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Wang AY, Lin GL, Keller JJ, Wang LH. Association between antihyperlipidemic agents and the risk of chronic periodontitis in patients with hyperlipidemia: A population-based retrospective cohort study in Taiwan. J Periodontol 2024; 95:483-493. [PMID: 37793052 DOI: 10.1002/jper.23-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/23/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The lipid-lowering and anti-inflammatory effects of statins and fibrates may ameliorate periodontitis. Patients with hyperlipidemia tend to have a worse periodontal status. This study assessed the association between the use of statins/fibrates and the incidence of chronic periodontitis in patients with hyperlipidemia in Taiwan. METHODS This retrospective cohort study enrolled patients newly diagnosed with hyperlipidemia between 2001 and 2012 from the 2000 Longitudinal Generation Tracking Database and followed them for 5 years. The study population was divided into four groups: statin monotherapy, fibrate monotherapy, combination therapy (both statins and fibrates), and control (neither statins nor fibrates). Each patient in the treatment group was matched at a ratio of 1:1 with a control. Chronic periodontitis risk was compared in the three study arms by using a Cox proportional hazard model. RESULTS Chronic periodontitis risk was reduced by 25.7% in the combination therapy group compared with the control group (adjusted hazard ratio [aHR], 0.743; 95% confidence interval (CI), 0.678-0.815). Low dose (<360 cumulative defined daily dose [cDDD]) and shorter duration (<2 years) of statin monotherapy seem to be associated with an increased risk of chronic periodontitis; high dose (≥720 cDDD/≥1080 cDDD) and longer duration (≥3 years) of statin/fibrate monotherapy may be correlated with a lower risk of periodontitis. Hydrophobic statin users had a lower chronic periodontitis risk than hydrophilic statin users. CONCLUSION Chronic periodontitis risk was lower in patients with hyperlipidemia on combination treatment with statins and fibrates, and the risk decreased when patients used statins or fibrates for >3 years.
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Affiliation(s)
- An-Yi Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Guan-Ling Lin
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Joseph Jordan Keller
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Li-Hsuan Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
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Lee T, Han K, Yun KI. Association between dental scaling and metabolic syndrome and lifestyle. PLoS One 2024; 19:e0297545. [PMID: 38573898 PMCID: PMC10994476 DOI: 10.1371/journal.pone.0297545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/09/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Periodontal disease is a risk factor for diabetes and metabolic syndrome, and non-surgical periodontal treatment has been shown to help maintain stable blood sugar in diabetic patients. Determining the level of preventive scaling in patients with metabolic syndrome will help manage the disease. The purpose of this study was to investigate the extent to which people with metabolic syndrome or bad lifestyle performed scaling and the association between preventive scaling and metabolic syndrome or lifestyle in a large population. METHODS This study was conducted on adults aged 20 years or older from January 2014 to December 2017 in the National Health Insurance System (NHIS) database. Among 558,067 people who underwent health checkups, 555,929 people were included. A total of 543,791 people were investigated for preventive scaling. Metabolic syndrome components were abdominal obesity, lower high density lipoprotein cholesterol (HDL)-C, high triglycerides, high blood pressure and hyperglycemia. Unhealthy lifestyle score was calculated by assigning 1 point each for current smokers, drinkers, and no performing regular exercise. RESULTS When multiple logistic regression analysis was performed after adjusting for age, sex, income, body mass index (BMI), smoking, drinking and regular exercise, the Odds ratios (OR) and 95% confidence intervals (CI) of the group with 5 metabolic syndrome components were 0.741 (0.710, 0.773) (p<0.0001). After adjustment for age, sex, income, BMI, smoking, drinking, regular exercise, diabetes, hypertension and dyslipidemia, the OR (95% CI) of the group with unhealthy lifestyle score = 3 was 0.612 (0.586, 0.640) (p<0.0001). CONCLUSIONS The more metabolic syndrome components, and the higher unhealthy lifestyle score, the less scaling was performed.
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Affiliation(s)
- TaeYeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyoung-In Yun
- Department of Oral and Maxillofacial Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Güvenç KK, Fentoğlu Ö, Calapoğlu M, Aksoy F, Orhan H. Periodontal and cardiovascular therapies modify specialized pro-resolving lipid mediator (sPRLM) (LPXA4, PD1, RvE1, RvD1, and MaR1)-mediated pathway: the first pilot clinical study. Clin Oral Investig 2023; 27:5549-5558. [PMID: 37535198 DOI: 10.1007/s00784-023-05174-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/15/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Cardiovascular disease (CVD) and periodontal disease have a common pathogenesis with inflammation and resolution steps. Although the relationships among periodontal disease, CVD, and specialized pro-resolving lipid mediator (sPRLM)s are well known, there is no study about the combined effects of cardiovascular and periodontal treatments on sPRLM levels. It was aimed to evaluate the effects of periodontal and cardiovascular therapies on sPRLMs (lipoxin A4, protectin (PD)1, resolvin (Rv) E1, RvD1, and maresin (MaR)1) in patients with CVD and periodontal disease. METHODS This observational study consisted of fifty-five patients with CVD and mild or moderate periodontitis. The clinical periodontal parameters (plaque index, gingival index, probing pocket depth, percentage of bleeding on probing, and clinical attachment level) and blood and unstimulated total saliva samples were obtained at baseline, at 3 months (following only cardiovascular therapy), and at 6 months (following cardiovascular and periodontal therapies). The blood count and serum levels of cardiometabolic biomarkers (white blood cell, neutrophil/lymphocyte, serum total cholesterol (TC), triglyceride, and low and high-density lipoprotein (HDL) levels) were evaluated. sPRLMs were evaluated by ELISA. RESULTS There were significant decreases in body mass index, clinical periodontal parameters, WBC, LDL, PD1, and RvD1 at 6 months compared to baseline. The decreases in TC/HDL, RvE1, and MaR1 levels were significant at 3 and 6 months compared to baseline (p < 0.05). CONCLUSION(S) The combination of cardiovascular and periodontal treatments leads to significant reductions in clinical periodontal and cardiometabolic parameters and sPRLMs. CLINICAL RELEVANCE Our report, which is the first in their field, suggested that cardiovascular and periodontal therapies provide an important contribution via decreasing the periodontal and atherosclerotic inflammation modulating sPRLMs. This finding will be a big step toward increasing the quality of life in these patients by drawing attention to importance of public health associated with oral hygiene, periodontal health, and systemic phase of periodontal treatment.
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Affiliation(s)
- Kübra Karakoç Güvenç
- Faculty of Dentistry, Department of Periodontology, Süleyman Demirel University, Isparta, Turkey
| | - Özlem Fentoğlu
- Faculty of Dentistry, Department of Periodontology, Süleyman Demirel University, Isparta, Turkey.
| | - Mustafa Calapoğlu
- Faculty of Science, Department of Biochemistry, Süleyman Demirel University, Isparta, Turkey
| | - Fatih Aksoy
- Faculty of Medicine, Department of Cardiology, Süleyman Demirel University, Isparta, Turkey
| | - Hikmet Orhan
- Faculty of Medicine, Department of Biostatistics, Süleyman Demirel Üniversitesi, Isparta, Turkey
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Oswal N, Thangavel H, Lizardo K, Dhanyalayam D, Sidrat T, Salgame P, Nagajyothi JF. Diets Differently Regulate Pulmonary Pathogenesis and Immune Signaling in Mice during Acute and Chronic Mycobacterium tuberculosis Infection. Life (Basel) 2023; 13:228. [PMID: 36676177 PMCID: PMC9861969 DOI: 10.3390/life13010228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) infection persists as a leading cause of mortality and morbidity globally, especially in developing and underdeveloped countries. The prevalence of TB-DM (diabetes mellitus) is higher in low- and middle-income countries where TB and DM are most prevalent. Epidemiological data suggest that slight obesity reduces the risk of TB, whereas DM increases the risk of pulmonary TB. Diets can alter the levels of body fat mass and body mass index by regulating systemic adiposity. Earlier, using a transgenic Mtb-infected murine model, we demonstrated that loss of body fat increased the risk of pulmonary bacterial load and pathology. In the present study, we investigated whether increased adiposity alters pulmonary pathology and bacterial load using C57BL/6 mice infected with HN878 Mtb strain and fed a medium-fat diet (MFD). We analyzed the effects of MFD on the lung during acute and chronic infections by comparing the results to those obtained with infected mice fed a regular diet (RD). Histological and biochemical analyses demonstrated that MFD reduces bacterial burden by increasing the activation of immune cells in the lungs during acute infection and reduces necrosis in the lungs during chronic infection by decreasing lipid accumulation. Our data suggest that slight adiposity likely protects the host during active TB infection by regulating immune and metabolic conditions in the lungs.
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Affiliation(s)
- Neelam Oswal
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Hariprasad Thangavel
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Kezia Lizardo
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Dhanya Dhanyalayam
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Tabinda Sidrat
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Padmini Salgame
- Department of Medicine, Center for Emerging Pathogens, Rutgers-New Jersey Medical School, Newark, NJ 07103, USA
| | - Jyothi F. Nagajyothi
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
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de Sousa VC, Sousa FRN, Vasconcelos RF, Martins CS, Lopes AP, Alves NM, Viana D, Alves K, Leitão R, Brito GAC, Girão V, Goes P. Atorvastatin reduces zoledronic acid-induced osteonecrosis of the jaws of rats. Bone 2022; 164:116523. [PMID: 35985466 DOI: 10.1016/j.bone.2022.116523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/03/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Vanessa Costa de Sousa
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Raquel Felipe Vasconcelos
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Conceição S Martins
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Amanda Pimentel Lopes
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Militão Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Delane Viana
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Karuza Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Renata Leitão
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Gerly A C Brito
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Virginia Girão
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Paula Goes
- Department of Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.
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Wu Z, Jayachandran M, Cheang WS, Xu B. Black Truffle Extract Exerts Antidiabetic Effects through Inhibition of Inflammation and Lipid Metabolism Regulation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6099872. [PMID: 35251478 PMCID: PMC8894047 DOI: 10.1155/2022/6099872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
Black truffle, a culinary and medical fungus, is highly valued worldwide for its nutritional and therapeutic importance. To enhance the existing knowledge about the beneficial properties, this study investigates the antioxidant, antihyperlipidemic, and anti-inflammatory effects of black truffle extract in in vitro biochemical assays and animal study. Briefly, black truffle extract was administered orally to treat streptozotocin- (STZ-) induced diabetic Wistar rats for 45 days. At the end of the experimental duration, rats were sacrificed to perform biochemical and gene expression analyses related to lipid regulatory and inflammatory pathways. Our results indicated that total cholesterol, triglycerides, free fatty acids, phospholipids, and low-density lipoprotein in different tissues and circulation were significantly increased in diabetic rats. Furthermore, the β-hydroxy β-methylglutaryl-CoA enzyme was also significantly increased; lipoprotein lipase and lecithin-cholesterol acyltransferase enzymes were significantly decreased in diabetic rats. However, the above conditions were reversed upon black truffle extract feeding. Furthermore, black truffle extract was also found to downregulate the expression of proinflammatory cytokines (tumor necrosis factor-α and interleukin-6) and lipid regulatory genes (serum regulatory element-binding protein-1 and fatty acid synthase). The truffle extract-treated effects were comparable to glibenclamide and medication commonly used to treat diabetes mellitus. Overall, our results suggested that black truffle possesses strong antihyperlipidemic and anti-inflammatory effects on diabetic rats. These findings will enhance the current knowledge about the therapeutic importance of black truffles. They might be exploited as a possible food supplement or even as a natural source of pharmaceutical agents for diabetes prevention and treatment.
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Affiliation(s)
- Ziyuan Wu
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, Guangdong 519087, China
| | - Muthukumaran Jayachandran
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, Guangdong 519087, China
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Wai San Cheang
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macao SAR, China
| | - Baojun Xu
- Food Science and Technology Program, BNU-HKBU United International College, Zhuhai, Guangdong 519087, China
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7
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Treadmill Exercise Ameliorates Short-term Memory Impairment by Suppressing Hippocampal Neuroinflammation in Poloxamer-407-Induced Hyperlipidemia Rats. Int Neurourol J 2021; 25:S81-89. [PMID: 34844390 PMCID: PMC8654313 DOI: 10.5213/inj.2142342.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Poloxamer-407 (P-407) is used to induce hyperlipidemia. Exercise is effective in improving arteriosclerosis and cognitive impairment. In this research, the effect of treadmill running on short-term memory in the P-407-treated hyperlipidemia rats was studied focusing on neuroinflammation. METHODS Rats were classified in normal group, normal and treadmill exercise group, P-407-treated group, and P-407-treated and treadmill exercise group. Hyperlipidemia rats were made by single intraperitoneal injection with P-407 (500 mg/kg). Treadmill exercise was conducted for 30 minutes once a day, 5 days per week during 28 days. Step-down avoidance task was done to measure short-term memory. Glial fibrillary acidic protein and ionized calcium binding adaptor molecule 1 were assessed by immunohistochemistry. Expression of adhesion molecules and proinflammatory cytokines was determined by western blot analysis. RESULTS Treadmill exercise alleviated lipid profiles in the P-407-induced hyperlipidemia rats. Treadmill exercise improved short-term memory, inhibited reactive astrogliosis and microglia activation, and suppressed expression of adhesion molecules and proinflammatory cytokines in the hyperlipidemic rats. CONCLUSION Treadmill exercise exerts alleviating effect on memory deficits by inhibiting hippocampal neuroinflammation in the hyperlipidemia. The current results suggest that treadmill running serves as the treatment strategy for the cognitive dysfunction caused by hyperlipidemia.
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8
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Ferreira JA, Kantorski KZ, Dubey N, Daghrery A, Fenno JC, Mishina Y, Chan HL, Mendonça G, Bottino MC. Personalized and Defect-Specific Antibiotic-Laden Scaffolds for Periodontal Infection Ablation. ACS APPLIED MATERIALS & INTERFACES 2021; 13:49642-49657. [PMID: 34637255 DOI: 10.1021/acsami.1c11787] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Periodontitis compromises the integrity and function of tooth-supporting structures. Although therapeutic approaches have been offered, predictable regeneration of periodontal tissues remains intangible, particularly in anatomically complex defects. In this work, personalized and defect-specific antibiotic-laden polymeric scaffolds containing metronidazole (MET), tetracycline (TCH), or their combination (MET/TCH) were created via electrospinning. An initial screening of the synthesized fibers comprising chemo-morphological analyses, cytocompatibility assessment, and antimicrobial validation against periodontopathogens was accomplished to determine the cell-friendly and anti-infective nature of the scaffolds. According to the cytocompatibility and antimicrobial data, the 1:3 MET/TCH formulation was used to obtain three-dimensional defect-specific scaffolds to treat periodontally compromised three-wall osseous defects in rats. Inflammatory cell response and new bone formation were assessed by histology. Micro-computerized tomography was performed to assess bone loss in the furcation area at 2 and 6 weeks post implantation. Chemo-morphological and cell compatibility analyses confirmed the synthesis of cytocompatible antibiotic-laden fibers with antimicrobial action. Importantly, the 1:3 MET/TCH defect-specific scaffolds led to increased new bone formation, lower bone loss, and reduced inflammatory response when compared to antibiotic-free scaffolds. Altogether, our results suggest that the fabrication of defect-specific antibiotic-laden scaffolds holds great potential toward the development of personalized (i.e., patient-specific medication) scaffolds to ablate infection while affording regenerative properties.
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Affiliation(s)
- Jessica A Ferreira
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Karla Z Kantorski
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
- Post-Graduate Program in Oral Sciences (Periodontology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, 97105-900, Brazil
| | - Nileshkumar Dubey
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Arwa Daghrery
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Yuji Mishina
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan 48109-1078, United States
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de Carvalho RDP, Côrrea Viana Casarin R, Lima POD, Cogo-Müller K. STATINSWITH POTENTIAL TO CONTROL PERIODONTITIS: FROM BIOLOGICAL MECHANISMS TO CLINICAL STUDIES. J Oral Biosci 2021; 63:232-244. [PMID: 34146687 DOI: 10.1016/j.job.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Statins are widely used for the treatment of hyperlipidemia. However, these drugs have pleiotropic effects that can be promising for the prevention and treatment of oral diseases, such as periodontitis. HIGHLIGHT This review aimed to identify preclinical, observational, and clinical studies that evaluate the effects and biological mechanisms of statins on oral cells and tissues and those using these drugs to treat periodontitis. A LITERATURE SURVEY HAS BEEN CONDUCTED IN PUBMED USING COMBINATIONS OF THE UNITERMS: "statins," "dentistry," "periodontal disease," and "periodontal treatment." In vitro findings showed positive statin results in cell lines related to alveolar bone metabolism by altering the signaling pathway Osteoprotegerin/Receptor Activator of Nuclear Factor Kappa B/Receptor Activator of Nuclear Factor Kappa B Ligand (OPG/RANK/RANKL), stimulating the production of alkaline phosphatase and osteocalcin, and reducing the production of matrix metalloproteinases (MMPs). Animal studies have shown a reduction in alveolar bone loss and osteoclastic activity, in addition to a reduction in inflammatory markers, such as IL-1, IL-6, and TNF-α, when statins were used prophylactically. Clinical trials showed a positive impact on clinical parameters, leading to a higher reduction in probing depth and gain in clinical attachment when a local statin was adjunctively associated with mechanical therapy. CONCLUSION Statins were shown to be promising for regenerating and stimulating bone activity, with great potential for treating chronic periodontitis. However, further studies are required to confirm its effectiveness.
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Affiliation(s)
| | | | | | - Karina Cogo-Müller
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
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10
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Regulation of Osteoclast Differentiation and Activity by Lipid Metabolism. Cells 2021; 10:cells10010089. [PMID: 33430327 PMCID: PMC7825801 DOI: 10.3390/cells10010089] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/02/2021] [Accepted: 01/05/2021] [Indexed: 02/07/2023] Open
Abstract
Bone is a dynamic tissue and is constantly being remodeled by bone cells. Metabolic reprogramming plays a critical role in the activation of these bone cells and skeletal metabolism, which fulfills the energy demand for bone remodeling. Among various metabolic pathways, the importance of lipid metabolism in bone cells has long been appreciated. More recent studies also establish the link between bone loss and lipid-altering conditions—such as atherosclerotic vascular disease, hyperlipidemia, and obesity—and uncover the detrimental effect of fat accumulation on skeletal homeostasis and increased risk of fracture. Targeting lipid metabolism with statin, a lipid-lowering drug, has been shown to improve bone density and quality in metabolic bone diseases. However, the molecular mechanisms of lipid-mediated regulation in osteoclasts are not completely understood. Thus, a better understanding of lipid metabolism in osteoclasts can be used to harness bone cell activity to treat pathological bone disorders. This review summarizes the recent developments of the contribution of lipid metabolism to the function and phenotype of osteoclasts.
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11
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Jain P, Ved A, Dubey R, Singh N, Parihar AS, Maytreyee R. Comparative Evaluation of Serum Tumor Necrosis Factor α in Health and Chronic Periodontitis: A Case-Control Study. Contemp Clin Dent 2020; 11:342-349. [PMID: 33850400 PMCID: PMC8035841 DOI: 10.4103/ccd.ccd_97_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background Tumor necrosis factor-alpha (TNF-α), a " major inflammatory cytokine," not only plays an important role in periodontal destruction but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF-α in serum and its relationship to periodontal disease. Aim Our study aimed to compare the serum TNF-α among the two study groups, namely, healthy controls and chronic periodontitis patients and establish a correlation between serum TNF-α and various clinical parameters. Hence, an attempt is made to estimate the level of TNF-α in serum, its relationship to periodontal disease and to explore the possibility of using the level of TNF-α in serum as a biochemical " marker" of periodontal disease. Materials and Methods Forty individuals participated in the study and were grouped into two subgroups. Group A - 20 systemically and periodontally healthy controls. Group B - twenty patients with generalized chronic periodontitis. The serum samples were assayed for TNF-α levels by enzyme-linked immunosorbent assay method. Results The mean serum TNF-α cytokines for Group B Generalized chronic periodontitis (GCP) was 2.977 ± 1.011, and Group A (healthy) was 0.867 ± 0.865. The range of serum TNF-α was from (0.867 to 2.977). Serum TNF-α cytokines had highly significant correlation with all clinical parameters (plaque index, probing pocket depth, clinical attachment loss, and gingival index) among all study participants (P = 0.001). Conclusion These observations suggest a positive association between periodontal disease and increased levels of TNF-α in serum. It can be concluded that there is a prospect of using the estimation of TNF-α in serum as a "marker" of periodontal disease in future. However, it remains a possibility that the absence or low levels of TNF-α in serum might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease "activity" and "inactivity" could suggest the possibility of using TNF-α in serum as an "Indicator" of periodontal disease.
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Affiliation(s)
- Prince Jain
- Consultant Periodontist and Implantologist, Vidisha, India
| | - Aditi Ved
- Dental Surgeon, Dental Planet Clinic, Vidisha, India
| | - Rajat Dubey
- Department of Dentistry, Government Hospital, Ratlam, India
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12
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Veroneze R, Cruz Tfaile Corbi S, Roque da Silva B, de S. Rocha C, V. Maurer-Morelli C, Perez Orrico SR, Cirelli JA, Von Zuben FJ, Mantuaneli Scarel-Caminaga R. Using association rule mining to jointly detect clinical features and differentially expressed genes related to chronic inflammatory diseases. PLoS One 2020; 15:e0240269. [PMID: 33007040 PMCID: PMC7531780 DOI: 10.1371/journal.pone.0240269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/23/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE It is increasingly common to find patients affected by a combination of type 2 diabetes mellitus (T2DM), dyslipidemia (DLP) and periodontitis (PD), which are chronic inflammatory diseases. More studies able to capture unknown relationships among these diseases will contribute to raise biological and clinical evidence. The aim of this study was to apply association rule mining (ARM) to discover whether there are consistent patterns of clinical features (CFs) and differentially expressed genes (DEGs) relevant to these diseases. We intend to reinforce the evidence of the T2DM-DLP-PD-interplay and demonstrate the ARM ability to provide new insights into multivariate pattern discovery. METHODS We utilized 29 clinical glycemic, lipid and periodontal parameters from 143 patients divided into five groups based upon diabetic, dyslipidemic and periodontal conditions (including a healthy-control group). At least 5 patients from each group were selected to assess the transcriptome by microarray. ARM was utilized to assess relevant association rules considering: (i) only CFs; and (ii) CFs+DEGs, such that the identified DEGs, specific to each group of patients, were submitted to gene expression validation by quantitative polymerase chain reaction (qPCR). RESULTS We obtained 78 CF-rules and 161 CF+DEG-rules. Based on their clinical significance, Periodontists and Geneticist experts selected 11 CF-rules, and 5 CF+DEG-rules. From the five DEGs prospected by the rules, four of them were validated by qPCR as significantly different from the control group; and two of them validated the previous microarray findings. CONCLUSIONS ARM was a powerful data analysis technique to identify multivariate patterns involving clinical and molecular profiles of patients affected by specific pathological panels. ARM proved to be an effective mining approach to analyze gene expression with the advantage of including patient's CFs. A combination of CFs and DEGs might be employed in modeling the patient's chance to develop complex diseases, such as those studied here.
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Affiliation(s)
- Rosana Veroneze
- Department of Computer Engineering and Industrial Automation, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Sâmia Cruz Tfaile Corbi
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Bárbara Roque da Silva
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Cristiane de S. Rocha
- Department of Medical Genetics and Genomic Medicine, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Cláudia V. Maurer-Morelli
- Department of Medical Genetics and Genomic Medicine, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Silvana Regina Perez Orrico
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil
- Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, SP, Brazil
| | - Joni A. Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Fernando J. Von Zuben
- Department of Computer Engineering and Industrial Automation, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Raquel Mantuaneli Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Petit C, Batool F, Stutz C, Anton N, Klymchenko A, Vandamme T, Benkirane-Jessel N, Huck O. Development of a thermosensitive statin loaded chitosan-based hydrogel promoting bone healing. Int J Pharm 2020; 586:119534. [PMID: 32531451 DOI: 10.1016/j.ijpharm.2020.119534] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 01/04/2023]
Abstract
Statins have been proposed as potential adjuvant to periodontal treatment due to their pleiotropic properties. A new thermosensitive chitosan hydrogel loaded with statins (atorvastatin and lovastatin) nanoemulsions was synthesized to allow a spatially controlled local administration of active compounds at lesion site. Spontaneous nano-emulsification method was used to synthesize statins loaded nanoemulsions. In vitro, atorvastatin and lovastatin loaded nanoemulsions were cytocompatible and were able to be uptake by oral epithelial cells. Treatment of Porphyromonas gingivalis infected oral epithelial cells and gingival fibroblasts with atorvastatin and lovastatin loaded nanoemulsions decreased significantly pro-inflammatory markers expression (TNF-α and IL-1β) and pro-osteoclastic RANKL. Nevertheless, such treatment induced the expression of Bone sialoprotein 2 (BSP2) in osteoblast emphasizing the pro-healing properties of atorvastatin and lovastatin nanoemulsions. In vivo, in a calvarial bone defect model (2 mm), treatment with the hydrogel loaded with atorvastatin and lovastatin nanoemulsions induced a significant increase of the neobone formation in comparison with systemic administration of statins. This study demonstrates the potential of this statins loaded hydrogel to improve bone regeneration and to decrease soft tissue inflammation. Its use in the specific context of periodontitis management could be considered in the future with a reduced risk of side effects.
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Affiliation(s)
- Catherine Petit
- INSERM, UMR 1260 'Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France; Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Fareeha Batool
- INSERM, UMR 1260 'Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Céline Stutz
- INSERM, UMR 1260 'Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Nicolas Anton
- Université de Strasbourg, CNRS, CAMB UMR 7199, Strasbourg, France
| | - Andrey Klymchenko
- Université de Strasbourg, CNRS, LBP UMR 7021, F-67000 Strasbourg, France
| | - Thierry Vandamme
- Université de Strasbourg, CNRS, CAMB UMR 7199, Strasbourg, France
| | - Nadia Benkirane-Jessel
- INSERM, UMR 1260 'Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- INSERM, UMR 1260 'Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France; Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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14
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Circulating lymphocytes and monocytes transcriptomic analysis of patients with type 2 diabetes mellitus, dyslipidemia and periodontitis. Sci Rep 2020; 10:8145. [PMID: 32424199 PMCID: PMC7235087 DOI: 10.1038/s41598-020-65042-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM), dyslipidemia and periodontitis are frequently associated pathologies; however, there are no studies showing the peripheral blood transcript profile of these combined diseases. Here we identified the differentially expressed genes (DEGs) of circulating lymphocytes and monocytes to reveal potential biomarkers that may be used as molecular targets for future diagnosis of each combination of these pathologies (compared to healthy patients) and give insights into the underlying molecular mechanisms of these diseases. Study participants (n = 150) were divided into groups: (H) systemically and periodontal healthy (control group); (P) with periodontitis, but systemically healthy; (DL-P) with dyslipidemia and periodontitis; (T2DMwell-DL-P) well-controlled type 2 diabetes mellitus with dyslipidemia and periodontitis; and (T2DMpoorly-DL-P) poorly-controlled type 2 diabetes mellitus with dyslipidemia and periodontitis. We preprocessed the microarray data using the Robust Multichip Average (RMA) strategy, followed by the RankProd method to identify candidates for DEGs. Furthermore, we performed functional enrichment analysis using Ingenuity Pathway Analysis and Gene Set Enrichment Analysis. DEGs were submitted to pairwise comparisons, and selected DEGs were validated by quantitative polymerase chain reaction. Validated DEGs verified from T2DMpoorly-DL-P versus H were: TGFB1I1, VNN1, HLADRB4 and CXCL8; T2DMwell-DL-P versus H: FN1, BPTF and PDE3B; DL-P versus H: DAB2, CD47 and HLADRB4; P versus H: IGHDL-P, ITGB2 and HLADRB4. In conclusion, we identified that circulating lymphocytes and monocytes of individuals simultaneously affected by T2DM, dyslipidemia and periodontitis, showed an altered molecular profile mainly associated to inflammatory response, immune cell trafficking, and infectious disease pathways. Altogether, these results shed light on novel potential targets for future diagnosis, monitoring or development of targeted therapies for patients sharing these conditions.
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15
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Sanz M, Marco del Castillo A, Jepsen S, Gonzalez‐Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel J, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol 2020; 47:268-288. [PMID: 32011025 PMCID: PMC7027895 DOI: 10.1111/jcpe.13189] [Citation(s) in RCA: 586] [Impact Index Per Article: 146.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. MATERIAL AND METHODS There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of BonnBonnGermany
| | - Jose R. Gonzalez‐Juanatey
- Cardiology DepartmentUniversity HospitalIDISCIBERCVUniverity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Francesco D’Aiuto
- Department of PeriodontologyEastman Dental Institute and HospitalUniversity College LondonLondonUK
| | - Philippe Bouchard
- U.F.R. d'odontologieUniversité Paris DiderotHôpital Rothschild AP‐HPParisFrance
| | - Iain Chapple
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Thomas Dietrich
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Israel Gotsman
- Heart InstituteHadassah University HospitalJerusalemIsrael
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
| | - David Herrera
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Phoebus Madianos
- Department of PeriodontologySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Jean‐Baptiste Michel
- Inserm Unit 1148Laboratory for Translational CV ScienceX. Bichat HospitalParisFrance
| | - Pablo Perel
- World Heart FederationGenevaSwitzerland
- Centre for Global Chronic ConditionsLondon School of Hygiene & Tropical MedicineLondonUK
| | - Burkert Pieske
- Department of Internal Medicin & CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- DZHK (German Center for Cardiovascular Research) Partnersite BerlinGerman Heart Institut BerlinBerlinGermany
| | - Lior Shapira
- Department of PeriodontologyHebrew University – Hadassah Faculty of Dental MedicineJerusalemIsrael
| | - Michael Shechter
- Leviev Heart CenterChaim Sheba Medical Centertel Hashomer and the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv‐YafoIsrael
| | - Maurizio Tonetti
- Department of PeriodontologyPrince Philip Dental HospitalThe University of Hong KongHong KongHong Kong
| | | | - Gernot Wimmer
- Department of Prosthetic DentistrySchool of Dental MedicineKarl‐Franzens University GrazGrazAustria
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16
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Sanz M, del Castillo AM, Jepsen S, Gonzalez-Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and Cardiovascular Diseases. Consensus Report. Glob Heart 2020; 15:1. [PMID: 32489774 PMCID: PMC7218770 DOI: 10.5334/gh.400] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. Material and Methods There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations. Results and Conclusions The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- M. Sanz
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | | | - S. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, DE
| | - J. R. Gonzalez-Juanatey
- Cardiology Department, University Hospital, University of Santiago de Compostela, IDIS, CIBERCV, ES
| | - F. D’Aiuto
- Department of Periodontology, Eastman Dental Institute and Hospital, University College London, London, UK
| | - P. Bouchard
- U.F.R. d’odontologie, Université Paris Diderot, Hôpital Rothschild AP-HP, Paris, FR
| | - I. Chapple
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - T. Dietrich
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - I. Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem, IL
| | - F. Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, IT
| | - D. Herrera
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | - B. Loos
- ACTA University, Amsterdam, NL
| | - P. Madianos
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, GR
| | - J. B. Michel
- Inserm Unit 1148, laboratory for translational CV science, X. Bichat hospital, Paris, FR
| | - P. Perel
- World Heart Federation, Geneva, CH
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, UK
| | - B. Pieske
- Charité Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Berlin, DE
- DZHK (German Center for Cardiovascular Research) Partnersite Berlin, German Heart Institut Berlin, DE
| | - L. Shapira
- Department of Periodontology, Hebrew University – Hadassah Faculty of Dental Medicine, Jerusalem, IL
| | - M. Shechter
- Leviev Heart Center, Chaim Sheba Medical Center, tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, IL
| | - M. Tonetti
- Department of Periodontology, The University of Hong Kong, Prince Philip Dental Hospital, HK
| | - C. Vlachopoulos
- Department of Cardiology, National and Kapodistrian University of Athens, GR
| | - G. Wimmer
- Department of Prosthetic Dentistry, School of Dental Medicine, Karl-Franzens University Graz, AT
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Yücel Ç, Omma A, Sertoğlu E, Sezer S, Turhan T, Özgürtaş T. Evaluation of atherogenic laboratory markers in Behçet's disease patients with vascular involvement. Arch Med Sci 2020; 16:531-537. [PMID: 32399099 PMCID: PMC7212210 DOI: 10.5114/aoms.2018.79139] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/21/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Behçet's disease is a chronic inflammatory vasculitis presenting with immunological and endothelial changes. The aim of the present study is to evaluate blood levels of diagnostic markers which can be used in Behçet's patients with vascular involvement. MATERIAL AND METHODS Fifty Behçet's patients (22 with vascular involvement) and 30 healthy controls were included in the study. High-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), tumor necrosis factor-α (TNF-α), apolipoprotein A1 (apoA1), apolipoprotein B (apoB), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, Lp-plA-2, homocysteine and ischemia modified albumin (IMA) levels were analyzed. Statistical analysis was performed with the SPSS program version 11.0. p < 0.05 was accepted as statistically significant. RESULTS hsCRP, TNF-α, homocysteine, IMA, apoA1, apoB, HDL, Lp-pla2 and ESR levels in patient and control groups were significantly different (p < 0.001, p = 0.001, p < 0.001, p < 0.001, p = 0.005, p < 0.001, p < 0.001, p < 0.001 and p = 0.003 respectively). In Behçet's patients with vascular involvement, homocysteine, TNF-α and Lp-pla2 levels were significantly higher than in Behçet's patients without vascular involvement (p = 0.035, p = 0.010 and p < 0.001 respectively). CONCLUSIONS Increased levels of inflammatory and atherogenic markers in Behçet's patients are an expected outcome due to the inflammatory nature of the disease. Especially, elevated levels of homocysteine, TNF-α and Lp-pla2 make them candidate diagnostic tools to be helpful in clinical evaluation of Behçet's disease patients with vascular involvement.
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Affiliation(s)
- Çiğdem Yücel
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Ahmet Omma
- Department of Rheumatology Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Erdim Sertoğlu
- Department of Clinical Biochemistry, Ankara Gülhane Training and Research Hospital, Etlik, Ankara, Turkey
| | - Sevilay Sezer
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Turan Turhan
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Altındağ, Ankara, Turkey
| | - Taner Özgürtaş
- Department of Clinical Biochemistry, Ankara Gülhane Training and Research Hospital, Etlik, Ankara, Turkey
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Reiniger APP, Londero AB, Ferreira TDGM, da Rocha JM, Moreira CHC, Kantorski KZ. Validity of self‐reported measures for periodontitis surveillance in a rural sample. J Periodontol 2019; 91:617-627. [DOI: 10.1002/jper.19-0292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Ana Paula Pereira Reiniger
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Ananda Barrachini Londero
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Ticiane de Góes Mário Ferreira
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - José Mariano da Rocha
- Graduate Program in Oral SciencePeriodontology UnitSchool of DentistryFederal University of Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
| | - Carlos Heitor Cunha Moreira
- Graduate Program in Oral ScienceDepartment of StomatologySchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
| | - Karla Zanini Kantorski
- Graduate Program in Oral ScienceDepartment of StomatologySchool of DentistryFederal University of Santa Maria Santa Maria Rio Grande do Sul Brazil
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Suresh R, Jayachandran P, Fenol A, Biswas R, Krishnan S, Kumar KA, Divakar DD, Vellappally S. Effect of Non-Surgical Periodontal Therapy on the Serum Sialic Acid Levels in Diabetic Patients with Periodontitis. ACTA MEDICA (HRADEC KRÁLOVÉ) 2019; 62:109-116. [PMID: 31663504 DOI: 10.14712/18059694.2019.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Sialic acid (SA), a family of acetylated derivatives of neuraminic acid, an acute phase reactant by itself. It usually occurs as a terminal component at the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. SA participates in multiple physiological functions, such as cell-to-cell interactions, cell migration and proliferation. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by rise in blood glucose level. Periodontitis is a chronic inflammatory disease of the periodontal tissue, leading to destruction of bone surrounding the tooth and ultimately tooth loss. There is a two way relationship between diabetes mellitus and periodontitis. Periodontitis is the sixth complication of diabetes along with retinopathy, nephropathy, neuropathy, macrovascular disease, and altered wound healing. Inflammatory mediators like interleukin-6 and tumor necrosis factor-alpha produced during periodontal inflammation can interfere with the actions of insulin receptors and worsen the glycemic control of diabetic patients. Periodontitis is a major cause of tooth loss, affecting over 300 million people and bacteria associated with periodontitis are also linked with systemic problems like endocarditis, atherosclerosis. Recent work has highlighted a major role for the host sugar sialic acid in the biofilm physiology and host-pathogen interactions of T. forsithya, a key periodontal pathogen. There exists a need for a biomarker, for early detection of disease evolution and more robust therapy efficacy measurements. Serum sialic acids were estimated in Indian population by diphenylamine method and Thiobarbituric acid method. The average values were 68 ± 2.6 mg percent by DPA method and 56 ± 5 mg percent by TBA (thiobarbituric acid assay) method. Age and sex showed no influence on serum sialic acid level. Objectives of the present study was to compare (TSSA) level in healthy subjects, subjects with (CMP) with and without (NIDDM) and its effect on non-surgical periodontal therapy. In the present study, the participants were divided into three groups: Group A, B and C. Group A consists of systemically healthy subjects, Group B consists of subjects with (CMP) while Group C consists of subjects with (CMP) with (NIDDM) and results of this study indicated that, at baseline, there were significant differences between Group A, B and Group C with respect to all the clinical parameters, including (GI), (OHI-S), (PPD), (CAL), (TSSA) and (HbA1c) levels. Thus (TSSA) level could be considered as novel biomarker in the progression of periodontal disease and diabetic status. Periodontitis could be considered as a potential, modifiable, and independent risk factor for the development of diabetes. Early detection of elevated (TSSA) level may help in interpreting the progression of periodontitis, risk of development of diabetes mellitus in future and also to prevent complications.
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Affiliation(s)
- Reshma Suresh
- Department of Periodontics, Amrita School of Dentistry, Amrita vishwa vidhyapeetham, Ponekara, Edapally, Cochin, India.
| | - Perayil Jayachandran
- Department of Periodontics, Amrita School of Dentistry, Amrita vishwa vidhyapeetham, Ponekara, Edapally, Cochin, India
| | - Angel Fenol
- Department of Periodontics, Amrita School of Dentistry, Amrita vishwa vidhyapeetham, Ponekara, Edapally, Cochin, India
| | - Raja Biswas
- Nano Science and Molecular Biology, Amrita institute of medical science, Cochin, India
| | - Sajitha Krishnan
- Department of Biochemistry, Amrita Institute of Medical Science, Cochin, India
| | - K Aswini Kumar
- Department of Prosthodontics, Amrita School of Dentistry, Cochin, India
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sajith Vellappally
- Division of Preventive Dentistry, Dental Health Department College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
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Cao R, Li Q, Chen Y, Yao M, Wu Q, Zhou H. Efficacy of locally-delivered statins adjunct to non-surgical periodontal therapy for chronic periodontitis: a Bayesian network analysis. BMC Oral Health 2019; 19:105. [PMID: 31196047 PMCID: PMC6567452 DOI: 10.1186/s12903-019-0789-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/20/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Studies indicate locally-delivered statins offer additional benefits to scaling and root planning (SRP), however, it is still hard to say which type of statins is better. This network meta-analysis aimed to assess the effect of locally-delivered statins and rank the most efficacious statin for treating chronic periodontitis (CP) in combination with SRP. METHODS We screened four literature databases (Pubmed, Embase, Cochrane Library, and Web of Science) for randomized controlled clinical trials (RCTs) published up to June 2018 that compared different statins in the treatment of chronic periodontitis. The outcomes analyzed were changes in intrabony defect depth (IBD), pocket depth (PD), and clinical attachment level (CAL). We carried out Bayesian network meta-analysis of CP without systemic diseases. Traditional and Bayesian network meta-analyses were conducted using random-effects models. RESULTS Greater filling of IBD, reduction in PD, and gain in CAL were observed for SRP treated in combination with statins when compared to SRP alone for treating CP without systemic diseases. Specifically, SRP+ Atorvastatin (ATV) (mean difference [MD]: 1.5 mm, 1.4 mm, 1.8 mm, respectively), SRP + Rosuvastatin (RSV) (MD: 1.8 mm, 2.0 mm, 2.1 mm, respectively), and SRP + Simvastatin (SMV) (MD: 1.1 mm, 2.2 mm, 2.1 mm, respectively) were identified. However, no difference was found among the statins tested. In CP patients with type 2 diabetic (T2DM) or in smokers, additional benefits were observed from locally delivered statins. CONCLUSION Local statin use adjunctive to SRP confers additional benefits in treating CP by SRP, even in T2DM and smokers. RSV may be the best one to fill in IBD. However, considering the limitations of this study, clinicians must use cautious when applying the results and further studies are required to explore the efficacy of statins in CP with or without the risk factors (T2DM comorbidity or smoking history).
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Affiliation(s)
- Ruoyan Cao
- Department of Prosthodontics, Xiangya Stomatological Hospital & School of Stomatology, Central South University, 72 Xiangya Road, Changsha, 410000 China
| | - Qiulan Li
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, 410011 China
| | - Yu Chen
- Department of Prosthodontics, Xiangya Stomatological Hospital & School of Stomatology, Central South University, 72 Xiangya Road, Changsha, 410000 China
| | - Mianfeng Yao
- Department of Oral Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410083 China
| | - Qiqi Wu
- Department of Operative Dentistry and Endodontics, Stomatological Hospital & School of Stomatology, Central South University, 72 Xiangya Road, Changsha, 410000 China
| | - Hongbo Zhou
- Department of Prosthodontics, Xiangya Stomatological Hospital & School of Stomatology, Central South University, 72 Xiangya Road, Changsha, 410000 China
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Chen Q, Cai J, Li X, Song A, Guo H, Sun Q, Yang C, Yang P. Progranulin Promotes Regeneration of Inflammatory Periodontal Bone Defect in Rats via Anti-inflammation, Osteoclastogenic Inhibition, and Osteogenic Promotion. Inflammation 2019; 42:221-234. [PMID: 30187338 DOI: 10.1007/s10753-018-0886-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Progranulin (PGRN) has been proved to play a crucial role in anti-inflammation and osteogenesis promotion; thus, it was hypothesized that PGRN could promote bone regeneration in periodontal disease. In this experiment, the periodontal bone defects were established in periodontitis rats; recombinant human progranulin (rhPGRN), tumor necrosis factor alpha inhibitor (anti-TNF-α), or phosphate buffer saline (PBS)-loaded collagen membrane scaffolds were implanted within defects and the rats were sacrificed at scheduled time points. Volume of new bone was assessed by radiological and histomorphometric analyses. Expression of osteogenesis-related markers and tumor necrosis factor-α (TNF-α) was evaluated using immunohistochemistry. Tartrate-resistant acid phosphatase (TRAP) staining was also performed to determine the number of osteoclasts. Immunofluorescence (IF) staining was performed to explore the interaction between rhPGRN and tumor necrosis factor receptors (TNFRs). The results showed that the rhPGRN group had significantly superior quantity and quality of newly formed bone, higher expression of alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2), and TNFR2 compared with the PBS group and the anti-TNF-α group. Similarly to the anti-TNF-α group, the rhPGRN group also exhibited the significant inhibitory effect on the expression of TNF-α and the number of TRAP-positive cells compared with the PBS group. Hence, our experiment suggests that PGRN promotes regeneration of inflammatory periodontal bone defect in rats via anti-inflammation, osteoclastogenic inhibition, and osteogenic promotion. Local administration of PGRN may provide a new therapeutic strategy for periodontal bone regeneration.
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Affiliation(s)
- Qian Chen
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong, China.,Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, China
| | - Jun Cai
- Department of Comprehensive Dentistry, Jinan Stomatological Hospital, Jinan, Shandong, China
| | - Xiao Li
- Department of Periodontology, Jinan Stomatological Hospital, Jinan, Shandong, China
| | - Aimei Song
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, China
| | - Hongmei Guo
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, China
| | - Qinfeng Sun
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, China
| | - Chengzhe Yang
- Department of Oral and Maxillofacial Surgery, Qilu Hospital, and Institute of Stomatology, Shandong University, Jinan, Shandong, China.
| | - Pishan Yang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong, China. .,Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, China. .,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China.
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Ou L, Sun T, Cheng Y, Huang L, Zhan X, Zhang P, Yang J, Zhang Y, Zhou Z. MicroRNA-214 contributes to regulation of necroptosis via targeting ATF4 in diabetes-associated periodontitis. J Cell Biochem 2019; 120:14791-14803. [PMID: 31090954 DOI: 10.1002/jcb.28740] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/01/2019] [Accepted: 02/14/2019] [Indexed: 12/26/2022]
Abstract
Diabetes and periodontal diseases have a mutual promoting relationship that induces severe tissue damage and cell death. The potential roles of microRNAs (miRNAs) and the type of cell death involved in diabetes-associated periodontitis are obscure. The gingival tissues of patients were obtained and MC3T3-E1 cells were costimulated with high glucose and lipopolysaccharide (LPS). Osseous morphometric analysis was evaluated with micro-CT, and histological characteristics were measured by hematoxylin/eosin and immunohistochemical staining. Cytokine secretion was confirmed by enzyme-linked immunosorbent assay, and reactive oxygen species (ROS) was measured using a DCFH-DA probe kit. Gene expression was measured by real-time quantitative reverse transcription PCR (qRT-PCR), and protein expression was assessed by Western blot and immunofluorescence analysis. The miR-214 level, receptor-interacting serine-threonine protein (RIP) 1, RIP3, and phospho-mixed lineage kinase domain-like (p-MLKL) protein expression were elevated in the inflamed gingival tissues of diabetes-associated periodontitis patients, with activating transcription factor 4 (ATF4) expression showing the opposite effect. The high glucose (22 mM) could not induce significant increase of RIP1, RIP3, and p-MLKL; however, the high glucose and LPS (500-1000 ng/mL) cotreatment resulted in increase in the number of RIP1, RIP3, and p-MLKL in MC3T3-E1 cells. NAC (ROS inhibitor) inhibited RIP1, RIP3, and increased ATF4; however, necrostatin-1 (Nec-1) (RIP1 inhibitor) specifically inhibited the protein expression of RIP1 and RIP3 and had no influence on ATF4. The use of antagomir-214 suppressed the expression of miR-214, RIP1, RIP3, and p-MLKL, but increased ATF4 protein level in glucose and LPS-induced cells. ATF4 knockdown by ATF4 small interfering RNA offset the effect of antagomir-214. RIP1- and RIP3-dependent necroptosis was confirmed in the inflamed gingival tissues of diabetes-associated periodontitis patients and high glucose- and LPS- cotreated cells. It was suggested that miR-214-targeted ATF4 participated in the regulation of necroptosis in vivo and in vitro.
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Affiliation(s)
- Lingling Ou
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Ting Sun
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Yaodong Cheng
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Linwei Huang
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Xiaozhen Zhan
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Peng Zhang
- Department of Pathology, Medical School of Yichun University, Yichun, Jiangxi, P.R. China
| | - Junjie Yang
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Ye Zhang
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Zhiying Zhou
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
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Poklepovic Pericic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, Tugwell P. WITHDRAWN: Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 2019; 4:CD009857. [PMID: 31017680 PMCID: PMC6481275 DOI: 10.1002/14651858.cd009857.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Effective oral hygiene is a crucial factor in maintaining good oral health, which is associated with overall health and health-related quality of life. Dental floss has been used for many years in conjunction with toothbrushing for removing dental plaque in between teeth, however, interdental brushes have been developed which many people find easier to use than floss, providing there is sufficient space between the teeth. OBJECTIVES To evaluate the effects of interdental brushing in addition to toothbrushing, as compared with toothbrushing alone or toothbrushing and flossing for the prevention and control of periodontal diseases, dental plaque and dental caries. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 7 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 2), MEDLINE via OVID (1946 to 7 March 2013), EMBASE via OVID (1980 to 7 March 2013), CINAHL via EBSCO (1980 to 7 March 2013), LILACS via BIREME (1982 to 7 March 2013), ZETOC Conference Proceedings (1980 to 7 March 2013) and Web of Science Conference Proceedings (1990 to 7 March 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/) for ongoing trials to 7 March 2013. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (including split-mouth design, cross-over and cluster-randomised trials) of dentate adult patients. The interventions were a combination of toothbrushing and any interdental brushing procedure compared with toothbrushing only or toothbrushing and flossing. DATA COLLECTION AND ANALYSIS At least two review authors assessed each of the included studies to confirm eligibility, assessed risk of bias and extracted data using a piloted data extraction form. We calculated standardised mean difference (SMD) and 95% confidence interval (CI) for continuous outcomes where different scales were used to assess an outcome. We attempted to extract data on adverse effects of interventions. Where data were missing or unclear we attempted to contact study authors to obtain further information. MAIN RESULTS There were seven studies (total 354 participants analysed) included in this review. We assessed one study as being low, three studies as being high and three studies as being at unclear risk of bias. Studies only reported the clinical outcome gingivitis and plaque data, with no studies providing data on many of the outcomes: periodontitis, caries, halitosis and quality of life. Three studies reported that no adverse events were observed or reported during the study. Two other studies provided some data on adverse events but we were unable to pool the data due to lack of detail. Two studies did not report whether adverse events occurred.Interdental brushing in addition to toothbrushing, as compared with toothbrushing aloneOnly one high risk of bias study (62 participants in analysis) looked at this comparison and there was very low-quality evidence for a reduction in gingivitis (0 to 4 scale, mean in control): mean difference (MD) 0.53 (95% CI 0.23 to 0.83) and plaque (0 to 5 scale): MD 0.95 (95% CI 0.56 to 1.34) at one month, favouring of use of interdental brushes. This represents a 34% reduction in gingivitis and a 32% reduction in plaque.Interdental brushing in addition to toothbrushing, as compared with toothbrushing and flossingSeven studies provided data showing a reduction in gingivitis in favour of interdental brushing at one month: SMD -0.53 (95% CI -0.81 to -0.24, seven studies, 326 participants, low-quality evidence). This translates to a 52% reduction in gingivitis (Eastman Bleeding Index). Although a high effect size in the same direction was observed at three months (SMD -1.98, 95% CI -5.42 to 1.47, two studies, 107 participants, very low quality), the confidence interval was wide and did not exclude the possibility of no difference. There was insufficient evidence to claim a benefit for either interdental brushing or flossing for reducing plaque (SMD at one month 0.10, 95% CI -0.13 to 0.33, seven studies, 326 participants, low-quality evidence) and insufficient evidence at three months (SMD -2.14, 95% CI -5.25 to 0.97, two studies, 107 participants very low-quality evidence). AUTHORS' CONCLUSIONS Only one study looked at whether toothbrushing with interdental brushing was better than toothbrushing alone, and there was very low-quality evidence for a reduction in gingivitis and plaque at one month. There is also low-quality evidence from seven studies that interdental brushing reduces gingivitis when compared with flossing, but these results were only found at one month. There was insufficient evidence to determine whether interdental brushing reduced or increased levels of plaque when compared to flossing.
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Affiliation(s)
- Tina Poklepovic Pericic
- School of Medicine, University of SplitCochrane CroatiaSoltanska 2SplitSplitsko‐dalmatinska CountyCroatia21 000
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Trevor M Johnson
- RCS EnglandFaculty of General Dental Practice (UK)35‐43 Lincoln's Inn FieldsLondonUKWC2A 3PE
| | - Dario Sambunjak
- Catholic University of CroatiaCenter for Evidence‐Based Medicine and Health CareIlica 242ZagrebCroatia10000
| | - Pauline Imai
- MTI Community CollegeHealthcare FacultySuite 2004980 KingswayBurnabyBCCanadaV5H 4K7
| | - Janet E Clarkson
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
| | - Peter Tugwell
- University of OttawaDepartment of Medicine, Faculty of MedicineOttawaONCanadaK1H 8M5
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Worthington HV, MacDonald L, Poklepovic Pericic T, Sambunjak D, Johnson TM, Imai P, Clarkson JE. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev 2019; 4:CD012018. [PMID: 30968949 PMCID: PMC6953268 DOI: 10.1002/14651858.cd012018.pub2] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Dental caries (tooth decay) and periodontal diseases (gingivitis and periodontitis) affect the majority of people worldwide, and treatment costs place a significant burden on health services. Decay and gum disease can cause pain, eating and speaking difficulties, low self-esteem, and even tooth loss and the need for surgery. As dental plaque is the primary cause, self-administered daily mechanical disruption and removal of plaque is important for oral health. Toothbrushing can remove supragingival plaque on the facial and lingual/palatal surfaces, but special devices (such as floss, brushes, sticks, and irrigators) are often recommended to reach into the interdental area. OBJECTIVES To evaluate the effectiveness of interdental cleaning devices used at home, in addition to toothbrushing, compared with toothbrushing alone, for preventing and controlling periodontal diseases, caries, and plaque. A secondary objective was to compare different interdental cleaning devices with each other. SEARCH METHODS Cochrane Oral Health's Information Specialist searched: Cochrane Oral Health's Trials Register (to 16 January 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2018, Issue 12), MEDLINE Ovid (1946 to 16 January 2019), Embase Ovid (1980 to 16 January 2019) and CINAHL EBSCO (1937 to 16 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared toothbrushing and a home-use interdental cleaning device versus toothbrushing alone or with another device (minimum duration four weeks). DATA COLLECTION AND ANALYSIS At least two review authors independently screened searches, selected studies, extracted data, assessed studies' risk of bias, and assessed evidence certainty as high, moderate, low or very low, according to GRADE. We extracted indices measured on interproximal surfaces, where possible. We conducted random-effects meta-analyses, using mean differences (MDs) or standardised mean differences (SMDs). MAIN RESULTS We included 35 RCTs (3929 randomised adult participants). Studies were at high risk of performance bias as blinding of participants was not possible. Only two studies were otherwise at low risk of bias. Many participants had a low level of baseline gingival inflammation.Studies evaluated the following devices plus toothbrushing versus toothbrushing: floss (15 trials), interdental brushes (2 trials), wooden cleaning sticks (2 trials), rubber/elastomeric cleaning sticks (2 trials), oral irrigators (5 trials). Four devices were compared with floss: interdental brushes (9 trials), wooden cleaning sticks (3 trials), rubber/elastomeric cleaning sticks (9 trials) and oral irrigators (2 trials). Another comparison was rubber/elastomeric cleaning sticks versus interdental brushes (3 trials).No trials assessed interproximal caries, and most did not assess periodontitis. Gingivitis was measured by indices (most commonly, Löe-Silness, 0 to 3 scale) and by proportion of bleeding sites. Plaque was measured by indices, most often Quigley-Hein (0 to 5). PRIMARY OBJECTIVE comparisons against toothbrushing aloneLow-certainty evidence suggested that flossing, in addition to toothbrushing, may reduce gingivitis (measured by gingival index (GI)) at one month (SMD -0.58, 95% confidence interval (CI) -1.12 to -0.04; 8 trials, 585 participants), three months or six months. The results for proportion of bleeding sites and plaque were inconsistent (very low-certainty evidence).Very low-certainty evidence suggested that using an interdental brush, plus toothbrushing, may reduce gingivitis (measured by GI) at one month (MD -0.53, 95% CI -0.83 to -0.23; 1 trial, 62 participants), though there was no clear difference in bleeding sites (MD -0.05, 95% CI -0.13 to 0.03; 1 trial, 31 participants). Low-certainty evidence suggested interdental brushes may reduce plaque more than toothbrushing alone (SMD -1.07, 95% CI -1.51 to -0.63; 2 trials, 93 participants).Very low-certainty evidence suggested that using wooden cleaning sticks, plus toothbrushing, may reduce bleeding sites at three months (MD -0.25, 95% CI -0.37 to -0.13; 1 trial, 24 participants), but not plaque (MD -0.03, 95% CI -0.13 to 0.07).Very low-certainty evidence suggested that using rubber/elastomeric interdental cleaning sticks, plus toothbrushing, may reduce plaque at one month (MD -0.22, 95% CI -0.41 to -0.03), but this was not found for gingivitis (GI MD -0.01, 95% CI -0.19 to 0.21; 1 trial, 12 participants; bleeding MD 0.07, 95% CI -0.15 to 0.01; 1 trial, 30 participants).Very-low certainty evidence suggested oral irrigators may reduce gingivitis measured by GI at one month (SMD -0.48, 95% CI -0.89 to -0.06; 4 trials, 380 participants), but not at three or six months. Low-certainty evidence suggested that oral irrigators did not reduce bleeding sites at one month (MD -0.00, 95% CI -0.07 to 0.06; 2 trials, 126 participants) or three months, or plaque at one month (SMD -0.16, 95% CI -0.41 to 0.10; 3 trials, 235 participants), three months or six months, more than toothbrushing alone. SECONDARY OBJECTIVE comparisons between devicesLow-certainty evidence suggested interdental brushes may reduce gingivitis more than floss at one and three months, but did not show a difference for periodontitis measured by probing pocket depth. Evidence for plaque was inconsistent.Low- to very low-certainty evidence suggested oral irrigation may reduce gingivitis at one month compared to flossing, but very low-certainty evidence did not suggest a difference between devices for plaque.Very low-certainty evidence for interdental brushes or flossing versus interdental cleaning sticks did not demonstrate superiority of either intervention.Adverse eventsStudies that measured adverse events found no severe events caused by devices, and no evidence of differences between study groups in minor effects such as gingival irritation. AUTHORS' CONCLUSIONS Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent. Outcomes were mostly measured in the short term and participants in most studies had a low level of baseline gingival inflammation. Overall, the evidence was low to very low-certainty, and the effect sizes observed may not be clinically important. Future trials should report participant periodontal status according to the new periodontal diseases classification, and last long enough to measure interproximal caries and periodontitis.
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Affiliation(s)
- Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Laura MacDonald
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Tina Poklepovic Pericic
- School of Medicine, University of SplitCochrane CroatiaSoltanska 2SplitSplitsko‐dalmatinska CountyCroatia21 000
| | - Dario Sambunjak
- Catholic University of CroatiaCenter for Evidence‐Based Medicine and Health CareIlica 242ZagrebCroatia10000
| | - Trevor M Johnson
- RCS EnglandFaculty of General Dental Practice (UK)35‐43 Lincoln's Inn FieldsLondonUKWC2A 3PE
| | - Pauline Imai
- MTI Community CollegeHealthcare FacultySuite 2004980 KingswayBurnabyBCCanadaV5H 4K7
| | - Janet E Clarkson
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
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Abraham S, Premnath A, Arunima PR, Kassim RM. Critical Appraisal of Bidirectional Relationship between Periodontitis and Hyperlipidemia. J Int Soc Prev Community Dent 2019; 9:112-118. [PMID: 31058060 PMCID: PMC6489519 DOI: 10.4103/jispcd.jispcd_316_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease and hyperlipidemia are both multifactorial disease with a high prevalence Worldwide. Cross-sectional and longitudinal prospective clinical studies show some evidence for a bidirectional relationship. Periodontitis and hyperlipidemia share some common risk factors and there exist a mechanistic link between both. Studies have found a positive response to periodontal therapy among hyperlipidemic patients, and statin use by hyperlipidemic patients has shown to influence the periodontal health. However, in spite of the rising prevalence of both diseases, many people remain unaware of their association with each other. Hence, this article summarizes the cyclic relationship between periodontal disease and hyperlipidemia.
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Affiliation(s)
- Seba Abraham
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Arya Premnath
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - P. R. Arunima
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Reejamol Mohammed Kassim
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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Contribution of Statins towards Periodontal Treatment: A Review. Mediators Inflamm 2019; 2019:6367402. [PMID: 30936777 PMCID: PMC6415285 DOI: 10.1155/2019/6367402] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 12/23/2018] [Indexed: 01/09/2023] Open
Abstract
The pleiotropic effects of statins have been evaluated to assess their potential benefit in the treatment of various inflammatory and immune-mediated diseases including periodontitis. Herein, the adjunctive use of statins in periodontal therapy in vitro, in vivo, and in clinical trials was reviewed. Statins act through several pathways to modulate inflammation, immune response, bone metabolism, and bacterial clearance. They control periodontal inflammation through inhibition of proinflammatory cytokines and promotion of anti-inflammatory and/or proresolution molecule release, mainly, through the ERK, MAPK, PI3-Akt, and NF-κB pathways. Moreover, they are able to modulate the host response activated by bacterial challenge, to prevent inflammation-mediated bone resorption and to promote bone formation. Furthermore, they reduce bacterial growth, disrupt bacterial membrane stability, and increase bacterial clearance, thus averting the exacerbation of infection. Local statin delivery as adjunct to both nonsurgical and surgical periodontal therapies results in better periodontal treatment outcomes compared to systemic delivery. Moreover, combination of statin therapy with other regenerative agents improves periodontal healing response. Therefore, statins could be proposed as a potential adjuvant to periodontal therapy. However, optimization of the combination of their dose, type, and carrier could be instrumental in achieving the best treatment response.
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27
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Cytokine levels in crevicular fluid associated with compliance during periodontal maintenance therapy. Clin Oral Investig 2018; 23:3517-3526. [DOI: 10.1007/s00784-018-2770-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/05/2018] [Indexed: 12/14/2022]
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Zhou R, Shen L, Yang C, Wang L, Guo H, Yang P, Song A. Periodontitis May Restrain the Mandibular Bone Healing via Disturbing Osteogenic and Osteoclastic Balance. Inflammation 2018; 41:972-983. [PMID: 29460020 DOI: 10.1007/s10753-018-0751-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Periodontitis has been advocated as a systematic chronic low-grade infection burden. However, the relationship between periodontitis and bone defect healing has not been elucidated. One hundred and eight male Wister rats were randomly assigned into three groups: control (healthy) group, periodontitis group, and periodontitis plus human tumor necrosis factor receptorII:IgG Fc fusion protein (rhTNFR:Fc) group. The experimental periodontitis model was established by ligaturing with orthodontic wire and silk suture plus local administration of 20 μl of lipopolysaccharide (LPS). Mandibular bone defects in size of 4 × 2 × 1 mm were created for all the rats and rhTNFR:Fc subcutaneously injected at neck at a dose of 2.5 mg/kg every 3 days for the periodontitis plus rhTNFR:Fc group. The gene and protein expressions of bone-related markers in the healing tissue were monitored and new bone formation was histologically evaluated. Tartrate-resistant acid phosphatase (TRAP) staining was performed to determine the number of osteoclasts. The results showed that the mRNA and protein expressions of osteogenesis-related markers were significantly lower while nuclear factor of activated T cells, cytoplasmic 1 (NFATc1) gene expression was significantly higher in the periodontitis group. The periodontitis group showed decreased new bone formation and increased number of osteoclasts when compared to the control group. However, there was no significant difference between the periodontitis plus rhTNFR:Fc group and the control group. These results demonstrated that periodontitis may restrain the mandibular bone healing via disturbing osteogenic and osteoclastic balance in which tumor necrosis factor-α (TNF-α) could act as a leverage.
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Affiliation(s)
- Rongjing Zhou
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong, China
- Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Lili Shen
- Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Chengzhe Yang
- Department of Oral & Maxillofacial Surgery, Qilu Hospital and Institute of Stomatology, Shandong University, Jinan, Shandong, China
| | - Limei Wang
- Department of Stomatology, Qilu Hospital and Institute of Stomatology, Shandong University, Jinan, Shandong, China
| | - Hongmei Guo
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, 250000, China
| | - Pishan Yang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Shandong University, Jinan, Shandong, China.
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, 250000, China.
| | - Aimei Song
- Department of Periodontology, School of Dentistry, Shandong University, Jinan, Shandong, 250000, China.
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Bertl K, Parllaku A, Pandis N, Buhlin K, Klinge B, Stavropoulos A. The effect of local and systemic statin use as an adjunct to non-surgical and surgical periodontal therapy-A systematic review and meta-analysis. J Dent 2018; 67:18-28. [PMID: 28855141 DOI: 10.1016/j.jdent.2017.08.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/19/2017] [Accepted: 08/23/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To evaluate the effect of local and/or systemic statin use as an adjunct to non-surgical and/or surgical periodontal therapy. DATA Literature search according to PRISMA guidelines with the following eligibility criteria: (a) English or German language; (b) interventional studies; (c) statins as monotherapy or as an adjunct to non-surgical and/or surgical treatment of periodontitis; (d) clinical and/or radiographic treatment effect size of statin intake reported. SOURCES Medline (PubMed), Embase (Ovid), CENTRAL (Ovid). STUDY SELECTION Thirteen clinical studies regarding local application and 2 with systemic administration of statins as an adjunct to non-surgical treatment (SRP) and 4 studies regarding intrasurgical statin application with a maximum follow-up of 9 months could be included; simvastatin, atorvastatin, and rosuvastatin were used. Local but not systemic statin application as an adjunct to SRP yielded significantly larger probing pocket depth (PD), radiographic defect depth (RDD), and bleeding index reduction, and larger clinical attachment level gain, and less residual PD and RDD (p≤0.016); rosuvastatin appeared as the most efficacious. Three of 4 studies reported a significant positive effect of intrasurgical statin application. No adverse events were reported after statin use. The vast majority of the included studies were from the same research group. CONCLUSIONS Significant additional clinical and radiographic improvements are obtained after local, but not systemic, statin use as an adjunct to SRP in deep pockets associated with intrabony defects and seemingly with furcation defects; intrasurgical statin application seems similarly beneficial. Confirmation of these results, and especially of the effect size, from other research groups is warranted.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden; Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Austria
| | - Arlinda Parllaku
- Private Practice, Tirana, Albania; Postgraduate Course Periodontology, Medical University of Vienna
| | - Nikolaos Pandis
- School of Dental Medicine, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
| | - Kåre Buhlin
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden.
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Gunepin M, Derache F, Trousselard M, Salsou B, Risso JJ. Impact of chronic stress on periodontal health. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2018. [DOI: 10.1051/mbcb/2017028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Periodontal diseases are caused by pathogenic microorganisms that induce increases in of local and systemic proinflammatory cytokines, resulting in periodontal damage. The onset and evolution of periodontal diseases are influenced by many local and systemic risk factors. Educational objective: In this article, we aim to review the results of the research on the impact of chronic stress on the occurrence, development, and response to periodontal disease treatments and on the pathophysiological mechanisms of periodontal disease. Conclusion: Chronic stress has a negative impact on the occurrence, development, and response to the treatment of periodontal disease via indirect actions on the periodontium. This can result from behavioral changes caused by stress (poor dental hygiene, smoking, etc.) and a direct neuroimmunoendocrinological action related to the consequences (particularly immunological) of the secretion of certain chemicals (e.g., cortisol) induced by the activation of the hypothalamus and the autonomic nervous system in response to stress. These factors necessitate multidisciplinary management (e.g., physician, oral surgeon, and psychologist) of patients to identify subjects with chronic stress and to employ countermeasures to decrease the impact of stress on the periodontium.
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Madureira DF, Lucas De Abreu Lima I, Costa GC, Lages EMB, Martins CC, Aparecida Da Silva T. Tumor Necrosis Factor-alpha in Gingival Crevicular Fluid as a Diagnostic Marker for Periodontal Diseases: A Systematic Review. J Evid Based Dent Pract 2018; 18:315-331. [PMID: 30514445 DOI: 10.1016/j.jebdp.2018.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 12/30/2017] [Accepted: 04/22/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate human gingival crevicular fluid (GCF) tumor necrosis factor-alpha (TNF-α) as a potential biomarker for diagnosis of periodontal disease (International prospective register of systematic reviews [PROSPERO] number: CRD42015020199). METHODS An electronic search for TNF-α in human GCF was conducted until May 17, 2018. Data from systemically healthy patients with healthy periodontium or periodontal disease were incorporated. Risk bias was assessed by Newcastle-Ottawa Scale for case-control studies and Jadad scale for clinical trials. RESULTS Twenty-six studies were included (12 case-control studies, 7 clinical trials, and 7 randomized controlled trials). Most case-control studies showed increased TNF-α concentration in GCF of patients with periodontal disease. The clinical trials and randomized controlled trials demonstrated no consistent modification of TNF-α level after periodontal intervention. CONCLUSION The present data support the use of TNF-α in GCF as a potential biomarker for diagnosis of periodontal disease but not to monitor the healing after therapy.
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Affiliation(s)
- Davidson Fróis Madureira
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Izabella Lucas De Abreu Lima
- Department of Morphology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Giselle Cabral Costa
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Elizabeth Maria Bastos Lages
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Castro Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tarcília Aparecida Da Silva
- Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Kemer Doğan ES, Kırzıoğlu FY, Doğan B, Fentoğlu Ö, Kale B. The effect of menopause on the relationship between hyperlipidemia and periodontal disease via salivary 8-hydroxy-2'-deoxyguanosine and myeloperoxidase levels. Acta Odontol Scand 2018; 76:92-97. [PMID: 28984174 DOI: 10.1080/00016357.2017.1386798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Impairment of the lipid metabolism could affect the periodontal disease; increased oxidative stress may have a role in this relationship. The aim of the present study was to evaluate the role of menopause in the relationship between hyperlipidemia and periodontal disease via oxidative stress markers in saliva. MATERIALS AND METHODS Sixty-seven women were enrolled in the study and divided into four groups as systemically healthy and premenopause (C) (n = 18), hyperlipidemia and premenopause (H) (n = 16), systemically healthy and postmenopause (M) (n = 17), and hyperlipidemia and postmenopause (MH) (n = 16). Sociodemographics, periodontal and metabolic parameters, and saliva oxidative markers (myeloperoxidase [MPO] and 8-hydroxy-2'-deoxyguanosine [8-OHdG]) were evaluated. RESULTS Menopause and/or hyperlipidemia were associated with an increase in all evaluated periodontal parameters. Saliva 8-OHdG and MPO levels were higher in menopausal groups (M and MH). Multivariate linear regression analyses revealed that hyperlipidemia was related to an increase in periodontal parameters. Salivary oxidative stress markers and periodontal parameters were also positively associated with menopause and hyperlipidemia. CONCLUSION Saliva 8-OHdG and MPO levels may indicate that the relationship between periodontal disease and hyperlipidemia is aggravated by menopause.
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Affiliation(s)
- Esra Sinem Kemer Doğan
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Fatma Yeşim Kırzıoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Burak Doğan
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Özlem Fentoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Banu Kale
- Endocrinologist, Private Practice, Isparta, Turkey
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Muniz FWMG, Taminski K, Cavagni J, Celeste RK, Weidlich P, Rösing CK. The effect of statins on periodontal treatment-a systematic review with meta-analyses and meta-regression. Clin Oral Investig 2018; 22:671-687. [PMID: 29396642 DOI: 10.1007/s00784-018-2354-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 01/23/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to systematically review clinical trials about the effect of statins as adjunct to mechanical periodontal therapy, on probing pocket depth, clinical attachment level, and intrabony defects, in comparison to mechanical periodontal therapy alone or in association with placebo. MATERIAL AND METHODS Three databases were searched for controlled clinical trials that used any locally delivered or systemically statin as a sole adjunctive therapy to mechanical periodontal treatment. Weighted mean differences between baseline and 6 months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD), and intrabony defect (IBD) were calculated. A high heterogeneity was detected. Therefore, a meta-regression adjusted for type of statin and year of publication was performed. RESULTS Fifteen studies were included in the systematic review, and ten studies were included in the meta-analysis. In the meta-regression, the adjunct use of simvastatin, rosuvastatin, and atorvastatin additionally reduced PPD in comparison to mechanical periodontal therapy and a placebo gel (2.90 ± 0.35, 3.90 ± 0.77, 3.06 ± 0.71 mm, respectively; p < 0.05). Regarding the resolution of IBD, simvastatin and rosuvastatin significantly improved in comparison to control group (0.89 ± 0.35 and 1.93 ± 0.77 mm, respectively; p < 0.05). No statistically significant difference was found between the statins for both PPD and IBD (p < 0.05). Regarding CAL gain, simvastatin provided a statistically significant improvement as compared to the control group (2.02 ± 0.79 mm; p = 0.043). CONCLUSIONS The use of statins, used as sole adjuncts to mechanical periodontal treatment, improved the periodontal parameters. In the quantitative analyses, simvastatin was the only drug that showed additional benefits in all evaluated parameters. CLINICAL RELEVANCE Statins promote significantly clinical periodontal improvements when administered in association with non-surgical scaling and root planning (SRP), when compared to SRP alone or in association with a placebo.
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Affiliation(s)
- Francisco Wilker Mustafa Gomes Muniz
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
| | - Keity Taminski
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Juliano Cavagni
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Patrícia Weidlich
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
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Bertl K, Steiner I, Pandis N, Buhlin K, Klinge B, Stavropoulos A. Statins in nonsurgical and surgical periodontal therapy. A systematic review and meta-analysis of preclinical in vivo trials. J Periodontal Res 2017; 53:267-287. [PMID: 29211309 DOI: 10.1111/jre.12514] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/13/2022]
Abstract
The cholesterol-lowering drugs, statins, possess anti-inflammatory, antimicrobial and pro-osteogenic properties, and thus have been tested as an adjunct to periodontal treatment. The present systematic review aimed to answer the following focused research question: What is the effect of local and/or systemic statin use on periodontal tissues in preclinical in vivo studies of experimentally induced periodontitis (EIP) and/or acute/chronified periodontal defect (ACP) models? A literature search (of Medline/PubMed, Embase/Ovid, CENTRAL/Ovid) using the following main eligibility criteria was performed: (i) English or German language; (ii) controlled preclinical in vivo trials; (iii) local and/or systemic statin use in EIP and/or ACP models; and (iv) quantitative evaluation of periodontal tissues (i.e., alveolar bone level/amount, attachment level, cementum formation, periodontal ligament formation). Sixteen studies in EIP models and 7 studies in ACP models evaluated simvastatin, atorvastatin or rosuvastatin. Thirteen of the EIP (81%) and 2 of the ACP (29%) studies presented significantly better results in terms of alveolar bone level/amount in favor of statins. Meta-analysis based on 14 EIP trials confirmed a significant benefit of local and systemic statin use (P < .001) in terms of alveolar bone level/amount; meta-regression revealed that statin type exhibited a significant effect (P = .014) in favor of atorvastatin. Three studies reported a significantly higher periodontal attachment level in favor of statin use (P < .001). Complete periodontal regeneration was never observed; furthermore, statins did not exert any apparent effect on cementum formation. Neither local nor systemic use of statins resulted in severe adverse effects. Statin use in periodontal indications has a positive effect on periodontal tissue parameters, supporting the positive results already observed in clinical trials. Nevertheless, not all statins available have been tested so far, and further research is needed to identify the maximum effective concentration/dose and optimal carrier.
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Affiliation(s)
- K Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - I Steiner
- Private Practice, Taiskirchen, Austria.,Postgraduate Course Periodontology, Medical University of Vienna, Vienna, Austria
| | - N Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - K Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - B Klinge
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - A Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
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35
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Wassall RR, Preshaw PM. Clinical and technical considerations in the analysis of gingival crevicular fluid. Periodontol 2000 2017; 70:65-79. [PMID: 26662483 DOI: 10.1111/prd.12109] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 01/05/2023]
Abstract
Despite the technical challenges involved when collecting, processing and analyzing gingival crevicular fluid samples, research using gingival crevicular fluid has, and will continue to play, a fundamental role in expanding our understanding of periodontal pathogenesis and healing outcomes following treatment. A review of the literature, however, clearly demonstrates that there is considerable variation in the methods used for collection, processing and analysis of gingival crevicular fluid samples by different research groups around the world. Inconsistent or inadequate reporting impairs interpretation of results, prevents accurate comparison of data between studies and potentially limits the conclusions that can be made from a larger body of evidence. The precise methods used for collection and analysis of gingival crevicular fluid (including calibration studies required before definitive clinical studies) should be reported in detail, either in the methods section of published papers or as an online supplementary file, so that other researchers may reproduce the methodology. Only with clear and transparent reporting will the full impact of future gingival crevicular fluid research be realized. This paper discusses the complexities of gingival crevicular fluid collection and analysis and provides guidance to researchers working in this field.
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Goes P, Lima NA, Rodrigues JAG, Benevides NMB, Brito GAC, Lima V. Anti-inflammatory and Anti-resorptive Effects of Atorvastatin on Alveolar Bone Loss in Wistar Rats. Braz Dent J 2017; 27:267-72. [PMID: 27224558 DOI: 10.1590/0103-6440201600600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/17/2016] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to evaluate the anti-inflammatory and anti-resorptive effect of atorvastatin (ATV) in an experimental alveolar bone loss (ABL) model. Wistar rats were subjected to ligature placement around the maxillary second molar for 11 days. The animals received 0.9% saline (2 mL/kg) or ATV (0.3, 3 or 27 mg/kg) daily by gavage. ABL was evaluated by resorption area and histopathological analysis. Serum bone-specific alkaline phosphatase (BALP) activity was also evaluated. Leukogram was performed at 0 h, 6th h, 2nd, 7th and 11th days. Kidney and liver conditions and the body mass variation were analyzed. ATV (3 and 27 mg/kg) inhibited ABL by 39% and 56%, respectively. Histopathological analysis showed that ATV 27 mg/kg prevented ABL and cemental resorption, and inflammatory cell infiltration induced by ligature. ATV (27 mg/kg) prevented serum BALP levels reduction. ATV (27 mg/kg) prevented leukocytosis and did not affect either kidney or liver function nor body mass weight. ATV showed a protecting effect in the ligature-induced periodontitis, without affecting system parameters, by inhibition of inflammatory process and by its anabolic activity on the alveolar bone.
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Affiliation(s)
- Paula Goes
- Department of Pathology and Legal Medicine, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Pathology and Legal Medicine, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Neiberg Alcântara Lima
- Department of Physiology and Pharmacology, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Physiology and Pharmacology, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - José Ariévilo Gurgel Rodrigues
- Department of Biochemistry and Molecular Biology, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Biochemistry and Molecular Biology, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Norma Maria Barros Benevides
- Department of Biochemistry and Molecular Biology, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Biochemistry and Molecular Biology, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Gerly Anne Castro Brito
- Department of Morphology, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Morphology, Universidade Federal do Ceará, Fortaleza CE , Brazil
| | - Vilma Lima
- Department of Physiology and Pharmacology, UFC - Universidade Federal do Ceará, Fortaleza, CE, Brazil, Universidade Federal do Ceará, Department of Physiology and Pharmacology, Universidade Federal do Ceará, Fortaleza CE , Brazil
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37
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Sayar F, Fallah S, Akhondi N, Jamshidi S. Association of serum lipid indices and statin consumption with periodontal status. Oral Dis 2016; 22:775-780. [DOI: 10.1111/odi.12545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 01/10/2023]
Affiliation(s)
- F Sayar
- Department of Periodontics; Tehran Dental Branch; Islamic Azad University; Tehran Iran
| | - S Fallah
- Gastroenterology Department; Milad Hospital; Tehran Iran
| | - N Akhondi
- Department of Mathematics; South Tehran Branch; Islamic Azad University; Tehran Iran
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Stadler AF, Angst PDM, Arce RM, Gomes SC, Oppermann RV, Susin C. Gingival crevicular fluid levels of cytokines/chemokines in chronic periodontitis: a meta-analysis. J Clin Periodontol 2016; 43:727-45. [PMID: 27027257 DOI: 10.1111/jcpe.12557] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2016] [Indexed: 12/14/2022]
Abstract
AIMS To compare gingival crevicular fluid (GCF) cytokines/chemokines levels between periodontally healthy subjects and subjects diagnosed with chronic periodontitis (ChP), before and after non-surgical periodontal treatment, and to establish their predictive value for periodontal disease progression. METHODS Studies indexed in MEDLINE and EMBASE published in English, Portuguese and Spanish were eligible for this review. Database searches up to December 2015, and manual search of the reference list from reviews and selected articles was performed. Only studies providing data on GCF cytokines/chemokines levels in subjects diagnosed with ChP and periodontally healthy controls were included. Cross-sectional, case series, single-arm clinical studies, randomized controlled trials and prospective/retrospective cohort studies were included. Meta-analyses were conducted for those cytokines/chemokines with at least three available studies. RESULTS GCF levels of IL-1β, IL-6, IFN-γ and MCP-1/CCL2 were significantly higher in subjects diagnosed with ChP than periodontally healthy subjects. A significant decrease in GCF levels of IL-1β and IL-17 was observed after non-surgical periodontal treatment, whereas a significant increase was observed for IL-4. CONCLUSION Evidence for significant differences between periodontal health and ChP was observed for a few cytokines and one chemokine. No conclusions could be drawn with regards to increased risk of disease progression.
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Affiliation(s)
- Amanda F Stadler
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Patrícia D M Angst
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roger M Arce
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Sabrina C Gomes
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rui V Oppermann
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiano Susin
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
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Sangwan A, Tewari S, Singh H, Sharma RK, Narula SC. Effect of hyperlipidemia on response to nonsurgical periodontal therapy: Statin users versus nonusers. Eur J Dent 2016; 10:69-76. [PMID: 27011743 PMCID: PMC4784157 DOI: 10.4103/1305-7456.175685] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: To evaluate the response to nonsurgical periodontal therapy among hyperlipidemic subjects and whether statin use by hyperlipidemic subjects influences the response. Materials and Methods: This study was conducted on 107 chronic periodontitis subjects (35 normolipidemic [NL] controls, 36 hyperlipidemics on nonpharmacological therapy and 36 hyperlipidemics on statins). Periodontal (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]) and biochemical (plasma triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-DL-C [HDL-C] levels) examination was done at baseline and 3 months after nonsurgical periodontal treatment. Results: Both the NL and statin groups exhibited significantly greater improvement in GI as compared to the hyperlipidemic group on nonpharmacological therapy (P = 0.004 and 0.006, respectively). Mean change in PD correlated negatively with baseline TC (r = −0.306) and LDL-C (r = −0.360) while mean change in GI positively correlated with baseline HDL-C (r = 0.219). Regression analyses revealed that mean change in PD was negatively associated with LDL-C (β = −0.358, P < 0.001) while mean change in GI was positively associated with HDL-C (β = 0.219, P = 0.023). Conclusions: While higher baseline lipid levels were somewhat detrimental to the resolution of inflammation postperiodontal treatment, the inclusion of statin therapy among hyperlipidemic subjects seemed to improve clinical response as compared to those devoid of the drug. The findings of the study are suggestive of a possible adjunctive role of statins in periodontal treatment that warrants future studies.
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Affiliation(s)
- Aditi Sangwan
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shikha Tewari
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Harpreet Singh
- Department of Medicine, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rajinder Kumar Sharma
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Satish Chander Narula
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Johnson TM, Worthington HV, Clarkson JE, Poklepovic Pericic T, Sambunjak D, Imai P. Mechanical interdental cleaning for preventing and controlling periodontal diseases and dental caries. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd012018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Trevor M Johnson
- RCS England; Faculty of General Dental Practice (UK); 35-43 Lincoln's Inn Fields London UK WC2A 3PE
| | - Helen V Worthington
- School of Dentistry, The University of Manchester; Cochrane Oral Health Group; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Jan E Clarkson
- University of Dundee; Division of Oral Health Sciences; Dental Hospital & School Park Place Dundee Scotland UK DD1 4HR
| | - Tina Poklepovic Pericic
- School of Medicine, University of Split; Cochrane Croatia; Soltanska 2 Split Splitsko-dalmatinska County Croatia 21 000
| | - Dario Sambunjak
- Catholic University of Croatia; Center for evidence-based medicine and health care; Ilica 242 Zagreb Croatia 10000
| | - Pauline Imai
- MTI Community College; Healthcare Faculty; Suite 200 4980 Kingsway Burnaby BC Canada V5H 4K7
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Kimak A, Strycharz-Dudziak M, Bachanek T, Kimak E. Lipids and lipoproteins and inflammatory markers in patients with chronic apical periodontitis. Lipids Health Dis 2015; 14:162. [PMID: 26666260 PMCID: PMC4678471 DOI: 10.1186/s12944-015-0156-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 11/16/2015] [Indexed: 01/25/2023] Open
Abstract
Background Since chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease, the aim of the study was to determine the relationship between the size of CAP lesion and inflammatory markers (hsCRP, IL-6, TNF-α), as well as lipids and lipoproteins (LpPLA2, apoAI, apoB level) in blood serum of patients with CAP. Methods The patients studied (n = 43) were divided into groups: patients under 50 and over 50 years of age, and a separate subgroup of the oldest age with the largest size of CAP lesions. Apolipoprotein AI (apoAI) above 150 mg/dL and below 150 mg/dL was used as an important criterion for the division of patients into groups. The CAP lesion size was measured using the Kodak digital imaging system software. The control group consisted of clinically healthy volunteers (n = 20) without CAP. Lipids were measured on a Siemens analyzer (Germany), apoAI, apoB, hsCRP levels were determined by immunonephelometric method, using the Health Care Diagnostic Product (Siemens GmbH, Germany), and IL-6, TNF-α and LpPLAG7 assay kits (ELISA, R&D Systems) were used. Results The findings suggested that in patients with CAP and their age increase, the CAP lesion size, the concentration of inflammatory markers and LpPLA2 mass increased. Correlations between the CAP lesion size and LpPLA2 mass and between the CAP lesion size and TG level in patients with apoAI 150 ≤ mg/dL showed increase TG in atherogenic apoB-containing triglyceride-rich lipoprotein and TC in cholesterol-rich lipoprotein. The patients with a low apoAI and high LpPLA2 level can have a higher risk of odontogenic disease and progression of atherosclerosis and coronary heart disease. Conclusion We have found a positive correlation between apoAI level and the CAP lesion size and a negative correlation between LpPLA2 level and the CAP lesion size. The results suggest that apoAI and LpPLA2 in HDL particles have antiinflammatory action and together can limit the CAP lesion size in patient with a higher apoAI level. The literature data on the distribution of lipoprotein particles in subjects are still insufficient, so this problem requires further studies.
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Affiliation(s)
- Aleksandra Kimak
- Department of Conservative Dentistry with Endodontic, Medical University, Karmelicka 7, 20-081, Lublin, Poland.
| | | | - Teresa Bachanek
- Department of Conservative Dentistry with Endodontic, Medical University, Karmelicka 7, 20-081, Lublin, Poland.
| | - Elżbieta Kimak
- Department of Laboratory Diagnostics, Medical University, Street Chodźki 1, 20-093, Lublin, Poland.
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Perayil J, Suresh N, Fenol A, Vyloppillil R, Bhaskar A, Menon S. Comparison of glycated hemoglobin levels in individuals without diabetes and with and without periodontitis before and after non-surgical periodontal therapy. J Periodontol 2015; 85:1658-66. [PMID: 24968250 DOI: 10.1902/jop.2014.130661] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Only a few studies have examined the association between periodontitis and glycated hemoglobin (HbA1c) levels in individuals without diabetes. The aim of this study is to compare HbA1c levels in individuals without diabetes and with and without periodontitis before and after non-surgical periodontal therapy. METHODS This comparative study was done on individuals without diabetes who were 35 to 65 years old. Group A consisted of 30 individuals without periodontitis, and group B consisted of 30 individuals with periodontitis. Body mass indices and clinical parameters, including oral hygiene index-simplified (OHI-S) score, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and HbA1c level, of all participants were recorded. All participants received non-surgical periodontal therapy (scaling and root planing). After 3 months, all participants were reexamined, and clinical parameters and HbA1c levels were evaluated and compared to baseline values. RESULTS There were significant differences between group A and group B in regard to baseline OHI-S, GI, PD, and HbA1c (P <0.05). There was no clinical attachment loss in group A, either at baseline or after 3 months. At the end of 3 months, group B showed improvement in all clinical parameters (P <0.05) and their HbA1c levels also significantly decreased (P <0.05), although the values never reached those of group A. CONCLUSION The HbA1c levels of individuals without diabetes and with periodontitis (group B) were significantly reduced 3 months after non-surgical periodontal therapy, although they never reached the same levels as those of the individuals without diabetes or periodontitis (group A).
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Affiliation(s)
- Jayachandran Perayil
- Department of Periodontics, Amrita School of Dentistry, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India
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Torumtay G, Kırzıoğlu FY, Öztürk Tonguç M, Kale B, Calapoğlu M, Orhan H. Effects of periodontal treatment on inflammation and oxidative stress markers in patients with metabolic syndrome. J Periodontal Res 2015; 51:489-98. [DOI: 10.1111/jre.12328] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2015] [Indexed: 12/20/2022]
Affiliation(s)
- G. Torumtay
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - F. Y. Kırzıoğlu
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - M. Öztürk Tonguç
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - B. Kale
- Department of Internal Medicine; Faculty of Medicine; Süleyman Demirel University; Isparta Turkey
| | - M. Calapoğlu
- Department of Biochemistry; Faculty of Arts and Sciences; Süleyman Demirel University; Isparta Turkey
| | - H. Orhan
- Department of Biostatistics and Medical Informatics; Faculty of Medicine; Süleyman Demirel University; Isparta Turkey
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Javed F, Warnakulasuriya S. Is there a relationship between periodontal disease and oral cancer? A systematic review of currently available evidence. Crit Rev Oncol Hematol 2015; 97:197-205. [PMID: 26343577 DOI: 10.1016/j.critrevonc.2015.08.018] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/29/2015] [Accepted: 08/13/2015] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Oral cancer (OC) is known to have a multi-factorial etiology; tobacco, alcohol and betel quid being the major risk factors. Tooth loss and periodontal disease (PD) have been implicated to increase the risk of developing various cancers. The aim of this systematic review was to assess any possible association between PD and OC. Indexed databases were searched using different combinations of the following key words: "oral cancer", "periodontal disease", "tooth loss", "squamous cell carcinoma", "missing teeth" "alveolar bone loss", "clinical attachment loss" and "periodontitis". PRISMA criteria were followed to accrue data and databases were searched from 1984 up to and including June 2015. In total, 12 case-control studies were selected from the published literature. RESULTS Nine studies reported a 2-5 fold increase in the risk of OC among patients with PD as compared to those without PD. Three studies reported no association between PD and OC. In one study, an increased risk of tongue cancer was associated with each millimeter of alveolar bone loss and in two studies clinical attachment loss of more than 1.5mm was associated with an increased risk of OC. In studies reporting significant findings these associations persisted after adjusting for major risk factors. PD is associated with a small but significant increase in risk for OC. In several reported studies this association was attenuated following adjustment for tobacco and alcohol use.
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Affiliation(s)
- Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY 14620, USA.
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London and WHO Collaborating Centre for Oral Cancer and Precancer, London, United Kingdom
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Estanislau IMG, Terceiro IRC, Lisboa MRP, Teles PDB, Carvalho RDS, Martins RS, Moreira MMSM. Pleiotropic effects of statins on the treatment of chronic periodontitis--a systematic review. Br J Clin Pharmacol 2015; 79:877-85. [PMID: 25444240 PMCID: PMC4456120 DOI: 10.1111/bcp.12564] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/26/2014] [Indexed: 12/23/2022] Open
Abstract
AIM Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss. METHODS In order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected. RESULTS Statins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts. CONCLUSION Although we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis.
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Affiliation(s)
- Ilanna Mara Gomes Estanislau
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of CearáFortaleza, Brazil
| | | | | | | | - Rosimary de Sousa Carvalho
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of CearáFortaleza, Brazil
| | - Ricardo Souza Martins
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of CearáFortaleza, Brazil
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Perayil J, Menon KS, Kurup S, Thomas AE, Fenol A, Vyloppillil R, Bhaskar A, Megha S. Influence of Vitamin D & Calcium Supplementation in the Management of Periodontitis. J Clin Diagn Res 2015; 9:ZC35-8. [PMID: 26266214 DOI: 10.7860/jcdr/2015/12292.6091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 04/21/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION It has long been recognized that vitamin D is a hormone and were many studies reporting that patients in periodontal maintenance programs taking vitamin D and calcium supplementation had a trend for better periodontal health compared to patients not taking supplementation. AIM To evaluate the effect of vitamin D and calcium supplementation in reducing gingival inflammation, using clinical parameters like gingival index (GI), oral hygiene index-simplified (OHIS), probing pocket depth (PPD), clinical attachment level (CAL) and bone density (BD). Also, to assess whether calcium and vitamin D oral supplementation influences alveolar Bone Density (BD). DESIGN AND SETTINGS A nonrandomised clinical trial done in Amrita School of dentistry, Kochi, India. MATERIALS AND METHODS Group A taking vitamin D (250IU/day) and calcium (500 mg/day) supplementation, and Group B were not taking oral supplementation. All subjects had at least one or more teeth with chronic moderate periodontitis. Digital Orthopantomogram images were taken to assess bone density. Data were collected at baseline and three months. STATISTICAL ANALYSIS USED OHI-S, GI, PPD, CAL, and Bone Densities (BD) were calculated per group. Karl Pearson Coefficient of correlation was used to test correlation of bone density with GI and OHI -S. Intergroup comparison of parameters were done using Independent two Sample t-test. Intragroup comparison of parameters at recall interval was done using Paired sample t-test. The results were considered statistically significant when p-value was <0.05. RESULTS Both Groups showed significant change in the periodontal parameters and bone density after three months and intragroup comparison showed highly significant results for vitamin D group in relation to GI, OHI S and bone density. CONCLUSION Calcium and vitamin D supplementation has got a positive effect on periodontal health and it can be used as an adjunct to non surgical periodontal therapy.
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Affiliation(s)
- Jayachandran Perayil
- Professor and HOD, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Keerthy S Menon
- Post Graduate Trainee, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Seema Kurup
- Professor and HOD, Department of Oral Medicine and Radiology, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Anju Elizebath Thomas
- Post Graduate Trainee, Department of Oral Medicine and Radiology, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Angel Fenol
- Professor, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Rajesh Vyloppillil
- Professor, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Anuradha Bhaskar
- Reader, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
| | - Sai Megha
- Assistant Professor, Department of Periodontics, Amrita School of Dentistry , Ponekkara, Kochi, India
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Tawfig A. Effects of non-surgical periodontal therapy on serum lipids and C-reactive protein among hyperlipidemic patients with chronic periodontitis. J Int Soc Prev Community Dent 2015; 5:S49-56. [PMID: 25984468 PMCID: PMC4428020 DOI: 10.4103/2231-0762.156524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: To evaluate the effect of non-surgical periodontal therapy on plasma lipid levels in hyperlipidemic patients with chronic periodontitis. Materials and Methods: After considering the inclusion and exclusion criteria, 30 hyperlipidemic patients with chronic periodontitis in the age group of 30–70 years, undergoing treatment in Ahmed Gasim Cardiac and Renal transplant Centre in north Sudan were recruited for the study. Patients were randomly assigned to the study and control groups. The study group received non-surgical periodontal therapy – oral hygiene instructions, scaling and root planing. The control group participants received only oral hygiene instructions. Lipid profile [total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG)], C-reactive protein (CRP), and periodontal parameters [Plaque index (PI), Gingival index (GI), probing pocket depth (PD), and attachment loss (ATL)] were measured and compared at baseline and after 3 months of the respective intervention. Between-groups analysis was done using independent “t” test and within-group analysis was done using dependent “t” test. Results: At baseline, groups were comparable based on lipid profile and periodontal parameters. After 3 months, the control group showed significant decrease in the PI and GI scores while there was no significant change in the other parameters. However, the study group showed significant decrease in the LDL and CRP levels along with a significant decrease in PD, ATL, PI, and GI scores, compared to the baseline values. Conclusion: Local non-surgical periodontal therapy resulted in improved periodontal health, with significant decrease in the LDL and CRP levels in hyperlipidemic patients with chronic periodontitis. Hence, local non-surgical periodontal therapy may be considered as an adjunct in the control of hyperlipidemia, along with standard care.
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Affiliation(s)
- Ahmed Tawfig
- Department of Preventive Dentistry, Division of Periodontics, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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Golpasand Hagh L, Zakavi F, Hajizadeh F, Saleki M. The association between hyperlipidemia and periodontal infection. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e6577. [PMID: 25763249 PMCID: PMC4341345 DOI: 10.5812/ircmj.6577] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 02/01/2014] [Accepted: 10/25/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Periodontitis is a local chronic inflammatory condition of the supporting structures of the teeth resulting from a dental plaque biofilm attached to teeth surfaces. Recent studies have indicated that this oral disease may have effects on systemic health. OBJECTIVES The aim of the present study was to evaluate the association between periodontitis and hyperlipidemia. PATIENTS AND METHODS This case-control study was conducted in Iran during March 2011. In this case-control study, levels of serum lipids in 45 subjects with periodontitis were measured and compared with 45 age, gender and body mass index (BMI) matched controls. Data were analyzed using student t-test and chi-square test with P < 0.05 as the limit of significance. RESULTS Mean values of total cholesterol (CHL) (periodontitis group = 218.11 ± 29.77, control group = 162.31 ± 48.24) and triglycerides (TG) (periodontitis group = 209.77 ± 44.30, control group = 125.60 ± 44.16) were significantly higher in the periodontitis group (P < 0.001). High-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels were higher in the case group, but this difference was not statistically significant. Frequency of pathological values of CHL and TG were significantly higher in cases compared with the controls (P = 0.002 and P = 0.015, respectively). CONCLUSIONS This study indicates that hyperlipidemia may be associated with periodontal disease in healthy individuals; yet whether periodontitis causes an increase in levels of plasma lipids or whether hyperlipidemia is a risk factor for periodontal infection and cardiovascular disease, it needs further investigations.
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Affiliation(s)
- Leila Golpasand Hagh
- Department of Periodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Faramarz Zakavi
- Department of Operative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Fatemeh Hajizadeh
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding Author: Fatemeh Hajizadeh, Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Golestan St., Ahvaz, IR Iran. Tel: +98-9166317753, Fax: +98-6133730142, E-mail:
| | - Morteza Saleki
- Department of Pediatric Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Arvand Branch, Ahvaz, IR Iran
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Hyperlipidemia causes changes in inflammatory responses to periodontal pathogen challenge: implications in acute and chronic infections. Arch Oral Biol 2014; 59:1075-84. [PMID: 24992577 DOI: 10.1016/j.archoralbio.2014.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/02/2014] [Accepted: 06/12/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE In this study, the effect of hyperlipidemia on immune responses to periodontal bacterial infections was investigated. METHODS Sixty male New Zealand white rabbits were equally assigned to normal diet (ND) and high-fat diet (HFD) for 6 weeks. Every six rabbits with ND or HFD were orally inoculated with live Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis three times a week for 8 weeks. Also every six rabbits with ND or HFD rabbits were injected intravenously with A. actinomycetemcomitans and P. gingivalis LPS. Periodontal disease severity was quantified by macroscopic and radiographical evaluation. Serum cytokines were examined by enzyme-linked immunosorbent assay. In vitro, peripheral mononuclear cells were collected and stimulated with LPS. Quantitative real-time polymerase chain reaction was used to determine the changes in gene expression of macrophages. RESULTS In the early stages of infection, HFD rabbits were exposed to oral infection and systemic infection developed a weak inflammatory response to the reduced cytokine expression compared with ND rabbits. However, HFD rabbits exhibited higher inflammatory cytokine expression during long-term infections. Moreover, the pronounced changes in inflammatory cytokine expression elicited a significantly increase in bone loss in HFD rabbits with oral infection. Peripheral macrophages harvested from HFD rabbits and exposed to LPS exhibited reduced levels of pro-inflammatory cytokines compared with those from ND rabbits in vitro. CONCLUSION These data indicated that hyperlipidemia interfered with immune responses differently. The mechanism is possibly associated with immune paralysis in the acute phase and accumulation of inflammatory mediators in the chronic period.
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Lee HR, Jun HK, Choi BK. Tannerella forsythia BspA increases the risk factors for atherosclerosis in ApoE(-/-) mice. Oral Dis 2013; 20:803-8. [PMID: 24372897 DOI: 10.1111/odi.12214] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/04/2013] [Accepted: 11/18/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of Tannerella forsythia and its major surface virulence factor, BspA, on the progression of atherosclerosis in ApoE(-/-) mice and the expression of lipid metabolism-related genes. METHODS PMA-differentiated THP-1 cells were treated with BspA to detect foam cell formation. The proximal aortas of ApoE(-/-) mice injected with T. forsythia or BspA were stained with oil red O to examine lipid deposition. The serum levels of CRP, HDL, and LDL were detected by ELISA. The liver tissue of T. forsythia- or BspA-injected ApoE(-/-) mice was examined for mRNA expression of lipid metabolism-related genes, such as liver X receptors (LXRα and LXRβ) and ATP-binding cassette transporter A1 (ABCA1). RESULTS Tannerella forsythia and BspA induced foam cell formation in THP-1 cells and accelerated the progression of atherosclerotic lesions in ApoE(-/-) mice. Mouse serum levels of CRP and LDL were increased, and HDL was decreased by T. forsythia and BspA. The expression levels of LXRα and LXRβ, and ABCA1 in liver tissue were decreased by T. forsythia and BspA. CONCLUSIONS Tannerella forsythia and BspA augmented atherosclerotic lesion progression in ApoE(-/-) mice. This process may be associated with downregulation of lipid metabolism-related gene expression.
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Affiliation(s)
- H R Lee
- Division of High-Risk Pathogen Research, Center for Infectious Diseases, National Institute of Health, Cheongwon-gun, Chungbuk, Korea
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