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Tan J, Lamont GJ, Sekula M, Hong H, Sloan L, Scott DA. The transcriptomic response to cannabidiol of Treponema denticola, a phytocannabinoid-resistant periodontal pathogen. J Clin Periodontol 2024; 51:222-232. [PMID: 38105008 DOI: 10.1111/jcpe.13892] [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: 05/12/2023] [Revised: 09/14/2023] [Accepted: 09/26/2023] [Indexed: 12/19/2023]
Abstract
AIM The use of cannabis, which contains multiple antimicrobials, may be a risk factor for periodontitis. We hypothesized that multiple oral spirochetes would be phytocannabinoid-resistant and that cannabidiol (CBD) would act as an environmental stressor to which Treponema denticola would respond transcriptionally, thereby providing first insights into spirochetal survival strategies. MATERIALS AND METHODS Oral spirochete growth was monitored spectrophotometrically in the presence and absence of physiologically relevant phytocannabinoid doses, the transcriptional response to phytocannabinoid exposure determined by RNAseq, specific gene activity fluxes verified using qRT-PCR and orthologues among fully sequenced oral spirochetes identified. RESULTS Multiple strains of oral treponemes were resistant to CBD (0.1-10 μg/mL), while T. denticola ATCC 35405 was resistant to all phytocannabinoids tested (CBD, cannabinol [CBN], tetrahydrocannabinol [THC]). A total of 392 T. denticola ATCC 35405 genes were found to be CBD-responsive by RNAseq. A selected subset of these genes was independently verified by qRT-PCR. Genes found to be differentially activated by both methods included several involved in transcriptional regulation and toxin control. Suppressed genes included several involved in chemotaxis and proteolysis. CONCLUSIONS Oral spirochetes, unlike some other periodontal bacteria, are resistant to physiological doses of phytocannabinoids. Investigation of CBD-induced transcriptomic changes provided insight into the resistance mechanisms of this important periodontal pathogen. These findings should be considered in the context of the reported enhanced susceptibility to periodontitis in cannabis users.
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Affiliation(s)
- Jinlian Tan
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Gwyneth J Lamont
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Michael Sekula
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - HeeJue Hong
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Lucy Sloan
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky, USA
| | - David A Scott
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
- Center for Microbiomics, Inflammation and Pathogenicity, University of Louisville, Louisville, Kentucky, USA
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Dickie J, Sherriff A, McEwan M, Bell A, Naudi K. Longitudinal assessment of undergraduate dental students: Building evidence for validity. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:1136-1150. [PMID: 37141495 DOI: 10.1111/eje.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/27/2022] [Accepted: 03/31/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To investigate the content and criterion validity, and reliability of longitudinal clinical assessment of undergraduate dental student clinical competence by determining patterns of clinical performance and comparing them with validated standalone undergraduate examinations. METHODS Group-based trajectory models tracking students' clinical performance over time were produced from LIFTUPP© data for three dental student cohorts (2017-19; n = 235) using threshold models based on the Bayesian information criterion. Content validity was investigated using LIFTUPP© performance indicator 4 as the threshold for competence. Criterion validity was investigated using performance indicator 5 to create distinct trajectories of performance before linking and cross-tabulating trajectory group memberships with a 'top 20%' performance in the final Bachelor of Dental Surgery (BDS) examinations. Reliability was calculated using Cronbach's alpha. RESULTS Threshold 4 models showed all students followed a single upward trajectory in all three cohorts, showing clear progression in competence over three clinical BDS years. A threshold 5 model produced two distinct trajectories, and in each cohort a 'better performing' trajectory was identified. Students allocated to the 'better performing' trajectories scored higher on average in the final examinations for cohort 2 (29% vs 18% (BDS4); 33% vs. 15% (BDS5)) and cohort 3 (19% vs. 16% (BDS4); 21% vs. 16% (BDS5)). Reliability for the undergraduate examinations was high for all three cohorts (≥0.8815) and did not change appreciably when longitudinal assessment was included. CONCLUSIONS There is some evidence to support that longitudinal data have a degree of content and criterion validity for assessing the development of clinical competence in undergraduate dental students, which should increase confidence in decisions based on these data. The findings also provide a good foundation for subsequent research.
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Affiliation(s)
- Jamie Dickie
- University of Glasgow School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, Glasgow, UK
| | - Andrea Sherriff
- University of Glasgow School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, Glasgow, UK
| | - Michael McEwan
- University of Glasgow, Learning Enhancement and Academic Development Service, Glasgow, UK
| | - Aileen Bell
- University of Glasgow School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, Glasgow, UK
| | - Kurt Naudi
- University of Glasgow School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, Glasgow, UK
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Trullenque-Eriksson A, Derks J, Andersson JS. Onset of periodontitis - a registry-based cohort study. Clin Oral Investig 2023; 27:2187-2195. [PMID: 36811673 PMCID: PMC10160190 DOI: 10.1007/s00784-023-04923-5] [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: 11/18/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVES The present retrospective registry-based cohort study aimed to identify parameters associated with the onset of periodontitis in young adults. MATERIAL AND METHODS A total of 345 Swedish subjects were clinically examined at age 19 years (as part of an epidemiological survey) and then followed up to 31 years through the Swedish Quality Registry for Caries and Periodontal diseases (SKaPa). The registry data including periodontal parameters were obtained for the period 2010-2018 (23-31 years). Logistic regression and survival models were used to identify risk factors for periodontitis (PPD ≥6 mm at ≥2 teeth). RESULTS The incidence of periodontitis during the 12-year observation period was 9.8%. Cigarette smoking (modified pack-years; HR 2.35, 95%CI 1.34-4.13) and increased probing pocket depth (number of sites with PPD 4-5 mm; HR 1.04, 95%CI 1.01-1.07) at 19 years were risk factors for periodontitis in subsequent young adulthood. No statistically significant association was identified for gender, snuff use, plaque and marginal bleeding scores. CONCLUSION Cigarette smoking and increased probing pocket depth (≥4 mm) in late adolescence (19 years) were relevant risk factors for periodontitis in young adulthood. CLINICAL RELEVANCE Our study identified cigarette smoking and increased probing depth in late adolescence as relevant risk factors of periodontitis in young adulthood. Preventive programs should therefore consider both cigarette smoking and probing pocket depths in their risk assessment.
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Affiliation(s)
- Anna Trullenque-Eriksson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Box 450, 405 30, Gothenburg, SE, Sweden.
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Box 450, 405 30, Gothenburg, SE, Sweden
| | - Jessica Skoogh Andersson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Box 450, 405 30, Gothenburg, SE, Sweden
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4
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Nandkeoliar T, Kumar A, Chungkham S, Singh SS. Estimation of vestibular depth: An observational cross-sectional study. J Indian Soc Periodontol 2023; 27:320-327. [PMID: 37346864 PMCID: PMC10281317 DOI: 10.4103/jisp.jisp_293_22] [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: 06/20/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 06/23/2023] Open
Abstract
Background The vestibular depth (VD) varies to a great extent among individuals and at different points of reference. The normal range of depth of the vestibule at different areas in the mouth remains to be established. Aim The primary objective of this study is to assess the average VD around different teeth in the maxilla and the mandible. Furthermore, an attempt has been made to identify the various ranges of VD and understand what could be suggestive of a normal VD. Materials and Methods The participants included were divided into four age groups, i.e., 6-14 years (Group 1), 15-30 years (Group 2), 31-50 years (Group 3), and >50 years (Group 4). Further, the subjects were grouped into subgroup A, periodontally healthy and subgroup B, gingival recession (GR). Group 1, 2, and 3 included 30 subjects each in subgroup A, while Group 4 subgroup B had 18 subjects. In case of subgroup B, Group 2 included 9 subjects, Group 3-31 subjects, and Group 4-30 subjects. Measurements included the depth of vestibule from 2 reference point, i.e., gingival margin (GM) and incisal edge (IE). Results In subgroup A, the average VD from GM was found to be the least in the Group 1 i.e., 6-14 years (9.2 mm ± 4.26 in maxilla and 7.01 mm ± 3.14 in the mandible) and the highest in the Group 4 i.e., >50 years (12.06 mm ± 2.73 in maxilla and 10.08 mm ± 2.58 in the mandible). In the case of subgroup B, the least depth from GM was found in the Group 3 i.e., >30-50 years (9.44 mm ± 2.73 in the maxilla and 8.32 mm ± 1.7 in the mandible) and the maximum depth in the Group 4 (>50 years) (11.28 ± 2.31 in maxilla and 9.42 ± 2.87 in the mandible). Conclusion The study provides a range of VD s in different areas of the mouth in periodontally healthy and individuals with GR, which will contribute to constitute a normal range of VD.
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Affiliation(s)
- Tanya Nandkeoliar
- Department of Periodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Kumar
- Department of Periodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Sachidananda Chungkham
- Department of Periodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Sinam Subhaschandra Singh
- Department of Periodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
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Costa SA, Ribeiro CCC, Leite FRM, Peres MA, Souza SDFC, Nascimento GG. Chronic oral diseases burden: The confluence of caries and periodontitis throughout life. J Clin Periodontol 2023; 50:452-462. [PMID: 36549902 DOI: 10.1111/jcpe.13761] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
AIM To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans. MATERIALS AND METHODS This cross-sectional study explored the grouping among a set of caries and periodontitis indicators (the proportion of sites with bleeding on probing, moderate probing pocket depth [PPD, 4-5 mm], severe PPD [≥6 mm], moderate clinical attachment level [CAL, 3-4 mm], severe CAL [≥5 mm], number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement, and the number of missing teeth) in 14,421 Americans from the NHANES III study. Exploratory factorial analysis was used to determine the constructs between those indicators (factorial loading ≥0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011-2014. RESULTS Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13-39 years old), while for the subjects over 50 years, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators. CONCLUSIONS Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years.
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Affiliation(s)
- Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Cecilia Claudia Costa Ribeiro
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Fábio Renato Manzolli Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | | | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
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Income-related inequalities in the association of smoking with periodontitis: a cross-sectional analysis in Tokyo Metropolitan Districts. Clin Oral Investig 2023; 27:519-528. [PMID: 36241924 DOI: 10.1007/s00784-022-04747-9] [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: 03/23/2022] [Accepted: 10/02/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Socio-economic status (SES) and smoking are risk factors for periodontitis; however, their interaction has not been determined. We investigated the effect of modification of SES and smoking with periodontal conditions. MATERIALS AND METHODS Data on the social background, smoking status, and dental examination of 1033 individuals residing in the Tokyo Metropolitan District were analyzed. The outcomes were the number of remaining teeth and the proportion of teeth with probing pocket depth (PPD) ≥ 4 mm and ≥ 6 mm. Multilevel linear and Poisson regression analyses were performed after adjusting for possible confounding factors, including SES, assessed by the average income of the residential area. RESULTS The mean number of remaining teeth was 24.6 ± 4.8, and the proportion of teeth with PPD ≥ 4 mm and ≥ 6 mm was 31.2 ± 28.5% and 12.2 ± 18.1%, respectively. After adjusting for confounding factors, the lowest-income population had significantly lesser teeth (coefficient: - 0.46, 95% CI - 0.89, 0.02, p = 0.039) and a higher proportion of teeth with PPD ≥ 4 mm than the highest-income population (ratio of means: 1.22, 95% CI 1.03-1.44, p = 0.013). Significant interactions were observed; income inequalities in periodontitis were significant only among current smokers. CONCLUSION Inequality in socio-economic status is associated with oral health inequalities. The adverse effects of smoking on periodontitis might be greater in the low-income population. CLINICAL RELEVANCE The low-income population, especially current smokers, had significantly more compromised oral health than the high-income population. In addition to the emphasis on smoking cessation, the promotion of universal health coverage for dental care is necessary to reduce oral health inequalities.
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7
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Ju X, Mejia G, Chrisopoulos S, Luzzi L, Jamieson LM. A longitudinal assessment of chronic periodontitis in Australian adults. J Clin Periodontol 2023; 50:276-285. [PMID: 36330664 PMCID: PMC10947095 DOI: 10.1111/jcpe.13741] [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: 05/03/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
AIM The study aimed to estimate the incidence/progression and reversal of chronic periodontitis and to identify factors associated with chronic periodontitis in Australian adults over a 12-year period. MATERIALS AND METHODS Data were obtained from the longitudinal component of the National Study of Adult Oral Health (NSAOH) in 2004-2006, and repeated data, among the same adults, in 2017-2018. NSAOH 2004-2006 was a population-based study of Australian adults aged 15+ years. The American Academy of Periodontology/European Federation of Periodontology case definitions were used, and then compared with two other case definitions. Multivariable Poisson regression models were used to estimate incidence rate ratios (IRRs) and reversal rate ratio (RRRs) of periodontitis. RESULTS A total of 775 dentate Australian adults had dental examinations at both times. The proportion of incidence/progression and reversal among Australian adults was 56.4% and 11.0%, respectively. Tobacco smokers presented with more than three times higher incidence (IRR: 3.32, 95% CI: 1.50-7.60) and lower reversals (RRR: 0.94, 95% CI: 0.39-0.98) than those who had never smoked. Cessation of smoking was positively associated with periodontitis reversal. The total incidence/progression was 471.7/10,000 person-years, with reversal being 107.5/10,000 person-years. The average number of teeth lost due to periodontal disease was 1.9 in 2017-2018. Being male and not having periodontal treatment were significant risk markers for the incidence/progression of periodontitis. CONCLUSION Smoking is a risk factor for periodontitis. Cessation of smoking is an effective means of reducing the incidence and progression of chronic periodontitis, to reduce the risk of tooth loss, and to improve overall periodontal health.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Gloria Mejia
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
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8
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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Scott D, Dukka H, Saxena D. Potential Mechanisms Underlying Marijuana-Associated Periodontal Tissue Destruction. J Dent Res 2022; 101:133-142. [PMID: 34515556 PMCID: PMC8905217 DOI: 10.1177/00220345211036072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
While definitive evidence awaits, cannabis is emerging as a likely risk factor for periodontal tissue destruction. The mechanisms that underlie potential cannabis-induced or cannabis-enhanced periodontal diseases, however, remain to be elucidated. Herein, we 1) examine insights obtained from the endocannabinoid system, 2) summarize animal models of exposure to cannabinoid receptor agonists and antagonists, 3) review the evidence suggesting that cannabis and cannabis-derived molecules exert a profound influence on components of the oral microbiome, and 4) assess studies indicating that marijuana and phytocannabinoids compromise the immune response to plaque. Furthermore, we address how knowledge of cannabinoid influences in the oral cavity may be exploited to provide potential novel periodontal therapeutics, while recognizing that such medicinal approaches may be most appropriate for nonhabitual marijuana users. The suspected increase in susceptibility to periodontitis in marijuana users is multifaceted, and it is clear that we are only beginning to understand the complex toxicological, cellular, and microbial interactions involved. With marijuana consumption increasing across all societal demographics, periodontal complications of use may represent a significant, growing oral health concern. In preparation, an enhanced research response would seem appropriate.
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Affiliation(s)
- D.A. Scott
- Oral Immunology and Infectious
Diseases, School of Dentistry, University of Louisville, Louisville, KY,
USA
- D.A. Scott, School of Dentistry,
University of Louisville, 501 S. Preston St, Louisville, KY 40292,
USA.
| | - H. Dukka
- Diagnosis and Oral Health, School
of Dentistry, University of Louisville, Louisville, KY, USA
| | - D. Saxena
- Molecular Pathobiology, College
of Dentistry, New York University, New York, USA
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Morelli E, Broadbent J, Knight E, Leichter J, Thomson W. Does having children affect women's oral health? A longitudinal study. J Public Health Dent 2022; 82:31-39. [PMID: 34124780 PMCID: PMC8669016 DOI: 10.1111/jphd.12466] [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: 10/09/2020] [Revised: 05/16/2021] [Accepted: 06/02/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest. METHODS This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years. RESULTS Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss. CONCLUSIONS Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management.
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Affiliation(s)
- E. Morelli
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - J.M. Broadbent
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - E. Knight
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - J. Leichter
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - W.M. Thomson
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
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11
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Hasturk H, Hajishengallis G, Lambris JD, Mastellos DC, Yancopoulou D. Phase 2a clinical trial of complement C3 inhibitor AMY-101 in adults with periodontal inflammation. J Clin Invest 2021; 131:152973. [PMID: 34618684 DOI: 10.1172/jci152973] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gingivitis and periodontitis are prevalent inflammatory diseases of the periodontal tissues. Current treatments are often ineffective or do not prevent disease recurrence. Uncontrolled complement activation and resulting chronic gingival inflammation is a hallmark of periodontal diseases. We determined efficacy and safety of a complement 3-targeted therapeutic, AMY-101, locally administered in adults with periodontal inflammation. METHODS Thirty-two patients with gingival inflammation were enrolled into a randomized, placebo-controlled, double-blind, split-mouth design phase 2a trial, after dose-escalation study to select safe and effective dose with additional 8 patients. Half of the mouth was randomly assigned to AMY-101 (0.1mg/site) or placebo injections at sites of inflammation, administered on days 0, 7 and 14 and evaluated for safety and efficacy outcomes at days 28, 60 and 90. The primary efficacy outcome was change in gingival inflammation, measured by modified gingival index (MGI), and secondary outcomes included changes in bleeding-on-probing (BOP), amount of plaque, pocket depth, clinical attachment level, and gingival crevicular fluid levels of matrix metalloproteinases (MMPs) over 90 days. RESULTS A once-per-week intragingival injection of AMY-101 for 3 weeks was safe and well-tolerated in all participants resulting in significant (P<0.001) reductions in clinical indices measuring gingival inflammation (MGI and BOP). AMY-101 significantly (P<0.05) reduced MMP-8 and MMP-9 levels, indicators of inflammatory tissue destruction. These therapeutic effects persisted for at least 3 months post-treatment. CONCLUSION AMY-101 causes significant and sustainable reduction in gingival inflammation without adverse events and merits further investigation for the treatment of periodontitis and other oral or peri-implant inflammatory conditions. TRIAL REGISTRATION ClinicalTrials.gov: NCT03694444. FUNDING Amyndas Pharmaceuticals. Amyndas contributed to the design and conducts of the clinical trial and in the writing of the manuscript.
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Affiliation(s)
- Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, United States of America
| | - George Hajishengallis
- Department of Basic and Translational Sciences, University of Pennsylvania, Philadelphia, United States of America
| | - John D Lambris
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Dimitrios C Mastellos
- Division of Biodiagnostic Sciences and Technologies, National Center for Scientific Research 'Demokritos', Athens, Greece
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Ortigara GB, Mário Ferreira TDG, Tatsch KF, Romito GA, Ardenghi TM, Sfreddo CS, Moreira CHC. The 2018 EFP/AAP periodontitis case classification demonstrates high agreement with the 2012 CDC/AAP criteria. J Clin Periodontol 2021; 48:886-895. [PMID: 33755241 DOI: 10.1111/jcpe.13462] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
AIM To investigate the agreement between the 2018 EFP/AAP periodontitis case classification and the 2012 CDC/AAP criteria. MATERIALS AND METHODS This cross-sectional study assessed a population-based sample from a rural area in southern Brazil. A complete periodontal examination was performed at six sites/tooth. The periodontitis case definition was estimated and compared according to the 2018 EFP/AAP classification and the 2012 CDC/AAP criteria (reference). Diagnostic tests included sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and area under ROC curve (AUC). RESULTS Five hundred and eighty-eight subjects with ≥6 teeth each were included. Based on the 2018 EFP/AAP classification, 71.1% of the subjects were classified as stage III/IV showing 100% agreement with 2012 CDC/AAP criteria for the severe category. For the moderate and severe classification, the 2018 EFP/AAP SN was 99.8% and 100%, SP 13.6% and 43.6%, PPV 83.4% and 47.4%, and NPV 93.7% and 100%, respectively. The AUC was 0.9059 (95% CI = 0.879-0.933) and the optimal cut-off based on the curve was stage III. CONCLUSIONS The 2018 EFP/AAP periodontitis case classification showed high agreement with the 2012 CDC/AAP criteria in a rural sample with high periodontitis occurrence.
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Affiliation(s)
- Gabriela Barbieri Ortigara
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Karen Finger Tatsch
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Thiago Machado Ardenghi
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Carlos Heitor Cunha Moreira
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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13
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Peres KG, Thomson WM, Chaffee BW, Peres MA, Birungi N, Do LG, Feldens CA, Fontana M, Marshall TA, Pitiphat W, Seow WK, Wagner Y, Wong HM, Rugg-Gunn AJ. Oral Health Birth Cohort Studies: Achievements, Challenges, and Potential. J Dent Res 2020; 99:1321-1331. [PMID: 32680439 DOI: 10.1177/0022034520942208] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Birth cohorts are those among observational studies that provide understanding of the natural history and causality of diseases since early in life. Discussions during an International Association for Dental Research symposium in London, United Kingdom, in 2018, followed by a workshop in Bangkok, Thailand, in 2019, concluded that there are few birth cohort studies that consider oral health and that a broader discussion on similarities and differences among those studies would be valuable. This article aims to 1) bring together available long-term data of oral health birth cohort studies from the low, middle, and high-income countries worldwide and 2) describe similarities and differences among these studies. This work comprises 15 studies from all 5 continents. The most studied dental conditions and exposures are identified; findings are summarized; and methodological differences and similarities among studies are presented. Methodological strengths and weaknesses are also highlighted. Findings are summarized in 1) the negative impact of detrimental socioeconomic status on oral health changes over time, 2) the role of unfavorable patterns of dental visiting on oral health, 3) associations between general and oral health, 4) nutritional and dietary effects on oral health, and 5) intergenerational influences on oral health. Dental caries and dental visiting patterns have been recorded in all studies. Sources of fluoride exposure have been documented in most of the more recent studies. Despite some methodological differences in the way that the exposures and outcomes were measured, some findings are consistent. Predictive models have been used with caries risk tools, periodontitis occurrence, and permanent dentition orthodontic treatment need. The next steps of the group's work are as follows: 1) establishing a consortium of oral health birth cohort studies, 2) conducting a scoping review, 3) exploring opportunities for pooled data analyses to answer pressing research questions, and 4) promoting and enabling the development of the next generation of oral health researchers.
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Affiliation(s)
- K G Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - W M Thomson
- Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - B W Chaffee
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California-San Francisco, San Francisco, CA, USA
| | - M A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - N Birungi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - L G Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - C A Feldens
- Lutheran University of Brazil, Canoas, Brazil
| | - M Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - T A Marshall
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - W Pitiphat
- Chronic Inflammatory Diseases and Systemic Diseases Associated with Oral Health Research Group, and Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - W K Seow
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Y Wagner
- Department of Orthodontics, Jena University Hospital, Jena, Germany
| | - H M Wong
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - A J Rugg-Gunn
- The Borrow Foundation, Waterlooville, UK.,School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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14
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Hong C, Broadbent J, Thomson W, Poulton R. The Dunedin Multidisciplinary Health and Development Study: Oral health findings and their implications. J R Soc N Z 2020; 50:35-46. [PMID: 32226196 PMCID: PMC7100605 DOI: 10.1080/03036758.2020.1716816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
Longitudinal research is needed to better understand the natural history of oral conditions and long-term health and social outcomes. Oral health data has been collected periodically in the Dunedin Multidisciplinary Health and Development Study for over 40 years. To date, 70+ peer-review articles on the Study's oral health-related findings have been published, providing insight into the natural history of oral conditions, risk factors, impacts on quality of life, and disparities in oral health. Some of these report new findings, while others build upon the existing body of evidence. This paper provides an overview of these findings and reflects on their public health implications and policy utility in New Zealand.
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Affiliation(s)
- C.L. Hong
- Department of Oral Sciences, University of Otago
| | | | - W.M. Thomson
- Department of Oral Sciences, University of Otago
| | - R. Poulton
- Department of Psychology, University of Otago
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15
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Işık Y, Telatar GY, Neşelioğlu S, Biçer C, Gürlek B. Evaluation of periodontal status in different phenotypes of polycystic ovary syndrome in untreated patients of early reproductive age: A case-control study. J Obstet Gynaecol Res 2020; 46:459-465. [PMID: 31922343 DOI: 10.1111/jog.14179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/30/2019] [Indexed: 12/24/2022]
Abstract
AIM A few studies demonstrated an increased risk of periodontal disease in patients with polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the periodontal status in women of reproductive age who were recently diagnosed with different phenotypes of PCOS. METHODS This prospectively designed cross-sectional case-control study included 116 consecutive subjects with PCOS and 90 healthy volunteers, aged between 18 and 24, who were admitted to the gynecology polyclinic between April 2018 and December 2018. All subjects of PCOS diagnosed using the Rotterdam criteria were subdivided into four phenotypes based on clinical, biochemical and ultrasonographic parameters according to the guidelines of the National Institutes of Health. The same dentist investigated periodontal parameters including plaque index, gingival index, bleeding on probing (%), probing depth, clinical attachment loss and the decayed, missing, filled teeth index. RESULTS Probing depth, a periodontal parameter, was higher in all sub-phenotypes of the PCOS group compared to the control group. There was no difference in other periodontal parameters. CONCLUSION Periodontal probing depth, which is an important parameter in the diagnosis of periodontal diseases, was higher in all phenotypic subgroups of PCOS in early reproductive age.
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Affiliation(s)
- Yaser Işık
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Gül Y Telatar
- Department of Restorative Dentistry, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Salim Neşelioğlu
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Cemile Biçer
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Beril Gürlek
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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16
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Gu Z, Singh S, Niyogi RG, Lamont GJ, Wang H, Lamont RJ, Scott DA. Marijuana-Derived Cannabinoids Trigger a CB2/PI3K Axis of Suppression of the Innate Response to Oral Pathogens. Front Immunol 2019; 10:2288. [PMID: 31681262 PMCID: PMC6804395 DOI: 10.3389/fimmu.2019.02288] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 09/10/2019] [Indexed: 12/18/2022] Open
Abstract
Cannabis use is an emergent risk factor for periodontitis, a chronic bacterial-induced disease of the supporting structures of the teeth. However, the mechanisms by which marijuana exposure predisposes to periodontal tissue destruction have yet to be elucidated. Therefore, we examined the influence of physiologically relevant doses of major marijuana-derived phytocannabinoid subtypes (cannabidiol [CBD]; cannabinol [CBN]; and tetrahydrocannabinol [THC], 1.0 μg/ml) on the interactions of three ultrastructurally variant oral pathogens, Porphyromonas gingivalis, Filifactor alocis, and Treponema denticola with the immune system. CBD, CBN, and THC each suppressed P. gingivalis-induced IL-12 p40, IL-6, IL-8, and TNF release while enhancing the anti-inflammatory cytokine, IL-10, from human innate cells. Similar phenomena were observed in F. alocis- and T. denticola-exposed human monocytes and human gingival keratinocytes. Higher phytocannabinoid doses (≥5.0 μg/ml) compromised innate cell viability and inhibited the growth of P. gingivalis and F. alocis, relative to unexposed bacteria. T. denticola, however, was resistant to all cannabinoid doses tested (up to 10.0 μg/ml). Pharmaceutical inhibition and efficient gene silencing indicated that a common CB2/PI3K axis of immune suppression is triggered by phytocannabinoids in vitro. This pathway does not appear to perpetuate through the canonical GSK3β-dependent cholinergic anti-inflammatory pathway, the predominant endogenous inflammatory control system. In a repetitive, transient oral infection model, CBD also suppressed P. gingivalis-induced innate immune markers in wild-type mice, but not in CB2−/− mice. If such phenomena occur in humans in situ, environmental cannabinoids may enhance periodontitis via direct toxic effects on specific oral bacteria; by compromising innate cell vitality; and/or through a suppressed innate response to periodontal pathogens involving a CB2/PI3K signaling lineage.
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Affiliation(s)
- Zhen Gu
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Shilpa Singh
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Rajarshi G Niyogi
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Gwyneth J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Huizhi Wang
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Richard J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - David A Scott
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
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17
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Periodontitis: A Multifaceted Disease of Tooth-Supporting Tissues. J Clin Med 2019; 8:jcm8081135. [PMID: 31370168 PMCID: PMC6723779 DOI: 10.3390/jcm8081135] [Citation(s) in RCA: 318] [Impact Index Per Article: 63.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022] Open
Abstract
Periodontitis is an infection-driven inflammatory disease in which the composition of biofilms plays a significant role. Dental plaque accumulation at the gingival margin initiates an inflammatory response that, in turn, causes microbial alterations and may lead to drastic consequences in the periodontium of susceptible individuals. Chronic inflammation affects the gingiva and can proceed to periodontitis, which characteristically results in irreversible loss of attachment and alveolar bone. Periodontitis appears typically in adult-aged populations, but young individuals can also experience it and its harmful outcome. Advanced disease is the major cause of tooth loss in adults. In addition, periodontitis is associated with many chronic diseases and conditions affecting general health.
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18
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Mofidi A, Fang D, Flores-Mir C. Cannabis and periodontal harm: How convincing is the association? Oral Dis 2018; 25:350-352. [PMID: 30240507 DOI: 10.1111/odi.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Amirsalar Mofidi
- Periodontal Graduate Program, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dongdong Fang
- Periodontal Graduate Program, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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19
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Le A, Palamar JJ. Oral health implications of increased cannabis use among older adults: Another public health concern? JOURNAL OF SUBSTANCE USE 2018; 24:61-65. [PMID: 30524195 PMCID: PMC6277025 DOI: 10.1080/14659891.2018.1508518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/29/2018] [Indexed: 12/29/2022]
Abstract
Prevalence of cannabis use among older Americans (aged ≥ 65) appears to be rising, and emerging evidence associates cannabis use with several oral diseases. The burden of oral diseases among older Americans is great, but literature discussing potential implications of increasing rates of cannabis use and the oral health of older persons is lacking. This paper explores the latest trends in prevalence of cannabis use among older Americans and summarizes the literature on the oral health status of older adults and oral effects of cannabis use, and considers broad implications for oral health and public health policy and future research. Further studies on the effects cannabis use on the oral health of older adults are needed. Future research should investigate older subjects' susceptibility to cannabis-related oral diseases, as well as the proportions that develop disease. Policymakers may wish to tackle barriers to access of dental services for the older population, or target subsets of the population that suffer from comparably higher rates of oral diseases, while dental professionals may require training on managing underlying substance use behaviors in addition to clinical oral manifestations.
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Affiliation(s)
- Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, USA
- New York University College of Dentistry, New York, USA
| | - Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
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20
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Periodontol 2018; 89 Suppl 1:S120-S139. [DOI: 10.1002/jper.17-0062] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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21
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Clin Periodontol 2018; 45 Suppl 20:S112-S129. [DOI: 10.1111/jcpe.12943] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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22
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Effect of Smoking on Periodontitis: A Systematic Review and Meta-regression. Am J Prev Med 2018; 54:831-841. [PMID: 29656920 DOI: 10.1016/j.amepre.2018.02.014] [Citation(s) in RCA: 229] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/02/2018] [Accepted: 02/19/2018] [Indexed: 11/23/2022]
Abstract
CONTEXT The study systematically reviewed articles on the association between tobacco smoking and periodontitis, as it has been hypothesized that smoking affects the course of periodontitis through impairment of immunological and vascular mechanisms. EVIDENCE ACQUISITION Searches of articles indexed in PubMed, Scopus, and Embase were performed up to and including May 2017. Search strategy included MeSH and free terms: periodontitis, periodontal diseases, smoking, tobacco use, tobacco, tobacco products, cigarette, pipe, and cigar. Only original prospective longitudinal studies that investigated the association between smoking and periodontitis incidence or progression were included. Results were shown as combined risk ratio. Meta-regression and subgroup analyses were used to explore potential sources of heterogeneity. Analyses were conducted in August 2017. EVIDENCE SYNTHESIS Twenty-eight studies were included in the review; of these, only 14 presented data that could be included in the meta-analysis. Pooled adjusted risk ratios estimate that smoking increases the risk of periodontitis by 85% (risk ratio=1.85, 95% CI=1.5, 2.2). Meta-regression demonstrated that age explained 54.2% of the variability between studies, time of follow-up explained 13.5%, loss to follow-up 10.7%, criteria used to assess the periodontal status explained 2.1%, and severity of periodontitis explained 16.9%. CONCLUSIONS Smoking has a detrimental effect on the incidence and progression of periodontitis. Tobacco smoking, therefore, is important information that should be assessed along with other risk factors for periodontitis.
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23
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MacEntee MI, Donnelly LR. Oral health and the frailty syndrome. Periodontol 2000 2018; 72:135-41. [PMID: 27501496 DOI: 10.1111/prd.12134] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/27/2022]
Abstract
The frailty syndrome is an ever-growing area of study among older adults because of its association with an increased risk of falls, hospitalization, institutionalization, dependency and mortality. Frailty is neither a disease nor a disability but is better understood as a medical syndrome of multisystem dysregulation that results in a diminished ability to overcome everyday stressors. The prevalence of frailty in any given population can vary widely, in part because of the way in which it is defined and measured, but in general it is higher among women and in those with advanced age and declining health. Whilst it is largely understood that older adults will differ biologically, psychologically and socially, and that each of these domains can impact oral health, we are only beginning to investigate how the mouth is affected in frailty. Given that both hard and soft structures contribute to oral health and disease status among older adults with varying degrees of impairment and disability, frailty adds yet another dimension to be considered. This paper will discuss how frailty can influence and be influenced by oral disorders, as well as the potential relationship to oral neglect and the resultant consequences among this vulnerable population.
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24
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Nascimento GG, Leite FRM, Scheutz F, López R. Periodontitis: from Infection to Inflammation. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40496-017-0158-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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25
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Leite FR, Peres KG, Do LG, Demarco FF, Peres MA. Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information. J Periodontol 2017; 88:731-743. [DOI: 10.1902/jop.2017.160607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fábio R.M. Leite
- Currently, Department of Dentistry and Oral Health, Section of Periodontology, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; previously, Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen G. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G. Do
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Flávio F. Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas
- Postgraduate Program in Dentistry, Federal University of Pelotas
| | - Marco A.A. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
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26
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Thorbert-Mros S, Cassel B, Berglundh T. Age of onset of disease in subjects with severe periodontitis: A 9- to 34-year retrospective study. J Clin Periodontol 2017; 44:778-783. [DOI: 10.1111/jcpe.12757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sara Thorbert-Mros
- Department of Periodontology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Björn Cassel
- Clinic of Periodontics; Public Dental Health Services; Region Västra Götaland; Gothenburg Sweden
| | - Tord Berglundh
- Department of Periodontology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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27
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Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2017; 71:82-112. [PMID: 27045432 DOI: 10.1111/prd.12121] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
Abstract
This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3 mm for additional pocket reduction and 0.2 mm for additional clinical attachment gain, have been documented for moderately deep sites (4-6 mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained-delivery devices may offer a benefit of an additional 0.4 mm in pocket depth reduction and 0.3 mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.
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28
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López R, Smith PC, Göstemeyer G, Schwendicke F. Ageing, dental caries and periodontal diseases. J Clin Periodontol 2017; 44 Suppl 18:S145-S152. [DOI: 10.1111/jcpe.12683] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Rodrigo López
- Section of Periodontology; Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - Patricio C Smith
- Dentistry Academic Unit; Faculty of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
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29
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Schuch HS, Peres KG, Singh A, Peres MA, Do LG. Socioeconomic position during life and periodontitis in adulthood: a systematic review. Community Dent Oral Epidemiol 2016; 45:201-208. [DOI: 10.1111/cdoe.12278] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/27/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Helena Silveira Schuch
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Karen G. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Loc G. Do
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
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30
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Momen-Heravi F, Kang P. Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report. J Am Dent Assoc 2016; 148:179-184. [PMID: 27871617 DOI: 10.1016/j.adaj.2016.10.009] [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: 07/19/2016] [Revised: 09/05/2016] [Accepted: 10/18/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OVERVIEW There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy. CASE DESCRIPTION A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period. CONCLUSIONS AND PRACTICAL IMPLICATIONS Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis.
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Bahrami G, Vaeth M, Kirkevang LL, Wenzel A, Isidor F. The impact of smoking on marginal bone loss in a 10-year prospective longitudinal study. Community Dent Oral Epidemiol 2016; 45:59-65. [PMID: 27649930 DOI: 10.1111/cdoe.12260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/30/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this epidemiologic study was to determine the impact of smoking on marginal bone loss in a subsample derived from an original randomly selected adult sample, after adjusting for oral and general factors. METHODS The number of participants at baseline in this 10-year longitudinal study was 616 (mean age: 42 years, range 21-63 years). The participants underwent a full-mouth radiographic survey. After recall in 2003, 473 (77%) of the participants accepted and completed an identical survey. In 2008, the survey was repeated, and 301 (48.9%) individuals were included in this study. The marginal bone level of each tooth was measured in mm. Age, gender, smoking habits, number of teeth, apical periodontitis, crowns and initial marginal bone level were also recorded for each individual. Only individuals who did not report a change in smoking habits during the 10-year period were included in the study. Multiple regression analyses were used to evaluate crude and adjusted associations between smoking and marginal bone loss. RESULTS At the first, radiographic survey smokers had a statistically significantly more reduced marginal bone level (in average 0.9 mm) than nonsmokers. After 10 years, a progression of a mean marginal bone loss of > 2 mm was statistically significantly more common in smokers than in nonsmokers (7.1% and 0%, respectively). Furthermore, a marginal bone loss of 1-2 mm was observed in 29% of the smokers and 19% of the nonsmokers, and ≤ 1 mm marginal bone loss was found in 69% of smokers and 81% of nonsmokers. Even after adjusting for initial marginal bone level, gender, age, and also presence of apical periodontitis and crowns, the difference in progression of marginal bone loss was still statistically higher in smokers (on average 0.36 mm). CONCLUSIONS The smokers started out with a more reduced marginal bone level than nonsmokers. However, even after adjusting for the initial marginal bone level, the progression of marginal bone loss in smokers was more pronounced than in nonsmokers. This shows that smoking is a factor with significant impact on the marginal bone level and can be assumed to be a true risk factor for marginal bone loss.
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Affiliation(s)
- Golnosh Bahrami
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Michael Vaeth
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lise-Lotte Kirkevang
- Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.,Department of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
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Thomson WM, Zeng J, Broadbent JM, Foster Page LA, Shalev I, Moffitt TE, Caspi A, Williams SM, Braithwaite AW, Robertson SP, Poulton R. Telomere length and periodontal attachment loss: a prospective cohort study. J Clin Periodontol 2016; 43:121-7. [PMID: 26713854 DOI: 10.1111/jcpe.12499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 01/08/2023]
Abstract
AIM The aim of the study was to examine the association between telomere erosion and periodontitis in a long-standing prospective cohort study of New Zealand adults. Specific hypotheses tested were as follows: (i) that exposure to periodontitis at ages 26 and 38 was associated with accelerated leucocyte telomere erosion and (ii) that accelerated leucocyte telomere erosion was associated with higher rates of periodontitis by ages 26 and 38. MATERIALS AND METHODS Periodontal attachment loss data were collected at ages 26 and 38. Blood samples taken at the same ages were analysed to obtain estimates of leucocyte telomere length and erosion over a 12-year period. RESULTS Overall, the mean telomere length was reduced by 0.15 T/S ratio (adjusted) from age 26 to 38 among the 661 participants reported on here. During the same period, the mean attachment loss increased by 10%, after adjusting for sex, socio-economic status and smoking. Regression models showed that attachment loss did not predict telomere length, and that telomere erosion did not predict attachment loss. CONCLUSIONS Although both periodontitis and telomere length are age-dependent, they do not appear to be linked, suggesting that determination of leucocyte telomere length may not be a promising clinical approach at this age for identifying people who are at risk for periodontitis.
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Affiliation(s)
- William Murray Thomson
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Jiaxu Zeng
- Department of Preventive and Social Medicine, Dunedin School of Medicine, The University of Otago, Dunedin, New Zealand
| | - Jonathan M Broadbent
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Lyndie A Foster Page
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Idan Shalev
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
| | - Sheila M Williams
- Department of Preventive and Social Medicine, Dunedin School of Medicine, The University of Otago, Dunedin, New Zealand
| | - Antony W Braithwaite
- Department of Pathology, School of Medicine, University of Otago, Dunedin, New Zealand
| | - Stephen P Robertson
- Department of Paediatrics and Child Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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Oral Health Over the Life Course. A LIFE COURSE PERSPECTIVE ON HEALTH TRAJECTORIES AND TRANSITIONS 2015. [DOI: 10.1007/978-3-319-20484-0_3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Interleukin-6 c.-174G>C Polymorphism and Periodontitis in a Brazilian Population. Mol Biol Int 2014; 2014:490308. [PMID: 25548674 PMCID: PMC4274816 DOI: 10.1155/2014/490308] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/12/2014] [Accepted: 11/19/2014] [Indexed: 02/05/2023] Open
Abstract
Aim. Periodontitis is an inflammatory disease that affects the teeth supporting structures, triggered by periodontal pathogens, and is influenced by environmental and genetic factors. Genes encoding molecules related to the immune response, such as cytokine, are the main candidates for polymorphisms analysis and may be possibly associated with this pathology. A G/C promoter polymorphism on the IL6 gene has been shown to affect basal IL-6 levels. The aim of this study was to investigate the association between the IL6 c.-174G>C polymorphism and periodontitis in individuals from Vitória da Conquista, Bahia, Brazil. Material and Methods. Three hundred and thirty individuals (134 cases, 196 controls) were genotyped for the IL6 c.-174G>C by MS-PCR technique. Concentrations of salivary IL-6 were determined by ELISA method. Results. The IL6 c.-174G>C polymorphism was associated with periodontitis when comparing the distribution of genotypes between patients with periodontitis and control subjects. The GC genotype appeared as a protective factor for periodontitis. Results showed increased levels of salivary IL-6 in periodontitis patients. Nevertheless, there was no relationship between the concentrations of IL-6 and genotypes when comparing the case and control groups. Conclusions. Our data indicate an association between IL6 c.-174G>C polymorphism and periodontitis and showed that IL-6 may be considered an important marker for periodontitis.
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Zeng J, Williams SM, Fletcher DJ, Cameron CM, Broadbent JM, Shearer DM, Thomson WM. Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach. J Periodontol 2014; 85:1390-7. [DOI: 10.1902/jop.2014.130577] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res 2014; 93:1045-53. [PMID: 25261053 DOI: 10.1177/0022034514552491] [Citation(s) in RCA: 1278] [Impact Index Per Article: 127.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
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Affiliation(s)
- N J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - E Bernabé
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| | - M Dahiya
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - B Bhandari
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| | - C J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - W Marcenes
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Bergstrom J. Smoking rate and periodontal disease prevalence: 40-year trends in Sweden 1970-2010. J Clin Periodontol 2014; 41:952-7. [PMID: 25039432 DOI: 10.1111/jcpe.12293] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship between smoking rate and periodontal disease prevalence in Sweden. MATERIAL AND METHODS National smoking rates were found from Swedish National Statistics on smoking habits. Based on smoking rates for the years 1970-2010, periodontal disease prevalence estimates were calculated for the age bracket 40-70 years and smoking-associated relative risks between 2.0 and 20.0. The impact of smoking on the population was estimated according to the concept of population attributable fraction. RESULTS The age-standardized smoking rate in Sweden declined from 44% in 1970 to 15% in 2010. In parallel with the smoking decline the calculated prevalence estimate of periodontal disease dropped from 26% to 12% assuming a 10-fold smoking-associated relative risk. Even at more moderate magnitudes of the relative risk, e.g. 2-fold or 5-fold, the prevalence decrease was quite tangible, suggesting that the current prevalence in Sweden is about 20-50% of the level 40 years ago. The population attributable fraction, estimating the portion of the disease that would have been avoided in the absence of smoking, was 80% in 1970 and 58% in 2010 at a ten-fold relative risk. CONCLUSION Calculated estimates of periodontal disease prevalence are closely related to real changes in smoking rate. As smoking rate drops periodontal disease prevalence will drop.
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Affiliation(s)
- Jan Bergstrom
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Griffin MC. Biocultural implications of oral pathology in an ancient Central California population. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 154:171-88. [DOI: 10.1002/ajpa.22491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Mark C. Griffin
- Department of Anthropology; San Francisco State University; 1600 Holloway Avenue San Francisco CA 94132
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Haas AN, Wagner MC, Oppermann RV, Rösing CK, Albandar JM, Susin C. Risk factors for the progression of periodontal attachment loss: a 5-year population-based study in South Brazil. J Clin Periodontol 2014; 41:215-23. [DOI: 10.1111/jcpe.12213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Marcius Comparsi Wagner
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Rui Vicente Oppermann
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Jasim M. Albandar
- Periodontal Diagnostics Research Laboratory; Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA USA
| | - Cristiano Susin
- Department of Periodontics and Oral Biology; College of Dental Medicine; Georgia Regents University; Augusta GA USA
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