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Knie LV, Leknes KN, Xue Y, Lie SA, Bunæs DF. Serum biomarker levels in smokers and non-smokers following periodontal therapy. A prospective cohort study. BMC Oral Health 2024; 24:463. [PMID: 38627806 PMCID: PMC11020793 DOI: 10.1186/s12903-024-04196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND To compare presence and levels of serum cytokines in smokers and non-smokers with periodontitis following periodontal therapy. METHODS Thirty heavy smokers and 30 non-smokers with stage III or IV periodontitis were included in this prospective cohort study. Clinical data and blood serum were collected at baseline (T0), after step I-III (T1), and after 12 months step IV periodontal therapy (T2). Cytokine IL-1β, IL-6, IL-8, TNF-α, IL-10, and IP-10 levels were measured using multiplex kit Bio-Plex Human Pro™ Assay. Linear regression models with cluster robust variance estimates to adjust for repeated observations were used to test intra- and intergroup levels for each marker, IL-6 and IL-8 defined as primary outcomes. RESULTS Clinical outcomes improved in both groups following therapy (p < 0.05). IL-6 levels increased with 75.0% from T0-T2 among smokers (p = 0.004). No significant intra- or intergroup differences were observed for IL-8. Higher levels of TNF-α (44.1%) and IL-10 (50.6%) were detected in smokers compared with non-smokers at T1 (p = 0.007 and p = 0.037, respectively). From T1-T2, differences in mean change over time for levels of TNF-α and IL-10 were observed in smokers compared with non-smokers (p = 0.005 and p = 0.008, respectively). CONCLUSION Upregulated levels of serum cytokines in smokers indicate a systemic effect of smoking following periodontal therapy. Differences in cytokine levels between smokers and non-smokers demonstrate a smoking induced modulation of specific systemic immunological responses in patients with severe periodontitis.
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Affiliation(s)
- Lorenz V Knie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
- Oral Health Centre of Expertise Rogaland, Stavanger, Norway
| | - Knut N Leknes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
| | - Ying Xue
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
- Faculty of Health Sciences, Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
| | - Dagmar F Bunæs
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway.
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Martinez-Amargant J, de Tapia B, Pascual A, Takamoli J, Esquinas C, Nart J, Valles C. Association between smoking and peri-implant diseases: A retrospective study. Clin Oral Implants Res 2023; 34:1127-1140. [PMID: 37523460 DOI: 10.1111/clr.14147] [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: 11/17/2022] [Revised: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES To determine the association between tobacco and peri-implant diseases in a sample of patients who had received implant-supported restorations in a university dental clinic. Furthermore, the study aimed to investigate patient- and implant-related variables associated with peri-implant diseases. MATERIALS AND METHODS The present retrospective study analyzed data from 117 patients treated with implant-supported restorations from 2001 to 2013. A total of 450 implants were evaluated. Patients were selected from an electronic database, and patient- and implant-related variables were evaluated. Detailed information regarding the smoking history (i.e., smoking status, lifetime cumulative dose, duration of exposure, intensity of the habit, and smoking cessation) was recorded. The primary study outcome was peri-implant status [i.e., health (H), peri-implant mucositis (PM) and peri-implantitis (PI)]. Univariate and multinomial regression models comparing PM and PI versus peri-implant health were conducted. RESULTS A total of 117 subjects [55 (47%) females and 62 (53%) males] with a mean age at examination of 64.2 years (SD 11.6) and rehabilitated with 450 implants were included. The average number of implants per patient was 4.6 (SD 3.3) with a mean time in function of 8.0 years (SD 1.9). Fifty-six patients (47.9%) were non-smokers, 42 (35.9%) were former-smokers, and 19 (16.2%) were current-smokers. Thirty-nine subjects (33.4%) were H, whereas 41 (35%) and 37 (31.6%) exhibited PM and PI, respectively. At implant level, the corresponding values were 142 (31.6%), 230 (51.1%) and 78 (17.3%). In the multinomial regression model, significant associations for peri-implant diseases were observed for the mean number of implants per patient (p = .016), function time (p = .048), implants placed simultaneously with guided bone regeneration (p = .016), implant surface (p = .020), keratinized mucosa at the buccal aspect (p = .032), and access to interproximal hygiene (p < .001). In addition, ever smokers >23 pack-years exhibited a significantly higher risk for peri-implantitis (p = .002). Finally, the multinomial regression analysis revealed that subjects who had stopped smoking more than 21 years before the last examination presented a significantly lower risk of peri-implant diseases than a smoking cessation of ≤21 years (p = .028). CONCLUSIONS Smoke intensity was associated with an increased risk of the development of peri-implantitis. Moreover, the risk of peri-implant diseases might be similar in those subjects who had stopped smoking for more than 21 years with respect to never-smokers.
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Affiliation(s)
- J Martinez-Amargant
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - B de Tapia
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - A Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - J Takamoli
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - C Esquinas
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - J Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - C Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Nilsen A, Thorsnes A, Lie SA, Methlie P, Bunaes DF, Reinholtsen KK, Leknes KN. Periodontitis in obese adults with and without metabolic syndrome: a cross-sectional study. BMC Oral Health 2023; 23:439. [PMID: 37393272 PMCID: PMC10315020 DOI: 10.1186/s12903-023-03133-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/14/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Epidemiological studies support an association between obesity, metabolic syndrome (MetS), and periodontitis. Still, understanding of the effects of low-grade inflammation in obese subjects on periodontitis and influence of MetS remains incomplete. The aims of this cross-sectional study were to explore the association between obesity related variables and periodontitis, and assess if MetS is a risk indicator for periodontitis in a sample of obese adults. METHODS The study sample comprised 52 adults with a body mass index (BMI) of ≥ 30 kg/m2 referred for obesity therapy at the Obesity Centre at Haukeland University Hospital (HUH), Bergen, Norway. The subjects had prior to enrolment completed a 5-month lifestyle intervention course as part of a 2-year managing program. According to the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) classification of MetS, 38 subjects were recruited to the MetS group and 14 subjects to the non-MetS group. Medical data including peripheral blood samples were obtained from records at HUH at the time of enrolment. Probing depth, clinical attachment level, tooth mobility, furcation involvement, bleeding on probing (BoP) were recorded and intraoral bitewings evaluated at a full-mouth periodontal examination. Associations between risk variables for obesity/MetS and periodontitis were explored using linear and logistic regression models. RESULTS In the present sample 79% of the subjects were diagnosed with periodontitis. The prevalence of stage III/IV periodontitis was 42.9% in the non-MetS group vs. 36.8% in the MetS group (p = 0.200). In the non-MetS group 29.8% of the sites displayed BoP vs. 23.5% in the MetS group (p = 0.048). For stage III/IV periodontitis, the effect of age appeared to be significant for obesity related variables and MetS (p = 0.006, p = 0.002, respectively). None of the other analyses showed significant association with the outcome variables. CONCLUSION In the present sample of obese subjects, periodontitis occurred independently of MetS. Reaching a certain BMI level, suggested association between MetS and periodontitis might be non-significant due to the dominating impact of obesity related variables undermining the effect of other systemic factors. TRIAL REGISTRATION The principal clinical trial, entitled "Obesity and Oral Diseases", was prospectively registered in ClinicalTrials.gov with registration NCT04602572 (20.10.2020).
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Affiliation(s)
- Astrid Nilsen
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Anette Thorsnes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Paal Methlie
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Dagmar F Bunaes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Karen K Reinholtsen
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway
| | - Knut N Leknes
- Department of Clinical Dentistry - Periodontics, Faculty of Medicine, University of Bergen, Aarstadveien 19, Bergen, N-5009, Norway.
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Do HT, Nguyen TT, Vo TL, Huynh NCN, Nguyen AT. The influence of smoking on oral neutrophils and matrix metalloproteinase-8 in periodontitis patients before and after nonsurgical treatment. J Oral Biol Craniofac Res 2023; 13:442-447. [PMID: 37215391 PMCID: PMC10193004 DOI: 10.1016/j.jobcr.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/16/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
Objective To evaluate and compare the oral neutrophil numbers (ONN) in saliva, the level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid (GCF) and the periodontal parameters in smokers versus non-smokers with periodontitis, before and after nonsurgical periodontal treatment (NSPT). Materials and method 40 chronic periodontitis patients including 20 smokers and 20 non-smokers were enrolled in this quasi-experimental study. All patients were received the NSPT included instructing oral hygiene, scaling and root planing. At baseline (T0) and after NSPT 1 month (T1) and 3 months (T3), all patients were assessed for salivary ONN, GCF MMP-8, and clinical parameters like plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL). The differences between the two groups were analyzed using the independent sample t-test and the Mann-Whitney U test; and the differences between T0, T1 and T3 of each group were analyzed with paired-samples t-test and Wilcoxon signed-rank test. The level of significance was set at 0.05. Results The ONN was significantly less in smokers than in non-smokers although there was no significant difference in other parameters between the two groups at baseline (p > 0.05). All clinical periodontal parameters reduced significantly after 1 month and 3 months of NSPT in both groups (p < 0.01). PPD of non-smokers was significantly lower than those of smokers at T1 and T3. ONN and MMP-8 level showed a significant decrease in non-smoking subjects, while there was no significant difference in smoking ones after NSPT (T1 and T3). At 1 month after treatment, ONN tended to reduce in non-smokers whereas to increase in smokers significantly. Conclusion Smoking reduced ONN, impaired treatment effect in reducing PPD, and changed the MMP-8 level in gingival crevicular fluid to NSPT. Trial registration Identifier NCT04974502 in CLinicalTrials.gov.
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Affiliation(s)
- Hang T. Do
- Department of Periodontology, Faculty of Odonto-stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Thuy T. Nguyen
- Department of Periodontology, Faculty of Odonto-stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Thuy L. Vo
- Department of Implantology, Faculty of Odonto-stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Nam C-N. Huynh
- Department of Dental Basic Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Anh T.K. Nguyen
- Department of Dental Basic Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
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Selimović A, Bunæs DF, Lie SA, Lobekk MA, Leknes KN. Non-surgical treatment of peri-implantitis with and without erythritol air-polishing a 12-month randomized controlled trial. BMC Oral Health 2023; 23:240. [PMID: 37095488 PMCID: PMC10125257 DOI: 10.1186/s12903-023-02973-5] [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: 12/17/2022] [Accepted: 04/17/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND A variety of interventions have been explored in the non-surgical management of peri-implantitis. In spite of extensive testing of various study protocols, effective treatments largely remain unavailable. The objective of the present 12-month single-centre, examiner-masked, randomized controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system produces added clinical benefit when used adjunctive to conventional non-surgical management of peri-implantitis and to record any associated patient-centered outcomes. METHODS Forty-three patients with mild to severe peri-implantitis including at least one implant either received ultrasonic/curette subgingival instrumentation and erythritol air-polishing (test) or ultrasonic/curette instrumentation only (control) at baseline and at 3, 6, 9, and 12 months. Probing depth (PD), bleeding on probing (BoP), dental plaque, suppuration (SUP), crestal bone level (CBL), and peri-implant crevicular fluid (PCF) were recorded at baseline, 6 and 12 months. Visual Analogue Scale (VAS) scores were collected immediately following subgingival interventions at all time-points. RESULTS A reduction in PD was observed from baseline to 6 months for the test (p = 0.006) and control (p < 0.001) and from baseline to 12 months for the control (p < 0.001). No intergroup differences were observed for primary outcome variables PD or CBL over time (p > 0.05). At 6 months, a intergroup difference in PCF was observed in favor of the test (p = 0.042). Moreover, a reduction in SUP from baseline to 6 and 12 months was observed in the test (p = 0.019). Overall, patients in the control group experienced less pain/discomfort compared with the test (p < 0.05), females reporting more pain/discomfort than males (p = 0.005). CONCLUSIONS This study confirms that conventional non-surgical management of peri-implantitis produces limited clinical improvement. It is shown that an erythritol air-polishing system may not produce added clinical benefits when used adjunctive to conventional non-surgical management. In other words, neither approach effectively resolved peri-implantitis. Moreover, the erythritol air-polishing system produced added pain/discomfort particularly in female patients. TRIAL REGISTRATION The clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04152668 (05/11/2019).
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Affiliation(s)
- Armin Selimović
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Dagmar F Bunæs
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway
| | | | - Knut N Leknes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway.
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Madi M, Smith S, Alshehri S, Zakaria O, Almas K. Influence of Smoking on Periodontal and Implant Therapy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5368. [PMID: 37047982 PMCID: PMC10094532 DOI: 10.3390/ijerph20075368] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND smoking is considered the most modifiable risk factor for periodontal disease. OBJECTIVE the aim of this narrative review is to emphasize the effect of smoking on periodontal and implant therapy. METHODS The authors reviewed the literature reporting the clinical outcomes of smoking on periodontal surgical and nonsurgical treatment. The impact of smoking on implant therapy and sinus lifting procedures were also reviewed. RESULTS Periodontal and implant therapy outcomes are adversely affected by smoking. Smokers respond less favorably to periodontal therapy and periodontal flap procedures as compared to nonsmokers. Clinical outcomes for smokers are 50-75% worse than for nonsmokers. Studies reveal that smokers experience a significantly lower reduction in pocket depth compared to nonsmokers as well as less bone growth after treating infra-bony defects with guided tissue regeneration. The relative risk of implant failure is significantly higher in patients who smoke 20 cigarettes or more per day compared to nonsmokers. Additionally, smoking has also been shown to increase postoperative wound dehiscence and infection rates following sinus floor elevation. Longitudinal studies on smoke cessation have shown a reduction in bone loss and probing depths for periodontitis patients after cessation compared to those who smoke. CONCLUSION Smoking cessation can reduce probing depths and improve clinical attachment after nonsurgical periodontal therapy. There is insufficient evidence regarding the effect of smoking on peri-implantitis, as well as the loss of implants in the long-term.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Steph Smith
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sami Alshehri
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Vilarrasa J, Soldini MC, Pons R, Valles C, Blasi G, Monje A, Nart J. Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis. Clin Oral Investig 2023:10.1007/s00784-023-04918-2. [PMID: 36786958 DOI: 10.1007/s00784-023-04918-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up. METHODS This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. RESULTS A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed. CONCLUSION Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm). CLINICAL RELEVANCE This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Maria Costanza Soldini
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.,Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
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Salhi L, Lambert F, Seidel L, Albert A. Predicting probing depth reduction after periodontal non-surgical treatment in smokers according to the nicotine dependence and the number of cigarette consumed. Heliyon 2022; 8:e10143. [PMID: 36039129 PMCID: PMC9418199 DOI: 10.1016/j.heliyon.2022.e10143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/08/2022] [Accepted: 07/27/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Smoking is considered as a risk factor for the poor outcomes after periodontitis non-surgical treatment (PNST). The aim of this short communication is to predict probing depth reduction after periodontal non-surgical treatment in smokers according to the nicotine dependence (FTND) and the number of cigarette consumed (NCC). Methods This work is a post-hoc study of a prospective controlled study on the effect of oral hygiene instructions and PNST on periodontal outcomes. This short communication focused only on the current conventional smokers (N = 34), based on specific smoking indicators, and on probing depth (PD) parameter that were recorded at baseline (time 0), after oral hygiene instruction (time 1) and 3 months after PNST (time 2). Results The 34 smokers had a mean age 46.5 ± 11.5 years. The NCC- and FTND-based predictions allowed to show in a specific nomogram the PD values 3 months after PNST for each NCC and FTND category. Conclusion Two nomograms are proposed for prognostic purposes and allow patients to understand the impact of smoking on periodontitis according to the number of cigarette consumed and the level of nicotine dependence. These nomograms might be also used for supporting smoking cessation. Clinical significance In smoker patients with periodontitis, there is a need to predict, for both patient and clinicians, the impact of the number of cigarettes consumed and the level of nicotine dependence on probing depth after oral hygiene instructions and debridement. Two nomograms are proposed for prognostic purposes.
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Barutta F, Bellini S, Durazzo M, Gruden G. Novel Insight into the Mechanisms of the Bidirectional Relationship between Diabetes and Periodontitis. Biomedicines 2022; 10:biomedicines10010178. [PMID: 35052857 PMCID: PMC8774037 DOI: 10.3390/biomedicines10010178] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023] Open
Abstract
Periodontitis and diabetes are two major global health problems despite their prevalence being significantly underreported and underestimated. Both epidemiological and intervention studies show a bidirectional relationship between periodontitis and diabetes. The hypothesis of a potential causal link between the two diseases is corroborated by recent studies in experimental animals that identified mechanisms whereby periodontitis and diabetes can adversely affect each other. Herein, we will review clinical data on the existence of a two-way relationship between periodontitis and diabetes and discuss possible mechanistic interactions in both directions, focusing in particular on new data highlighting the importance of the host response. Moreover, we will address the hypothesis that trained immunity may represent the unifying mechanism explaining the intertwined association between diabetes and periodontitis. Achieving a better mechanistic insight on clustering of infectious, inflammatory, and metabolic diseases may provide new therapeutic options to reduce the risk of diabetes and diabetes-associated comorbidities.
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Liu HJ, Wang B, Wang AC, Zhang DH, Mao C, Li QH. Prognostic factors affecting the short-term efficacy of non-surgical treatment of chronic periodontitis: a multilevel modeling analysis. Eur J Med Res 2021; 26:50. [PMID: 34074306 PMCID: PMC8170789 DOI: 10.1186/s40001-021-00520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis. MATERIALS AND METHODS A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD - finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model. RESULTS Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001). CONCLUSIONS Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.
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Affiliation(s)
- Hui-Jie Liu
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Bo Wang
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China
| | - Ao-Chen Wang
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, 110122, Liaoning, China
| | - Dan-Hong Zhang
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Cui Mao
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.,Medical Department of Graduate School, Dalian Medical University, Dalian, 116000, Liaoning, China
| | - Qiu-Hong Li
- Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, No.222 Zhongshan Road, Dalian, 116000, Liaoning, China.
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11
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Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. BIOLOGY 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
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Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
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12
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Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health 2021; 21:38. [PMID: 33478480 PMCID: PMC7819243 DOI: 10.1186/s12903-021-01397-3] [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: 09/17/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background Due to complex morphology and limited access, the cleaning of the furcation area is extremely challenging. Therefore, novel therapeutic approaches need to be tested to potentially overcome debridement limitations. The aim of the present prospective 12-month study was to compare clinical and microbiological effects following erythritol air-polishing versus conventional mechanical debridement of furcation defects in a cohort of periodontal maintenance patients.
Methods Twenty patients with grade II mandibular molar furcation defects volunteered to enroll in this single-centre, examiner masked, randomized controlled trial. In a split-mouth study design, two furcation sites in each patient were randomly assigned to either receive subgingival debridement using erythritol air-polishing (test) or conventional ultrasonic/curette debridement (control) at baseline, and at 3, 6, 9 and 12 months. Probing depth, clinical attachment level and bleeding on probing were recorded at 3-month intervals. Subgingival microbiological samples obtained at baseline, 6 and 12 months were analyzed using checkerboard DNA–DNA hybridization. Discomfort from treatment was scored at 12 months using a visual analogue scale. The differences between treatments, and time-points, were tested using multilevel analysis (mixed effect models and robust variance estimates). Results A significant reduction in probing depth took place following both treatments (p < 0.001). Control sites experienced a significant mean gain in clinical attachment level of 0.5 mm (± 0.2) (p = 0.004), whereas a non-significant gain of 0.4 mm (± 0.3) was observed at test sites (p = 0.119). At 6 months, a significant between-treatment difference of 0.8 mm (± 0.4) was observed in favor of the control (p = 0.032). No significant between-treatment differences were observed in microbial load or composition. Notably, at 12 months patients experienced significantly less discomfort following air-polishing compared with control (p = 0.001). Conclusions The 12-month observations indicate that erythritol air-polishing and conventional mechanical debridement both support clinical improvements. A significant between-treatment difference in clinical attachment level was, however, detected in favour of control debridement at 6 months. In terms of patient comfort, erythritol air-polishing is superior. Trial Registration: The clinical trial was retrospectively registered in ClinicalTrial.gov with registration NCT04493398 (07/28/2020).
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Affiliation(s)
- Ingvild M Ulvik
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Terje Sæthre
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Dagmar F Bunæs
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute for Oral Biology, University of Oslo, Oslo, Norway
| | - Knut N Leknes
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway.
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13
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Feres M, Retamal-Valdes B, Gonçalves C, Cristina Figueiredo L, Teles F. Did Omics change periodontal therapy? Periodontol 2000 2020; 85:182-209. [PMID: 33226695 DOI: 10.1111/prd.12358] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The starting point for defining effective treatment protocols is a clear understanding of the etiology and pathogenesis of a condition. In periodontal diseases, this understanding has been hindered by a number of factors, such as the difficulty in differentiating primary pathogens from nonpathogens in complex biofilm structures. The introduction of DNA sequencing technologies, including taxonomic and functional analyses, has allowed the oral microbiome to be investigated in much greater breadth and depth. This article aims to compile the results of studies, using next-generation sequencing techniques to evaluate the periodontal microbiome, in an attempt to determine how far the knowledge provided by these studies has brought us in terms of influencing the way we treat periodontitis. The taxonomic data provided, to date, by published association and elimination studies using next-generation sequencing confirm previous knowledge on the role of classic periodontal pathogens in the pathobiology of disease and include new species/genera. Conversely, species and genera already considered as host-compatible and others less explored were associated with periodontal health as their levels were elevated in healthy individuals and increased after therapy. Functional and transcriptomic analyses also demonstrated that periodontal biofilms are taxonomically diverse, functionally congruent, and highly cooperative. Very few interventional studies to date have examined the effects of treatment on the periodontal microbiome, and such studies are heterogeneous in terms of design, sample size, sampling method, treatment provided, and duration of follow-up. Hence, it is still difficult to draw meaningful conclusions from them. Thus, although OMICS knowledge has not yet changed the way we treat patients in daily practice, the information provided by these studies opens new avenues for future research in this field. As new pathogens and beneficial species become identified, future randomized clinical trials could monitor these species/genera more comprehensively. In addition, the metatranscriptomic data, although still embryonic, suggest that the interplay between the host and the oral microbiome may be our best opportunity to implement personalized periodontal treatments. Therapeutic schemes targeting particular bacterial protein products in subjects with specific genetic profiles, for example, may be the futuristic view of enhanced periodontal therapy.
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Affiliation(s)
- Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Brazil
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Brazil
| | - Cristiane Gonçalves
- Department of Periodontology, Estácio de Sá University, Rio de Janeiro, Brazil
| | | | - Flavia Teles
- Center for Innovation & Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
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14
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Salhi L, Albert A, Seidel L, Lambert F. Respective Effects of Oral Hygiene Instructions and Periodontal Nonsurgical Treatment (Debridement) on Clinical Parameters and Patient-Reported Outcome Measures with Respect to Smoking. J Clin Med 2020; 9:E2491. [PMID: 32756385 PMCID: PMC7464916 DOI: 10.3390/jcm9082491] [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: 07/03/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Oral hygiene instructions (OHI) and periodontal nonsurgical treatment (PNST) play pivotal roles in the management of periodontitis. The study aims to discern their respective effects on periodontal clinical parameters and patient-reported outcome measures (PROMs). METHODS Ninety-one patients were included, 34 non-smokers (NS), 25 former smokers (FS) and 32 current smoker (CS). Clinical parameters such as probing depth (PD) and bleeding on probing (BOP) were collected, and the periodontal inflamed tissue area (PISA) was calculated. Clinical parameters and PROMs were recorded before and after receiving OHI, with electronic tooth brush and interdental brushes, as well as 3 months after debridement. RESULTS Smokers presented a significantly higher proportion of severe periodontitis (64.7%) with generalized extension (76.5%) and with a rapid rate of progression (97.1%) compared to NS and FS. OHI led to a significant decrease of PD, BOP, and PISA (p < 0.0001) only in NS and FS. Debridement reduced PD and the percentage of PD >6 mm in all groups (p < 0.0001). OHI induced significant improvement of oral hygiene, frequency of interdental cleaning, and PROMs (p < 0.0001). Further debridement induced significant additional improvement PROMs in FS and NS (p < 0.0001). CONCLUSION OHI and debridement improved periodontal clinical parameters and PROMs in both NS and FS. Former smokers had comparable outcomes to non-smokers, suggesting that smoking cessation should be encouraged.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, 4000 Liège, Belgium
| | - Adelin Albert
- Department of Public Health Sciences, University of Liège, 4000 Liège, Belgium;
| | - Laurence Seidel
- Department of Biostatistics and Medico-economic information, University of Liège, 4000 Liège, Belgium;
| | - France Lambert
- Dental Biomaterials Research Unit, Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, 4000 Liège, Belgium;
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15
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Vohra F, Bukhari IA, Sheikh SA, Albaijan R, Naseem M, Hussain M. Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among
shamma
users and non‐users: A randomized controlled trial. J Periodontol 2020; 91:1177-1185. [DOI: 10.1002/jper.19-0464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Science College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Ishfaq A. Bukhari
- Department of Pharmacology College of Medicine King Saud University Riyadh Saudi Arabia
| | - Saeed A. Sheikh
- Department of Pharmacology College of Medicine King Saud University Riyadh Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Mustafa Naseem
- Department of Community And Preventive Dental sciences Dow International Dental College (DIDC) Pakistan
| | - Mudassir Hussain
- Department of Community Dentistry Karachi Medical and Dental College Karachi Pakistan
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16
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Prognostic Factors of Grade 2-3 Endo-Periodontal Lesions Treated Nonsurgically in Patients with Periodontitis: A Retrospective Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1592910. [PMID: 32090068 PMCID: PMC7031715 DOI: 10.1155/2020/1592910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/30/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023]
Abstract
Background Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. It is hard for clinicians to predict their prognosis. The aim of this study is to investigate the factors affecting the prognosis of endo-periodontal lesions. Methods A total of 140 teeth diagnosed with grade 2-3 endo-periodontal lesions in patients with periodontitis were recruited in this study. They were divided into high and low responder groups, according to the clinical symptoms and parameters of the teeth involved after nonsurgical treatment of both the endodontic and periodontal components. Clinical parameters and symptoms were compared before and after treatment, and gender, age, smoking, and all clinical parameters were compared between high and low responder groups using univariate analyses. Logistic regression was applied to evaluate the independent effects on endo-periodontal lesion prognosis. Results Compared with the clinical parameters at baseline, the values of tooth mobility (TM), periapical index (PAI), and discomfort when chewing were decreased after endodontic therapy, and the values of periodontal probing depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), TM, simplified oral hygiene index (OHI-S), full-mouth periodontitis severity, PAI, and discomfort when chewing were decreased after periodontal therapy. Univariate analysis revealed that smoking, PD, CAL, TM, PAI, clinical crown-root ratio (CR), full-mouth periodontitis severities, and the number of root canals were significantly different between the high and low responder groups (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis ( Conclusions and Practical Implications. High PD and CAL, multirooted teeth, smoking, and serious full-mouth periodontitis indicated a poor prognosis for teeth with grade 2-3 endo-periodontal lesions.
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17
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Jiang Y, Zhou X, Cheng L, Li M. The Impact of Smoking on Subgingival Microflora: From Periodontal Health to Disease. Front Microbiol 2020; 11:66. [PMID: 32063898 PMCID: PMC7000377 DOI: 10.3389/fmicb.2020.00066] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/13/2020] [Indexed: 02/05/2023] Open
Abstract
Periodontal disease is one of the most common diseases of the oral cavity affecting up to 90% of the worldwide population. Smoking has been identified as a major risk factor in the development and progression of periodontal disease. It is essential to assess the influence of smoking on subgingival microflora that is the principal etiological factor of the disease to clarify the contribution of smoking to periodontal disease. Therefore, this article reviews the current research findings regarding the impact of smoking on subgingival microflora and discusses several potential mechanisms. Cultivation-based and targeted molecular approaches yield controversial results in determining the presence or absence of smoking-induced differences in the prevalence or levels of certain periodontal pathogens, such as the “red complex.” However, substantial changes in the subgingival microflora of smokers, regardless of their periodontal condition (clinical health, gingivitis, or periodontitis), have been demonstrated in recent microbiome studies. Available literature suggests that smoking facilitates early acquisition and colonization of periodontal pathogens, resulting in an “at-risk-for-harm” subgingival microbial community in the healthy periodontium. In periodontal diseases, the subgingival microflora in smokers is characterized by a pathogen-enriched community with lower resilience compared to that in non-smokers, which increases the difficulty of treatment. Biological changes in key pathogens, such as Porphyromonas gingivalis, together with the ineffective host immune response for clearance, might contribute to alterations in the subgingival microflora in smokers. Nonetheless, further studies are necessary to provide solid evidence for the underlying mechanisms.
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Affiliation(s)
- Yaling Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Operative Dentistry and Endodontics, 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 Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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18
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Wang Y, Anderson EP, Tatakis DN. Whole transcriptome analysis of smoker palatal mucosa identifies multiple downregulated innate immunity genes. J Periodontol 2020; 91:756-766. [DOI: 10.1002/jper.19-0467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yun Wang
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
| | - Eric P. Anderson
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
- Private practice Aurora CO
| | - Dimitris N. Tatakis
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
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19
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Periodontitis: A Multifaceted Disease of Tooth-Supporting Tissues. J Clin Med 2019; 8:jcm8081135. [PMID: 31370168 PMCID: PMC6723779 DOI: 10.3390/jcm8081135] [Citation(s) in RCA: 332] [Impact Index Per Article: 66.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022] Open
Abstract
Periodontitis is an infection-driven inflammatory disease in which the composition of biofilms plays a significant role. Dental plaque accumulation at the gingival margin initiates an inflammatory response that, in turn, causes microbial alterations and may lead to drastic consequences in the periodontium of susceptible individuals. Chronic inflammation affects the gingiva and can proceed to periodontitis, which characteristically results in irreversible loss of attachment and alveolar bone. Periodontitis appears typically in adult-aged populations, but young individuals can also experience it and its harmful outcome. Advanced disease is the major cause of tooth loss in adults. In addition, periodontitis is associated with many chronic diseases and conditions affecting general health.
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20
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Hanioka T, Morita M, Yamamoto T, Inagaki K, Wang PL, Ito H, Morozumi T, Takeshita T, Suzuki N, Shigeishi H, Sugiyama M, Ohta K, Nagao T, Hanada N, Ojima M, Ogawa H. Smoking and periodontal microorganisms. JAPANESE DENTAL SCIENCE REVIEW 2019; 55:88-94. [PMID: 31049117 PMCID: PMC6484221 DOI: 10.1016/j.jdsr.2019.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 03/16/2019] [Accepted: 03/28/2019] [Indexed: 12/24/2022] Open
Abstract
Resolution of dysbiosis following treatment for periodontal disease and tobacco dependence has been reported in longitudinal intervention studies. In the present report, we evaluated the biological findings regarding the effect of smoking on the periodontal microbiome. A standardized electronic search was conducted using MEDLINE; overall, 1099 papers were extracted. Studies that addressed the relationship between tobacco and periodontal pathogens were included. Finally, 42 papers were deemed appropriate for the present review. Functional changes in periodontal pathogens exposed to nicotine and cigarette smoke extract support the clinical findings regarding dysbiosis of the subgingival microbiome. Dysbiosis of the periodontal microbiome was presented in smokers regardless of their periodontal condition (healthy, gingivitis, or periodontitis) and remained significant only in smokers even after the resolution of experimentally-induced gingivitis and following reduction of clinical signs of periodontitis with non-surgical periodontal treatment and over 3 months post-therapy. Based on these findings, smoking cessation in periodontitis patients is beneficial for promoting a health-compatible subgingival microbial community. To maximize the benefits of these interventions in dental settings, further studies on periodontal microbiome are needed to elucidate the impact of tobacco intervention on preventing recurrence of periodontal destruction in the susceptible subjects.
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Affiliation(s)
- Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Japan
| | - Koji Inagaki
- Department of Dental Hygiene, Aichi Gakuin Junior College, Japan
| | - Pao-Li Wang
- Department of Dental Education Innovation, Osaka Dental University, Japan
| | - Hiroshi Ito
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Japan
| | - Toshiya Morozumi
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Kanagawa Dental University Graduate School of Dentistry, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Japan
| | - Nao Suzuki
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Kouji Ohta
- Department of Oral & Maxillofacial Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Japan
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Japan
| | - Miki Ojima
- Department of Oral Health Sciences, Faculty of Nursing and Health Care, BAIKA Women's University, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, and WHO Collaborating Center for Translation of Oral Health Science, Niigata University, Japan
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21
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ALHarthi SS, BinShabaib M, Akram Z, Rahman I, Romanos GE, Javed F. Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study. Clin Oral Investig 2018; 23:2751-2758. [PMID: 30361795 DOI: 10.1007/s00784-018-2725-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/18/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES There are no studies that have assessed the oral soft tissue response to full-mouth ultrasonic scaling (FMUS) among cigarette-smokers (CS) (group 1), individuals vaping electronic-cigarettes (E-cigs) (group 2), and never-smokers (NS) (group 3). The aim was to assess the impact of cigarette smoking and vaping on periodontal tissues following FMUS. MATERIALS AND METHODS In a clinical prospective study, 89 male individuals were divided into three groups: CS (group 1), E-cig users (group 2), and NS (group 3). A questionnaire was used to gather demographic data and information regarding duration and daily frequency of CS and vaping. Full-mouth plaque index (PI), bleeding on probing (BOP), clinical attachment loss (AL), and probing depth (PD) were measured at baseline and 3 and 6 months after FMUS (without root surface debridement). Numbers of missing teeth (MT) were also recorded. RESULTS In groups 1, 2, and 3, 30, 28, and 31 individuals, respectively were included. In group 1, there was no statistically significant difference in mean PI and PD and numbers of sites with PD ≥ 4 mm at 6 months' follow-up compared with baseline and 3 months' follow-up. In groups 2 and 3, there was no significant difference in PI, BOP, and PD at 3 months' (P > 0.05) and 6-months' (P > 0.05) follow-up. There were no pockets with PD ≥ 4 mm at 3 and 6 months' follow-up in groups 2 and 3. There was no difference in the numbers of MT and none of the individuals exhibited clinical AL in all groups. CONCLUSION Following FMUS, gingival inflammation is worse in CS compared with individuals vaping E-cigs and NS. CLINICAL RELEVANCE Periodontal inflammatory parameters are worse in cigarette-smokers than individuals vaping electronic cigarettes and never-smokers following FMUS. However, these findings should be interpreted with extreme caution as a number of factors may have influenced the present results.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munerah BinShabaib
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan.
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Georgios E Romanos
- Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Frankfurt, Germany.,Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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22
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Nicolini AC, Grisa TA, Muniz FWMG, Rösing CK, Cavagni J. Effect of adjuvant use of metformin on periodontal treatment: a systematic review and meta-analysis. Clin Oral Investig 2018; 23:2659-2666. [DOI: 10.1007/s00784-018-2666-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/25/2018] [Indexed: 12/13/2022]
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23
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Fardal Ø, Grytten J, Martin J, Ellingsen S, Fardal P, Heasman P, Linden GJ. Adding smoking to the Fardal model of cost-effectiveness for the lifetime treatment of periodontal diseases. J Periodontol 2018; 89:1283-1289. [DOI: 10.1002/jper.17-0467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 11/13/2017] [Accepted: 11/19/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Øystein Fardal
- Private practice; Egersund Norway
- Institute of Education for Medical and Dental Sciences, University of Aberdeen, Aberdeen; UK
- Institute of Community Dentistry; University of Oslo; Norway
| | - Jostein Grytten
- Institute of Community Dentistry; University of Oslo; Norway
| | - John Martin
- Private practice; State College; PA and PreViser Corporation; Concord NH
| | | | | | - Peter Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | - Gerard J. Linden
- Centre for Public Health; School of Medicine Dentistry and Biomedical Science; Queen's University; Belfast UK
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Eshghipour B, Tofighi H, Nehal F, Vohra F, Javed F, Akram Z. Effect of scaling and root planing on gingival crevicular fluid cytokine/chemokine levels in smokers with chronic periodontitis: A systematic review. ACTA ACUST UNITED AC 2018; 9:e12327. [DOI: 10.1111/jicd.12327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/24/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Baharak Eshghipour
- Department of DentistryTehran University of Medical Sciences and Health Services Tehran Iran
- Department of Public HealthEastman Institute for Oral HealthUniversity of Rochester Rochester NY USA
| | - Hamid Tofighi
- Department of Pediatric DentistryEastman Institute for Oral HealthUniversity of Rochester Rochester NY USA
| | - Faham Nehal
- Department of EndodonticsLiaquat College of Medicine and Dentistry Karachi Pakistan
| | - Fahim Vohra
- Department of Prosthetic Dental SciencesCollege of DentistryKing Saud University Riyadh Saudi Arabia
| | - Fawad Javed
- Department of General DentistryEastman Institute for Oral HealthUniversity of Rochester Rochester NY USA
| | - Zohaib Akram
- Department of PeriodontologyFaculty of DentistryZiauddin University Karachi Pakistan
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Is Antimicrobial Photodynamic Therapy Effective as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis? A Systematic Review. Biomolecules 2017; 7:biom7040079. [PMID: 29186805 PMCID: PMC5745461 DOI: 10.3390/biom7040079] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this systematic review was to investigate whether antimicrobial photodynamic therapy (aPDT) as either a primary mode of treatment or an adjunct to non-surgical treatment was more effective than scaling and root planing (SRP) alone in treating chronic periodontitis in terms of clinical attachment level (CAL) gain and probing depth (PD) reduction. The focused question was developed using the Patient, Intervention, Comparison, and Outcome (PICO) format, and two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2008 to December 2016. Twenty studies included in this systematic review were randomized clinical trials (RCTs) or quasi-RCTs of aPDT compared to placebo, no intervention, or non-surgical treatment in an adult population. Basic study characteristics, photosensitizing agents and wavelengths used in aPDT, frequency of aPDT application, effect of aPDT on clinical parameters, antimicrobial effect of aPDT in chronic periodontitis, effect of immunological parameters following aPDT and patient-based outcome measures were collected from the studies. Although there was a wide range of heterogeneity in the included studied, they all indicated that aPDT has the potential to be an effective adjunct in the treatment of chronic periodontitis. Long-term, multicenter studies with larger sample sizes are needed before aPDT can be recommended as an effective treatment modality.
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Al-Hamoudi N. Is antimicrobial photodynamic therapy an effective treatment for chronic periodontitis in diabetes mellitus and cigarette smokers: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2017; 19:375-382. [DOI: 10.1016/j.pdpdt.2017.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 05/21/2017] [Accepted: 05/24/2017] [Indexed: 12/22/2022]
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Bunaes DF, Mustafa M, Mohamed HG, Lie SA, Leknes KN. The effect of smoking on inflammatory and bone remodeling markers in gingival crevicular fluid and subgingival microbiota following periodontal therapy. J Periodontal Res 2017; 52:713-724. [PMID: 28306142 DOI: 10.1111/jre.12438] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontal health is mediated by suppressing microorganisms inducing a local inflammatory host response. Smoking may impair this process. This study compares gingival crevicular fluid levels of inflammatory and bone remodeling markers in heavy smokers and non-smokers following active and supportive periodontal therapy in patients with chronic periodontitis. MATERIAL AND METHODS Gingival crevicular fluid and subgingival plaque were collected from the deepest periodontal pocket in 50 patients, 25 smokers and 25 non-smokers, at baseline (T0), following active (T1) and 12 mo of supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Gingival crevicular fluid levels of 27 inflammatory and two bone remodeling markers were analyzed using multiplex and singleplex micro-bed immunoassays, and subgingival plaque samples using checkerboard DNA-DNA hybridization. Amounts of markers in smokers and non-smokers were compared calculating the effect size. RESULTS Expression of inflammatory and bone-remodeling markers in smokers demonstrated an overall reduced effect size at T0 and T2 (p < 0.001). In particular, proinflammatory markers (p < 0.001), chemokines (p = 0.007) and growth factors (p = 0.003) at T0, osteoprotegerin (p = 0.003) at T1, proinflammatory markers (p = 0.019) and chemokines (p = 0.005) at T2. At T2, interleukin-8 was detected in significantly higher levels in smokers. Ten different markers in non-smokers and none in smokers responded to periodontal therapy (p < 0.05). An overall negative association was revealed between smoking and subgroups of markers at sites presenting ≥ 105 red complex periodontal microbial species. CONCLUSION Except for an upregulation of interleukin-8, smokers exhibited reduced gingival crevicular fluid levels of several inflammatory markers at baseline and following active and supportive periodontal therapy. Only inflammatory responses in non-smokers adapted to periodontal therapy. Apparently, there seems to be an immunosuppressant effect of smoking regulating the local inflammatory response and bone remodeling markers captured in gingival crevicular fluid following periodontal therapy.
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Affiliation(s)
- D F Bunaes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - M Mustafa
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - H G Mohamed
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - S A Lie
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - K N Leknes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Akram Z, Abduljabbar T, Sauro S, Daood U. Effect of photodynamic therapy and laser alone as adjunct to scaling and root planing on gingival crevicular fluid inflammatory proteins in periodontal disease: A systematic review. Photodiagnosis Photodyn Ther 2016; 16:142-153. [DOI: 10.1016/j.pdpdt.2016.09.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 08/28/2016] [Accepted: 09/08/2016] [Indexed: 01/06/2023]
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Bunaes DF, Lie SA, Åstrøm AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following 12 months of supportive periodontal therapy. J Clin Periodontol 2016; 43:1086-1093. [PMID: 27554463 PMCID: PMC5132109 DOI: 10.1111/jcpe.12619] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2016] [Indexed: 12/05/2022]
Abstract
Aim To evaluate the effect of cigarette smoking on periodontal health at patient, tooth, and site levels following supportive therapy. Materials and Methods Eighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to a single‐arm clinical trial. Periodontal examinations were performed at baseline (T0), 3 months following active periodontal therapy (T1), and 12 months following supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Logistic regression analyses adjusted for clustered observations of patients, teeth, and sites and mixed effects models were employed to analyse the data. Results All clinical parameters improved from T0 to T2 (p < 0.001), whereas PD, bleeding index (BI), and plaque index (PI) increased from T1 to T2 in smokers and non‐smokers (p < 0.001). An overall negative effect of smoking was revealed at T2 (OR = 2.78, CI: 1.49, 5.18, p < 0.001), with the most pronounced effect at maxillary single‐rooted teeth (OR = 5.08, CI: 2.01, 12.78, p < 0.001). At the patient level, less variation in treatment outcome was detected within smokers (ICC = 0.137) compared with non‐smokers (ICC = 0.051). Conclusion Smoking has a negative effect on periodontal health following 12 months of supportive therapy, in particular at maxillary single‐rooted teeth.
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Affiliation(s)
- Dagmar F Bunaes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Kamal Mustafa
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Knut N Leknes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z. Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 2016; 32:449-459. [DOI: 10.1007/s10103-016-2086-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/21/2016] [Indexed: 12/31/2022]
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Eick S, Mathey A, Vollroth K, Kramesberger M, Bürgin W, Sculean A, Ramseier C, Jentsch H. Persistence of Porphyromonas gingivalis is a negative predictor in patients with moderate to severe periodontitis after nonsurgical periodontal therapy. Clin Oral Investig 2016; 21:665-674. [PMID: 27558382 DOI: 10.1007/s00784-016-1933-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 08/02/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the quality of prediction for stable results after nonsurgical periodontal therapy by several microbiological variables of the subgingival biofilm and biomarkers of gingival crevicular fluid or oral lavage. MATERIAL AND METHODS Forty-six individuals with moderate or severe chronic periodontitis receiving nonsurgical periodontal therapy were monitored for clinical variables, selected microorganisms, and biomarkers at baseline and 3 and 6 months thereafter. Logistic regression analysis and general linear model (GLM) were applied for analysis of variance and covariance. RESULTS At 6 months, 20 patients showed a high response (HR) to treatment (at least 60 % of reduction of numbers of sites with PD >4 mm), whereas 26 did not (low response, LR). All clinical variables were significantly improved at 3 and 6 months within each group (p < 0.001, each compared with baseline). Modeling the impact of Porphyromonas gingivalis, Treponema denticola, and median of MMP-8 on to the response to treatment as continuous variables by GLM showed a significant influence of these variables (p = 0.045) with the strongest influence of P. gingivalis (p = 0.012) followed by T. denticola (p = 0.045) and no association with MMP-8 (p = 0.982). Samples tested positively for P. gingivalis decreased only in HR (3 months: p = 0.003; 6 months: p = 0.002). Calprotectin levels in GCF were lower in the HR group compared with the LR group at 3 months (p = 0.008) and at 6 months (p = 0.018). CONCLUSION Persistence of P. gingivalis combined with a high GCF level of calprotectin may have a negative predictive value on response to periodontal therapy. CLINICAL RELEVANCE Microbiological diagnostics for P. gingivalis before and 3 months after SRP may have a predictive value on response to periodontal therapy. The combination with MMP-8 in oral lavage or preferably calprotectin in GCF might give additional information.
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Affiliation(s)
- Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Ayse Mathey
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Karolin Vollroth
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Martin Kramesberger
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Walter Bürgin
- Ressort Research, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Christoph Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Holger Jentsch
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
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Pussinen PJ, Könönen E. Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association? Eur J Prev Cardiol 2016; 23:834-8. [PMID: 26915578 DOI: 10.1177/2047487316636506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of Turku and City of Turku, Welfare Division, Turku, Finland
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Bunaes DF, Lie SA, Enersen M, Aastrøm AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following non-surgical and surgical periodontal therapy. J Clin Periodontol 2015; 42:933-42. [PMID: 26407817 PMCID: PMC6207927 DOI: 10.1111/jcpe.12462] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 11/26/2022]
Abstract
Aim To evaluate the effect of smoking at patient, tooth, and site level following non‐surgical and surgical periodontal therapy. Material and Methods Eighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to this single‐arm clinical trial. Smoking status was validated by measuring serum cotinine levels. Periodontal examinations were performed at baseline (T0) and 3 months following non‐surgical and surgical periodontal therapy (T1). At T0 and T1, subgingival plaque samples were collected from the deepest periodontal pocket in each patient and analysed using checkerboard DNA–DNA hybridization. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Unadjusted and adjusted logistic regression analyses, corrected for clustered observations within patients and teeth, were conducted comparing smokers with non‐smokers. Results Clinical parameters significantly improved in both groups (p < 0.001). An association was revealed between smoking and PD ≥ 5 mm with BoP (OR= 1.90, CI: 1.14, 3.15, p = 0.013), especially for plaque‐positive sites (OR= 4.14, CI: 2.16, 7.96, p < 0.001). A significant reduction of red complex microbiota was observed for non‐smokers only (p = 0.010). Conclusion Smokers respond less favourably to non‐surgical and surgical periodontal therapy compared with non‐smokers, in particular at plaque‐positive sites.
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Affiliation(s)
- Dagmar F Bunaes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute of Oral Biology, University of Oslo, Oslo, Norway
| | - Anne Nordrehaug Aastrøm
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Kamal Mustafa
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Knut N Leknes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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