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Morrison AG, Sarkar S, Umar S, Lee STM, Thomas SM. The Contribution of the Human Oral Microbiome to Oral Disease: A Review. Microorganisms 2023; 11:318. [PMID: 36838283 PMCID: PMC9962706 DOI: 10.3390/microorganisms11020318] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
The oral microbiome is an emerging field that has been a topic of discussion since the development of next generation sequencing and the implementation of the human microbiome project. This article reviews the current literature surrounding the oral microbiome, briefly highlighting most recent methods of microbiome characterization including cutting edge omics, databases for the microbiome, and areas with current gaps in knowledge. This article also describes reports on microorganisms contained in the oral microbiome which include viruses, archaea, fungi, and bacteria, and provides an in-depth analysis of their significant roles in tissue homeostasis. Finally, we detail key bacteria involved in oral disease, including oral cancer, and the current research surrounding their role in stimulation of inflammatory cytokines, the role of gingival crevicular fluid in periodontal disease, the creation of a network of interactions between microorganisms, the influence of the planktonic microbiome and cospecies biofilms, and the implications of antibiotic resistance. This paper provides a comprehensive literature analysis while also identifying gaps in knowledge to enable future studies to be conducted.
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Affiliation(s)
- Austin Gregory Morrison
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Soumyadev Sarkar
- Division of Biology, Kansas State University, Manhattan, KS 66506, USA
| | - Shahid Umar
- Department of General Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Sonny T. M. Lee
- Division of Biology, Kansas State University, Manhattan, KS 66506, USA
- 1717 Claflin Road, 136 Ackert Hall, Manhattan, KS 66506, USA
| | - Sufi Mary Thomas
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Departments of Otolaryngology, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Departments of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
- 3901 Rainbow Blvd., 4031 Wahl Hall East, MS 3040, Kansas City, KS 66160, USA
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2
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Periodontal status and the incidence of selected bacterial pathogens in periodontal pockets and vascular walls in patients with atherosclerosis and abdominal aortic aneurysms. PLoS One 2022; 17:e0270177. [PMID: 35951554 PMCID: PMC9371326 DOI: 10.1371/journal.pone.0270177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/06/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of the study was to examine the periodontal status of patients with atherosclerosis and abdominal aortic aneurysms. The occurrence of 5 periodontopathogens was evaluated in periodontal pockets and atheromatous plaques together with specimens from pathologically changed vascular walls of aortic aneurysms. The study comprised 39 patients who qualified for vascular surgeries. Patients with periodontitis and concomitant atherosclerosis or aneurysms were enrolled in the study. Periodontal indices were evaluated, and subgingival plaque samples were examined together with atheromatous plaques or specimens from vascular walls to identify, by polymerase chain reaction (PCR), the following periodontopathogens: Porphyromonas gingivalis, Tanarella forsythia, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Treponema denticola. The majority of patients had chronic severe generalized periodontitis in stages III and IV. Laboratory investigations showed the occurrence of one or more of the five targeted periodontopathogens in 94.6% of the periodontal pockets examined. Of the examined periodontopathogens, only Porphyromonas gingivalis was confirmed in 1 atheromatous plaque sample collected from the wall of an aortic aneurysm. Therefore, the occurrence of this bacterium in these vessels was considered to be occasional in patients with chronic periodontitis.
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Gupta S, Mohindra R, Singla M, Khera S, Kumar A, Rathnayake N, Sorsa T, Pfützner A, Räisänen IT, Soni RK, Kanta P, Jain A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Suri V, Bhalla A. Validation of a noninvasive aMMP‐8 point‐of‐care diagnostic methodology in COVID‐19 patients with periodontal disease. Clin Exp Dent Res 2022; 8:988-1001. [PMID: 35818743 PMCID: PMC9350191 DOI: 10.1002/cre2.589] [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: 09/29/2021] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives The aim of this study was to validate an active matrix metalloproteinase (MMP‐8) point‐of‐care diagnostic tool in COVID‐19 patients with periodontal disease. Subjects, Materials, and Methods Seventy‐two COVID‐19‐positive and 30 COVID‐19‐negative subjects were enrolled in the study. Demographic data were recorded, periodontal examination carried out, and chairside tests run for evaluating the expression of active MMP‐8 (aMMP‐8) in the site with maximum periodontal breakdown via gingival crevicular fluid sampling as well as via a mouth rinse‐based kit for general disease activity. In COVID‐19‐positive patients, the kits were run again once the patients turned COVID‐19 negative. Results The overall (n = 102) sensitivity/specificity of the mouthrinse‐based kits to detect periodontal disease was 79.41%/36.76% and that of site‐specific kits was 64.71%/55.88% while adjusting for age, gender, and smoking status increased the sensitivity and specificity (82.35%/76.47% and 73.53%/88.24, respectively). Receiver operating characteristic (ROC) analysis for the adjusted model revealed very good area under the ROC curve 0.746–0.869 (p < .001) and 0.740–0.872 (p < .001) (the aMMP‐8 mouth rinse and site‐specific kits, respectively). No statistically significant difference was observed in the distribution of results of aMMP‐8 mouth rinse test (p = .302) and aMMP‐8 site‐specific test (p = .189) once the subjects recovered from COVID‐19. Conclusions The findings of the present study support the aMMP‐8 point‐of‐care testing (PoCT) kits as screening tools for periodontitis in COVID‐19 patients. The overall screening accuracy can be further increased by utilizing adjunctively risk factors of periodontitis. The reported noninvasive, user‐friendly, and objective PoCT diagnostic methodology may provide a way of stratifying risk groups, deciding upon referrals, and in the institution of diligent oral hygiene regimens.
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Affiliation(s)
- Shipra Gupta
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Ritin Mohindra
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Mohita Singla
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Sagar Khera
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Amit Kumar
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Nilminie Rathnayake
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
- Department of Dental Medicine, Division of Periodontology Karolinska Institutet Huddinge Sweden
| | - Andreas Pfützner
- Clinical Research Department, Diabetes Center and Practice Pfützner Science and Health Institute Mainz Germany
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Roop K. Soni
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Poonam Kanta
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Akanksha Jain
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Krishan Gauba
- Unit of Periodontics, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kapil Goyal
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Mini P. Singh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Arnab Ghosh
- Department of Virology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Kamal Kajal
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Varun Mahajan
- Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - Vikas Suri
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
| | - Ashish Bhalla
- Department of Internal Medicine Post Graduate Institute of Medical Education & Research (PGIMER) Chandigarh India
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Ding N, Luo M, Wen YH, Li RY, Bao QY. The Effects of Non-Surgical Periodontitis Therapy on the Clinical Features and Serological Parameters of Patients Suffering from Rheumatoid Arthritis as Well as Chronic Periodontitis. J Inflamm Res 2022; 15:177-185. [PMID: 35046692 PMCID: PMC8760992 DOI: 10.2147/jir.s326896] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/09/2021] [Indexed: 01/22/2023] Open
Affiliation(s)
- Nan Ding
- Department of Stomatology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China
- Correspondence: Nan Ding Department of Stomatology, Beijing LuHe Hospital, Capital Medical University, No. 82 of Xinhua South Road, Tongzhou District, Beijing, 101149, People’s Republic of ChinaTel/Fax +86 10 69543901 Email
| | - Mei Luo
- Department of Central Laboratory, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China
| | - Ya-Hui Wen
- Department of Internal Medicine, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China
| | - Rong-Yin Li
- Department of Stomatology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China
| | - Qi-Yan Bao
- Department of Stomatology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China
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Chmielewski M, Załachowska O, Rybakowska W, Komandera D, Knura A, Albert A, Kostanowicz J, Garbacz K. COVID-19 in dental care: What do we know? J Oral Microbiol 2021; 13:1957351. [PMID: 34377355 PMCID: PMC8330703 DOI: 10.1080/20002297.2021.1957351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/04/2023] Open
Abstract
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is primarily transmitted by airborne droplets and its spread is favored by close human contact, thus the COVID-19 pandemic is the new challenge in dental practice. The oral cavity was considered as a SARS-CoV-2 reservoir, the viruses were detected in the saliva and periodontal pockets of infected persons. Therefore, aside from the most common symptoms, COVID-19 can manifest as lesions in the oral cavity. Due to the high risk of cross-contamination in the dental office, new precautionary measures were implemented in professional dental care to ensure safety for both, dental staff and patients. Given the dynamically changing situation, dental practitioners should follow local guidelines and implement them according to current needs and available resources. The key to success is to reduce the risk of cross-infection with SARS-CoV-2 at no cost to the good oral health of the population.
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Affiliation(s)
- Marek Chmielewski
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Oliwia Załachowska
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Weronika Rybakowska
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Dominika Komandera
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Agata Knura
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Adrian Albert
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Julia Kostanowicz
- Oral Microbiology Student Scientific Club, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, Gdansk, Poland
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Pathak JL, Yan Y, Zhang Q, Wang L, Ge L. The role of oral microbiome in respiratory health and diseases. Respir Med 2021; 185:106475. [PMID: 34049183 DOI: 10.1016/j.rmed.2021.106475] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/16/2022]
Abstract
The oral cavity (mouth) has various microbial habitats, including, teeth, gingival sulcus, gingiva, tongue, inner cheek, hard palate, and soft palate. The human oral cavity houses the second most diverse microbiome in the body harboring over 700 bacterial species. The fine-tuned equilibrium of the oral microbiome ecosystem maintains oral health. Oral dysbiosis caused by food habits and poor oral hygiene leads to various oral diseases such as periodontitis, caries, gingivitis, and oral cancer. Recent advances in technology have revealed the correlation between the oral microbiome and systemic diseases such as pulmonary diseases, cardiovascular diseases, rheumatoid arthritis, Alzheimer's disease, and other metabolic diseases. Since the oral cavity directly connects with the upper respiratory tract, the oral microbiome has easier access to the respiratory system compared to other organ systems. Direct aspiration of oral microflora in the respiratory system and oral dysbiosis-induced host immune reaction and inflammation are mainly responsible for various pulmonary complications. Numbers of literature have reported the correlation between oral diseases and pulmonary diseases, suggesting the possible role of the oral microbiome in respiratory diseases such as chronic obstructive pulmonary diseases, pneumonia, lung cancer, etc. This paper reviews the current evidence in establishing a link between the oral microbiome and pulmonary diseases. We also discuss future research directions focusing on the oral microbiome to unravel novel therapeutic approaches that could prevent or treat the various pulmonary complications.
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Affiliation(s)
- Janak L Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Yongyong Yan
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Qingbin Zhang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
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Campisi G, Bizzoca ME, Lo Muzio L. COVID-19 and periodontitis: reflecting on a possible association. Head Face Med 2021; 17:16. [PMID: 33975613 PMCID: PMC8110692 DOI: 10.1186/s13005-021-00267-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/04/2021] [Indexed: 01/19/2023] Open
Abstract
Recent studies have demonstrated a relationship between the severe clinical course of COVID-19 and other chronic diseases such as: cardiovascular disease, hypertension, diabetes mellitus, obesity and chronic renal disease. It may be possible to extend this association to a common and chronic oral disease in adults: periodontitis. Alternatively, the latter could be simply related to the systemic chronic diseases cited above, as already observed in the non-COVID-19 literature. In order to provide an overview and their opinion, the authors in this perspective article will report and discuss the most recent references of interest relating to COVID-19 and periodontitis pathophysiology. Within such a narrative review, the authors will hypothesize that the association between chronic periodontitis and COVID-19 could exist via two pathways: a direct link, through the ACEII and CD147 receptors used by the virus to infect the cells, which would occur in greater numbers in cases of periodontitis (thereby favoring a SARS-CoV-2 infection); and/or an indirect pathway involving the overexpression of inflammatory molecules, especially IL-6 and IL-17. An expression of the latter has been found to play a role in periodontitis, in addition to severe cases of COVID-19, although it is still unclear if it plays a direct role in the worsening of the clinical course.
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Affiliation(s)
- Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy.
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), Chieti, Italy.
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8
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Introducing Standardized Assessment and Management of Oral Cares in a Rehabilitation Unit: Patient Outcomes and Experiences. Rehabil Nurs 2020; 46:262-269. [PMID: 33315719 DOI: 10.1097/rnj.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to improve patient oral hygiene outcomes in a rehabilitation unit by implementing a nursing education package and oral hygiene assessment tool. DESIGN A case-control design with 50 rehabilitation patients was performed. METHODS Nursing staff received education and training in applying the Modified Oral Health Assessment Tool. Clinician assessment of patient oral hygiene occurred on admission and at days 5-7. Each patient reported their perceptions of oral hygiene and comfort prior to hospitalization, while in the hospital, and after transfer to the rehabilitation unit. FINDINGS Oral hygiene rating scores improved significantly from admission to the rehabilitation unit to days 5-7 (p = .00). The mean score of patient perceived cleanliness improved from hospital admission to admission to the rehabilitation unit. CONCLUSION Oral hygiene was improved following admission to a rehabilitation unit with a consistent and individualized approach to oral hygiene. CLINICAL RELEVANCE The introduction of a consistent and individualized approach to oral hygiene demonstrates positive patient outcomes and high patient acceptance.
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Sampson V, Kamona N, Sampson A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? Br Dent J 2020; 228:971-975. [PMID: 32591714 PMCID: PMC7319209 DOI: 10.1038/s41415-020-1747-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
On 30 January 2020, the World Health Organisation identified COVID-19, caused by the virus SARS-CoV-2, to be a global emergency. The risk factors already identified for developing complications from a COVID-19 infection are age, gender and comorbidities such as diabetes, hypertension, obesity and cardiovascular disease. These risk factors, however, do not account for the other 52% of deaths arising from COVID-19 in often seemingly healthy individuals. This paper investigates the potential link between SARS-CoV-2 and bacterial load, questioning whether bacteria may play a role in bacterial superinfections and complications such as pneumonia, acute respiratory distress syndrome and sepsis. The connection between COVID-19 complications and oral health and periodontal disease is also examined, as the comorbidities at highest risk of COVID-19 complications also cause imbalances in the oral microbiome and increase the risk of periodontal disease. We explore the connection between high bacterial load in the mouth and post-viral complications, and how improving oral health may reduce the risk of complications from COVID-19.
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Affiliation(s)
| | - Nawar Kamona
- Centre for Nutrition Education & Lifestyle Management, London, RG40 1DH, UK
| | - Ariane Sampson
- Orthodontics, Cambridge University Hospital Trust, Cambridge, CB1 00Q, UK
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Pessolano LG, Kramer CD, Simas A, Weinberg EO, Genco CA, Schreiber BM. Periodontal Disease and Birth Outcomes: Are We Missing Something? ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s40496-020-00255-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Kim SJ, Kim K, Choi S, Chang J, Kim SM, Park SM, Cho HJ. Chronic periodontitis and community-acquired pneumonia: a population-based cohort study. BMC Pulm Med 2019; 19:268. [PMID: 31888597 PMCID: PMC6937706 DOI: 10.1186/s12890-019-1017-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 12/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database. METHODS Data from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates. RESULTS A total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models. CONCLUSION The results of this study show that CP may not be a potential risk factor for CAP.
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Affiliation(s)
- Seon-Jip Kim
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehakro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, 03080, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
| | - Hyun-Jae Cho
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehakro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Kumar A, Rai A. Oral Health Status, Health Behaviour and Treatment Needs of Patients Undergoing Cardiovascular Surgery. Braz J Cardiovasc Surg 2019; 33:151-154. [PMID: 29898144 PMCID: PMC5985841 DOI: 10.21470/1678-9741-2017-0137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/22/2017] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of the present study was to assess the oral health status and
treatment needs of cardiovascular surgery patients. Second, the awareness of
cardiovascular surgery patients regarding the association between oral
health and heart disease was considered. Methods Assessment of oral health status, oral hygiene practices and treatment needs
of 106 hospitalized patients in preparation for cardiovascular surgery.
Patients were interviewed using a structured questionnaire designed for this
study and oral examination was carried out by a dentist. Results The oral hygiene practices of the study cohort were not up to the standard.
Patients' awareness of infective endocarditis was poor. Approximately 68%
patients experienced dental caries as decayed teeth or missing teeth due to
caries and filled teeth. The mean plaque index in the study group was 1.25.
In this study cohort, the mean probing depth of periodontal pockets was
5.7±1.3, whereas the mean number of teeth with periodontal pockets
> 6 mm was 0.5±0.9. A total of 84 (74.2%) of the patients required
dental treatment. Conclusion The principal finding in this study was that patients with heart disease had
poor oral health. This study also highlights the importance of better
interaction among all healthcare professionals to integrate oral health as
part of comprehensive inpatient healthcare.
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Affiliation(s)
- Ansul Kumar
- Rajendra Institute of Medical Sciences (RIMS) Ranchi, Jharkhand, India
| | - Arpita Rai
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
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OmpA-like proteins of Porphyromonas gingivalis contribute to serum resistance and prevent Toll-like receptor 4-mediated host cell activation. PLoS One 2018; 13:e0202791. [PMID: 30153274 PMCID: PMC6112661 DOI: 10.1371/journal.pone.0202791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/09/2018] [Indexed: 12/03/2022] Open
Abstract
Porphyromonas gingivalis possesses various abilities to evade and disrupt host immune responses, by which it acts as an important periodontal pathogen. P. gingivalis produces outer membrane protein A (OmpA)-like proteins (OmpALPs), Pgm6 and Pgm7, as major O-linked glycoproteins, but their pathological roles in P. gingivalis infection are largely unknown. Here, we report that OmpALP-deficient strains of P. gingivalis show an enhanced stimulatory activity in coculture with host cells. Such an altered ability of the OmpALP-deficient strains was found to be due to their impaired survival in coculture and the release of LPS from dead bacterial cells to stimulate Toll-like receptor 4 (TLR4). Further analyses revealed that the OmpALP-deficient strains were inviable in serum-containing media although they grew normally in the bacterial medium. The wild-type strain was able to grow in 90% normal human serum, while the OmpALP-deficient strains did not survive even at 5%. The OmpALP-deficient strains did not survive in heat-inactivated serum, but they gained the ability to survive and grow in proteinase K-treated serum. Of note, the sensitivity of the OmpALP-deficient strains to the bactericidal activity of human β-defensin 3 was increased as compared with the WT. Thus, this study suggests that OmpALPs Pgm6 and Pgm7 are important for serum resistance of P. gingivalis. These proteins prevent bacterial cell destruction by serum and innate immune recognition by TLR4; this way, P. gingivalis may adeptly colonize serum-containing gingival crevicular fluids and subgingival environments.
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Abstract
Conventional root canal therapies yield high success rates. The treatment outcomes are negatively affected by the presence of apical periodontitis (AP), which reflects active root canal infection and inflammatory responses. Also, cross-sectional studies revealed surprisingly high prevalence of AP in the general population, especially in those with prior endodontic treatments. Hence, AP is an ongoing disease entity in endodontics that needs further understanding of the pathogenesis and disease progression. The current Chapter will discuss the basic mechanisms of AP with emphasis on emerging role of epigenetic regulators in regulation of inflammatory mediators.
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Wallet SM, Puri V, Gibson FC. Linkage of Infection to Adverse Systemic Complications: Periodontal Disease, Toll-Like Receptors, and Other Pattern Recognition Systems. Vaccines (Basel) 2018; 6:E21. [PMID: 29621153 PMCID: PMC6027258 DOI: 10.3390/vaccines6020021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/25/2018] [Accepted: 03/30/2018] [Indexed: 12/13/2022] Open
Abstract
Toll-like receptors (TLRs) are a group of pattern recognition receptors (PRRs) that provide innate immune sensing of conserved pathogen-associated molecular patterns (PAMPs) to engage early immune recognition of bacteria, viruses, and protozoa. Furthermore, TLRs provide a conduit for initiation of non-infectious inflammation following the sensing of danger-associated molecular patterns (DAMPs) generated as a consequence of cellular injury. Due to their essential role as DAMP and PAMP sensors, TLR signaling also contributes importantly to several systemic diseases including cardiovascular disease, diabetes, and others. The overlapping participation of TLRs in the control of infection, and pathogenesis of systemic diseases, has served as a starting point for research delving into the poorly defined area of infection leading to increased risk of various systemic diseases. Although conflicting studies exist, cardiovascular disease, diabetes, cancer, rheumatoid arthritis, and obesity/metabolic dysfunction have been associated with differing degrees of strength to infectious diseases. Here we will discuss elements of these connections focusing on the contributions of TLR signaling as a consequence of bacterial exposure in the context of the oral infections leading to periodontal disease, and associations with metabolic diseases including atherosclerosis and type 2 diabetes.
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Affiliation(s)
- Shannon M Wallet
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
| | - Vishwajeet Puri
- Department of Biomedical Sciences and Diabetes Institute, Ohio University, Athens, OH 45701, USA.
| | - Frank C Gibson
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
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Biehler‐Gomez L, Cappella A, Castoldi E, Martrille L, Cattaneo C. Survival of Atherosclerotic Calcifications in Skeletonized Material: Forensic and Pathological Implications. J Forensic Sci 2017; 63:386-394. [DOI: 10.1111/1556-4029.13592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/18/2017] [Accepted: 06/06/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Lucie Biehler‐Gomez
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense Sezione Di Medicina Legale Dipartimento Di Scienze Biomediche per La Salute Università Degli Studi Di Milano Via Mangiagalli 37 20133 Milan Italy
| | - Annalisa Cappella
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense Sezione Di Medicina Legale Dipartimento Di Scienze Biomediche per La Salute Università Degli Studi Di Milano Via Mangiagalli 37 20133 Milan Italy
| | - Elisa Castoldi
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense Sezione Di Medicina Legale Dipartimento Di Scienze Biomediche per La Salute Università Degli Studi Di Milano Via Mangiagalli 37 20133 Milan Italy
| | | | - Cristina Cattaneo
- LABANOF, Laboratorio Di Antropologia E Odontologia Forense Sezione Di Medicina Legale Dipartimento Di Scienze Biomediche per La Salute Università Degli Studi Di Milano Via Mangiagalli 37 20133 Milan Italy
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Accuracy of Teledentistry for Diagnosing Dental Pathology Using Direct Examination as a Gold Standard: Results of the Tel-e-dent Study of Older Adults Living in Nursing Homes. J Am Med Dir Assoc 2017; 18:528-532. [DOI: 10.1016/j.jamda.2016.12.082] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/30/2016] [Indexed: 11/19/2022]
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Le Bars P, Matamoros S, Montassier E, Le Vacon F, Potel G, Soueidan A, Jordana F, de La Cochetière MF. The oral cavity microbiota: between health, oral disease, and cancers of the aerodigestive tract. Can J Microbiol 2017; 63:475-492. [PMID: 28257583 DOI: 10.1139/cjm-2016-0603] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many studies show that the human microbiome plays a critical role in the chronic pathologies of obesity, inflammatory bowel diseases, and diabetes. More recently, the interaction between cancer and the microbiome has been highlighted. Most studies have focused on the gut microbiota because it represents the most extensive bacterial community, and the body of evidence correlating it with gut syndromes is increasing. However, in the strict sense, the gastrointestinal (GI) tract begins in the oral cavity, and special attention should be paid to the specific flora of this cavity. This study reviewed the current knowledge about the various microbial ecosystems of the upper part of the GI tract and discussed their potential link to carcinogenesis. The overall composition of the microbial communities, as well as the presence or absence of "key species", in relation to carcinogenesis is addressed. Alterations in the oral microbiota can potentially be used to predict the risk of cancer. Molecular advances and the further monitoring of the microbiota will increase our understanding of the role of the microbiota in carcinogenesis and open new perspectives for future therapeutic and prophylactic modalities.
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Affiliation(s)
- Pierre Le Bars
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Sébastien Matamoros
- b Walloon Excellence in Life Sciences and Biotechnology, Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, 1, place de l'Université, 1348 Brussels, Belgium
| | - Emmanuel Montassier
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Françoise Le Vacon
- d Biofortis Innovation Services - Mérieux NutriSciences, 3, route de la Chatterie, 44800 Saint-Herblain, France
| | - Gilles Potel
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Assem Soueidan
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Fabienne Jordana
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Marie-France de La Cochetière
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
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Muthu J, Muthanandam S, Mahendra J. Mouth the mirror of lungs: where does the connection lie? Front Med 2016; 10:405-409. [DOI: 10.1007/s11684-016-0476-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 07/19/2016] [Indexed: 11/28/2022]
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Salivary Myeloperoxidase, Assessed by 3,3'-Diaminobenzidine Colorimetry, Can Differentiate Periodontal Patients from Nonperiodontal Subjects. Enzyme Res 2016; 2016:7517928. [PMID: 27274868 PMCID: PMC4871957 DOI: 10.1155/2016/7517928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/22/2016] [Accepted: 04/19/2016] [Indexed: 01/15/2023] Open
Abstract
Periodontal diseases, which result from inflammation of tooth supporting tissues, are highly prevalent worldwide. Myeloperoxidase (MPO), from certain white blood cells in saliva, is a biomarker for inflammation. We report our study on the salivary MPO activity and its association with severity of periodontal diseases among Thai patients. Periodontally healthy subjects (n = 11) and gingivitis (n = 32) and periodontitis patients (n = 19) were enrolled. Assessments of clinically periodontal parameters were reported as percentages for gingival bleeding index (GI) and bleeding on probing (BOP), whereas pocket depth (PD) and clinical attachment loss (CAL) were measured in millimeters and then made to index scores. Salivary MPO activity was measured by colorimetry using 3,3′-diaminobenzidine as substrate. The results showed that salivary MPO activity in periodontitis patients was significantly higher than in healthy subjects (p = 0.003) and higher than in gingivitis patients (p = 0.059). No difference was found between gingivitis and healthy groups (p = 0.181). Significant correlations were observed (p < 0.01) between salivary MPO activity and GI (r = 0.632, p < 0.001), BOP (r = 0.599, p < 0.001), PD (r = 0.179, p = 0.164), and CAL (r = 0.357, p = 0.004) index scores. Sensitivity (94.12%), specificity (54.55%), and positive (90.57%) and negative (66.67%) predictive values indicate that salivary MPO activity has potential use as a screening marker for oral health of the Thai community.
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Le Bars P, Kouadio AA, N'goran JK, Badran Z, Soueidan A. Relationship between removable prosthesis and some systemics disorders. J Indian Prosthodont Soc 2016; 15:292-9. [PMID: 26929530 PMCID: PMC4762353 DOI: 10.4103/0972-4052.171828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-Helicobacter pylori, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed, Candida albicans organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing C. albicans may be beneficial in these medically compromised patients.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Alain Ayepa Kouadio
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France; Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Justin Koffi N'goran
- Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Zahi Badran
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
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Mootha A, Malaiappan S, Jayakumar ND, Varghese SS, Toby Thomas J. The Effect of Periodontitis on Expression of Interleukin-21: A Systematic Review. Int J Inflam 2016; 2016:3507503. [PMID: 26998377 PMCID: PMC4779837 DOI: 10.1155/2016/3507503] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/24/2015] [Accepted: 01/11/2016] [Indexed: 01/11/2023] Open
Abstract
Purpose. Inflammation and tissue breakdown are led by an array of inflammatory destructive mediators associated with initiation and progression of inflammatory diseases like periodontitis. Current evidence shows that these inflammatory mediators have a definitive role in the pathogenesis of various systemic diseases with an inflammatory component. Interleukin-21 (IL-21) has been associated with systemic diseases like rheumatoid arthritis and Crohn's disease that follow a chronic inflammatory cascade. Similarly recent studies have associated Interleukin-21 levels with periodontitis. This systematic review was aimed to assess the levels of IL-21 in subjects with periodontitis. Methods. A complete literature search was done in PubMed, Medline, Science Direct, and Cochrane databases and Google Scholar based on the inclusion/exclusion criteria. Six relevant articles were procured. Full text was read individually by two reviewers and data extraction was done based on STROBE statement. Results. After data extraction five observational and one interventional study were obtained. All the studies showed an increased expression of IL-21 in periodontitis and the interventional study showed reduction in IL-21 levels after nonsurgical periodontal therapy (NSP). Conclusion. Interleukin-21 levels are higher in periodontitis than controls. With this limited evidence further longitudinal studies are required to consider this as a definitive inflammatory marker.
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Affiliation(s)
- Archana Mootha
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Sankari Malaiappan
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - N. D. Jayakumar
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Sheeja S. Varghese
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
| | - Julie Toby Thomas
- Department of Periodontics, Saveetha Dental College and Hospitals, No. 162, Poonamallee High Road, Velappanchavadi, Chennai 600077, India
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Martelli FS, Fanti E, Rosati C, Martelli M, Bacci G, Martelli ML, Medico E. Long-term efficacy of microbiology-driven periodontal laser-assisted therapy. Eur J Clin Microbiol Infect Dis 2016; 35:423-31. [DOI: 10.1007/s10096-015-2555-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/10/2015] [Indexed: 12/23/2022]
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Lin PY, Chien KL, Chang HJ, Chi LY. Unfinished Root Canal Treatments and the Risk of Cardiovascular Disease. J Endod 2015; 41:1991-6. [DOI: 10.1016/j.joen.2015.08.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 08/30/2015] [Indexed: 12/24/2022]
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Kinane DF, Zhang P, Benakanakere M, Singleton J, Biesbrock A, Nonnenmacher C, He T. Experimental gingivitis, bacteremia and systemic biomarkers: a randomized clinical trial. J Periodontal Res 2015; 50:864-9. [PMID: 25960104 DOI: 10.1111/jre.12280] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Bacteremia and systemic inflammatory markers are associated with periodontal and systemic diseases and may be linking mechanisms between these conditions. We hypothesized that in the development of gingival inflammation, systemic markers of inflammation and bacteremia would increase. MATERIAL AND METHODS To study the effect of bacteremia on systemic inflammatory markers, we recruited 80 subjects to participate in an experimental gingivitis study. Subjects were stratified based on gender, smoking and the number of bleeding sites and then randomized to one of two groups: control group (n = 40) or experimental gingivitis group (n = 40). Subjects in the control group conducted an oral hygiene regimen: brushing twice daily with a regular sodium fluoride cavity protection dentifrice and a standard manual toothbrush, flossing twice daily, and mouth rinsing with an anti-cavity fluoride rinse once daily. The experimental group stopped brushing and flossing, and used only the fluoride anti-cavity mouth rinse for 21 d. RESULTS Seventy-nine of 80 subjects were evaluable. One subject in the control group was excluded from the results due to antibiotic use during the study. Our data showed the experimental gingivitis group exhibited a significant (p < 0.05) increase in dental plaque level and gingival inflammatory indices relative to baseline and the control group but a decrease in bacteremia and soluble intercellular adhesion molecule-1 levels vs. baseline. Bacteremia was negatively correlated with gingival inflammatory indices and soluble intercellular adhesion molecule-1 levels in the experimental gingivitis group, thus negating our hypothesis. CONCLUSION We conclude that there are marked differences in systemic cytokine levels over the course of short-term experimentally induced gingivitis and further conclude that a long-term periodontitis study must be considered to address mechanisms whereby oral diseases may affect systemic diseases.
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Affiliation(s)
- D F Kinane
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Zhang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M Benakanakere
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J Singleton
- Department of Periodontics, Endodontics and Dental Hygiene, Center for Oral Health and Systemic Disease, University of Louisville School of Dentistry, Louisville, KY, USA
| | - A Biesbrock
- Health Care Research Center, Procter & Gamble Company, Mason, OH, USA
| | - C Nonnenmacher
- Institute of Medical Microbiology and Hygiene, Philipps University Marburg, Marburg, Germany
| | - T He
- Health Care Research Center, Procter & Gamble Company, Mason, OH, USA
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Bartova J, Sommerova P, Lyuya-Mi Y, Mysak J, Prochazkova J, Duskova J, Janatova T, Podzimek S. Periodontitis as a risk factor of atherosclerosis. J Immunol Res 2014; 2014:636893. [PMID: 24741613 PMCID: PMC3987959 DOI: 10.1155/2014/636893] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/29/2014] [Accepted: 02/17/2014] [Indexed: 11/24/2022] Open
Abstract
Over the last two decades, the amount of evidence corroborating an association between dental plaque bacteria and coronary diseases that develop as a result of atherosclerosis has increased. These findings have brought a new aspect to the etiology of the disease. There are several mechanisms by which dental plaque bacteria may initiate or worsen atherosclerotic processes: activation of innate immunity, bacteremia related to dental treatment, and direct involvement of mediators activated by dental plaque and involvement of cytokines and heat shock proteins from dental plaque bacteria. There are common predisposing factors which influence both periodontitis and atherosclerosis. Both diseases can be initiated in early childhood, although the first symptoms may not appear until adulthood. The formation of lipid stripes has been reported in 10-year-old children and the increased prevalence of obesity in children and adolescents is a risk factor contributing to lipid stripes development. Endothelium damage caused by the formation of lipid stripes in early childhood may lead to bacteria penetrating into blood circulation after oral cavity procedures for children as well as for patients with aggressive and chronic periodontitis.
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Affiliation(s)
- Jirina Bartova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Pavla Sommerova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Yelena Lyuya-Mi
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jaroslav Mysak
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jarmila Prochazkova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jana Duskova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Tatjana Janatova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Stepan Podzimek
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
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Langfeldt D, Neulinger SC, Heuer W, Staufenbiel I, Künzel S, Baines JF, Eberhard J, Schmitz RA. Composition of microbial oral biofilms during maturation in young healthy adults. PLoS One 2014; 9:e87449. [PMID: 24503584 PMCID: PMC3913613 DOI: 10.1371/journal.pone.0087449] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 12/26/2013] [Indexed: 11/18/2022] Open
Abstract
In the present study we aimed to analyze the bacterial community structure of oral biofilms at different maturation stages in young healthy adults. Oral biofilms established on membrane filters were collected from 32 human subjects after 5 different maturation intervals (1, 3, 5, 9 and 14 days) and the respective phylogenetic diversity was analyzed by 16S rDNA amplicon sequencing. Our analyses revealed highly diverse entire colonization profiles, spread into 8 phyla/candidate divisions and in 15 different bacterial classes. A large inter-individual difference in the subjects' microbiota was observed, comprising 35% of the total variance, but lacking conspicuous general temporal trends in both alpha and beta diversity. We further obtained strong evidence that subjects can be categorized into three clusters based on three differently occurring and mutually exclusive species clusters.
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Affiliation(s)
- Daniela Langfeldt
- Institute for General Microbiology, Christian-Albrechts-University, Kiel, Germany
| | - Sven C. Neulinger
- Institute for General Microbiology, Christian-Albrechts-University, Kiel, Germany
| | - Wieland Heuer
- Department of Prosthetic Dentistry and Biomaterials Science, Hannover Medical School, Hannover, Germany
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Sven Künzel
- Max-Planck Institute for Evolutionary Biology, Plön, Germany
| | - John F. Baines
- Max-Planck Institute for Evolutionary Biology, Plön, Germany
- Institute for Experimental Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Jörg Eberhard
- Department of Prosthetic Dentistry and Biomaterials Science, Hannover Medical School, Hannover, Germany
| | - Ruth A. Schmitz
- Institute for General Microbiology, Christian-Albrechts-University, Kiel, Germany
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Jung YS, Shin MH, Kim IS, Kweon SS, Lee YH, Kim OJ, Kim YJ, Chung HJ, Kim OS. Relationship between periodontal disease and subclinical atherosclerosis: the Dong-gu study. J Clin Periodontol 2013; 41:262-8. [PMID: 24256094 DOI: 10.1111/jcpe.12204] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 12/01/2022]
Abstract
AIM We assessed the association of periodontal disease and number of missing teeth with subclinical atherosclerosis in an adult Korean population. MATERIALS AND METHODS Cross-sectional data from 5404 individuals aged ≥50 years were obtained from the 2008-2010 Dong-gu study. Periodontal examinations were conducted to determine the number of missing teeth, pocket depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP). The percentages of sites with PD ≥ 4 mm (PD 4%), CAL ≥ 4 mm (CAL 4%), and BOP (BOP%) were recorded for each participant. B-mode ultrasound was performed to determine common carotid artery intima-media thickness (CCA IMT) and the presence of carotid plaques. Multivariate linear regression models were used to assess the associations between periodontal parameters and CCA IMT and carotid plaque. RESULTS Number of missing teeth was associated with increased CCA IMT, and BOP% was associated with increased CCA IMT in females only. This association was robust in never smokers. CONCLUSIONS The number of missing teeth was associated with CCA IMT, and BOP% was associated with CCA IMT in females only. These associations were robust in never smokers. Our results suggest that tooth loss due to oral disease may play a role in subclinical carotid atherosclerosis.
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Affiliation(s)
- Young-Suk Jung
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, South Korea
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Impact of improvement in preoperative oral health on nosocomial pneumonia in a group of cardiac surgery patients: a single arm prospective intervention study. Intensive Care Med 2013; 40:23-31. [DOI: 10.1007/s00134-013-3049-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/25/2013] [Indexed: 11/25/2022]
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Pires JR, Dezem TU, Barroso EM, Toledo BECD, Monteiro SCM, Martins AT, Zuza EP. Cardiovascular risk in obese patients with chronic periodontitis: a clinical controlled study. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000300008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Studies have shown that obesity is considered a risk factor for the development of periodontal disease and cardiovascular events. OBJECTIVE: The objective was to evaluate the risk for cardiovascular diseases (CVDs) in obese patients with and without periodontal. MATERIAL AND METHOD: One hundred patients were divided into four groups: Group O - obese without chronic periodontitis (n=25); Group OP - obese with chronic periodontitis (n=25); Group NO - non-obese without chronic periodontitis (n=25); and Group NOP - non-obese with chronic periodontitis (n=25). Demographic and laboratorial data (total cholesterol, high-density lipoprotein - HDL and low-density lipoprotein - LDL, triglycerides, and glucose); anthropometric measurements (body mass index - BMI; waist circumference - WC; body fat - BF); blood pressure; and periodontal parameters (bleeding on probing - BOP, periodontal probing depth - PPD, and the clinical attachment level - CAL) were evaluated. Cardiovascular risk was obtained according to the PROCAM's score. The correlation between obesity, periodontal disease and risk for CVD was verified by Spearman's test (α = 0.05). RESULT: The group OP showed a statistically higher rate of PPD > 7 mm (11.2 ± 2.03) when compared with other groups, as well as higher levels of triglycerides, total cholesterol, and LDL (p<0.05). The risk for CVD was statistically higher in the group OP (28.1 ± 3.3) when compared with group O (16.5 ± 3.5), group NOP (12.8 ± 3.9), and group NO (7.7 ± 0.9). Obesity and periodontal disease are directly related to a moderate increase in CVD risk (r = 0.53, p <0.0001 and r = 0.62, p <0.0001, respectively). CONCLUSION: It was concluded that obesity and periodontal disease increases the risk to cardiovascular events.
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Wilensky A, Segev H, Mizraji G, Shaul Y, Capucha T, Shacham M, Hovav AH. Dendritic cells and their role in periodontal disease. Oral Dis 2013; 20:119-26. [DOI: 10.1111/odi.12122] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/17/2013] [Accepted: 04/17/2013] [Indexed: 01/08/2023]
Affiliation(s)
- A Wilensky
- Department of Periodontology; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - H Segev
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - G Mizraji
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - Y Shaul
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - T Capucha
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - M Shacham
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
| | - A-H Hovav
- Institute of Dental Sciences; Hebrew University-Hadassah Faculty of Dental Medicine; Jerusalem Israel
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Shaik-Dasthagirisaheb YB, Huang N, Baer MT, Gibson FC. Role of MyD88-dependent and MyD88-independent signaling in Porphyromonas gingivalis-elicited macrophage foam cell formation. Mol Oral Microbiol 2013; 28:28-39. [PMID: 23194377 PMCID: PMC3543481 DOI: 10.1111/omi.12003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2012] [Indexed: 12/13/2022]
Abstract
Clinical studies and experimental modeling identify a potential link between periodontal disease and periodontal pathogens such as Porphyromonas gingivalis and atherosclerosis and formation of macrophage foam cells. Toll-like receptors and molecules governing their intracellular signaling pathways such as MyD88 play roles in atherosclerosis, as well as host response to P. gingivalis. The aim of this study was to define roles of MyD88 and TRIF during macrophage foam cell formation in response to P. gingivalis. In the presence of human low-density lipoprotein (LDL) mouse bone-marrow-derived macrophages (BMφ) cultured with P. gingivalis responded with significant reduction in tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). The BMφ stained strongly with oil red O, regardless of whether bacterial challenge occurred concurrent with or before LDL treatment. Heat-killed P. gingivalis stimulated foam cell formation in a similar way to live bacteria. The BMφ from MyD88-knockout and Lps2 mice revealed a significant role for MyD88, and a minor role for TRIF in P. gingivalis-elicited foam cell formation. Porphyromonas gingivalis-elicited TNF-α and IL-6 were affected by MyD88 ablation and to a lesser extent by TRIF status. These data indicate that LDL affects the TNF-α and IL-6 response of macrophages to P. gingivalis challenge and that MyD88 and TRIF play important roles in P. gingivalis-elicited foam cell formation.
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Affiliation(s)
| | - Nasi Huang
- Section of Infectious Diseases, Department of Medicine, Boston University Medical Center, Boston, MA 02118
| | | | - Frank C. Gibson
- Section of Infectious Diseases, Department of Medicine, Boston University Medical Center, Boston, MA 02118
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Yildirim E, Kormi I, Başoğlu ÖK, Gürgün A, Kaval B, Sorsa T, Buduneli N. Periodontal health and serum, saliva matrix metalloproteinases in patients with mild chronic obstructive pulmonary disease. J Periodontal Res 2012; 48:269-75. [DOI: 10.1111/jre.12004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2012] [Indexed: 11/28/2022]
Affiliation(s)
- E. Yildirim
- Department of Periodontology; School of Dentistry; Ege University; İzmir Turkey
| | - I. Kormi
- Department of Oral and Maxillofacial Surgery; University of Oulu and Oulu University Central Hospital; Oulu Finland
- Helsinki University Hospital; Institute of Dentistry and Department of Oral and Maxillofacial Diseases; University of Helsinki; Helsinki Finland
| | - Ö. K. Başoğlu
- Department of Chest Diseases; School of Medicine; Ege University; İzmir Turkey
| | - A. Gürgün
- Department of Chest Diseases; School of Medicine; Ege University; İzmir Turkey
| | - B. Kaval
- Department of Periodontology; School of Dentistry; Ege University; İzmir Turkey
| | - T. Sorsa
- Helsinki University Hospital; Institute of Dentistry and Department of Oral and Maxillofacial Diseases; University of Helsinki; Helsinki Finland
| | - N. Buduneli
- Department of Periodontology; School of Dentistry; Ege University; İzmir Turkey
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Periodontal infections and community-acquired pneumonia: a case–control study. Eur J Clin Microbiol Infect Dis 2012; 32:27-32. [DOI: 10.1007/s10096-012-1710-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 07/18/2012] [Indexed: 10/28/2022]
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36
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Dutzan N, Vernal R, Vaque JP, García-Sesnich J, Hernandez M, Abusleme L, Dezerega A, Gutkind JS, Gamonal J. Interleukin-21 Expression and Its Association With Proinflammatory Cytokines in Untreated Chronic Periodontitis Patients. J Periodontol 2012; 83:948-54. [DOI: 10.1902/jop.2011.110482] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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Cogo K, de Andrade A, Labate CA, Bergamaschi CC, Berto LA, Franco GCN, Gonçalves RB, Groppo FC. Proteomic analysis ofPorphyromonas gingivalisexposed to nicotine and cotinine. J Periodontal Res 2012; 47:766-75. [DOI: 10.1111/j.1600-0765.2012.01494.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Adibrad M, Deyhimi P, Ganjalikhani Hakemi M, Behfarnia P, Shahabuei M, Rafiee L. Signs of the presence of Th17 cells in chronic periodontal disease. J Periodontal Res 2012; 47:525-31. [PMID: 22309127 DOI: 10.1111/j.1600-0765.2011.01464.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Adibrad
- Department of Periodontology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
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39
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Si Y, Fan H, Song Y, Zhou X, Zhang J, Wang Z. Association between periodontitis and chronic obstructive pulmonary disease in a Chinese population. J Periodontol 2012; 83:1288-96. [PMID: 22248220 DOI: 10.1902/jop.2012.110472] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND A relationship between periodontitis and chronic respiratory disease has been suggested by recent studies. The aim of this study is to explore the association between periodontitis and chronic obstructive pulmonary disease (COPD) in a Chinese population. METHODS We conducted a case-control study of 581 COPD cases and 438 non-COPD controls. Lung function examination, a 6-minute walk test, and the British Medical Research Council questionnaire were performed. Periodontal clinical examination index included probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PI), and alveolar bone loss. A validated index for predicting COPD prognosis, the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index, was also calculated. RESULTS Participants with more severe COPD were more likely to have severe periodontal disease. PD, AL, PI, alveolar bone loss, and the number of teeth were significantly associated with all stages of COPD (all P <0.001). When compared to controls (BODE = 0), participants with higher BODE scores had significantly higher AL (P <0.001), BI (P = 0.027), PI (P <0.001), alveolar bone loss (P <0.001), and the number of teeth (P <0.001). PI appeared to be the main periodontal health-related factor for COPD, with an odds ratio (OR) = 9.01 (95% CI = 3.98 to 20.4) in the entire study population OR = 8.28 (95% CI = 2.36 to 29.0), OR = 5.89 (95% CI = 2.64 to 13.1), and OR = 2.46 (95% CI = 1.47 to 4.10) for current, smokers, and non-smokers, respectively. CONCLUSION Our study found a strong association between periodontitis and COPD, and PI seemed to be a major periodontal factor for predicting COPD among Chinese adults.
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Affiliation(s)
- Yan Si
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
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Dutzan N, Rivas C, García-Sesnich J, Henríquez L, Rivera O, Dezerega A, Hernández M, Silva N, Aguillón JC, Puente J, Vernal R, Gamonal J. Levels of Interleukin-21 in Patients With Untreated Chronic Periodontitis. J Periodontol 2011; 82:1483-9. [DOI: 10.1902/jop.2011.100449] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Prasanna SJ. Causal relationship between periodontitis and chronic obstructive pulmonary disease. J Indian Soc Periodontol 2011; 15:359-65. [PMID: 22368360 PMCID: PMC3283933 DOI: 10.4103/0972-124x.92570] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 08/30/2011] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases. An association between periodontal disease and chronic obstructive pulmonary disease (COPD) has been observed. AIMS The aim of the present study was to evaluate the potential association between periodontal health and COPD and to assess the potential health status of patients with and without COPD. SETTINGS AND DESIGN In this observational study, the association between periodontal disease and COPD has been assessed. MATERIALS AND METHODS HUNDRED PATIENTS WERE CHOSEN FOR THE STUDY: group A comprising 50 COPD patients and group B consisting of 50 patients without COPD. Gingival Index (GI) and Papilla Bleeding Index (PBI) were used to assess the gingival status. Periodontal indices included Russell's Periodontal Index (PI) and Periodontal Index for Risk of Infectiousness (PIRI), which were assessed in all 100 patients. Analysis of covariance (ANCOVA) was the statistical analysis used. RESULTS After eliminating age affects using ANCOVA, the mean indices of all variables between groups were found to be highly significant (P<0.001). The scores were highly significant in COPD group than in non-COPD group. CONCLUSIONS The findings of the present study show that there is an association between periodontal disease and COPD. It is suggested that periodontitis is one of the risk factors for COPD.
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Affiliation(s)
- Surya J. Prasanna
- Department of Periodontics, Panineeya Maha Vidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Andhra Pradesh, India
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El-Solh AA. Association between pneumonia and oral care in nursing home residents. Lung 2011; 189:173-80. [PMID: 21533635 DOI: 10.1007/s00408-011-9297-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 04/17/2011] [Indexed: 11/25/2022]
Abstract
Pneumonia remains the leading cause of death in nursing home residents. The accumulation of dental plaque and colonization of oral surfaces and dentures with respiratory pathogens serves as a reservoir for recurrent lower respiratory tract infections. Control of gingivitis and dental plaques has been effective in reducing the rate of pneumonia but the provision of dental care for institutionalized elderly is inadequate, with treatment often sought only when patients experience pain or denture problems. Direct mechanical cleaning is thwarted by the lack of adequate training of nursing staff and residents' uncooperativeness. Chlorhexidine-based interventions are advocated as alternative methods for managing the oral health of frail older people; however, efficacy is yet to be demonstrated in randomized controlled trials. Development and maintenance of an oral hygiene program is a critical step in the prevention of pneumonia. While resources may be limited in long-term-care facilities, incorporating oral care in daily routine practice helps to reduce systemic diseases and to promote overall quality of life in nursing home residents.
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Affiliation(s)
- Ali A El-Solh
- Medical Research, Bldg. 20 (151) VISN02, VA Western New York Healthcare System, Buffalo, NY 14215-1199, USA.
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Sharma N, Shamsuddin H. Association between respiratory disease in hospitalized patients and periodontal disease: a cross-sectional study. J Periodontol 2011; 82:1155-60. [PMID: 21219100 DOI: 10.1902/jop.2011.100582] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recent research indicated that periodontal infection may worsen systemic diseases, including pulmonary disease. Respiratory infections, such as pneumonia and the exacerbation of chronic obstructive pulmonary disease, involve the aspiration of bacteria from the oropharynx into the lower respiratory tract. METHODS A group of 100 cases (hospitalized patients with respiratory disease) and a group of 100 age-, sex-, and race-matched outpatient controls (systemically healthy patients from the outpatient clinic, Department of Periodontics, Government Dental College and Hospital, Calicut, Kerala, India) were selected for the study. Standardized measures of oral health that were performed and compared included the gingival index (GI), plaque index (PI), and simplified oral hygiene index (OHI). Data regarding probing depths and clinical attachment levels (CALs) were recorded at four sites per tooth and compared statistically. The χ(2) and Student t tests were used for statistical analyses. RESULTS The comparison of study-population demographics on the basis of age, sex, education, and income showed no significant differences between groups. Patients with respiratory disease had significantly greater poor periodontal health (OHI and PI), gingival inflammation (GI), deeper pockets, and CALs compared to controls. In the case group, patients with a low income were 4.4 times more prone to periodontal disease compared to high-income patients. Smokers had significantly higher CALs compared to non-smokers in the control group. CONCLUSION The findings of the present analysis support an association between respiratory and periodontal disease.
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Affiliation(s)
- Nikhil Sharma
- Department of Periodontics, Institute of Technology and Science, Center for Dental Studies and Research, Murad Nagar, Ghaziabad, Uttar Pradesh, India.
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Nudel I, Elnekave M, Furmanov K, Arizon M, Clausen BE, Wilensky A, Hovav AH. Dendritic Cells in Distinct Oral Mucosal Tissues Engage Different Mechanisms To Prime CD8+T Cells. THE JOURNAL OF IMMUNOLOGY 2010; 186:891-900. [DOI: 10.4049/jimmunol.1002943] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chen H, Zheng P, Zhu H, Zhu J, Zhao L, El Mokhtari NE, Eberhard J, Lins M, Jepsen S. Platelet-activating factor levels of serum and gingival crevicular fluid in nonsmoking patients with periodontitis and/or coronary heart disease. Clin Oral Investig 2010; 14:629-36. [PMID: 19826843 PMCID: PMC3128738 DOI: 10.1007/s00784-009-0346-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 09/22/2009] [Indexed: 11/17/2022]
Abstract
The purpose of the present study was to investigate systemic and local levels of platelet-activating factor (PAF), a potent proinflammatory mediator implicated in cardiovascular pathophysiology in adult nonsmoking patients with periodontitis with or without coronary heart disease (CHD). Eighty-seven volunteers, 25 periodontitis patients, 19 periodontitis with CHD patients, 19 CHD patients, and 24 healthy controls were included, and periodontal conditions were assessed. Gingival crevicular fluid (GCF) and venous blood were collected, and PAF levels were measured by enzyme-linked immunosorbent assay. PAF levels in serum (303.3 ± 204 pg/ml) and in GCF (26.3 ± 6 pg/μl) of the periodontitis group with CHD, the periodontitis group (serum, 302.4 ± 241 pg/ml and GCF, 26.3 ± 8 pg/μl) and the CHD group (serum, 284.7 ± 192 pg/ml and GCF, 20.8 ± 6 pg/μl) were significantly higher than the healthy control group (serum, 65.4 ± 35 pg/ml and GCF, 7.7 ± 3 pg/μl; p < 0.05). In summary, the present study could demonstrate that in patients with periodontitis, the inflammatory mediator PAF is released into serum at least in the same range as for patients with coronary heart disease. However, no additive effects were seen when both conditions were present.
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Affiliation(s)
- Hui Chen
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Pei Zheng
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Haihua Zhu
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Jianhua Zhu
- Department of Cardiology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Lili Zhao
- Department of Cardiology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Nour Eddine El Mokhtari
- Department of Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jörg Eberhard
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Göttingen, Germany
| | - Markus Lins
- Department of Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstr, 17, 53111 Bonn, Germany
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Schaefer AS, Richter GM, Nothnagel M, Manke T, Dommisch H, Jacobs G, Arlt A, Rosenstiel P, Noack B, Groessner-Schreiber B, Jepsen S, Loos BG, Schreiber S. A genome-wide association study identifies GLT6D1 as a susceptibility locus for periodontitis. Hum Mol Genet 2009; 19:553-62. [PMID: 19897590 DOI: 10.1093/hmg/ddp508] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Periodontitis is a widespread, complex inflammatory disease of the mouth, which results in a loss of gingival tissue and alveolar bone, with aggressive periodontitis (AgP) as its most severe form. To identify genetic risk factors for periodontitis, we conducted a genome-wide association study in German AgP patients. We found AgP to be strongly associated with the intronic SNP rs1537415, which is located in the glycosyltransferase gene GLT6D1. We replicated the association in a panel of Dutch generalized and localized AgP patients. In the combined analysis including 1758 subjects, rs1537415 reached a genome-wide significance level of P= 5.51 x 10(-9), OR = 1.59 (95% CI 1.36-1.86). The associated rare G allele of rs1537415 showed an enrichment of 10% in periodontitis cases (48.4% in comparison with 38.8% in controls). Fine-mapping and a haplotype analysis indicated that rs1537415 showed the strongest association signal. Sequencing identified no further associated variant. Tissue-specific expression analysis of GLT6D1 indicated high transcript levels in the leukocytes, the gingiva and testis. Analysis of potential transcription factor binding sites at this locus predicted a significant reduction of GATA-3 binding affinity, and an electrophoretic mobility assay indicated a T cell specific reduction of protein binding for the G allele. Overexpression of GATA-3 in HEK293 cells resulted in allele-specific binding of GATA-3, indicating the identity of GATA-3 as the binding protein. The identified association of GLT6D1 with AgP implicates this locus as an important susceptibility factor, and GATA-3 as a potential signaling component in the pathophysiology of periodontitis.
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Affiliation(s)
- Arne S Schaefer
- Institute for Clinical Molecular Biology, Christian-Albrechts-University Kiel, Schittenhelmstrasse 12, Kiel, Germany.
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Guentsch A, Puklo M, Preshaw PM, Glockmann E, Pfister W, Potempa J, Eick S. Neutrophils in chronic and aggressive periodontitis in interaction with Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. J Periodontal Res 2009; 44:368-77. [PMID: 19210340 DOI: 10.1111/j.1600-0765.2008.01113.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE This study analyzed the interaction of Porphyromonas gingivalis ATCC 33277 and Aggregatibacter actinomycetemcomitans Y4 with peripheral blood polymorphonuclear neutrophils taken from patients with aggressive periodontitis and chronic periodontitis. MATERIAL AND METHODS Peripheral blood polymorphonuclear neutrophils obtained from 12 patients with chronic periodontitis, six patients with aggressive periodontitis and 12 healthy controls were exposed to P. gingivalis and A. actinomycetemcomitans following opsonization of the bacteria using the patient's own serum. Serum immunoglobulin G (IgG) levels against both periodontopathogens were measured. Phagocytosis and killing of the bacteria, as well as the extracellular human neutrophil elastase activity, were quantified. The total amount and the extracellular release of reactive oxygen species were measured using luminol-dependent and isoluminol-dependent chemiluminescence. RESULTS Polymorphonuclear neutrophils from patients with chronic (62.16 +/- 19.39%) and aggressive (43.26 +/- 26.63%) periodontitis phagocytosed more P. gingivalis than the healthy controls (24.43 +/- 19.87%) at the 30-min time point after exposure to the bacteria (p < 0.05). High serum IgG levels against P. gingivalis and A. actinomycetemcomitans were detected in subjects with periodontitis. Polymorphonuclear neutrophils from subjects with chronic and aggressive periodontitis released significantly more reactive oxygen species and demonstrated greater human neutrophil elastase activity in the absence of any stimulus than polymorphonuclear neutrophils from healthy controls (p < 0.05). Polymorphonuclear neutrophils in chronic periodontitis released significantly more reactive oxygen species when exposed to P. gingivalis and A. actinomycetemcomitans than polymorphonuclear neutrophils in aggressive periodontitis. CONCLUSION High serum IgG levels against P. gingivalis and A. actinomycetemcomitans promote phagocytosis in periodontitis. The extracellular release of reactive oxygen species and neutrophil elastase by polymorphonuclear neutrophils may also contribute to damage of the surrounding periodontal tissues.
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Affiliation(s)
- A Guentsch
- Department of Conservative Dentistry, University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
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The interleukin-17 receptor plays a gender-dependent role in host protection against Porphyromonas gingivalis-induced periodontal bone loss. Infect Immun 2008; 76:4206-13. [PMID: 18591228 DOI: 10.1128/iai.01209-07] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Interleukin-17 (IL-17) is a proinflammatory cytokine secreted by the newly described CD4(+) Th17 subset, which is distinct from classic Th1 and Th2 lineages. IL-17 contributes to bone destruction in rheumatoid arthritis but is essential in host defense against pathogens that are susceptible to neutrophils. Periodontal disease (PD) is a chronic inflammatory condition initiated by anaerobic oral pathogens such as Porphyromonas gingivalis, and it is characterized by host-mediated alveolar bone destruction due primarily to the immune response. The role of IL-17 in PD is controversial. Whereas elevated IL-17 levels have been found in humans with severe PD, we recently reported that female C57BL/6J mice lacking the IL-17 receptor (IL-17RA(KO)) are significantly more susceptible to PD bone loss due to defects in the chemokine-neutrophil axis (J. J. Yu, M. J. Ruddy, G. C. Wong, C. Sfintescu, P. J. Baker, J. B. Smith, R. T. Evans, and S. L. Gaffen, Blood 109:3794-3802, 2007). Since different mouse strains exhibit differences in susceptibility to PD as well as Th1/Th2 cell skewing, we crossed the IL-17RA gene knockout onto the BALB/c background and observed a similar enhancement in alveolar bone loss following P. gingivalis infection. Unexpectedly, in both strains IL-17RA(KO) female mice were much more susceptible to PD bone loss than males. Moreover, female BALB/c-IL-17RA(KO) mice were defective in producing anti-P. gingivalis immunoglobulin G and the chemokines KC/Groalpha and MIP-2. In contrast, male mice produced normal levels of chemokines and anti-P. gingivalis antibodies, but they were defective in granulocyte colony-stimulating factor upregulation. This study demonstrates a gender-dependent effect of IL-17 signaling and indicates that gender differences should be taken into account in the preclinical and clinical safety testing of anti-IL-17 biologic therapies.
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Navarro-Sanchez AB, Faria-Almeida R, Bascones-Martinez A. Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. J Clin Periodontol 2007; 34:835-43. [PMID: 17850602 DOI: 10.1111/j.1600-051x.2007.01127.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the local efficacy of nonsurgical periodontal therapy between type 2 diabetic and non-diabetic patients and the effect of periodontal therapy on glycaemic control. BACKGROUND A complex two-way relationship exists between diabetes mellitus and periodontitis. MATERIALS AND METHODS After selection, 20 subjects (10 diabetic and 10 non-diabetic) underwent baseline examination, periodontal clinical study and biochemical analysis of gingival crevicular fluid (GCF). After the pre-treatment phase, subgingival scaling and root planing were performed. Subsequently, all subjects continued the maintenance programme and were re-examined at 3 and 6 months. RESULTS Diabetic and non-diabetic subjects responded well after therapy, showing a very similar progression during the follow-up period. Both groups showed clinically and immunologically significant improvements. Significant reductions were also found in the total volume of GCF and levels of interleukin-1beta and tumour necrosis factor-alpha. Diabetic subjects showed an improvement in their metabolic control. The change in glycosylated haemoglobin (HbA(1C)) was statistically significant at 3 and 6 months. CONCLUSIONS The clinical and immunological improvements obtained were accompanied by a significant reduction in HbA(1C) values in type 2 diabetic subjects. Larger studies are needed to confirm this finding and establish whether periodontal therapy has a significant effect on glycaemic control.
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Bazen J, Paul D, Tennant M. An aboriginal and Torres Strait Islander oral health curriculum framework: development experiences in Western Australia. Aust Dent J 2007; 52:86-92. [PMID: 17687952 DOI: 10.1111/j.1834-7819.2007.tb00470.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Indigenous oral health is widely acknowledged as paralleling the significant issues faced in general health. It is recognized that as part of the process of addressing these issues, practitioners need to be aware of the complex nature of working in an Indigenous social and cultural context, including issues beyond direct health care services. It is against this backdrop that collaborators from The University of Western Australia's (UWA) Centre for Rural and Remote Oral Health (CRROH) and Centre for Aboriginal Medical and Dental Health (CAMDH) developed a comprehensive, integrated Indigenous Oral Health Curriculum Framework for the Bachelor of Dental Science (BDSc) course. This development was based on the existing framework developed by the Committee of Deans of Australian Medical Schools (CDAMS) for medical education but was tailored to the specific issues and needs of oral health. Additional consultation with the Oral Health Centre of Western Australia (OHCWA), the School of Indigenous Studies (SIS) as well as Indigenous Australian groups occurred to ensure the development process was inclusive. The inclusion of an Indigenous Oral Health Curriculum Framework in the BDSc will enable UWA dental graduates to practise dentistry in a culturally appropriate manner. The framework provides the structure for students to develop and demonstrate an understanding of Indigenous histories, cultures and social experiences and how these impact on Indigenous peoples' health. It is anticipated that this will foster more positive and culturally secure patient-practitioner interactions between UWA dental graduates and Indigenous Australians, thereby making it more likely for Indigenous Australians to present for treatment. The increased awareness of Indigenous oral health issues will hopefully encourage more graduates to become involved in the treatment of Indigenous peoples. The combination of these factors could lead to an improvement in oral health outcomes for Australia's Indigenous peoples and a concomitant positive impact on the general health of Indigenous Australians.
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Affiliation(s)
- J Bazen
- The Centre for Rural and Remote Oral Health, The University of Western Australia, Crawley.
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