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Batista-Cárdenas D, Araya-Castillo A, Arias-Campos MP, Solís-Rivera AP, Jiménez-Matarrita J, Piedra-Hernández L, Madriz-Montero L, Ramírez K. Association of the severity and progression rate of periodontitis with systemic medication intake. FRONTIERS IN ORAL HEALTH 2024; 5:1447019. [PMID: 39157205 PMCID: PMC11328918 DOI: 10.3389/froh.2024.1447019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Background/purpose Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.
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Affiliation(s)
| | | | | | | | | | | | | | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, San José, Costa Rica
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2
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Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Luján-Urviola E, Farje-Gallardo CA. Association between Periodontal Disease and Obesity: Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:621. [PMID: 38674267 PMCID: PMC11051919 DOI: 10.3390/medicina60040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Faculty of Dentistry, Dentistry School, San Martin de Porres University, Chiclayo 14012, Peru;
- Faculty of Human Medicine, Human Medicine School, San Martín de Porres University, Chiclayo 14012, Peru
| | - Fredy Hugo Cruzado-Oliva
- Faculty of Stomatology, Stomatology School, Nacional University of Trujillo, Trujillo 13001, Peru;
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Eduardo Luján-Urviola
- Faculty of Dentistry, Néstor Cáceres Velásquez Andean University, Juliaca 21104, Peru;
| | - Carlos Alberto Farje-Gallardo
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
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Beukers NGFM, Su N, van der Heijden GJMG, Loos BG. Periodontitis is associated with multimorbidity in a large dental school population. J Clin Periodontol 2023; 50:1621-1632. [PMID: 37658672 DOI: 10.1111/jcpe.13870] [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: 04/22/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
AIM To investigate whether and which diseases co-occur with periodontitis (PD) to assess the prevalence of comorbidities and multimorbidity and to identify patterns and profiles of comorbidity and multimorbidity and the influence of demographic and lifestyle factors to identify distinct groups of multimorbid patients. MATERIALS AND METHODS A database from the Academic Centre of Dentistry Amsterdam (ACTA) with 37,801 adult individuals containing information about demographic (age, sex, socio-economic position [SEP]) and lifestyle factors (smoking, alcohol use and addictive substance use) and PD and systemic diseases was constructed. PD assessment was based on clinical information by the use of claim codes and systemic diseases data were derived from self-reported medical history. For analyses, univariable and multivariable (adjusted for age, sex, SEP, smoking, alcohol use and addictive substance use) logistic regression analyses and cluster analysis were used. RESULTS Individuals with PD more often had one or multiple diseases. The adjusted odds ratio (OR) for PD patients having up to four systemic diseases ranged from 1.46 to 1.20. Co-occurrence of PD with several systemic diseases and a higher prevalence of multimorbidity was found (adjusted OR comorbidity = 1.36; 95% confidence interval (CI): 1.30-1.43; multimorbidity = 1.18; 95% CI: 1.11-1.25). Four clusters existed: cluster 1 was defined as a periodontal and systemically healthy group and cluster 4 as burdened with PD but not containing any systemic diseases. Individuals in cluster 1 were of the lowest age (44.9 [SD: 15.5]) and had the lowest prevalence of the lifestyle factors of smoking (13.6%) and alcohol use (3.9%). Clusters 2 and 3 contained both PD and had several systemic diseases but were different from each other. Cluster 2 contained 34.5% of PD individuals and had mainly respiratory tract, immune system and digestive system diseases. Cluster 3 contained 45.9% of PD individuals and had mainly cardiometabolic diseases. Cluster 2 had the highest prevalence of females (63.1%) and the highest prevalence of smokers (23.8%) and addictive substance users (8.9%). Cluster 3 included individuals of the highest age (63.5 [SD: 11.9]), and had highest prevalence of alcohol users (17.7%) and lowest prevalence of addictive substance users (3.8%). CONCLUSIONS This study shows that individuals with PD are more often burdened with comorbidity and multimorbidity. Presence of distinct clusters suggests overlap in pathophysiology between certain types of PD and specific systemic diseases. Therefore, PD can be considered as part of multimorbidity, as one of the systemic diseases co-occurring in certain groups of individuals.
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Affiliation(s)
- Nicky G F M Beukers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Geert J M G van der Heijden
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Ribeiro IM, de Souza Barroso ME, Kampke EH, Braga LTF, Campagnaro BP, Meyrelles SDS. Infrared laser therapy decreases systemic oxidative stress and inflammation in hypercholesterolemic mice with periodontitis. Lipids Health Dis 2023; 22:171. [PMID: 37817126 PMCID: PMC10566050 DOI: 10.1186/s12944-023-01934-9] [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: 07/31/2023] [Accepted: 10/02/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Near-infrared irradiation photobiomodulation (NIR-PBM) has been successfully used in periodontal treatment as an adjuvant tool to locally improve cell function and regeneration. Although the relationship between periodontitis and systemic disease constitutes an important aspect of periodontal clinical research, the systemic effects of NIR-PBM in periodontitis are not well known. In this study, we aimed to investigate the effects of NIR-PBM on systemic oxidative stress and inflammation in an apolipoprotein E (ApoE) knockout mouse model of periodontal disease (PD). METHODS We evaluated alveolar bone loss by measuring the distance from the cementoenamel junction (CEJ) to the alveolar bone crest (ABC), reactive oxygen species (ROS) production in blood cells, inflammatory activity, plasma cholesterol levels, and lipid peroxidation levels in three experimental groups: (1) ApoEC, control group without intervention; (2) ApoEP, first molar ligation-induced periodontitis for 4 weeks; and (3) ApoEP + PBM, exposed to 808 nm continuous wave, ø ~ 3 mm2, 100 mW, 60 s of NIR-PBM for 7 consecutive days after 4 weeks of periodontitis. At the end of the experimental protocols, ApoEP mice presented significantly increased alveolar bone loss, ROS production, inflammatory activity, plasma cholesterol, and lipid peroxidation levels compared to the ApoEC group (P < 0.05). NIR-PBM for 7 days in the ApoEP + PBM mice significantly decreased systemic ROS production, inflammatory response, plasma cholesterol, and lipid peroxidation levels, similar to those found in the ApoEC group (P > 0.05). However, it was not capable of preventing alveolar bone loss (P > 0.05 compared to ApoEP mice). CONCLUSION A 7-day treatment with NIR-PBM effectively reduces systemic oxidative stress and inflammatory parameters in hypercholesterolemic mice with PD. However, more studies with longer evaluation times are needed to confirm the systemic effects of locally applied NIR-PBM on PD associated with hypercholesterolemia.
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Affiliation(s)
- Isadora Martins Ribeiro
- Graduate Program in Dental Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | - Maria Eduarda de Souza Barroso
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | - Edgar Hell Kampke
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil
| | | | - Bianca Prandi Campagnaro
- Graduate Program in Pharmaceutical Sciences, Vila Velha University (UVV), Vila Velha, 29102-920, ES, Brazil
| | - Silvana Dos Santos Meyrelles
- Graduate Program in Dental Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil.
- Graduate Program in Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, 29.043-900, ES, Brazil.
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Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence. Metabolites 2022; 13:metabo13010040. [PMID: 36676965 PMCID: PMC9865290 DOI: 10.3390/metabo13010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Periodontitis is a microbially driven, host-mediated disease that leads to loss of periodontal attachment and resorption of bone. It is associated with the elevation of systemic inflammatory markers and with the presence of systemic comorbidities. Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients have mild symptoms, others experience important complications that can lead to death. After the spread of the COVID-19 pandemic, several investigations demonstrating the possible relationship between periodontitis and COVID-19 have been reported. In addition, both periodontal disease and COVID-19 seem to provoke and/or impair several cardiometabolic complications such as cardiovascular disease, type 2 diabetes, metabolic syndrome, dyslipidemia, insulin resistance, obesity, non-alcoholic fatty liver disease, and neurological and neuropsychiatric complications. Therefore, due to the increasing number of investigations focusing on the periodontitis-COVID-19 relationship and considering the severe complications that such an association might cause, this review aims to summarize all existing emerging evidence regarding the link between the periodontitis-COVID-19 axis and consequent cardiometabolic impairments.
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6
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Lavigne SE. Evolving evidence for relationships between periodontitis and systemic diseases: Position paper from the Canadian Dental Hygienists Association. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2022; 56:155-171. [PMID: 36451995 PMCID: PMC9674001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 06/17/2023]
Abstract
AIM The aim of this position paper is to investigate the current state of the evidence for proposed associations between periodontitis and rheumatoid arthritis, Alzheimer's disease, obesity, inflammatory cancers, and renal disease using a narrative review approach. This is the last of a series of 5 position papers from the Canadian Dental Hygienists Association (CDHA) on the relationship between periodontitis and systemic conditions. METHODS Individual literature searches were conducted for each of the 5 proposed linkages and limited to human studies, with a preference for systematic reviews (SRs) and prospective studies, in the English language, published between 2015 and 2021, focused on associations between 1) periodontitis and rheumatoid arthritis; 2) periodontitis and Alzheimer's disease/cognitive impairment; 3) periodontitis and obesity; 4) periodontitis and inflammatory cancers; and 5) periodontitis and chronic kidney disease. Databases searched were PubMed, MEDLINE/OVID, CINAHL, Scopus, Cochrane Registry of Systematic Reviews, and Web of Science. RESULTS A total of 39 papers were selected for discussion, including 6 SRs for rheumatoid arthritis; 7 SRs for Alzheimer's disease/cognitive impairment; 11 SRs, 1 meta-review of SRs, and 1 population-based cohort study for obesity; 9 SRs for inflammatory cancers; and 4 SRs for kidney disease. CONCLUSIONS The evidence for the 5 proposed associations varied in strength, with obesity being most strongly associated with periodontal disease. More robust studies are recommended to clarify the exact nature of these associations.
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Affiliation(s)
- Salme E Lavigne
- Senior scholar and retired professor, School of Dental Hygiene, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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7
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Folayan MO, Zuniga RAA, Ezechi OC, Brown B, Nguyen AL, Aly NM, Ellakany P, Idigbe IE, Khan ATA, Lawal FB, Jafer M, Gaffar B, Popoola BO, Quadri MFA, Virtanen JI, Lusher J, El Tantawi M. Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11550. [PMID: 36141821 PMCID: PMC9516999 DOI: 10.3390/ijerph191811550] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/10/2022] [Accepted: 09/10/2022] [Indexed: 06/12/2023]
Abstract
This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Roberto Ariel Abeldaño Zuniga
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Post Graduate School, University of Sierra Sur, Oaxaca 70805, Mexico
| | - Oliver C Ezechi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Brandon Brown
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Social Medicine, Population and Public Health, Riverside School of Medicine, University of California, Riverside, CA 92501, USA
| | - Annie L Nguyen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Nourhan M Aly
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21544, Egypt
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Ifeoma E Idigbe
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Abeedha Tu-Allah Khan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Biological Sciences, Faculty of Science, Superior University Lahore, Main Raiwind Road Punjab, Lahore 54590, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan 200132, Nigeria
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Preventive Dental Sciences Department, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam 31441, Saudi Arabia
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Child Oral Health, University of Ibadan, Ibadan 200132, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98105, USA
| | - Jorma I Virtanen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Faculty of Medicine, University of Turku, 20014 Turku, Finland
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Provost's Group, Regent's University London, London NW1 4NS, UK
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21544, Egypt
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8
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Ptasiewicz M, Bębnowska D, Małkowska P, Sierawska O, Poniewierska-Baran A, Hrynkiewicz R, Niedźwiedzka-Rystwej P, Grywalska E, Chałas R. Immunoglobulin Disorders and the Oral Cavity: A Narrative Review. J Clin Med 2022; 11:jcm11164873. [PMID: 36013115 PMCID: PMC9409910 DOI: 10.3390/jcm11164873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
The oral mucosa is a mechanical barrier against the penetration and colonization of microorganisms. Oral homeostasis is maintained by congenital and adaptive systems in conjunction with normal oral flora and an intact oral mucosa. Components contributing to the defense of the oral cavity include the salivary glands, innate antimicrobial proteins of saliva, plasma proteins, circulating white blood cells, keratinocyte products of the oral mucosa, and gingival crevicular fluid. General disturbances in the level of immunoglobulins in the human body may be manifested as pathological lesions in the oral mucosa. Symptoms of immunoglobulin-related general diseases such as mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), linear IgA bullous dermatosis (LABD), Epidermolysis Bullosa Aquisita (EBA), and Hyper-IgE syndrome (HIES) may appear in the oral cavity. In this review, authors present selected diseases associated with immunoglobulins in which the lesions appear in the oral cavity. Early detection and treatment of autoimmune diseases, sometimes showing a severe evolution (e.g., PV), allow the control of their dissemination and involvement of skin or other body organs. Immunoglobulin disorders with oral manifestations are not common, but knowledge, differentiation and diagnosis are essential for proper treatment.
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Affiliation(s)
- Maja Ptasiewicz
- Department of Oral Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | | | - Paulina Małkowska
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
- Doctoral School, University of Szczecin, 71-412 Szczecin, Poland
| | - Olga Sierawska
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
- Doctoral School, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Rafał Hrynkiewicz
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, 20-093 Lublin, Poland
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Mainas G, Ide M, Rizzo M, Magan-Fernandez A, Mesa F, Nibali L. Managing the Systemic Impact of Periodontitis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:621. [PMID: 35630038 PMCID: PMC9147054 DOI: 10.3390/medicina58050621] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 01/22/2023]
Abstract
Periodontitis is a microbially driven host-mediated disease that leads to loss of periodontal attachment and bone. It is associated with elevation of systemic inflammatory markers and with the presence of systemic co-morbidities. Furthermore, periodontal treatment leads to a 24-48 h-long acute local and systemic inflammatory response. This systemic response might increase the burden of patients with compromised medical history and/or uncontrolled systemic diseases. The correlation between periodontitis and systemic diseases, the impact of periodontitis on the quality of life and public health, the effects of periodontal treatment on systemic health and disease, and the available methods to manage systemic inflammation after periodontal therapy are discussed. The main focus then shifts to a description of the existing evidence regarding the impact of periodontitis and periodontal treatment on systemic health and to the identification of approaches aiming to reduce the effect of periodontitis on systemic inflammation.
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Affiliation(s)
- Giuseppe Mainas
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK; (G.M.); (M.I.)
| | - Mark Ide
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK; (G.M.); (M.I.)
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, School of Medicine, University of Palermo, 90133 Palermo, Italy;
| | - Antonio Magan-Fernandez
- Department of Periodontics, School of Dentistry, University of Granada, 18071 Granada, Spain; (A.M.-F.); (F.M.)
| | - Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, 18071 Granada, Spain; (A.M.-F.); (F.M.)
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK; (G.M.); (M.I.)
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Costea CA, Christodorescu R, Soancă A, Roman A, Micu IC, Stratul ȘI, Rusu D, Popescu DM, Popa-Wagner A, Bulboacă AE. Periodontitis in Ischemic Stroke Patients: Case Definition Challenges of the New Classification Scheme (2018). J Clin Med 2022; 11:520. [PMID: 35159973 PMCID: PMC8836590 DOI: 10.3390/jcm11030520] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of the associative relationships between ischemic stroke (IS) and risk factors such as advanced age and periodontitis is essential to design real screening protocols and to address them using primary and secondary preventive policies. This study primarily aimed to evaluate the diagnostic performance of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) case definition in detecting periodontitis against the 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) case definition in a group of IS patients. Secondarily, we report the periodontal status of IS patients and the associative relationship with respect to some risk factors. Patients with their first IS were assessed based on demographic data, medical, oral risk factors and periodontal parameters. The two case definitions were applied to identify the periodontitis burden. The agreement between the two case definition systems, as well as the misclassification ratio, were calculated. A total of 141 patients were included. According to the 2012 CDC/AAP and the 2018 EFP/AAP case definitions, a frequency of periodontitis of 98.5% and 97.8% based on two modalities of inclusion of cases in the severity groups, sensitivity values of 98.54% or 100%, and specificity values of 25% or 14.7% were calculated. Thus, the new case definition system has a higher capacity to detect periodontitis, especially the well-established forms.
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Affiliation(s)
- Cristina Andrada Costea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Ruxandra Christodorescu
- Institute of Cardiovascular Diseases Research Center, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției, No. 12, 300024 Timisoara, Romania;
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Ștefan Ioan Stratul
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției din 1989, No. 9, 300230 Timisoara, Romania; (Ș.I.S.); (D.R.)
| | - Darian Rusu
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției din 1989, No. 9, 300230 Timisoara, Romania; (Ș.I.S.); (D.R.)
| | - Dora Maria Popescu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Petru Rareș St., No. 2, 200349 Craiova, Romania;
| | - Aurel Popa-Wagner
- Chair of Vascular Neurology and Dementia Center, University of Medicine, Essen, Hufeland St., No. 55, 45122 Essen, Germany
- Experimental Research Center in Normal and Pathological Aging (ARES), University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy, Victor Babeș St., No. 2–4, 400012 Cluj-Napoca, Romania;
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11
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A study to assess the awareness of periodontitis and its relationship with systemic health among undergraduate medical students. Br Dent J 2021; 231:641-645. [PMID: 34824433 DOI: 10.1038/s41415-021-3665-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/10/2021] [Indexed: 11/08/2022]
Abstract
Introduction The association between periodontitis and certain systemic diseases is well established; however, there is a distinct lack of research available on its awareness among medical students in the United Kingdom.Aims To determine the awareness of fourth-year undergraduate medical students concerning periodontitis including its risk factors, relationship with systemic health and students' attitudes towards oral diseases and further education.Methods We delivered an online survey via a weekly email news bulletin to 299 fourth-year medical students and received 101 completed responses.Results Medical students were largely aware of the most common features of periodontitis and recognised that systemic diseases may affect the periodontium. There was less awareness of the associations between certain systemic diseases and periodontitis and there appeared to be confusion with tooth decay. Perceived knowledge was generally reported to be poor and most students believed that further teaching would improve their medical practice.Conclusions Increased teaching on periodontitis within the medical curriculum would benefit students. This may be achieved using an integrated teaching approach. Future doctors should graduate with an adequate education on the interdisciplinary links and should be capable of signposting or referring patients early to the appropriate services where indicated to improve patient care.
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12
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Varshney S, Sharma M, Kapoor S, Siddharth M. Association between rheumatoid arthritis and periodontitis in an adult population - A cross sectional study. J Clin Exp Dent 2021; 13:e980-e986. [PMID: 34667492 PMCID: PMC8501867 DOI: 10.4317/jced.57562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/23/2021] [Indexed: 12/31/2022] Open
Abstract
Background This investigation was aimed to analyse the existence of an association between rheumatoid arthritis and periodontitis among Indian subjects.
Material and Methods This observational study included a total of 110 individuals between 18-78 years of age, which were divided equally into RA (Rheumatoid Arthritis) and NRA (Non-Rheumatoid Arthritis) groups. General, Oral and a complete Periodontal examination included recording of Gingival Index (GI), Plaque index (PI), Pocket Probing Depth (PPD), Clinical attachment level (CAL) in a questionnaire form. Laboratory and rheumatologcal parameters like C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR) and Disease Activity Score 28(DAS 28), Health Assessment Questionnaire–Disability Index (HAQ), Rheumatoid factor (RF) were also respectively estimated.
Results Prevalence of moderate or severe periodontitis was higher in RA than in NRA group. (41.8% vs 23.6%, p= 0.047). Periodontal structural damage represented by clinical attachment level was more in RA patients (2.89 mm v/s 2.54mm, p=0.261). Mean score of HAQ was co-related significantly in patients with CAL ≥ 2mm than with CAL < 2mm (0.69 v/s 0.455, p=0.0415). Through logistic regression analysis, periodontitis and CAL were related to RA with OR (Odds Ratio) of 2.1 and 2.89 respectively.
Conclusions Indian RA patients have higher odds for periodontitis and CAL may act as a risk indicator for RA. Key words:Chronic periodontitis, rheumatoid arthritis, disease activity score 28, health assessment questionnaire, rheumatoid factor, c-reactive protein , erythrocyte sedimentation rate.
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Affiliation(s)
- Shailesh Varshney
- Periodontist, MDS, Department of Periodontology, School of Dental Sciences, Greater Noida
| | - Manish Sharma
- Post Graduate Student, Department of Periodontology , School of Dental Sciences, Greater Noida
| | - Sanjeev Kapoor
- Rheumatologist, MD, DM, Maharaj Agrasen Hospital, Punjabi Bagh, Arthritis Unit, Department of Rheumatology, New Delhi
| | - M Siddharth
- Periodontist, MDS, Department of Periodontology, School of Dental Sciences, Greater Noida
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Sojod B, Pidorodeski Nagano C, Garcia Lopez GM, Zalcberg A, Dridi SM, Anagnostou F. Systemic Lupus Erythematosus and Periodontal Disease: A Complex Clinical and Biological Interplay. J Clin Med 2021; 10:jcm10091957. [PMID: 34063235 PMCID: PMC8125164 DOI: 10.3390/jcm10091957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing to systemic inflammation. SLE is a multi-system chronic inflammatory autoimmune disease that has a wide range of clinical presentations, touching multiple organ systems. Many epidemiological studies have investigated the two-way relationship between PD and SLE, though their results are heterogeneous. SLE and PD are multifactorial conditions and many biological-based hypotheses suggest common physiopathological pathways between the two diseases, including genetics, microbiology, immunity, and environmental common risk factors. By focusing on recent clinical and translational research, this review aimed to discuss and give an overview of the relationship of SLE with PD, as well as looking at the similarities in the immune-pathological aspects and the possible mechanisms connecting the development and progression of both diseases.
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Affiliation(s)
- Bouchra Sojod
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Glenda Melissa Garcia Lopez
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | - Antoine Zalcberg
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Fani Anagnostou
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
- B3OA, CNRS UMR 7052-INSERM U1271, Université de Paris, 75010 Paris, France;
- Correspondence:
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Kaura Parbhakar K, Farmer JW, Quiñonez C. The influence of living conditions and individual behaviors on the oral-systemic disease connection: a cross-sectional analysis. J Public Health Dent 2021; 82:220-228. [PMID: 33890301 DOI: 10.1111/jphd.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/27/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the extent to which living conditions and individual behaviors influence the association between oral health status and systemic disease outcomes in Ontario, Canada's most populated province. METHODS A secondary data analysis of Ontario data from the Canadian Community. Health Survey 2013/14 was undertaken. Separate analyses were conducted for participants aged 35-59 years (n = 11,858) and 60+ years (n = 11,273). A series of regression models were constructed to examine the association between self-reported oral health status and systemic disease outcomes (arthritis, diabetes, hypertension, heart disease, chronic obstructive pulmonary disease, and stroke). Models were adjusted by proxies of living conditions (income, education, ethnicity, country of birth, employment, and food security) and individual behaviors (smoking status, alcohol use, tooth brushing, life stress, physical activity, sense of belonging). Percent attenuation between models was calculated to determine the extent of the living condition-behavior impact. RESULTS In both age groups, the prevalence of arthritis and high blood pressure was the highest, followed by heart disease. There was variation in percent attenuation by age group and outcome. Among participants aged 35-59 years, living conditions had a greater impact on the oral-systemic relationship, while individual behaviors played a greater role in this association among adults aged 60+ years. CONCLUSION There is an association between oral and systemic diseases; however, after accounting for living conditions and individual behaviors, this relationship was attenuated. This highlights the need to address upstream and midstream factors that are common to oral and systemic conditions.
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Affiliation(s)
| | - Julie W Farmer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Carlos Quiñonez
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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15
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Moura MF, Cota LOM, Costa AM, Silva TA, Costa FO. Rheumatoid arthritis associated with the occurrence, severity and extension of periodontitis: A case-control study. J Clin Exp Dent 2021; 13:e389-e396. [PMID: 33841739 PMCID: PMC8020312 DOI: 10.4317/jced.57540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/02/2020] [Indexed: 11/05/2022] Open
Abstract
Background Emerging evidence pointed to a potential association between periodontitis (PE) and rheumatoid arthritis (RA), based on shared characteristics and similarities in risk factors, immunogenetics and pathways of tissue destruction. The aim of this study was to evaluate the potential association between RA and PE, as well as the influence of risk variables in this association. Material and Methods The present case-control study comprised 471 individuals (157 cases with RA and 314 controls) that underwent a full-mouth periodontal examination. The association between risk variables and the occurrence of AR and PE were evaluated through univariate and multivariate logistic analysis. Results Higher frequency (p<0.001), severity (p=0.006) and extension (p=0.018) of PE was observed among the cases when compared to controls. Variables retained in the final multivariate models for the occurrence of PE were: lower number of teeth, smoking, no use of dental floss, ≥4 daily toothbrushing and RA; for the occurrence of RA were: higher age, female gender, smoking, alcohol use and PE. It is important to stress that RA (OR=2.53; 95%CI 1.24-3.86; p<0.001) was retained in the model for PE, and PE (OR=3.12; 95%CI 1.47-4.26; p<0.001) was retained in the model for RA. Conclusions The present study demonstrated a high frequency of PE among individuals with RA and an important association among the occurrence, severity and extension of PE and RA and smoking. Key words:Case-control study, risk factors, periodontitis, rheumatoid arthritis.
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Affiliation(s)
- Marcela-Faria Moura
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís-Otávio-Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Tarcília-Aparecida Silva
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando-Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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16
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Kapellas K, Hughes JT, Cass A, Maple-Brown LJ, Skilton MR, Harris D, Askie LM, Hoy W, Pawar B, McKenzie K, Sajiv CT, Arrow P, Brown A, Jamieson LM. Oral health of aboriginal people with kidney disease living in Central Australia. BMC Oral Health 2021; 21:50. [PMID: 33541341 PMCID: PMC7863237 DOI: 10.1186/s12903-021-01415-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/28/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Associations between kidney disease and periodontal disease are not well documented among Aboriginal people of Australia. The purpose of this investigation was to report and compare demographic, oral health, anthropometric and systemic health status of Aboriginal Australians with kidney disease and to compare against relevant Aboriginal Australians and Australian population estimates. This provides much needed evidence to inform dental health service provision policies for Aboriginal Australians with kidney disease. METHODS Sample frequencies and means were assessed in adults represented in six datasets including: (1) 102 Aboriginal Australians with kidney disease residing in Central Australia who participated in a detailed oral health assessment; (2) 312 Aboriginal participants of the Northern Territory's PerioCardio study; (3) weighted estimates from 4775 participants from Australia's National Survey of Adult Oral Health (NSAOH); (4) Australian 2016 Census (all Australians); (5) National Health Survey 2017-2018 (all Australians) and; (6) Australian Health Survey: Biomedical Results for Chronic Diseases, 2011-2012 (all Australians). Oral health status was described by periodontal disease and experience of dental caries (tooth decay). Statistically significant differences were determined via non-overlapping 95% confidence intervals. RESULTS Aboriginal Australians with kidney disease were significantly older, less likely to have a tertiary qualification or be employed compared with both PerioCardio study counterparts and NSAOH participants. Severe periodontitis was found in 54.3% of Aboriginal Australians with kidney disease, almost 20 times the 2.8% reported in NSAOH. A higher proportion of Aboriginal Australians with kidney disease had teeth with untreated caries and fewer dental restorations when compared to NSAOH participants. The extent of periodontal attachment loss and periodontal pocketing among Aboriginal Australians with kidney disease (51.0%, 21.4% respectively) was several magnitudes greater than PerioCardio study (22.0%, 12.3% respectively) and NSAOH (5.4%, 1.3% respectively) estimates. CONCLUSIONS Aboriginal Australians with kidney disease exhibited more indicators of poorer oral health than both the general Australian population and a general Aboriginal population from Australia's Northern Territory. It is imperative that management of oral health among Aboriginal Australians with kidney disease be included as part of their ongoing medical care.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Jaquelyne T Hughes
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Australia
| | - Alan Cass
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Michael R Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - David Harris
- Department of Renal Medicine, Westmead Centre for Medical Research, Westmead Hospital, University of Sydney, Westmead, Australia
| | - Lisa M Askie
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Wendy Hoy
- Griffith University, Brisbane, Australia
| | | | - Kirsty McKenzie
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | | | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
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Heo SC, Kim YN, Choi Y, Joo JY, Hwang JJ, Bae MK, Kim HJ. Elevated Expression of Cathepsin K in Periodontal Ligament Fibroblast by Inflammatory Cytokines Accelerates Osteoclastogenesis via Paracrine Mechanism in Periodontal Disease. Int J Mol Sci 2021; 22:E695. [PMID: 33445732 PMCID: PMC7828200 DOI: 10.3390/ijms22020695] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 12/15/2022] Open
Abstract
Cathepsin K (CTSK) is a cysteine protease that is mainly produced from mature osteoclasts and contributes to the destruction of connective tissues and mineralized matrix as a consequence of periodontal disease (PD). However, few studies have reported its regulatory role in osteoclastogenesis-supporting cells in inflammatory conditions. Here, we investigated the role of CTSK in osteoclastogenesis-supporting cells, focusing on the modulation of paracrine function. Microarray data showed that CTSK was upregulated in PD patients compared with healthy individuals, which was further supported by immunohistochemistry and qPCR analyses performed with human gingival tissues. The expression of CTSK in the osteoclastogenesis-supporting cells, including dental pulp stem cells, gingival fibroblasts, and periodontal ligament fibroblasts (PDLFs) was significantly elevated by treatment with inflammatory cytokines such as TNFα and IL-1β. Moreover, TNFα stimulation potentiated the PDLF-mediated osteoclastogenesis of bone marrow-derived macrophages. Interestingly, small interfering RNA-mediated silencing of CTSK in PDLF noticeably attenuated the TNFα-triggered upregulation of receptor activator of nuclear factor kappa-B ligand (RANKL), macrophage colony-stimulating factor, and RANKL/osteoprotegerin ratio, thereby abrogating the enhanced osteoclastogenesis-supporting activity of PDLF. Collectively, these results suggest a novel role of CTSK in the paracrine function of osteoclastogenesis-supporting cells in periodontal disease.
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Affiliation(s)
- Soon Chul Heo
- Department of Oral Physiology, Periodontal Diseases Signaling Network Research Center, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (S.C.H.); (Y.N.K.); (Y.C.); (M.-K.B.)
| | - Yu Na Kim
- Department of Oral Physiology, Periodontal Diseases Signaling Network Research Center, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (S.C.H.); (Y.N.K.); (Y.C.); (M.-K.B.)
| | - YunJeong Choi
- Department of Oral Physiology, Periodontal Diseases Signaling Network Research Center, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (S.C.H.); (Y.N.K.); (Y.C.); (M.-K.B.)
| | - Ji-Young Joo
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea;
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Pusan National University, Yangsan 50612, Korea;
| | - Moon-Kyoung Bae
- Department of Oral Physiology, Periodontal Diseases Signaling Network Research Center, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (S.C.H.); (Y.N.K.); (Y.C.); (M.-K.B.)
| | - Hyung Joon Kim
- Department of Oral Physiology, Periodontal Diseases Signaling Network Research Center, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (S.C.H.); (Y.N.K.); (Y.C.); (M.-K.B.)
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18
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Costa FO, Esteves Lima RP, Cortelli SC, Costa AM, Cortelli JR, Cota LOM. Effect of compliance during periodontal maintenance therapy on c-reactive protein levels: a 6-year follow-up. J Clin Periodontol 2020; 48:400-409. [PMID: 33259118 DOI: 10.1111/jcpe.13407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/06/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
AIMS To longitudinally evaluate the effects of compliance during periodontal maintenance therapy (PMT) on C-reactive protein (CRP) levels and its relation to periodontal status. MATERIALS AND METHODS A subsample comprising of 30 matched pairs was taken from a previous 6-year longitudinal study under PMT. Pairs were composed of one regular (RC) and one irregular (IC) compliers, matched by age and sex. Periodontal parameters and plasma samples were collected at 3 times: T1[prior to active periodontal therapy (APT)], T2(after APT), and T3(after 6 years). CRP plasma levels were quantified using ELISA. RESULTS RC presented better clinical periodontal status, lower recurrence of periodontitis (sites with PD ≥4 mm and CAL ≥3 mm, together with the persistence and/or presence of BOP and/or suppuration, during any of the subsequent recall evaluations) and significant reductions in CRP levels over time [(T1: RC = 3.64 ± 2.13 and IC = 3.92 ± 2.02 mg/L) and (T3: RC = 2.12 ± 1.39 mg/L and IC = 3.71 ± 1.82 mg/L)]. Logistic regression analysis demonstrated that individuals with periodontitis recurrence presented 2.19 higher chances of presenting altered CRP levels (values ≥3 mg/L- T2 to T3) than those without periodontitis recurrence (95%CI:1.16-3.27; p = 0.017). CONCLUSIONS Higher CRP plasma levels were associated with higher recurrence of periodontitis and worse clinical periodontal parameters among IC when compared to RC.
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Affiliation(s)
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | | | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
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Moura MF, Cota LOM, Silva TA, Cortelli SC, Ferreira GA, López MM, Cortelli JR, Costa FO. Clinical and microbiological effects of non-surgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial. Odontology 2020; 109:484-493. [PMID: 33145632 DOI: 10.1007/s10266-020-00566-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/18/2020] [Indexed: 12/12/2022]
Abstract
The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical periodontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (- PE-RA, n = 30); (2) individuals without PE and with RA (- PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
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Affiliation(s)
- Marcela F Moura
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Luís O M Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Tarcília A Silva
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | | | - Gilda A Ferreira
- Faculty of Medicine Federal, University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marina M López
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - José R Cortelli
- Faculty of Dentistry, University of Taubaté, São Paulo, Brazil
| | - Fernando O Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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20
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Zhou X, Wang J, Liu W, Huang X, Song Y, Wang Z, Jia X. Periodontal Status and Microbiologic Pathogens in Patients with Chronic Obstructive Pulmonary Disease and Periodontitis: A Case-Control Study. Int J Chron Obstruct Pulmon Dis 2020; 15:2071-2079. [PMID: 32943860 PMCID: PMC7478369 DOI: 10.2147/copd.s266612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/11/2020] [Indexed: 01/07/2023] Open
Abstract
Purpose To evaluate clinical periodontal status and microbiologic pathogens in patients with chronic obstructive pulmonary disease (COPD) and periodontitis. Patients and Methods We conducted a case–control study of 60 periodontitis patients with COPD (case group) and 60 periodontitis patients with normal pulmonary function (control group). Their periodontal status and respiratory function were clinically examined. Real-time polymerase chain reaction assays were used to measure five dental pathogens and four respiratory pathogens in subgingival dental plaque. Spearman’s rank correlation coefficients (r2) were calculated to assess correlations of pathogens. Principal component analysis (PCA) was employed to assess the similarity of bacterial diversity between the two groups. Logistic regression was performed to examine the associations of periodontal variables and pathogens with COPD risk. Results COPD patients had fewer remaining teeth, higher plaque index (PLI), and more severe site percentages of clinical attachment level (CAL) than the controls. Although COPD patients tended to have relatively higher ranked means of Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, and Haemophilus influenza than control participants, the differences were not significant. Some periodontal pathogens and respiratory pathogens were positively correlated with each other (r2 =0.29 to 0.47, all P < 0.05). The PCA graph showed that the distributions of pathogens were more dispersed but less discriminated in the COPD group than those in the control group. PLI (P = 0.045) and CAL ≥ 5mm site percentages (P = 0.01) were significantly associated with an increased risk of COPD, while pathogens were not associated with COPD. Conclusion Our results from this study do not indicate periodontal pathogens as potential predictors of COPD risk, despite significantly poor periodontal status associated with COPD.
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Affiliation(s)
- Xuan Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jitian Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wenyan Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xuan Huang
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xingyuan Jia
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.,Department of Ophthalmology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
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21
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Scherbaum I, Heidecke H, Bunte K, Peters U, Beikler T, Boege F. Autoantibodies against M 5-muscarinic and beta 1-adrenergic receptors in periodontitis patients. Aging (Albany NY) 2020; 12:16609-16620. [PMID: 32857064 PMCID: PMC7485715 DOI: 10.18632/aging.103864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
Autoantibodies against muscarinic and beta1-adrenergic receptors are considered a potential cause and/or risk factor for chronic heart failure. Association of periodontitis with such autoantibodies and with impaired heart function has been observed in patients exposed to endemic Chagas' disease, which triggers by itself cardiomyopathy and receptor immunization.Here we studied the association between periodontitis, markers of cardiac injury and receptor autoimmunization in periodontitis patients (n = 147) not exposed to Chagas' disease. The autoantibodies were determined by IgG binding to native intact muscarinic and beta1-adrenergic receptors or to a cyclic peptide mimicking the disease-relevant conformational autoepitope presented by the active beta1-adrenergic receptor. Possible cardiac injury and inflammatory status were judged by serum levels of proBNP/Troponin I and CRP/IL-6, respectively. These parameters were analysed in healthy and periodontally diseased individuals as well as before and after periodontal therapy.Patients with periodontitis had significantly (p < 0.001) higher levels of autoantibodies against M5-muscarinic and beta1-adrenergic receptors, which further increased following periodontal therapy. Receptor autoantibodies were associated with increased inflammatory status but not with increased markers of cardiac injury. Thus, our data indicate that periodontitis triggers systemic inflammation, which is associated with receptor autoimmunization, and, independently thereof, with cardiac injury.
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Affiliation(s)
- Isabel Scherbaum
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Heinrich Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | | | - Kübra Bunte
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fritz Boege
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Heinrich Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany
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22
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Kim HJ, Kim EH, Park AK, Shin Y, Kang J, Lim J, Bhak J, Lee JY, Kim BC, Joo JY. Detection of association between periodontitis and polymorphisms of IL-1β + 3954 and TNF-α -863 in the Korean population after controlling for confounding risk factors. J Periodontal Res 2020; 55:905-917. [PMID: 32618013 PMCID: PMC7689763 DOI: 10.1111/jre.12783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 01/05/2023]
Abstract
Background and Objective Interleukin (IL)‐1 and tumor necrosis factor (TNF)‐α are inflammatory cytokines that play an important role in periodontitis, and their genetic variations have been suggested to be associated with increased risk of periodontitis. Focusing on three single nucleotide polymorphisms (SNPs) of IL‐1α + 4845, IL‐1β + 3954, and TNF‐α −863, we aimed to investigate the relationship between periodontitis risk and the polymorphisms of IL‐1 α/β and TNF‐α in Koreans. Material and Methods Mouthwash samples from 548 subjects (135 controls without periodontitis, 387 generalized chronic periodontitis patients, and 26 generalized aggressive periodontitis patients) were collected for isolation of genomic DNA. Genotyping of selected SNPs was performed using real‐time PCR. Univariable associations between the polymorphisms and periodontitis were assessed by chi‐squared test or Fisher's exact test. To evaluate the association after controlling for confounding effects of various risk factors, we stratified the subjects according to the presence or absence of self‐reported diseases and employed multiple logistic regression model to adjust for age, smoking status, and oral hygiene indices and behaviors. Results Significant association of IL‐1β + 3954 and TNF‐α −863 polymorphisms with periodontitis was observed after adjusting for the confounding risk factors, but not in univariable association analysis. The significant association between genotype CT of IL‐1β + 3954 and increased risk of advanced periodontitis was consistently detected regardless of the status of self‐reported diseases. In the polymorphism of TNF‐α −863, the genotype with minor allele (CA + AA) was significantly associated with periodontitis susceptibility, which was observed only in the subjects with self‐reported diseases. Conclusion The results suggest that genetic variations of IL‐1β + 3954 and TNF‐α −863 are associated with increased risk of periodontitis in Koreans. In addition, our findings underscore the importance of controlling for confounding risk factors to detect significant association between genetic factors and risk of periodontitis. A further well‐designed large‐scale study is needed to warrant our results.
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Affiliation(s)
- Hyun-Joo Kim
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | | | - Ae Kyung Park
- College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Republic of Korea
| | | | | | | | - Jong Bhak
- Korean Genomics Industrialization and Commercialization Center, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea.,Clinomics Inc, Ulsan, Republic of Korea
| | - Ju-Youn Lee
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | | | - Ji-Young Joo
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.,Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
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23
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Ibrahim HA, Kassim NK, Jamsari FZ, Zainuddin SLA, Hanafi MH, Adnan AS. Periodontal Health of Pre-Dialysis Chronic Kidney Disease Patients in a Northeast Peninsular Malaysia Tertiary Hospital. Malays J Med Sci 2020; 27:106-114. [PMID: 32158350 PMCID: PMC7053543 DOI: 10.21315/mjms2020.27.1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/05/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction Chronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia. Objective To assess the periodontal status of pre-dialysis CKD patients in Hospital Universiti Sains Malaysia. Methods A total of 46 pre-dialysis CKD patients who attended the nephrology clinic at Hospital Universiti Sains Malaysia were enrolled in this study. Periodontal examination was performed using the periodontal probing depth (PPD), clinical attachment loss (CAL) and plaque index. Results The majority of the CKD patients were Malay (95.7%) and 80.4% were males. The mean age of the patients was 58.5 years. Using PPD measurement, 37 (74.0%) of the patients had mild periodontitis, 9 (20.0%) had moderate periodontitis and 3 (6.0%) had no periodontitis. Based on CAL measurement, 12 (26%) patients had mild periodontitis, 29 (63.0%) had moderate periodontitis and 5 (11%) had severe periodontitis. The mean (standard deviation [SD]) value of mild and moderate-to-severe periodontitis by PPD measurement were 4.26 (0.26) and 5.24 (0.36), respectively. The mean of mild and moderate-to-severe periodontitis by CAL measurement were 2.66 (0.62) and 4.98 (0.73), respectively. There was no correlation between the periodontal parameters and estimated glomerular filtration rate (PPD: r = −0.160, P = 0.914; CAL: r = −0.135, P = 0.372; plaque index: r = 0.005, P = 0.974). Conclusion This study revealed a greater prevalence and severity of chronic periodontitis among CKD patients. Thus, the periodontal health of CKD patients’ needs to be screened and monitored.
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Affiliation(s)
- Hanim Afzan Ibrahim
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.,Chemical Pathology Department, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nur Karyatee Kassim
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.,Chemical Pathology Department, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | | | - Azreen Syazril Adnan
- Chronic Kidney Disease Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.,Management Science University (MSU) Medical Centre, Shah Alam, Selangor
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24
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Lopez-Oliva I, de Pablo P, Dietrich T, Chapple I. Gums and joints: is there a connection? Part one: epidemiological and clinical links. Br Dent J 2019; 227:605-609. [PMID: 31605071 DOI: 10.1038/s41415-019-0722-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rheumatoid arthritis (RA) and chronic periodontitis are common chronic inflammatory diseases that share numerous clinical and pathobiological characteristics. Due to their similarities, despite manifesting at anatomically distinct sites, the relationship between these two diseases has been investigated for many years. This review attempts to summarise the state of the field based on evidence published in the last ten years.
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Affiliation(s)
| | - Paola de Pablo
- Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Thomas Dietrich
- Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- University of Birmingham Dental School, Periodontology, Queensway, Birmingham, UK
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25
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Bizzarro S, Loos BG. The link between periodontitis and erectile dysfunction: a review. Br Dent J 2019; 227:599-603. [DOI: 10.1038/s41415-019-0724-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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26
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Morimoto J, Senior A, Ruiz K, Wali JA, Pulpitel T, Solon-Biet SM, Cogger VC, Raubenheimer D, Le Couteur DG, Simpson SJ, Eberhard J. Sucrose and starch intake contribute to reduced alveolar bone height in a rodent model of naturally occurring periodontitis. PLoS One 2019; 14:e0212796. [PMID: 30865648 PMCID: PMC6415785 DOI: 10.1371/journal.pone.0212796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/08/2019] [Indexed: 12/01/2022] Open
Abstract
While there is a burgeoning interest in the effects of nutrition on systemic inflammatory diseases, how dietary macronutrient balance impacts local chronic inflammatory diseases in the mouth has been largely overlooked. Here, we used the Geometric Framework for Nutrition to test how the amounts of dietary macronutrients and their interactions, as well as carbohydrate type (starch vs sucrose vs resistant starch) influenced periodontitis-associated alveolar bone height in mice. Increasing intake of carbohydrates reduced alveolar bone height, while dietary protein had no effect. Whether carbohydrate came from sugar or starch did not influence the extent of alveolar bone height. In summary, the amount of carbohydrate in the diet modulated periodontitis-associated alveolar bone height independent of the source of carbohydrates.
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Affiliation(s)
- Juliano Morimoto
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- Programa de Pós-Graduação em Ecologia e Conservação, Federal University of Paraná, Curitiba, Brazil
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alistair Senior
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Mathematics and Statistics, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Kate Ruiz
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney Dental School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Jibran A. Wali
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Tamara Pulpitel
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Samantha M. Solon-Biet
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Victoria C. Cogger
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- Centre for Education and Research on Ageing, Concord, New South Wales, Australia
- Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - David G. Le Couteur
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- Centre for Education and Research on Ageing, Concord, New South Wales, Australia
- Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Joerg Eberhard
- Charles Perkins Centre, Camperdown, New South Wales, Australia
- The University of Sydney Dental School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia
- * E-mail:
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27
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Shi T, Min M, Sun C, Zhang Y, Liang M, Sun Y. Periodontal disease and susceptibility to breast cancer: A meta-analysis of observational studies. J Clin Periodontol 2018; 45:1025-1033. [PMID: 29974484 DOI: 10.1111/jcpe.12982] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/19/2018] [Accepted: 07/01/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE While some individual studies have suggested an association between periodontal disease and breast cancer, there has not been a formal meta-analysis that collates the existing evidence supporting the hypothesis that periodontal disease leads to a higher risk of developing breast cancer. Accordingly, this meta-analysis was conducted. METHODS Relevant studies published until April 2018 were retrieved and were screened according to established inclusion criteria. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess the association between periodontal disease and the risk of breast cancer and fixed effect models were used according to the results of the heterogeneity test. RESULTS Eight studies, involving 168,111 individuals, were identified as having explored the association between periodontal disease and breast cancer. Summary estimates in view of adjusted data showed that periodontal disease did increase susceptibility to breast cancer (RR = 1.18, 95%CI: 1.11-1.26, I2 = 17.6%), with robust results confirmed by sensitivity analysis. CONCLUSION Our results provided evidence of a modest positive association between periodontal disease and breast cancer. Implementation of practical measures to prevent and treat periodontal disease is of great public health significance. Moreover, additional studies are recommended to explore this topic in more detail.
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Affiliation(s)
- Tingting Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Min Min
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chenyu Sun
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China
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28
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Ameijeira P, Leira Y, Domínguez C, Leira R, Blanco J. Association between periodontitis and chronic migraine: a case-control study. Odontology 2018; 107:90-95. [PMID: 29651667 DOI: 10.1007/s10266-018-0360-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/03/2018] [Indexed: 12/22/2022]
Abstract
The aim of this investigation was to examine whether chronic periodontitis (CP) is a risk indicator of chronic migraine (CM). We performed a case-control study consisted of 102 cases (patients diagnosed with CM) and 91 controls (non-CM individuals) matched by age and gender. Full-mouth periodontal charts, demographic, medical, clinical, as well as neurological data were obtained. In addition, high sensitive C-reactive protein serum levels were determined from blood samples of both cases (taken during migraine interictal period) and controls. The prevalence of CP was significantly higher in patients with CM compared to those without CM (58.8 vs. 30.8%, p < 0.0001). Logistic regression analysis showed that CP was significantly associated with the presence of CM, independently of well-known chronifying factors of migraine (OR 2.4; 95% CI 1.2-4.7; p = 0.012). Based on our results, CP could be considered as a risk indicator of CM. However, more evidence is necessary to investigate if this relationship is causal or not.
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Affiliation(s)
- Pablo Ameijeira
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain
| | - Yago Leira
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain. .,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Clara Domínguez
- Headache Unit, Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Rogelio Leira
- Headache Unit, Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782, Santiago de Compostela, Spain.,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Abstract
Data sourcesMedline, Embase, OpenGrey, Journal of Clinical Periodontology, Journal of Periodontology and a hand search of the bibliographies of retrieved publications.Study selectionTwo reviewers screened the title and abstract of 1134 studies from the literature and selected 37 suitable publications for inclusion following full text analysis of 109 papers and agreement between both reviewers. The search included observational, epidemiological studies and clinical trials that fufilled the inclusion criteria. The publications assessed contained a periodontal clinical examination and a validated OHRQoL questionnaire. There were no language restrictions and the review was performed according to the MOOSE statement.Data extraction and synthesisData were extracted from each study applying the PECO format. The quality of the observational studies was evaluated by the Newcastle Ottawa Scale (NOS) and clinical trials by the (MINORS) methodological index for non-randomised studies. The Strength of Grading Taxonomy (SORT) was utilised to assess the level of evidence and strength of recommendation of the included studies. A meta-analysis was not undertaken due the heterogeneity of the included studies, therefore results were synthesised by applying a vote counting method.ResultsThirty-seven studies included in the review were evaluated by the vote counting method. According to NOS and MINORS the risk of bias was identified as moderate with most studies assessing 50% to 83% of the parameters established. A level two for quality of evidence and a level B for strength of recommendation were applicable for the relationship between clinically diagnosed periodontal disease and OHRQoL. The evidence level was consistent across the studies. Nineteen of the studies examined a distinct population group with respect to diagnosis of systemic disease, socioeconomic status, demographic background or periodontal diagnosis. Twenty-eight of the included studies reported an association between periodontal diseases and OHRQoL while eight of the publications highlighted a dose-response relationship between and extent and severity of periodontal disease and the impact on OHRQoL.ConclusionsThe findings support the association between clinically diagnosed periodontal diseases and subjectively assessed OHRQoL with a dose-response relationship demonstrated. In summation, periodontal diseases play a significant role in oral health and impact on the QoL of affected individuals. In publications that undertook a full mouth recording the results were more evident, therefore a comprehensive periodontal exam in conjunction with a validated OHRQoL questionnaire is recommended.
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Affiliation(s)
| | - Brett Duane
- Dublin Dental University Hospital, Dublin, Eire
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30
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Omori S, Uchida F, Oh S, So R, Tsujimoto T, Yanagawa T, Sakai S, Shoda J, Tanaka K, Bukawa H. Exercise habituation is effective for improvement of periodontal disease status: a prospective intervention study. Ther Clin Risk Manag 2018; 14:565-574. [PMID: 29593415 PMCID: PMC5865566 DOI: 10.2147/tcrm.s153397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background and purpose Periodontal disease is closely related to lifestyle-related diseases and obesity. It is widely known that moderate exercise habits lead to improvement in lifestyle-related diseases and obesity. However, little research has been undertaken into how exercise habits affect periodontal disease. The purpose of this study was to examine the effect of exercise habits on periodontal diseases and metabolic pathology. Methods We conducted a prospective intervention research for 12 weeks. The subjects were 71 obese men who participated in an exercise and/or dietary intervention program. Fifty subjects were assigned to exercise interventions (exercise intervention group) and 21 subjects were assigned to dietary interventions (dietary intervention group). This research was conducted before and after each intervention program. Results In the exercise intervention group, the number of teeth with a probing pocket depth (PPD) ≥4 mm significantly decreased from 14.4% to 5.6% (P<0.001), and the number of teeth with bleeding on probing (BOP) significantly decreased from 39.8% to 14.4% (P<0.001). The copy counts of Tannerella forsythia and Treponema denticola decreased significantly (P=0.001). A positive correlation was found between the change in the copy count of T. denticola and the number of teeth with PPD ≥4 mm (P=0.003) and the number of teeth with BOP (P=0.010). A positive correlation was also found between the change in the copy count of T. denticola and body weight (P=0.008), low-density lipoprotein cholesterol (P=0.049), and fasting insulin (P=0.041). However, in the dietary intervention group the copy count of T. denticola decreased significantly (P=0.007) and there was no correlation between the number of periodontal disease-causing bacteria and PPD and BOP. Conclusion Our results are the first to show that exercise might contribute to improvements in periodontal disease.
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Affiliation(s)
- Shoei Omori
- Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Dental Oral Surgery, Kitaibaraki City Hospital, Kitaibaraki, Ibaraki, Japan
| | - Fumihiko Uchida
- Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Sechang Oh
- Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,The Center of Sports Medicine and Health Sciences, Tsukuba University Hospital, Tsukuba, Ibaraki, Japan
| | - Rina So
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Kawasaki, Kanagawa, Japan
| | - Takehiko Tsujimoto
- Department of Sports Medicine, Faculty of Human Sciences, Shimane University, Matsue, Shimane, Japan
| | - Toru Yanagawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoshi Sakai
- Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Junichi Shoda
- Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,The Center of Sports Medicine and Health Sciences, Tsukuba University Hospital, Tsukuba, Ibaraki, Japan
| | - Kiyoji Tanaka
- Department of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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31
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Miranda TS, Feres M, Retamal-Valdés B, Perez-Chaparro PJ, Maciel SS, Duarte PM. Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes. J Appl Oral Sci 2017; 25:82-89. [PMID: 28198980 PMCID: PMC5289404 DOI: 10.1590/1678-77572016-0302] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/30/2016] [Indexed: 01/04/2023] Open
Abstract
Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP). Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1c<8% (n=28) or HbA1c≥8% (n=28). Three subgingival biofilm samples from sites with probing depth (PD)<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR) for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05). Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.
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Affiliation(s)
| | - Magda Feres
- Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil
| | - Belén Retamal-Valdés
- Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil
| | | | - Suellen Silva Maciel
- Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil
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32
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Corrêa JD, Calderaro DC, Ferreira GA, Mendonça SMS, Fernandes GR, Xiao E, Teixeira AL, Leys EJ, Graves DT, Silva TA. Subgingival microbiota dysbiosis in systemic lupus erythematosus: association with periodontal status. MICROBIOME 2017; 5:34. [PMID: 28320468 PMCID: PMC5359961 DOI: 10.1186/s40168-017-0252-z] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/07/2017] [Indexed: 05/05/2023]
Abstract
BACKGROUND Periodontitis results from the interaction between a subgingival biofilm and host immune response. Changes in biofilm composition are thought to disrupt homeostasis between the host and subgingival bacteria resulting in periodontal damage. Chronic systemic inflammatory disorders have been shown to affect the subgingival microbiota and clinical periodontal status. However, this relationship has not been examined in subjects with systemic lupus erythematosus (SLE). The objective of our study was to investigate the influence of SLE on the subgingival microbiota and its connection with periodontal disease and SLE activity. METHODS We evaluated 52 patients with SLE compared to 52 subjects without SLE (control group). Subjects were classified as without periodontitis and with periodontitis. Oral microbiota composition was assessed by amplifying the V4 region of 16S rRNA gene from subgingival dental plaque DNA extracts. These amplicons were examined by Illumina MiSeq sequencing. RESULTS SLE patients exhibited higher prevalence of periodontitis which occurred at a younger age compared to subjects of the control group. More severe forms of periodontitis were found in SLE subjects that had higher bacterial loads and decreased microbial diversity. Bacterial species frequently detected in periodontal disease were observed in higher proportions in SLE patients, even in periodontal healthy sites such as Fretibacterium, Prevotella nigrescens, and Selenomonas. Changes in the oral microbiota were linked to increased local inflammation, as demonstrated by higher concentrations of IL-6, IL-17, and IL-33 in SLE patients with periodontitis. CONCLUSIONS SLE is associated with differences in the composition of the microbiota, independently of periodontal status.
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Affiliation(s)
- Jôice Dias Corrêa
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | | | | | | | - Gabriel R. Fernandes
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais Brazil
| | - E. Xiao
- Penn Dental School, University of Pennsylvania, Philadelphia, PA USA
| | - Antônio Lúcio Teixeira
- University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Eugene J. Leys
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Dana T. Graves
- Penn Dental School, University of Pennsylvania, Philadelphia, PA USA
| | - Tarcília Aparecida Silva
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
- Departamento de Patologia e Cirurgia Odontológica, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, CEP 31.270-901 Belo Horizonte, Minas Gerais Brazil
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33
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Winning L, Linden GJ. Periodontitis and Systemic Disease: Association or Causality? CURRENT ORAL HEALTH REPORTS 2017; 4:1-7. [PMID: 28303212 PMCID: PMC5332497 DOI: 10.1007/s40496-017-0121-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW The aim was to assess recent evidence that diabetes, metabolic syndrome (MetS) and obesity impact the progression of periodontitis. RECENT FINDINGS Electronic searches using Embase, Medline, and Web of Science were carried out for epidemiological studies on humans, published between 2014 and 2016. A small number of prospective studies and systematic reviews were identified that in general provide further support for the hypothesis that diabetes, metabolic syndrome and obesity can adversely affect the periodontal condition. SUMMARY Confounding remains the most challenging issue in the interpretation of the associations found between diabetes, MetS, obesity and periodontal disease. Recent research applying a Mendelian randomisation approach concluded that the association between obesity and periodontitis is confounded and questioned a role for obesity in causation. Further studies are warranted to assess the issue of causality.
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Affiliation(s)
- Lewis Winning
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Gerard J. Linden
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- School of Dentistry, Queen’s University, Grosvenor Road, Belfast, BT12 6BP UK
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34
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Kumar PS. From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease. J Physiol 2017; 595:465-476. [PMID: 27426277 PMCID: PMC5233655 DOI: 10.1113/jp272427] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/01/2016] [Indexed: 12/19/2022] Open
Abstract
The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and metabolic disease. It was proposed that periodontal pathobionts played a causal role in the initiating or exacerbating certain diseases either by direct invasion or by stimulating a florid immune-inflammatory response that extended into the systemic circulation. This review will examine the strength of current evidence in establishing a causal link between oral pathobionts and systemic disease.
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Affiliation(s)
- Purnima S. Kumar
- Division of Periodontology, College of DentistryThe Ohio State UniversityColumbusOHUSA
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35
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Periodontitis, cardiovascular disease and pregnancy outcome--focal infection revisited? Br Dent J 2016; 217:467-74. [PMID: 25342358 DOI: 10.1038/sj.bdj.2014.903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 01/17/2023]
Abstract
Over the last two decades there has been a renewed interest around the possible effects of periodontal disease on both cardiovascular health and pregnancy outcome (among other diseases), a topic which has interested science for hundreds of years. These have led to a range of studies, workshops and consensus documents being published, with corresponding coverage in general and professional media. In this article the authors summarise the history and supporting theories behind such associations, whether clinical studies have been able to confirm these and what this might mean for general practitioners who are questioned on this topic by patients.
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36
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Renatus A, Kottmann T, Schwarzenberger F, Jentsch H. Evaluation of a New Self-Reported Tool for Periodontitis Screening. J Clin Diagn Res 2016; 10:ZC107-12. [PMID: 27504399 PMCID: PMC4963759 DOI: 10.7860/jcdr/2016/19518.8063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Periodontitis is still highly prevalent in industrial population whereas at the same time appropriate screening programs are missing. AIM To evaluate, a self-reported questionnaire about periodontal risk factors in combination with the Periodontal Screening Index (PSI) to identify an existing need for periodontal treatment combined with the early recognition of high-risk patients. MATERIALS AND METHODS Total 200 patients took part in the questionnaire based study and were examined using the PSI. Thereafter the participants were divided into two groups, subjects with periodontitis (Group 1; PSI 0-2) and subjects without periodontitis (Group 2; PSI 3-4). The answers were evaluated using a point system ranging from 0 to 8, based on known periodontal risk factors and their assumed degree of influence. Receiver-Operating Characteristic (ROC) curve analysis were applied to examine the overall discriminatory power, sensitivity, specificity and corresponding cut-off points of the self-reported periodontal disease scale. RESULTS There was a significant difference between Group 1 and 2 concerning the majority of the inquired items (12 of 16, p<0.05). The distribution of the individual total score exhibited a high statistical significance (p<0.001) of robustness in terms of differing definitions of periodontitis. The Area Under the Curve (AUC) was 0.912 with a sensitivity of 86% and a specificity of 76%. CONCLUSION The questionnaire produced a reliable assessment of the individual risk (total score) and the need for periodontal treatment as well as the differentiation between gingivitis and periodontitis. CLINICAL RELEVANCE Patient-based data (clinical variables and periodontal risk factors of periodontitis) were adequate to make a preliminary assessment of a possible need for periodontal treatment.
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Affiliation(s)
- Antonio Renatus
- Faculty, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | | | - Fabian Schwarzenberger
- Professor for Stochastics, Faculty of Informatics/Mathematics at the HTW Dresden, Dresden, Germany
| | - Holger Jentsch
- Professor, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
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37
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Monsarrat P, Blaizot A, Kémoun P, Ravaud P, Nabet C, Sixou M, Vergnes JN. Clinical research activity in periodontal medicine: a systematic mapping of trial registers. J Clin Periodontol 2016; 43:390-400. [PMID: 26881700 DOI: 10.1111/jcpe.12534] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 12/25/2022]
Abstract
AIM The primary aim of the study was to systematically map registration records on periodontal medicine in clinical trial registers. The secondary aim was to assess the evolution of periodontal medicine in clinical periodontal research as a whole. MATERIAL AND METHODS We searched all registration records related to periodontology in the World Health Organization International Clinical Trials Registry Platform. For registration records classified in the field of periodontal medicine, we assigned the 2015 MeSH(®) term for the most precisely corresponding systemic condition. RESULTS Fifty-seven systemic conditions have been hypothesized to be linked with periodontal diseases, covering nearly 2% of the diseases indexed in MeSH. In addition to diabetes, cardiovascular disease or preterm birth, other systemic conditions have been the subject of registration records, such as anaemia, liver diseases, dyspepsia or ankylosing spondylitis. A trend towards increasing diversification of systemic conditions has appeared over time. About a third of registration records in clinical periodontal research deals with periodontal medicine. CONCLUSIONS Periodontal medicine now constitutes an important part of clinical periodontal research. Research activity in periodontal medicine has grown continuously since the early 2000s, and exploration of registers gives a useful up-to-date snapshot of this constantly evolving field of research.
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Affiliation(s)
- Paul Monsarrat
- Dental Faculty, Department of Anatomical Sciences and Radiology, Paul Sabatier University, Toulouse University Hospital, Toulouse, France.,CNRS 5273, UMR STROMALab, University of Toulouse UPS, INSERM U1031, EFS Pyrenees - Mediterranean, Toulouse, France
| | - Alessandra Blaizot
- University of Lille, Dental faculty, Place de Verdun, F-59000 Lille, France
| | - Philippe Kémoun
- Dental Faculty, Department of Biological Sciences, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - Philippe Ravaud
- Faculty of Medicine, Paris Descartes University, Paris, France.,INSERM UMR-1153, Paris, France.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Cathy Nabet
- Dental Faculty, Department of Epidemiology and Public Health, Paul Sabatier University, Toulouse University Hospital, Toulouse, France.,INSERM U1027, Paul Sabatier University, Toulouse, France
| | - Michel Sixou
- Dental Faculty, Department of Epidemiology and Public Health, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - Jean-Noel Vergnes
- Dental Faculty, Department of Epidemiology and Public Health, Paul Sabatier University, Toulouse University Hospital, Toulouse, France.,Division of Oral Health and Society, Faculty of dentistry, McGill University, Montreal, QC, Canada
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38
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Gurav AN. Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough? World J Diabetes 2016; 7:50-66. [PMID: 26962409 PMCID: PMC4766246 DOI: 10.4239/wjd.v7.i4.50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/16/2015] [Accepted: 01/19/2016] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.
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39
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Alfakry H, Malle E, Koyani CN, Pussinen PJ, Sorsa T. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease. Innate Immun 2016; 22:85-99. [PMID: 26608308 DOI: 10.1177/1753425915617521] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/13/2015] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.
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Affiliation(s)
- Hatem Alfakry
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ernst Malle
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Chintan N Koyani
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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40
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Nylund KM, Meurman JH, Heikkinen AM, Honkanen E, Vesterinen M, Furuholm JO, Tervahartiala T, Sorsa T, Ruokonen HM. Periodontal Inflammatory Burden and Salivary Matrix Metalloproteinase-8 Concentration Among Patients With Chronic Kidney Disease at the Predialysis Stage. J Periodontol 2015; 86:1212-20. [DOI: 10.1902/jop.2015.150285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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41
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Chapple ILC, Wilson NHF. Manifesto for a paradigm shift: periodontal health for a better life. Br Dent J 2015; 216:159-62. [PMID: 24557384 DOI: 10.1038/sj.bdj.2014.97] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2013] [Indexed: 12/12/2022]
Abstract
This article outlines the European Federation of Periodontology's (EFP) manifesto Periodontal Health for a Better Life which was informed by the first joint EFP/American Academy of Periodontology workshop on periodontitis and systemic health. The EFP manifesto calls upon the dental profession to engage in screening and providing preventive advice to patients who are at risk of common chronic diseases and conditions such as cardiovascular disease, diabetes and cancer. In particular, the article emphasises the dental team's role in promoting behaviour change in their patients aimed at reducing smoking and obesity levels, by promoting healthy nutrition and exercise. The chairman of the National Association of Primary Care Medicine, Dr Charles Alessi, has strongly endorsed this model and highlighted the important opportunities offered by a capitation-based new contract for the dental team to engage fully in preventive medicine in support of medical colleagues and in the best interests of public health and patients across England.
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Affiliation(s)
| | - N H F Wilson
- King's College London Dental Institute, and Professional Strategic Executive, European Federation of Periodontology
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42
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Severe periodontal disease associated with long-term treatment with intravenous immunoglobulin. Case Rep Dent 2014; 2014:860804. [PMID: 25379295 PMCID: PMC4213401 DOI: 10.1155/2014/860804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/18/2014] [Indexed: 02/02/2023] Open
Abstract
Intravenous immunoglobulin (IVIG) is used in the treatment of neuropathy. This case report presents, for the first time, a patient with severe periodontal destruction after chronic therapy with IVIG. The patient reported having extracted his maxillary anterior teeth himself due to high mobility. Clinical examination and radiographic images show a generalized and severe periodontitis. No significant alterations in genetic or microbiological features were observed. The present case suggests that periodontal disease aggravation could be considered a new adverse effect of IVIG therapy. Postulated mechanisms are immune complexes formation, complement activation, and a direct effect in osteoclasts. In conclusion, it is important that patients that will receive IVIG treatment underwent dental evaluation.
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43
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Weight loss maintenance: Predictors of successful weight loss maintenance: a qualitative comparative analysis. Br Dent J 2014. [DOI: 10.1038/sj.bdj.2014.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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44
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Abstract
Background. The pathophysiology of cardiovascular disease (CVD) includes inflammation in the development of atherosclerosis and thrombosis. Increasing evidence supports oral infections, and in particular the common periodontal disease, to be associated with CVD development. Periodontal infection is present in populations worldwide and in the moderate to mild form in about 35% of populations according to the World Health Organization. Objective. This review of the literature aims to present cross evidence from medical research disciplines that explore how oral infections can contribute to increase the risk for CVDs and how treatment of oral infections can reduce the risk for CVDs. Design. Review article. Results. Long-term exposure to active nontreated infections of the oral cavity presents an opportunity for bacteria, bacterial products, and viruses to enter the circulation. Toxic bacterial products enter the circulation, affecting atherosclerosis, causing platelet adhesiveness that results in clot formation, and establishing cardiac vegetation. Pathological observations have identified oral bacteria in heart valves, aortic aneurysms, and arterial walls. Clinical intervention studies on periodontal disease reduce the risk level of serological predictors for CVDs. Conclusions. This paper presents evidence across medical research disciplines for oral infections to be considered as one of the risk factors for CVDs.
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45
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Zhou X, Han J, Liu Z, Song Y, Wang Z, Sun Z. Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: a 2-year pilot randomized controlled trial. J Clin Periodontol 2014; 41:564-72. [PMID: 24593836 DOI: 10.1111/jcpe.12247] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2014] [Indexed: 12/16/2022]
Abstract
AIM To evaluate the direct effects of periodontal therapy in Chronic Obstructive Pulmonary Disease (COPD) patients with chronic periodontitis (CP). MATERIALS AND METHODS In a pilot randomized controlled trial, 60 COPD patients with CP were randomly assigned to receive scaling and root planing (SRP) treatment, supragingival scaling treatment, or oral hygiene instructions only with no periodontal treatment. We evaluated their periodontal indexes, respiratory function, and COPD exacerbations at baseline, 6 months, 1, and 2 years. RESULTS Compared with the control group, measurements of periodontal indexes were significantly improved in patients in two treatment groups at 6-month, 1-year, and 2-year follow-up (all p < 0.05). Overall, the means of forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) and FEV1 were significantly higher in the two therapy groups compared with the control group during the follow-up (p < 0.05). In addition, the frequencies of COPD exacerbation were significantly lower in the two therapy groups than in the control group at 2-year follow-up (p < 0.05). CONCLUSIONS Our preliminary results from this pilot trial suggest that periodontal therapy in COPD patients with CP may improve lung function and decrease the frequency of COPD exacerbation.
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Affiliation(s)
- Xuan Zhou
- Department of Stomatology, Beijing ChaoYang Hospital affiliated to Capital Medical University, Beijing, China
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46
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Bertl K. [MUW researcher of the month]. Wien Klin Wochenschr 2013; 125:784-5. [PMID: 24337527 DOI: 10.1007/s00508-013-0494-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristina Bertl
- Abteilung für Orale Chirurgie, Bernhard-Gottlieb Universitätszahnklinik Wien, Medizinische Universität Wien, Sensengasse 2a, 1090, Wien, Österreich,
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47
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Periodontitis and systemic diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Br Dent J 2013. [DOI: 10.1038/sj.bdj.2013.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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