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Bertoldi C, Salvatori R, Pinti M, Mattioli AV. Could the periodontal therapy improve the cardiologic patient health? A narrative review. Curr Probl Cardiol 2024; 49:102699. [PMID: 38852913 DOI: 10.1016/j.cpcardiol.2024.102699] [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: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Cardiovascular diseases (CVD) is the major cause of mortality globally, with increasing evidence suggesting a link between periodontitis, and CVD. This study aims to explore the association between periodontitis and CVD, and the impact of periodontal therapy on cardiovascular health. METHODS This review synthesized findings from preclinical and clinical studies, without publication year restrictions, examining periodontitis and CVD through various lenses. Scientific databases were inspected with keywords related to periodontitis and CVD. RESULTS The review identifies a substantial association between periodontitis and an increased risk of several CVD, supported by both epidemiological and interventional studies. Results suggest the complexity of the relationship, influenced by factors like the severity of periodontitis and the presence of other systemic conditions. Clinical data indicates that periodontal therapy, particularly non-surgical periodontal therapy, may reduce systemic inflammatory markers and thus may play a role in the primary and secondary prevention of CVD events, highlighting the potential of periodontal therapy to not only maintain oral health but also to modulate cardiovascular risk factors. CONCLUSIONS Current evidence supports a significant association between periodontitis and increased cardiovascular risk, promoting integrated healthcare approaches that consider oral health as a key-component of cardiovascular care and wellbeing.
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Affiliation(s)
- Carlo Bertoldi
- Department, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena MO, Italy
| | - Roberta Salvatori
- Department of Childhood and Adult Medical and Surgical Sciences, Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia, Modena MO, Italy.
| | - Marcello Pinti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena MO, Italy
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Unlu O, Demirci M, Paksoy T, Eden AB, Tansuker HD, Dalmizrak A, Aktan C, Senel F, Sunter AV, Yigit O, Cakir BO, Kantarci A. Oral microbial dysbiosis in patients with oral cavity cancers. Clin Oral Investig 2024; 28:377. [PMID: 38884817 PMCID: PMC11182825 DOI: 10.1007/s00784-024-05770-8] [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: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES The pathogenesis of oral cavity cancers is complex. We tested the hypothesis that oral microbiota dysbiosis is associated with oral cavity cancer. MATERIALS AND METHODS Patients with primary oral cavity cancer who met the inclusion and exclusion criteria were included in the study. Matching healthy individuals were recruited as controls. Data on socio-demographic and behavioral factors, self-reported periodontal measures and habits, and current dental status were collected using a structured questionnaire and periodontal chartings. In addition to self-reported oral health measures, each participant received a standard and detailed clinical examination. DNA was extracted from saliva samples from patients and healthy controls. Next-generation sequencing was performed by targeting V3-V4 gene regions of the 16 S rRNA with subsequent bioinformatic analyses. RESULTS Patients with oral cavity cancers had a lower quality of oral health than healthy controls. Proteobacteria, Aggregatibacter, Haemophilus, and Neisseria decreased, while Firmicutes, Bacteroidetes, Actinobacteria, Lactobacillus, Gemella, and Fusobacteria increased in oral cancer patients. At the species level, C. durum, L. umeaens, N. subflava, A. massiliensis, and V. dispar were significantly lower, while G. haemolysans was significantly increased (p < 0.05). Major periodontopathogens associated with periodontal disease (P. gingivalis and F.nucleatum) increased 6.5- and 2.8-fold, respectively. CONCLUSION These data suggested that patients with oral cancer had worse oral health conditions and a distinct oral microbiome composition that is affected by personal daily habits and may be associated with the pathogenicity of the disease and interspecies interactions. CLINICAL RELEVANCE This paper demonstrates the link between oral bacteria and oral cancers, identifying mechanistic interactions between species of oral microbiome.
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Affiliation(s)
- Ozge Unlu
- Faculty of Medicine, Department of Medical Microbiology, Istanbul Atlas University, Istanbul, Turkey.
- ADA Forsyth Institute, Cambridge, MA, USA.
| | - Mehmet Demirci
- Faculty of Medicine, Department of Medical Microbiology, Kırklareli University, Kırklareli, Turkey
| | - Tugce Paksoy
- Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - Arzu Baygul Eden
- Faculty of Medicine, Department of Biostatistics, Koc University, Istanbul, Turkey
| | - Hasan Deniz Tansuker
- Faculty of Medicine, Department of Otolaryngology, Yeditepe University, Istanbul, Turkey
| | - Aysegul Dalmizrak
- Faculty of Medicine, Department of Medical Biology, Balıkesir University, Balıkesir, Turkey
| | - Cagdas Aktan
- Faculty of Medicine, Department of Medical Biology, Bandirma University, Balıkesir, Turkey
| | - Firdevs Senel
- Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Beykent University, Istanbul, Turkey
| | - Ahmet Volkan Sunter
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Ozgur Yigit
- Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Burak Omur Cakir
- Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Istanbul Aydin University, Istanbul, Turkey
| | - Alpdogan Kantarci
- ADA Forsyth Institute, Cambridge, MA, USA
- School of Dental Medicine, Harvard University, Boston, MA, USA
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Ahmad P, Escalante-Herrera A, Marin LM, Siqueira WL. Progression from healthy periodontium to gingivitis and periodontitis: Insights from bioinformatics-driven proteomics - A systematic review with meta-analysis. J Periodontal Res 2024. [PMID: 38873831 DOI: 10.1111/jre.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/15/2024]
Abstract
AIM The current study aimed to: (1) systematically review the published literature regarding the proteomics analyses of saliva and gingival crevicular fluid (GCF) in healthy humans and gingivitis and/or periodontitis patients; and (2) to identify the differentially expressed proteins (DEPs) based on the systematic review, and comprehensively conduct meta-analyses and bioinformatics analyses. METHODS An online search of Web of Science, Scopus, and PubMed was performed without any restriction on the year and language of publication. After the identification of the DEPs reported by the included human primary studies, gene ontology (GO), the Kyoto encyclopedia of genes and genomes pathway (KEGG), protein-protein interaction (PPI), and meta-analyses were conducted. The risk of bias among the included studies was evaluated using the modified Newcastle-Ottawa quality assessment scale. RESULTS The review identified significant differences in protein expression between healthy individuals and those with gingivitis and periodontitis. In GCF, 247 proteins were upregulated and 128 downregulated in periodontal diseases. Saliva analysis revealed 79 upregulated and 70 downregulated proteins. There were distinct protein profiles between gingivitis and periodontitis, with 159 and 31 unique upregulated proteins in GCF, respectively. Meta-analyses confirmed significant upregulation of various proteins in periodontitis, including ALB and MMP9, while CSTB and GSTP1 were downregulated. AMY1A and SERPINA1 were upregulated in periodontitis saliva. HBD was upregulated in gingivitis GCF, while DEFA3 was downregulated. PPI analysis revealed complex networks of interactions among DEPs. GO and KEGG pathway analyses provided insights into biological processes and pathways associated with periodontal diseases. CONCLUSION The ongoing MS-based proteomics studies emphasize the need for a highly sensitive and specific diagnostic tool for periodontal diseases. Clinician acceptance of the eventual diagnostic method relies on its ability to provide superior or complementary information to current clinical assessment procedures. Future research should prioritize the multiplex measurement of multiple biomarkers simultaneously to enhance diagnostic accuracy and large study cohorts are necessary to ensure the validity and reliability of research findings.
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Affiliation(s)
- Paras Ahmad
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Lina M Marin
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Walter L Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Xiao K, Chen L, Mao Y, Bao H, Chen W, Li X, Wu Y. Expression of visfatin in gingival crevicular fluid and gingival tissues in different periodontal conditions: a cross-sectional study. BMC Oral Health 2024; 24:514. [PMID: 38698364 PMCID: PMC11064311 DOI: 10.1186/s12903-024-04299-2] [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: 02/25/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Studies have shown that visfatin is an inflammatory factor closely related to periodontitis. We examined the levels of visfatin in gingival crevicular fluid (GCF) and gingival tissues under different periodontal conditions, in order to provide more theoretical basis for exploring the role of visfatin in the pathogenesis of periodontitis. METHODS We enrolled 87 subjects, with 43 in the chronic periodontitis (CP) group, 21 in the chronic gingivitis (CG) group, and 23 in the periodontal health (PH) group. Periodontal indexes (PD, AL, PLI, and BI) were recorded. GCF samples were collected for visfatin quantification, and gingival tissues were assessed via immunohistochemical staining. RESULTS Visfatin levels in GCF decreased sequentially from CP to CG and PH groups, with statistically significant differences (P < 0.05). The CP group exhibited the highest visfatin levels, while the PH group had the lowest. Gingival tissues showed a similar trend, with significant differences between groups (P < 0.001). Periodontal indexes were positively correlated with visfatin levels in both GCF and gingival tissues (P < 0.001). A strong positive correlation was observed between visfatin levels in GCF and gingival tissues (rs = 0.772, P < 0.001). CONCLUSION Greater periodontal destruction corresponded to higher visfatin levels in GCF and gingival tissues, indicating their potential collaboration in damaging periodontal tissues. Visfatin emerges as a promising biomarker for periodontitis and may play a role in its pathogenesis.
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Affiliation(s)
- Kang Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ling Chen
- Stomatological Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Stomatological Center, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Yudian Mao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Han Bao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Weirong Chen
- Stomatological Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Stomatological Center, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Xiang Li
- Stomatological Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Stomatological Center, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China
| | - Yun Wu
- Stomatological Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
- Stomatological Center, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
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Daluz A, Saliba-Serre B, Foti B, Lan R. Age estimation from alveolar bone loss, re-evaluation of Ruquet's method. Forensic Sci Med Pathol 2024; 20:79-88. [PMID: 37061600 DOI: 10.1007/s12024-023-00617-2] [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] [Accepted: 03/15/2023] [Indexed: 04/17/2023]
Abstract
There are many dental age estimation methods, but all the methods do not correspond, especially for aging methods for adults and mature individuals, to the reality of the forensic field, which favors simple, effective, and easy-to-use methods. Ruquet (2015) developed a method based on alveolar bone loss that predicts age for individuals between 25 and 60 years old and is even more accurate for those 25-40 years old. This study re-evaluated Ruquet's alveolar bone loss method using three-dimensional imaging of individuals whose age and sex were known, without taking into account their medical conditions. Digital measurements, from the cemento-enamel junction (CEJ) to the alveolar bone crest (ABC), were performed on the mesial and distal surfaces of teeth on 243 patients, independent of the tridimensional imaging test. With these measurements, two alveolar bone loss averages (ABL) were calculated, one with all the teeth present on the arches and another with only Ramfjörd's teeth. Bone loss showed a significant correlation with age (p < 0.001). The age estimation with all teeth and with only Ramfjörd's teeth showed a statistically significant difference, and age estimation was more accurate when all teeth were used. The assessment of alveolar resorption appears to be an interesting tool for age estimation in adult individuals. However, the method still lacks precision, and the mean absolute errors (MAEs) obtained by age group were all greater than 5 years, except for the age group 35-39 years old, for the age estimation with all teeth. Further studies should explore this existing correlation between alveolar bone loss and age and refine this method to make it more accurate.
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Affiliation(s)
- Auréliane Daluz
- Aix Marseille Université, CNRS, EFS, ADÉS, faculté des sciences médicales et paramédicales, secteur Nord, bât. A, CS 80011, 51, bld Pierre-Dramard, F-13344, Marseille Cedex 15, France.
| | - Bérengère Saliba-Serre
- Aix Marseille Université, CNRS, EFS, ADÉS, faculté des sciences médicales et paramédicales, secteur Nord, bât. A, CS 80011, 51, bld Pierre-Dramard, F-13344, Marseille Cedex 15, France
| | - Bruno Foti
- Aix Marseille Université, CNRS, EFS, ADÉS, faculté des sciences médicales et paramédicales, secteur Nord, bât. A, CS 80011, 51, bld Pierre-Dramard, F-13344, Marseille Cedex 15, France
- Assistance publique Hôpitaux de Marseille, CHU Timone, Pôle odontologie, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
| | - Romain Lan
- Aix Marseille Université, CNRS, EFS, ADÉS, faculté des sciences médicales et paramédicales, secteur Nord, bât. A, CS 80011, 51, bld Pierre-Dramard, F-13344, Marseille Cedex 15, France
- Assistance publique Hôpitaux de Marseille, CHU Timone, Pôle odontologie, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
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Muacevic A, Adler JR, Nair SV. Prevalence of Chronic Periodontitis and Chronic Stress in the South Indian Population. Cureus 2023; 15:e33215. [PMID: 36733568 PMCID: PMC9888594 DOI: 10.7759/cureus.33215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2023] [Indexed: 01/02/2023] Open
Abstract
Background Chronic stress is commonly thought to have a net negative effect on the efficacy of the immune response, leading to an imbalance between host and parasite and consequently resulting in a periodontal breakdown. Aim To identify the prevalence of chronic periodontitis and chronic stress as well as a comparative evaluation of clinical, demographic, and psychoanalytical parameters among the South Indian population. Materials and methods A total of 500 subjects between the ages of 30 and 60 were chosen from the Trivandrum district, Kerala, using multistage random sampling. Subjects were evaluated based on psychoanalytical parameters as well as periodontal examination. Psychoanalytical parameters were measured by the questionnaire method using the perceived stress scale. Periodontal parameters examined were the probing depth, clinical attachment loss, bleeding on probing, simplified oral hygiene index, and community periodontal index (loss of attachment). Statistical Analysis Categorical and quantitative variables were expressed as frequency (percentage) and mean ± SD respectively. Logistic regression analysis was used to analyze the association between the periodontal variables and psychoanalytical variables. All the statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows (IBM Corp., USA). Results A total of 500 subjects, of whom 308 (61.6%) were female and 192 (38.1%) were male, participated in this study. The overall prevalence of periodontitis among all the subjects was found to be 42.4%, and the proportion of periodontitis among the stressed participants was found to be 46.2%, which is 10% higher compared to the non-stressed (36.1%) participants. Conclusion Our study showed an increased frequency of periodontitis among the stressed subjects as compared to the non-stressed subjects. These findings suggest that there is a positive association between chronic stress and chronic periodontitis, but further prospective studies are required to establish the extent of the effect chronic stress has on chronic periodontitis and vice versa.
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Accurate gingival recession quantification using 3D digital dental models. Clin Oral Investig 2022; 27:1697-1705. [PMID: 36424472 PMCID: PMC10102060 DOI: 10.1007/s00784-022-04795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022]
Abstract
Abstract
Objectives
To develop and validate a method for accurate quantitative assessment of gingival recessions based on superimposition of serial 3D digital models.
Materials and methods
Gingival recessions of mild (0.5–2 mm) and increased (3–7 mm) severity were simulated on stone casts and surface models were created. The outlines of the gingival margins of the mild (A) and severe recessions (B) were compared to the original gingival margins following 3D best fit superimposition through a gold standard technique (GS), which used intact adjacent structures, and the tested method (CC), which used single tooth crowns at the position of recessions, as superimposition reference. The primary outcome was the distance between the most apical point of each corresponding gingival margin along the respective tooth long axis.
Results
For mild recessions, the median difference of the test methods (CC_A) from the reference method (GS_A) was 0.008 mm (IQR: 0.093; range: − 0.143, 0.147). For severe recessions, the median difference of the test method (CC_B) from the reference method (GS_B) was 0.009 mm (IQR: 0.091; range: − 0.170, 0.198). The proposed method (CC) showed very high intra- and inter-operator reproducibility (median: 0.025 and 0.033 mm, respectively).
Conclusions
The suggested method offers highly accurate monitoring of gingival margin changes and diagnosis of gingival recessions using 3D digital dental models. The method is applicable irrespective of changes in tooth position or form, allowing for assessments over any time span.
Clinical relevance
The accurate detection and visualization of gingival margin changes in 3D will enhance diagnosis and patient-doctor communication.
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A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness. Psychosom Med 2022; 84:836-847. [PMID: 35797566 DOI: 10.1097/psy.0000000000001102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Periodontal disease represents a global public health concern, with a disproportionate burden being borne by vulnerable populations. One such group is people with severe mental illness (SMI), and this study examined whether periodontal health is poorer in people with SMI than the general population. METHODS We conducted a systematic search for studies published before March 2021 on the periodontal health of people with SMI using the following databases: PubMed, PsycINFO, EMBASE, China National Knowledge Infrastructure, and Chongqing VIP. Outcomes were periodontitis, periodontal disease, and shallow and deep periodontal pockets. Results were compared with the general population. RESULTS Seventeen studies had sufficient data for a random-effects meta-analysis, consisting of 4404 psychiatric patients and 95,411 controls. SMI was associated with an increased prevalence of periodontitis (odds ratio = 1.97, 95% confidence interval [CI] = 1.15-3.35) compared with the general population. People with SMI had 4.28 the odds of having periodontal disease compared with controls (95% CI = 2.54-7.21). They also had 3.65 the odds of shallow pockets (95% CI = 1.80-7.42) and 2.76 the odds of deep pockets (95% CI = 1.10-6.93). CONCLUSIONS Our findings highlight the increased prevalence and severity of periodontal disease in people with SMI. Oral health is often considered the gateway to overall health and should be a public health priority for this population.
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Sato Y, Yoshioka E, Takekawa M, Saijo Y. Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan. PeerJ 2022; 10:e13792. [PMID: 35891644 PMCID: PMC9308962 DOI: 10.7717/peerj.13792] [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: 04/22/2022] [Accepted: 07/05/2022] [Indexed: 01/17/2023] Open
Abstract
Background Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss. Methods This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status. Results Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models. Conclusion ERI at work was associated with an increased risk of poor periodontal status.
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Affiliation(s)
- Yukihiro Sato
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Eiji Yoshioka
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Masanori Takekawa
- Department of Oral and Maxillo-Facial Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Belay AS, Achimano AA. Prevalence and Risk Factors for Periodontal Disease Among Women Attending Antenatal Care in Public Hospitals, Southwest Ethiopia, 2022: A Multicenter Cross-Sectional Study. Clin Cosmet Investig Dent 2022; 14:153-170. [PMID: 35698646 PMCID: PMC9188398 DOI: 10.2147/ccide.s367713] [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: 03/24/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Periodontal disease is characterized by the inflammation of all tissues that surround and support the teeth, and it is the most common public health problem worldwide. It has many different contributing factors, such as poor oral hygiene, smoking, anemia, bacterial plaque, poor economic status, and nutritional deficiency. It also causes different feto-maternal complications like preeclampsia, gestational diabetes, preterm labor, low birth weight, and early abortion. Thus, this study aimed to assess the prevalence and associated factors of periodontal disease among pregnant women. Methods A cross-sectional study was conducted among 618 women at public hospitals in the Southwest Ethiopia. Data were collected using a systematic random sampling method and a structured interviewer administered questionnaire. The data were entered into Epi-Data Manager 4.2 and then transferred to a statistical package for social science (SPSS) version 21 for analysis. The logistic regression analysis was done to see the significant association between each predictor with periodontal disease by considering a p-value of <0.05 and a CI of 95%. Results A total of 618 women attending ANC with a 100% response rate were enrolled in this study. The mean and standard deviation of the age of the study participants was 31.07 ± 7.8 years. The periodontal disease was observed among 240 (38.8%) of the total participants with 95% C.I of (35%, 43%). Predictors like rural residency, women who could not read and write, women with poor wealth index, nutritional status of underweight, had no information about periodontal disease, depression, history of diabetes mellitus, self-perceived halitosis, no history of ANC, and lower gestational age were found to be significantly associated with periodontal disease. Conclusion In this study, the prevalence of periodontal disease was found to be significantly higher. Therefore, in order to minimize the burden of periodontal disease among pregnant women, oral, medical, and mental health education should be promoted.
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Affiliation(s)
- Alemayehu Sayih Belay
- Mizan Tepi University, College of Medicine and Health Sciences, Department of Nursing, Mizan Aman, Ethiopia
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Kim H, Lee E, Lee SW. Association between oral health and frailty: results from the Korea National Health and Nutrition Examination Survey. BMC Geriatr 2022; 22:369. [PMID: 35477396 PMCID: PMC9044774 DOI: 10.1186/s12877-022-02968-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous research has suggested that poor oral health is positively associated with frailty. The objective of this study was to explore associations of key oral diseases (periodontal disease, tooth loss), and oral hygiene and management behaviors with the level of frailty in community-dwelling older Korean adults using national representative survey data. Methods This study used cross-sectional, 6th and 7th Korea National Health and Nutrition Examination Survey (KNHANES VI, VII) data. Adults aged 50+ years were included. Frailty was measured using frailty phenotype (FP) and frailty index (FI). FP was determined using five frailty criteria, i.e., weight loss, weakness, exhaustion, slowness, or low physical activity, and the level of frailty was classified with the number of criteria present (robust, none; pre-frail, 1–2; frail, 3+). FI was determined using a 44-item FI constructed according to a standard protocol, and the level of frailty was classified as robust (FI: ≤ 0.08), pre-frail (FI: 0.08–0.25), and frail (FI: ≥ 0.25). Multiple ordinal regression analyses were conducted with each type of frailty as the outcome variable. Independent variables of interest were the periodontal status, number of teeth, and practices on oral hygiene and management. Analyses were additionally adjusted for participants’ socioeconomic, diet, and behavioral characteristics. Results The prevalence of frailty was 4.38% according to the FP classification (n = 4156), 10.74% according to the FI classification (n = 15,073). In the final adjusted model, having more teeth and brushing after all three meals were significantly associated with lower odds of being more frail (in both frailty models); no significant association was observed between periodontal disease and frailty. Conclusions Findings from this study show having more teeth and practicing adequate brushing are significantly associated with frailty. Due to limitations of the study design, well-designed longitudinal studies are needed to confirm these findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02968-x.
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Affiliation(s)
- Hyunjoo Kim
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
| | - Seok-Woo Lee
- Department of Dental Education and Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, 61186, Republic of Korea.
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Accuracy of Estimating Periodontitis and Its Risk Association Using Partial-Mouth Recordings for Surveillance Studies: A Systematic Review and Meta-Analysis. Int J Dent 2022; 2022:7961199. [PMID: 35342426 PMCID: PMC8947864 DOI: 10.1155/2022/7961199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Our aim is to conduct an up-to-date systematic review and meta-analysis pertaining to the accuracy of using the partial-mouth recording protocol (PRP) in surveillance studies to estimate the periodontitis prevalence, extent, severity, and its risk associations. Methods Medline and Embase databases were searched for studies which assessed the periodontitis prevalence, severity, extent, or its risk associations using PRPs versus full-mouth recording protocols (FRPs); searches were conducted up until May 26, 2021. The risk of bias and the applicability of the studies were assessed using the QUADAS-2 tool. Both qualitative data synthesis and quantitative data synthesis were performed, and comparisons were done for the accuracy and precision of PRPs for different periodontitis outcomes. The study's protocol was registered through the International Platform of Registered Systematic Review and Meta-analysis Protocols (registration number: INPLASY202160032). Results A total of 14 studies were included. The studies had a considerable degree of heterogeneity, along with a moderate risk of bias and applicability concerns. Several factors influenced the accuracy or precision of using PRPs, including the age, distribution of periodontitis in the studied population, PRP selection, total PRP sites, the threshold for minimum sites with CAL, and the severity of periodontitis case definitions. Overall, the PRP with the highest accuracy and precision mainly included (1) a full-mouth protocol at the following partial sites: mesiobuccal-midbuccal-distolingual (MB-B-DL), mesiobuccal-distolingual (MB-DL), mesiobuccal-midbuccal-distobuccal (MB-B-DB), mesiobuccal-distobuccal (MB-DB), and 84 sites using the random site selection method (RSSM) and (2) random-half-mouth (RHM) protocols. Conclusions The PRPs with the highest overall accuracy and precision in estimating the periodontitis prevalence, extent, severity, and risk associations included the full-mouth assessment at the following partial sites: MB-B-DL, MB-DL, MB-B-DB, MB-DB, and 84 sites using RSSM and RHM protocols.
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13
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Brito LF, Taboza ZA, Silveira VR, Teixeira AK, Rego RO. Diagnostic accuracy of severe periodontitis case definitions: Comparison of the CDC/AAP, EFP/AAP, and CPI criteria. J Periodontol 2021; 93:867-876. [PMID: 34494266 DOI: 10.1002/jper.21-0365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/07/2021] [Accepted: 08/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND This cross-sectional study aimed to evaluate the diagnostic accuracy of severe periodontitis by three different case definitions. METHODS Patients aged >35 years (n = 243, mean age = 47.8 ± 9.3 years) were evaluated by periodontal examinations and classified in patients with severe periodontitis according to the case definition proposed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Academy of Periodontology (AAP)-CDC/AAP, the new periodontal disease classification proposed jointly by the AAP and the European Federation of Periodontology (EFP/AAP), and the Community Periodontal Index (CPI). The primary outcome was to compare the diagnostic accuracy of severe periodontitis between the three case definitions. Sensitivity (SS), specificity (SP), and area under the receiver operating characteristic (ROC) curve were used to analyze the accuracy. RESULTS The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 47.3%, type III and IV periodontitis (EFP/AAP) = 43.2% and CPI code 4 = 44.4%. When comparing the CDC/AAP case definitions with the EFP/AAP classification, SS, SP, and ROC of 81.7%, 91.4%, and 0.866 (CI, 95%: 0.816 to 0.916), respectively, were obtained. Similarly, when comparing CDC/AAP to CPI code 4, SS, SP, and ROC of 81.7%, 89.1%, and 0.854 (CI, 95%: 0.802 to 0.906), respectively, were obtained. When type III and IV periodontitis (EFP/AAP) was compared with CPI code 4, the values were 92.4%, 92%, and 0.922 (CI, 95%: 0.883 to 0.961), respectively. CONCLUSIONS The EFP/AAP classification and the CPI demonstrated high diagnostic accuracy with the CDC/AAP case definition to diagnose severe periodontitis.
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Affiliation(s)
- Liana F Brito
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Zuila A Taboza
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Virginia R Silveira
- Federal University of Ceara, School of Dentistry at Sobral, Department of Dentistry, Sobral, Ceara, Brazil
| | - Ana K Teixeira
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Rodrigo O Rego
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
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14
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Li W, Liang Y, Zhang X, Liu C, He L, Miao L, Sun W. A deep learning approach to automatic gingivitis screening based on classification and localization in RGB photos. Sci Rep 2021; 11:16831. [PMID: 34413332 PMCID: PMC8376991 DOI: 10.1038/s41598-021-96091-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/26/2021] [Indexed: 12/22/2022] Open
Abstract
Routine dental visit is the most common approach to detect the gingivitis. However, such diagnosis can sometimes be unavailable due to the limited medical resources in certain areas and costly for low-income populations. This study proposes to screen the existence of gingivitis and its irritants, i.e., dental calculus and soft deposits, from oral photos with a novel Multi-Task Learning convolutional neural network (CNN) model. The study can be meaningful for promoting the public dental health, since it sheds light on a cost-effective and ubiquitous solution for the early detection of dental issues. With 625 patients included in this study, the classification Area Under the Curve (AUC) for detecting gingivitis, dental calculus and soft deposits were 87.11%, 80.11%, and 78.57%, respectively; Meanwhile, according to our experiments, the model can also localize the three types of findings on oral photos with moderate accuracy, which enables the model to explain the screen results. By comparing to general-purpose CNNs, we showed our model significantly outperformed on both classification and localization tasks, which indicates the effectiveness of Multi-Task Learning on dental disease detection. In all, the study shows the potential of deep learning for enabling the screening of dental diseases among large populations.
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Affiliation(s)
- Wen Li
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China
| | - Yuan Liang
- University of California, Los Angeles, USA
| | - Xuan Zhang
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China
| | - Chao Liu
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Lei He
- University of California, Los Angeles, USA
| | - Leiying Miao
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China.
| | - Weibin Sun
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China.
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15
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Chen MX, Zhong YJ, Dong QQ, Wong HM, Wen YF. Global, regional, and national burden of severe periodontitis, 1990-2019: An analysis of the Global Burden of Disease Study 2019. J Clin Periodontol 2021; 48:1165-1188. [PMID: 34101223 DOI: 10.1111/jcpe.13506] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
AIM Up-to-date epidemiological studies on the global burden of severe periodontitis is scarce. This study aimed to present the latest estimates for prevalence of severe periodontitis from 1990 to 2019, by region, age, and level of socio-demographic development. MATERIALS AND METHODS Estimates from the Global Burden of Disease study 2019 were used to investigate burden and trends of prevalence of severe periodontitis and its association with socio-demographic development at global, regional, and national level. Decomposition analysis was performed to explore the contribution of demographic and epidemiological factors to the evolving burden of severe periodontitis. RESULTS In 2019, there were 1.1 billion (95% uncertainty interval: 0.8-1.4 billion) prevalent cases of severe periodontitis globally. From 1990 to 2019, age-standardized prevalence rate of severe periodontitis increased by 8.44% (6.62%-10.59%) worldwide. Prevalence of severe periodontitis is higher among less developed countries/regions. Global population growth accounted for 67.9% of the increase in the number of prevalent cases of severe periodontitis from 1990 to 2019. CONCLUSIONS The global burden of severe periodontitis has been substantial and increasing over the past three decades. Upstream policy changes are urgently needed to address the global public health challenge of severe periodontitis.
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Affiliation(s)
- Meng Xuan Chen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yu Jie Zhong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Qian Qian Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
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16
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Boese S, Gill HS. Coated floss for drug delivery into the gum pocket. Int J Pharm 2021; 606:120855. [PMID: 34224840 DOI: 10.1016/j.ijpharm.2021.120855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to develop a drug-coated floss to allow delivery of therapeutics into diseased gum pocket. Periodontal (gum) disease affects nearly 45% of adults over 30 years of age. Bacterial persistence makes treatment challenging. Drug-coated floss is expected to provide a self-administrable and targeted method for drug delivery into the diseased gum pockets. We investigated various types of floss and sutures as potential candidates to coat drug. An un-waxed nylon braided floss was selected and dip-coated with model hydrophilic and hydrophobic drugs either in free form or after encapsulation in poly(lactic-co-glycolic acid) particles. By tuning the drug concentration or the number of times a floss is dipped into the coating solution we were able to coat from as little as 0.4 μg to as high as 1.6 mg of drug. Coated floss was passed within the gum pocket of excised porcine mandibles to demonstrate delivery efficiency up to 91%. Utilizing the porcine jaw in an ex-vivo condition we illustrated the ability of the delivered drug to diffuse into the tissue. Overall, the data illustrates the potential of coated floss as an innovative modality for drug delivery to the gum pocket.
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Affiliation(s)
- Seth Boese
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Harvinder Singh Gill
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA.
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17
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Pitchika V, Jordan R, Micheelis W, Welk A, Kocher T, Holtfreter B. Impact of Powered Toothbrush Use and Interdental Cleaning on Oral Health. J Dent Res 2021; 100:487-495. [PMID: 33213272 PMCID: PMC8058831 DOI: 10.1177/0022034520973952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The long-term effectiveness of powered toothbrushes (PTBs) and interdental cleaning aids (IDAs) on a population level is unproven. We evaluated to what extent changes in PTB and IDA use may explain changes in periodontitis, caries, and tooth loss over the course of 17 y using data for adults (35 to 44 y) and seniors (65 to 74 y) from 3 independent cross-sectional surveys of the German Oral Health Studies (DMS). Oaxaca decomposition analyses assessed to what extent changes in mean probing depth (PD), number of caries-free surfaces, and number of teeth between 1) DMS III and DMS V and 2) DMS IV and DMS V could be explained by changes in PTB and IDA use. Between DMS III and V, PTB (adults: 33.5%; seniors: 28.5%) and IDA use (adults: 32.5%; seniors: 41.4%) increased along with an increase in mean PD, number of caries-free surfaces, and number of teeth. Among adults, IDA use contributed toward increased number of teeth between DMS III and V as well as DMS IV and V. In general, the estimates for adults were of lower magnitude. Among seniors between DMS III and V, PTB and IDA use explained a significant amount of explained change in the number of caries-free surfaces (1.72 and 5.80 out of 8.44, respectively) and the number of teeth (0.49 and 1.25 out of 2.19, respectively). Between DMS IV and V, PTB and IDA use contributed most of the explained change in caries-free surfaces (0.85 and 1.61 out of 2.72, respectively) and the number of teeth (0.25 and 0.46 out of 0.94, respectively) among seniors. In contrast to reported results from short-term clinical studies, in the long run, both PTB and IDA use contributed to increased number of caries-free healthy surfaces and teeth in both adults and seniors.
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Affiliation(s)
- V. Pitchika
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - R. Jordan
- Institute of German Dentists (IDZ), Cologne, Germany
| | - W. Micheelis
- Institute of German Dentists (IDZ), Cologne, Germany
| | - A. Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - T. Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B. Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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18
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Suwanprasit W, Lertpimonchai A, Thienpramuk L, Vathesatogkit P, Sritara P, Tamsailom S. Metabolic syndrome and severe periodontitis were associated in Thai adults: A cross-sectional study. J Periodontol 2021; 92:1420-1429. [PMID: 33590483 DOI: 10.1002/jper.20-0651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Studies support the relationship between metabolic syndrome (MetS) and periodontitis. However, age is the major confounding factor for both conditions. Therefore, this cross-sectional study was performed to investigate the relationship between MetS and severe periodontitis in different Thai adult age groups. METHODS Data on the medical history, medical examination, and full mouth oral examination of 5,690 Electricity Generating Authority of Thailand employees aged 25 to 77 years were collected. The prevalence ratio (PR) between risk variables, MetS, and periodontitis was determined using Poisson regression analysis. Moreover, the subgroup analysis and effect modification by age on severe periodontitis were performed. RESULTS Overall, MetS was significantly associated with severe periodontitis compared with non-severe periodontitis (adjusted PR, 1.11; 95% confidence interval [CI], 1.01 to 1.13). The association was modified by age, with negative effect modification observed on the multiplicative and additive scales. The subgroup analysis revealed a significant relationship between MetS and severe periodontitis only in participants aged <45 years with an adjusted PR of 1.69 (95% CI, 1.29 to 2.21). All MetS components, except hypertension, were associated with severe periodontitis in this group. CONCLUSIONS There is a significant relationship between MetS and severe periodontitis in adults aged <45 years. Therefore, attempts to control the risk of MetS and periodontitis should be emphasized for early adults to reduce the incidence of these conditions and related complications when they become elderly.
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Affiliation(s)
- Winita Suwanprasit
- Department of Periodontology, Center of Excellent in Periodontal Disease and Dental Implant, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Center of Excellent in Periodontal Disease and Dental Implant, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lalitsara Thienpramuk
- Health Division, Medical and Health Department, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - Prin Vathesatogkit
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suphot Tamsailom
- Department of Periodontology, Center of Excellent in Periodontal Disease and Dental Implant, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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19
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Shimpi N, McRoy S, Zhao H, Wu M, Acharya A. Development of a periodontitis risk assessment model for primary care providers in an interdisciplinary setting. Technol Health Care 2021; 28:143-154. [PMID: 31282445 DOI: 10.3233/thc-191642] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Periodontitis (PD), a form of gum disease, is a major public health concern as it is globally prevalent and harms both individual quality of life and economic productivity. Global cost in lost productivity is estimated at US$54 billion annually. Moreover, current PD assessment applies only after the damage has already occurred. OBJECTIVE This study proposes and tests a new PD risk assessment model applicable at point-of-care, using supervised machine learning methods. METHODS We compare the performance of five algorithms using retrospective clinical data: Naïve Bayes (NB), Logistic Regression (LR), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Decision Tree (DT). RESULTS DT and ANN demonstrated higher accuracy in classifying the patients with high or low PD risk as compared to NB, LR and SVM. The resultant model with DT showed a sensitivity of 87.08% (95% CI 84.12% to 89.76%) and specificity of 93.5% (95% CI 91% to 95.49%). CONCLUSIONS A predictive model with high sensitivity and specificity to stratify individuals into low and high PD risk tiers was developed. Validation in other populations will inform translational value of this approach and its potential applicability as clinical decision support tool.
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Affiliation(s)
- Neel Shimpi
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Susan McRoy
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Huimin Zhao
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Min Wu
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
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20
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Sekundo C, Bölk T, Kalmus O, Listl S. Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening. J Clin Med 2021; 10:E287. [PMID: 33466797 PMCID: PMC7830157 DOI: 10.3390/jcm10020287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76-0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82-132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.
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Affiliation(s)
- Caroline Sekundo
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Tobias Bölk
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Olivier Kalmus
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Stefan Listl
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 Nijmegen, The Netherlands
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21
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Gofur NRP, Handono K, Nurdiana N, Kalim H. Periodontal Comparison on Systemic Lupus Erythematosus Patients and Healthy Subjects: A Cross-Sectional Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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22
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Handono K, Putra Gofur NR, Nurdiana N, Kalim H, Wahono CS, Poeranto S, Barlianto W. Role of Lymphocytes CD4/CD8 Ratio and Immunoglobulin G Cytomegalovirus as Potential Markers for Systemic Lupus Erythematosus Patients with Periodontal Disease. Eur J Dent 2020; 14:544-550. [PMID: 32932531 PMCID: PMC7535962 DOI: 10.1055/s-0040-1715788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives
The aim of the study was to analyze the correlation between periodontitis severity in systemic lupus erythematosus (SLE) with CD4/CD8 lymphocytes ratio and cytomegalovirus gamma immunoglobulin (IgG CMV) level.
Materials and Methods
This is a descriptive study using a cross-sectional approach that included 93 subjects who were diagnosed with SLE in Rheumatology Department, Saiful Anwar Hospital, during 2017 to 2019. Periodontitis severity was assessed by periodontal Index (PI). CD4/CD8 lymphocyte ratio was determined using flow cytometry and IgG CMV levels using enzyme-linked immunosorbent assay.
Statistical Analysis
The differences among the three groups were analyzed using analysis of variance. Correlation among the groups was calculated using Spearman/Pearson correlation coefficient test, while regression analysis was done using Statistical Package for the Social Sciences.
Results
The mean of periodontitis severity and standard deviation in SLE was 2.66 ± 1.02. There were negative correlation between CD4/CD8 lymphocyte ratio with periodontal index (
r
= –0.971) and positive correlation between IgG CMV level with periodontal index (
r
= 0.977).
Conclusions
Inverted CD4/CD8 ratio and IgG CMV were found associated with periodontitis severity in SLE patient. Further research was recomended that CD4/CD8 lymphocytes ratio and IgG CMV can be used as a potensial marker of periodontitis severity in SLE patients.
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Affiliation(s)
- Kusworini Handono
- Department of Clinical Pathology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Nanda Rachmad Putra Gofur
- Biomedical Science, Postgraduate Program, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Nurdiana Nurdiana
- Department of Pharmacology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Handono Kalim
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Cesarius Singgih Wahono
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Sri Poeranto
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Wisnu Barlianto
- Department of Pediatric, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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23
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Talakey AA, Hughes F, Almoharib H, Al-Askar M, Bernabé E. The added value of periodontal measurements for identification of diabetes among Saudi adults. J Periodontol 2020; 92:62-71. [PMID: 33507569 DOI: 10.1002/jper.20-0118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/06/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aims of this study were to develop a prediction model for identification of individuals with diabetes based on clinical and perceived periodontal measurements; and to evaluate its added value when combined with standard diabetes screening tools. METHODS The study was carried out among 250 adults attending primary care clinics in Riyadh (Saudi Arabia). The study adopted a case-control approach, where diabetes status was first ascertained, and the Finnish Diabetes Risk Score (FINDRISC), Canadian Diabetes Risk questionnaire (CANRISK), and periodontal examinations were carried out afterward. RESULTS A periodontal prediction model (PPM) including three periodontal indicators (missing teeth, percentage of sites with pocket probing depth ≥6 mm, and mean pocket probing depth) had an area under the curve (AUC) of 0.694 (95% Confidence Interval: 0.612-0.776) and classified correctly 62.4% of participants. The FINDRISC and CANRISK tools had AUCs of 0.766 (95% CI: 0.690-0.843) and 0.821 (95% CI: 0.763-0.879), respectively. The addition of the PPM significantly improved the AUC of FINDRISC (P = 0.048) but not of CANRISK (P = 0.144), with 26.8% and 9.8% of participants correctly reclassified, respectively. Finally, decision curve analysis showed that adding the PPM to both tools would result in net benefits among patients with probability scores lower than 70%. CONCLUSIONS This study showed that periodontal measurements could play a role in identifying individuals with diabetes, and that addition of clinical periodontal measurements improved the performance of FINDRISC and CANRISK.
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Affiliation(s)
- Arwa A Talakey
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Periodontics and Community Dentistry, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Francis Hughes
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Hani Almoharib
- Department of Periodontics and Community Dentistry, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mansour Al-Askar
- Department of Periodontics and Community Dentistry, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Machado V, Proença L, Morgado M, Mendes JJ, Botelho J. Accuracy of Panoramic Radiograph for Diagnosing Periodontitis Comparing to Clinical Examination. J Clin Med 2020; 9:jcm9072313. [PMID: 32708230 PMCID: PMC7408796 DOI: 10.3390/jcm9072313] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
In this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (≥80% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (<66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic/are under the curve (ROC/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
- Correspondence:
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - Mariana Morgado
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
| | - José João Mendes
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal; (M.M.); (J.J.M.)
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Periodontal Diseases as Putative Risk Factors for Head and Neck Cancer: Systematic Review and Meta-Analysis. Cancers (Basel) 2020; 12:cancers12071893. [PMID: 32674369 PMCID: PMC7409086 DOI: 10.3390/cancers12071893] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Whether "periodontal disease" can be considered as an independent risk factor for head and neck cancer (HNC) remains controversial. The aim of the current meta-analysis was to quantitatively assess this relationship in order to determine whether this represents a true risk factor, with implications for cancer prevention and management. PubMed, Scopus, and Embase databases were systematically searched. Selective studies were reviewed, and meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CIs) on eligible studies using a random effects model. In total, 21 eligible observational studies (4 cohorts and 17 case-controls) were identified for qualitative synthesis after a review of 1051 articles. Significant heterogeneity could be identified in measures utilized for reporting of periodontal disease. Meta-analysis performed on nine studies that employed objective measures for reporting periodontal disease demonstrated a significant association between periodontal disease and HNC [OR 3.17, 95% CI, 1.78-5.64]. A diseased periodontium represents an independent risk marker, and a putative risk factor, for HNC. Prospective studies with standardized measures of periodontal disease severity and extent, integrated with microbiological and host susceptibility facets, are needed to elucidate the mechanisms of this positive association and whether treatment of the former influences the incidence and outcomes for HNC.
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Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global Prevalence of Periodontal Disease and Lack of Its Surveillance. ScientificWorldJournal 2020; 2020:2146160. [PMID: 32549797 PMCID: PMC7275199 DOI: 10.1155/2020/2146160] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. OBJECTIVE To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. METHODS This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. RESULTS Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. CONCLUSIONS Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.
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Affiliation(s)
- Muhammad Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Asim Al-Ansari
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalifa Al-Khalifa
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhanad Alhareky
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Botelho J, Machado V, Proença L, Mendes JJ. The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocols. Sci Rep 2020; 10:7093. [PMID: 32341429 PMCID: PMC7184582 DOI: 10.1038/s41598-020-63700-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
We aimed to compare the accuracy performance of the new 2018 periodontitis case definition by the European Federation of Periodontology (EFP)/ American Association of Periodontology (AAP) with Centers for Disease Control (CDC)/AAP 2012 in full-mouth partial recording protocols (PRP). Retrospective data from NHANES 2011-2012 and 2013-2014 were analyzed. For each case definition, full-mouth diagnostic was defined as the reference standard. Patients were diagnosed for the presence of periodontitis and staging for each PRP. Sensitivity, specificity, accuracy and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass ROC/AUC analyses. Our performance analysis shows that the new 2018 classification outperforms the 2012 classification regarding the diagnosis and staging of periodontitis on full-mouth PRPs. This recent case definition has strengthened the utility of PRPs and its improvements certainly explain the observed findings. Also, our findings contribute to the reliability of PRPs and its use in future worldwide epidemiological surveys.
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Affiliation(s)
- João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal.
- Clinical Research Unit (CRU), CiiEM, IUEM, Almada, Portugal.
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, IUEM, Almada, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Almada, Portugal
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Diet Practices, Body Mass Index, and Oral Health-Related Quality of Life in Adults with Periodontitis- A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072340. [PMID: 32235665 PMCID: PMC7177499 DOI: 10.3390/ijerph17072340] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022]
Abstract
Objectives: To assess and compare diet practices, body mass index (BMI), and oral health-related quality of life (OHRQoL) in adults with and without periodontitis. Methods: Demographics, health-related behaviors, BMI, dental and periodontal parameters, diet practices, and Oral Health Impact Profile-14 (OHIP-14) were collected from 62 periodontitis patients and 100 controls without periodontitis. Results: Having periodontitis was positively associated with male sex (p = 0.004), older age (p < 0.001), smoking pack-years (p = 0.006), weight (p = 0.008), BMI (p = 0.003), number of meals per day (p < 0.001) and had a negative association with decayed teeth (p = 0.013), alcohol (p = 0.006), and sweets (p = 0.007) consumption. Periodontitis patients were more likely to avoid carbonated beverages (p = 0.028), hot (p = 0.003), and cold drinks (p = 0.013), cold (p = 0.028), hard textured (p = 0.002), and fibrous foods (p = 0.02) than the controls, and exhibited higher global OHIP-14 (p < 0.001) and most domain scores. Age (p < 0.001), BMI (p =0.045), number of meals per day (p = 0.024), and global OHIP-14 score (p < 0.001) remained positively associated with periodontitis in the multivariate analysis. Conclusions: Periodontitis patients exhibited higher BMI and altered diet practices and OHRQoL as compared to controls. Assessment of diet practices, BMI, and OHRQoL should be part of periodontal work-up. Dentists and dietitians should collaborate to design strategies to address these challenges.
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Coronado-Cerda EE, Ancer-Rodríguez J, Montemayor-Martínez R, Canabal-Hermida F, Gallegos-Avila G, De la Garza-Ramos MA. Chlamydia trachomatis in the gingival sulcus and pharynx in patients of Northeast Mexico. Clin Exp Dent Res 2020; 6:415-419. [PMID: 32220009 PMCID: PMC7453775 DOI: 10.1002/cre2.290] [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: 10/29/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 01/10/2023] Open
Abstract
Background The oral microenvironment provides the conditions for the establishment of microorganisms not usually considered residents of the normal oral microbiota. Sexually transmitted microorganisms such as Chlamydia trachomatis can adhere to any mucosal surface and ascend to reach appropriate locations to survive and develop symptomatic infections. Materials and methods To determine the presence of C. trachomatis, direct immunofluorescence of this microorganism was carried out in 76 randomly selected patients attending a periodontal clinic during a period of 1 year. Samples from the gingival sulcus and the pharynx were collected for detection of C. trachomatis. Patients who attended the periodontal clinic were divided into two groups: those without periodontitis and those with periodontitis. For the purpose of performing other statistical analyses, all patients were also divided by gender and age. Results From the total of 76 patients, in the group without periodontitis, 61% were positive for C. trachomatis in the gingival sulcus and 63.4% in the pharynx; in the periodontitis group, 45.7% were positive in the sulcus and 40% in the pharynx. When we compared patients by gender or age, no statistical difference was found. Conclusions The prevalence of C. trachomatis in this group was 53.9% in the gingival sulcus and pharynx of the studied patients.
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Affiliation(s)
- Erika E Coronado-Cerda
- Escuela Ciencias de la Salud, Universidad del Valle de México, Monterrey, Nuevo Leon, Mexico
| | - Jesus Ancer-Rodríguez
- Facultad de Odontología/Posgrado de Periodoncia y Unidad de Odontología Integral y Especialidades del CIDICS, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.,Departamento de Patología, Facultad de Medicina y Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Raul Montemayor-Martínez
- Facultad de Odontología/Posgrado de Periodoncia y Unidad de Odontología Integral y Especialidades del CIDICS, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | - Guadalupe Gallegos-Avila
- Departamento de Patología, Facultad de Medicina y Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | - Myriam A De la Garza-Ramos
- Facultad de Odontología/Posgrado de Periodoncia y Unidad de Odontología Integral y Especialidades del CIDICS, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
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Gofur NRP, Handono K, Nurdiana N, Kalim H, Barlianto W. Oral Hygiene and Dental Caries Status on Systemic Lupus Erythematosus Patients: A Cross-Sectional Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Estimation of Sialic Acid and IL10 Levels in Stage 1 and 2 Periodontitis Patients. Int J Dent 2019; 2019:2917124. [PMID: 31871458 PMCID: PMC6906883 DOI: 10.1155/2019/2917124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/05/2019] [Indexed: 12/04/2022] Open
Abstract
Objective The role of biomarkers in staging and grading periodontal disease has become detrimental in relation to the overall treatment plan. This study aimed at evaluating and comparing the role of sialic acid and IL10 in the early and moderate stages of periodontitis. Materials and Methods Patients were selected according to the assessment of pocket depth and radiographic bone loss. Bone loss was calculated as <15% for stage 1 and 15–33% for stage 2. Salivary samples were collected using spit technique 2 hrs post consumption of food. The unstimulated saliva was collected in a sterile graduated container every minute for 5–8 minutes. IL10 estimation was done using ELISA, and sialic acid estimation was done using the diphenylamine method. The variables for the three groups were assessed using ANOVA, and intragroup comparisons for quantitative data were evaluated using the post hoc Bonferroni test (P < 0.05). Results On comparing sialic acid levels among the three groups, stage 2 showed the highest mean (8.61) compared with the other two groups and was highly significant (P < 0.001). On the contrary, IL10 when compared to stage 1 and 2 periodontitis revealed insignificant change. Conclusion The value of IL10 was higher as patients progressed from health to periodontitis.
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Lertpimonchai A, Rattanasiri S, Tamsailom S, Champaiboon C, Ingsathit A, Kitiyakara C, Limpianunchai A, Attia J, Sritara P, Thakkinstian A. Periodontitis as the risk factor of chronic kidney disease: Mediation analysis. J Clin Periodontol 2019; 46:631-639. [PMID: 30993705 PMCID: PMC6593715 DOI: 10.1111/jcpe.13114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 01/29/2023]
Abstract
AIM To determine sequences and magnitude of causality among periodontitis, diabetes and chronic kidney disease (CKD) by mediation analysis. METHODS Ten-year-data were retrieved from the Electric Generation Authority of Thailand (EGAT) study. A cohort of 2,635 subjects was identified with no CKD at baseline. The interested outcome was CKD incidence defined as glomerular filtration rate <60 ml/min/1.73 m2 . The percentage of proximal sites with clinical attachment loss ≥5 mm was used to represent periodontitis. Mediation analysis with 1,000-replication bootstrapping was applied to two causal diagrams, diagram A (Periodontitis → Diabetes → CKD) and diagram B (Diabetes → Periodontitis → CKD). RESULTS The cumulative incidence of CKD was 10.3 cases per 100 persons during 10-year period. In diagram A, each increasing percentage of proximal sites with severe periodontitis increased the adjusted odds ratio of CKD 1.010 (95% CI: 1.005, 1.015) and 1.007 (95% CI: 1.004, 1.013), by direct and indirect effect through diabetes, respectively. In diagram B, diabetes increased the odds of CKD twofold, with 6.5% of this effect mediated via periodontitis. CONCLUSIONS Periodontitis had significant direct effect, and indirect effect through diabetes, on the incidence of CKD. Awareness about systemic morbidities from periodontitis should be emphasized.
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Affiliation(s)
- Attawood Lertpimonchai
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suphot Tamsailom
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chantrakorn Champaiboon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiporn Ingsathit
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chagriya Kitiyakara
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anusorn Limpianunchai
- Medical and Health Division, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Piyamitr Sritara
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Alqaderi H, Goodson JM, Agaku I. Association between sleep and severe periodontitis in a nationally representative adult US population. J Periodontol 2019; 91:767-774. [DOI: 10.1002/jper.19-0105] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 09/10/2019] [Accepted: 09/27/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Hend Alqaderi
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental Medicine Boston MA
- The Forsyth Institute Cambridge MA
| | | | - Israel Agaku
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental Medicine Boston MA
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Gofur NR, Nurdiana N, Kalim H, Handono K. Periodontitis is associated with disease severity and anti-double stranded DNA antibody and interferon-gamma levels in patients with systemic lupus erythematosus. J Taibah Univ Med Sci 2019; 14:560-565. [PMID: 31908645 PMCID: PMC6940663 DOI: 10.1016/j.jtumed.2019.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To analyse the correlation between periodontitis severity and disease activity, anti-double stranded DNA (anti-dsDNA) antibody, and interferon-gamma (IFN-γ) levels in patients with systemic lupus erythematous (SLE). METHODS We selected 61 patients with SLE (age 18-55 years) selected from a hospital in Malang, Indonesia. Clinical examination and laboratory tests were performed to assess disease activity. The severity of SLE was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), while periodontitis severity was measured according to the Periodontal Index (PI) criteria. Levels of anti-dsDNA and IFN-γ were determined using an enzyme-linked immunosorbent assay. Optical density at 450 nm was measured using an automated plate reader. RESULTS The mean age of the subjects with SLE was 29 years, and mean disease duration was 2.8 years. Fifty-four of 61 (88.53%) subjects with SLE had periodontitis according to the PI. SLE subjects exhibited other clinical manifestations such as lupus nephritis, vasculitis, arthritis, mucocutaneous manifestation, fatigue, fever, and/or leukopenia. SLE severity was assessed according to the average SLEDAI score (17.70 ± 12.70), and average anti-dsDNA (122.6 ± 81.01 U/mL), and IFN-γ (14.64 ± 11.17 pg/mL) levels. There was a significantly positive correlation between periodontitis score and SLEDAI score (r = 0.927; p ≤ 0.0001), anti-dsDNA antibody (r = 0.948; p ≤ 0.0001), and IFN-γ (r = 0.951; p ≤ 0.0001) levels. CONCLUSION Results of the present study demonstrated that periodontitis was associated with SLE disease activity, and was a biomarker of immune aging. Furthermore, this biomarker could be a reliable predictor of periodontal condition and prognosis of periodontitis and can also help in selecting the most appropriate treatment strategy for periodontitis in patients with SLE.
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Affiliation(s)
- Nanda R.P. Gofur
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Nurdiana Nurdiana
- Department of Pharmacology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Handono Kalim
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Kusworini Handono
- Department of Pathology Clinic, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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Costa FO, Vieira TR, Cortelli SC, Cota LOM, Costa JE, Aguiar MCF, Cortelli JR. Effect of compliance during periodontal maintenance therapy on levels of bacteria associated with periodontitis: A 6-year prospective study. J Periodontol 2019. [PMID: 29537663 DOI: 10.1002/jper.17-0173] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is well established that regular compliance during periodontal maintenance therapy (PMT) maintains the stability of periodontal clinical parameters obtained after active periodontal therapy (APT). However, compliance during PMT has not yet been related to subgingival bacterial levels. Thus, this study followed individuals in PMT over 6 years and longitudinally evaluated the effects of compliance on periodontitis-associated bacterial levels and its relation to periodontal status. METHODS From a 6-year prospective cohort study with 212 individuals in PMT, 91 were determined to be eligible. From this total, 28 regular compliers (RC) were randomly selected and matched for age and sex with 28 irregular compliers (IC). Complete periodontal examination and microbiological samples were obtained 5 times: T1 (prior to APT), T2 (after APT), T3 (2 years), T4 (4 years), and T5 (6 years). Total bacteria counts and levels of Actinomyces naeslundii, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were evaluated through quantitative polymerase chain reaction. RESULTS RC had less tooth loss and better clinical and microbiological conditions over time when compared with IC. IC had higher total bacterial counts and higher levels of T. denticola. Moreover, among IC, total bacterial counts were positively associated with plaque index and bleeding on probing, while levels of A. naeslundii, T. forsythia, and T. denticola were negatively associated with clinical attachment loss (4 to 5 mm) among RC. CONCLUSIONS Compliance positively influenced subgingival microbiota and contributed to stability of periodontal clinical status. Regular visits during PMT sustained microbiological benefits provided by APT over a 6-year period.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thaís Riberal Vieira
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Eustáquio Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Cássia Ferreira Aguiar
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
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Botelho J, Machado V, Proença L, Alves R, Cavacas MA, Amaro L, Mendes JJ. Study of Periodontal Health in Almada-Seixal (SoPHiAS): a cross-sectional study in the Lisbon Metropolitan Area. Sci Rep 2019; 9:15538. [PMID: 31664143 PMCID: PMC6820786 DOI: 10.1038/s41598-019-52116-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022] Open
Abstract
This study aimed to describe the prevalence and extent of periodontal diseases among adults in the southern region of the Lisbon Metropolitan Area. This population-based cross-sectional study included 1,064 randomized participants (aged 18 to 95 years, 617 females/447 males). Sociodemographic, behaviours and medical information were recorded. Periodontal conditions were assessed with a full-mouth circumferential periodontal examination. It was used the American Association of Periodontology/European Federation of Periodontology 2017 case definitions. A logistic regression analysis was applied to ascertain hypothetical risk factors towards periodontitis. The prevalence of periodontitis was 59.9%, with 24.0% and 22.2% of the participants exhibiting severe and moderate periodontitis, respectively. The risk of periodontitis significantly increased with age (OR = 1.05, 95% CI: 1.04-1.06), for active and former smokers (OR = 3.76 and OR = 2.11, respectively), with lower education levels (OR = 2.08, OR = 1.86, for middle and elementary education, respectively) and with diabetes mellitus (OR = 1.53). This study confirms a high burden of periodontitis in the target (Portuguese) sub-population. The findings provide a comprehensive understanding that will empower appropriate national public oral health programmes and population-based preventive actions.
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Affiliation(s)
- João Botelho
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal.
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal.
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Ricardo Alves
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Maria Alzira Cavacas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
- Hospital Garcia de Orta, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
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Grillo C, La Mantia I, Zappala G, Cocuzza S, Ciprandi G, Andaloro C. Oral health in children with sleep-disordered breathing: a cross-sectional study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:52-59. [PMID: 31292428 PMCID: PMC6776166 DOI: 10.23750/abm.v90i7-s.8661] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Indexed: 12/22/2022]
Abstract
Sleep-disordered breathing (SDB) is associated with a wide range of oral manifestations, including adeno-tonsillar hypertrophy, narrow dentoalveolar width, increased overjet, reduced overbite, and malocclusion. There are no studies about the relationship between SDB and poor oral health in the pediatric population. The aim of this study was to investigate oral health status and oral health-related quality of life (OHRQoL) in children at risk of SDB (SDB+), compared with a control group, not at risk for SDB (SDB). The current cross-sectional study recruited consecutive children, aged between 8 and 17 years, from a university-based dental clinic. Caregivers completed the Pediatric Sleep Questionnaire (PSQ) to stratify risk of SDB. Both children and caregivers completed the Child Oral Health Impact Profile (COHIP) to measure the OHRQoL. A dental exam was conducted to evaluate dental caries, periodontal status, oropharyngeal characteristics, and dental occlusion. DMFS (decay-missing-filled for permanent teeth), dmfs (for primary teeth), PPD (pocket probing depth), parent COHIP score, child COHIP score, and BOP (bleeding on probing) were compared between children SDB+ and SDB-. In this study, 122 children were enrolled and divided into two equal subgroups (61 each). There was a significant association between SDB and all six outcomes (all p < 0.05) with higher values in SDB+ children. SDB+ was associated with a poorer OHRQoL, and a greater COHIP score for both parents and children. In conclusion, the current study suggests that the impact of SDB on oral health and OHRQoL in children is relevant and far-reaching. Therefore, it is necessary to closely monitor the oral health of SDB+ children, and, if appropriate, to use gentle non-pharmacological treatments able to reduce nasal congestion. (www.actabiomedica.it)
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Affiliation(s)
- Calogero Grillo
- Otolayngology Unit, Department of Medical Sciences, Surgical and Advanced Technologies, University of Catania, Catania, Italy.
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Romano F, Perotto S, Castiglione A, Aimetti M. Prevalence of periodontitis: misclassification, under-recognition or over-diagnosis using partial and full-mouth periodontal examination protocols. Acta Odontol Scand 2019; 77:189-196. [PMID: 30623706 DOI: 10.1080/00016357.2018.1535136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to assess the bias in estimating the prevalence of periodontitis due to partial-mouth periodontal examination protocols (PMPE) and to relate the severity and extent of periodontal damage to periodontitis misclassification when applying case definitions by Centres of Disease Control and Prevention and American Academy of Periodontology (CDC/AAP). MATERIALS AND METHODS A full-mouth periodontal examination (FMPE) was performed in 721 adults living in North Italy to identify moderate and severe periodontitis. These results were compared with those obtained with two PMPE protocols analyzing two interproximal sites on all teeth (fMB-DL) or four interproximal sites in two random diagonal quadrants (pMDB-MDL). RESULTS Both PMPE systems estimated the prevalence of moderate periodontitis with limited bias (-2.79% for pMDB-MDL and -3.49% for fMB-DL), whereas produced larger relative biases for severe periodontitis (-28.74% versus - 14.55%). The percentage of under-recognition of existing periodontal disease was 8.9% under fMB-DL and 15.5% under pMDB-MDL. The diagnosis of moderate and severe periodontal disease was correctly assigned to individuals with on average 8% and 30% of pathological sites, respectively. CONCLUSION These findings suggest that PMPE systems provide high level of bias when using CDC/AAP case definitions.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School University of Turin, Turin, Italy
| | - Stefano Perotto
- Postgraduate Program in Periodontology, University of Turin, Turin, Italy
| | - Anna Castiglione
- Città della Salute e della Scienza and CPO Piedmont, Unit of Clinical Epidemiology, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin, Turin, Italy
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Cytokine levels in crevicular fluid associated with compliance during periodontal maintenance therapy. Clin Oral Investig 2018; 23:3517-3526. [DOI: 10.1007/s00784-018-2770-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/05/2018] [Indexed: 12/14/2022]
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Kim EH, Joo JY, Lee YJ, Koh JK, Choi JH, Shin Y, Cho J, Park E, Kang J, Lee K, Bhak J, Kim BC, Lee JY. Grading system for periodontitis by analyzing levels of periodontal pathogens in saliva. PLoS One 2018; 13:e0200900. [PMID: 30475813 PMCID: PMC6257921 DOI: 10.1371/journal.pone.0200900] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/20/2018] [Indexed: 12/19/2022] Open
Abstract
Periodontitis is an infectious disease that is associated with microorganisms that colonize the tooth surface. Clinically, periodontal condition stability reflects dynamic equilibrium between bacterial challenge and host response. Therefore, periodontal pathogen assessment can assist in the early detection of periodontitis. Here we developed a grading system called the periodontal pathogen index (PPI) by analyzing the copy numbers of multiple pathogens both in healthy and chronic periodontitis patients. We collected 170 mouthwash samples (64 periodontally healthy controls and 106 chronic periodontitis patients) and analyzed the salivary 16S rRNA levels of nine pathogens using multiplex, quantitative real-time polymerase chain reaction. Except for Aggregatibacter actinomycetemcomitans, copy numbers of all pathogens were significantly higher in chronic periodontitis patients. We classified the samples based on optimal cut-off values with maximum sensitivity and specificity from receiver operating characteristic curve analyses (AUC = 0.91, 95% CI: 0.87-0.96) into four categories of PPI: Healthy (1-40), Moderate (41-60), At Risk (61-80), and Severe (81-100). PPI scores were significantly higher in all chronic periodontitis patients than in the controls (odds ratio: 31.7, 95% CI: 13.41-61.61) and were associated with age, scaling as well as clinical characteristics including clinical attachment level and plaque index. Our PPI grading system can be clinically useful for the early assessment of pathogenic bacterial burden and follow-up monitoring after periodontitis treatment.
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Affiliation(s)
| | - Ji-Young Joo
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
- Department of Periodontology and Institute of Translational Dental Science, Pusan National University, School of Dentistry, Yangsan, Republic of Korea
| | | | - Jae-Kwon Koh
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
| | - Jung-Hyeok Choi
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
| | | | - Juok Cho
- The Genomics Institute, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Eunha Park
- The Genomics Institute, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | | | | | - Jong Bhak
- The Genomics Institute, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
- Geromics Inc., Ulsan, Republic of Korea
- The Aging Institute, Genome Research Foundation, Osong, Republic of Korea
| | - Byung Chul Kim
- Clinomics Inc., Ulsan, Republic of Korea
- * E-mail: (BCK); (JYL)
| | - Ju-Youn Lee
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
- Department of Periodontology and Institute of Translational Dental Science, Pusan National University, School of Dentistry, Yangsan, Republic of Korea
- * E-mail: (BCK); (JYL)
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Aldahlawi S, Youssef AR, Shahabuddin S. Evaluation of chemokine CXCL10 in human gingival crevicular fluid, saliva, and serum as periodontitis biomarker. J Inflamm Res 2018; 11:389-396. [PMID: 30464571 PMCID: PMC6216963 DOI: 10.2147/jir.s177188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose The aim of this study was to evaluate CXCL10 as a biomarker for periodontitis by determining the CXCL10 levels in saliva, serum, and gingival crevicular fluid (GCF) samples from periodontally healthy control subjects and adult subjects with chronic periodontitis. Patients and methods Adult patients seeking dental treatment at Umm Al-Qura University dental clinic underwent a complete periodontal examination, and saliva, serum, and GCF samples were collected. Subjects were classified as chronic periodontitis patients (n=31) if they have a periodontal probing depth (PD) of ≥4 mm and/or clinical attachment level (CAL) of ≥3 mm in >30% of the teeth. The control group (n=25) had PD ≤3 mm and/or CAL ≤2 mm. ELISA was performed to determine the concentration of CXCL10 in saliva, serum, and GCF samples. Student’s t-test was carried out to evaluate the significant difference between different groups. Spearman’s correlation test was used to analyze the relationship between the levels of CXCL10 and the clinical periodontal parameters. P-value of ≤0.05 was considered significant. Results Significantly higher concentrations of CXCL10 were found in saliva and serum in chronic periodontitis patients as compared with the controls (272±60.4 pg/mL and 72±13.4 pg/mL vs 130±22.2 pg/mL and 44.08±4.5 pg/mL, P≤0.05). The CXCL10 levels in GCF were higher in the periodontitis group as compared with the control group (66.36±32.0 pg/mL and 44.56±17.5 pg/mL, respectively); the difference did not reach statistical significance (P≥0.05). Moreover, serum CXCL10 level was significantly higher in periodontitis patients with moderate to severe bone loss as compared with those with mild bone loss (71.05±4.7 pg/mL vs 54.8±7.7 pg/mL, P≤0.05). The serum CXCL10 levels were found to be related to CAL measurements (r=0.3, P=0.026), while the saliva CXCL10 levels were related to PD measurements (r=0.8, P=0.0007). Conclusion CXCL10 is significantly increased in periodontitis subjects as compared with controls and could be used as a marker for periodontal disease.
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Affiliation(s)
- Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia,
| | - Abdel-Rahman Youssef
- Department of Basic and Clinical Oral Sciences, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia,
| | - Syed Shahabuddin
- Abbvie, North Chicago, IL, USA.,Deportment of Biology, City Colleges of Chicago, Chicago, IL, USA
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Cunha FA, Cota LOM, Cortelli SC, Miranda TB, Neves FS, Cortelli JR, Costa FO. Periodontal condition and levels of bacteria associated with periodontitis in individuals with bipolar affective disorders: A case-control study. J Periodontal Res 2018; 54:63-72. [DOI: 10.1111/jre.12605] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/28/2018] [Accepted: 08/04/2018] [Indexed: 12/12/2022]
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Levin L, Zini A, Levine J, Weiss M, Lev R, Chebath Taub D, Hai A, Almoznino G. Demographic profile, Oral Health Impact Profile and Dental Anxiety Scale in patients with chronic periodontitis: a case-control study. Int Dent J 2018; 68:269-278. [PMID: 29383701 DOI: 10.1111/idj.12381] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To examine whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differ between persons with and those without chronic periodontitis. METHODS One-hundred patients with chronic periodontitis and 50 age- and- sex-matched controls were included. Data were collected on the following: demographics; smoking habits; Numerical Rating Scale (NRS) for dental pain assessment; Corah's Dental Anxiety Scale (DAS); Oral Health Impact Profile 14 (OHIP-14); Decayed, Missing and Filled Teeth (DMFT) index; Plaque Index (PI); probing depth (PD); bleeding on probing (BOP); and radiographic bone loss. RESULTS Patients with chronic periodontitis exhibited a significantly higher percentage of high anxiety and phobia compared with subjects in the control group. Furthermore, patients with chronic periodontitis were statistically significantly more likely to consider themselves as suffering from dental anxiety (68.7% vs. 14.3%, P < 0.001) as well as more likely to have fear of receiving dental injections, hearing the dental drill noise and feeling a foreign object in the mouth. Patients with chronic periodontitis exhibited worse OHIP-14 global scores as well as worse scores in the following individual domains: functional limitation (P = 0.005); physical disability (P = 0.003); psychological disability (P = 0.010); social disability (P = 0.011); and handicap (P = 0.012). CONCLUSIONS Compared with controls, patients with chronic periodontitis had higher levels of dental anxiety and worse OHRQoL. It is important to consider dental anxiety and OHRQoL assessment as an integral component of the evaluation of patients with chronic periodontitis. Communication between dental and behavioral health professionals is needed to implement a multidisciplinary team approach involving behavioural and psychological interventions.
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Affiliation(s)
- Liran Levin
- Department of Periodontology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Avraham Zini
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Jonathan Levine
- Department of Prosthodontics, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Maor Weiss
- Department of Prosthodontics, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Ron Lev
- Department of Periodontology, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Daniella Chebath Taub
- Department of Periodontology, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Avihai Hai
- Department of Periodontology, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Galit Almoznino
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.,Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Pérez Barrionuevo AM, Gómez Real F, Igland J, Johannessen A, Omenaas E, Franklin KA, Pérez Barrionuevo L, Åstrøm AN, Svanes C, Bertelsen RJ. Periodontal health status and lung function in two Norwegian cohorts. PLoS One 2018; 13:e0191410. [PMID: 29351551 PMCID: PMC5774767 DOI: 10.1371/journal.pone.0191410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/21/2017] [Indexed: 01/08/2023] Open
Abstract
RATIONALE AND OBJECTIVES The oral cavity is united with the airways, and thus poor oral health may affect respiratory health. However, data on the interaction of periodontal and respiratory health is limited. We aimed to evaluate whether periodontal health status, assessed by the Community Periodontal Index (CPI), was related to lung function among young and middle-aged adults in two Norwegian cohorts. METHODS Periodontal health status and lung function were measured among 656 participants in the Norwegian part of the European Community Respiratory Health Survey (ECHRS III) and the RHINESSA offspring study. Each participant was given a CPI-index from 0 to 4 where higher values reflect poorer periodontal status. The association between CPI and lung function was estimated with linear regression adjusting for age, gender, smoking, body mass index, exercise, education, use of antibiotics, inhaled medication and corrected for clustering within families. MAIN RESULTS Participants with CPI 3-4 had significantly lower FEV1/FVC ratio compared to participants with CPI 0, b (95% CI) = -0.032 (-0.055, -0.009). Poorer periodontal health was associated with a significant decrease in the FEV1/FVC ratio with an adjusted regression coefficient for linear trend b (95% CI) = -0.009 (-0.015, -0.004) per unit increase in CPI. This negative association remained when excluding asthmatics and smokers (-0.014 (-0.022, -0,006)). CONCLUSIONS Poorer periodontal health was associated with increasing airways obstruction in a relatively young, healthy population. The oral cavity is united with the airways and our findings indicate an opportunity to influence respiratory health by improving oral health.
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Affiliation(s)
| | | | - Jannicke Igland
- Department of Global Health and Community Medicine, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ernst Omenaas
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Karl A. Franklin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | | | | | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- * E-mail:
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Sihuay Torres K, Ibarra Vásquez L, Alegre Collas C, Palomino-Espinoza I. Exactitud del sondaje periodontal según observadores y tipos de sondas periodontales. ACTA ODONTOLÓGICA COLOMBIANA 2018. [DOI: 10.15446/aoc.v8n1.70353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: las sondas periodontales son de alta sensibilidad para determinar la pérdida de inserción clínica y son utilizadas en el diagnóstico periodontal. Uno de los factores más críticos al considerar su uso, es el reconocimiento de la posición de las marcas en los diversos modelos de sondas, pues pueden in uir en el registro de las medidas del sondaje periodontal. Objetivo: evaluar la exactitud del sondaje periodontal, según tres tipos de sondas y observadores. Metodología: se diseñaron bloques de madera con perforaciones que simularon cavidades para realizar el son- daje periodontal. Participaron cinco evaluadores quienes midieron las perforaciones usando tres tipos de sondas (Organización Mundial de la Salud -OMS, Universidad de North Carolina -UNC y Universidad de Michigan). La concordancia de mediciones, entre observadores, se realizó mediante promedios y márgenes de error. La exacti- tud de las mediciones de las sondas se evaluó, siguiendo el promedio de distancias obtenidas respecto a los valores reales de las perforaciones. Resultados: el promedio de medición con la sonda OMS fue de 64,12mm; con la sonda UNC: 64,9mm y con la sonda Michigan de 66,2mm, respecto al valor real que fue de 65,5mm. El margen de error para las sondas OMS, UNC y Michigan fue de 4,05mm; 2,89mm y 3,76mm, respectivamente. La concordancia interobservador con la sonda UNC fue del 99% con una exactitud del 60%. Conclusión: la sonda periodontal con mayor exactitud, respecto al patrón real, fue la sonda UNC, seguida de la sonda Michigan y, luego, la sonda OMS.
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Dental anxiety and oral health-related quality of life in aggressive periodontitis patients. Clin Oral Investig 2017; 22:1411-1422. [PMID: 29022175 DOI: 10.1007/s00784-017-2234-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 09/28/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To measure dental anxiety levels and oral health-related qualities of life (OHRQoL) in patients with aggressive periodontitis (AgP) compared to controls and analyze their association with various demographic and clinical parameters. METHODS Sixty consecutive patients with AgP were compared to 80 age- and sex-matched controls with no known history of periodontal disease. Collected data included demographics, smoking habits, numerical rating scale (NRS), Corah's Dental Anxiety Scale (DAS) and Oral Health Impact Profile-14 (OHIP-14), DMFT index (Decayed, Missing and Filled Teeth), Plaque Index (PI), probing depth (PD), bleeding on probing (BOP), and radiographic bone loss. RESULTS AgP patients exhibited statistically significant higher scores in the DAS total as well as sub-scores, except from DAS 1st question. Compared to the control group, AgP patients exhibited worse OHIP-14 global as well as in all individual OHIP-14 domains scores. Among both AgP and control patients, the physical pain domain was where the highest impact was recorded, while the lowest impact was recorded in the functional limitation domain. CONCLUSIONS AgP patients were positively associated with higher levels of dental anxiety and worse OHRQoL. Self-perception of dental anxiety and OHRQoL should be regarded as an integral element in routine diagnostic work-up process of periodontal diseases. STATEMENT OF CLINICAL RELEVANCE Aggressive periodontitis (AgP) patients exhibited higher dental anxiety levels and worse oral health-related quality of life (OHRQoL) compared to controls. Professionals should design strategies that will cope with the dental anxiety associated with the treatment and prevent decreases in OHRQoL.
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Miyazaki H, Jones JA, Beltrán-Aguilar ED. Surveillance and monitoring of oral health in elderly people. Int Dent J 2017; 67 Suppl 2:34-41. [PMID: 29023740 DOI: 10.1111/idj.12348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hideo Miyazaki
- Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Judith A Jones
- University of Detroit Mercy School of Dentistry, Detroit, MI, USA
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Rams TE, Loesche WJ. Relationship Between Periodontal Screening and Recording Index Scores and Need for Periodontal Access Surgery. J Periodontol 2017; 88:1042-1050. [PMID: 28517975 DOI: 10.1902/jop.2017.170070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The validity of using pretreatment Periodontal Screening and Recording (PSR) index sextant scores to estimate periodontal access surgery needs is evaluated in patients with chronic periodontitis before and after completion of non-surgical periodontal therapy. METHODS In 110 adults, pretreatment probing data identified 486 sextants with PSR scores of 4 and 125 sextants with PSR scores of 3. Periodontal access surgery needs for all sextants were determined prior to treatment and after completion of non-surgical periodontal therapy for 213 sextants in 38 patients by two experienced periodontist examiners. RESULTS PSR scores of 4 identified untreated sextants with periodontal access surgery needs significantly better than PSR scores of 3 (odds ratio = 27.8; P <0.001) in multilevel, mixed-effects, logistic regression modeling analysis. However, only 37.6% of sextants with both pretreatment PSR scores of 4 and a pretreatment periodontal access surgery need continued to have surgical access needs after completion of non-surgical periodontal therapy. A higher percentage of sextants with PSR scores of 4 or 3 revealed periodontal access surgical needs when Class II or III furcation involvements and/or Grade II or III tooth mobility were also detected in the sextant than when these parameters were not detected. CONCLUSIONS Pretreatment PSR index scores of 4 were a strong indicator of periodontal access surgery needs in untreated dentition sextants but markedly overestimated surgical access needs remaining after completion of non-surgical periodontal therapy. These findings raise questions about the usefulness of pretreatment PSR evaluations for estimating potential periodontal access surgery needs in patients to be initially treated with non-surgical periodontal therapy.
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Affiliation(s)
- Thomas E Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA.,Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA
| | - Walter J Loesche
- Deceased; previously, Department of Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI.,Deceased; previously, Department of Microbiology and Immunology, University of Michigan School of Medicine, Ann Arbor, MI
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Rebelo MA, de Castro PH, Rebelo Vieira JM, Robinson PG, Vettore MV. Low Social Position, Periodontal Disease, and Poor Oral Health-Related Quality of Life in Adults With Systemic Arterial Hypertension. J Periodontol 2016; 87:1379-1387. [DOI: 10.1902/jop.2016.160204] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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50
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Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients. J Periodontol 2016; 87:1165-73. [DOI: 10.1902/jop.2016.160043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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