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Drumond VZ, de Arruda JAA, de Andrade BAB, Silva TA, Mesquita RA, Abreu LG. Tooth loss from the perspective of studies employing a life course approach: a systematic review. Health Promot Int 2024; 39:daae112. [PMID: 39322426 DOI: 10.1093/heapro/daae112] [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] [Indexed: 09/27/2024] Open
Abstract
The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.
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Affiliation(s)
- Victor Zanetti Drumond
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Professor Rodolho Paulo Rocco 325, Cidade Universitária, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruno Augusto Benevenuto de Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Professor Rodolho Paulo Rocco 325, Cidade Universitária, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Peditto M, Rupe C, Gambino G, Di Martino M, Barbato L, Cairo F, Oteri G, Cavalcanti R. Influence of mobility on the long-term risk of tooth extraction/loss in periodontitis patients. A systematic review and meta-analysis. J Periodontal Res 2024. [PMID: 38766764 DOI: 10.1111/jre.13286] [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: 02/21/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024]
Abstract
The aim of this systematic review (SR) was to assess whether tooth mobility (TM) increases the risk of tooth extraction/loss. The protocol was registered in PROSPERO database (CRD42023485425). The focused PECO questions were as follows: (1) "In patients with periodontitis, undergoing periodontal treatment, are teeth affected by mobility at higher risk of being extracted/lost compared to non-mobile teeth, with a minimum follow-up of 10 years?" and (2) "In these patients, does varying degrees of tooth mobility increase the risk of tooth extraction/loss, with a minimum follow-up of 10 years?". Results were reported according to PRISMA statement. Electronic and manual searches were conducted to identify longitudinal studies. The different assessments of tooth mobility were pooled into three groups: TM0: Undetectable tooth mobility, TM1: Horizontal/Mesio-distal mobility ≤1 mm, TM2: Horizontal/Mesio-distal mobility >1 mm or vertical tooth mobility. Tooth loss was the primary outcome. Various meta-analyses were conducted, including subgroup analyses considering different follow-up lengths and the timing of TM assessment, along with sensitivity analyses. A trial sequential analysis was also performed. Eleven studies were included (1883 patients). The mean follow-up range was 10-25 years. The weighted total of included teeth, based on the sample size, was 18 918, with a total of 1604 (8.47%) extracted/lost teeth. The overall rate of tooth extraction/loss increased with increasing mobility: TM0 was associated with a 5.85% rate (866/14822), TM1 with the 11.8% (384/3255), TM2 with the 40.3% (339/841). Mobile teeth (TM1/TM2) were at an increased risk for tooth extraction/loss, compared to TM0 (HR: 2.85; [95% CI 1.88-4.32]; p < .00001). TM1 had a higher risk than TM0 (HR: 1.96; [95% CI 1.09-3.53]; p < .00001). TM2 had a higher risk than TM1 (HR: 2.85; [95% CI 2.19-3.70]; p < .00001) and TM0 (HR: 7.12; [95% CI 3.27-15.51]; p < .00001). The results of the tests for subgroup differences were not significant. Sensitivity meta-analyses yielded consistent results with other meta-analyses. Within the limits of the quality of the studies included in the meta-analyses, mobile teeth were at higher risk of being extracted/lost in the long-term and higher degrees of TM significantly influenced clinicians' decision to extract a tooth. However, most teeth can be retained in the long-term and thus TM should not be considered a reason for extraction or a risk factor for tooth loss, regardless of the degree of TM.
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Affiliation(s)
- Matteo Peditto
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Cosimo Rupe
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Giorgia Gambino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Maria Di Martino
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine-Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Raffaele Cavalcanti
- Private Practice Bari, Bari, Italy
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Saleh MHA, Dias DR, Mandil O, Oliveira RPD, Alrmali A, Araújo MG, Wang HL, Barath Z, Urban IA. Influence of residual pockets on periodontal tooth loss: A retrospective analysis. J Periodontol 2024; 95:444-455. [PMID: 38112067 DOI: 10.1002/jper.23-0448] [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: 08/03/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined "threshold" at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk. METHODS Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model. RESULTS Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit. CONCLUSION Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Obada Mandil
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | | | - Abdusalam Alrmali
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zoltan Barath
- Department of Prosthetic Dentistry, University of Szeged, Szeged, Hungary
| | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Prosthetic Dentistry, University of Szeged, Szeged, Hungary
- Department of Oral Medicine, Infection Control and Immunity, Harvard University, Boston, Massachusetts, USA
- Urban Regeneration Institute, Budapest, Hungary
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Mitani AA, Feng X, Kaye EK. Modelling time-varying risk factors of tooth loss: Results from joint model compared with extended Cox regression model. J Clin Periodontol 2024; 51:110-117. [PMID: 37846605 DOI: 10.1111/jcpe.13888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/10/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
AIM To illustrate the use of joint models (JMs) for longitudinal and survival data in estimating risk factors of tooth loss as a function of time-varying endogenous periodontal biomarkers (probing pocket depth [PPD], alveolar bone loss [ABL] and mobility [MOB]). MATERIALS AND METHODS We used data from the Veterans Affairs Dental Longitudinal Study, a longitudinal cohort study of over 30 years of follow-up. We compared the results from the JM with those from the extended Cox regression model which assumes that the time-varying covariates are exogenous. RESULTS Our results showed that PPD is an important risk factor of tooth loss, but each model produced different estimates of the hazard. In the tooth-level analysis, based on the JM, the hazard of tooth loss increased by 4.57 (95% confidence interval [CI]: 2.13-8.50) times for a 1-mm increase in maximum PPD, whereas based on the extended Cox model, the hazard of tooth loss increased by 1.60 (95% CI: 1.37-1.87) times. CONCLUSIONS JMs can incorporate time-varying periodontal biomarkers to estimate the hazard of tooth loss. As JMs are not commonly used in oral health research, we provide a comprehensive set of R codes and an example dataset to implement the method.
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Affiliation(s)
- Aya A Mitani
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Xinyang Feng
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth K Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
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Dederichs M, Joedecke P, Weber CT, Guentsch A. Functional Load Capacity of Teeth with Reduced Periodontal Support: A Finite Element Analysis. Bioengineering (Basel) 2023; 10:1330. [PMID: 38002454 PMCID: PMC10669356 DOI: 10.3390/bioengineering10111330] [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: 09/14/2023] [Revised: 10/25/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
The purpose of this study was to investigate the functional load capacity of the periodontal ligament (PDL) in a full arch maxilla and mandible model using a numerical simulation. The goal was to determine the functional load pattern in multi- and single-rooted teeth with full and reduced periodontal support. CBCT data were used to create 3D models of a maxilla and mandible. The DICOM dataset was used to create a CAD model. For a precise description of the surfaces of each structure (enamel, dentin, cementum, pulp, PDL, gingiva, bone), each tooth was segmented separately, and the biomechanical characteristics were considered. Finite Element Analysis (FEA) software computed the biomechanical behavior of the stepwise increased force of 700 N in the cranial and 350 N in the ventral direction of the muscle approach of the masseter muscle. The periodontal attachment (cementum-PDL-bone contact) was subsequently reduced in 1 mm increments, and the simulation was repeated. Quantitative (pressure, tension, and deformation) and qualitative (color-coded images) data were recorded and descriptively analyzed. The teeth with the highest load capacities were the upper and lower molars (0.4-0.6 MPa), followed by the premolars (0.4-0.5 MPa) and canines (0.3-0.4 MPa) when vertically loaded. Qualitative data showed that the areas with the highest stress in the PDL were single-rooted teeth in the cervical and apical area and molars in the cervical and apical area in addition to the furcation roof. In both single- and multi-rooted teeth, the gradual reduction in bone levels caused an increase in the load on the remaining PDL. Cervical and apical areas, as well as the furcation roof, are the zones with the highest functional stress. The greater the bone loss, the higher the mechanical load on the residual periodontal supporting structures.
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Affiliation(s)
- Marco Dederichs
- Policlinic of Prosthetic Dentistry and Material Science, Centre for Dental Medicine, Jena University Hospital, D-07743 Jena, Germany;
| | - Paul Joedecke
- Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, D-39114 Magdeburg, Germany (C.-T.W.)
| | - Christian-Toralf Weber
- Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, D-39114 Magdeburg, Germany (C.-T.W.)
| | - Arndt Guentsch
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
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Lafaurie GI, Sabogal MA, Contreras A, Castillo DM, Gualtero DF, Avila JD, Trujillo TG, Duque A, Giraldo A, Duarte S, Gutierrez SJ, Ardila CM. Factors Associated with the Extent of Clinical Attachment Loss in Periodontitis: A Multicenter Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7043. [PMID: 37998274 PMCID: PMC10671280 DOI: 10.3390/ijerph20227043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
Periodontitis has significant public health implications, affecting individuals' overall health, well-being, and quality of life. This study aimed to assess the risk factors associated with the extent of clinical attachment loss (CAL) in a population diagnosed with periodontitis. Six hundred and sixty-seven patients with different degrees of CAL (mild, n = 223; moderate, n = 256; and advanced, n = 188) were enrolled. Socio-demographics, lifestyle, microbiological profiles, specific immune response, obesity, and single-nucleotide polymorphism of the IL1 gene were determined. Unconditional logistic regression models were conducted to determine the factors associated with the extent of CAL. Aging, smoking, microbial factors, plaque index, and IgG2 antibodies against Aggregatibacter actinomycetemcomitans were associated with advanced CAL. IgG2 antibodies against A. actinomycetemcomitans (OR 1.50; CI 95% 1.23-1.81), plaque accumulation (OR 2.69; CI 95% 2.20-3.29), Porphyromonas gingivalis (OR 1.93; CI 95% 1.35-2.76), Tanerella forsythia (OR 1.88; CI 95%1.30-2.70), and current smoking (OR 1.94; CI 95% 1.31-2.87) were associated with advanced CAL. Gene IL polymorphisms, obesity, and stress were not associated with the extent of CAL. Aging, plaque accumulation, smoking, and having antibodies against A. actinomycetemcomitans were the most critical factors associated with advanced CAL. In contrast, obesity, stress, and gene polymorphisms were not associated with the extent of CAL.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - María Alejandra Sabogal
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Adolfo Contreras
- Periodontal Medicine Group, Universidad del Valle, Cali 760042, Colombia; (A.C.); (S.J.G.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Diego Fernando Gualtero
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Juliette De Avila
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Tamy Goretty Trujillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Andrés Duque
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Astrid Giraldo
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Silvia Duarte
- Dental Research Center-CIO, Pontificia Universidad Javeriana, Bogota 110311, Colombia;
| | | | - Carlos Martín Ardila
- Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia UdeA, Medellin 050010, Colombia
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Salvi GE, Roccuzzo A, Imber JC, Stähli A, Klinge B, Lang NP. Clinical periodontal diagnosis. Periodontol 2000 2023. [PMID: 37452444 DOI: 10.1111/prd.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 07/18/2023]
Abstract
Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Cárcamo-España V, Cuesta Reyes N, Flores Saldivar P, Chimenos-Küstner E, Estrugo Devesa A, López-López J. Compromised Teeth Preserve or Extract: A Review of the Literature. J Clin Med 2022; 11:jcm11185301. [PMID: 36142946 PMCID: PMC9504015 DOI: 10.3390/jcm11185301] [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: 08/21/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Multiple systems and associated factors have been described in the literature to assess the prognosis of teeth with periodontal disease. Nowadays there is a tendency among clinicians to consider implants as the best solution after tooth extraction, in cases of teeth with a questionable prognosis. However, the value of the natural tooth must be considered, as the proprioception of the periodontal ligament is preserved, and it adapts to stress during functional loads. We first review the literature focusing on analyzing the factors that should guide decision-making to maintain or extract a tooth with a compromised periodontium. Then, we propose a schematic diagram of prognostic indicators to reflect the main factors to consider and the survival rate that each one represents when preserving or extracting a tooth.
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Affiliation(s)
- Valentina Cárcamo-España
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (V.C.-E.); or (J.L.-L.); Tel.: +34-606-45-73-62 (J.L.-L.)
| | - Nataly Cuesta Reyes
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Paul Flores Saldivar
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Eduardo Chimenos-Küstner
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Alberto Estrugo Devesa
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - José López-López
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (V.C.-E.); or (J.L.-L.); Tel.: +34-606-45-73-62 (J.L.-L.)
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Evaluation of periodontitis-related tooth loss according to the new 2018 classification of periodontitis. Sci Rep 2022; 12:11893. [PMID: 35831375 PMCID: PMC9279363 DOI: 10.1038/s41598-022-15462-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
The new 2018 classification of periodontal diseases is reported to be related to tooth loss due to periodontal disease (TLPD) during supportive periodontal therapy (SPT). However, few reports have evaluated this relationship for Asians or have analyzed the association of the new classification and TLPD by distinguishing between active periodontal therapy (APT) and SPT. In this study, we retrospectively applied the new classification to 607 Japanese periodontitis patients and examined the relationship between the new classification and annual TLPD rates per patient during the respective periods. TLPD rates were higher in patients in stage IV and/or grade C during both APT and SPT. TLPD during SPT was not associated with the presence or absence of TLPD during APT. Multivariate analysis revealed that stage IV and grade C as independent variables were significantly associated with the number of instances of TLPD not only during the total treatment period, but also during APT or SPT. Our results suggest that the new classification has a significantly strong association with TLPD during both APT and SPT, and that patients diagnosed with stage IV and/or grade C periodontitis had a higher risk of TLPD during both periods.
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Jacob L, Shin JI, Oh H, López-Sánchez GF, Smith L, Haro JM, Koyanagi A. Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries. BMJ Open Diabetes Res Care 2021; 9:9/1/e002514. [PMID: 34620622 PMCID: PMC8499266 DOI: 10.1136/bmjdrc-2021-002514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/26/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Previous studies on the diabetes-edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs). RESEARCH DESIGN AND METHODS Data from the World Health Survey were used for this cross-sectional study (2002-2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models. RESULTS There were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only. CONCLUSIONS Diabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Abstract
Introduction Little is understood about the socioeconomic predictors of tooth loss, a condition that can negatively impact individual’s quality of life. The goal of this study is to develop a machine-learning algorithm to predict complete and incremental tooth loss among adults and to compare the predictive performance of these models. Methods We used data from the National Health and Nutrition Examination Survey from 2011 to 2014. We developed multiple machine-learning algorithms and assessed their predictive performances by examining the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values. Results The extreme gradient boosting trees presented the highest performance in the prediction of edentulism (AUC = 88.7%; 95%CI: 87.1, 90.2), the absence of a functional dentition (AUC = 88.3% 95%CI: 87.3,89.3) and for predicting missing any tooth (AUC = 83.2%; 95%CI, 82.0, 84.4). Although, as expected, age and routine dental care emerged as strong predictors of tooth loss, the machine learning approach identified additional predictors, including socioeconomic conditions. Indeed, the performance of models incorporating socioeconomic characteristics was better at predicting tooth loss than those relying on clinical dental indicators alone. Conclusions Future application of machine-learning algorithm, with longitudinal cohorts, for identification of individuals at risk for tooth loss could assist clinicians to prioritize interventions directed toward the prevention of tooth loss.
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12
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Saleh MHA, Dukka H, Troiano G, Ravidà A, Qazi M, Wang HL, Greenwell H. Long term comparison of the prognostic performance of PerioRisk, periodontal risk assessment, periodontal risk calculator, and staging and grading systems. J Periodontol 2021; 93:57-68. [PMID: 33914347 DOI: 10.1002/jper.20-0662] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Clinicians predominantly use personal judgment for risk assessment. Periodontal risk assessment tools (PRATs) provide an effective and logical system to stratify patients based on their individual treatment needs. This retrospective longitudinal study aimed to validate the association of different risk categories of four PRATs (Staging and grading; Periodontal Risk Assessment (PRA); Periodontal Risk Calculator; and PerioRisk) with periodontal related tooth loss (TLP), and to compare their prognostic performance. METHODS Data on medical history, smoking status, and clinical periodontal parameters were retrieved from patients who received surgical and non-surgical periodontal treatment. A comparison of the rate of TLP and non-periodontal related tooth loss (TLO) within the risk tool classes were performed by means of Kruskal-Wallis test followed by post-hoc comparison with the Bonferroni test. Both univariate and multivariate Cox Proportional hazard regression models were built to analyze the prognostic significance for each single risk assessment tool class on TLP. RESULTS A total of 167 patients with 4321 teeth followed up for a mean period of 26 years were assigned to four PRATs. PerioRisk class 5 had a hazard ratio of 18.43, Stage 4 had a hazard ratio of 7.99, and PRA class 3 had a hazard ratio of 6.13 compared with class/stage I. With respect to prognostic performance, PerioRisk tool demonstrated the best discrimination and model fit followed by PRA. CONCLUSION All PRATs displayed very good predictive capability of TLP. PerioRisk showed the best discrimination and model fit, followed by PRA.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Himabindu Dukka
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Henry Greenwell
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
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13
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Association, prediction, generalizability: Cross-center validity of predicting tooth loss in periodontitis patients. J Dent 2021; 109:103662. [PMID: 33857544 DOI: 10.1016/j.jdent.2021.103662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To predict patients' tooth loss during supportive periodontal therapy across four German university centers. METHODS Tooth loss in 897 patients in four centers (Kiel (KI) n = 391; Greifswald (GW) n = 282; Heidelberg (HD) n = 175; Frankfurt/Main (F) n = 49) during supportive periodontal therapy (SPT) was assessed. Our outcome was annualized tooth loss per patient. Multivariable linear regression models were built on data of 75 % of patients from one center and used for predictions on the remaining 25 % of this center and 100 % of data from the other three centers. The prediction error was assessed as root-mean-squared-error (RMSE), i.e., the deviation of predicted from actually lost teeth per patient and year. RESULTS Annualized tooth loss/patient differed significantly between centers (between median 0.00 (interquartile interval: 0.00, 0.17) in GW and 0.09 (0.00, 0.19) in F, p = 0.001). Age, smoking status and number of teeth before SPT were significantly associated with tooth loss (p < 0.03). Prediction within centers showed RMSE of 0.14-0.30, and cross-center RMSE was 0.15-0.31. Predictions were more accurate in F and KI than in HD and GW, while the center on which the model was trained had a less consistent impact. No model showed useful predictive values. CONCLUSION While covariates were significantly associated with tooth loss in linear regression models, a clinically useful prediction was not possible with any of the models and generalizability was not given. Predictions were more accurate for certain centers. CLINICAL RELEVANCE Association should not be confused with predictive value: Despite significant associations of covariates with tooth loss, none of our models was useful for prediction. Usually, model accuracy was even lower when tested across centers, indicating low generalizability.
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14
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Povšič K, Čuk K, Milavec S, Erčulj V, Seme K, Gašperšič R. Systemic azithromycin as an adjunct to scaling and root planing in patients with stage III/IV periodontitis: 12-month results of a randomized controlled clinical trial. Clin Oral Investig 2021; 25:5997-6006. [PMID: 33786649 DOI: 10.1007/s00784-021-03906-8] [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: 12/07/2020] [Accepted: 03/23/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine whether azithromycin (AZI) as an adjunct to scaling and root planing (SRP), when compared to placebo, decreases the number of sites demonstrating pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) 12 months post-treatment in stage III/IV periodontitis patients. MATERIALS AND METHODS In a double-blind randomized parallel-arm placebo-controlled trial, 40 stage III/IV periodontitis patients received steps 1 and 2 of periodontal treatment in two sessions within 7 days. Patients then received systemic antibiotic therapy (n = 20; AZI 500 mg/day, 3 days) or placebo (n = 20). Additional instrumentation of residual diseased sites (DS) - sites with PD ≥ 5 mm and BOP - was performed at the 3-, 6- and 9-month follow-ups. The primary outcome variable was the number of DS at the 12-month re-evaluation. Using a multivariate multilevel logistic regression model, the effects of gender, age, antibiotic therapy, presence of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated. RESULTS The number of DS after 12 months was similar in the test (median (Me) = 4, interquartile range (IQR) = 0-6) and control (Me = 3, IQR = 1-6.5) groups. Both groups showed substantial but equivalent improvements in periodontal parameters, with no intergroup differences at initially shallow or deep sites. The logistic regression showed a lower odds ratio (OR) for the healing of DS on molars (OR = 0.29; p < 0.001) and in smokers (OR = 0.36; p = 0.048). CONCLUSION Stage III/IV periodontitis patients showed significant but comparable improvements in periodontal parameters and the number of residual DS at the 12-month revaluation regardless of treatment type. This may have been the result of the additional instrumentation received by patients at residual DS in both treatment groups. CLINICAL RELEVANCE Treatment with AZI + SRP provided no additional benefits after 12 months in terms of periodontal parameters or the number of persisting sites with PD ≥ 5 mm + BOP as compared to SRP plus placebo. TRIAL REGISTRATION EUDRA-CT: 2015-004306-42; https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004306-42/SI , registered 17. 12. 2015.
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Affiliation(s)
- Katja Povšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.
| | - Katarina Čuk
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia
| | | | - Vanja Erčulj
- Rho Sigma Research & Statistics, 1000, Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia
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15
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Petsos H, Ramich T, Nickles K, Dannewitz B, Pfeifer L, Zuhr O, Eickholz P. Tooth loss in periodontally compromised patients: Retrospective long-term results 10 years after active periodontal therapy. Tooth-related outcomes. J Periodontol 2021; 92:1761-1775. [PMID: 33748997 DOI: 10.1002/jper.21-0056] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Estimating prognosis of periodontally affected teeth at the beginning of supportive periodontal care (SPC) is an important component for further treatment planning. This study aimed to evaluate tooth loss (TL) during 10 years of SPC in periodontally compromised patients and to identify tooth-related factors affecting TL. METHODS Patients were re-examined 120 ± 12 months after accomplishment of active periodontal therapy. TL was defined as primary outcome variable and tooth-related factors (abutment status, furcation involvement [FI], tooth mobility, mean periodontal probing depth [PD], and clinical attachment level [CAL] at beginning of SPC, and initial bone loss [BL]) were estimated based on an adjusted regression analyses model. RESULTS Ninety-seven patients (51 females and 46 males; mean age, 65.3 ± 11 years) lost 119 of 2,323 teeth (overall TL [OTL]: 0.12 teeth/patient/y) during 10 years of SPC. Forty of these teeth (33.6%) were lost for periodontal reasons (TLP; 0.04 teeth/patient/y). Significantly more teeth were lost due to other reasons (P <0.0001). TLP (OTL) only occurred in 5.9% (14.7%) of all teeth, when BL was at least 80%. Use as abutment tooth, FI degree III, tooth mobility degrees I and II, mean PD, and CAL positively correlated with OTL (P <0.05). For TLP, FI and tooth mobility degree III as well as mean CAL were identified as tooth-related prognostic factors (P <0.05). CONCLUSIONS During 10 years of SPC, most of the teeth (93.4%) of periodontally compromised patients were retained, showing the positive effect of a well-established treatment concept. Well-known tooth-related prognostic factors were confirmed.
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Affiliation(s)
- Hari Petsos
- Private practice, Soest, Germany.,Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany
| | - Tatjana Ramich
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany
| | - Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany.,Private practice, Mannheim, Germany
| | - Bettina Dannewitz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany.,Private practice, Weilburg, Germany
| | - Leon Pfeifer
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany
| | - Otto Zuhr
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany.,Private practice, Münich, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt am Main, Germany
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16
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Ravidà A, Qazi M, Rodriguez MV, Galli M, Saleh MHA, Troiano G, Wang HL. The influence of the interaction between staging, grading and extent on tooth loss due to periodontitis. J Clin Periodontol 2021; 48:648-658. [PMID: 33484162 DOI: 10.1111/jcpe.13430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/25/2020] [Accepted: 01/15/2021] [Indexed: 01/10/2023]
Abstract
AIM To assess the ability of two-way interactions between baseline stage, grade and extent to predict tooth loss due to periodontitis (TLP) over a long-term follow-up period. MATERIALS AND METHODS Patients treated for periodontal disease with a complete medical history, baseline periodontal chart, full mouth radiographs and a minimum of ≥10 years follow-up were recruited. Supportive periodontal therapy (SPT) visits were recorded during the entire follow-up period. Patients were categorized according to their stage, grade and extent. The absolute survival at 10-, 20-, and 30-year follow-up was calculated for TLP. Kaplan-Meier survival curves were plotted at the tooth-level and multilevel Cox regression frailty models were constructed in order to assess the association among predictive variables and TLP by taking into account the hierarchical patient-teeth structure. RESULTS 442 patients (11,125 teeth) with a mean follow-up of 23 years met the inclusion criteria and were included in this study. The most prevalent diagnosis at baseline was stage III grade B (30.3%), followed by stage II grade B (23.5%). Among the parameters analysed, stage and grade were found to be the best predictors of TLP. Statistically significant differences were observed for extent only in patients with severe disease (stage IV or grade C). The multilevel Cox regression analysis demonstrated that patients with higher concomitant baseline staging and grading developed greater TLP over the follow-up period. CONCLUSIONS Higher concomitant staging and grading corresponded to greater risk for TLP and generalized extent only became a significant predictor in patients with stage IV or grade C disease.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Maria V Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Muhammad H A Saleh
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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17
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Loos BG, Needleman I. Endpoints of active periodontal therapy. J Clin Periodontol 2021; 47 Suppl 22:61-71. [PMID: 31912527 PMCID: PMC7670400 DOI: 10.1111/jcpe.13253] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/21/2019] [Accepted: 01/04/2020] [Indexed: 01/01/2023]
Abstract
Aim Position paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life. Methods A literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>. Results A total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient. Conclusions Based on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Ian Needleman
- Unit of Periodontology, University College London Eastman Dental Institute, London, UK
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18
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Bilgin Çetin M, Sezgin Y, Maraş E, Cebeci İA. Association of probable bruxism with periodontal status: A cross-sectional study in patients seeking periodontal care. J Periodontal Res 2020; 56:370-378. [PMID: 33368265 DOI: 10.1111/jre.12829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/06/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The goals of this study were to investigate the prevalence of probable bruxism in a group of patients seeking a periodontal care and the association between probable bruxism and periodontal status. BACKGROUND The results of previous studies evaluating the relationship between bruxism and periodontitis are contradictory. In addition, the relationship between probable bruxism and periodontitis in adults has not been evaluated, yet. Therefore, new studies are required in this field to clarify the relationship between bruxism and periodontitis. METHODS Patients seeking periodontal care at a university periodontology unit were considered in this study. Their periodontal diagnosis, number of missing teeth, presence of probable bruxism, and sociodemographic characteristics were recorded. The periodontal status of each study participant was defined according to the latest consensus of the American Association of Periodontology/European Federation of Periodontology, and the 2018 consensus report on the assessment of bruxism was used to evaluate probable bruxism. A multiple logistic regression analysis was performed to determine the effects of bruxism on periodontitis. RESULTS A total of 541 patients (289 females and 252 males, mean age 42.1 ± 15.9 years) were enrolled in the present study. The prevalence of probable bruxism was 36.6%. Additionally, 40.9% of the study population was diagnosed with periodontitis. The probable bruxers were older (P < 0.001), had a higher number of missing teeth (P < 0.001), and had poor periodontal status (P < 0.001). The multivariate logistic regression analysis suggested that probable bruxism was associated with periodontitis, after adjusting relevant factors (odds ratio: 2.243, 95% CI: 1.465-3.434, P < 0.001). CONCLUSIONS It was observed that the prevalence of probable bruxism was 36.6% and probable bruxers showed higher odds of periodontitis. Future studies with prospective randomized design should be conducted to confirm these results among a larger study population.
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Affiliation(s)
- Mehtap Bilgin Çetin
- Faculty of Dentistry, Department of Periodontology, Baskent University, Ankara, Turkey
| | - Yasemin Sezgin
- Faculty of Dentistry, Department of Periodontology, Baskent University, Ankara, Turkey
| | - Enes Maraş
- Faculty of Dentistry, Department of Periodontology, Baskent University, Ankara, Turkey
| | - İlker Ata Cebeci
- Faculty of Dentistry, Department of Orthodontics, Baskent University, Ankara, Turkey
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19
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Liu Y, Duan D, Ma R, Ding Y, Xu Y, Zhou X, Zhao L, Xu X. The combined use of salivary biomarkers and clinical parameters to predict the outcome of scaling and root planing: A cohort study. J Clin Periodontol 2020; 47:1379-1390. [PMID: 32935363 DOI: 10.1111/jcpe.13367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 08/13/2020] [Accepted: 09/05/2020] [Indexed: 02/05/2023]
Abstract
AIM To explore the application of the combined use of baseline salivary biomarkers and clinical parameters in predicting the outcome of scaling and root planing (SRP). MATERIALS AND METHODS Forty patients with advanced periodontitis were included. Baseline saliva samples were analysed for interleukin-1β (IL-1β), matrix metalloproteinase-8 and the loads of Porphyromonas gingivalis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans and Tannerella forsythia. After SRP, pocket closure and further attachment loss at 6 months post-treatment were chosen as outcome variables. Models to predict the outcomes were established by generalized estimating equations. RESULTS The combined use of baseline clinical attachment level (CAL), site location and IL-1β (area under the curve [AUC] = 0.764) better predicted pocket closure than probing depth (AUC = 0.672), CAL (AUC = 0.679), site location (AUC = 0.654) or IL-1β (AUC = 0.579) alone. The combination of site location, tooth loss, percentage of deep pockets, detection of A. actinomycetemcomitans and T. forsythia load (AUC = 0.842) better predicted further clinical attachment loss than site location (AUC = 0.715), tooth loss (AUC = 0.530), percentage of deep pockets (AUC = 0.659) or T. forsythia load (AUC = 0.647) alone. CONCLUSION The combination of baseline salivary biomarkers and clinical parameters better predicted SRP outcomes than each alone. The current study indicates the possible usefulness of salivary biomarkers in addition to tooth-related parameters in predicting SRP outcomes.
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Affiliation(s)
- Yiying Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dingyu Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Ma
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Ding
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & 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 & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Clinical Research Center for Oral Diseases of Sichuan Province, Chengdu, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Clinical Research Center for Oral Diseases of Sichuan Province, Chengdu, China
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20
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Rahim‐Wöstefeld S, El Sayed N, Weber D, Kaltschmitt J, Bäumer A, El‐Sayed S, Eickholz P, Pretzl B. Tooth‐related factors for tooth loss 20 years after active periodontal therapy–A partially prospective study. J Clin Periodontol 2020; 47:1227-1236. [DOI: 10.1111/jcpe.13348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/28/2020] [Accepted: 06/28/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Sonja Rahim‐Wöstefeld
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Nihad El Sayed
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics (IMBI) University Hospital Heidelberg Heidelberg Germany
| | | | - Amelie Bäumer
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
- Private Practice Bielefeld Germany
| | - Shirin El‐Sayed
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | - Peter Eickholz
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main, Frankfurt Germany
| | - Bernadette Pretzl
- Section of Periodontology Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
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21
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Petit C, Anadon-Rosinach V, Rettig L, Schmidt-Mutter C, Tuzin N, Davideau JL, Huck O. Influence of psychological stress on non-surgical periodontal treatment outcomes in patients with severe chronic periodontitis. J Periodontol 2020; 92:186-195. [PMID: 32716522 DOI: 10.1002/jper.20-0105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/21/2020] [Accepted: 06/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the influence of psychological stress on non-surgical periodontal treatment (SRP) outcomes in patients with severe chronic periodontitis (stage 3/4 generalized periodontitis) at 6 months in the French population. METHODS Patients diagnosed with severe generalized chronic periodontitis (periodontitis stage 3/4) were included in this study. At baseline, psychological status was evaluated by self-administered questionnaire (Depression Anxiety Stress Scale 42 [DASS-42] and Toulouse coping scale [TCS]). Plasma levels of cortisol and chromogranin-A were determined. Patients were then managed by oral hygiene instructions, scaling and root planing of sites with PD >3 mm and followed at 3 and 6 months. Quantitative and qualitative variables were described and interactions were determined by linear and logistic regressions. RESULTS Seventy-one patients were included in this study and 54 were followed up to 6 months. An average probing depth (PD) reduction of 0.73 ± 0.11 mm and decrease of diseased sites (PD >3 mm) were measured at 6 months illustrating SRP efficacy. Multivariable analysis showed that increased DASS-stress score was associated to worsened SRP outcomes in terms of bleeding on probing (BOP) (OR = 1.02, P <0.05) and mean PD (P <0.05) reduction. An increase of DASS-depression score negatively influenced PD >5 mm (OR = 1.06, P <0.05), PD >7 mm (OR = 1.17, P <0.01), CAL >5 mm (OR = 1.03, P <0.05), and CAL >7 mm (OR = 1.07, P <0.05) reduction. Negative coping strategies were also associated with worsened SRP outcomes. CONCLUSIONS Patients with increased stress, anxiety, and depression scores as well as those exhibiting negative coping strategies demonstrate worsened SRP outcomes. DASS-42 and TCS were useful to determine psychological status and their use could be incorporated to assess treatment prognosis.
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Affiliation(s)
- Catherine Petit
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France.,UMR 1260 Regenerative Nanomedicine, INSERM (French National Institute of Health and Medical Research), Strasbourg, France
| | - Victor Anadon-Rosinach
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Laurence Rettig
- Clinical Investigation Center, INSERM U1434, University Hospital of Strasbourg, Strasbourg, France
| | - Catherine Schmidt-Mutter
- Clinical Investigation Center, INSERM U1434, University Hospital of Strasbourg, Strasbourg, France
| | - Nicolas Tuzin
- Methodology and Biostatistics Group, Public Health Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Jean-Luc Davideau
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Olivier Huck
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France.,UMR 1260 Regenerative Nanomedicine, INSERM (French National Institute of Health and Medical Research), Strasbourg, France
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Ravidà A, Troiano G, Qazi M, Saleh MHA, Saleh I, Borgnakke WS, Wang H. Dose‐dependent effect of smoking and smoking cessation on periodontitis‐related tooth loss during 10 ‐ 47 years periodontal maintenance—A retrospective study in compliant cohort. J Clin Periodontol 2020; 47:1132-1143. [DOI: 10.1111/jcpe.13336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/09/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine University of Foggia Foggia Italy
| | - Musa Qazi
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
- Department of Periodontics University of Louisville School of Dentistry Louisville KY USA
| | - Islam Saleh
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
| | - Wenche S. Borgnakke
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral Medicine School of Dentistry University of Michigan Ann Arbor MI USA
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Petsos H, Schacher B, Ramich T, Nickles K, Dannewitz B, Arendt S, Seidel K, Eickholz P. Retrospectively analysed tooth loss in periodontally compromised patients: Long‐term results 10 years after active periodontal therapy—Patient‐related outcomes. J Periodontal Res 2020; 55:946-958. [DOI: 10.1111/jre.12786] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/09/2020] [Accepted: 06/21/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Hari Petsos
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
- Private Practice Soest Germany
| | - Beate Schacher
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
| | - Tatjana Ramich
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
| | - Katrin Nickles
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
- Private Practice Mannheim Germany
| | - Bettina Dannewitz
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
- Private Practice Weilburg Germany
| | | | - Kathrin Seidel
- Department of Prosthodontics Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
| | - Peter Eickholz
- Department of Periodontology Center of Dentistry and Oral Medicine (Carolinum) Johann Wolfgang Goethe‐University Frankfurt/Main Frankfurt/Main Germany
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Yoshioka S, Miyamoto T, Satomi J, Tada Y, Yagi K, Shimada K, Naruishi K, Shikata E, Yamaguchi I, Yamaguchi T, Korai M, Okayama Y, Harada M, Kitazato KT, Kanematsu Y, Nagahiro S, Takagi Y. Disequilibrium of Plasma Protease/Anti-Protease Due to Severe Periodontal Disease Contributes to Human Subarachnoid Hemorrhage. NEUROSURGERY OPEN 2020. [DOI: 10.1093/neuopn/okaa007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
ABSTRACT
BACKGROUND
The pathophysiology of subarachnoid hemorrhages (SAHs) due to ruptured intracranial aneurysms (IAs) remains unclear. Although a relationship between SAHs and periodontal disease (PD) has been suggested, the mechanism requires clarification.
OBJECTIVE
To evaluate the relationship between PD and SAHs and to identify periodontal pathogens associated with SAHs.
METHODS
This prospective study included consecutive patients with ruptured (n = 11) and unruptured (n = 14) IAs and healthy controls (n = 8). The plasma and plaque subgingival bacterial deoxyribonucleic acid (DNA) levels in PD were evaluated by a dentist using the Community Periodontal Index of Treatment Needs (CPITN). Plasma levels of matrix metalloproteinase (MMP-9), tissue inhibitors of matrix metalloproteinase (TIMP2), and procollagen I were analyzed.
RESULTS
Patients with ruptured IAs, had significantly higher CPITN scores than the controls, suggesting that ruptured IAs were associated with severe PD. Although no rupture-specific bacteria were identified, the positive rate of plaque subgingival bacterial DNA was significantly higher in patients with severe PD than in those without severe PD. Multivariate logistic regression analysis indicated that bleeding on probing (BOP) was associated with ruptured IAs (odds ratio, 1.10; 95% confidence interval 1.04–1.20; P = .0001). BOP was positively associated with plasma MMP-9 levels and a disequilibrium in the MMP-9/TIMP2 ratio. BOP was negatively correlated with plasma procollagen I levels (P < .05, for each). This suggested that local inflammation with severe PD might have systemic effects and lead to ruptured IAs.
CONCLUSION
Disequilibrium of plasma protease/anti-protease associated with a high BOP rate in severe PD may be attributable to IA rupture.
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Affiliation(s)
- Shotaro Yoshioka
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Takeshi Miyamoto
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Junichiro Satomi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yoshiteru Tada
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kenji Yagi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kenji Shimada
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Koji Naruishi
- Department of Periodontology and Endodontology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Eiji Shikata
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Izumi Yamaguchi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tadashi Yamaguchi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Masaaki Korai
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yoshihiro Okayama
- Clinical Trial Center, Tokushima University and Tokushima University Hospital, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Keiko T Kitazato
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yasuhisa Kanematsu
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shinji Nagahiro
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yasushi Takagi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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25
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Graetz C, Bäumer A, Eickholz P, Kocher T, Petsos H, Pretzl B, Schwendicke F, Holtfreter B. Long-term tooth retention in periodontitis patients in four German university centres. J Dent 2020; 94:103307. [DOI: 10.1016/j.jdent.2020.103307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
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Abstract
Data sources Three electronic databases including Medline, Embase and Cochrane Central were searched for finding the relevant literature. Cross-referencing, reviews and editorials were also used to identify original studies. Unpublished studies/ Grey literature were excluded. Study selection Both observational and interventional studies were included for the review and only the studies with a minimum of 3 year follow-up period and which have reported the association between the predictor and tooth loss via odds/risk ratio or their derivatives were selected. Data extraction and synthesis Data like study characteristics, assessed predictors (risk factors or indicators), tooth loss per year as well as the association estimated (as OR, RR or any derivative) were extracted from the included studies. Meta-analysis and meta-regression analysis was carried to find the impact of predictors on the tooth loss.Results After screening, 20 studies were finally included in the study with a total of 15,422 participants. The mean age of the patient was 44.5 (range: 31-54 years) while the mean follow-up period was 12 years (range: 4-20 years). Predictors were pooled as patient level and tooth level predictors. Strong association was found for most of the patient level (age, compliance, diabetes, IL-1 polymorphism, diabetes and smoking) as well as tooth level predictors (Bone loss, pocket depth, tooth type, furcation involvement and mobility) except for sex (patient level predictor) and endodontic involvement (tooth level predictor).Conclusions The meta-analysis depicted in the review exhibited strong association for most of the predictors which can be used by the dentists for treatment planning. Overall tooth level factors have stronger associations than patient level factors.
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Affiliation(s)
- Shalini Gugnani
- Department of Periodontics and Oral Implantology, DAV (C) Dental College Yamunanagar, Haryana, India
| | - Neeraj Gugnani
- Department of Pedodontics and Preventive Dentistry, DAV (C) Dental College Yamunanagar, Haryana, India
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27
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Müller Campanile V, Megally A, Campanile G, Gayet-Ageron A, Giannopoulou C, Mombelli A. Risk factors for recurrence of periodontal disease in patients in maintenance care in a private practice. J Clin Periodontol 2019; 46:918-926. [PMID: 31271667 DOI: 10.1111/jcpe.13165] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/03/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess periodontal and dental conditions in individuals in maintenance care after periodontal therapy in private practice, and to identify risk factors for recurrence of disease and tooth loss. MATERIALS AND METHODS One hundred patients attending a routine recall visit were included. All had been treated for periodontal disease and were in maintenance since ≥ 2 years. RESULTS Examinations took place 18.0 (±8.71) years after the start of periodontal therapy. A total of 40.1 ± 22.5 recall visits were registered during this time. 91% of the participants had an initial diagnosis of chronic, 9% of aggressive periodontitis. The average participant was 46 years old and had 26 teeth. 283 of 2,549 initially present teeth were lost, half of them being molars. Periodontal and endo-periodontal complications accounted for only 16 lost teeth. The prevalence of all probing depth (PD) categories decreased significantly. The longer the time, the more frequent the recall visits, and the more was spent during the maintenance phase, the greater was the reduction. Multivariate analysis rendered BMI and smoking as factors influencing number of sites with PD ≥ 4 mm and bleeding on probing. CONCLUSION Tooth loss and periodontal tissue damage can be contained over prolonged periods if periodontal disease is treated and patients attend regular maintenance care.
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Affiliation(s)
| | - Andrew Megally
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Angèle Gayet-Ageron
- CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrea Mombelli
- Division of Periodontology, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
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Abstract
Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and periodontal disease. Although dental trauma injuries and caries are more frequently encountered in a younger population, tooth loss because of periodontal disease occurs in the older population. In the dental implant era, the trend sometimes seems to be to extract compromised teeth and replace them with dental implants. However, the long-term prognosis of teeth might not be comparable with the prognosis of dental implants. Complications, failures, and diseases such as peri-implantitis are not uncommon, and, despite popular belief, implants are not 99% successful. Other treatment options that aim to save compromised or diseased teeth such as endodontic treatment, periodontal treatment, intentional replantation, and autotransplantation should be considered on an individual basis. These treatments have competing success rates to dental implants but, more importantly, retain the natural tooth in the dentition for a longer period of time. These options are important to discuss in detail during treatment planning with patients in order to clarify any misconceptions about teeth and dental implants. In the event a tooth does have to be extracted, procedures such as decoronation and orthodontic extrusion might be useful to preserve hard and soft tissues for future dental implant placement. Regardless of the treatment modality, it is critical that strict maintenance and follow-up protocols are implemented and that treatment planning is ethically responsible and evidence based.
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29
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Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dent Traumatol 2019; 35:368-375. [DOI: 10.1111/edt.12492] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Danielle Clark
- Division of Periodontology Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - Liran Levin
- Division of Periodontology Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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30
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Botelho J, Machado V, Mascarenhas P, Alves R, Cavacas MA, Mendes JJ. Fine-tuning multilevel modeling of risk factors associated with nonsurgical periodontal treatment outcome. Braz Oral Res 2019; 33:e081. [PMID: 31460607 DOI: 10.1590/1807-3107bor-2019.vol33.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 06/06/2019] [Indexed: 01/09/2023] Open
Abstract
This retrospective study evaluated the influence of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Overall, 37 patients (24 males and 13 females) with moderate-to-severe chronic periodontitis underwent NSPT. Follow-up visits at 3, 6, and 12 months included measurements of several clinical periodontal parameters. Data were sourced from a previously reported database. In a total of 1416 initially affected sites (baseline PD ≥ 4 mm) on 536 teeth, probing depth (PD) and clinical attachment loss (CAL) reductions after NSPT were evaluated against known risk factors at 3 hierarchical levels (patient, tooth, and site). For each post-treatment follow-up, the variance component models fitted to evaluate the 3-level variance of PD and CAL decrease revealed that all levels contributed significantly to the overall variance (p < 0.001). Patients who underwent NSPT and were continually monitored had curative results. All 3 hierarchical levels included risk factors influencing the degree of PD and CAL reduction. Specifically, the type of tooth, surfaces involved, and tooth mobility site-level risk factors had the strongest impact on these reductions and were highly relevant for the success of NSPT.
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31
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Krois J, Graetz C, Holtfreter B, Brinkmann P, Kocher T, Schwendicke F. Evaluating Modeling and Validation Strategies for Tooth Loss. J Dent Res 2019; 98:1088-1095. [PMID: 31361174 PMCID: PMC6710618 DOI: 10.1177/0022034519864889] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Prediction models learn patterns from available data (training) and are then validated on new data (testing). Prediction modeling is increasingly common in dental research. We aimed to evaluate how different model development and validation steps affect the predictive performance of tooth loss prediction models of patients with periodontitis. Two independent cohorts (627 patients, 11,651 teeth) were followed over a mean ± SD 18.2 ± 5.6 y (Kiel cohort) and 6.6 ± 2.9 y (Greifswald cohort). Tooth loss and 10 patient- and tooth-level predictors were recorded. The impact of different model development and validation steps was evaluated: 1) model complexity (logistic regression, recursive partitioning, random forest, extreme gradient boosting), 2) sample size (full data set or 10%, 25%, or 75% of cases dropped at random), 3) prediction periods (maximum 10, 15, or 20 y or uncensored), and 4) validation schemes (internal or external by centers/time). Tooth loss was generally a rare event (880 teeth were lost). All models showed limited sensitivity but high specificity. Patients' age and tooth loss at baseline as well as probing pocket depths showed high variable importance. More complex models (random forest, extreme gradient boosting) had no consistent advantages over simpler ones (logistic regression, recursive partitioning). Internal validation (in sample) overestimated the predictive power (area under the curve up to 0.90), while external validation (out of sample) found lower areas under the curve (range 0.62 to 0.82). Reducing the sample size decreased the predictive power, particularly for more complex models. Censoring the prediction period had only limited impact. When the model was trained in one period and tested in another, model outcomes were similar to the base case, indicating temporal validation as a valid option. No model showed higher accuracy than the no-information rate. In conclusion, none of the developed models would be useful in a clinical setting, despite high accuracy. During modeling, rigorous development and external validation should be applied and reported accordingly.
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Affiliation(s)
- J Krois
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Graetz
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - B Holtfreter
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - P Brinkmann
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - T Kocher
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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33
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Pini Prato GP, Di Gianfilippo R, Wang H. Success in periodontology: An evolutive concept. J Clin Periodontol 2019; 46:840-845. [DOI: 10.1111/jcpe.13150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 05/13/2019] [Accepted: 05/20/2019] [Indexed: 11/27/2022]
Affiliation(s)
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine The University of Michigan ‐ School of Dentistry Ann Arbor Michigan
| | - Hom‐Lay Wang
- Department of Periodontics and Oral Medicine The University of Michigan ‐ School of Dentistry Ann Arbor Michigan
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34
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Helal O, Göstemeyer G, Krois J, Fawzy El Sayed K, Graetz C, Schwendicke F. Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis. J Clin Periodontol 2019; 46:699-712. [PMID: 31025366 DOI: 10.1111/jcpe.13118] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/19/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
AIM A range of predictors for tooth loss in periodontitis patients have been reported. We performed a systematic review and meta-analysis to assess the consistency and magnitude of any association between a total of 12 predictors and tooth loss. MATERIALS AND METHODS Medline/Embase/Central were searched for longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. Random-effects meta-analysis was performed, and study quality assessed. RESULTS Twenty studies (15,422 patients, mean follow-up: 12 years) were included. The mean annual tooth loss/patient was 0.12 (min./max: 0.01/0.36). Older patients (n = 8 studies; OR: 1.05, 95% CI: 1.03-1.08/year), non-compliant ones (n = 11; 1.51, 1.06-2.16), diabetics (n = 7; 1.80, 1.26-2.57), those with IL-1-polymorphism (n = 3; 1.80; 1.29-2.52) and smokers (n = 15; 1.98, 1.58-2.48) had a significantly higher risk of tooth loss. Teeth with bone loss (n = 3; 1.04, 1.03-1.05/%), high probing pocket depth (n = 6; 3.19, 1.70-5.98), mobility (n = 4; 3.71, 1.65-8.38) and molars (n = 4; 4.22, 2.12-8.39), especially with furcation involvement (n = 5; 2.68, 1.75-4.08) also showed higher risks. Gender (n = 16; 0.95, 0.86-1.05) and endodontic affection (n = 3; 3.62, 0.99-13.2) were not significantly associated with tooth loss. CONCLUSIONS Older, non-compliant, smoking or diabetic patients, and teeth with bone loss, high probing pocket depth, mobility, or molars, especially with furcation involvement showed higher risks of tooth loss.
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Affiliation(s)
- Omar Helal
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Karim Fawzy El Sayed
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo, Egypt
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
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35
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Kato H, Takahashi Y, Iseki C, Igari R, Sato H, Sato H, Koyama S, Tobita M, Kawanami T, Iino M, Ishizawa K, Kato T. Tooth Loss-associated Cognitive Impairment in the Elderly: A Community-based Study in Japan. Intern Med 2019; 58:1411-1416. [PMID: 30626824 PMCID: PMC6548929 DOI: 10.2169/internalmedicine.1896-18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Dementia is a major cause of disruption for a healthy life expectancy in Japan. It has been suggested that the number of teeth is a modifiable risk factor for cognitive impairment and dementia. We therefore examined the possible association between the cognitive function and the number of natural and artificial teeth in community-dwelling Japanese elderly individuals. Methods Among the participants in our prospective, community-based study, 210 elderly individuals (103 men and 107 women; 78.1±4.9 years; mean age±standard deviation) underwent both dental examinations and a Mini-Mental State Examination (MMSE), as well as various medical checkups, in 2016 and 2017. Results The number of natural teeth was significantly associated with an individual's MMSE score. The percentage of cognitively normal subjects (MMSE scores: 27-30) decreased significantly with a decrease in the number of natural teeth. Among the MMSE items, the calculation ability was significantly and independently associated with the number of natural teeth. Regression was calculated as the predicted score of MMSE =21+0.3× (years of schooling) +0.1× (number of natural teeth). Among individuals with 19 or fewer natural teeth, those who had a total of 20 teeth or more, including both natural and artificial teeth, had significantly higher MMSE scores than those who had 19 or fewer natural and artificial teeth combined. Conclusion The number of natural teeth was significantly associated with the cognitive function, especially the calculation ability, and the use of artificial teeth was associated with the preservation of the cognitive function in community-dwelling elderly individuals.
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Affiliation(s)
- Hajime Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
- National Hospital Organization Yonezawa Hospital, Japan
| | - Yoshimi Takahashi
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Chifumi Iseki
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Ryosuke Igari
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hidenori Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hiroyasu Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Shingo Koyama
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | | | - Toru Kawanami
- National Hospital Organization Yamagata Hospital, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
| | - Kenichi Ishizawa
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Takeo Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Yamagata City Office, Japan
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Detection of Salivary miRNAs Reflecting Chronic Periodontitis: A Pilot Study. Molecules 2019; 24:molecules24061034. [PMID: 30875931 PMCID: PMC6470766 DOI: 10.3390/molecules24061034] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/07/2019] [Accepted: 03/13/2019] [Indexed: 12/16/2022] Open
Abstract
The purpose of this cross-sectional pilot study was to find salivary microRNAs (miRNAs) reflecting periodontal condition in chronic periodontitis. One hundred and twenty chronic periodontitis patients (mean age, 68.4 years) participated in the study, from whom unstimulated whole saliva was collected. A multiphase study was conducted to explore salivary miRNAs as biomarkers of periodontitis. At first, a polymerase chain reaction (PCR) array was performed to compare salivary miRNAs profiles in no and mild (no/mild) and severe periodontitis patients. Next, the relative expression of salivary miRNAs on individual samples was assessed by real-time reverse transcription-PCR. The numbers (%) of patients were 26 (21.6%, no/mild), 58 (48.3%, moderate) and 36 (30.0%, severe), respectively. Among 84 miRNAs, only the relative expression of hsa-miR-381-3p in the severe periodontitis group was significantly higher than that of the no/mild periodontitis group (p < 0.05). Among the 120 patients, there was also a significant correlation between the relative expression of hsa-miR-381-3p and the mean probing pocket depth (PPD) (r = 0.181, p < 0.05). Salivary hsa-miR-381-3p was correlated with periodontitis condition in chronic periodontitis patients.
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Risk factors associated with long-term outcomes after active and supporting periodontal treatments: impact of various compliance definitions on tooth loss. Clin Oral Investig 2019; 23:4123-4131. [DOI: 10.1007/s00784-019-02851-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/13/2019] [Indexed: 11/25/2022]
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Du M, Bo T, Kapellas K, Peres MA. Prediction models for the incidence and progression of periodontitis: A systematic review. J Clin Periodontol 2018; 45:1408-1420. [DOI: 10.1111/jcpe.13037] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Mi Du
- Australian Research Centre for Population Oral Healththe University of Adelaide Adelaide South Australia Australia
| | - Tao Bo
- Central LaboratoryShandong Provincial Hospital Affiliated to Shandong University Jinan China
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Healththe University of Adelaide Adelaide South Australia Australia
| | - Marco A Peres
- Australian Research Centre for Population Oral Healththe University of Adelaide Adelaide South Australia Australia
- Menzies Health Institute Queensland and School of Dentistry and Oral HealthGriffith University Gold Coast Queensland Australia
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Pretzl B, El Sayed S, Weber D, Eickholz P, Bäumer A. Tooth loss in periodontally compromised patients: Results 20 years after active periodontal therapy. J Clin Periodontol 2018; 45:1356-1364. [DOI: 10.1111/jcpe.13010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Shirin El Sayed
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics (IMBI); University Hospital Heidelberg; Heidelberg Germany
| | - Peter Eickholz
- Department of Periodontology; Center of Dentistry and Oral Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | - Amelie Bäumer
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
- Private Practice; Bielefeld Germany
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Kocher T, König J, Borgnakke WS, Pink C, Meisel P. Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge. Periodontol 2000 2018; 78:59-97. [DOI: 10.1111/prd.12235] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Jörgen König
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Peter Meisel
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
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Nazir MA, AlGhamdi L, AlKadi M, AlBeajan N, AlRashoudi L, AlHussan M. The burden of Diabetes, Its Oral Complications and Their Prevention and Management. Open Access Maced J Med Sci 2018; 6:1545-1553. [PMID: 30159091 PMCID: PMC6108795 DOI: 10.3889/oamjms.2018.294] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM), chronic disease, is a public health problem that affects 8.5% adult population worldwide. The number of adults with DM has risen sharply from 108 million in 1980 to 422 million in 2014. In 2012, 1.5 million individuals died because of DM and an additional 2.2 million deaths occurred because of high blood glucose level resulting in cardiovascular and other systemic diseases. DM brings huge economic loss to patients, their families, and healthcare systems. Globally, the cost of DM was US$1•31 trillion in 2015. AIM This review article utilised the prevalence data of diabetes mellitus from the World Health Organization and International Diabetes Federation to provide a comprehensive picture of the disease in different parts of the world. METHODS Electronic databases such as Google Scholar, Medline via PubMed, Scopus, and Web of Science were used to search the literature. The library resources of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia were used to retrieve studies on the topics of the present review. RESULTS Systemic complications of DM include heart attack, kidney disease, limb loss, blindness, and peripheral nerve damage. More than 90% of diabetic patients were found to have oral manifestations. It is known that DM severely damages oral tissues causing periodontal disease, tooth loss, xerostomia, caries, burning mouth disorder, taste and salivary gland dysfunction, delayed wound healing, lichen planus, geographic tongue, and candidiasis. The evidence is mounting about a strong bidirectional relationship between DM and periodontal disease. Unfortunately, many diabetic patients are unaware of the association between DM and oral health, and only a small percentage of them visit the dentist for routine dental check-ups. Changes in lifestyles (control of blood glucose levels and self-care practices), regular dental check-ups with emphasis on periodontal assessment, and reinforcement of oral health instructions can effectively prevent oral complications of DM. Scaling and root planning are effective in improving glycemic control among diabetic patients. CONCLUSION Dental professionals should be part of the multidisciplinary team that helps individuals with diabetes.
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Affiliation(s)
- Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lamiah AlGhamdi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mariam AlKadi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noura AlBeajan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Latifah AlRashoudi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mai AlHussan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Han K, Park JB. Evaluation of the association between the number of natural teeth and anemia among Korean adults using nationally representative data. J Periodontol 2018; 89:1184-1192. [PMID: 29624683 DOI: 10.1002/jper.17-0440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 01/22/2018] [Accepted: 01/30/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Anemia as a chronic disease is defined as anemia occurring in chronic infections with inflammatory conditions. The purpose of this study is to assess the association between the number of natural teeth and anemia using nationally representative data. METHODS This study involved a cross-sectional analysis using data from the Korean National Health and Nutrition Examination Survey from 2010 to 2012. A total of 16,875 respondents aged > 19 years without missing values were included in this study. The association between the number of natural teeth and anemia was evaluated by multivariable logistic regression analyses after adjusting for age, sex, body mass index, smoking habits, drinking habits, exercise levels, income levels, education levels, vitamin D levels, diabetes, toothbrushing frequency, energy intake, and percentage of fat in total energy intake among Korean adults. RESULTS There was a significant decrease in prevalence of anemia and a significant increase in hemoglobin levels in participants with more natural teeth (P < 0.05). Adjusted odds ratios and their 95% confidence intervals for anemia in participants with numbers of natural teeth of < 15, 15 to 19, 20 to 24, or 24 to 28 were 1 (reference), 0.856(0.591 to 1.24), 0.659(0.5 to 0.868), and 0.607(0.463 to 0.797), respectively, with adjustment for confounding factors (P < 0.05). CONCLUSION The number of natural teeth is negatively associated with anemia in Korean adults, and the number of natural teeth may be considered an independent risk indicator of anemia.
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Affiliation(s)
- Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Effects of non-surgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis. Clin Oral Investig 2018; 23:141-151. [DOI: 10.1007/s00784-018-2420-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/13/2018] [Indexed: 12/31/2022]
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Martinez‐Canut P, Alcaraz J, Alcaraz J, Alvarez‐Novoa P, Alvarez‐Novoa C, Marcos A, Noguerol B, Noguerol F, Zabalegui I. Introduction of a prediction model to assigning periodontal prognosis based on survival time. J Clin Periodontol 2018; 45:46-55. [PMID: 28871596 PMCID: PMC5767737 DOI: 10.1111/jcpe.12810] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/17/2022]
Abstract
AIMS To develop a prediction model for tooth loss due to periodontal disease (TLPD) in patients following periodontal maintenance (PM), and assess its performance using a multicentre approach. MATERIAL AND METHODS A multilevel analysis of eleven predictors of TLPD in 500 patients following PM was carried out to calculate the probability of TLPD. This algorithm was applied to three different TLPD samples (369 teeth) gathered retrospectively by nine periodontist, associating several intervals of probability with the corresponding survival time, based on significant differences in the mean survival time. The reproducibility of these associations was assessed in each sample (One-way ANOVA and pairwise comparison with Bonferroni corrections). RESULTS The model presented high specificity and moderate sensitivity, with optimal calibration and discrimination measurements. Seven intervals of probability were associated with seven survival time and these associations contained close to 80% of the cases: the probability predicted the survival time at this percentage. The model performed well in the three samples, as the mean survival time of each association were significantly different within each sample, while no significant differences between the samples were found in pairwise comparisons of means. CONCLUSIONS This model might be useful for predicting survival time in different TLPD samples.
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Affiliation(s)
- Pedro Martinez‐Canut
- Private PracticeValenciaSpain
- Division of PeriodonticsFacultad de Medicina y OdontologíaU. ValenciaValenciaSpain
| | - Jaime Alcaraz
- Assistant professor Postgraduate Program in PeriodonticsFacultad de Medicina y OdontologíaU. ValenciaValenciaSpain
- Private PracticeAlicanteSpain
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Kufta K, Forman M, Swisher-McClure S, Sollecito TP, Panchal N. Pre-Radiation dental considerations and management for head and neck cancer patients. Oral Oncol 2018; 76:42-51. [DOI: 10.1016/j.oraloncology.2017.11.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/22/2017] [Accepted: 11/25/2017] [Indexed: 12/20/2022]
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Martinez-Canut P, Llobell A. A comprehensive approach to assigning periodontal prognosis. J Clin Periodontol 2017; 45:431-439. [PMID: 29247450 PMCID: PMC5900888 DOI: 10.1111/jcpe.12857] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 12/31/2022]
Abstract
AIM The purpose of this retrospective case series study was to evaluate the usefulness and performance of a comprehensive approach to assigning periodontal prognosis by assessing the risk of tooth loss due to periodontal disease (TLPD) and estimate the survival time (ST) of periodontally compromised teeth (PCT). MATERIAL AND METHODS The Long-Term Outcome (LTO) index was utilized to assess the risk of TLPD, at baseline, in 100 patients following periodontal maintenance for a mean 24.7 year (±2.4). A TLPD prediction model was utilized to assign ST to PCT. The performance of the TLPD prediction based on both parameters was assessed. RESULTS The mean TLPD rate increased as the LTO index increased (Kruskal-Wallis p < .001). The percentage of TLPD increased as the ST decreased, with significantly differences between the LTO categories <4 and ≥4 for all ST intervals (Mann-Whitney p < .001 to p .021). Only 21% of PCT were lost. This percentage was 58% for teeth assigned the shortest ST and increased to 71% and 88% for these teeth in LTO ≥4 patients. CONCLUSIONS This approach might be useful to predict TLPD in patients with an initial higher risk of TLPD while it was not useful in patients with lower risk of TLPD.
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Affiliation(s)
- Pedro Martinez-Canut
- Division of Periodontics, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain.,Private Practice, Valencia, Spain
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Martinez‐Canut P, Llobell A, Romero A. Predictors of long-term outcomes in patients undergoing periodontal maintenance. J Clin Periodontol 2017; 44:620-631. [PMID: 28419497 PMCID: PMC5519943 DOI: 10.1111/jcpe.12730] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 01/03/2023]
Abstract
AIM This retrospective study aimed to characterize the baseline status of patients following periodontal maintenance, analysing the association between the long-term outcome of these patients, smoking, bruxism, and the main clinical and radiographic variables. MATERIAL AND METHODS A sample of 174 patients with moderate to severe periodontitis was refined into homogeneous subsamples according to smoking and bruxism and the rate of tooth loss due to periodontal disease (TLPD): 0, 1-2, and >2 teeth. The association and the distribution (χ² test) of the variables within the subsamples were analysed. RESULTS Smoking and bruxism were significantly associated with higher TLPD rates. Vertical and circumferential bone defects (p < .0001), and abfractions (p < .0001) were associated with bruxism and particularly with bruxism and TLPD >2. Furcation defects (p = .0002), fewer radio-opaque subgingival calculus (χ² p < .0001), a lower mean Gingival index (χ² p = .027), and increased mean recessions >1.5 mm (χ² p = .0026) were associated with smoking and higher TLPD rates. The mean baseline mobility, abfractions, and recessions characterized two basic types of TLPD. CONCLUSIONS Smoking, bruxism, and routine clinical and radiological parameters can be used to characterize the baseline status of patients with worse outcomes.
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Affiliation(s)
- Pedro Martinez‐Canut
- Division of PeriodonticsFacultad de Medicina y OdontologíaUniversidad de ValenciaValenciaSpain
- Private practiceValenciaSpain
| | - Andrés Llobell
- Private practiceValenciaSpain
- Division of PeriodonticsFacultad de Medicina y OdontologíaUniversidad de ValenciaValenciaSpain
| | - Antonio Romero
- Private practiceValenciaSpain
- Orofacial Pain. Tufts U. School of Dental MedicineBoston, MAUSA
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Graetz C, Sälzer S, Plaumann A, Schlattmann P, Kahl M, Springer C, Dörfer C, Schwendicke F. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol 2017; 44:612-619. [DOI: 10.1111/jcpe.12725] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics; Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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Li J, Xu H, Pan W, Wu B. Association between tooth loss and cognitive decline: A 13-year longitudinal study of Chinese older adults. PLoS One 2017; 12:e0171404. [PMID: 28158261 PMCID: PMC5291434 DOI: 10.1371/journal.pone.0171404] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 01/18/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. DESIGN A large national longitudinal survey of Chinese older adults. SETTING The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2011). PARTICIPANTS A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. MEASUREMENTS Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. RESULTS The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. CONCLUSION This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data.
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Affiliation(s)
- Juan Li
- Nursing School of Second Military Medical University, Shanghai, China
- Duke University School of Nursing, Durham, United States of America
| | - Hanzhang Xu
- Duke University School of Nursing, Durham, United States of America
- Duke Global Health Institute, Durham, United States of America
| | - Wei Pan
- Duke University School of Nursing, Durham, United States of America
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, United States of America
- * E-mail:
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