- Department of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
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Bakri I, Douglas CWI, Rawlinson A. The effects of stress on periodontal treatment: a longitudinal investigation using clinical and biological markers. J Clin Periodontol 2013; 40:955-61. [DOI: 10.1111/jcpe.12142] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Issam Bakri
- Oral and Maxillofacial Medicine and Surgery; Charles Clifford Dental Hospital; Sheffield UK
| | - Charles W. Ian Douglas
- Academic Unit of Oral and Maxillofacial Pathology; University of Sheffield; Sheffield UK
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry; University of Sheffield; Sheffield UK
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Scalco GPDC, Abegg C, Celeste RK, Hökerberg YHM, Faerstein E. Occupational stress and self-perceived oral health in Brazilian adults: a Pro-Saude study. CIENCIA & SAUDE COLETIVA 2013; 18:2069-74. [DOI: 10.1590/s1413-81232013000700022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 10/15/2012] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is to investigate the association between occupational stress and self-perception of oral health. Data were obtained through a self-administered questionnaire filled out in a Pró-Saúde Study by 3253 administrative technical staff from Rio de Janeiro's State University. Occupational stress was measured by means of a questionnaire elaborated in 1970 by Karasek, duly shortened by Thorell in 1988. Ordinal logistic regression was used for data analysis, subsequently adjusted for three blocks of variables. Workers exposed to high occupational demands and little occupational control and to passive work had higher chances of self-perception of worse oral health, when compared with those exposed to low occupational demands, there being no association observed in those exposed to active work. However, in the multiple regression model the following estimates were reduced in magnitude and lost statistical significance, namely high occupational demands and passive work. Workers exposed to high occupational demands revealed worse self-reported oral health, which seems to be partly explained by health behavior patterns, the presence of oral health problems and seeking dental services at longer intervals than once per year.
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Darby IB, Ngo L. Minimum intervention dentistry: periodontics and implant dentistry. Aust Dent J 2013; 58 Suppl 1:76-84. [DOI: 10.1111/adj.12053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- IB Darby
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
| | - L Ngo
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
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Breivik T, Gundersen Y, Gjermo P, Opstad PK. Chronic treatment with the glucocorticoid receptor antagonist RU486 inhibits diabetes-induced enhancement of experimental periodontitis. J Periodontal Res 2013; 49:36-44. [PMID: 23586673 DOI: 10.1111/jre.12076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity and excessive glucocorticoid hormone release have been associated with diabetes, altered immune responses and increased susceptibility to periodontitis. In the present study we tested the impact of streptozotocin (STZ)-induced diabetes on ligature-induced periodontitis and the effect of subsequent treatment with the glucocorticoid receptor (GR) antagonist, RU486. MATERIAL AND METHODS A single dose of STZ [45 mg/kg, intraperitoneally (i.p.)] or vehicle was given 10 d before induction of ligature-induced periodontitis and implantation subcutaneously of a drug pellet containing the GR antagonist, RU486, or a placebo pellet. Periodontitis was assessed when the ligatures had been in place for 21 d. Two hours before decapitation all rats received gram-negative bacterial lipopolysaccharide (LPS) (150 μg/kg, i.p.) to induce a robust immune and stress response. RESULTS Compared with control rats, STZ-treated rats developed significantly more periodontal bone loss, and RU486 treatment of STZ -treated rats significantly inhibited this effect. STZ-treated rats also showed significantly higher levels of the HPA axis-derived hormone, corticosterone, as well as of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF-α), but lower levels of the anti-inflammatory cytokines interleukin-10 (IL-10) and transforming growth factor-1beta (TGF-1β) after LPS stimulation. GR blockade had no statistically significant effects on these measurements in diabetic rats, but tended to enhance the levels of TNF-α and TGF-1β, and reduce the levels of IL-10 and blood glucose. CONCLUSION In diabetic subjects, excessive GR activation as a result of chronic high levels of glucocorticoid hormones may alter immune-system responses in a manner that may increase the susceptibility to periodontitis.
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Affiliation(s)
- T Breivik
- Faculty of Dentistry, Department of Periodontology, University of Oslo, Oslo, Norway; Division of Protection, Norwegian Defence Research Establishment, Kjeller, Norway
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Mannem S, Chava VK. The effect of stress on periodontitis: A clinicobiochemical study. J Indian Soc Periodontol 2013; 16:365-9. [PMID: 23162330 PMCID: PMC3498705 DOI: 10.4103/0972-124x.100912] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 04/11/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Clinical and epidemiological data suggest that negative life experience events, like depression, may contribute to an increased susceptibility to periodontal disease. AIM To study the association between psychological stress and chronic periodontitis. MATERIALS AND METHODS One hundred and eleven dentate individuals, of age 40 years and above, were selected. The clinical examination included, the number of teeth present, plaque index, Probing Pocket Depth, and Clinical Attachment Level. Assessment of Psychological stress levels were done by a questionnaire and were correlated with salivary cortisol levels, which were estimated biochemically by using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS Statistical analysis was done by using the student 't' test and Mann Whitney test. According to our observation, chronic periodontitis showed a significant correlation with hypercortisolemia (P<0.0001), work tension (P=0.04), economic problems (P<0.0001), clinical stress syndrome (P<0.0001), plaque index (P<0.0001), and unsecured job (P=0.003). CONCLUSION Stress may be considered as an important risk factor for periodontal disease. Routine salivary cortisol assessment may be an economical and useful diagnostic marker to rule out stress in periodontitis patients.
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Affiliation(s)
- Satheesh Mannem
- Department of Periodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
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Abstract
Stress is an equated response to constant adverse stimuli. At one point or another everybody suffers from stress. Stress is compatible with good health, being necessary to cope with the challenges of everyday life. Problems start when the stress response is inappropriate to the intensity of the challenge. Psychological stress can down regulate the cellular immune response. Communication between the central nervous system and the immune system occurs via a complex network of bidirectional signals linking the nervous, endocrine, and immune systems. Stress disrupts the homeostasis of this network, which in turn, alters immune function. Direct association between periodontal disease and stress remains to be proven, which is partly due to lack of an adequate animal models and difficulty to quantifying the amount and duration of stress and also there are many factors influencing the incidence and severity of periodontal disease. Nevertheless, more recent studies indicate that psychosocial stress represents a risk indicator for periodontal disease and should be addressed before and during treatment. This paper discusses how stress may modulate host response to bacteria and influence the course and progression of periodontal disease.
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Affiliation(s)
- Sachin Goyal
- Department of Periodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Garima Gupta
- Department of Orthodontics and Dentofacial Orthopaedics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Betsy Thomas
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - K. M. Bhat
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - G. S. Bhat
- Department of Periodontics, PDS Division, College of Dentistry, University of Dammam, Saudi Arabia
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Laine ML, Crielaard W. Functional foods/ingredients and periodontal diseases. Eur J Nutr 2012; 51 Suppl 2:S27-30. [PMID: 22535144 DOI: 10.1007/s00394-012-0325-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marja L Laine
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
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Preeja C, Ambili R, Nisha KJ, Seba A, Archana V. Unveiling the role of stress in periodontal etiopathogenesis: an evidence-based review. ACTA ACUST UNITED AC 2012; 4:78-83. [PMID: 23073923 DOI: 10.1111/jicd.12000] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 07/24/2012] [Indexed: 11/30/2022]
Abstract
Periodontal disease is a multifactorial disease affecting the supporting tissues of the teeth, resulting in progressive attachment loss and bone loss. Periodontal disease is influenced by various systemic, environmental, and psychologic factors that have the potential to alter periodontal tissues and host immune response, resulting in more severe periodontal destruction. Several studies have documented the relationship between psychosocial stress and chronic forms of periodontal disease. Stress impairs periodontal health through changes in behavior and complex interactions among the nervous, endocrine, and immune systems. The influence of stress on periodontal disease is affected by the emotional coping skills of the individual. Psychologic stress and depression may also influence the outcome of periodontal therapy. Stressful life events and coping skills are factors to consider in the risk of periodontal disease destruction and the potential for successful periodontal therapy. Therefore psychosocial stress is considered as an important risk factor for periodontal disease, and emotional stress in periodontitis patients should be diagnosed and treatment should be administered for the proper management and successful outcome of periodontal disease.
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Affiliation(s)
- C Preeja
- Department of Periodontics, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.
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48
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Rivera C, Monsalve F, Suazo I, Becerra J. Stress increases periodontal inflammation. Exp Ther Med 2012; 4:883-888. [PMID: 23226743 PMCID: PMC3493748 DOI: 10.3892/etm.2012.675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 08/09/2012] [Indexed: 11/21/2022] Open
Abstract
This study aimed to examine the effect of chronic restraint stress (RS) on the severity of experimental periodontal disease in rats. A total of 32 male Sprague Dawley (SD) rats were divided into four groups: i) Rats receiving two treatment regimens, chronic stress induced by movement restriction in acrylic cylinders for 1–1.5 h daily and induction of experimental periodontal disease, using a nylon ligature which was placed around the first left mandibular molars (n=8); ii) induction of periodontal disease, without RS (n=8); iii) RS (n=8) and iv) control (n=8). After 15 days, blood samples were obtained, and blood glucose levels and the corticosterone concentration were measured as stress markers. The severity of periodontal disease was analyzed according to the level of gingival and bone inflammation, leading to compromise of the teeth involved. Chronic stress was induced with movement restriction (P≤0.05, Mann-Whitney U-test) and increased the severity (P≤0.05, Mann-Whitney U-test) of experimental perio dontal disease in rats, according to the level of gingival and bone inflammation around the first left mandibular molars. The results of the present study showed that RS modulates periodontal inflammation and that the rat model described herein is suitable for investigating the association between stress and periodontal disease.
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Affiliation(s)
- César Rivera
- Unit of Histology and Embryology, Department of Basic Biomedical Sciences, Faculty of Health Sciences; ; Master Program in Biomedical Sciences, Oral Pathology mention, University of Talca, Talca
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Haririan H, Bertl K, Laky M, Rausch WD, Böttcher M, Matejka M, Andrukhov O, Rausch-Fan X. Salivary and serum chromogranin A and α-amylase in periodontal health and disease. J Periodontol 2012; 83:1314-21. [PMID: 22264209 DOI: 10.1902/jop.2012.110604] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Salivary stress-related biomarkers in connection with periodontal disease have not been extensively studied. In addition to cortisol as a well-known marker of stress loading, chromogranin A (CgA) and α-amylase (AA) are supposed to link the activity of the neuroendocrine system to local and systemic immune functions and to be related to periodontitis. This study aims to determine CgA and AA in saliva and serum in periodontal health and disease to assess their potential relationship to periodontitis. METHODS Patients with aggressive (AgP) (n = 24) and chronic periodontitis (CP) (n = 34) as well as healthy control (CO) (n = 30) individuals participated in this study. CgA and AA were determined in saliva and serum with enzyme-linked immunosorbent assay and an adapted clinical amylase test; salivary cortisol was determined using mass spectrometry. Clinical parameters of periodontal disease were evaluated, and their possible correlations with stress-related biomarkers were assessed. RESULTS Significantly higher CgA levels were found in the saliva of patients with AgP compared with those in patients with CP and CO individuals (P <0.001). Salivary cortisol levels were higher in the AgP group compared with those in patients with CP (P <0.05). No differences in serum CgA levels and salivary and serum AA activities were found among all groups. A positive correlation was revealed between salivary AA activity or salivary CgA levels and the extent of periodontitis (P <0.05). CONCLUSION The results suggest an association of CgA and cortisol levels as well as AA activity in saliva with periodontitis, especially a significant relationship of salivary CgA and cortisol to AgP.
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Affiliation(s)
- Hady Haririan
- Department of Periodontology, Bernhard Gottlieb School of Dentistry, Medical University, Vienna, Austria
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50
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Rettori E, De Laurentiis A, Zorrilla Zubilete M, Rettori V, Elverdin JC. Anti-inflammatory effect of the endocannabinoid anandamide in experimental periodontitis and stress in the rat. Neuroimmunomodulation 2012; 19:293-303. [PMID: 22777139 DOI: 10.1159/000339113] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 04/19/2012] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Periodontitis is an infectious disease leading to inflammation and destruction of tissue surrounding and supporting the tooth. The progress of the inflammatory response depends on the host's immune system and risk factors such as stress. The aim of the present study was to investigate the role of the endocannabinoid anandamide (AEA) in experimental periodontitis with restraint stress, since the endocannabinoid system is known to modulate the hypothalamo-pituitary-adrenal axis as well as immune functions and has been found in human gingival tissues. METHODS Experimental periodontitis was induced by ligature around first inferior molars and immobilization stress for 2 h twice daily for 7 days in a rat model. RESULTS Corticosterone plasma levels, locomotor activity, adrenal gland weight and bone loss were increased in periodontitis and stress groups, and there was also less weight gain. The inflammatory parameters such as prostaglandin E(2) (radioimmunoassay), nitric oxide (radioconversion of (14)C-arginine), tumor necrosis factor (TNF)-α (ELISA) and interleukin (IL)-1β (Western blot) measured in the gingival tissue were significantly increased in the periodontitis groups compared to the control group. Local injection of AEA (10(-8)M, 30 µl) decreased corticosterone plasma levels and the content of the cytokines TNF-α and IL-1β in gingival tissue in periodontitis-stress groups. These AEA-induced inhibitions were mediated by CB(1) and CB(2) cannabinoid receptors since the injection of both antagonists together, AM251 (10(-6)M) and AM630 (10(-6)M) in 30 µl, prevented these effects. CONCLUSION The endocannabinoid AEA diminishes the inflammatory response in periodontitis even during a stressful situation.
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Affiliation(s)
- Elisa Rettori
- Department of Physiology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
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