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Wiernik E, Renuy A, Kab S, Steg PG, Goldberg M, Zins M, Caligiuri G, Bouchard P, Carra MC. Prevalence of self-reported severe periodontitis: Data from the population-based CONSTANCES cohort. J Clin Periodontol 2024; 51:884-894. [PMID: 38430050 DOI: 10.1111/jcpe.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
AIM To assess the prevalence of severe periodontitis based on the population-based CONSTANCES cohort using a validated self-reported questionnaire. MATERIALS AND METHODS Individuals were selected from the adult population in France using a random sampling scheme. Analyses were restricted to those invited in 2013-2014 who completed the periodontal health questionnaire at the 2017 follow-up. The risk of severe periodontitis was assessed using the periodontal screening score (PESS) and weighting coefficients were applied to provide representative results in the general French population. RESULTS The study included 19,859 participants (9204 men, mean age: 52.8 ± 12.6 years). Based on a PESS ≥ 5, 7106 participants were at risk of severe periodontitis, corresponding to a weighted prevalence of 31.6% (95% confidence interval: 30.6%-32.7%). This prevalence was higher among participants aged 55 and over, those with lower socio-economic status as well as current smokers, e-cigarette users and heavy drinkers. Among individuals at risk of severe periodontitis, only 18.8% (17.3%-20.4%) thought they had gum disease, although 50.5% (48.6%-52.5%) reported that their last dental visit was less than 6 months. CONCLUSIONS The present survey indicates that (1) self-reported severe periodontitis is highly prevalent with marked disparities between groups in the general French adult population, and (2) periodontitis could frequently be under-diagnosed given the low awareness.
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Affiliation(s)
- Emmanuel Wiernik
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Adeline Renuy
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Sofiane Kab
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Philippe Gabriel Steg
- UFR de Médecine, Université Paris-Cité, Paris, France
- Cardiology Department, AP-HP, Hôpital Bichat, Paris, France
- Laboratory for Vascular Translational Science, INSERM U1148, Paris, France
- Institut Universitaire de France, Paris, France
| | - Marcel Goldberg
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
| | - Marie Zins
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
- UFR de Médecine, Université Paris-Cité, Paris, France
| | - Giuseppina Caligiuri
- UFR de Médecine, Université Paris-Cité, Paris, France
- Cardiology Department, AP-HP, Hôpital Bichat, Paris, France
- Laboratory for Vascular Translational Science, INSERM U1148, Paris, France
| | - Philippe Bouchard
- UFR of Odontology, Université Paris Cité, Paris, France
- URP 2496, Montrouge, France
| | - Maria Clotilde Carra
- UMS 011 Population-based Cohorts Unit, Université Paris Cité, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, INSERM, Paris, France
- UFR of Odontology, Université Paris Cité, Paris, France
- Service of Odontology, Rothschild Hospital (AP-HP) and Department of Periodontology, UFR of Odontology, Université Paris Cité, Paris, France
- INSERM-Sorbonne Paris Cité Epidemiology and Statistics Research Centre, Paris, France
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2
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Son JY, Kim EJ. Interdental cleaning and periodontal status among older Koreans: Findings from KNHANES VII. Gerodontology 2024; 41:295-304. [PMID: 37927103 DOI: 10.1111/ger.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea. BACKGROUND In order to maintain oral health in older people, it is very important to use interdental cleaning devices. However, there is a lack of research on periodontal status and interdental cleaning device use in older people. METHODS This study used data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018). A total of 3426 older people adults aged 65 years or older were selected from 16 489 participants. Data on sociodemographic status (sex, age, level of education, income, residential area), personal health practice (subjective health status, smoking, physical activity, hypertension, and diabetes mellitus), oral health practice (subjective oral health status, tooth brushing frequency, dental visits, and chewing problem), the number of teeth and periodontitis were collected. Periodontitis was defined as having a World Health Organisation community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as a CPI code 4. Participants having a CPI code of 3 or 4 were considered to have periodontal disease in this study. Logistic regression analysis investigated the association between interdental cleaning devices usage and periodontitis controlling the confounding factors. RESULTS Those who do not use dental floss had a higher rate of periodontal disease (AOR = 1.47, 95% confidence interval [CI]: 1.05 to 2.1). However, there were no significant differences by interdental brush use. In those with 20 or more teeth, non-users of dental floss had a higher risk of periodontitis in all models. Conversely, in those with fewer than 20 teeth, no significant differences were observed. CONCLUSIONS Older people with mostly intact dentitions have better periodontal health if they clean between their teeth.
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Affiliation(s)
- Ji-Young Son
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Eun-Jeong Kim
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
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Herrera D, Chapple I, Jepsen S, Berglundh T, Tonetti MS, Kebschull M, Sculean A, Papapanou PN, Sanz M. Consensus report of the second European Consensus Workshop on Education in Periodontology. J Clin Periodontol 2024. [PMID: 38710626 DOI: 10.1111/jcpe.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/21/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND The second European Consensus Workshop on Education in Periodontology was commissioned, as a result of the changes in the discipline and the advances in educational methods/technology, to update the 2009 Consensus report of the first European Federation of Periodontology (EFP) Workshop on the same topic that was jointly authored by the Association for Dental Education in Europe. AIM To identify and propose changes necessary in periodontal education at three levels, namely undergraduate, specialist and continuing professional development (CPD), with respect to learning outcomes, competencies and methods of learning/training and evaluation. METHODS Four working groups (WGs) considered education in periodontology at the undergraduate, specialist and CPD levels, and education methods. Four commissioned position papers, one per WG, summarized the relevant information. Workshop participants gathered at an in-person consensus meeting to discuss the individual reviews, and this consensus report summarizes the conclusions. RESULTS The learning outcomes for undergraduate and specialist education in periodontology have been updated, and a proposal for learning outcomes for CPD programmes was made. Learning/teaching/training and evaluation methods were proposed for each level of education, which included face-to-face, virtual and blended learning methods. CONCLUSION Developments in oral/dental medicine and in contemporary educational technologies have been translated into updated learning outcomes and learning/teaching/ training/evaluation methods relevant to education in periodontology.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Centre for Oral Diseases, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
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4
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Noureldin A, Alshehri W, Tapias H, Mallonee L, Mancl LM, Milgrom P, Svboda K. Efficacy of 38% silver diamine fluoride in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes: A randomized controlled pilot trial. J Dent 2024; 143:104890. [PMID: 38387597 DOI: 10.1016/j.jdent.2024.104890] [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: 01/25/2024] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES Emerging from earlier case reports the potential benefits of 38 % silver diamine fluoride (SDF) in addressing pathogenic biofilms and mitigating gingival inflammation and enlargement have sparked interest. Our study aimed to evaluate the efficacy of 38 % SDF in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. METHODS This 7-week randomized, controlled, double-blinded pilot trial employed a parallel assignment design. The study enrolled older adults (aged ≥65) residing in retirement homes in Dallas County, ultimately comprising a cohort of 40 participants who were evenly divided into two arms. The experimental group received SDF treatment, whereas the comparator group received a placebo. Over three consecutive weeks, both groups had solutions applied to the facial surfaces of all their teeth once per week. The primary outcomes measured the change in Löe-Silness Gingival Index (GI) and Silness-Löe Plaque Index (PI) at 7 weeks following baseline treatment. Repeated measures ANOVA was utilized to assess changes over time within each group (n = 15 each). Post-hoc paired t-tests were conducted to compare changes between week 1 and each subsequent follow-up time point (weeks 3, 5, 7), supplemented with 95 % confidence intervals for change from week 1. RESULTS In the SDF group, within-group comparisons demonstrated significant reductions (adjusted p < .05) in GI scores within 3 weeks (-.93±.37), as opposed to week 1 (1.90±.39). Between-group comparisons unveiled reductions in both mean GI (p < .05) and PI (p < .05), indicating less gingival inflammation and plaque accumulation in the SDF group at all time points, commencing at week 3. CONCLUSIONS This study showed that 38 % SDF was effective in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. CLINICAL SIGNIFICANCE Oral health in older adults is a public health concern, especially for the medically compromised or those without traditional care. Our findings offer hope for enhancing oral health quality of life by introducing a cost-effective, compliance-free, noninvasive, and accessible therapeutic. TRIAL REGISTRATION NCT03445286.(clinicaltrials.gov).
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Affiliation(s)
- Amal Noureldin
- Department of Department Public Health Sciences, Texas A&M University, School of Dentistry, United States
| | - Wedad Alshehri
- Department of Dental Health, College of Applied Medical Science, King Saud University, United States
| | - Helena Tapias
- Department of Comprehensive Dentistry, Texas A&M University, School of Dentistry, United States
| | - Lisa Mallonee
- School of Dental Hygiene, Texas A&M University, School of Dentistry, United States
| | - Lloyd M Mancl
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, United States
| | - Peter Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, United States.
| | - Kathy Svboda
- Department of Biomedical Sciences, School of Dentistry, Texas A&M University, United States
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5
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da Silva SMSD, Ferreira CL, Rizzato JMB, Toledo GDS, Furukawa M, Rovai ES, Nogueira MS, Carvalho LFDCESD. Infrared spectroscopy for fast screening of diabetes and periodontitis. Photodiagnosis Photodyn Ther 2024; 46:104106. [PMID: 38677501 DOI: 10.1016/j.pdpdt.2024.104106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/12/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
SIGNIFICANCE FT-IR is an important and emerging tool, providing information related to the biochemical composition of biofluids. It is important to demonstrate that there is an efficacy in separating healthy and diseased groups, helping to establish FT-IR uses as fast screening tool. AIM Via saliva diagnosis evaluate the accuracy of FT-IR associate with machine learning model for classification among healthy (control group), diabetic (D) and periodontitis (P) patients and the association of both diseases (DP). APPROACH Eighty patients diagnosed with diabetes and periodontitis through conventional methods were recruited and allocated in one of the four groups. Saliva samples were collected from participants of each group (n = 20) and were processed using Bruker Alpha II spectrometer in a FT-IR spectral fingerprint region between 600 and-1800 cm-1, followed by data preprocessing and analysis using machine learning tools. RESULTS Various FTI-R peaks were detectable and attributed to specific vibrational modes, which were classified based on confusion matrices showed in paired groups. The highest true positive rates (TPR) appeared between groups C vs D (93.5 % ± 2.7 %), groups C vs. DP (89.2 % ± 4.1 %), and groups D and P (90.4 % ± 3.2 %). However, P vs DP presented higher TPR for DP (84.1 % ±3.1 %) while D vs. DP the highest rate for DP was 81.7 % ± 4.3 %. Analyzing all groups together, the TPR decreased. CONCLUSION The system used is portable and robust and can be widely used in clinical environments and hospitals as a new diagnostic technique. Studies in our groups are being conducted to solidify and expand data analysis methods with friendly language for healthcare professionals. It was possible to classify healthy patients in a range of 78-93 % of accuracy. Range over 80 % of accuracy between periodontitis and diabetes were observed. A general classification model with lower TPR instead of a pairwise classification would only have advantages in scenarios where no prior patient information is available regarding diabetes and periodontitis status.
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Affiliation(s)
| | | | | | | | - Monique Furukawa
- Science Health Post-graduate Program, University of Taubaté - UNITAU, SP, Brazil
| | - Emanuel Silva Rovai
- Department of Diagnosis and Surgery, Institute of Science and Technology of São José dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil
| | - Marcelo Saito Nogueira
- Tyndall National Institute, University College Cork, Cork, Ireland; Department of Physics, University College Cork, Cork, Ireland.
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Landi L, Oteri G, Barbato L, Discepoli N, Carrassi AM, Rigoni M, Cairo F, Cavalcanti R, Crea A, Gianserra R, Sforza NM. Anti-resorptive therapy and MRONJ. A survey of the Italian Society of Periodontology and Implantology. Oral Dis 2024. [PMID: 38424699 DOI: 10.1111/odi.14907] [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: 11/06/2023] [Revised: 01/14/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Anti-resorptive agents have been linked to the development of MRONJ in patients undergoing dental surgical procedures. This survey aims to explore the level of knowledge and experience of Italian Society of Periodontology and Implantology members in the management of patients treated with anti-resorptive agents and with the risk of developing MRONJ. MATERIALS AND METHODS An 18-item questionnaire was submitted by e-mail to the SIdP members. Statistical analyses were carried out. Continuous variables were described as mean ± standard deviation (SD) or median, and first and third quartile according to distribution's normality. Normality of data was checked with Shapiro-Wilk test. RESULTS Four hundred and fifty-one questionnaires were returned by e-mail (32%). Most of the respondents were private practitioners (81.8%). Only 47.7% declared to be highly confident in managing patients on anti-resorptive therapy while 92.5% reported to have performed tooth extractions and 52.3% implant surgery in patients under anti-resorptive therapy for osteometabolic disorders. One or more MRONJ-affected patients were encountered by 63.2% of the respondents. CONCLUSIONS This survey highlights the need to develop a "dedicated" program both for dentists and prescribers to improve the level of cooperation and to increase the level of awareness of patients treated with anti-resorptive agents.
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Affiliation(s)
- L Landi
- Private Practice, Verona and Roma, Italy
| | - G Oteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - L Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - N Discepoli
- Department of Medical Biotechnologies, Unit of Periodontology, University of Siena, Siena, Italy
| | - A M Carrassi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - M Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - F Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - R Cavalcanti
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Bari, Italy
- Private Practice, Bari, Italy
| | - A Crea
- Private Practice, Viterbo, Italy
| | - R Gianserra
- Private Practice, Campobasso and Roma, Italy
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7
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Nazário RMF, Frazão DR, Peinado BRR, Ferreira MKM, Ferreira RDO, Magno MB, Fagundes NCF, Vidigal MTC, Paranhos LR, Maia LC, Lima RR. Is there an association between periodontal disease and root caries? A systematic review and meta-analysis. PLoS One 2023; 18:e0285955. [PMID: 37972211 PMCID: PMC10653397 DOI: 10.1371/journal.pone.0285955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/04/2023] [Indexed: 11/19/2023] Open
Abstract
Some periodontal diseases can be associated with cariogenic bacterial growth due to various oral health imbalances. This fact may be linked to a greater development of root caries. Thus, this systematic review analyzed the evidence on the association between periodontal disease and root caries. An electronic search was performed in five databases (Cochrane Library, LILACS, MedLine via PubMed, Scopus, and Web of Science) and two additional sources (Google Scholar and Open Grey) to partially capture the grey literature. The PECO strategy was used to identify prospective or retrospective observational studies assessing root caries in patients with periodontal disease without language or year publication restrictions. Two reviewers extracted data and evaluated the individual risk of bias in the eligible studies. Random effects meta-analyses were performed to calculate the Odds Ratio (OR). The risk of bias was assessed by the NIH tool, and the certainty of evidence was classified according to the GRADE tool. There were 1,725 studies retrieved, of which four met the eligibility criteria. All of them were evaluated for the control statements for possible confounders, bias consideration, and confounding factors because they had multivariate analysis. Adults with periodontal disease had a greater chance of presenting root caries than adults without, with OR 1.38 [CI 1.25, 1.53]. The certainty of evidence was classified as very low. Within the limits presented in this review, there was an association between periodontal disease and root caries, highlighted in the qualitative synthesis and the meta-analysis results.
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Affiliation(s)
- Rayssa Maitê Farias Nazário
- Functional and Structural Biology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Deborah Ribeiro Frazão
- Functional and Structural Biology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | | | - Railson de Oliveira Ferreira
- Functional and Structural Biology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Maria Tereza Campos Vidigal
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Luiz Renato Paranhos
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Functional and Structural Biology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Baima G, Ribaldone DG, Romano F, Aimetti M, Romandini M. The Gum-Gut Axis: Periodontitis and the Risk of Gastrointestinal Cancers. Cancers (Basel) 2023; 15:4594. [PMID: 37760563 PMCID: PMC10526746 DOI: 10.3390/cancers15184594] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/01/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Periodontitis has been linked to an increased risk of various chronic non-communicable diseases, including gastrointestinal cancers. Indeed, dysbiosis of the oral microbiome and immune-inflammatory pathways related to periodontitis may impact the pathophysiology of the gastrointestinal tract and its accessory organs through the so-called "gum-gut axis". In addition to the hematogenous spread of periodontal pathogens and inflammatory cytokines, recent research suggests that oral pathobionts may translocate to the gastrointestinal tract through saliva, possibly impacting neoplastic processes in the gastrointestinal, liver, and pancreatic systems. The exact mechanisms by which oral pathogens contribute to the development of digestive tract cancers are not fully understood but may involve dysbiosis of the gut microbiome, chronic inflammation, and immune modulation/evasion, mainly through the interaction with T-helper and monocytic cells. Specifically, keystone periodontal pathogens, including Porphyromonas gingivalis and Fusobacterium nucleatum, are known to interact with the molecular hallmarks of gastrointestinal cancers, inducing genomic mutations, and promote a permissive immune microenvironment by impairing anti-tumor checkpoints. The evidence gathered here suggests a possible role of periodontitis and oral dysbiosis in the carcinogenesis of the enteral tract. The "gum-gut axis" may therefore represent a promising target for the development of strategies for the prevention and treatment of gastrointestinal cancers.
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Affiliation(s)
- Giacomo Baima
- Department of Surgical Sciences, University of Turin, 10125 Torino, Italy; (G.B.); (F.R.); (M.A.)
| | | | - Federica Romano
- Department of Surgical Sciences, University of Turin, 10125 Torino, Italy; (G.B.); (F.R.); (M.A.)
| | - Mario Aimetti
- Department of Surgical Sciences, University of Turin, 10125 Torino, Italy; (G.B.); (F.R.); (M.A.)
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, 0313 Oslo, Norway
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9
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Landi L, Leali PT, Barbato L, Carrassi AM, Discepoli N, Muti PCM, Oteri G, Rigoni M, Romanini E, Ruggiero C, Tarantino U, Varoni E, Sforza NM, Brandi ML. Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP). J Orthop Traumatol 2023; 24:36. [PMID: 37453950 DOI: 10.1186/s10195-023-00713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023] Open
Abstract
This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior.
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Affiliation(s)
- L Landi
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy.
- Private Practice Verona and Roma, Verona, Italy.
| | - P Tranquilli Leali
- SIOT Panel, Rome, Italy
- Department of Orthopedic Diseases, University of Sassari, Sassari, Italy
| | - L Barbato
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - A M Carrassi
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - N Discepoli
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Medical Biotechnologies, Unit of Periodontology, University of Siena, Siena, Italy
| | - P C M Muti
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Oteri
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - M Rigoni
- SIOT Panel, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - E Romanini
- SIOT Panel, Rome, Italy
- RomaPro, Polo Sanitario San Feliciano, Rome, Italy
| | - C Ruggiero
- SIOT Panel, Rome, Italy
- Department of Medicine and Surgery, Gerontology and Geriatric Section, University of Perugia, Perugia, Italy
| | - U Tarantino
- SIOT Panel, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Rome, Italy
| | - E Varoni
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - N M Sforza
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Private Practice Bologna, Bologna, Italy
| | - M L Brandi
- SIOT Panel, Rome, Italy.
- Osservatorio Fratture da Fragilità, Via San Gallo 123, 50100, Florence, Italy.
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10
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Baima G, Muwalla M, Testa G, Mazza F, Bebars A, Perotto S, Vernero M, Massano A, Romano F, Ribaldone DG, Aimetti M. Periodontitis prevalence and severity in inflammatory bowel disease: A case-control study. J Periodontol 2023; 94:313-322. [PMID: 36111636 DOI: 10.1002/jper.22-0322] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recent evidence is supporting the notion of a microbiological and immunological continuum on the gum-gut axis in health and disease. Therefore, the purpose of this study was to assess the prevalence and risk indicators of periodontitis in patients with Crohn's disease (CD) or ulcerative colitis (UC) compared to age- and sex-matched controls without inflammatory bowel disease (IBD). METHODS A total of 180 IBD (117 CD, 60 UC, 3 IBD-unclassified) and 180 healthy controls were compared for their periodontitis diagnosis (Centers for Disease Control and Prevention/American Academy of Periodontology [CDC/AAP] case definition) and full-mouth periodontal parameters. In addition, explorative logistic regression models were performed. RESULTS Significantly more patients with IBD had moderate/severe periodontitis (85.6% vs. 65.6%, p < 0.001) and severe periodontitis (36.7% vs. 25.6%, p < 0.001) than controls. Differences were higher in the 35-50 and 51-65 age groups, without significant changes between CD and UC. IBD subjects presented chances ∼3.5 higher of having moderate/severe periodontitis (p < 0.001). Significant variables associated with periodontitis in the whole sample were older age, presence of IBD, and higher full-mouth plaque scores, whereas in the IBD group they were male sex, IBD-associated surgery, and IBD duration and localization (pancolitis). Positive risk indicators for IBD were periodontitis severity and higher bleeding scores, while smoking was negatively associated with UC. CONCLUSIONS Relevant associations between IBD and periodontitis were found, being modified by CD and UC clinical characteristics. Preventive and therapeutic strategies involving the gum-gut axis should be enforced in IBD patients.
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Affiliation(s)
- Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
- Politecnico di Torino, Turin, Italy
| | - Mamdouh Muwalla
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giulia Testa
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Mazza
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Ahmad Bebars
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Stefano Perotto
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Marta Vernero
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | | | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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11
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Del Pinto R, Landi L, Grassi G, Marco Sforza N, Cairo F, Citterio F, Paolantoni G, D'aiuto F, Ferri C, Monaco A, Pietropaoli D. Hypertension and periodontitis: A joint report by the Italian society of hypertension (SIIA) and the Italian society of periodontology and implantology (SIdP). Oral Dis 2023; 29:803-814. [PMID: 34561934 DOI: 10.1111/odi.14009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023]
Abstract
An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low-grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy-Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low-grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre-hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health.
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Affiliation(s)
- Rita Del Pinto
- Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | | | - Guido Grassi
- Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | | | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | | | - Francesco D'aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Claudio Ferri
- Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Annalisa Monaco
- Unit of Oral Diseases, Prevention and Translational Research, Department of Life, Health and Environmental Sciences, Dental Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Davide Pietropaoli
- Unit of Oral Diseases, Prevention and Translational Research, Department of Life, Health and Environmental Sciences, Dental Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
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12
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Antonoglou GN, Romandini M, Meurman JH, Surakka M, Janket SJ, Sanz M. Periodontitis and edentulism as risk indicators for mortality: Results from a prospective cohort study with 20 years of follow-up. J Periodontal Res 2023; 58:12-21. [PMID: 36282792 PMCID: PMC10092146 DOI: 10.1111/jre.13061] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 01/19/2023]
Abstract
AIM To investigate the association between periodontitis and edentulism with cardiovascular disease (CVD) and all-cause mortality. METHODS Baseline data of 506 subjects including 256 angiographically verified coronary artery disease patients and 250 matched participants in cardiovascular health from the Kuopio Oral Health and Heart study were collected from 1995-1996. Mortality data were accrued until May 31, 2015, and related to baseline periodontal health and edentulism, assessed as exposure and collected by means of clinical and radiographic examination by a single examiner. Cox proportional hazards regression models were fit using covariates such as age, gender, smoking, BMI, and education. The final sample size for the periodontitis models ranged from 358 to 376, while the edentate models included 413 to 503 subjects for CVD and all-cause mortality, respectively with no missing values in the predictor, confounders, and outcome. RESULTS The strongest association was found between edentulism and CVD and all-cause mortality (HR: 1.9 CVD , HR: 1.6all-cause ; p < .01). CONCLUSIONS Edentulism considered as a poor oral health marker was associated strongly with CVD mortality while periodontitis was not.
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Affiliation(s)
- Georgios N Antonoglou
- ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Mario Romandini
- ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Surakka
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sok-Ja Janket
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Center for Clinical and Translational Research, The Forsyth Institute, Massachusetts, Cambridge, USA
| | - Mariano Sanz
- ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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13
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Guerreiro E, Botelho J, Machado V, Proença L, Mendes JJ, Manso AC. Caries Experience and Risk Indicators in a Portuguese Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2511. [PMID: 36767876 PMCID: PMC9915840 DOI: 10.3390/ijerph20032511] [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: 01/13/2023] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Oral health surveys are essential for assessing the dental caries experience and to influence national policies. This retrospective cross-sectional study aims to analyze dental caries experience for which dental treatment was sought in a reference university dental hospital at the Lisbon Metropolitan Area between January 2016 and March 2020. Full-mouth examination, and sociodemographic, behavior, and medical information were included. Descriptive analyses and logistic regression analysis were applied to ascertain risk indicators associated with dental caries experience. A final sample of 9349 participants (5592 females/3757 males) were included, aged 18 to 99 years old. In this population, caries experience was 91.1%, higher in female participants. Age (OR = 1.01, 95% CI [1.00-1.02], occupation (OR = 2.94, 95% CI [2.37-3.65], OR = 3.35, 95% CI [2.40-4.67], OR = 2.55, 95% CI [1.66-3.91], for employed, unemployed, and retired, respectively), overweight (OR = 1.52, 95% CI [1.18-1.96]), reporting to have never visited a dentist (OR = 0.38, 95% CI [0.23-0.64], and self-reported week teeth status (OR = 2.14, 95% CI [1.40-3.28]) were identified as risk indicators for the presence of dental caries, according to adjusted multivariable logistic analyses. These results highlight a substantial rate of dental experience in a Portuguese cohort and will pave the way for future tailored oral public health programs in Portugal.
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Affiliation(s)
- Eduardo Guerreiro
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
- Evidenced-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
- Evidenced-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
| | - Luís Proença
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
- Evidenced-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
- Evidenced-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
| | - Ana Cristina Manso
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz—School of Health and Science, 2829-511 Almada, Portugal
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14
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Del Pinto R, Pietropaoli D, Grassi G, Muiesan ML, Monaco A, Cossolo M, Procaccini A, Ferri C. Home oral hygiene is associated with blood pressure profiles: Results of a nationwide survey in Italian pharmacies. J Clin Periodontol 2022; 49:1234-1243. [PMID: 36089901 PMCID: PMC9826426 DOI: 10.1111/jcpe.13720] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/17/2022] [Accepted: 08/28/2022] [Indexed: 01/11/2023]
Abstract
AIM Periodontal diseases are associated with cardiovascular risk factors/diseases, and whether home oral hygiene practices are inversely related to the same conditions could carry relevant practical implications. We investigated the association of home oral hygiene habits with hypertension. MATERIALS AND METHODS During World Hypertension Day 2020, a nationwide cross-sectional survey was conducted on volunteers ≥18 years at 733 Italian pharmacies. Participants underwent standardized blood pressure (BP) measurement and answered a questionnaire on cardiovascular risk factors, oral health status, and home oral hygiene habits (toothbrushing daily frequency and manual/electric toothbrush). The association between home oral care habits and BP was assessed using multivariate logistic regression. Interactions between exposures and outcome were formally tested. RESULTS Among the 4506 participants (44.8% males, 66.1 ± 37.8 years), 47.6% reported brushing ≥3 times/day and 23.4% declared using the electric toothbrush. Brushing ≥3 versus <3 times/day and use of electric versus manual toothbrush were associated with 19% (odds ratio [OR]: 0.81, 95% confidence interval [CI] 0.70-0.94) and 28% (OR: 0.72, 95% CI 0.61-0.85) lower odds of hypertension, respectively. No significant additive interaction was observed in the association of exposures with the outcome. CONCLUSIONS Regular daily brushing and electric toothbrushing are associated with a better BP profile in a real-world context. Future interdisciplinary research is warranted to test these findings.
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Affiliation(s)
- Rita Del Pinto
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
- Dept. of Medicine | Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Young Investigators Group of the Italian Society of Hypertension, Milan, Italy
| | - Davide Pietropaoli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Dept. of Medicine | Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | - Guido Grassi
- Clinica Medica, University of Milano Bicocca, Milan, Italy
- The Italian Society of Hypertension, Milan, Italy
| | - Maria Lorenza Muiesan
- The Italian Society of Hypertension, Milan, Italy
- Internal Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Annalisa Monaco
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | | | | | - Claudio Ferri
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- The Italian Society of Hypertension, Milan, Italy
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15
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Effect of vitamin D receptor gene polymorphisms on the risk of chronic and aggressive periodontitis: A systematic review and meta-analysis of the Chinese population. Arch Oral Biol 2022; 144:105566. [DOI: 10.1016/j.archoralbio.2022.105566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022]
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16
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Antunes A, Botelho J, Mendes JJ, Delgado AS, Machado V, Proença L. Geographical Distribution of Periodontitis Risk and Prevalence in Portugal Using Multivariable Data Mining and Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13634. [PMID: 36294214 PMCID: PMC9602853 DOI: 10.3390/ijerph192013634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
We aimed to estimate the geographical distribution of periodontitis prevalence and risk based on sociodemographic and economic data. This study used sociodemographic, economic, and health services data obtained from a regional survey and governmental open data sources. Information was gathered for all 308 Portuguese municipalities and compiled in a large set of 52 variables. We employed principal component analysis (PCA), factor analysis (FA) and clustering techniques to model the Portuguese nationwide geographical distribution of the disease. Estimation of periodontitis risk for each municipality was achieved by calculation of a normalized score, obtained as an adjusted linear combination of six independent factors that were extracted through PCA/FA. The municipalities were also classified according to a quartile-based risk grade in each cluster. Additionally, linear regression was used to estimate the periodontitis prevalence within the peri-urban municipality clusters, accounting for 30.5% of the Portuguese population. A total of nine municipality clusters were obtained with the following characteristics: mainly rural/low populated, including small villages (one), partly rural, including small cities (two), mainly urban/peri-urban, including medium-sized to large cities (4), and urban/large cities (2). Within the clusters, a higher periodontitis risk was identified for municipalities with lower income, older populations. The estimated periodontitis prevalence for the 18 municipalities included in the four peri-urban clusters ranged from 41.2% to 69.0%. Periodontitis prevalence estimates range from 41.2% to 69.0% for the municipalities characterized as peri-urban and mainly urban, most of them located in the Lisbon Metropolitan Area, the tenth largest in Europe.
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Affiliation(s)
- Ana Antunes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - Ana Sintra Delgado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
| | - Luís Proença
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, Caparica, 2829-511 Almada, Portugal
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17
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Oral Health in Breast Cancer Women with Vitamin D Deficiency: A Machine Learning Study. J Clin Med 2022; 11:jcm11164662. [PMID: 36012901 PMCID: PMC9410090 DOI: 10.3390/jcm11164662] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022] Open
Abstract
Breast cancer (BC) survivors treated with aromatase inhibitors (AIs) commonly show several pathological issues, including poor oral health, bone health impairment, and vitamin D deficiency. However, to date, oral health issues in BC survivors treated with AIs have been poorly investigated and their relationship with vitamin D deficiency are far from being understood. This study aimed to evaluate the correlation between oral health and vitamin D status in BC survivors undergoing treatment with AIs through a machine learning approach. In this cross-sectional study, we included post-menopausal BC women with vitamin D deficiency undergoing AIs therapy. The outcome measures were the following: oral health indexes as the Decayed, Missing, and Filled Permanent Teeth Index (DMFT); serum levels of 25(OH)D3; Bone Mineral Density (BMD); and the diagnosis of osteoporosis. We included 41 post-menopausal BC women, mean aged 66.10 ± 8.47 years, with mean serum levels of vitamin D of 14.63 ± 6.62 ng/mL. Furthermore, 56.10% of patients had a diagnosis of osteoporosis and 36.59% were osteopenic. DMFT was significantly related to smoking (p-value = 0.005) and dental floss use (p-value = 0.001). There was a significant correlation between DMFT and vitamin D levels (Pearson’s r: −0.73; p-value = 0.001). The regression machine learning model showed that vitamin D status and the use of dental floss were the most relevant variables in terms of correlation with DMFT. In conclusion, vitamin D deficiency, inadequate use of dental floss, and smoking had a negative impact on oral health in BC women. Thus, vitamin D deficiency screening and supplementation and a prompt oral rehabilitation plan should be suggested and implemented in the complex treatment framework of BC survivors undergoing treatment with AIs.
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18
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Romano F, Perotto S, Baima G, Macrì G, Picollo F, Romandini M, Mariani GM, Aimetti M. Estimates and multivariable risk assessment of mid-buccal gingival recessions in an Italian adult population according to the 2018 World Workshop Classification System. Clin Oral Investig 2022; 26:4769-4780. [PMID: 35301598 PMCID: PMC9276566 DOI: 10.1007/s00784-022-04441-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/04/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this cross-sectional study was to provide estimate of mid-buccal gingival recession (GR) according to the 2018 World Workshop Classification System and to explore GR risk indicators in a representative urban population in North-West of Italy. MATERIAL AND METHODS This is a secondary analysis using data collected in an epidemiological study enrolling a representative sample of 736 adults, living in Turin. GR prevalence was defined as the presence of at least one mid-buccal GR ≥ 1 mm. GRs were categorized according to the 2018 classification system (RT1, RT2, RT3) and to different severity cutoffs. Logistic regression analysis was performed to identify RT GR risk indicators. RESULTS Mid-buccal GR ≥ 1 mm affected 57.20% of subjects and 14.56% of teeth. When considering RT1 GRs, their prevalence was 40.90% and 6.29% at the patient and tooth level. RT2 and RT3 GRs affected 25.82% and 36.68% of the study population, respectively. RT1 GRs occurred mostly on maxillary and mandibular premolars and maxillary canines, while RT2 and RT3 GRs on maxillary molars and mandibular incisors. Older age, high education, and full-mouth plaque score (FMPS) < 30% were risk indicators for RT1 GRs, while older age, poor education, periodontitis, and FMPS > 60% were significant contributors to RT2 and RT3 GRs. CONCLUSIONS RT1 and RT3 are fairly common findings in this Italian population and are significantly associated to different contributing factors and tooth type distribution pattern. CLINICAL RELEVANCE Prevention strategies should target different socio-demographic, behavioral, and clinical risk indicators based on the RT classes.
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Affiliation(s)
- Federica Romano
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy.
| | - Stefano Perotto
- Postgraduate Program in Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giacomo Baima
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Gianfranco Macrì
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Fabrizio Picollo
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Giulia Maria Mariani
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Mario Aimetti
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
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19
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Relvas M, López-Jarana P, Monteiro L, Pacheco JJ, Braga AC, Salazar F. Study of Prevalence, Severity and Risk Factors of Periodontal Disease in a Portuguese Population. J Clin Med 2022; 11:3728. [PMID: 35807013 PMCID: PMC9267442 DOI: 10.3390/jcm11133728] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/17/2022] [Accepted: 06/25/2022] [Indexed: 02/07/2023] Open
Abstract
Periodontal disease is a common worldwide oral inflammation/infection affecting tissues that surround and support teeth. This study aims to evaluate the prevalence, extent and severity of periodontal diseases and its risk factors, according to the most recent periodontal classification, in an adult population of Northern Portugal. This observational study collected data from clinical records of patients who attended the University Clinic of Gandra between April 2021 and April 2022. Of a total of 941 patients included, 457 (48.6%) had periodontitis, 253 (26.9%) had gingivitis and the remaining 231 (24.5%) were healthy patients. The prevalence of stage III severe periodontitis was 51.2%, more prevalent in males, and in the age group of 61-70 years. Gingivitis was more prevalent in females, and in the age group of 31-40 years; in both diseases, the most prevalent extension was the generalized one. Using a binary logistic regression, we observe a significant relation of the risk of periodontitis with age (p = 0.019; OR 1.033; 95% CI 1.005-1.062), tooth brushing (p = 0.002; OR 0.25; 95% CI 0.105-0.599) and dental flossing (p = 0.015; OR 0.63; 95% CI 0.09-0.768). This study revealed a high prevalence of periodontitis. Increased age, lack of tooth brushing and flossing were identified as potential risk factors for periodontitis in the investigated Portuguese population.
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Affiliation(s)
- Marta Relvas
- Medicine and Oral Surgery Service, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (M.R.); (P.L.-J.); (J.J.P.); (F.S.)
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), IUCS, CESPU, 4585-116 Gandra, Portugal
| | - Paula López-Jarana
- Medicine and Oral Surgery Service, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (M.R.); (P.L.-J.); (J.J.P.); (F.S.)
| | - Luis Monteiro
- Medicine and Oral Surgery Service, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (M.R.); (P.L.-J.); (J.J.P.); (F.S.)
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), IUCS, CESPU, 4585-116 Gandra, Portugal
| | - José Júlio Pacheco
- Medicine and Oral Surgery Service, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (M.R.); (P.L.-J.); (J.J.P.); (F.S.)
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), IUCS, CESPU, 4585-116 Gandra, Portugal
| | - Ana Cristina Braga
- Algoritmi Centre, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal;
| | - Filomena Salazar
- Medicine and Oral Surgery Service, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (M.R.); (P.L.-J.); (J.J.P.); (F.S.)
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), IUCS, CESPU, 4585-116 Gandra, Portugal
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20
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The Dental-BIOfilm Detection TECHnique (D-BioTECH): A Proof of Concept of a Patient-Based Oral Hygiene. Medicina (B Aires) 2022; 58:medicina58040537. [PMID: 35454375 PMCID: PMC9030559 DOI: 10.3390/medicina58040537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 12/13/2022] Open
Abstract
To date, no strong long-term data have been reported about new innovative clinical protocols to manage oral hygiene. An improper management of oral hygiene may lead to an increase in dental implant failure, and to an increase in infective complications in prosthetic rehabilitation. Personalized techniques are strongly required in dentistry and dental hygiene. A customized and personalized approach to oral hygiene is crucial in ensuring not only effective treatment, but also a careful analysis of the general health status of the patient involved in the therapeutic process. D-BioTECH is an acronym for Dental BIOfilm Detection Technique: it is based on a tailored approach to patients, ensuring that the operator actively interacts with the patient and their specific needs, especially during the domiciliary therapy. D-BioTECH is an approach to preventive care: in D-BioTECH, both dental hygienists and dentists play a central role. The use of a personalized approach to oral hygiene is the first step towards increasing implant and prosthesis survival rate; moreover, personalized medicine is strategic for managing and preventing the biological complications associated with several dental risk factors.
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21
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Jia X, Yang R, Li J, Zhao L, Zhou X, Xu X. Gut-Bone Axis: A Non-Negligible Contributor to Periodontitis. Front Cell Infect Microbiol 2021; 11:752708. [PMID: 34869062 PMCID: PMC8637199 DOI: 10.3389/fcimb.2021.752708] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/26/2021] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is a polymicrobial infectious disease characterized by alveolar bone loss. Systemic diseases or local infections, such as diabetes, postmenopausal osteoporosis, obesity, and inflammatory bowel disease, promote the development and progression of periodontitis. Accumulating evidences have revealed the pivotal effects of gut microbiota on bone health via gut-alveolar-bone axis. Gut pathogens or metabolites may translocate to distant alveolar bone via circulation and regulate bone homeostasis. In addition, gut pathogens can induce aberrant gut immune responses and subsequent homing of immunocytes to distant organs, contributing to pathological bone loss. Gut microbial translocation also enhances systemic inflammation and induces trained myelopoiesis in the bone marrow, which potentially aggravates periodontitis. Furthermore, gut microbiota possibly affects bone health via regulating the production of hormone or hormone-like substances. In this review, we discussed the links between gut microbiota and periodontitis, with a particular focus on the underlying mechanisms of gut-bone axis by which systemic diseases or local infections contribute to the pathogenesis of periodontitis.
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Affiliation(s)
- Xiaoyue Jia
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ran Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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22
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Koffi-Coulibaly NT, Pockpa ZAD, Mobio GS. Prevalence and severity of periodontitis among adults in Côte d'Ivoire according to the new EFP/AAP periodontal disease classification. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2021; 13:76-83. [PMID: 35919678 PMCID: PMC9327475 DOI: 10.34172/japid.2021.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
Background To describe the prevalence and severity of periodontitis in patients attending the Periodontics Service of the Cocody University Hospital at Abidjan. Methods This retrospective observational study reviewed records of patients aged 20-80 years who attended the Periodontics Service between January 2014 and December 2018. Periodontitis was diagnosed, according to the 2018 EFP/AAP new classification of Periodontal and Peri-Implant Diseases and Conditions. Chi-square test, 1-factor Anova test, and logistic regression were performed for analysis. Results A total number of 596 patients were included. The mean age was 44.94 ± 14.34 years and 59.20% of were males. 2 (0.40%) patients were classified as Stage I, 221 (37.08%) as Stage II, and 373 (62.58%) as Stage III/V; the extent of periodontitis was generalized in 39.77% of patients. PD ≥ 6 mm, missing teeth ≥ 5 and mobile teeth were present in 47.15%, 26.35% and 25.50% of the sample, respectively.Severity of periodontitis were associated with age (p < 0.001), socio-economic status (p=0.001), diabetes (p < 0.001), missing teeth (p < 0.001) and smoking (p=0.009). Age (OR= 1.59, 95% CI: 1.11-2.26) and missing teeth (OR= 2.31, 95% CI: 1.08-4.89) were identified as independent risks indicators. Conclusion The prevalence and severity of periodontitis were high. Risks indicators identified may allow early detection and management of groups at high risk in Côte d'Ivoire.
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Affiliation(s)
| | | | - Gnaba Samson Mobio
- Department of Periodontology, Dental College, Felix Houphouet Boigny University, Cote d’Ivoire
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23
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Baima G, Iaderosa G, Corana M, Romano F, Citterio F, Giacomino A, Berta GN, Aimetti M. Macro and trace elements signature of periodontitis in saliva: A systematic review with quality assessment of ionomics studies. J Periodontal Res 2021; 57:30-40. [PMID: 34837226 PMCID: PMC9298699 DOI: 10.1111/jre.12956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/25/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022]
Abstract
Objectives The present systematic review examined the available evidence on distinctive salivary ion profile in periodontitis compared to periodontal health and provided a qualitative assessment of the literature. Background Macro and trace elements are essential for cellular physiology, and their changes in biological fluids can be revelatory of an underlying pathological status. Methods Data from relevant studies identified from PubMed, Embase, and Scopus databases were retrieved to answer the following PECO question: “In systemically healthy individuals, are there any differences in any salivary macro or trace element concentration between periodontally healthy subjects (H) and patients with periodontitis (P)?” Quality of included studies was rated using a modified version of the QUADOMICS tool. A consistency analysis was performed to identify significantly discriminant chemical elements. Results After the screening of 873 titles, 13 studies were included reporting data on 22 different elements. Among them, levels of sodium and potassium were consistently and significantly higher in P compared to H. Conflicting results were found for all the other elements, despite concentration of calcium, copper, and manganese mostly increased in saliva of P. Levels of magnesium were found higher in P than in H in 2 studies but lower in 3. Zinc resulted significantly increased in saliva from H compared to P individuals in 2 studies, but one study reported opposite results. Four studies were considered as high quality, while reporting of operative protocols and statistical analysis was a major limitation for the others. Due to high methodologic heterogeneity, meta‐analysis was not performed. Conclusions Levels of macro or trace elements were differentially identified in saliva across diverse periodontal conditions, having a major potential for investigation of oral homeostasis and for high‐resolution periodontal diagnosis. Products of inflammatory physiologic cellular impairment, such as sodium and potassium, were the most consistently associated with periodontitis (PROSPERO CRD42021235744).
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Affiliation(s)
- Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giovanni Iaderosa
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Matteo Corana
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Agnese Giacomino
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Giovanni N Berta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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24
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Hewlett SA, Anto F, Blankson PK, Tormeti D, Ayettey-Adamafio M, Bayitse P, Danso-Appiah T, Amoah AG. Periodontitis prevalence and severity in an African population: A cross-sectional study in the Greater Accra Region of Ghana. J Periodontol 2021; 93:732-744. [PMID: 34724216 DOI: 10.1002/jper.21-0329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent and associated risk factors of periodontitis in an adult Ghanaian population. METHODS A population based cross-sectional study involving adults aged 25 years and above in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on socio-demographic and risk factors was collected using a semi-structured questionnaire. A full mouth periodontal examination was carried out to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. RESULTS A total of 729 participants were included in the study, with a mean age of 43.9 ±14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (CAL) was 1.36 ±0.67mm and 1.41 ±0.57mm for probing pocket depth (PPD). Factors associated with periodontitis included, increasing age, smoking and alcohol use, being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance was associated with severe periodontitis. CONCLUSION This study shows a high burden of periodontitis with comparatively more severe disease. Existing socio-demographic disparities in disease burden highlights the need of developing targeted population based preventive programs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sandra Ama Hewlett
- Department of Restorative Dentistry, University of Ghana Dental School, Accra, Ghana
| | - Francis Anto
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health Accra, Ghana
| | - Paa Kwesi Blankson
- Department of Oral and Maxillofacial Surgery, University of Ghana Dental School, Accra, Ghana
| | - Daniel Tormeti
- Department of Community and Preventive Dentistry, University of Ghana Dental School, Accra, Ghana
| | - Mary Ayettey-Adamafio
- Department of Community and Preventive Dentistry, University of Ghana Dental School, Accra, Ghana
| | | | - Tony Danso-Appiah
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health Accra, Ghana
| | - Albert G Amoah
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
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25
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Baima G, Romandini M, Citterio F, Romano F, Aimetti M. Periodontitis and Accelerated Biological Aging: A Geroscience Approach. J Dent Res 2021; 101:125-132. [PMID: 34609209 DOI: 10.1177/00220345211037977] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As the whole world is epidemically aging, the burden of periodontitis and tooth loss is becoming a major health concern. Growing meta-epidemiological data implicate chronic systemic inflammation/infection due to periodontitis as an independent risk factor for aging-related diseases and mortality. However, because people age differently, chronological age is not a reliable marker of an individual's functional status. Recent advances in geroscience have shown that various biomarker signatures of biological aging are longitudinally associated with declined physical function, morbidity, and mortality due to major age-related diseases, including periodontitis. Here, we emphasize novel research developments bidirectionally linking periodontitis to accelerated biological aging. Using a composite biomarker age estimator, a striking increase in periodontitis and tooth loss was observed in subjects whose biological age at baseline was higher than their chronological age. Moreover, significantly shortened telomeres were encountered in populations affected by severe periodontitis. Second, we elucidate the cellular and molecular pillars of the aging process at the periodontal level. Accumulating evidence suggests that cellular senescence, stem cell exhaustion, and immunoaging are hallmarks of biological aging implicated in the impairment of periodontal homeostasis and the pathophysiology of periodontitis. Indeed, persistent bacteria-derived lipopolysaccharide stimulation influences cellular senescence in osteocytes, driving alveolar bone resorption. Moreover, inflammaging status induced by chronic hyperglycemia elevates the burden of senescent cells in gingival tissues, impairing their barrier function. Lastly, we reviewed a recent breakthrough in senotherapy to directly target the mechanisms of aging at the periodontal level. Physical exercise and intermittent fasting, together with natural compounds, senolytic drugs, and cell therapy, are increasingly being evaluated to rejuvenate the oral cavity. Following these innovations in geroscience, further advancements could provide oral clinicians the chance to intercept biological aging when still "subclinical" and set interventions for halting or delaying the trajectory toward aging-related diseases while patients are still chronologically young.
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Affiliation(s)
- G Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - M Romandini
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - F Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - F Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - M Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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26
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Del Pinto R, Landi L, Grassi G, Sforza NM, Cairo F, Citterio F, Paolantoni G, D'Aiuto F, Ferri C, Monaco A, Pietropaoli D. Hypertension and Periodontitis: A Joint Report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP). High Blood Press Cardiovasc Prev 2021; 28:427-438. [PMID: 34562228 PMCID: PMC8484186 DOI: 10.1007/s40292-021-00466-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023] Open
Abstract
An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low-grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy-Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low-grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre-hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health.
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Affiliation(s)
- Rita Del Pinto
- Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Luca Landi
- Private Practice, Via della Balduina, 114, 00136, Rome, Italy.
| | - Guido Grassi
- Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | | | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | | | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Claudio Ferri
- Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
| | - Annalisa Monaco
- Unit of Oral Diseases, Department of Life, Health and Environmental Sciences, Prevention and Translational Research, Dental Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Davide Pietropaoli
- Unit of Oral Diseases, Department of Life, Health and Environmental Sciences, Prevention and Translational Research, Dental Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
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27
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Brito LF, Taboza ZA, Silveira VR, Teixeira AK, Rego RO. Diagnostic accuracy of severe periodontitis case definitions: Comparison of the CDC/AAP, EFP/AAP, and CPI criteria. J Periodontol 2021; 93:867-876. [PMID: 34494266 DOI: 10.1002/jper.21-0365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/07/2021] [Accepted: 08/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND This cross-sectional study aimed to evaluate the diagnostic accuracy of severe periodontitis by three different case definitions. METHODS Patients aged >35 years (n = 243, mean age = 47.8 ± 9.3 years) were evaluated by periodontal examinations and classified in patients with severe periodontitis according to the case definition proposed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Academy of Periodontology (AAP)-CDC/AAP, the new periodontal disease classification proposed jointly by the AAP and the European Federation of Periodontology (EFP/AAP), and the Community Periodontal Index (CPI). The primary outcome was to compare the diagnostic accuracy of severe periodontitis between the three case definitions. Sensitivity (SS), specificity (SP), and area under the receiver operating characteristic (ROC) curve were used to analyze the accuracy. RESULTS The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 47.3%, type III and IV periodontitis (EFP/AAP) = 43.2% and CPI code 4 = 44.4%. When comparing the CDC/AAP case definitions with the EFP/AAP classification, SS, SP, and ROC of 81.7%, 91.4%, and 0.866 (CI, 95%: 0.816 to 0.916), respectively, were obtained. Similarly, when comparing CDC/AAP to CPI code 4, SS, SP, and ROC of 81.7%, 89.1%, and 0.854 (CI, 95%: 0.802 to 0.906), respectively, were obtained. When type III and IV periodontitis (EFP/AAP) was compared with CPI code 4, the values were 92.4%, 92%, and 0.922 (CI, 95%: 0.883 to 0.961), respectively. CONCLUSIONS The EFP/AAP classification and the CPI demonstrated high diagnostic accuracy with the CDC/AAP case definition to diagnose severe periodontitis.
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Affiliation(s)
- Liana F Brito
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Zuila A Taboza
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Virginia R Silveira
- Federal University of Ceara, School of Dentistry at Sobral, Department of Dentistry, Sobral, Ceara, Brazil
| | - Ana K Teixeira
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
| | - Rodrigo O Rego
- Federal University of Ceara Faculty of Pharmacy, Dentistry and Nursing, Department of Clinical Dentistry, Graduate Program in Dentistry, Fortaleza, Ceara, Brazil
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Adda G, Aimetti M, Citterio F, Consoli A, Di Bartolo P, Landi L, Lione L, Luzi L. Consensus report of the joint workshop of the Italian Society of Diabetology, Italian Society of Periodontology and Implantology, Italian Association of Clinical Diabetologists (SID-SIdP-AMD). Nutr Metab Cardiovasc Dis 2021; 31:2515-2525. [PMID: 34238654 DOI: 10.1016/j.numecd.2021.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 12/21/2022]
Abstract
Periodontitis has been defined as the Sixth complication of Diabetes Mellitus. Since both diabetes mellitus and periodontitis have a high prevalence in the general population, the Italian Society of Diabetology, the Italian Society of Periodontology and Implantology and the Italian Association of Clinical Diabetologists revised the present scientific literature in the present consensus report. A bi-directional interaction was demonstrated: Patients affected by type 1 and type 2 diabetes have a higher prevalence of periodontitis than the general population, due to several metabolic factors (e.g. chronic hyperglycemia, autoimmunity, dietary and life-style factors); similarly, periodontitis predisposes to type 2 diabetes mellitus mainly via the increase of systemic cytokines release. Conversely, improvement of metabolic control of diabetic patients delay the progression of periodontitis as well as periodontitis treatment reduces glycosylated hemoglobin levels in blood. Due to the bi-directional causal interaction between periodontitis and diabetes mellitus, a strict collaboration among dentists and diabetologists is required and strongly recommended. The inter-societies consensus proposes specific flow-diagrams to improve the treatment of patients and management of the general population regarding the issue of periodontitis and diabetes.
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Affiliation(s)
- Guido Adda
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, University of Turin, Italy
| | - Filippo Citterio
- Department of Medicine and Sciences of Aging, University of Chieti, Italy
| | - Agostino Consoli
- Department of Medicine and Sciences of Aging, University of Chieti, Italy
| | | | - Luca Landi
- President Italian Society of Periodontology and Implantology, Firenze, Italy
| | - Luca Lione
- Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
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29
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Bevilacqua L, Antonini V, Russi E, Severin A, Frattini C, Angerame D. The knowledge about periodontal health of northeastern Italian pharmacists: a cross-sectional survey. Minerva Dent Oral Sci 2021; 70:173-179. [PMID: 33908746 DOI: 10.23736/s2724-6329.21.04348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study is to determine the knowledge of periodontal health and prevention of periodontal diseases of a pool of pharmacists working in Friuli Venezia Giulia. METHODS A 22 questions questionnaire about oral health was sent by mail to all the pharmacies working in Friuli Venezia Giulia and to the most known associations of pharmacists. The data were collected and analysed by Google Forms software. RESULTS 164 questionnaires were analysed. 91% of the pharmacists assert to give advices about prevention and treatment of oral affection during professional practice but 97% never attended university courses about it. Only 21% took part in post graduate courses about oral health. Most of them have not enough notions about periodontal disease. CONCLUSIONS The findings from this study highlight that pharmacists have not enough knowledge about periodontal disease and its treatment but every day they provide advices about oral health. It would be appropriate a better organization of post-graduate courses about oral health and prevention of periodontal diseases.
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Affiliation(s)
- Lorenzo Bevilacqua
- Unit of Periodontology and Dental Hygiene, Departement of Medicine, Surgery and Health Sciences, School of Dental Sciences, University of Trieste, Trieste, Italy
| | | | - Erika Russi
- Unit of Periodontology and Dental Hygiene, Departement of Medicine, Surgery and Health Sciences, School of Dental Sciences, University of Trieste, Trieste, Italy
| | | | - Costanza Frattini
- Unit of Periodontology and Dental Hygiene, Departement of Medicine, Surgery and Health Sciences, School of Dental Sciences, University of Trieste, Trieste, Italy -
| | - Daniele Angerame
- Departement of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Romano F, Perotto S, Mohamed SEO, Bernardi S, Giraudi M, Caropreso P, Mengozzi G, Baima G, Citterio F, Berta GN, Durazzo M, Gruden G, Aimetti M. Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population. J Clin Med 2021; 10:jcm10081787. [PMID: 33924022 PMCID: PMC8073754 DOI: 10.3390/jcm10081787] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Stefano Perotto
- Postgraduate Program in Periodontology, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | - Sara Elamin Osman Mohamed
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Sara Bernardi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Paola Caropreso
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Giovanni Nicolao Berta
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
- Correspondence: (G.N.B.); (M.A.)
| | - Marilena Durazzo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Gabriella Gruden
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
- Correspondence: (G.N.B.); (M.A.)
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Biofabrication of Gingival Fibroblast Cell-Laden Collagen/Strontium-Doped Calcium Silicate 3D-Printed Bi-Layered Scaffold for Osteoporotic Periodontal Regeneration. Biomedicines 2021; 9:biomedicines9040431. [PMID: 33923505 PMCID: PMC8073616 DOI: 10.3390/biomedicines9040431] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease is a chronic disease that can lead to lose teeth and even tooth loss if left untreated. Osteoporosis and periodontal disease share similar characteristics and associated factors. Current regenerative techniques for periodontal diseases are ineffective in restoring complete function and structural integrity of periodontium due to unwanted migration of cells. In this study, we applied the concept of guided tissue regeneration (GTR) and 3D fabricated gingival fibroblast cell-laden collagen/strontium-doped calcium silicate (SrCS) bi-layer scaffold for periodontal regeneration. The results revealed that the bioactive SrCS had a hydroxyapatite formation on its surface after 14 days of immersion and that SrCS could release Sr and Si ions even after 6 months of immersion. In addition, in vitro results showed that the bi-layer scaffold enhanced secretion of FGF-2, BMP-2, and VEGF from human gingival fibroblasts and increased secretion of osteogenic-related proteins ALP, BSP, and OC from WJMSCs. In vivo studies using animal osteoporotic models showed that the 3D-printed cell-laden collagen/SrCS bi-layer scaffold was able to enhance osteoporotic bone regeneration, as seen from the increased Tb.Th and BV/TV ratio and the histological stains. In conclusion, it can be seen that the bi-layer scaffolds enhanced osteogenesis and further showed that guided periodontal regeneration could be achieved using collagen/SrCS scaffolds, thus making it a potential candidate for future clinical applications.
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Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073459. [PMID: 33810461 PMCID: PMC8037399 DOI: 10.3390/ijerph18073459] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. METHODS We included 488 participants aged 35-74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). RESULTS The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III-IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. CONCLUSION It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.
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Iao S, Pei X, Ouyang X, Liu J, Liu W, Cao C. Natural progression of periodontal diseases in Chinese villagers based on the 2018 classification. J Periodontol 2020; 92:1232-1242. [PMID: 33277921 DOI: 10.1002/jper.20-0199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Based on the 2018 classification, we aimed to determine the prevalence, distribution, and progression of periodontitis in the rural Chinese population without access to dental care. METHODS In all, 404 subjects (28.7 ± 8.9 years, M:F = 182:222) were randomly enrolled in 1992 and re-called in 1996. With the new classification, the prevalence and distribution of stage, grade, and extent were characterized. Stage progression was compared with the progression of clinical attachment loss (CAL) and radiographic bone loss (RBL). RESULTS At baseline, 94.1% villagers suffered from periodontitis, of whom 53.7% were in stage III/IV. The prevalence of stage III/IV increased from 18.2% in the age group of 15 to 24 years to 60.9% in 25 to 34-year-old group and 88.7% in the 35 to 44-year-old group. Significantly more stage III/IV, generalized, and grade C periodontitis were found in male villagers than female villagers. In 1996, the prevalence rate of periodontitis increased to 98.5%, with 80.0% in stage III/IV. Further, 84.2% villagers presented with grade C periodontitis based on longitudinal ΔCAL. The rate of progression (≥1 site with ΔCAL ≥3 mm) was 63.7%. Stage progression correlated significantly with CAL and RBL progression in stage I/II, but this association was not found in stage III/IV. Among subjects with disease progression in stage III/IV, 90.4% shifted from localized to generalized cases. Furthermore, ceiling effects were observed in stage III/IV. CONCLUSIONS In villagers without access to dental care, 94.1% suffered from periodontitis, with more than half having stage III/IV disease based on the 2018 classification. The majority cases presented with rapid periodontal progression. Although stage progression correlated significantly with CAL and RBL progression in stage I/II, ceiling effects existed in stage III/IV.
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Affiliation(s)
- Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiyan Pei
- First Clinic Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenyi Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Caifang Cao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Matichescu A, Ardelean LC, Rusu LC, Craciun D, Bratu EA, Babucea M, Leretter M. Advanced Biomaterials and Techniques for Oral Tissue Engineering and Regeneration-A Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5303. [PMID: 33238625 PMCID: PMC7700200 DOI: 10.3390/ma13225303] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
The reconstruction or repair of oral and maxillofacial functionalities and aesthetics is a priority for patients affected by tooth loss, congenital defects, trauma deformities, or various dental diseases. Therefore, in dental medicine, tissue reconstruction represents a major interest in oral and maxillofacial surgery, periodontics, orthodontics, endodontics, and even daily clinical practice. The current clinical approaches involve a vast array of techniques ranging from the traditional use of tissue grafts to the most innovative regenerative procedures, such as tissue engineering. In recent decades, a wide range of both artificial and natural biomaterials and scaffolds, genes, stem cells isolated from the mouth area (dental follicle, deciduous teeth, periodontal ligament, dental pulp, salivary glands, and adipose tissue), and various growth factors have been tested in tissue engineering approaches in dentistry, with many being proven successful. However, to fully eliminate the problems of traditional bone and tissue reconstruction in dentistry, continuous research is needed. Based on a recent literature review, this paper creates a picture of current innovative strategies applying dental stem cells for tissue regeneration in different dental fields and maxillofacial surgery, and offers detailed information regarding the available scientific data and practical applications.
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Affiliation(s)
- Anamaria Matichescu
- Department of Preventive Dentistry, Community and Oral Health, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Dragos Craciun
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Emanuel Adrian Bratu
- Department of Implant Supported Restorations, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Marius Babucea
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Marius Leretter
- Department of Prosthodontics, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
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Jiao J, Jing W, Si Y, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Li W, Meng H, Wang X. The prevalence and severity of periodontal disease in Mainland China: Data from the Fourth National Oral Health Survey (2015-2016). J Clin Periodontol 2020; 48:168-179. [PMID: 33103285 DOI: 10.1111/jcpe.13396] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/17/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey. MATERIALS AND METHODS Data of adult subjects (35- to 44-year-old group [N = 4409], 55- to 64-year-old group [N = 4622], and 65- to 74-year-old group [N = 4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders. RESULTS The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females. CONCLUSION Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status.
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Affiliation(s)
- Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wudi Jing
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yetsen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjing Li
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, China
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Zheng DX, Kang XN, Wang YX, Huang YN, Pang CF, Chen YX, Kuang ZL, Peng Y. Periodontal disease and emotional disorders: A meta-analysis. J Clin Periodontol 2020; 48:180-204. [PMID: 33103263 DOI: 10.1111/jcpe.13395] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/08/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the relationship of periodontal disease with depression and anxiety via a systematic review and meta-analysis. METHOD We systematically searched the EMBASE, PubMed, Web of Science, PsycINFO, and SinoMed databases (until August 4, 2019) with language restricted to English and Chinese. Case-control, cross-sectional, and cohort studies that calculated the risk ratio (RR), odds ratio (OR)/prevalence OR (POR), and hazard ratio (HR) of depression/anxiety with periodontal disease or the OR/POR/RR/HR of periodontal disease caused by depression/anxiety were included. Observational studies that reported the depression/anxiety scale score of patients with periodontal disease and healthy periodontal subjects aged ≥14 years were also included. We used the standard format to extract the following information from each included study: author/s, survey year, study design, age of participants, periodontal disease definition, depression/anxiety measurement, and summary of results. The Newcastle-Ottawa scale was used to ascertain the quality of the included citations. RESULTS After screening, 40 studies were included. A meta-analysis of the case-control studies showed that periodontal disease was positively associated with depression (OR = 1.70, 95% confidence interval [CI] = 1.01-2.83). A meta-analysis of 12 studies showed that periodontal disease was significantly correlated with anxiety (OR = 1.36, 95% CI = 1.11-1.66). A meta-analysis of 18 studies showed that subjects with periodontal disease had higher depression scale score (standardized mean difference [SMD] = 1.05, 95% CI = 0.68-1.41) and anxiety scale score (SMD = 0.70, 95% CI = 0.44-0.96). CONCLUSION Periodontal disease is associated with emotional disorders. However, the high degree of heterogeneity among studies should be considered. More high-quality prospective studies are required to confirm the relationship.
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Affiliation(s)
- De-Xiu Zheng
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Ning Kang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yi-Xi Wang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yi-Na Huang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Chun-Feng Pang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Xuan Chen
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Li Kuang
- The Department of Stomatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yun Peng
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
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Wang CY, Yang YH, Li H, Lin PY, Su YT, Kuo MYP, Tu YK. Adjunctive local treatments for patients with residual pockets during supportive periodontal care: A systematic review and network meta-analysis. J Clin Periodontol 2020; 47:1496-1510. [PMID: 33010026 DOI: 10.1111/jcpe.13379] [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] [Received: 04/09/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
AIM This systematic review and network meta-analysis aimed to evaluate the efficacy of adjunctive locally delivered antimicrobials, compared to subgingival instrumentation alone or plus a placebo, on changes in probing pocket depth (PPD) and clinical attachment level (CAL), in patients with residual pockets during supportive periodontal care. MATERIALS AND METHODS Literature search was performed with electronic databases and by hand until 31 May 2020. Primary outcome was the changes in PPD. The treatment effects between groups were estimated with weighted mean differences (WMD) with 95% confidence intervals (CI) and prediction intervals (PI) by using random-effects network meta-analysis. RESULTS Twenty-two studies were included. Significantly greater PPD reduction was achieved in chlorhexidine chip group (WMD: 0.65 mm, 95% CI: 0.21-1.10) and tetracycline fibre group (WMD: 0.64 mm, 95% CI: 0.20-1.08) over 6-month follow-up. Other adjunctive antimicrobial agents achieved non-significant improvements compared to scaling and root planing alone. All differences between adjunctive therapies were statistically non-significant. Similar findings were observed for CAL gain. CONCLUSION Adjunctive local antimicrobial agents achieved small additional PPD reduction and CAL gain in residual pockets for a follow-up of up to 6 months. Tetracycline fibre and chlorhexidine chip achieved better results than other antimicrobials.
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Affiliation(s)
- Chen-Ying Wang
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hao Yang
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hua Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ping-Yi Lin
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yu-Ting Su
- Department of Dentistry, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Mark Yen-Ping Kuo
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Kang Tu
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Abdullah MA, Alasqah M, Sanaa MS, Gufran K. The Relationship between Volatile Sulfur Compounds and the Severity of Chronic Periodontitis: A Cross-sectional Study. J Pharm Bioallied Sci 2020; 12:S268-S273. [PMID: 33149469 PMCID: PMC7595518 DOI: 10.4103/jpbs.jpbs_81_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/04/2020] [Accepted: 03/06/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Halitosis is a problem that is often ignored or undervalued. It is not considered a major clinical issue; thus, little is carried out to eradicate it. Little is known about the relationship of malodorous breath with the severity of periodontitis. Hence, the study aimed to investigate the relationship between volatile sulfur compounds (VSCs) and chronic periodontitis. Materials and Methods: According to the severity of chronic periodontitis, 80 patients were categorized into four groups (mild, moderate, severe, and control). Probing depth and clinical attachment level were measured. Portable sulfide monitor (Halimeter) is used to assess VSCs. Statistical analyses were conducted using R studio (Northern Ave, Boston). Results: The differences in the VSC levels among the four groups were found to be statistically significant. The greater the severity of periodontitis, the higher the VSC levels found (P < 0.001). Male had higher levels of VSCs than female (225 and 180.53 parts per billion [ppb], respectively). The lowest mean level of VSCs was found in the subjects aged 15–29 years (161.79 ppb); the mean values increased with the age, reaching 282.89 ppb in subjects aged >59 years. Conclusion: Highly significant differences were found in the VSC levels among different severities of chronic periodontitis. Moreover, an age-related increase in the VSC levels was determined. In addition, male had higher concentration of VSCs than female.
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Affiliation(s)
| | - Mohammed Alasqah
- Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - M Shafshak Sanaa
- Department of Periodontics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Khalid Gufran
- Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Machado V, Botelho J, Proença L, Alves R, Oliveira MJ, Amaro L, Águas A, Mendes JJ. Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis. BMC Oral Health 2020; 20:229. [PMID: 32819351 PMCID: PMC7441730 DOI: 10.1186/s12903-020-01219-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 08/13/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To determine if periodontal risk assessment (PRA), the number of missing teeth, diabetes mellitus (DM), perceived stress and interproximal cleaning are associated with oral health-related quality of life (OHRQoL), using Andersen's behavioral modelling (ABM). MATERIAL AND METHODS Data derived from 472 adults derived from a representative population of the Study of Periodontal Health in Almada-Seixal (SoPHiAS) was used. Socioeconomic status, perceived stress scale (PSS-10), oral health behaviors and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal conditions were assessed with a full-mouth periodontal examination. PRA was computed through behavioral and clinical information. Variables were grouped into Predisposing Factors, Enabling, Need, Oral Health Behaviors and Perceived Health Outcome latent variables. Confirmatory factor analysis, structural ABM and model fitness were conducted. RESULTS ABM applied to OHIP-14 showed acceptable model fit (χ2 = 2.75, CFI = 0.92, TLI = 0.90, RMSEA = 0.05, CI 90% [0.04-0.07]). The average of OHRQoL was 9.5 ± 11.3. Patient with periodontitis and with a high number of missing teeth experienced worse OHRQoL. Uncontrolled DM participants had more periodontal treatment necessity and poorer OHRQoL. Characteristic like aging and lower levels of education were directly associated with better OHRQoL, but in indirect path the OHRQoL was diminishes. Good oral hygiene and preventative measures were associated to lower periodontal treatment necessity. Lower periodontal treatment necessity was associated to higher OHRQoL. Age, tooth loss and interproximal cleaning were the most associated items to Predisposing, Need and Oral Health Behaviors, respectively. CONCLUSION ABM confirmed age, number of missing teeth, DM, interproximal cleaning and perceived stress as associated factors for OHRQoL. Uncontrolled DM was associated to higher Need and poorer OHRQoL. Good oral hygiene habits promote a healthy periodontium and, consequently, increases OHRQoL.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal.
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Almada, Portugal
| | - Ricardo Alves
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Egas Moniz Cooperativa de Ensino Superior Campus Universitário, Quinta da Granja, 2829 - 511, Almada, Portugal
| | - Maria João Oliveira
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
| | - Artur Águas
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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Raedel M, Noack B, Priess HW, Bohm S, Walter MH. Massive data analyses show negative impact of type 1 and 2 diabetes on the outcome of periodontal treatment. Clin Oral Investig 2020; 25:2037-2043. [PMID: 32820433 PMCID: PMC7966218 DOI: 10.1007/s00784-020-03512-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/06/2020] [Indexed: 11/25/2022]
Abstract
Objectives The aim was to evaluate the impact of diabetes on the outcome of periodontal treatment based on massive data analyses. Materials and methods Data originated from the database of a major German National Health Insurance. Patients who underwent periodontal treatment were allocated to four groups according to their medical condition: type 1 diabetes (D1), type 2 diabetes with the intake of oral anti-diabetics (D2M), type 2 diabetes without the intake of oral anti-diabetics (D2), and a control group without diabetes (ND). Four-year Kaplan-Meier survival analyses on the patient level and multivariate regression analyses were conducted for tooth extraction. Results Of 415,718 patients, 4139 matched the criteria for D1, 22,430 for D2M, and 23,576 for D2. At 4 years, the cumulative survival rate (no extraction) was 51.7% in the D1 group, 54.0% in the D2M group, and 57.7% in the D2 group. The ND control group had a significantly higher survival rate of 65.9% (P < 0.0001). In the multivariate analyses, both diabetes types were significantly associated with further tooth loss after periodontal treatment. Conclusions The diagnosis of diabetes type 1 or 2 seems to be associated with a higher risk of tooth loss after periodontal treatment. Clinical relevance The long-term prognosis of teeth in diabetes patients should be judged carefully.
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Affiliation(s)
- Michael Raedel
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Barbara Noack
- Periodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | | | - Michael H Walter
- Prosthodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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Sun H, Du M, Tai B, Chang S, Wang Y, Jiang H. Prevalence and associated factors of periodontal conditions among 55- to 74-year-old adults in China: results from the 4th National Oral Health Survey. Clin Oral Investig 2020; 24:4403-4412. [PMID: 32382923 DOI: 10.1007/s00784-020-03306-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 04/23/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this study was to assess periodontal health conditions among 55- to 74-year-old Chinese people and to analyze the factors associated with periodontal diseases. MATERIALS AND METHODS In total, 9054 subjects aged 55-74 years were enrolled from all 31 provinces using a stratified multistage probability sampling method, autonomous regions and municipalities of the Chinese mainland, the response rate was 86.9%. All subjects underwent clinical examinations on the severest site for every tooth and completed a questionnaire that collected information on their sociodemographic characteristics and oral habits. T tests, chi-square tests and binary logistic regression analysis were performed to analyze the data. RESULTS The percentage of people without bleeding on probing, probing depth ≥ 4 mm and attachment loss > 3 mm was 5.0 and 9.3% in the 55- to 64-year-old and the 65- to 74-year-old age group. The prevalence of bleeding on probing was 88.4% among 55 to 64 years old and 82.6% among 65 to 74 years old. Mean number of teeth with bleeding on probing were 13.87 among 55 to 64 years old and 11.25 among 65 to 74 years old. The prevalence of probing depth ≥ 4 mm and attachment loss > 3 mm were 69.3 and 69.9% in people aged 55-64 years and were 64.6 and 74.2% in people aged 65-74 years. Mean number of teeth with probing depth = 4-5 mm and probing depth ≥ 6 mm were 4.48 and 0.36 in 55-64 age group and 3.70 and 0.33 in 65-74 age group. And mean number of teeth with attachment loss > 3 mm were 5.17 among 55 to 64 years old and 5.63 among 65 to 74 years old. Besides, attachment loss > 3 mm was associated with age, gender, smoking, toothbrushing frequency and toothpick use. CONCLUSIONS Periodontitis was not highly prevalent among 55- to 74-year-old Chinese adults. Age, gender, smoking, toothbrushing frequency and toothpick use could be risk factors. CLINICAL RELEVANCE Scientific rationale for the study: The periodontal conditions among 55 to 64 and 65 to 74 years old Chinese population were not highly serious, but prevalence of bleeding on probing, periodontal pockets and attachment loss should be drawn enough attention by relevant public health administrations. PRINCIPAL FINDINGS The prevalence of periodontal diseases was evaluated in 55- to 64-year-old and 65- to 74-year-old subjects in a nationally representative Chinese sample population. The prevalence of probing depth ≥ 4 mm and AL > 3 mm were high; these values were 69.3% and 69.9%, respectively, in the 55-64 age group and 64.6% and 74.2%, respectively, in the 65-74 age group. In addition, case percentage of AL = 4-5 mm combined with PD < 6 mm were 23.1 and 19.4% among 55- to 64-year-old and 65- to 74-year-old people. And case percentage of AL> 5 mm combined with PD ≥ 6 mm were 11.1% and 12.1% among 55- to 64-year-old and 65- to 74-year-old people, respectively. PRACTICAL IMPLICATIONS The present study provides a reference for the epidemiological analysis of periodontal diseases. To reduce widespread inadequate treatment of periodontal diseases, clinical management should be performed in dental practices. Furthermore, oral health recommendations should be made at multiple levels.
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Affiliation(s)
- Haoyun Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Minquan Du
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Baojun Tai
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Shuli Chang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Yixuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Han Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China.
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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Non-significant association between - 330 T/G polymorphism in interleukin-2 gene and chronic periodontitis: findings from a meta-analysis. BMC Oral Health 2020; 20:58. [PMID: 32075624 PMCID: PMC7031920 DOI: 10.1186/s12903-020-1034-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 01/31/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Chronic periodontitis (CP) is an immune-inflammatory disease that promotes tissue damage around the teeth. Among the several inflammatory mediators that orchestrate the periodontitis, there is the interleukin (IL)-2. Genetic variations in IL2 gene may be associated with the risk and severity of the disease. Contrary results are available in the literature with inconclusive findings and none meta-analysis to gather these data. METHODS A literature search was performed for studies published before June 11, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical evaluation was performed by Review Manager statistical program with heterogeneity (I2) and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations and a sensitive analysis to assess the accuracy of the obtained results. The publication bias was evaluated by Begg' and Egger's test with Comprehensive meta-analysis software. The value of P < 0.05 was considered as significant. RESULTS Five studies were identified in diverse ethnical groups with 1425 participants. The - 330 T/G polymorphism in IL2 gene was not significantly associated with CP in allelic evaluation (P > 0.05) as well as in the genotypic comparisons (P = 0.15). The Begg's test and the linear regression Egger's test did not show any evidence of publication bias risk (P > 0.05) which was corroborated by the absence of obvious asymmetry in Funnel plot graphic. CONCLUSIONS This meta-analysis showed a non-significant association between - 330 T/G polymorphism in IL2 gene and CP in any allelic evaluation.
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Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study. Dent J (Basel) 2020; 8:dj8010004. [PMID: 31906577 PMCID: PMC7175220 DOI: 10.3390/dj8010004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/10/2019] [Accepted: 12/19/2019] [Indexed: 01/21/2023] Open
Abstract
This study aimed to evaluate the periodontal health of orthodontic patients with supportive periodontal therapy in a 3 month follow-up. The sample comprised 20 patients (mean age 20.6 ± 8.1 years) in treatment with multibracket fixed appliances (fixed group-FG) and 20 patients (mean age 34.7 ± 12.5 years) in treatment with clear aligners (clear aligners group-CAG). At baseline (T0) and after 3 months (T1), probing depth (PD), plaque index (PI), bleeding on probing (BOP), and gingival recession (REC) were measured. Patients were trained to perform an individualized tooth brushing technique, and every 2 weeks they were re-called to reinforce the oral hygiene instructions. The intra-group comparisons (T1 vs. T0) were calculated with the Wilcoxon signed-rank test, while a linear regression model was used for the inter-group comparisons (FG vs. CAG). The significance level was set at p < 0.05. Statistically significant decrease in both groups was found for PD (FG: Δ, -9.2 inter-quartile range (IQR), -22.5, -5.5; CAG: Δ, -12.6 IQR, -25.4, -4.8), BOP (FG: Δ, -53.5 IQR, -70.5, -37; CAG: Δ, -37.5 IQR, -54.5, -23), and PI (FG: Δ, -17.5 IQR, -62.5, 14.5; CAG: Δ, -24 IQR, -49.5, -5). The result of the linear regression models suggested that the type of appliance did not have any effects on the improvement of periodontal variables. Therefore, patients undergoing orthodontic treatment with fixed appliances and clear aligners did not show differences in gingival health when followed by a dental hygienist.
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EFFECTIVE SCHEMES OF THERAPEUTIC AND PREVENTIVE MEASURES FOR DISEASES OF THE ORAL CAVITY IN PROFESSIONAL ATHLETES. WORLD OF MEDICINE AND BIOLOGY 2020. [DOI: 10.26724/2079-8334-2020-4-74-24-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Botelho J, Machado V, Proença L, Alves R, Cavacas MA, Amaro L, Mendes JJ. Study of Periodontal Health in Almada-Seixal (SoPHiAS): a cross-sectional study in the Lisbon Metropolitan Area. Sci Rep 2019; 9:15538. [PMID: 31664143 PMCID: PMC6820786 DOI: 10.1038/s41598-019-52116-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022] Open
Abstract
This study aimed to describe the prevalence and extent of periodontal diseases among adults in the southern region of the Lisbon Metropolitan Area. This population-based cross-sectional study included 1,064 randomized participants (aged 18 to 95 years, 617 females/447 males). Sociodemographic, behaviours and medical information were recorded. Periodontal conditions were assessed with a full-mouth circumferential periodontal examination. It was used the American Association of Periodontology/European Federation of Periodontology 2017 case definitions. A logistic regression analysis was applied to ascertain hypothetical risk factors towards periodontitis. The prevalence of periodontitis was 59.9%, with 24.0% and 22.2% of the participants exhibiting severe and moderate periodontitis, respectively. The risk of periodontitis significantly increased with age (OR = 1.05, 95% CI: 1.04-1.06), for active and former smokers (OR = 3.76 and OR = 2.11, respectively), with lower education levels (OR = 2.08, OR = 1.86, for middle and elementary education, respectively) and with diabetes mellitus (OR = 1.53). This study confirms a high burden of periodontitis in the target (Portuguese) sub-population. The findings provide a comprehensive understanding that will empower appropriate national public oral health programmes and population-based preventive actions.
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Affiliation(s)
- João Botelho
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal.
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal.
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Ricardo Alves
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Maria Alzira Cavacas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
- Hospital Garcia de Orta, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
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Lee CY, Chang CH, Teng NC, Chang HM, Huang WT, Huang YK. Associations between the phenotype and genotype of MnSOD and catalase in periodontal disease. BMC Oral Health 2019; 19:201. [PMID: 31470840 PMCID: PMC6717336 DOI: 10.1186/s12903-019-0877-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Periodontal disease is an inflammatory disease in which pathogenic infections trigger a series of inflammatory responses and redox regulation. The hypothesis of this study was that a host's redox regulation, as modified by genetic polymorphisms, may affect periodontal disease activities (including the plaque index (PlI), bleeding on probing (BOP), and pocket depth (PD)) during periodontal therapy. METHODS In total, 175 patients diagnosed with periodontitis were recruited from the Department of Periodontology, Taipei Medical University Hospital. Both saliva samples and clinical measurements (PlI, BOP, and PD) were taken at the baseline and at 1 month after completing treatment. Salivary manganese superoxide dismutase (MnSOD) and catalase, and corresponding genetic polymorphisms (MnSOD, T47C, rs4880 and Catalase, C-262 T, rs1001179) were determined. The extent of change (Δ) of MnSOD or catalase was calculated by subtracting the concentration after completing treatment from that at the baseline. RESULTS Subjects who carried the Catalase CC genotype had significantly higher salivary MnSOD or catalase levels. The MnSOD genotype had a significant effect on the percentage of PDs of 4~9 mm (p = 0.02), and salivary ΔMnSOD had a significant effect on the PlI (p = 0.03). The Catalase genotype had a significant effect on the PlI (p = 0.01~0.04), but the effect was not found for the mean PlI or PD. There was a significant interaction between the MnSOD genotype and salivary ΔMnSOD on PDs of 4~9 mm. After adjusting for gender, years of schooling, smoking status, and alcohol consumption, subjects with ΔMnSOD of < 0 μg/ml or Δcatalase of < 0 μg/ml had significantly higher 5.58- or 5.17-fold responses to scaling and root planing treatment. CONCLUSIONS The MnSOD T47C genotype interferes with the phenotype of salivary antioxidant level, alters MnSOD levels, and influences the PD recovery. MnSOD and catalase gene polymorphism associated with phenotype expression and susceptibility in periodontal root planing treatment responses.
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Affiliation(s)
- Chang-Yu Lee
- Division of Periodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031 Taiwan
| | - Chia-Huang Chang
- College of Public Health and Nutrition, Taipei Medical University, Taipei, 11031 Taiwan
| | - Nai-Chia Teng
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031 Taiwan
| | - Hung-Ming Chang
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031 Taiwan
| | - Wan-Ting Huang
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031 Taiwan
| | - Yung-Kai Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 80708 Taiwan
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, 11031 Taiwan
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Ausenda F, Rasperini G, Acunzo R, Gorbunkova A, Pagni G. New Perspectives in the Use of Biomaterials for Periodontal Regeneration. MATERIALS 2019; 12:ma12132197. [PMID: 31288437 PMCID: PMC6651816 DOI: 10.3390/ma12132197] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 02/05/2023]
Abstract
Periodontitis is a disease with a high prevalence among adults. If not treated, it can lead to loss of teeth. Periodontal therapy aims at maintaining patient’s teeth through infection control and correction of non-maintainable anatomies including—when possible—regeneration of lost periodontal tissues. The biological regenerative potential of the periodontium is high, and several biomaterials can be utilized to improve the outcome of periodontal therapy. Use of different natural and synthetic materials in the periodontal field has been studied for many years. The main materials used today in periodontology analyzed in this review are: Resorbable and non-resorbable barrier membranes; autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes; biological agents, such as amelogenins; platelet-derived growth factor; bone morphogenic proteins; rh fibroblast growth factor 2; teriparatide hormone; platelet concentrates; and 3D scaffolds. With the development of new surgical techniques some concepts on periodontal regeneration that were strictly applied in the past seem to be not so critical today. This can have an impact on the materials that are needed when attempting to regenerate lost periodontal structures. This review aims at presenting a rationale behind the use of biomaterials in modern periodontal regeneration
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Affiliation(s)
- Federico Ausenda
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Giulio Rasperini
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Raffaele Acunzo
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Angelina Gorbunkova
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Giorgio Pagni
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy.
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Farina R, Severi M, Carrieri A, Miotto E, Sabbioni S, Trombelli L, Scapoli C. Whole metagenomic shotgun sequencing of the subgingival microbiome of diabetics and non-diabetics with different periodontal conditions. Arch Oral Biol 2019; 104:13-23. [PMID: 31153098 DOI: 10.1016/j.archoralbio.2019.05.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to use high-resolution whole metagenomic shotgun sequencing to characterize the subgingival microbiome of patients with/without type 2 Diabetes Mellitus and with/without periodontitis. DESIGN Twelve subjects, falling into one of the four study groups based on the presence/absence of poorly controlled type 2 Diabetes Mellitus and moderate-severe periodontitis, were selected. For each eligible subject, subgingival plaque samples were collected at 4 sites, all representative of the periodontal condition of the individual (i.e., non-bleeding sulci in subjects without a history of periodontitis, bleeding pockets in patients with moderate-severe periodontitis). The subgingival microbiome was evaluated using high-resolution whole metagenomic shotgun sequencing. RESULTS The results showed that: (i) the presence of type 2 Diabetes Mellitus and/or periodontitis were associated with a tendency of the subgingival microbiome to decrease in richness and diversity; (ii) the presence of type 2 Diabetes Mellitus was not associated with significant differences in the relative abundance of one or more species in patients either with or without periodontitis; (iii) the presence of periodontitis was associated with a significantly higher relative abundance of Anaerolineaceae bacterium oral taxon 439 in type 2 Diabetes Mellitus patients. CONCLUSIONS Whole metagenomic shotgun sequencing of the subgingival microbiome was extremely effective in the detection of low-abundant taxon. Our results point out a significantly higher relative abundance of Anaerolineaceae bacterium oral taxon 439 in patients with moderate to severe periodontitis vs patients without history of periodontitis, which was maintained when the comparison was restricted to type 2 diabetics.
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Affiliation(s)
- Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy; Operative Unit of Dentistry, University-Hospital of Ferrara, Italy.
| | - Mattia Severi
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy
| | - Alberto Carrieri
- Department of Life Sciences and Biotechnology - Section of Biology and Evolution, University of Ferrara, Italy
| | - Elena Miotto
- Department of Life Sciences and Biotechnology - Section of Pathology and Applied Microbiology,University of Ferrara, Italy
| | - Silvia Sabbioni
- Department of Life Sciences and Biotechnology - Section of Pathology and Applied Microbiology,University of Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy; Operative Unit of Dentistry, University-Hospital of Ferrara, Italy
| | - Chiara Scapoli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy; Department of Life Sciences and Biotechnology - Section of Biology and Evolution, University of Ferrara, Italy
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Citterio F, Romano F, Ferrarotti F, Gualini G, Aimetti M. Quality of methods and reporting in association studies of chronic periodontitis and IL1A -889 and IL1B +3953/4 SNPs: A systematic review. J Periodontal Res 2019; 54:457-467. [PMID: 30982982 DOI: 10.1111/jre.12655] [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: 05/11/2018] [Revised: 11/30/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the quality of reporting and methodology in genetic association studies between IL1A -889 and IL1B +3954 polymorphisms and chronic periodontitis. BACKGROUND Evidence provided by periodontal research on genetic risk factors is of uttermost importance in clinical practice as a possible diagnostic and prognostic tool for periodontitis. Inadequate reporting of results as well as high risk of bias due to methodological inconsistency hampers the integration of evidence in terms of clinical applicability. METHODS This review includes case-control studies in humans published between 1997 and July 2017. Searching was conducted through MEDLINE, EMBASE, and search handing. Specific scoring systems have been developed to evaluate the quality of methods and reporting. Each article was scored according to its adequacy, and then, the total number and the percentage of items positively qualified for both methods and reporting were calculated. The quality of methods in studies scoring 0-6, 7-12, and 13-16 was, respectively, considered poor, moderate, and good. For reporting, scores of 0-9, 10-18, and 19-26 were deemed of poor, moderate, and good quality, respectively. Pearson's correlation coefficient was calculated to explore the correlation between the year of publication and the quality in terms of methods and reporting. RESULTS From the 531 screened studies, 52 met the inclusion criteria and were thus included in the study. The quality of methods and reporting of published genetic association papers on IL1 and chronic periodontitis is moderate. On a scale from 0 to 16, the mean score for methods of the reviewed studies was 8.19 ± 1.93. The items more frequently considered inadequate concerned the handling of confounders in statistical analysis, especially oral hygiene habits, socioeconomic status, subgingival colonization of specific periodontal pathogens, and stress. A significant positive correlation was found between the year of publication and the quality scores in terms of method (r = 0.401, P = 0.003). In terms of reporting, the mean score was 14.83 ± 3.04 on a scale from 0 to 26 and it was considered overall moderate. No statistically significant correlation was found between the year of publication and the quality of reporting (P = 0.266). CONCLUSIONS The association between IL1A -889 and IL1B +3954 polymorphisms and chronic periodontitis is questionable due to methodological inconsistency. Evidence arising from meta-analysis is unreliable due to high risk of bias and moderate quality in terms of reporting.
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Affiliation(s)
- Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Francesco Ferrarotti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giacomo Gualini
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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