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Anwar SK, Hafez AM, Roshdy YS. Clinical and microbiological efficacy of intra-pocket application of diode laser in grade C periodontitis: a randomized controlled clinical trial. BMC Oral Health 2024; 24:270. [PMID: 38395824 PMCID: PMC10893689 DOI: 10.1186/s12903-024-04031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Periodontitis is a microbially induced disease destroying structures anchoring teeth to jaw bones. Although metronidazole in combination with spiramycin is the effective conventional treatment of stage III grade C periodontitis, it has several systemic side effects. Laser therapy is widely used nowadays as an adjunct to scaling and root planing (SRP) to modulate inflammatory host response and eradicate microbes, due to bactericidal and detoxifying effects. Since microbiological analysis is one of the diagnostic methods identifying periodontal risk; our research aimed to investigate the efficacy of intra-pocket application of diode laser (980 nm) versus antibiotic therapy in enhancing clinical and microbiological parameters in stage III grade C periodontitis. METHODS A randomized controlled clinical trial was conducted on fifty patients with stage III grade C periodontitis, divided equally into two groups. We managed test group by SRP with intra-pocket application of diode laser (980 nm) and the control group by SRP with systemic antibiotic administration (spiramycin and metronidazole). Then, we measured periodontal pocket depth (PPD) and clinical attachment loss (CAL) for both groups, before treatment (baseline), four and twelve weeks after. Moreover, we collected gingival crevicular fluid from both groups at baseline, four and twelve weeks after treatment and analyzed by real-time polymerase chain reaction to detect the relative count of Aggregatibacter actinomycetemcomitans and Porhyromonas gingivalis. RESULTS Compared to baseline, all assessed clinical and microbiological parameters attested improvement at the end of the study period in each group individually with no significant difference between the two studied groups. Although, at twelve weeks, flare up of bacterial levels was detected with systemic antibiotic administration. CONCLUSION Laser therapy can be considered as an effective treatment modality in stage III grade C periodontitis, avoiding the systemic antibiotic side effects and solving the recurrence problems due to bacterial resistance by long term usage. TRIAL REGISTRATION NCT05222737 retrospectively on 03/02/2022, Clinicaltrial.gov.
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Affiliation(s)
- Souzy Kamal Anwar
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt.
| | - Amira Mohamed Hafez
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| | - Yara Safwat Roshdy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
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Conte G, Pacino SA, Urso S, Greiling D, Caponnetto P, Pedullà E, Generali L, Consolo U, Checchi V, Gospodaru S, Bordeniuc G, Fala V, Kowalski J, Nowak M, Górska R, Amaliya A, Chapple I, Milward M, Maclure R, Nardi GM, Polosa R. Changes in Oral Health and Dental Esthetic in Smokers Switching to Combustion-Free Nicotine Alternatives: Protocol for a Multicenter and Prospective Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53222. [PMID: 38393754 PMCID: PMC10924261 DOI: 10.2196/53222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Although the detrimental effects of conventional combustible cigarettes on oral health and dental esthetics are well known, there is limited information about the long-term impact of combustion-free nicotine alternatives (C-F NA) such as e-cigarettes or heated tobacco products. OBJECTIVE This multicenter, prospective, 3-parallel-arm randomized controlled trial will investigate whether switching from combustible cigarettes to C-F NA will lead to measurable improvements in oral health parameters and dental esthetics over 18 months in adult smokers with limited gum disease. METHODS Regular smokers not intending to quit and without clinical signs of periodontitis will be randomly assigned (1:4 ratio) to either standard of care with brief cessation advice (control group; arm A) or C-F NA use (intervention group; arm B). The study will also include a reference group of never smokers (reference group; arm C). The primary end point is the change in the Modified Gingival Index (MGI) score from baseline between the control arm (arm A) and the intervention arm (arm B) at the 18-month follow-up. In addition, the study will analyze the within- and between-group (arms A, B, and C) changes in MGI assessment, plaque imaging, dental shade quantitation, tooth stain scores, and oral health-related quality of life questionnaires measured at each study time point. All participants will attend a total of 7 clinic visits: screening, enrollment, and randomization (visit 0); baseline visit-day 14 (visit 1); day 90 (visit 2); day 180 (visit 3); day 360 (visit 4); and day 540 (visit 5). This multicenter study will be conducted in 4 dental clinics in 4 countries. The statistical analysis will involve descriptive statistics for continuous and categorical data. Primary end points will undergo tests for normality and, based on distribution, either a 2-sided t test or Mann-Whitney U test. Linear mixed model with random factors center and study arms by center will also be applied. Secondary end points, including MGI assessment and quality of life, will be subjected to similar tests and comparisons. Only if one value of the parameter MGI is missing after day 1, the last available observation will be carried forward. The analysis will be performed on the substituted data. Secondary parameters will not have missing value replacement. RESULTS Participant recruitment began in October 2021, and enrollment was completed in June 2023. Results will be reported in 2025. CONCLUSIONS This will be the first study to provide key insights into oral health benefits or risks associated with using C-F NA in smokers who are seeking alternatives to cigarette smoking. TRIAL REGISTRATION ClinicalTrials.gov NCT04649645; https://clinicaltrials.gov/ct2/show/NCT04649645. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53222.
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Affiliation(s)
| | - Sebastiano Antonio Pacino
- Addendo srl, Dental Clinic, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Salvatore Urso
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
- Department of Biological, Geological and Environmental Sciences, University of Catania, Catania, Italy
| | | | - Pasquale Caponnetto
- Center of Excellence for the Acceleration of HArm Reduction, University of Catania, Catania, Italy
- Department of Educational Sciences, Section of Psychology, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Center of Excellence for the Acceleration of HArm Reduction, University of Catania, Catania, Italy
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Vittorio Checchi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Jan Kowalski
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Nowak
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Iain Chapple
- Periodontal Research Group, The University of Birmingham & Birmingham Community Healthcare Trust, Birmingham, United Kingdom
| | - Michael Milward
- Periodontal Research Group, The University of Birmingham & Birmingham Community Healthcare Trust, Birmingham, United Kingdom
| | - Robert Maclure
- R Maclure Clinical Research Ltd, Irby, Wirral, United Kingdom
| | - Gianna Maria Nardi
- Department of Dental and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Khemiss M, Ben Messaoud NS, Hadidane M, Ben Khelifa M, Ben Saad H. The relationship between obesity and oral-health status in North African adults: A comparative study. Int J Dent Hyg 2024; 22:167-176. [PMID: 37804219 DOI: 10.1111/idh.12767] [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: 09/14/2021] [Revised: 09/21/2022] [Accepted: 09/03/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION The strength of the association between obesity and oral health is still indecisive. OBJECTIVE The objectives of the study were to compare some oral-health data between two groups involving obese (OG) and normal weight (NWG) participants and determine the influencing factors of the periodontal probing depth (PPD). METHODS This was a cross-sectional study including 67 Tunisian adults [OG (n = 33, body mass index (BMI) > 30 kg/m2 ), NWG (n = 34, BMI: 18.5-25.0 kg/m2 )]. The plaque level was recorded using the plaque index (PI). Gingival index (GI) was used to evaluate gingival inflammation. The depths of the sulci/pockets were probed using a periodontal probe. Stimulated saliva was collected for 5 min, and salivary flow rate (SFR) was determined. Salivary baseline pH (SBpH) was measured. A multivariable regression analysis was performed between PPD and some independent variables [i.e. obesity status, age, sex, socioeconomic status, systemic diseases and PI data]. RESULTS The OG and NWG were age- and sex-matched and included comparable percentages of participants with systemic diseases (27.3 vs. 29.4%, respectively). The OG included a higher percentage of participants having a low socioeconomic status (87.9 vs. 64.7%, respectively). Compared with the NWG, the OG: (i) had comparable values of daily toothbrushing frequency, PI, GI and tooth mobility, (ii) included comparable percentages of irregular brushers, of participants with periodontitis, PI classes [0-1]and [1-2]; and GI classes [0-1], [1-2] and [2, 3]; (iii) had a higher PPD (2.02 ± 0.41 vs. 2.35 ± 0.22 mm, respectively), (iv) had lower SBpH (7.59 ± 0.21 vs. 7.45 ± 0.22, respectively) and SFR (1.98 ± 0.28 vs. 1.60 ± 0.32 mL/mn, respectively) and (v) included a higher percentage of participants having a PI class [2, 3] (67.6 vs. 87.9%, respectively). The multivariable regression analysis revealed that only obesity status, age and PI classes influenced the PPD, altogether explained 29.62% of the PPD variance. CONCLUSION Obesity poses a risk for oral health, and obese adults had altered PPD and lower BSpH and SFR. Dentists should make obese patients aware of the health risks of obesity in an attempt to reduce the potential oral complications associated with this epidemic.
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Affiliation(s)
- Mehdi Khemiss
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Nour Sayda Ben Messaoud
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
- Department of Dental Medicine, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Meriem Hadidane
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Mohamed Ben Khelifa
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Helmi Ben Saad
- Hôpital Farhat Hached, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie
- Hôpital Farhat HACHED, Laboratoire de Recherche LR12SP09 'Insuffisance cardiaque', Université de Sousse, Sousse, Tunisie
- Faculté de Médecine de Sousse, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie
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Rodrigues RD, Araujo NS, Filho JMP, Vieira CLZ, Ribeiro DA, Dos Santos JN, Cury PR. Photodynamic therapy as adjunctive treatment of single-rooted teeth in patients with grade C periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2023; 44:103776. [PMID: 37657680 DOI: 10.1016/j.pdpdt.2023.103776] [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: 05/16/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND The present study aimed to evaluate the adjunctive effect of an antimicrobial photodynamic therapy (aPDT) protocol on single-rooted teeth of patients with grade C periodontitis. METHODS Sixty-four single-rooted teeth (14 patients) were included in each group of this double-blinded split-mouth randomized clinical trial. The teeth were randomly divided into scaling and root planing + aPDT (test group) and scaling and root planing+sham aPDT (control group). The aPDT protocol consisted of incubation with 1% methylene blue for 5 min, rinsing, and application of a diode laser (wavelength of 660 nm, power of 100 mW) for 10 s. aPDT was repeated after 7 days. Bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) were recorded before and 3 months after treatment. A 5% significance level was adopted for statistical analysis. RESULTS Final PD was significantly (P = 0.02) lower in the test group (2.87 ± 1.40 mm) compared to control (3.12 ± 1.69 mm). The test group showed a significantly higher percentage of sites with PD≤4 mm and concomitant BoP compared to control (91%x86%;P < 0.001). At sites with baseline PD>4 mm, final PD and CAL were significantly (P = 0.01) lower in the test group (4.11 ± 1.66 and 4.89 ± 2.49 mm, respectively) compared to control (4.88 ± 1.99 and 5.89 ± 2.74 mm, respectively). CONCLUSIONS aPDT combined with scaling and root planning provided slightly better periodontal clinical results than the latter procedure alone, exerting a superior effect at sites with greater baseline PD. aPDT might be used as adjunctive treatment in grade C periodontitis affecting single-rooted teeth since it improves the response to conventional periodontal treatment.
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Affiliation(s)
- Rafael Drummond Rodrigues
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Nara Santos Araujo
- Postgraduate Program in Biotechnology, Northeast Biotechnology Network (RENORBIO), Federal University of Bahia, Av. Araujo Pinho, 62, CEP 4110-160, Salvador, Bahia, Brazil
| | - Jorge Moreira Pinto Filho
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Carolina Letícia Zilli Vieira
- Department of Environmental Health, School of Public Health, Harvard T.H. Chan, 401 Park Dr Landmark Center West 420 Room, Boston, MA 02215, USA
| | - Daniel Araki Ribeiro
- Department of Biosciences, Federal University of São Paulo, Av. Ana Costa, 95 - Vila Mathias, CEP: 11060-001, Santos, São Paulo, Brazil
| | - Jean Nunes Dos Santos
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Patricia Ramos Cury
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil.
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Bumm CV, Wölfle UC, Keßler A, Werner N, Folwaczny M. Influence of decision-making algorithms on the diagnostic accuracy using the current classification of periodontal diseases-a randomized controlled trial. Clin Oral Investig 2023; 27:6589-6596. [PMID: 37752308 PMCID: PMC10630190 DOI: 10.1007/s00784-023-05264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES To examine the influence of the decision-making algorithms published by Tonetti and Sanz in 2019 on the diagnostic accuracy in two differently experienced groups of dental students using the current classification of periodontal diseases. MATERIALS AND METHODS Eighty-three students of two different clinical experience levels were randomly allocated to control and study group, receiving the staging and grading matrix, resulting in four subgroups. All diagnosed two patient cases with corresponding periodontal charts, panoramic radiographs, and intraoral photographs. Both presented severe periodontal disease (stage III, grade C) but considerably differed in complexity and phenotype according to the current classification of periodontal diseases. Controls received the staging and grading matrix published within the classification, while study groups were additionally provided with decision-trees published by Tonetti and Sanz. Obtained data was analyzed using chi-square test, Spearman's rank correlation, and logistic regression. RESULTS Using the algorithms significantly enhanced the diagnostic accuracy in staging (p = 0.001*, OR = 4.425) and grading (p < 0.001**, OR = 30.303) regardless of the clinical experience. In addition, even compared to the more experienced control, less experienced students using algorithms showed significantly higher accuracy in grading (p = 0.020*). No influence on the criteria extent could be observed comparing study groups to controls. CONCLUSION The decision-making algorithms may enhance diagnostic accuracy in dental students using the current classification of periodontal diseases. CLINICAL RELEVANCE The investigated decision-making algorithms significantly increased the diagnostic accuracy of differently experienced under graduated dental students and might be beneficial in periodontal education.
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Affiliation(s)
- Caspar Victor Bumm
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, DE, Germany
| | - Uta Christine Wölfle
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, DE, Germany.
| | - Andreas Keßler
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, DE, Germany
| | - Nils Werner
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, DE, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU, Munich, DE, Germany
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Patel JS, Shin D, Willis L, Zai A, Kumar K, Thyvalikakath TP. Comparing gingivitis diagnoses by bleeding on probing (BOP) exclusively versus BOP combined with visual signs using large electronic dental records. Sci Rep 2023; 13:17065. [PMID: 37816902 PMCID: PMC10564949 DOI: 10.1038/s41598-023-44307-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 10/06/2023] [Indexed: 10/12/2023] Open
Abstract
The major significance of the 2018 gingivitis classification criteria is utilizing a simple, objective, and reliable clinical sign, bleeding on probing score (BOP%), to diagnose gingivitis. However, studies report variations in gingivitis diagnoses with the potential to under- or over-estimating disease occurrence. This study determined the agreement between gingivitis diagnoses generated using the 2018 criteria (BOP%) versus diagnoses using BOP% and other gingival visual assessments. We conducted a retrospective study of 28,908 patients' electronic dental records (EDR) from January-2009 to December-2014, at the Indiana University School of Dentistry. Computational and natural language processing (NLP) approaches were developed to diagnose gingivitis cases from BOP% and retrieve diagnoses from clinical notes. Subsequently, we determined the agreement between BOP%-generated diagnoses and clinician-recorded diagnoses. A thirty-four percent agreement was present between BOP%-generated diagnoses and clinician-recorded diagnoses for disease status (no gingivitis/gingivitis) and a 9% agreement for the disease extent (localized/generalized gingivitis). The computational program and NLP performed excellently with 99.5% and 98% f-1 measures, respectively. Sixty-six percent of patients diagnosed with gingivitis were reclassified as having healthy gingiva based on the 2018 diagnostic classification. The results indicate potential challenges with clinicians adopting the new diagnostic criterion as they transition to using the BOP% alone and not considering the visual signs of inflammation. Periodic training and calibration could facilitate clinicians' and researchers' adoption of the 2018 diagnostic system. The informatics approaches developed could be utilized to automate diagnostic findings from EDR charting and clinical notes.
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Affiliation(s)
- Jay S Patel
- Division of Dental Informatics, Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA.
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA, USA.
- Bio-Health Informatics, Indiana University School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA.
| | - Daniel Shin
- Department of Periodontology, IUSD, Indianapolis, IN, USA
| | - Lisa Willis
- Division of Dental Informatics, Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA
| | - Ahad Zai
- Division of Dental Informatics, Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA
| | - Krishna Kumar
- Division of Dental Informatics, Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA
| | - Thankam P Thyvalikakath
- Division of Dental Informatics, Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, USA.
- Bio-Health Informatics, Indiana University School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA.
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, IN, USA.
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Doughan M, Chehab O, de Vasconcellos HD, Zeitoun R, Varadarajan V, Doughan B, Wu CO, Blaha MJ, Bluemke DA, Lima JAC. Periodontal Disease Associated With Interstitial Myocardial Fibrosis: The Multiethnic Study of Atherosclerosis. J Am Heart Assoc 2023; 12:e8146. [PMID: 36718872 PMCID: PMC9973639 DOI: 10.1161/jaha.122.027974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Periodontitis is a chronic inflammatory disease common among adults. It has been suggested that periodontal disease (PD) may be a contributing risk factor for cardiovascular disease; however, pathways underlying such a relationship require further investigation. Methods and Results A total of 665 men (mean age 68±9 years) and 611 women (mean age 67±9 years) enrolled in the MESA (Multiethnic Study of Atherosclerosis) underwent PD assessment using a 2-item questionnaire at baseline (2000-2002) and had cardiovascular magnetic resonance 10 years later. PD was defined when participants reported either a history of periodontitis or gum disease or lost teeth caused by periodontitis or gum disease. Multivariable linear regression models were constructed to assess the associations of baseline self-reported PD with cardiovascular magnetic resonance-obtained measures of interstitial myocardial fibrosis (IMF), including extracellular volume and native T1 time. Men with a self-reported history of PD had greater extracellular volume percent (ß=0.6%±0.2, P=0.01). This association was independent of age, left ventricular mass, traditional cardiovascular risk factors, and history of myocardial infarction. In a subsequent model, substituting myocardial infarction for coronary artery calcium score, the association of PD with IMF remained significant (ß=0.6%±0.3, P=0.03). In women, a self-reported history of PD was not linked to higher IMF. Importantly, a self-reported history of PD was not found to be associated with myocardial scar independent of sex (odds ratio, 1.01 [95% CI, 0.62-1.65]; P=0.9). Conclusions In a community-based setting, men but not women with a self-reported PD history at baseline were found to be associated with increased measures of IMF. These findings support a plausible link between PD, a proinflammatory condition, and subclinical IMF.
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Affiliation(s)
- Maria Doughan
- Division of Orthodontics, Department of DentistryUniversity of MarylandBaltimoreMD
| | - Omar Chehab
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | | | - Ralph Zeitoun
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | - Vinithra Varadarajan
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | - Bassel Doughan
- Faculty of Dental SurgeryCôte d’Azur UniversityNiceFrance
| | - Colin O. Wu
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
| | - Michael J Blaha
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | - David A. Bluemke
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HeathMadisonWI
| | - Joao A. C. Lima
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
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M. BA, Chakraborty P, Mukhopadhyay P, Ghosh S. Periodontal disease in fibrocalculous pancreatic diabetes (FCPD): common complication of an uncommon disease. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Assessment of Negative Gingival Recession: A Critical Component of Periodontal Diagnosis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accurate measurement of negative gingival recession (GR) is essential to accurately determine the clinical attachment loss, which leads to an accurate diagnosis and optimal therapy of periodontal disease. However, the accuracy of measuring the negative GR has been shown to be low and highly variable between examiners. The position of the gingiva margin in relation to the cemento-enamel junction (CEJ) varies among different stages of passive eruption. The amount of negative GR is about 2 mm on average at the mid-facial sites and ranges from 2 to 3.5 mm at interproximal sites in periodontally healthy patients. Some other clinical conditions may change the gingival dimension coronal to the CEJ, such as altered passive eruption and gingival enlargement. In addition to the traditional approach using a periodontal probe to assess the negative GR, nowadays dental ultrasound imaging may be able to assist in accurately measuring the amount of negative GR. This narrative review will discuss the existing evidence of the dimension of dentogingival tissue and the clinical assessment of negative GR using different clinical tools.
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Bunpeng N, Boriboonhirunsarn D, Boriboonhirunsarn C, Sawangpanyangkura T, Tansriratanawong K. Association between gestational diabetes mellitus and periodontitis via the effect of reactive oxygen species in peripheral blood cells. J Periodontol 2022; 93:758-769. [PMID: 34787908 DOI: 10.1002/jper.21-0455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Periodontitis (P) has emerged as a risk factor for gestational diabetes mellitus (GDM) through immune cell function alterations, elevated proinflammatory mediators, and increased reactive oxygen species (ROS). The main objective of present study was to determine associations between pregnancy with and without GDM and P. The secondary objective was to compare ROS production in peripheral blood cells (PBCs) of pregnant women with and without GDM. METHODS This cross-sectional case-control study included 128 pregnant women: 64 with and 64 without GDM. All participants were examined for clinical parameters of GDM and periodontal conditions. Associations between GDM-related periodontal data and GDM risk were evaluated by multiple logistic regression. PBCs were isolated and cultured. ROS productions in each PBCs types was investigated by flow cytometry with ROS antibodies. RESULTS P was significantly more prevalent in pregnant women with GDM than in those without GDM (57.8% versus 37.5%), with an odds ratio (OR) of 2.28, and a 95% confidence interval (CI) of 1.12 to 4.64 (P = 0.022). The OR (95% CI) was 2.59 (1.19 to 5.65) (P = 0.017) after adjusting for potential confounding factors, including diabetes mellitus (DM) family history, age ≥30 years, body mass index, and maternal age. ROS levels in all PBCs types were significantly higher in the GDM than in the non-GDM group (P < 0.05). CONCLUSION This study supported the association between P and GDM and indicated that P may be a risk factor for GDM. High levels of ROS production in the PBCs of pregnant women with GDM emphasized the association with GDM.
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Affiliation(s)
- Nattawan Bunpeng
- Department of Oral Medicine and Periodontology, Mahidol University, Bangkok, Thailand
| | - Dittakarn Boriboonhirunsarn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Teerat Sawangpanyangkura
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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11
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Oxidative/anti-oxidative effects of colloidal silver ions and chlorhexidine in saliva and gingival fluid of periodontal patients. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200921137k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Chronic periodontitis is an inflammatory disease. Oxidative stress is an important factor in periodontitis progress, hence examining the antioxidative properties of antiseptics, such as chlorhexidine (CHX) and silver ions solution (SSI), is a beneficial biomarker in estimating the recovery of tissue impairment during periodontal disease treatment. Methods. This clinical trial was conducted on the control group referred to healthy volunteers and individuals with periodontal disease, divided into two subgroups: before and after applying antiseptic treatments (CHX or SSI). Measurements of oxidative/antioxidative parameters were addressed to determine thiobarbituric acid products (TBARS) concentration and total superoxide dismutase (tSOD) activity in saliva and gingival crevicular fluid (GCF) of periodontal patients. Results. TBARS concentration was increased in saliva before the CHX treatment compared to the periodontal group after the CHX treatment, as well as before both CHX and SSI antiseptic treatment in CGF, compared to controls and periodontal groups after the treatment. Patients before SSI treatment had increased tSOD activity in saliva compared to the control group treated with SSI, as well as compared to patients after the SSI treatment. Additionally, tSOD activity was increased in GCF in patients with periodontitis before antiseptic treatment (CHX, SSI) compared to the control or the group of patients after the appropriate treatment. Conclusion. Our results revealed elevated lipid peroxidation in CGF, which reflected the promotion of oxidative stress during periodontal inflammation. The study suggests that antiseptics with antioxidant properties may reduce tissue damage initiated by periodontal disease. Moreover, the determination of oxidative/antioxidative parameters can be important for diagnosing, monitoring, and prognosis of the clinical state of periodontal patients.
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12
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Lee Y, Yoon Y, Choi KH. Probiotics-Mediated Bioconversion and Periodontitis. Food Sci Anim Resour 2021; 41:905-922. [PMID: 34796320 PMCID: PMC8564330 DOI: 10.5851/kosfa.2021.e57] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022] Open
Abstract
Novel bioactive metabolites have been developed through a bioconversion of dairy products or other foods using probiotics isolated from dairy products or other fermented foods. These probiotics-mediated bioconversion (PMB) metabolites show antioxidant, anti-inflammatory, antimicrobial, epithelial barrier, and anticancer activities. In addition, the effect of PMB metabolites in periodontitis is recently reported in several studies. Periodontitis is a chronic inflammatory disease caused by infections, and the tooth support tissue is destroyed. Common treatments for periodontitis include scaling and root planning with systemic antibiotics. However, the overuse of antibiotics has led to the emergence of drug-resistant microorganisms and disturbs the beneficial bacteria, including lactobacilli in the oral cavity. For this reason, PMB metabolites, such as fermented milk, have been suggested as substitutes for antibiotics to reduce periodontitis. This paper reviews the recent studies on the correlation between periodontitis and PMB metabolites and classifies the efficacy of major PMB metabolites for periodontitis. The review suggests that PMB is effective for periodontitis, and further studies are needed to confirm the therapeutic effect of PMB metabolites on periodontitis.
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Affiliation(s)
- Yewon Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea
| | - Yohan Yoon
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea.,Risk Analysis Research Center, Sookmyung Women's University, Seoul 04310, Korea
| | - Kyoung-Hee Choi
- Department of Oral Microbiology, College of Dentistry, Wonkwang University, Iksan 54538, Korea
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13
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Nguyen T, Brody H, Radaic A, Kapila Y. Probiotics for periodontal health-Current molecular findings. Periodontol 2000 2021; 87:254-267. [PMID: 34463979 PMCID: PMC8448672 DOI: 10.1111/prd.12382] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dysbiosis of the oral microbiome is associated with a variety of oral and systemic diseases, including periodontal disease. Oral dysbiosis in periodontal disease leads to an exacerbated host immune response that induces progressive periodontal tissue destruction and ultimately tooth loss. To counter the disease‐associated dysbiosis of the oral cavity, strategies have been proposed to reestablish a “healthy” microbiome via the use of probiotics. This study reviews the literature on the use of probiotics for modifying the oral microbial composition toward a beneficial state that might alleviate disease progression. Four in vitro and 10 preclinical studies were included in the analysis, and these studies explored the effects of probiotics on cultured biofilm growth and bacterial gene expressions, as well as modulation of the host response to inflammation. The current molecular findings on probiotics provide fundamental evidence for further clinical research for the use of probiotics in periodontal therapy. They also point out an important caveat: Changing the biofilm composition might alter the normal oral flora that is beneficial and/or critical for oral health.
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Affiliation(s)
- Trang Nguyen
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Hanna Brody
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Alan Radaic
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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14
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Qureshi A, Bokhari SAH, Haque Z, Baloch AA, Zaheer S. Clinical efficacy of scaling and root planing with and without metronidazole on glycemic control: three-arm randomized controlled trial. BMC Oral Health 2021; 21:253. [PMID: 33980234 PMCID: PMC8113795 DOI: 10.1186/s12903-021-01620-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Treating periodontitis through non-surgical periodontal therapy (NSPT) may improve glycemic control in type-2 Diabetes Mellitus (T2DM) patients. However, the evidence to maintain this improvement beyond four months is insufficient. Hence, this trial was conducted to assess clinical efficacy of NSPT on glycemic control in T2DM patients. Methods This three-arm randomized controlled trial recruited 150 known T2DM participants (35–65 years), suffering from moderate to severe periodontitis, having HbA1c level ≥ 6.5% at baseline. Participants were followed up at 3 and 6 months. Intervention for test group-1 included scaling and root planing (SRP) with metronidazole (MET) and oral hygiene instructions (OHI). Test group-2 was intervened with SRP + OHI and control group with OHI only. Stata v. 14 was used to observe inter and intragroup mean changes in glycemic [glycated hemoglobin (HbA1c), fasting blood glucose (FBG)] and periodontal variables [bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL)] using ANOVA and RMANOVA. Proportion of change in outcome variable (HbA1c) was assessed between treatment groups using chi-square test. Change was considered significant at p-value ≤ 0.05. Results A significant reduction was observed in BOP, PPD, CAL, HbA1c and FBG over time [p < 0.05]. Significant reductions were observed in same variables in both test groups in comparison to control arm [p < 0.05]. No change between the two test groups was observed [p > 0.05]. Conclusion Scaling and root planing improves glycemic control of T2DM patients independently of the use of MET. Therefore, SRP after every 6 months may be suggested and included as a part of overall diabetes management for patients suffering from T2DM. Clinical trial registration NCT 03,343,366 [Date of Registration: 17/11/2017]
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Affiliation(s)
- Ambrina Qureshi
- Department of Community and Preventive Dentistry, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan.
| | - Syed Akhtar Hussain Bokhari
- Department of Preventive Dental Sciences and Department of Postgraduate Studies and Scientific, College of Dentistry, King Faisal University Al-Ahsa, Al Hofuf, 31982, Kingdom of Saudi Arabia
| | - Zeba Haque
- Department of Biochemistry, Dow International Medical College, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Akhtar Ali Baloch
- National Institute of Diabetes & Endocrinology, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Sidra Zaheer
- Department of Research & Biostatistics, School of Public Health, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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15
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Vitkov L, Muñoz LE, Knopf J, Schauer C, Oberthaler H, Minnich B, Hannig M, Herrmann M. Connection between Periodontitis-Induced Low-Grade Endotoxemia and Systemic Diseases: Neutrophils as Protagonists and Targets. Int J Mol Sci 2021; 22:4647. [PMID: 33925019 PMCID: PMC8125370 DOI: 10.3390/ijms22094647] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is considered a promoter of many systemic diseases, but the signaling pathways of this interconnection remain elusive. Recently, it became evident that certain microbial challenges promote a heightened response of myeloid cell populations to subsequent infections either with the same or other pathogens. This phenomenon involves changes in the cell epigenetic and transcription, and is referred to as ''trained immunity''. It acts via modulation of hematopoietic stem and progenitor cells (HSPCs). A main modulation driver is the sustained, persistent low-level transmission of lipopolysaccharide from the periodontal pocket into the peripheral blood. Subsequently, the neutrophil phenotype changes and neutrophils become hyper-responsive and prone to boosted formation of neutrophil extracellular traps (NET). Cytotoxic neutrophil proteases and histones are responsible for ulcer formations on the pocket epithelium, which foster bacteremia and endoxemia. The latter promote systemic low-grade inflammation (SLGI), a precondition for many systemic diseases and some of them, e.g., atherosclerosis, diabetes etc., can be triggered by SLGI alone. Either reverting the polarized neutrophils back to the homeostatic state or attenuation of neutrophil hyper-responsiveness in periodontitis might be an approach to diminish or even to prevent systemic diseases.
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Affiliation(s)
- Ljubomir Vitkov
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, 66424 Homburg, Germany
| | - Luis E. Muñoz
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Jasmin Knopf
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Christine Schauer
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Hannah Oberthaler
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
| | - Bernd Minnich
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, 66424 Homburg, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
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16
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Chakraborty P, Mukhopadhyay P, Bhattacharjee K, Chakraborty A, Chowdhury S, Ghosh S. Periodontal Disease in Type 1 Diabetes Mellitus: Influence of Pubertal Stage and Glycemic Control. Endocr Pract 2021; 27:765-768. [PMID: 33486090 DOI: 10.1016/j.eprac.2021.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Though gingivitis is common in children with type 1 diabetes mellitus (T1DM), the overall periodontal health in T1DM during the pubertal stage is less well-characterized. The study was undertaken to explore the possible influence of puberty and metabolic derangement on periodontal health in T1DM. METHODS In this cross-sectional study, 110 subjects between 10-18 years with T1DM and 52 healthy siblings of similar age were evaluated for pubertal stage, glycosylated hemoglobin (HbA1c), and periodontal health. Simplified oral hygiene index (OHIS), gingival index (GI), plaque index (PI), bleeding on probing (BOP), and probing depth (PPD) were evaluated at 4 sites per tooth as per 6 Ramfjord index teeth used to assess periodontal disease (PD). RESULTS PD not merely gingivitis was significantly higher in T1DM (84/110, 76.36%) than the control group (28/52, 53.8%) (P = .004). Irrespective of pubertal status, children with T1DM had worse GI, PI, BOP, and PPD than nondiabetic subjects, although OHIS was better in diabetes. In both T1DM and nondiabetic subjects, pubertal subjects showed significantly worse OHIS, PPD, BOP, and GI than prepubertal subjects. PD was correlated with pubertal stage, age, and HbA1c, although less strongly with the duration of diabetes. In logistic regression, pubertal stage was a stronger predictor of PD (OR = 14.26) than age (OR = 2.22), and HbA1c (OR = 1.5) rather than the presence of diabetes and its duration. CONCLUSIONS Though pubertal status, age, and poor glycemic control rather than the presence of diabetes and its duration are associated with gingivitis and other forms of PD, puberty had a more profound effect in the pathogenesis of PD in T1DM.
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Affiliation(s)
- Pampita Chakraborty
- Departments of Endocrinology and Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Pradip Mukhopadhyay
- Departments of Endocrinology and Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | | | | | - Subhankar Chowdhury
- Departments of Endocrinology and Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Sujoy Ghosh
- Departments of Endocrinology and Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, India.
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17
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NETs Are Double-Edged Swords with the Potential to Aggravate or Resolve Periodontal Inflammation. Cells 2020; 9:cells9122614. [PMID: 33291407 PMCID: PMC7762037 DOI: 10.3390/cells9122614] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022] Open
Abstract
Periodontitis is a general term for diseases characterised by inflammatory destruction of tooth-supporting tissues, gradual destruction of the marginal periodontal ligament and resorption of alveolar bone. Early-onset periodontitis is due to disturbed neutrophil extracellular trap (NET) formation and clearance. Indeed, mutations that inactivate the cysteine proteases cathepsin C result in the massive periodontal damage seen in patients with deficient NET formation. In contrast, exaggerated NET formation due to polymorphonuclear neutrophil (PMN) hyper-responsiveness drives the pathology of late-onset periodontitis by damaging and ulcerating the gingival epithelium and retarding epithelial healing. Despite the gingival regeneration, periodontitis progression ends with almost complete loss of the periodontal ligament and subsequent tooth loss. Thus, NETs help to maintain periodontal health, and their dysregulation, either insufficiency or surplus, causes heavy periodontal pathology and edentulism.
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18
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Nikolic-Jakoba N, Barac M, Jankovic S, Aleksic Z, Spin-Neto R, Wenzel A. Effect of section thickness on cone beam computed tomography-based measurements of intrabony defects compared with clinical measurements. J Periodontol 2020; 92:670-677. [PMID: 32822070 DOI: 10.1002/jper.20-0338] [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: 05/06/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is unknown whether cone beam computed tomography (CBCT) image reconstruction characteristics, including section thickness, may affect linear bone measurements of periodontal intrabony defects. The aim of this study was to compare intrasurgical and CBCT-based linear measurements of intrabony defects focusing on CBCT section thickness. METHODS Sixty-six intrabony defects were assessed in 21 patients with chronic generalized severe periodontitis. Linear measurements of alveolar bone (radiographic bone level [rBL]), assessed in CBCT images at diverse section thicknesses: 0.25 mm (voxel size), 1 mm, and 3 mm, were compared with clinical bone level (cBL) measurements obtained intrasurgically. To provide identical reference points for rBL and cBL measurements, individually adjusted grooves on the reference stent were prepared for each periodontal defect site. CBCT measurements were performed in two rounds by two trained observers. Observer agreement was assessed by intraclass correlation coefficients (ICC). ANOVA assessed the difference among cBL and rBL at different section thicknesses. RESULTS Intra- and inter-observer agreement was excellent (ICC >0.99) and highly significant independent of the observer, evaluation round, and CBCT section thickness. Mean rBL in the diverse CBCT section thicknesses was very close to that measured clinically (cBL). There was no statistically significant difference between cBL and rBL for any section thickness, neither for the overall evaluated sites, nor the maxilla or mandible separately. CONCLUSIONS No statistically significant difference between clinical and radiographic bone level for 0.25-, 1-, and 3-mm CBCT section thicknesses were observed when assessing intrabony periodontal defects.
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Affiliation(s)
- Natasa Nikolic-Jakoba
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena Barac
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasa Jankovic
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Aleksic
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
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19
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Khoury W, Glogauer J, Tenenbaum HC, Glogauer M. Oral inflammatory load: Neutrophils as oral health biomarkers. J Periodontal Res 2020; 55:594-601. [PMID: 32372438 DOI: 10.1111/jre.12758] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 01/13/2023]
Abstract
Periodontal diseases present a significant challenge to our healthcare system in terms of morbidity from the disease itself as well as their putative and deleterious effects on systemic health. The current method of diagnosing periodontal disease utilizes clinical criteria solely. These are imprecise and are somewhat invasive. There is thus significant benefit to creating a non-invasive test as a method of screening for and monitoring of periodontal diseases, and, in particular, chronic periodontitis. Oral polymorphonuclear neutrophil (oPMN) counts have been found to correlate with extent of oral inflammation and the presence and severity of periodontal diseases. Potentially then, quantification of oPMNs might be used to identify and measure the severity of oral inflammation (oral inflammatory load; OIL) in subjects with healthy and inflamed periodontal tissues, demonstrating a positive correlation between higher oPMN counts and the extent/severity of OIL. These findings support the development and utilization of a non-invasive chair-side test enabling rapid, accurate, and objective screening of OIL based on measurement of oPMN numbers (similar to white blood cell levels in blood as used in medicine for assessment of infection). The use of such a test before, during, and after treatment of gingivitis and periodontitis could lead to improvements in timing of intervention (ie, when inflammation is active) thereby reducing long-term morbidity.
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Affiliation(s)
- William Khoury
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Queen's University School of Medicine, Kingston, ON, Canada
| | - Judah Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Michael G. DeGroote School of Medicine, Hamilton, ON, Canada
| | - Howard C Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Sinai Health System, Toronto, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Sinai Health System, Toronto, ON, Canada.,Princess Margaret Cancer Centre, Department of Dental Oncology, Toronto, ON, Canada
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20
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Nguyen T, Brody H, Lin GH, Rangé H, Kuraji R, Ye C, Kamarajan P, Radaic A, Gao L, Kapila Y. Probiotics, including nisin-based probiotics, improve clinical and microbial outcomes relevant to oral and systemic diseases. Periodontol 2000 2020; 82:173-185. [PMID: 31850634 DOI: 10.1111/prd.12324] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The effects of probiotic supplementation on systemic health and gastrointestinal diseases have been investigated in numerous studies. The aim of this review is to provide an overview of probiotics and their effects on periodontal health. Probiotics show beneficial effects as adjunctive therapeutics and as stand-alone agents in the treatment and prevention of gingivitis as well as specific clinical parameters of periodontitis. This review focuses on the clinical and microbiological aspects of probiotics in the context of health, gingivitis, and periodontitis. In addition, a special focus on nisin-producing probiotics and nisin itself showcase their significant potential for oral and systemic use.
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Affiliation(s)
- Trang Nguyen
- School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Hanna Brody
- School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Hélène Rangé
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Department of Periodontology, UFR of Odontology, APHP, Rothschild Hospital, University of Paris Diderot, Paris, France.,Faculty of Dental Surgery, University of Paris Descartes, Montrouge, France
| | - Ryutaro Kuraji
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan.,Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Changchang Ye
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,State Key Laboratory of Oral Diseases, Department of Periodontology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Allan Radaic
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, The University of Campinas, Campinas, Sao Paulo, Brazil
| | - Li Gao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Department of Periodontology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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21
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Rapone B, Corsalini M, Converti I, Loverro MT, Gnoni A, Trerotoli P, Ferrara E. Does Periodontal Inflammation Affect Type 1 Diabetes in Childhood and Adolescence? A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:278. [PMID: 32431669 PMCID: PMC7214631 DOI: 10.3389/fendo.2020.00278] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/14/2020] [Indexed: 01/26/2023] Open
Abstract
The emergence of link between periodontal disease and diabetes has created conditions for analyzing new interdisciplinary approach making toward tackling oral health and systemic issues. As periodontal disease is a readily modifiable risk factor this association has potential clinical implications. The aim of this paper was systematically review the extant literature related to analytics data in order to identify the association between type 1 diabetes (T1DM) in childhood and adolescence with periodontal inflammation. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a database search between 2004 and 2019. A manual search of the literature was conducted as an additional phase of the search process, with the aim of identifying studies that were missed in the primary search. One hundred and thirty-nine records were screened and 10 fulfilled the inclusion criteria. Most studies were of moderate methodological quality. Outcomes included assessments of diabetes and periodontal status. In diabetic populations, compared to healthy subjects, interindividual differences in periodontal status are reflected in higher severity of periodontal inflammation. The most reported barriers to evidence uptake were the intrinsic limits of cross-sectional report data and relevant research, and lack of timely research output. Based on the evidence presented within the literature, the aforementioned biomarkers correlate with poor periodontal status in type 1 diabetic patients. Whilst the corpus of the evidence suggests that there may be an association between periodontal status and type 1 diabetes, study designs and methodological limitations hinder interpretation of the current research.
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Affiliation(s)
- Biagio Rapone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, “Aldo Moro” University of Bari, Bari, Italy
- *Correspondence: Biagio Rapone
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Ilaria Converti
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, Bari, Italy
| | - Maria Teresa Loverro
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Antonio Gnoni
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, “Aldo Moro” University of Bari, Bari, Italy
| | - Paolo Trerotoli
- Medical Statistic, Department of Biomedical Science and Human Oncology, University of “Aldo Moro” Bari, Bari, Italy
| | - Elisabetta Ferrara
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, Chieti, Italy
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22
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S304-S312. [PMID: 29926953 DOI: 10.1002/jper.17-0588] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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23
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Clin Periodontol 2019; 45 Suppl 20:S278-S285. [PMID: 29926496 DOI: 10.1111/jcpe.12956] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 12/26/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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24
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Wang C, Zhou X, Chen Y, Zhang J, Chen W, Svensson P, Wang K. Somatosensory profiling of patients with plaque-induced gingivitis: a case–control study. Clin Oral Investig 2019; 24:875-882. [DOI: 10.1007/s00784-019-02963-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 05/16/2019] [Indexed: 11/24/2022]
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25
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Kraatz J, Hoang H, Ivanovski S, Ware RS, Crocombe LA. Periodontal diagnosis, treatment, and referral patterns of general dental practitioners. ACTA ACUST UNITED AC 2019; 10:e12411. [PMID: 31006957 DOI: 10.1111/jicd.12411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/08/2019] [Accepted: 02/01/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to investigate the diagnosis, treatment, and referral patterns of periodontal patients by general dental practitioners (GDP). METHODS A questionnaire was mailed to registered GDP with publicly-listed postal addresses in Tasmania, Australia. Information was collected on demographics, training and professional development, examination, diagnosis and referral patterns, and periodontal treatment patterns. RESULTS Seventy-seven (44.5%) questionnaires were completed. Over 85% always or usually screened for periodontal disease. On average, 0 to ≤7 patients were diagnosed with periodontal disease. GDP were always or usually confident in treating gingivitis (100%), mild (98.7%) and moderate periodontitis (73.7%), and rarely or never confident in treating severe (81.6%) and aggressive periodontitis (86.8%). Over 38% frequently referred to periodontists, 35.5% sometimes, 21.1% rarely, and 5.3% never. Clinical factors associated with referral were periodontal pocketing of ≥6 mm, tooth mobility, no improvement following treatment, and a complex medical history. CONCLUSIONS Most GDP performed periodontal screening and diagnosis. They were confident in treating gingivitis and mild-to-moderate periodontitis. Referral to a periodontist was associated with disease severity, tooth mobility, a complex medical history, or unsuccessful treatment.
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Affiliation(s)
- Jennifer Kraatz
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Ha Hoang
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,Centre for Rural Health, The University of Tasmania, Launceston, TAS, Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,School of Dentistry, University of Queensland, Brisbane, QLD, Australia
| | - Robert S Ware
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Leonard A Crocombe
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,Centre for Rural Health, The University of Tasmania, Launceston, TAS, Australia
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26
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Peikert SA, Spurzem W, Vach K, Frisch E, Ratka‐Krüger P, Woelber JP. Association of non‐surgical periodontal therapy on patients' oral health‐related quality of life—A multi‐centre cohort study. J Clin Periodontol 2019; 46:529-538. [DOI: 10.1111/jcpe.13093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 02/11/2019] [Accepted: 02/24/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Stefanie A. Peikert
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | | | - Kirstin Vach
- Institute for Medical Biometry and Statistics Medical Center – University of Freiburg Faculty of Medicine University of Freiburg Freiburg Germany
| | - Eberhard Frisch
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Northern Hessia Implant Center Hofgeismar Germany
| | - Petra Ratka‐Krüger
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
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27
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Enevold C, Nielsen CH, Molbo D, Lund R, Bendtzen K, Fiehn NE, Holmstrup P. Lewis and AB0 blood group-phenotypes in periodontitis, cardiovascular disease, obesity and stroke. Sci Rep 2019; 9:6283. [PMID: 31000730 PMCID: PMC6472418 DOI: 10.1038/s41598-019-42594-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 04/01/2019] [Indexed: 12/13/2022] Open
Abstract
The AB0 blood group has been linked to ischaemic heart disease, stroke, and periodontal disease, while the Lewis blood group has been linked to ischaemic heart disease and obesity, all of which have been associated with periodontitis. AB0 or Lewis blood group phenotype may therefore constitute common hereditary components predisposing to these disorders. In this study, we investigated if blood group phenotype associated with periodontitis in a subpopulation consisting of 702 participants from a Danish cross-sectional cohort and, secondarily, attempted to confirm their association with hypertension, ischaemic heart disease, stroke, and obesity. No significant association between blood group phenotype and periodontitis was detected, nor were previously reported associations between blood group phenotype and hypertension, ischaemic heart disease, stroke, and obesity confirmed. This may, at least partly, be attributed to differences in study type, outcome definitions, cohort sizes, and population attributable factors. However, our results suggested a strong association between self-reported stroke and the Lewis (a−b−) phenotype (P = 0.0002, OR: 22.28; CI 95: 4.72–131.63).
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Affiliation(s)
- C Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark.
| | - C H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark.,University of Copenhagen, Faculty of Health and Medical Sciences, Department of Odontology, Copenhagen, Denmark
| | - D Molbo
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Section of Social Medicine, Copenhagen, Denmark
| | - R Lund
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Section of Social Medicine, Copenhagen, Denmark
| | - K Bendtzen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - N -E Fiehn
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, Copenhagen, Denmark
| | - P Holmstrup
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Odontology, Copenhagen, Denmark
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28
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Trombley TM, Agarwal SC, Beauchesne PD, Goodson C, Candilio F, Coppa A, Rubini M. Making sense of medieval mouths: Investigating sex differences of dental pathological lesions in a late medieval Italian community. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:253-269. [PMID: 30924143 DOI: 10.1002/ajpa.23821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/21/2019] [Accepted: 03/02/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Bioarchaeological investigations of sex-based differences in the prevalence of dental pathological lesions, particularly caries, have drawn considerable attention, and out of this work, two dominant models have emerged. Traditionally, the first model interprets sex-related patterns in caries as a product of gendered differences in diet. A more recent model interprets a generally higher propensity for caries prevalence in females in light of reproductive ecology. To test the hypothesis that females have higher risk of caries in accordance with reproductive ecology, we examined and analyzed caries prevalence and other potentially synergistic oral pathological lesions in a late medieval (A.D. 1300-1500) Italian archaeological sample. MATERIALS AND METHODS We examined sex- and age-related prevalence in caries and other oral pathological lesions in a late medieval Italian skeletal assemblage excavated from Villamagna consisting of 38 females and 37 males (n = 1,534 teeth). We examined age- and sex-related patterns in six dental traits: antemortem tooth loss, caries, calculus, periapical inflammation, tooth wear, and periodontitis. RESULTS Significant age-related increases in antemortem tooth loss, caries, calculus, and tooth wear were observed in both males and females. However, there was a lack of expected sex differences in oral pathological lesions, with instead older males exhibiting significantly more antemortem tooth loss and corrected caries than females. DISCUSSION Results are discussed in relation to the ethnohistoric context of medieval rural dietary practices as well as biomedical salivary literature, which suggest that dietary changes throughout the life course may have facilitated trade-offs that buffered females from higher rates of dental pathological lesions.
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Affiliation(s)
- Trent M Trombley
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Sabrina C Agarwal
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Patrick D Beauchesne
- Department of Behavioral Sciences, University of Michigan, Dearborn, Dearborn, Michigan
| | - Caroline Goodson
- Faculty of History, University of Cambridge, King's College, Cambridge, United Kingdom
| | - Francesca Candilio
- Anthropological Service, Soprintendenza Archeologia, Belle Arti e Paesaggio per la città metropolitana di Cagliari e le province di Oristano e Sud Sardegna, Cagliari, Italy.,Physical Anthropology Section, University of Pennsylvania Museum of Archaeology and Anthropology, Philadelphia, Pennsylvania
| | - Alfredo Coppa
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Mauro Rubini
- Department of Archaeology, Foggia University, Foggia, Italy.,Anthropological Service, S.A.B.A.P.-LAZ, Rome, Italy
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29
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Teufer B, Sommer I, Nussbaumer-Streit B, Titscher V, Bruckmann C, Klerings I, Gartlehner G. Screening for periodontal diseases by non-dental health professionals: a protocol for a systematic review and overview of reviews. Syst Rev 2019; 8:61. [PMID: 30803450 PMCID: PMC6388477 DOI: 10.1186/s13643-019-0977-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/14/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Periodontal diseases are responsible for a vast burden of disease globally and are associated with other severe illnesses such as cardiovascular diseases or diabetes. Tests for early diagnosis of periodontal diseases and effective treatments are available. The effectiveness of screening for periodontal diseases to detect periodontal diseases at an early stage during periodic health examinations at primary care facilities, however, is unclear. The objective of this systematic review is to assess the benefits and risks of screening for periodontal diseases in adults during the periodic health examinations. METHODS We will use two methodological approaches: (1) a systematic review to assess the effectiveness and risk of harms of screening for periodontal diseases during periodic health examinations and (2) an overview of systematic reviews to determine the effectiveness of treatment approaches for early periodontal disease. We will search electronic databases (Ovid MEDLINE, Embase.com , the Cochrane Library, Epistemonikos, Centre for Reviews and Dissemination databases, PubMed (non-MEDLINE content)) for published studies as well as sources for grey literature to detect unpublished studies. Two authors will independently screen abstracts and full texts using pre-defined eligibility criteria, select studies, extract data, and assess the risk of bias of included studies or reviews. In general, we will conduct a systematic narrative synthesis. Criteria for conducting meta-analyses were defined a priori. Our primary outcomes of interest are tooth loss, loosening of teeth, and depletion of bone tissue. Secondary outcomes are gingivitis/gum inflammation, pocket depths, dental hygiene, lifestyle modifications (e.g., smoking, alcohol, nutrition), and toothache. We consulted a panel of experts and patient representatives to prioritize these outcomes. Two investigators will assess independently the certainty of the evidence for each outcome using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. DISCUSSION We anticipate that our review will highlight the gaps in the available evidence about the effectiveness of screening for periodontal diseases during periodic health examinations. Implications for screening programs may be based on linked evidence about the validity of available screening tools and the effectiveness of early treatment. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017081150.
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Affiliation(s)
- Birgit Teufer
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria.
| | - Isolde Sommer
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria
| | - Barbara Nussbaumer-Streit
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria
| | - Viktoria Titscher
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria
| | - Corinna Bruckmann
- Universitätszahnklinik Wien GmbH (School of Dentistry Vienna), Sensengasse 2a, 1090, Vienna, Austria
| | - Irma Klerings
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria.,RTI International, 3400 East Cornwallis Rd, Durham, NC, 27740, USA
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30
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Kraatz J, Hoang H, Ivanovski S, Ware RS, Crocombe LA. Non-clinical factors associated with referral to periodontal specialists. J Periodontol 2019; 90:877-883. [PMID: 30693957 DOI: 10.1002/jper.18-0642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND There is a limited body of literature exploring referral relationships between general dental practitioners and periodontists. Clinical and non-clinical factors associated with the referral process are rarely considered however a better understanding of these will improve the general dentist practitioner and periodontal specialist relationship and benefit patient management. This study investigated which non-clinical factors have an association with the referral of patients by general dental practitioners to periodontists in Tasmania, Australia. METHODS A questionnaire was emailed to registered general dental practitioners in Tasmania, Australia and information collected on demographics, referral patterns, and potential factors which may influence referral. RESULTS Response rate was 44.5%. Non-clinical factors that influenced referral were previous treatment by a periodontist (70.8%), a complex medical history (56.8%), the patient's reluctance to undergo periodontal treatment, medico-legal reasons, patient awareness of periodontal disease (47.3%), and lack of training (43.2%). Patients frequently declined periodontal referral due to cost (66.2%), oral health not being a priority (55.4%), or inconvenience (46.6%). The most important periodontist qualities were their reputation (84.0%), patient feedback (81.3%), ease of communication (72.0%), report quality (68.0%), and location (62.7%). CONCLUSION Non-clinical factors, such as practice type-, general dental practitioner-, patient-, periodontist-related factors are associated with referral by general dental practitioners to periodontists for periodontal management.
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Affiliation(s)
- Jennifer Kraatz
- School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia
| | - Ha Hoang
- School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia.,Centre for Rural Health, The University of Tasmania, Launceston, Tasmania, Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia.,School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Leonard A Crocombe
- School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia.,Centre for Rural Health, The University of Tasmania, Launceston, Tasmania, Australia
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31
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Vitkov L, Hannig M, Minnich B, Herrmann M. Periodontal sources of citrullinated antigens and TLR agonists related to RA. Autoimmunity 2018; 51:304-309. [DOI: 10.1080/08916934.2018.1527907] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Ljubomir Vitkov
- Department of Biosciences Vascular & Exercise Biology Unit, University of Salzburg, Salzburg, Austria
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Bernd Minnich
- Department of Biosciences Vascular & Exercise Biology Unit, University of Salzburg, Salzburg, Austria
| | - Martin Herrmann
- Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
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32
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Gonzalez-Navarro B, Pintó-Sala X, Corbella E, Jané-Salas E, Miedema MD, Yeboah J, Shea S, Nasir K, Comin-Colet J, Corbella X, Lopez-López J, Blumenthal RS, Blaha MJ, Cainzos-Achirica M. Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 278:110-116. [PMID: 30265891 DOI: 10.1016/j.atherosclerosis.2018.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire. METHODS In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use. RESULTS Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results. CONCLUSIONS Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.
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Affiliation(s)
- Beatriz Gonzalez-Navarro
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Pintó-Sala
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Emili Corbella
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Enric Jané-Salas
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Steve Shea
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | | | - Josep Comin-Colet
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Xavier Corbella
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Lopez-López
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Dental Hospital Barcelona University (HOUB), University of Barcelona, Barcelona, Spain
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Miguel Cainzos-Achirica
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain.
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Clinical effects of low body mass index on geriatric status in elderly patients. Exp Gerontol 2018; 110:86-91. [DOI: 10.1016/j.exger.2018.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
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Almeida ML, Tôrres ACSDP, de Oliveira KC, Calderon PDS, Carreiro ADFP, Gurgel BCDV. Longitudinal Improvement in Periodontal Parameters between RPD Abutment Teeth with Direct and Indirect Retainers, after Periodontal Therapy. J Prosthodont 2018; 28:e440-e444. [PMID: 29508481 DOI: 10.1111/jopr.12774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the effect of basic periodontal treatment on clinical periodontal parameters associated with abutment teeth of patients with mandibular Kennedy class I removable partial dentures (RPD) 18 months after treatment. MATERIALS AND METHODS Thirty patients with periodontal disease were treated and evaluated according to the following periodontal parameters: visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), clinical attachment loss (CAL), and keratinized mucosa (KM). These parameters were compared between abutment teeth with direct and indirect retainers at baseline, and after 6 and 18 months. Data were analyzed by Friedman Test and Wilcoxon Test for all variables. RESULTS Most patients (n = 26; 86.7%) included in the study were female and had a mean age of 61 years (±7.54). Results showed that VPI and BOP decreased over time, and that VPI values were higher in abutment teeth with direct retainers (p = 0.001). There was a reduction in PD after 6 months, which was maintained up to 18 months. In general, abutment teeth with direct retainers had significantly higher values for PD, GR, and CAL (p = 0.029). Data also indicated that the parameters for VPI, BOP, and PD improved; however, abutment teeth with direct retainers presented smaller improvements, compared with abutment teeth with indirect retainers, which presented significant improvements for almost all variables. CONCLUSION Periodontal treatment and oral hygiene care of patients were adequate for maintenance of adequate periodontal conditions, regardless of the use of prostheses.
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LLANOS AH, SILVA CGB, ICHIMURA KT, REBEIS ES, GIUDICISSI M, ROMANO MM, SARAIVA L. Impact of aggressive periodontitis and chronic periodontitis on oral health-related quality of life. Braz Oral Res 2018; 32:e006. [DOI: 10.1590/1807-3107bor-2018.vol32.0006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/18/2017] [Indexed: 12/20/2022] Open
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Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study. Clin Oral Investig 2018; 22:2575-2580. [PMID: 29388021 DOI: 10.1007/s00784-018-2356-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 01/23/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the relationship of the incidence of aspiration pneumonia to cognitive impairment and the oral condition. MATERIALS AND METHODS A total of 1174 elderly patients were analyzed in a cross-sectional study. Cognitive function was evaluated by the Clinical Dementia Rating scale and the oral condition was evaluated by inspection and palpation. Swallowing was examined in 196 patients by video-endoscopic evaluation. The Mann-Whitney U test or chi-square test was used for statistical analysis. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI). RESULTS Loss of posterior occlusion, impaired tongue movements, and impaired cognition were factors significantly related to aspiration pneumonia. The incidence of aspiration pneumonia was higher in patients with both cognitive impairment and loss of posterior occlusion compared with those having either factor alone (OR: 5.16). There was no statistical association between impaired swallowing and the incidence of aspiration pneumonia in elderly patients with normal cognitive function (cognitive impairment, OR: 3.45; normal function, OR: 0.94). CONCLUSION Co-existence of cognitive impairment and oral frailty significantly enhances the risk of aspiration pneumonia. CLINICAL RELEVANCE Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.
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Mysak J, Podzimek S, Vasakova J, Mazanek J, Vinsu A, Duskova J. C-reactive protein in patients with aggressive periodontitis. J Dent Sci 2017; 12:368-374. [PMID: 30895077 PMCID: PMC6395364 DOI: 10.1016/j.jds.2017.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/06/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP) in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. MATERIALS AND METHODS All patients (N = 45) were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23) and group LAgP (Localised form of aggressive periodontitis, N = 22). Control group (CON) included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. RESULTS CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP) in a similar way as bleeding on probing (BOP) and probing pocket depth (PPD) indices. CONCLUSION Our study results showed that CRP levels, as well as bleeding on probing (BOP) and probing pocket depth (PPD), indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis.
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Affiliation(s)
- Jaroslav Mysak
- Department of Periodontology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Stepan Podzimek
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Vasakova
- Department of Paediatric Dentistry, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jiri Mazanek
- Department of Maxillofacial Surgery, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Alex Vinsu
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Duskova
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
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Almiñana-Pastor PJ, Segarra-Vidal M, López-Roldán A, Alpiste-Illueca FM. A controlled clinical study of periodontal health in anticoagulated patients: Assessment of bleeding on probing. J Clin Exp Dent 2017; 9:e1431-e1438. [PMID: 29410759 PMCID: PMC5794121 DOI: 10.4317/jced.54331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/05/2017] [Indexed: 11/05/2022] Open
Abstract
Background According to the Spanish Society of Cardiology, 700,000 patients receive oral anticoagulants, and in these cases bleeding on probing (BOP) could be altered. However, no studies have analyzed the periodontal status of these patients and the effects anticoagulants may have upon BOP. A study was made of the possible relationship between plaque index, probing depth, INR (International Normalized Ratio) and acenocoumarol dose versus the clinical signs of BOP in a sample of anticoagulated patients. Likewise, an analysis was made of oral hygiene habits and attitude towards bleeding in these patients. Material and Methods A controlled observational clinical study was made in La Ribera Hospital (Valencia, Spain) involving 44 anticoagulated patients treated with Sintrom® (acenocoumarol) and a homogeneous control group of 44 non-anticoagulated patients. A survey on oral hygiene habits and attitude towards bleeding was carried out, and the main periodontal parameters were recorded. Results Probing depth was the parameter with the strongest correlation to BOP (p<0.001), followed by the plaque index (p<0.002). In contrast, no relationship was observed between acenocoumarol dose or INR and BOP. Mean BOP was greater in the control group than in the anticoagulated group (p<0.001). Oral hygiene habits and attitude towards bleeding differed significantly between groups. Conclusions We have found no explanation why BOP was greater in the control group. What seems clear is that in the presence of the same plaque index and probing depth, anticoagulated patients did not bleed more than non-anticoagulated patients. A lack of knowledge of health and oral hygiene habits was observed in these subjects. Key words:Anticoagulant therapy, bleeding on probing, periodontal health.
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Affiliation(s)
- Pedro J Almiñana-Pastor
- DD, Post-graduated in Periodontics, Department d´Estomatologia, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
| | - Marta Segarra-Vidal
- Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Andrés López-Roldán
- Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Francisco M Alpiste-Illueca
- MD DD, PhD in Medicine. Assistant Professor of Periodontics, Department d´Estomatologia, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
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Vitkov L, Hartl D, Minnich B, Hannig M. Janus-Faced Neutrophil Extracellular Traps in Periodontitis. Front Immunol 2017; 8:1404. [PMID: 29123528 PMCID: PMC5662558 DOI: 10.3389/fimmu.2017.01404] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/11/2017] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is characterized by PMN infiltration and formation of neutrophil extracellular traps (NETs). However, their functional role for periodontal health remains complex and partially understood. The main function of NETs appears to be evacuation of dental plaque pathogen-associated molecular patterns. The inability to produce NETs is concomitant with aggressive periodontitis. But in cases with exaggerated NET production, NETs are unable to maintain periodontal health and bystander damages occur. This pathology can be also demonstrated in animal models using lipopolysaccharide as PMN activator. The progress of periodontitis appears to be a consequence of the formation of gingival pockets obstructing the evacuation of both pathogen-associated and damage-associated molecular patterns, which are responsible for the self-perpetuation of inflammation. Thus, besides the pathogenic effects of the periodontal bacteria, the dysregulation of PMN activation appears to play a main role in the periodontal pathology. Consequently, modulation of PMN activation might be a useful approach to periodontal therapy.
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Affiliation(s)
- Ljubomir Vitkov
- Department of Cell Biology and Physiology, Division of Animal Structure and Function, University of Salzburg, Salzburg, Austria.,Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Dominik Hartl
- Department of Paediatrics, Paediatric Infectiology, Immunology and Cystic Fibrosis, Children's Hospital, University of Tübingen, Tübingen, Germany
| | - Bernd Minnich
- Department of Cell Biology and Physiology, Division of Animal Structure and Function, University of Salzburg, Salzburg, Austria
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
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Association between Oral Conditions and Returning Home after Discharge in Elderly Patients. Geriatrics (Basel) 2017; 2:geriatrics2030028. [PMID: 31011038 PMCID: PMC6371132 DOI: 10.3390/geriatrics2030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/24/2017] [Accepted: 08/24/2017] [Indexed: 11/16/2022] Open
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Almerich-Silla JM, Almiñana-Pastor PJ, Boronat-Catalá M, Bellot-Arcís C, Montiel-Company JM. Socioeconomic factors and severity of periodontal disease in adults (35-44 years). A cross sectional study. J Clin Exp Dent 2017; 9:e988-e994. [PMID: 28936289 PMCID: PMC5601116 DOI: 10.4317/jced.54033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/21/2017] [Indexed: 12/04/2022] Open
Abstract
Background Periodontal disease or periodontitis is an inflammatory disease with a hight prevalence. According to the last oral health survey of the Spanish population, between 24% and 37% of Spaniards aged over 35 years have periodontitis and 6% to 10% of the adult population have deep periodontal pockets. The aim of this study was to determine the association between risk factors and the presence of periodontal pockets in the adult population. Material and Methods A cross sectional or prevalence study of a representative sample of the adult population of the Valencia region was designed. The sample was recruited at 35 health centres, The study was conducted in November and December 2006 under standardized conditions as regards light sources, equipment and instruments and the position of the three previously calibrated dentist examiners. Results The sample examined consisted of 733 individuals (220 men and 513 women). Measured by the CPI, 13% were healthy and 5.5% presented bleeding. The prevalence of calculus was 59.3%, that of 3.5-5.5 mm pockets was 15.8% and that of pockets deeper than 5.5 mm was 4.6%. Almost half the sextants were healthy (2.89), 0.61 presented bleeding and 1.74 presented calculus. The mean number of sextants affected by 3.5-5.5 mm pockets was 0.46 and 0.07 presented deep pockets (>5.5 mm).
An adjusted multiple logistic regression model with the presence of periodontal pockets as the dependent variable showed that the significant independent variables were low social class (OR=1.81), smoking (OR=1.68), primary education (OR=1.57), male gender (OR=1.56) and age (OR=1.08). The other study variables were not significant in this model. Conclusions Socioeconomic factors such as primary education and low social class, as well as gender, age and smoking, were found to be associated to a significant degree with greater prevalence of periodontal disease in the adult population. Key words:Periodontal disease, adults, socioeconomic factors, periodontal pockets, cross sectional study.
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Affiliation(s)
- José-Manuel Almerich-Silla
- Tenured lecturer, Preventive Dentistry Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia (Spain)
| | - Pedro J Almiñana-Pastor
- Grado en Odontología [equivalent to BDS],, Specialist Master of Periodontics, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia (Spain)
| | - Montserrat Boronat-Catalá
- Grado en Odontología [equivalent to BDS],, Specialist Master of Periodontics, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia (Spain)
| | - Carlos Bellot-Arcís
- PhD, Associate lecturer, Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia (Spain)
| | - José-María Montiel-Company
- Post-doctoral contract lecturer, Preventive Dentistry Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia (Spain)
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Liu F, Pelekos G, Jin LJ. The gingival biotype in a cohort of Chinese subjects with and without history of periodontal disease. J Periodontal Res 2017; 52:1004-1010. [DOI: 10.1111/jre.12471] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- F. Liu
- Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - G. Pelekos
- Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - L. J. Jin
- Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
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Kim SH, Kang SR, Park HJ, Kim JM, Yi WJ, Kim TI. Improved accuracy in periodontal pocket depth measurement using optical coherence tomography. J Periodontal Implant Sci 2017; 47:13-19. [PMID: 28261520 PMCID: PMC5332330 DOI: 10.5051/jpis.2017.47.1.13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 01/18/2017] [Indexed: 01/06/2023] Open
Abstract
Purpose The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. Methods We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. Results The average periodontal pocket depth measured by OCT was 3.10±0.15 mm, 4.11±0.17 mm, 5.09±0.17 mm, and 6.05±0.21 mm for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. Conclusions OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.
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Affiliation(s)
- Sul-Hee Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Se-Ryong Kang
- Department of Biomedical Radiation Sciences, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea
| | - Hee-Jung Park
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.; Department of Health Policy and Management, Korea University College of Health Sciences, Seoul, Korea
| | - Jun-Min Kim
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Won-Jin Yi
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.; Department of Oral and Maxillofacial Radiology, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.; Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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44
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Bostanci N, Bao K. Contribution of proteomics to our understanding of periodontal inflammation. Proteomics 2017; 17. [DOI: 10.1002/pmic.201500518] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/15/2016] [Accepted: 12/15/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Nagihan Bostanci
- Department of Dental Medicine; Karolinska Institute; Huddinge Sweden
| | - Kai Bao
- Division of Oral Microbiology and Immunology; Institute of Oral Biology; Center of Dental Medicine; University of Zürich; Zürich Switzerland
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45
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Ren H, Du M. Role of Maternal Periodontitis in Preterm Birth. Front Immunol 2017; 8:139. [PMID: 28243243 PMCID: PMC5303728 DOI: 10.3389/fimmu.2017.00139] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 01/26/2017] [Indexed: 01/22/2023] Open
Abstract
In the last two decades, many studies have focused on whether periodontitis is a risk factor for preterm birth (PTB). However, both epidemiological investigation and intervention trials have reached contradictory results from different studies. What explains the different findings, and how should future studies be conducted to better assess this risk factor? This article reviews recent epidemiological, animal, and in vitro studies as well as intervention trials that evaluate the link between periodontitis and PTB. Periodontitis may act as a distant reservoir of microbes and inflammatory mediators and contribute to the induction of PTB. Animal studies revealed that maternal infections with periodontal pathogens increase levels of circulating IL-1β, IL-6, IL-8, IL-17, and TNF-α and induce PTB. In vitro models showed that periodontal pathogens/byproducts induce COX-2, IL-8, IFN-γ, and TNF-α secretion and/or apoptosis in placental tissues/cells. The effectiveness of periodontal treatment to prevent PTB is influenced by the diagnostic criteria of periodontitis, microbial community composition, severity of periodontitis, treatment strategy, treatment efficiency, and the period of treatment during pregnancy. Although intervention trials reported contradictory results, oral health maintenance is an important part of preventive care that is both effective and safe throughout pregnancy and should be supported before and during pregnancy. As contradictory epidemiological and intervention studies continue to be published, two new ideas are proposed here: (1) severe and/or generalized periodontitis promotes PTB and (2) periodontitis only promotes PTB for pregnant women who are young or HIV-infected or have preeclampsia, pre-pregnancy obesity, or susceptible genotypes.
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Affiliation(s)
- Hongyu Ren
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
| | - Minquan Du
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
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46
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Oral Health-Related Quality of Life and Periodontal Status of Pregnant Women. Matern Child Health J 2017; 21:1634-1642. [DOI: 10.1007/s10995-016-2255-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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47
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Oral Care in the Dysphagic Patient. Dysphagia 2017. [DOI: 10.1007/174_2017_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Cruz Olivo EA, Santos D, de Lima ME, Dos Santos VL, Sinisterra RD, Cortés ME. Antibacterial Effect of Synthetic Peptide LyeTxI and LyeTxI/β-Cyclodextrin Association Compound Against Planktonic and Multispecies Biofilms of Periodontal Pathogens. J Periodontol 2016; 88:e88-e96. [PMID: 27989223 DOI: 10.1902/jop.2016.160438] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Antimicrobial peptides (AMPs) have shown rapid and potent effect against planktonic bacteria. However, control of periodontopathic biofilms is a challenge even for AMPs. Thus, the present study evaluates in vitro antimicrobial activity of synthetic peptide LyeTxI and association compound LyeTxI/β-cyclodextrin (βCD) against multispecies biofilms. METHODS Sensibility to LyeTxI and LyeTxI/βCD was determined for planktonic Gram-negative periodontopathogens. Time-kill kinetic assay was performed at minimum inhibitory concentrations (MICs) in all planktonic strains. Multispecies biofilms were grown on pegs using a biofilm device and studied by scanning electron microscopy at 2, 5, and 10 days. Minimal biofilm eradication concentration (MBEC) was determined for 2- and 4-day multispecies biofilms. Metabolic activity of biofilms was determined by fluorometry study. RESULTS Biofilms showed reproducible cell density on pegs of the biofilm device. LyeTxI and LyeTxI/βCD were active against all strains tested at concentrations ≤62.5 μg/mL. Kinetic assays showed rapid bactericidal effect of LyeTxI against all periodontopathogens. MBECs of LyeTxI and LyeTxI/βCD against multispecies 2-day biofilms were two-fold higher than MICs of cells shed from biofilms. LyeTxI was able to reduce multispecies 2-day metabolic activity by 90%. Multispecies 4-day biofilms were tolerant to all agents tested. CONCLUSIONS LyeTxI and LyeTxI/βCD are active against periodontopathic bacteria, showing rapid bactericidal effect and may be used to prevent biofilm development. In the future, AMPs could be therapeutic tools for treatment of periodontitis.
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Affiliation(s)
- Edison Andrés Cruz Olivo
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daniel Santos
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais
| | - Maria Elena de Lima
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais
| | - Vera Lúcia Dos Santos
- Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais
| | - Rubén Dario Sinisterra
- Department of Inorganic Chemistry, Exacts Science Institute, Federal University of Minas Gerais
| | - María Esperanza Cortés
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais
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Evaluation of the Anti-Inflammatory Effect of Locally Delivered Vitamin C in the Treatment of Persistent Gingival Inflammation: Clinical and Histopathological Study. J Nutr Metab 2016; 2016:2978741. [PMID: 28050280 PMCID: PMC5165168 DOI: 10.1155/2016/2978741] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/25/2016] [Accepted: 10/30/2016] [Indexed: 01/30/2023] Open
Abstract
Objective. The purpose of this study is to investigate the role and efficiency of the locally injected vitamin C in the treatment of persistent gingival inflammation. Design. Twenty adult patients with persistent chronic gingival inflammation were included in this study. The same dose of sterile vitamin C was injected in gingival tissues after the completion of phase I therapy. Gingival biopsies were taken after total resolution of inflammation. The specimens were examined histologically, using H&E stain. Results. Clinical evaluation revealed great improvement of the injected sites with recall visits. Histopathological results revealed marked decrease in inflammatory cells and epithelial thickness and a higher number of newly formed subbasal capillaries. Conclusions. Vitamin C is an effective adjunctive treatment in reducing various degrees of chronic gingival inflammation.
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Coffey J, Choudhry M, Shlossman M, Makin IRS, Singh VK. Multiplex real-time PCR detection and relative quantification of periodontal pathogens. Clin Exp Dent Res 2016; 2:185-192. [PMID: 29744166 PMCID: PMC5839218 DOI: 10.1002/cre2.37] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/24/2016] [Accepted: 06/04/2016] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, which is strongly associated with certain pathogenic bacteria. The aim of this study was to develop a real-time multiplex polymerase chain reaction (PCR) assay to detect and quantify bacterial species associated with periodontitis. We targeted detection and relative quantification of the following five bacterial species relevant to periodontal diseases: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. The conserved regions of the genome of these species were targeted with oligos and TaqMan probes in real-time PCR assays. The species-specific TaqMan oligos and TaqMan probes showed no cross-amplification, and there was no loss of amplification yield in multiplex real-time PCR assays. All five bacterial targets were amplified analogous to the template concentrations used in these assays. This multiplex real-time PCR strategy could potentially be used to detect the bacterial species in periodontal pockets of patients with periodontal diseases. This assay may also serve as a quick tool for profiling and quantifying bacteria relevant to periodontal diseases and likely be a valuable tool for clinical translational research.
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Affiliation(s)
- Joshua Coffey
- Missouri School of Dentistry and Oral HealthMissouriUSA
| | | | - Marc Shlossman
- Arizona School of Dentistry and Oral Health, A.T. Still University of Health SciencesArizonaUSA
| | - Inder Raj S. Makin
- Arizona School of Dentistry and Oral Health, A.T. Still University of Health SciencesArizonaUSA
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