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Qi J, Chen J, Pang Y, Guo Y, Chen G, Liu Y, Wang J, Liu E. Association between periodontal disease and osteoporosis in postmenopausal women: A systematic review and meta-analysis. Heliyon 2023; 9:e20922. [PMID: 37920517 PMCID: PMC10618781 DOI: 10.1016/j.heliyon.2023.e20922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/23/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
Objective To evaluate the relationship between periodontitis and postmenopausal osteoporosis. Methods This research was carried out according to the principles laid down by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. We searched the Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang databases from inception to July 1, 2023 to collect all relevant publications, with no restrictions on publication date or Languages. Cochrane's tool for assessing RoB was used to evaluate the RoB for RCTs. The Newcastle-Ottawa Scale was used to assess the RoB for cohort studies and case-control studies. Mean differences (MD) with 95 % confidence intervals (CI) were used for analysis of continuous data. Heterogeneity was measured using the I2 statistic. Revman 5.4 software was used for the meta-analysis. Results 28 observational studies with 19611 patients, including 5813 cases in the postmenopausal osteoporosis group and 13798 cases in the non-osteoporosis group. The studies showed that the degrees of clinical attachment loss (CAL), probing depth (PD), gingival recession (GR), simplified oral hygiene index (OHIS), and percentage of sites with bleeding on probing (BOP) in the postmenopausal osteoporosis group were higher than those in the non-osteoporosis group[CAL(MD = 0.89(mm), 95 % CI [0.48,1.30], p < 0.00001), PD (MD = 0.27(mm), 95 % CI [0.13, 0.41], p = 0.0001), GR (MD = 0.28(mm), 95 % CI [0.20, 0.35], p < 0.00001), OHIS (MD = 1.32,95 % CI [1.12,1.51], p < 0.00001), BOP(MD = 12.71(%), 95 % CI [3.24,22.18], p = 0.009)]. Eleven studies found that bone mineral density (BMD) in the postmenopausal osteoporosis group was lower than that in non-osteoporosis group (MD = -0.41(U/cm2), 95 % CI [-0.77,-0.05], p = 0.03). The combined analysis results of the studies in the two groups showed that there were no significant differences in the loss of alveolar crestal height (ACH)[(MD = -1.76(%),95%CI [-3.64,0.12], p = 0.07)]. Conclusion Postmenopausal osteoporosis patients are more likely to suffer from periodontitis, and the condition is easily aggravated.
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Affiliation(s)
- Jing Qi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jiahui Chen
- Department of Clinical Skills Training Center, The First School of Clinical Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Yunqing Pang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- School of Stomatology Lanzhou University, Lanzhou, 730000, China
| | - Yufeng Guo
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Guang Chen
- Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, 730000, China
| | - Yuting Liu
- Radiology of Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jing Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
- School of Stomatology Lanzhou University, Lanzhou, 730000, China
| | - E. Liu
- Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China
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2
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Jeon B, Oh J, Son S. Effects of Tooth Brushing Training, Based on Augmented Reality Using a Smart Toothbrush, on Oral Hygiene Care among People with Intellectual Disability in Korea. Healthcare (Basel) 2021; 9:348. [PMID: 33803836 PMCID: PMC8003269 DOI: 10.3390/healthcare9030348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Purpose: In modern society, augmented reality (AR)-based training using a smart device has emerged as a means of resolving problems with training. Thus, this feasibility study aimed to identify the effects of tooth-brushing training, based on AR using a smart toothbrush, on oral hygiene care among people with an intellectual disability in Korea. (2) Methods: Thirty people with an intellectual disability, residing in a residential care facility, were selected. Tooth-brushing training based on AR, using a smart toothbrush, was applied in the experimental group (n = 15), and training using visual material was applied in the control group (n = 15). As an assessment of oral hygiene care, the changes in tooth-brushing performance and oral hygiene were measured. (3) Results: There were significant differences in all results after training between the two groups. (4) Conclusions: Tooth-brushing training based on AR using a smart toothbrush is more effective than training using visual material on oral hygiene care among the subjects of this feasibility study. Thus, training based on AR using a smart toothbrush could be applied to people with intellectual disabilities residing in residential care facilities as an individual tool for tooth-brushing training.
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Affiliation(s)
- Byoungjin Jeon
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, Korea;
| | - Jinseok Oh
- Department of Emergency Medical Rehabilitation Service, Graduate School of Kangwon National University, Samcheok 25949, Korea;
| | - Sungmin Son
- Department of Occupational Therapy, Jeonju Kijeon College, Jeonju 54989, Korea
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3
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Gupta S, Mathur S, Kapoor A, Vijay S, Khatri RK, Srivastava R. Clinical efficacy of amino bisphosphonate on periodontal disease status in postmenopausal women: Randomized double-blind placebo-controlled trial. J Family Med Prim Care 2020; 9:4919-4924. [PMID: 33209822 PMCID: PMC7652136 DOI: 10.4103/jfmpc.jfmpc_724_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/11/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives: Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women. Materials and Methods: Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months. Results: A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179). Conclusion: Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy.
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Affiliation(s)
- Shikha Gupta
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Setu Mathur
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Anjali Kapoor
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Sharmistha Vijay
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Rohit K Khatri
- Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Rashi Srivastava
- Department of Oral Pathology, Rajasthan Dental College, Jaipur, Rajasthan, India
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4
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Geisinger ML, Calvert Grosso K, Kaur M, Abou-Arraj RV, Basma H, Ogdon D, Geurs NC. Clinical Decision Making for Primary Peri-Implantitis Prevention: Practical Applications. Clin Adv Periodontics 2020; 11:43-53. [PMID: 32702205 DOI: 10.1002/cap.10115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
Abstract
FOCUSED CLINICAL QUESTION When planning dental implant therapy, what risk-reduction strategies allow practitioners to select patients, sites, and restorative plans that decrease the incidence of peri-implant disease? SUMMARY With a marked increase in the number of patients receiving dental implants to treat partial or complete edentulism, it follows that the prevalence of peri-implant mucositis and peri-implantitis have increased. Risks associated with implant therapies may vary based upon underlying local, environmental, surgical, patient, prosthetic, and fixture-related factors. Furthermore, an emphasis on preventative measures and maintenance should be undertaken to avoid development and progression of peri-implant diseases. Thorough risk assessment, proper treatment planning, and early diagnosis and intervention are critical in the absence of definitive data of long-term success of treatments for peri-implant condition. Given the difficulty in intervention once peri-implantitis is established, identification of risk factors and development of treatment plans to address those factors before dental implant therapy is critical to the long-term health and success of dental implants. CONCLUSIONS A patient-centered, evidence based approach to dental implant treatment planning to reduce the risk for peri-implantitis should be undertaken. Systematic diagnosis of disease state(s) and evaluation of the etiologic and modifying risk factors for peri-implant diseases can yield more optimal outcomes to reduce peri-implantitis rates.
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Affiliation(s)
- Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Maninder Kaur
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Ramzi V Abou-Arraj
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Hussein Basma
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Dorothy Ogdon
- Lister Hill Library, University of Alabama at Birmingham, Birmingham, AL
| | - Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
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5
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Goyal L, Goyal T, Gupta ND. Osteoporosis and Periodontitis in Postmenopausal Women: A Systematic Review. J Midlife Health 2017; 8:151-158. [PMID: 29307975 PMCID: PMC5753494 DOI: 10.4103/jmh.jmh_55_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This systematic review was done to assess the strength of association between osteoporosis and chronic periodontitis in postmenopausal women, assessed by bone mineral density (BMD) and clinical attachment loss, respectively. The Pubmed, Cochrane central, EMBASE, and Google Scholar were searched from year 1990 to 2015 for studies on association between chronic periodontitis and osteoporosis. Studies measuring osteoporosis in terms of central BMD and periodontitis in terms of clinical attachment level were studied. Data were extracted and descriptive analysis was performed. Screening of 1188 articles resulted in 24 articles for review after reading the titles and abstracts. Fifteen studies were shortlisted for inclusion in systematic review. Ten of these studies showed an association between periodontitis and osteoporosis. It implies that patients with severe periodontitis should also be evaluated for systemic bone health and vice versa.
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Affiliation(s)
- Lata Goyal
- Department of Dentistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Tarun Goyal
- Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - N. D. Gupta
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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6
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Svedha PR, Mahendra J, Theayarajar R, Namachivayam A. Comparison of bone mineral density among pre- and post-menopausal women with and without chronic generalized periodontitis. J Indian Soc Periodontol 2017; 21:119-124. [PMID: 29398856 PMCID: PMC5771108 DOI: 10.4103/jisp.jisp_43_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background There have been a very limited number of studies regarding the assessment of bone mineral density (BMD) using dual energy X-ray absorptiometry scan. Hence, the purpose of the study was to assess the relationship between BMD and periodontal health in three different study groups. Materials and Methods The study comprised of thirty female individuals who were categorized into three groups: ten premenopausal women with healthy periodontium (Group A), ten premenopausal women with generalized chronic periodontitis (Group B), and ten postmenopausal women with generalized chronic periodontitis (Group C). Number of teeth, plaque index, probing depth, clinical attachment level, interproximal alveolar bone loss, T-score for dual femur and posteroanterior (PA) spine, and BMD for dual femur and PA spine of each individual were recorded in all the three groups. Results The BMD and T-score of dual femur and PA spine were found to be low in Group C when compared to Group A and B which was statistically significant. Conclusion Postmenopausal women with generalized chronic periodontitis (Group C) exhibited severe periodontal destruction with less BMD. Hence, it is suggested that periodontitis may be a risk indicator for osteoporosis in postmenopausal women and vice versa.
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Affiliation(s)
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Ambalavanan Namachivayam
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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7
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Yu S, Pu Y, Jin H, Dian J, Ge T, Zhihe Z. [Role of DNA methylation in regulation of osteogenic differentiation of stem cells]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2016; 34:526-530. [PMID: 28326715 DOI: 10.7518/hxkq.2016.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
DNA methylation and demethylation are two important mechanisms of epigenetics, which is important in the study of cell differentiation, proliferation, and senescence. During osteogenic differentiation of stem cells, the expression of osteogenic specific genes and demethylated promoters is upregulated, whereas the expression of pluripotent genes and hypermethylated promoters is downregulated. The dynamic changes and balance between DNA methylation and demethylation are important for the coordination of gene expression and the inhibition of improper phenotypes. Abnormal changes in the methylation modification mechanism in osteogenic differentiation not only affect the normal function of stem cells but are also associated with the occurrence and development of many common skeletal diseases. This paper reviews the new progress of DNA methylation and demethylation in regulating osteogenic differentiation. The possible skeletal diseases caused by abnormal DNA methylation are also presented.
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Affiliation(s)
- Shen Yu
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Pu
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hao Jin
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing Dian
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Tang Ge
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhao Zhihe
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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8
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Cekici A, Baser U, Isik G, Akhan SE, Issever H, Onan U. Periodontal treatment outcomes in post menopausal women receiving hormone replacement therapy. J Istanb Univ Fac Dent 2015; 49:39-44. [PMID: 28955544 PMCID: PMC5573503 DOI: 10.17096/jiufd.61637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/20/2015] [Indexed: 12/26/2022] Open
Abstract
Purpose: To evaluate the effect of hormone replacement
therapy(HRT) on periodontal treatment outcomes in
a group of postmenopausal women with periodontitis. Materials and Methods: 23 post-menopausal
chronic periodontitis patients were included in this
study. The test group(n=11) consisted of women
who started HRT with this study and received
conjugated estrogen and medroxyprogesteron. The
control group(n=12) was women not taking any HRT
or supplement therapy. Study groups received the
same periodontal treatment. All subjects examiend
by recording the following: plaque index (PI), sulcus
bleeding index (SBI), periodontal pocket depth (PD)
and relative attachment level (RAL) from 6 sites in
each tooth. Measurements were recorded at the
baseline, 1 month, 3 months, and 6 months following
periodontal treatment. Serum estrogene level and
bone mineral density was recorded at baseline
and 6 months following periodontal treatment. Results: The GI change was greater in the
control group. There wasn’t significant difference
by means of PD, the attachment gain was
significantly greater in the HRT receiving group. Conclusion: HRT seems to have a positive
effect on periodontal treatment outcomes.
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Affiliation(s)
- Ali Cekici
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Turkey
| | - Ulku Baser
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Turkey
| | - Gulden Isik
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Turkey
| | - Suleyman E Akhan
- Department of Gyneocology and Obstetrics, Faculty of Medicine, Istanbul University, Turkey
| | - Halim Issever
- Department of Public Health, Faculty of Medicine, Istanbul University, Turkey
| | - Utku Onan
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Turkey
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Morita T, Yamazaki Y, Fujiharu C, Ishii T, Seto M, Nishinoue N, Sasaki Y, Kawato T, Motohashi M, Maeno M. Serum γ-glutamyltransferase level is associated with periodontal disease independent of drinking habits in Japanese adults. Med Sci Monit 2014; 20:2109-16. [PMID: 25360830 PMCID: PMC4226313 DOI: 10.12659/msm.891204] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Non-alcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome. Periodontal disease is a mild chronic inflammatory disease with systemic effects, and many studies have indicated an association between metabolic syndrome and periodontitis. In the present study, we investigated the relationship between periodontitis and liver biochemical parameters according to alcohol drinking habits through a cross-sectional study based on data from Japanese people in occupational settings. Material and Methods The subjects were 1510 employees (1218 males, 292 females, mean age 50.4 years) who underwent dental and medical checkups in 2012. Associations between the presence of periodontal pockets and serum levels of liver biochemical parameters were assessed. Results Alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) levels were higher in subjects with than without periodontal pockets. Multiple logistic regression analysis (adjusting for age, gender, cigarette smoking, and alcohol drinking habits, and components of metabolic syndrome) with GGT or ALT as the dependent variable revealed that there was a significant association between periodontal pockets and GGT (odds ratio, OR=1.48), but not ALT. Similar associations were observed when an analysis was performed according to the presence or absence of alcohol drinking habits; the OR was higher in subjects without (OR=1.84) than with drinking habits (OR=1.41). Conclusions The presence of periodontal pockets was associated with serum levels of GGT, a liver biochemical parameter, in Japanese adults with no drinking habit, suggesting that periodontal disease is associated with liver function, independent of alcohol ingestion.
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Affiliation(s)
| | | | | | | | - Misae Seto
- Health Care Center, Lion Corporation, Tokyo, Japan
| | | | - Yoshiyuki Sasaki
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Kawato
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Masafumi Motohashi
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Masao Maeno
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
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10
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Liu H, Gao K, Lin H, Zhang Y, Li B. Relative Skeletal Effects in Different Sites of the Mandible With the Proximal Tibia During Ovariectomy and the Subsequent Estrogen Treatment. J ORAL IMPLANTOL 2014; 41 Spec No:386-90. [PMID: 24914769 DOI: 10.1563/aaid-joi-d-13-00255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hao Liu
- 1 Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kai Gao
- 2 Key Laboratory of Human Diseases Comparative Medicine, Ministry of Health, Beijing, PR China; Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences & Comparative Medicine Centre, Peking Union Medical College, Beijing, PR China
| | - Hong Lin
- 3 Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yu Zhang
- 4 Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Binbin Li
- 5 Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China
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11
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López-López J, Castellanos-Cosano L, Estrugo-Devesa A, Gómez-Vaquero C, Velasco-Ortega E, Segura-Egea JJ. Radiolucent periapical lesions and bone mineral density in post-menopausal women. Gerodontology 2013; 32:195-201. [PMID: 24164489 DOI: 10.1111/ger.12076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the relationship between radiolucent periapical lesions and bone mineral density in post-menopausal women. MATERIAL AND METHODS Seventy-five post-menopausal women were recruited for the study. Bone mineral density was measured using dual-energy X-ray absorptiometry. Three groups were established: healthy bone group, osteopenic group and osteoporotic group. Periapical radiolucencies were diagnosed on the basis of examination of digital panoramic radiographs. Statistical analysis was carried out using anova and chi-squared tests, and logistic regression analysis. RESULTS In both the osteopenic and osteoporotic groups, 25% of women showed at least one periapical radiolucency, whereas this was only 7.4% in the healthy bone group (odds ratio = 4.2; p = 0.061). After multivariate logistic regression analysis adjusting for covariates (age, number of teeth, number of root-filled teeth and number of teeth with coronal restorations), a marginally significant association was evident between bone mineral density and the presence of periapical radiolucencies (odds ratio = 1.9; CI 95% = 1.0-3.8; p = 0.050). CONCLUSIONS After adjusting for covariates, low bone mineral density is marginally associated with a higher frequency of radiolucent periapical lesions.
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Affiliation(s)
- José López-López
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | - Albert Estrugo-Devesa
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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12
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Kim JW, Kong KA, Kim HY, Lee HS, Kim SJ, Lee SH, Sim KW, Kim MR, Lee JH. The association between bone mineral density and periodontitis in Korean adults (KNHANES 2008-2010). Oral Dis 2013; 20:609-15. [PMID: 24118189 DOI: 10.1111/odi.12179] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 08/05/2013] [Accepted: 08/19/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study investigated the association between bone mineral density (BMD) and periodontitis in a representative sample of Korean adults. MATERIAL AND METHODS Of 36 188 individuals who participated in the Korea National Health and Nutrition Examination Survey in 2008, 2009, and 2010, 9977 participants aged ≥40 years were included in this cross-sectional study. The associations of BMD of lumbar spine, total femur, and femoral neck with periodontitis were investigated using logistic regression analysis. Additionally, dose-response relationships with BMD divided into quintiles and the association between osteoporosis and periodontitis were investigated. RESULTS With the set of Community Periodontal Index (CPI) ≥ 3 as a dependent variable, logistic regression analysis revealed that a decrease of BMD was significantly associated with higher odds of periodontitis [range of adjusted odds ratios (AORs); 1.15-1.20, P < 0.001 for all BMD sites]. Similarly, these associations were also found in the CPI 4 model. With regard to dose-response relations, the lower the BMD quintile, the higher the AORs appeared with statistical significance in the CPI ≥ 3 model. (P for trend < 0.001) Participants with osteoporosis had 2.26 and 1.91 times higher odds for CPI ≥ 3 and CPI 4, respectively, than those with normal BMD, indicating a significant association between the two diseases. CONCLUSIONS Our results suggest that BMD is significantly associated with periodontitis.
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Affiliation(s)
- J W Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Korea
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13
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Cai C, Yuan GJ, Huang Y, Yang N, Chen X, Wen L, Wang X, Zhang L, Ding Y. Estrogen-related receptor α is involved in the osteogenic differentiation of mesenchymal stem cells isolated from human periodontal ligaments. Int J Mol Med 2013; 31:1195-201. [PMID: 23525223 DOI: 10.3892/ijmm.2013.1305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 02/25/2013] [Indexed: 11/06/2022] Open
Abstract
Recently, it has been reported that the orphan nuclear receptor estrogen-related receptor α (ERRα) is involved in the osteogenic differentiation of mesenchymal stem cells (MSCs). Moreover, ERRα has been identified as a novel therapeutic target for treating osteoporosis and other bone diseases. Human periodontal ligament tissue-derived mesenchymal stem cells (hPDLSCs) have recently been used in stem cell-mediated therapies because of their multipotency, particularly toward osteogenic differentiation. However, it is still unclear whether ERRα can regulate the osteogenic differentiation of hPDLSCs. In the present study, we investigated the role of ERRα in the osteogenic differentiation of hPDLSCs in vitro. We isolated hPDLSCs and confirmed their capacity for multipotent differentiation. Furthermore, we examined ERRα expression in hPDLSCs by RT-PCR and immunocytochemistry. We found that the expression of ERRα mRNA was significantly increased during the late stage of osteogenic differentiation of hPDLSCs. Moreover, transfection of recombinant lentiviral-mediated miRNA targeting ERRα significantly suppressed ALP activity, mineralization capacity, and the mRNA expression of osteogenesis-related genes (ALP, OCN, RUNX2 and OPN) in hPDLSCs. Our results indicate that ERRα may promote the osteogenic differentiation of hPDLSCs in vitro.
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Affiliation(s)
- Chuan Cai
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, P.R. China
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Radiologic bone loss in patients with bisphosphonate-associated osteonecrosis of the jaws: a case-control study. Clin Oral Investig 2013; 18:385-90. [PMID: 23525860 DOI: 10.1007/s00784-013-0974-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 03/14/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Most patients with bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) report a previous tooth extraction at the necrosis site before the diagnosis was made. At older ages, most teeth are extracted due to periodontal disease, which is per se another BP-ONJ trigger factor. The aim of this study was to evaluate the periodontal status of BP-ONJ patients using panoramic radiographs compared to a control. MATERIALS AND METHODS All patients treated for BP-ONJ up to January 1, 2010 comprised the study. The very first panoramic radiograph was analyzed. The number of remaining teeth and the radiographic bone loss from the cemento-enamel junction to the crestal bone were measured. For each patient, one control was analyzed (matching for gender and age). RESULTS One hundred twenty-nine BP-ONJ panoramic radiographs and 129 controls were analyzed (68 women, 61 men; 67.3 ± 9.7 years; osteoporosis [n = 11], breast cancer [n = 33], multiple myeloma [n = 61], prostate cancer [n = 24]). The average number of remaining teeth was 12.9 ± 8.4 for BP-ONJ and 16.4 ± 9.4 for the control (p = 0.02). The average radiographic bone loss was 5.5 ± 2.3 mm for BP-ONJ and 3.1 ± 1.1 mm for the control (p < 0.001); 96.6 % of BP-ONJ and 77.5 % had radiographic bone loss of more than 5 mm. Radiographic bone loss in the molar region was the highest for both groups (BP-ONJ 6.0 ± 2.3 mm; control 3.6 ± 1.4 mm). CONCLUSION Prevalence and severity of periodontal disease in patients with BP-ONJ is higher compared to healthy controls. CLINICAL RELEVANCE Patients with periodontal disease might be at a higher risk of developing BP-ONJ; therefore, periodontal disease therapy in patients who are about to receive bisphosphonates should be undertaken.
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Lee PH, McGrath CPJ, Kong AYC, Lam TH. Self-report poor oral health and chronic diseases: the Hong Kong FAMILY Project. Community Dent Oral Epidemiol 2013; 41:451-8. [PMID: 23330825 DOI: 10.1111/cdoe.12037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 12/21/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the association between self-reported oral health (SROH) and general health, this study examined the cross-sectional associations between SROH and nine chronic health conditions, namely cancer, diabetes, high blood pressure, high cholesterol, thyroid disease, nervous system disease, eye/nose/throat disease, stomach/intestinal disease, and musculoskeletal disease in Hong Kong. METHODS This study included 41,641 participants recruited in the FAMILY Project cohort study during March 2009-March 2011. SROH was measured on a 5-point Likert scale. Multiple logistic regression model was used to analyze the effect of dichotomized SROH (0: very good/good/average, 1: bad/very bad) on nine chronic health conditions, adjusted for age, sex, education, personal income, smoking and drinking habits, Body mass index (BMI), and blood pressures. RESULTS All the nine chronic health conditions investigated were associated with SROH. SROH showed the strongest cross-sectional association with nervous system disease (odds ratio = 3.30, P < 0.001), while the odds ratio with other significant chronic health conditions ranged from 1.13 (high cholesterol, P = 0.033)-1.73 (stomach/intestinal disease, P < 0.001). CONCLUSIONS Poor SROH is associated with cancer, diabetes, high blood pressure, high cholesterol, thyroid disease, nervous system disease, eye/nose/throat disease, stomach/intestinal disease, and musculoskeletal disease.
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Affiliation(s)
- Paul H Lee
- FAMILY: A Jockey Club Initiative for a Harmonious Society, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
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Seo WH, Cho ER, Thomas RJ, An SY, Ryu JJ, Kim H, Shin C. The association between periodontitis and obstructive sleep apnea: a preliminary study. J Periodontal Res 2012. [PMID: 23199371 DOI: 10.1111/jre.12032] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis is becoming a highly prevalent disease worldwide. Obstructive sleep apnea (OSA) is a common disorder that is characterized by repeated disruptions in breathing during sleep, and mouth breathing is a common characteristic among patients with OSA. We aimed to assess the hypothesis that OSA is associated with the onset and progression of periodontal disease. MATERIAL AND METHODS This is a cross-sectional study of a total of 687 participants (460 men and 227 women), 47-77 years of age, who were examined between August 2009 and September 2010 as part of the Korean Genome and Epidemiology Study. The participants underwent standard polysomnography, clinical periodontal examination and health-screening examinations. Periodontitis was defined as clinical attachment level (CAL) ≥ 6 mm and probing pocket depth ≥ 4 mm. OSA was determined using the apnea-hypopnea index (AHI), and an AHI score of ≥ 5 was the cut-off used to indicate the presence of OSA. RESULTS The results showed that 17.5% of the participants had periodontitis, 46.6% had OSA and 60.0% who were diagnosed with periodontitis had OSA. In our study, old age, male gender, current smoking status, mouth breathing during sleep and high AHI were identified as risk factors for periodontitis. OSA was positively associated with periodontitis [odds ratio (OR) = 1.84, 95% confidence interval (CI) = 1.18-2.87], probing pocket depth (OR = 2.22, 95% CI = 1.30-3.77) and CAL (OR = 1.86, 95% CI = 1.07-3.21) in a dose-response manner. Additionally, OSA was positively associated with periodontitis (OR = 2.51, 95% CI = 1.37-4.62) in subjects ≥ 55 years of age, but not in subjects < 55 years of age. CONCLUSION There is a significant association between OSA and periodontal disease. Further research is needed to clarify the causal relationship between the two conditions.
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Affiliation(s)
- W H Seo
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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17
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Loo WTY, Bai LJ, Fan CB, Yue Y, Dou YD, Wang M, Liang H, Cheung MNB, Chow LWC, Li JL, Tian Y, Qing L. Clinical application of human β-defensin and CD14 gene polymorphism in evaluating the status of chronic inflammation. J Transl Med 2012; 10 Suppl 1:S9. [PMID: 23046822 PMCID: PMC3445860 DOI: 10.1186/1479-5876-10-s1-s9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Periodontitis is a common disease that affects the periodontal tissue supporting the teeth. This disease is attributed to multiple risk factors, including diabetes, cigarette smoking, alcohol, pathogenic microorganisms, genetics and others. Human beta-defensin-1 (hBD-1) is a cationic antimicrobial peptide with cysteine-rich ß-sheets and broad-spectrum antimicrobial activity. CD14 is a protein involved in the detection of bacterial lipopolysaccharide (LPS) and has also been associated with periodontitis. This study investigates the single nucleotide polymorphic (SNP) region, -1654(V38I), of the human beta-defensin-1 (hBD-1) gene as well as the -159 region of the CD14 gene in subjects with chronic periodontitis. Methods Blood samples from periodontally healthy subjects and periodontitis patients were obtained. DNA was extracted from the blood and was used to perform restriction digest at the polymorphic G1654A site of DEFB1 with the enzyme HincII. The polymorphic site 159TT of CD14 was digested with the enzyme AvaII. Enzyme-linked immunosorbent assay (ELISA) was performed on soluble samples to determine the protein expressions. Results The control and patient groups expressed 35% and 38% 1654 A/A genotype of DEFB1, respectively. The A allele frequency of the control group was 40%, while the patient blood group was 54%. The mean hBD-1 protein levels of the control and patient samples were 102.83 pg/mL and 252.09 pg/mL, respectively. The genotype distribution of CD14 in healthy subjects was 16% for C/C, 26% for T/T and 58% for C/T. The genotype frequencies of CD14 in periodontitis patients were 10% for C/C, 43% for T/T and 47% for C/T. The CD14 protein expression determined by ELISA showed a mean protein level of the control samples at 76.28ng/mL and the patient blood samples at 179.27ng/mL with a p value of 0.001. Our study demonstrated that patients suffering from chronic periodontitis present more commonly with the 1654A/A genotype on the DEFB1 gene and the 159T/T genotype on the CD14 gene. Conclusions This study purely investigated the association between periodontitis and one polymorphic site on both DEFB1 and CD14 gene, with the purpose of expanding knowledge for the future development in diagnostic markers or therapeutic interventions to combat this disease.
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[Osteoporosis and oral diseases]. Med Clin (Barc) 2012; 140:169-74. [PMID: 22854070 DOI: 10.1016/j.medcli.2012.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 05/22/2012] [Accepted: 05/31/2012] [Indexed: 02/02/2023]
Abstract
Osteoporosis is a major cause of fractures in elderly women. Bone densitometry is used in order to detect osteoporosis. It has been observed can also be analyzed in the jawbone. The osteoporosis may be associated with resorption of the residual ridge, periodontitis and tooth loss; also the same treatments can affect the jaws. A search was carried out in the Medline-Pubmed database in order to search the association between osteoporosis and oral diseases over the past 5 years. Forty-two articles were obtained after the selection process. The authors stated that: in reference to periodontal disease the results are conflicting, but there seems to be a higher prevalence of the disease and tooth loss and resorption of the crest. Oral bisphosphonates have little risk of causing osteonecrosis, and there is no relationship in the dental implant failure among patients taking bisphosphonates. There is no clear scientific evidence that could link osteoporosis and oral diseases.
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Wakai K, Naito M, Naito T, Kojima M, Nakagaki H, Umemura O, Yokota M, Hanada N, Kawamura T. Tooth loss and risk of hip fracture: a prospective study of male Japanese dentists. Community Dent Oral Epidemiol 2012; 41:48-54. [DOI: 10.1111/j.1600-0528.2012.00706.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kenji Wakai
- Department of Preventive Medicine; Nagoya University Graduate School of Medicine; Nagoya; Japan
| | - Mariko Naito
- Department of Preventive Medicine; Nagoya University Graduate School of Medicine; Nagoya; Japan
| | - Toru Naito
- Department of Geriatric Dentistry; Fukuoka Dental College; Fukuoka; Japan
| | | | - Haruo Nakagaki
- Department of Preventive Dentistry and Dental Public Health; School of Dentistry, Aichi-Gakuin University; Nagoya; Japan
| | - Osami Umemura
- Department of Dentistry; Aichi San-no-maru Hospital; Nagoya; Japan
| | - Makoto Yokota
- Department of Periodontology and Endodontology; Kyushu Dental College; Kitakyushu; Japan
| | - Nobuhiro Hanada
- Department of Translational Research; School of Dental Medicine, Tsurumi University; Yokohama; Japan
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Grocholewicz K, Bohatyrewicz A. Oral health and bone mineral density in postmenopausal women. Arch Oral Biol 2011; 57:245-51. [PMID: 22153129 DOI: 10.1016/j.archoralbio.2011.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Revised: 08/24/2011] [Accepted: 09/04/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of the study was to assess dental and periodontal status in relation to bone mineral density (BMD), and to study cytological changes in oral epithelium. METHODS Thirty-seven postmenopausal women aged 50-70 were given a dental examination and a BMD assessment. RESULTS There was a relationship between the femoral neck BMD and teeth state, a negative correlation between the lumbar BMD and the periodontal disease index (PDI) and between the radius BMD and the papillary bleeding index (PBI). PDI correlated positively with the number of superficial cells in the marginal gingiva smears. Correlation between PDI and parabasal cells and the number of teeth was negative. CONCLUSIONS In observed postmenopausal women, there is a negative association between bone mineral density and teeth state and periodontal indices. Oral epithelium revealed atrophic changes resulting in low keratinization. The study suggests an association between decreasing in bone mineral density, alveolar bone loss and the numbers of various cell types in epithelial smears.
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Pizzo G, Guiglia R, Licata ME, Pizzo I, Davis JM, Giuliana G. Effect of hormone replacement therapy (HRT) on periodontal status of postmenopausal women. Med Sci Monit 2011; 17:PH23-7. [PMID: 21455116 PMCID: PMC3539527 DOI: 10.12659/msm.881700] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The risks/benefits balance of hormone replacement therapy (HRT) is controversial. The aim of this study was to assess the periodontal status of a postmenopausal women group receiving HRT and to determine the effects of HRT on clinical measures of periodontal disease. MATERIAL/METHODS Ninety-one postmenopausal women, 52 taking HRT (HRT+) and 39 not taking HRT (HRT-), completed the study. Clinical parameters measured included visible supragingival plaque, probing pocket depth (PD) and clinical attachment level (CAL). Gingival status was recorded as gingival bleeding on probing (BOP). Previous oral contraceptive use and current and past smoking status were also assessed. RESULTS Data indicated that PD and CAL were not significantly different between HRT+ patients and HRT- patients (P=0.8067 and P=0.1627, respectively). The HRT+ group exhibited significantly lower visible plaque levels compared to the control group (P<0.0001). The percentage of gingival sites with positive BOP was significantly lower in the HRT+ group compared to the HRT- group (34.85% vs. 65.15%; P=0.0007). Plaque accumulation was also tested in ANCOVA as a possible explanatory variable for the differences observed in gingival bleeding. The ANCOVA showed no significant differences in gingival bleeding between HRT+ and HRT- women (P=0.4677). No significant differences in past smoking status and oral contraceptive use were detected between HRT+ and HRT- women (P=0.9999 and P=0.0845, respectively). CONCLUSIONS These findings indicated that long-term HRT was not associated with relevant effects on periodontal status and clinical measures of periodontal disease, thus suggesting that HRT may not confer protection against periodontitis in postmenopausal women.
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Affiliation(s)
- Giuseppe Pizzo
- Section of Oral Sciences, University of Palermo, Palermo, Italy.
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Henriques PSG, Pinto Neto AM. Association between tooth loss and bone mineral density in Brazilian postmenopausal women. J Clin Med Res 2011; 3:118-23. [PMID: 21811542 PMCID: PMC3138408 DOI: 10.4021/jocmr513w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2011] [Indexed: 11/29/2022] Open
Abstract
Background To evaluate oral health in postmenopausal women and verify whether there is a correlation between tooth loss according to index of decayed, missing, filled teeth (DMFT) and bone mineral density (BMD). Methods A cross-sectional study was conducted with 100 women. The DMFT and its associations with lumbar and femoral BMD (T-score and g/cm2) were assessed. Analysis of covariance and multiple logistic regression were applied and the mean and standard deviation, absolute and relative frequencies (percentages) were obtained. Results The analysis of covariance (ANCOVA) revealed significant association between the DMFT index and bone mass (T-score), compared to the young adult in L2-L4 (P = 0.0252) and in bone mass in L2-L4 (below average) in g/cm2 and in the DMFT index (P = 0.0332), and for women with bone mass below the average index DMFT was higher. Between L2-L4 below average (g/cm2) and extracted component (P = 0.0483) association was also significant because women with bone mass below the average had a greater extracted component. Conclusions Postmenopausal women with poor oral health may present reduced bone mass. There was significant association between BMD and DMFT at the L2-L4 site. Women must be advised that their good oral health, amount and quality of bone mass should also be matters of concern. Keywords Bone mineral density; Post-menopausal; Osteoporosis; Tooth loss
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Persson GR, Berglund J, Persson RE, Renvert S. Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis. Bone 2011; 48:552-6. [PMID: 20951243 DOI: 10.1016/j.bone.2010.09.237] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 08/25/2010] [Accepted: 09/29/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. MATERIALS AND METHODS Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. RESULTS 788 Caucasians (52.4% women, overall mean age: 76 years, S.D.± 9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3 years. Calcaneus PIXI T-values < -1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p < 0.001). Older persons with osteoporosis had more severe periodontitis (p < 0.01). Periodontitis defined by ≥ 30% of sites with ≥ 5 mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p < 0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value < -2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p < 0.001). CONCLUSIONS Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures.
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Affiliation(s)
- G Rutger Persson
- Department of Periodontology, University of Bern, Bern, Switzerland
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Kyrgidis A, Tzellos TG, Toulis K, Antoniades K. The facial skeleton in patients with osteoporosis: a field for disease signs and treatment complications. J Osteoporos 2011; 2011:147689. [PMID: 21403823 PMCID: PMC3042625 DOI: 10.4061/2011/147689] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Revised: 12/31/2010] [Accepted: 01/15/2011] [Indexed: 01/04/2023] Open
Abstract
Osteoporosis affects all bones, including those of the facial skeleton. To date the facial bones have not drawn much attention due to the minimal probability of morbid fractures. Hearing and dentition loss due to osteoporosis has been reported. New research findings suggest that radiologic examination of the facial skeleton can be a cost-effective adjunct to complement the early diagnosis and the follow up of osteoporosis patients. Bone-mass preservation treatments have been associated with osteomyelitis of the jawbones, a condition commonly described as osteonecrosis of the jaws (ONJ). The facial skeleton, where alimentary tract mucosa attaches directly to periosteum and teeth which lie in their sockets of alveolar bone, is an area unique for the early detection of osteoporosis but also for the prevention of treatment-associated complications. We review facial bone involvement in patients with osteoporosis and we present data that make the multidisciplinary approach of these patients more appealing for both practitioners and dentists. With regard to ONJ, a tabular summary with currently available evidence is provided to facilitate multidisciplinary practice coordination for the treatment of patients receiving bisphosphonates.
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Affiliation(s)
- Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
- Department of Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Thrasivoulos-George Tzellos
- Department of Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Konstantinos Toulis
- Department of Endocrinology, 424 Military Hospital, Thessaloniki 56429, Greece
| | - Konstantinos Antoniades
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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Tamai R, Sugiyama A, Kiyoura Y. Alendronate regulates cytokine production induced by lipid A through nuclear factor-κB and Smad3 activation in human gingival fibroblasts. J Periodontal Res 2011; 46:13-20. [DOI: 10.1111/j.1600-0765.2010.01302.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pizzo G, Guiglia R, Lo Russo L, Campisi G. Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept. Eur J Intern Med 2010; 21:496-502. [PMID: 21111933 DOI: 10.1016/j.ejim.2010.07.011] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 07/14/2010] [Indexed: 01/07/2023]
Abstract
During past decades the relationship between dentistry and internal medicine and especially the concept of the so-called focal infection theory have long been a matter of debate. The pathogenesis of focal diseases has been classically attributed to dental pulp pathologies and periapical infections. Nonetheless, in recent years, their role is being dismissed while increasing interest is being devoted to the possible associations between periodontal infection and systemic diseases. In fact, periodontal pathogens and their products, as well as inflammatory mediators produced in periodontal tissues, might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. On the basis of this mechanism, chronic periodontitis has been suggested as a risk factor for cardiovascular diseases associated with atherosclerosis, bacterial endocarditis, diabetes mellitus, respiratory disease, preterm delivery, rheumatoid arthritis, and, recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. Various hypotheses, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. This narrative review summarizes the evolution of focal infection theory up to the current pathophysiology of periodontal disease, and presents an update on the relationships between chronic periodontitis and systemic diseases.
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Affiliation(s)
- Giuseppe Pizzo
- Section of Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Al Habashneh R, Alchalabi H, Khader YS, Hazza'a AM, Odat Z, Johnson GK. Association between periodontal disease and osteoporosis in postmenopausal women in jordan. J Periodontol 2010; 81:1613-21. [PMID: 20681809 DOI: 10.1902/jop.2010.100190] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Some studies suggest that females with osteoporosis are at an increased risk of periodontal attachment loss and tooth loss; however, results have varied. The aim of this study is to determine the relationship between periodontitis and osteoporosis among postmenopausal Jordanian women. METHODS This cross-sectional study includes 400 Jordanian postmenopausal women with a mean age of 62.5 years (SD ± 6.4 years). These subjects were recruited from patients who had received a routine dual-energy x-ray absorptiometry examination in the Radiology Department, King Abdullah Hospital, Jordan University of Science and Technology, between June 2008 and February 2009. The relationship between skeletal bone mineral density (BMD) and radiographic and clinical parameters of periodontal status, including the loss of alveolar crestal height (ACH), clinical attachment level, probing depth, and percentage of sites with bleeding on probing, was evaluated after controlling for known confounders. RESULTS Bivariate analyses revealed no significant differences in the severity and extent of clinical attachment and ACH loss among women with normal BMD, osteopenia, and osteoporosis. However, in the multivariate analysis, women with osteoporosis were more likely to have severe ACH loss (odds ratio [OR]: 4.20; 95% confidence interval [CI]: 1.57 to 11.22) and periodontitis (OR: 2.45; 95% CI: 1.38 to 4.34). CONCLUSION Osteoporosis was significantly associated with severe alveolar crestal bone loss and the prevalence of periodontitis cases in postmenopausal Jordanian women.
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Affiliation(s)
- Rola Al Habashneh
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Haas AN, Rösing CK, Oppermann RV, Albandar JM, Susin C. Association among menopause, hormone replacement therapy, and periodontal attachment loss in southern Brazilian women. J Periodontol 2009; 80:1380-7. [PMID: 19722786 DOI: 10.1902/jop.2009.090082] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the association among menopause, hormone replacement therapy (HRT), and periodontal attachment loss (PAL). METHODS Three hundred twenty-eight women (40 to 69 years old) who participated in a previous oral survey in South Brazil were included. Women who reported not having their monthly menstrual cycles for >or=12 months were classified as postmenopausal. Postmenopausal women were categorized according to HRT. Women with >or=30% teeth with PAL >or=5 mm were classified as having periodontitis. The data were analyzed using a multivariable logistic regression model and adjusted for age, smoking, socioeconomic status, and dental care. RESULTS The prevalence of periodontitis was significantly greater among postmenopausal women not using HRT (HRT-) than among premenopausal women (64.4% versus 46.3%; P = 0.005). Similarly, the multivariable analysis demonstrated a significantly higher chance of having periodontitis in postmenopausal HRT- women than in premenopausal women (odds ratio [OR], 2.1; 95% confidence interval [CI]: 1.1 to 4.0). In contrast, no significant differences were observed in the prevalence of periodontitis between postmenopausal women using HRT (HRT+) and premenopausal women (48.8% versus 46.3%; P = 0.77). After adjusting for cofactors, postmenopausal HRT+ women did not have a greater likelihood of having periodontitis than premenopausal women (OR, 1.2; 95% CI: 0.6 to 2.5). No significant differences in tooth loss were observed among the study groups after adjusting for confounders. CONCLUSIONS Postmenopausal HRT- women had a greater chance of having periodontitis than premenopausal women. In contrast, postmenopausal HRT+ women and premenopausal women had similar periodontal status. HRT may have a beneficial effect on periodontal health.
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Affiliation(s)
- Alex N Haas
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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SEM analysis of dental enamel morphological structures on the basis of their replicas in patients with systemic calcium deficiency. Open Life Sci 2009. [DOI: 10.2478/s11535-009-0007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractThe aim of the present study is to examine microscopically the surface of dental enamel by using a scanning electron microscope (SEM), using their replicas formed in female patients with diagnosed periodontal diseases and systemic calcium deficiency. Replicas of dental enamel surfaces in patients referred for treatment of periodontal diseases were subjected to microscopic analysis. The replicas, after coating with platinum-palladium alloy, were examined under the scanning electron microscope at magnifications of 15–5000 x. Densitometric examinations of spine (L2 - L4 segment) revealed bone mineral density BMD T-score lower than −2.5 in 5 patients, in the range of −1.5 to −2.5 in 10 patients, and higher than −1.5 in the remaining patients. Non-homogenous images of surfaces in the form of light and dark areas were observed. Light areas corresponded to damaged surfaces of dental tissues. Patients with higher systemic calcium deficiency had areas lighter in color. More of these areas were found in patients with higher systemic calcium deficiency. It can be assumed that the calcium deficit is likely to appear in the selected dental tissues, particularly in the dental enamel.
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Abstract
BACKGROUND Osteoporosis is a common disease in middle-aged and older Americans. The risk of sustaining fractures is a concern, and mortality rates after hip or vertebral fractures are high. Oral health maintenance for adults with osteoporosis is important. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search of the medical and dental literature with the objective of reviewing osteoporosis, its effect on public health in the population in the United States and the implications in providing dental care for these patients. They selected studies by performing a content search with National Library of Medicine medical subject headings (epidemiology, public health impact, treatment, adverse drug reactions, cost-effectiveness of osteoporosis therapy, oral health, periodontal disease, adverse drug reactions, bisphosphonates and osteonecrosis of the jaw). They then performed a study design search with a filter so that only randomized clinical trials were included. RESULTS Osteoporosis and related fractures are more common than coronary disease, stroke and breast cancer. Fractures resulting from osteoporosis can affect a patient's quality of life severely, and fractures result in functional impairment and increased health care cost and mortality. Medical management of osteoporosis includes diet control, with appropriate intake of calcium and vitamin D, weight-bearing exercise, discontinuation of tobacco and alcohol intake, and use of medications, including selective estrogen receptor modulators, calcitonin, anabolic agents and bisphosphonates. Bisphosphonates have been associated with the development of osteonecrosis of the jaws. CLINICAL IMPLICATIONS Oral health maintenance is important in patients with osteoporosis. Bisphosphonate therapy or other medical treatment for these people should be discontinued only after consultation with the patient's physician.
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Effect of estrogen receptor beta on the osteoblastic differentiation function of human periodontal ligament cells. Arch Oral Biol 2008; 53:553-7. [PMID: 18261710 DOI: 10.1016/j.archoralbio.2007.12.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2007] [Revised: 12/06/2007] [Accepted: 12/22/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the effect of estrogen receptor beta (ERbeta) on osteoblastic differentiation function of human periodontal ligament (hPDL) cells by measuring the alkaline phosphatase (ALP) activity and the production of osteocalcin (OCN) in vitro. DESIGN We employed a short interfering RNA (siRNA) technique to inhibit ERbeta expression in hPDL cells; the cells were cultured with a saturating concentration of 17beta-estradiol (10(-7)M). ALP activity was analysed by colorimetric assay using ALP kit and the amount of OCN was assessed by osteocalcin ELISA kit. RESULTS It was shown that estradiol significantly enhanced the ALP activity and the production of OCN in hPDL cells. However, the ALP activity and the production of OCN in hPDL-siERbeta cells were not significantly changed after estradiol treatment. CONCLUSIONS These results indicate that ERbeta may play important roles in estrogen-induced effects on osteoblastic differentiation function of PDL cells and estrogen influences the bone formation capacity of PDL cells mainly via ERbeta.
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