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Aminoshariae A, Nosrat A, Jakovljevic A, Jaćimović J, Narasimhan S, Nagendrababu V. Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-Analyses. J Endod 2024:S0099-2399(24)00364-9. [PMID: 38945200 DOI: 10.1016/j.joen.2024.06.012] [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: 02/19/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality. METHODS A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, CENTRAL, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias and sensitivity analysis were performed. RESULTS Twelve articles met the eligibility criteria with an overall "Good" quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio (HR) was 1.66 (95% CI: 1.32-2.09), and there was high heterogeneity (I2 = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (p = 0.626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (HR = 1.52, 95% CI: 1.28- 1.80), (I2 51.82%). CONCLUSION The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.
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Affiliation(s)
- Anita Aminoshariae
- Director, Predoctoral Endodontics Professor, Department of Endodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
| | - Ali Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, MD
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Purba MR, Putra MM, Sulijaya B, Widaryono A, Hartono V, Setiadharma Y, Rizany AK, Tadjoedin FM, Lachica MRCT. Effect of mobile app-based oral hygiene instructions on clinical parameters, oral bacterial diversity, and composition of subgingival microbiota in periodontitis patients. J Oral Microbiol 2024; 16:2372206. [PMID: 38948658 PMCID: PMC11212576 DOI: 10.1080/20002297.2024.2372206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Oral hygiene instruction (OHI) is essential during periodontitis treatment. Various OHI approaches have been explored, including mobile apps. Objective To evaluate the mobile app-based OHI's effect on periodontitis management by analyzing clinical parameters and subgingival microbiota. Methods Forty-four periodontitis patients were randomly assigned into two groups. The test group (n = 22) received scaling and root planing (SRP), OHI, and mobile app-based OHI, whereas the control group (n = 22) received SRP and OHI. Full mouth plaque score (FMPS), bleeding on probing (BOP) and probing pocket depth at the sampling sites (site-PPD) were assessed at baseline, one- and three-month visits. The 16S rRNA next-generation sequencing (NGS) was used to analyze subgingival plaque samples. Results Significant reduction in FMPS, BOP, and site-PPD at one- and three-month visits compared to baseline (p < 0.001) with no significant differences across groups (p > 0.05). In test groups, intra-group analysis showed better improvement in BOP and site-PPD (p < 0.05) than control. The diversity and composition of subgingival microbiota did not differ between groups or timepoints (p > 0.05). Conclusions Mobile app-based OHI showed no superior effects on improving clinical parameters and subgingival microbiota compared to conventional OHI. Further investigation into its long-term impact on periodontitis treatment is needed.
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Affiliation(s)
- Melinda Rabekka Purba
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Mardikacandra Manggala Putra
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Benso Sulijaya
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
- Dental Division, Universitas Indonesia Hospital, Depok, Indonesia
| | - Adityo Widaryono
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Valdy Hartono
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Yoga Setiadharma
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | | | - Fatimah Maria Tadjoedin
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
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De David SC, Ferreira TDGM, da Rocha JM, Moreira CHC, Fiorini T. Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population. Clin Oral Investig 2024; 28:397. [PMID: 38918232 DOI: 10.1007/s00784-024-05779-z] [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: 12/07/2023] [Accepted: 06/11/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP. RESULTS Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively. CONCLUSIONS Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results. CLINICAL RELEVANCE Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.
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Affiliation(s)
- Silvia Cardoso De David
- Department of Conservative Dentistry - Periodontology, School of Dentistry, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, 2492, Porto Alegre, RS, Zip Code 90035-003, Brazil
| | | | - José Mariano da Rocha
- Dental School, Post-Graduate Program of Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Tiago Fiorini
- Department of Conservative Dentistry - Periodontology, School of Dentistry, Federal University of Rio Grande Do Sul, Ramiro Barcelos Street, 2492, Porto Alegre, RS, Zip Code 90035-003, Brazil.
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Noriega Muro ST, Cucina A. Periodontitis and alveolar resorption in human skeletal remains: The relationship between quantitative alveolar bone loss, occlusal wear, antemortem tooth loss, dental calculus and age at death in a low socioeconomic status, modern forensic human collection from Yucatan. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 45:7-17. [PMID: 38447473 DOI: 10.1016/j.ijpp.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 02/13/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE This paper assesses the relationship between the distance between the cemento-enamel junction and alveolar crest and risk factors commonly associated with periodontitis. MATERIALS Eighty individuals between 28 and 92 years old with known biological sex and age were analyzed from a 20th century forensic human collection from Merida, Yucatan (Mexico). METHODS Macroscopic assessment, along with metric analysis, was employed using a probe. RESULTS Ante-mortem tooth loss was positively correlated with the distance between the cemento-enamel junction and alveolar crest, as was the presence of root calculus in females. CONCLUSIONS Cemento-enamel junction to alveolar crest distance is not a reliable indicator of periodontitis since it is not directly related to periodontitis-causing infectious pathogens, and since ante-mortem tooth loss can affect root exposure. SIGNIFICANCE This study demonstrates that a purely quantitative approach to diagnosing periodontitis in archaeological and forensic human remains can be misleading. LIMITATIONS The skeletal collection is only representative of the low socioeconomic class of Merida, and its female cohort is underrepresented. In addition, because the Xoclan collection is modern, limitations (particularly with respect to tooth wear) of the applicability of these interpretations to older archaeological remains exist. SUGGESTION FOR FURTHER RESEARCH A combination of quantitative and qualitative characteristics of alveolar bone is needed to reliably diagnose periodontitis in skeletal populations.
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Affiliation(s)
- S Thamara Noriega Muro
- Facultad de Odontología, Universidad Autónoma de Yucatán, Calle 61A, N. 492A, Centro, Mérida, Yucatán C.P. 97000, México
| | - Andrea Cucina
- Facultad de Ciencias Antropológicas, Universidad Autónoma de Yucatán, Km. 1, Carretera Mérida-Tizimín, Cholul, Mérida, Yucatán C.P. 97305, Mexico.
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Luo W, Du C, Huang H, Kong J, Ge Z, Lin L, Wang H. The Role of Macrophage Death in Periodontitis: A Review. Inflammation 2024:10.1007/s10753-024-02015-4. [PMID: 38691250 DOI: 10.1007/s10753-024-02015-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 01/21/2024] [Accepted: 03/28/2024] [Indexed: 05/03/2024]
Abstract
Periodontitis, an infectious inflammatory disease influenced by various factors, disrupts the delicate balance between the host microbiota and immunity. The resulting excessive immune response exacerbates the progressive destruction of the supporting periodontal tissue. Macrophages are essential elements of the host innate immune system. They are pivotal components in the periodontal immune microenvironment and actively participate in both physiological and pathological processes of periodontal tissue. When confronted with periodontitis-related irritant factors, macrophages may differentiate to pro- or anti-inflammatory subtypes that affect tissue homeostasis. Additionally, macrophages may die in response to bacterial infections, potentially affecting the severity of periodontitis. This article reviews the typical mechanisms underlying macrophage death and its effects on periodontitis. We describe five forms of macrophage death in periodontitis: apoptosis, pyroptosis, necroptosis, ferroptosis, and ETosis. Our review of macrophage death in the pathophysiology of periodontitis enhances comprehension of the pathogenesis of periodontitis that will be useful for clinical practice. Although our review elucidates the complex mechanisms by which macrophage death and inflammatory pathways perpetuate periodontitis, unresolved issues remain, necessitating further research.
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Affiliation(s)
- Wen Luo
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China
| | - Chengying Du
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China
| | - Hsiuwei Huang
- School of Stomatology, China Medical University, North Second Road 92, Shenyang, 110002, Liaoning Province, China
| | - Jie Kong
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China
| | - Ziming Ge
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China
| | - Li Lin
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China.
| | - Hongyan Wang
- Department of Periodontology, School of Stomatology, China Medical University, Nanjing North Street 117, Shenyang, 110000, Liaoning Province, China.
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Barczak K, Droździk A, Bosiacki M, Łagocka R, Cenariu D, Uriciuc WA, Baranowska-Bosiacka I. CCL5's Role in Periodontal Disease: A Narrative Review. Int J Mol Sci 2023; 24:17332. [PMID: 38139161 PMCID: PMC10744061 DOI: 10.3390/ijms242417332] [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: 10/30/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Persistent host inflammatory and immune responses to biofilm play a critical role in the mechanisms that govern soft and hard tissue destruction in periodontal disease. Among the less explored facets of these mechanisms are chemokines, including CCL5 (C-C motif chemokine ligand 5), also known as RANTES (regulated on activation, normal T cell expressed and secreted), a proinflammatory CC subfamily chemokine synthesized by T lymphocytes. Despite its importance, there is currently no comprehensive review of the role of CCL5 in periodontitis in the literature. Therefore, this paper aims to fill this gap by summarizing the existing knowledge on the involvement of CCL5 in the onset and progression of periodontitis. In addition, we aim to stimulate interest in this relatively overlooked factor among periodontitis researchers, potentially accelerating the development of drugs targeting CCL5 or its receptors. The review examines the association of CCL5 with periodontitis risk factors, including aging, cigarette smoking, diabetes, and obesity. It discusses the involvement of CCL5 in pathological processes during periodontitis, such as connective tissue and bone destruction. The data show that CCL5 expression is observed in affected gums and gingival crevicular fluid of periodontitis patients, with bacterial activity contributing significantly to this increase, but the reviewed studies of the association between CCL5 expression and periodontal disease have yielded inconclusive results. Although CCL5 has been implicated in the pathomechanism of periodontitis, a comprehensive understanding of its molecular mechanisms and significance remains elusive, hindering the development of drugs targeting this chemokine or its receptors.
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Affiliation(s)
- Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland;
| | - Agnieszka Droździk
- Laboratory of Preclinical Periodontology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland;
| | - Mateusz Bosiacki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.B.); (I.B.-B.)
| | - Ryta Łagocka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland;
| | - Diana Cenariu
- MEDFUTURE—Research Center for Advanced Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
| | - Willi Andrei Uriciuc
- Faculty of Dental Medicine, “Iuliu-Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.B.); (I.B.-B.)
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Carra MC, Rangé H, Caligiuri G, Bouchard P. Periodontitis and atherosclerotic cardiovascular disease: A critical appraisal. Periodontol 2000 2023. [PMID: 37997210 DOI: 10.1111/prd.12528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/12/2023] [Indexed: 11/25/2023]
Abstract
In spite of intensive research efforts driving spectacular advances in terms of prevention and treatments, cardiovascular diseases (CVDs) remain a leading health burden, accounting for 32% of all deaths (World Health Organization. "Cardiovascular Diseases (CVDs)." WHO, February 1, 2017, https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)). Cardiovascular diseases are a group of disorders affecting the heart and blood vessels. They encompass a collection of different conditions, among which atherosclerotic cardiovascular disease (ASCVD) is the most prevalent. CVDs caused by atherosclerosis, that is, ASCVD, are particularly fatal: with heart attack and stroke being together the most prevalent cause of death in the world. To reduce the health burden represented by ASCVD, it is urgent to identify the nature of the "residual risk," beyond the established risk factors (e.g., hypertension) and behavioral factors already maximally targeted by drugs and public health campaigns. Remarkably, periodontitis is increasingly recognized as an independent cardiovascular risk factor.
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Affiliation(s)
- Maria Clotilde Carra
- UFR d'Odontologie, Université Paris Cité, Paris, France
- Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- INSERM- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), Paris, France
| | - Hélène Rangé
- UFR d'Odontologie, Université de Rennes, Rennes, France
- Service of Odontology, Centre Hospitalier Universitaire de Rennes, Rennes, France
- NUMECAN Institute (Nutrition Metabolisms and Cancer), INSERM, INRAE, University of Rennes, Rennes, France
| | - Giuseppina Caligiuri
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, Laboratory for Vascular Translational Science (LVTS), Paris, France
- Department of Cardiology and of Physiology, Hôpitaux Universitaires Paris Nord Val-de-Seine, Site Bichat, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Philippe Bouchard
- UFR d'Odontologie, Université Paris Cité, Paris, France
- URP 2496, Université Paris Cité, Paris, France
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Toader C, Dobrin N, Brehar FM, Popa C, Covache-Busuioc RA, Glavan LA, Costin HP, Bratu BG, Corlatescu AD, Popa AA, Ciurea AV. From Recognition to Remedy: The Significance of Biomarkers in Neurodegenerative Disease Pathology. Int J Mol Sci 2023; 24:16119. [PMID: 38003309 PMCID: PMC10671641 DOI: 10.3390/ijms242216119] [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: 10/10/2023] [Revised: 10/28/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
With the inexorable aging of the global populace, neurodegenerative diseases (NDs) like Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS) pose escalating challenges, which are underscored by their socioeconomic repercussions. A pivotal aspect in addressing these challenges lies in the elucidation and application of biomarkers for timely diagnosis, vigilant monitoring, and effective treatment modalities. This review delineates the quintessence of biomarkers in the realm of NDs, elucidating various classifications and their indispensable roles. Particularly, the quest for novel biomarkers in AD, transcending traditional markers in PD, and the frontier of biomarker research in ALS are scrutinized. Emergent susceptibility and trait markers herald a new era of personalized medicine, promising enhanced treatment initiation especially in cases of SOD1-ALS. The discourse extends to diagnostic and state markers, revolutionizing early detection and monitoring, alongside progression markers that unveil the trajectory of NDs, propelling forward the potential for tailored interventions. The synergy between burgeoning technologies and innovative techniques like -omics, histologic assessments, and imaging is spotlighted, underscoring their pivotal roles in biomarker discovery. Reflecting on the progress hitherto, the review underscores the exigent need for multidisciplinary collaborations to surmount the challenges ahead, accelerate biomarker discovery, and herald a new epoch of understanding and managing NDs. Through a panoramic lens, this article endeavors to provide a comprehensive insight into the burgeoning field of biomarkers in NDs, spotlighting the promise they hold in transforming the diagnostic landscape, enhancing disease management, and illuminating the pathway toward efficacious therapeutic interventions.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | - Nicolaie Dobrin
- Department of Neurosurgery, Clinical Emergency Hospital “Prof. Dr. Nicolae Oblu”, 700309 Iasi, Romania
| | - Felix-Mircea Brehar
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
- Department of Neurosurgery, Clinical Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania
| | - Constantin Popa
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Neurology, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
- Medical Science Section, Romanian Academy, 060021 Bucharest, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Luca Andrei Glavan
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Andrei Adrian Popa
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (L.A.G.); (H.P.C.); (B.-G.B.); (A.D.C.); (A.V.C.)
- Medical Science Section, Romanian Academy, 060021 Bucharest, Romania
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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Väyrynen E, Hakola S, Keski-Salmi A, Jämsä H, Vainionpää R, Karki S. The Use of Patient-Oriented Mobile Phone Apps in Oral Health: Scoping Review. JMIR Mhealth Uhealth 2023; 11:e46143. [PMID: 37672331 PMCID: PMC10512118 DOI: 10.2196/46143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Oral health is a significant part of general health. Poor oral health can influence an individual's appearance, self-esteem, eating, and speaking. The use of mobile phone apps has been growing in the field of medicine, including dentistry. However, to date, there is no evidence related to the availability of mobile apps focusing on various branches of dentistry. OBJECTIVE The aim of this study was to review the scientific literature on the use of patient-oriented mobile phone apps in oral health and summarize the key findings. METHODS A scoping review of published scientific literature on the use of patient-oriented mobile phone apps in oral health was conducted in accordance with the Joanna Briggs Institute. A search was performed in PubMed and Scopus for studies published between January 2000 and June 2021 that were written in English. All study types except for those reporting developmental protocols were included in this review. In total, 2 reviewers independently screened the studies using the eligibility criteria. The study protocol was registered in the Open Science Framework registries in June 2021. RESULTS The initial search yielded a total of 977 studies, 45 (4.6%) of which met the inclusion criteria. All the studies (45/45, 100%) were published after 2009. Most studies (31/45, 69%) concerned oral health promotion using mobile phone apps, followed by behavior management (5/45, 11%). More than half (23/45, 51%) of the included studies were conducted in Asian countries. Overall, 31% (14/45) of the studies focused on adolescents. A total of 51% (23/45) of the studies were randomized controlled trials (RCTs). Approximately 39% (9/23) of the included RCT studies reported a substantial reduction in dental plaque, and 26% (6/23) of the studies reported significant improvement in gingival health. Regarding dental anxiety management, 13% (3/23) of the RCT studies reported a significant decrease in mean heart rate and lower Facial Image Scale scores. CONCLUSIONS According to the literature, the use of mobile apps in oral health is increasing among patients, mainly children and adolescents. Many studies that have used mobile apps have focused on promoting oral health. However, other areas such as diagnostic and remote consultations (teledentistry) have until recently been neglected despite their great potential.
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Affiliation(s)
- Elina Väyrynen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sanna Hakola
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Anniina Keski-Salmi
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Hannaleena Jämsä
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raija Vainionpää
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Saujanya Karki
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
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10
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Bianchi G, de'Angelis N, Gavriilidis P, Sobhani I, de'Angelis GL, Carra MC. Oral microbiota in obstructive sleep apnea patients: a systematic review. Sleep Breath 2023; 27:1203-1216. [PMID: 36207622 DOI: 10.1007/s11325-022-02718-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Evidence suggests that patients with obstructive sleep apnea (OSA) are at increased risk of suffering from periodontitis, a chronic inflammatory disease of the tooth-supporting tissues associated with a dysbiotic oral microbiota. This systematic review aims to explore the current literature about the composition of the oral microbiota in patients with OSA compared to those without OSA. METHODS Medline, Embase, and Cochrane Library were searched in May 2022 to identify original articles investigating the oral microbiota composition and/or oral microbiome (any microbiological technique) of patients with OSA (adults or children) vs. controls. Case report, reviews, and animal studies were excluded. RESULTS Of over 279 articles initially identified, 8 were selected, of which 3 dealt with pediatric patients. Overall, 344 patients with OSA and 131 controls were included. Five studies used salivary samples, 2 oral mucosal swabs, and 1 subgingival plaque sample. With different methods to characterize oral microbiota, 6/8 studies observed significant differences between patients with OSA patients and controls in the composition and relative abundance of several bacteria species/genera linked to periodontitis. CONCLUSION Within the limitations of the available literature, the present systematic review indicates that OSA and related conditions (e.g., mouth breathing) are associated with different oral microbiota compositions, which may underlie the association between OSA and periodontitis.
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Affiliation(s)
- Giorgio Bianchi
- Service of General Surgery, Henri Mondor University Hospital, Creteil, France
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicola de'Angelis
- Service of General Surgery, Henri Mondor University Hospital, Creteil, France
- Faculté de Santé, Université Paris Est, UPEC, Creteil, France
| | - Paschalis Gavriilidis
- Department of HBP Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK
| | - Iradj Sobhani
- Department of Gastroenterology, APHP-Henri Mondor University Hospital, Creteil, France
- EC2M-EA7375 Research Team, Henri Mondor Campus, Paris East University, Creteil, France
| | - Gian Luigi de'Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Maria Clotilde Carra
- Service of Odontology, Unit of Oral and Periodontal Surgery, Rothschild University Hospital and University Paris Cité, 5, rue Santerre, Paris, France.
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11
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Abu-Ta'a M, Marzouka D. Enamel Matrix Derivative (EMD) as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review. Cureus 2023; 15:e43530. [PMID: 37719602 PMCID: PMC10500965 DOI: 10.7759/cureus.43530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
If left untreated, periodontitis is a chronic, irreversible disease that can contribute to tooth loss. The primary objective of periodontal treatment is to arrest the progression of the disease and restore the supporting structures of the tooth. Scaling and root planing (SRP) is a common non-surgical periodontal therapy (NSPT) used to reduce inflammation, pocket depth, and clinical attachment loss. However, NSPT has limitations, notably in difficult-to-access deep pockets and molar furcations. Deep pockets (greater than 4 mm) frequently retain calculus following NSPT. To attain direct access, surgical periodontal therapy (SPT) is recommended, particularly for pockets deeper than 5 mm. Enamel matrix derivative (EMD) has emerged in recent years as a tool for periodontal regeneration when used in conjunction with NSP for infrabony defects. EMD may also have advantageous effects when combined with NSPT. The purpose of this review is to provide a thorough understanding of the effects of EMD as an adjunct to NSPT. The databases Scopus, PubMed/MEDLINE, Google Scholar, Cochrane, and Embase were systematically searched to identify relevant studies on the benefits of EMD and its use as an adjunct to NSPT. Incorporating EMD into NSPT reduces chair time, and 60% of studies demonstrated considerable benefits compared to SRP alone, according to the findings. On the basis of research, it can be concluded that EMD can be used as an adjunct to NSPT, thereby reducing the amount of time spent in the operating chair. In some cases, it can, therefore, be regarded as an alternative to surgical treatment.
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Affiliation(s)
| | - Dina Marzouka
- Dental Sciences, Arab American University, Ramallah, PSE
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12
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Basic A, Dahlén G. Microbial metabolites in the pathogenesis of periodontal diseases: a narrative review. FRONTIERS IN ORAL HEALTH 2023; 4:1210200. [PMID: 37388417 PMCID: PMC10300593 DOI: 10.3389/froh.2023.1210200] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/31/2023] [Indexed: 07/01/2023] Open
Abstract
The purpose of this narrative review is to highlight the importance of microbial metabolites in the pathogenesis of periodontal diseases. These diseases, involving gingivitis and periodontitis are inflammatory conditions initiated and maintained by the polymicrobial dental plaque/biofilm. Gingivitis is a reversible inflammatory condition while periodontitis involves also irreversible destruction of the periodontal tissues including the alveolar bone. The inflammatory response of the host is a natural reaction to the formation of plaque and the continuous release of metabolic waste products. The microorganisms grow in a nutritious and shielded niche in the periodontal pocket, protected from natural cleaning forces such as saliva. It is a paradox that the consequences of the enhanced inflammatory reaction also enable more slow-growing, fastidious, anaerobic bacteria, with often complex metabolic pathways, to colonize and thrive. Based on complex food chains, nutrient networks and bacterial interactions, a diverse microbial community is formed and established in the gingival pocket. This microbiota is dominated by anaerobic, often motile, Gram-negatives with proteolytic metabolism. Although this alternation in bacterial composition often is considered pathologic, it is a natural development that is promoted by ecological factors and not necessarily a true "dysbiosis". Normal commensals are adapting to the gingival crevice when tooth cleaning procedures are absent. The proteolytic metabolism is highly complex and involves a number of metabolic pathways with production of a cascade of metabolites in an unspecific manner. The metabolites involve short chain fatty acids (SCFAs; formic, acetic, propionic, butyric, and valeric acid), amines (indole, scatole, cadaverine, putrescine, spermine, spermidine) and gases (NH3, CO, NO, H2S, H2). A homeostatic condition is often present between the colonizers and the host response, where continuous metabolic fluctuations are balanced by the inflammatory response. While it is well established that the effect of the dental biofilm on the host response and tissue repair is mediated by microbial metabolites, the mechanisms behind the tissue destruction (loss of clinical attachment and bone) are still poorly understood. Studies addressing the functions of the microbiota, the metabolites, and how they interplay with host tissues and cells, are therefore warranted.
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Romano F, Bebars A, Ortu V, Bottone M, Giraudi M, Mariani GM, Baima G, Aimetti M. Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study. Clin Oral Investig 2023:10.1007/s00784-023-04956-w. [PMID: 36961591 DOI: 10.1007/s00784-023-04956-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/17/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES The aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS After the administration of psychological questionnaires, patients diagnosed with generalized stage III-IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT. RESULTS Of the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD. CONCLUSION Psychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017). PRACTICAL IMPLICATIONS Based on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Ahmad Bebars
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | | | - Michele Bottone
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy.
- Politecnico di Torino, Turin, Italy.
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, via Nizza, 230, Turin, Italy
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Jaumet L, Hamdi Z, Julia C, Hercberg S, Touvier M, Bouchard P, Carra MC, Andreeva VA. Periodontitis assessed with a new screening tool and oral health-related quality of life: cross-sectional findings among general-population adults. Qual Life Res 2023; 32:259-272. [PMID: 35948787 PMCID: PMC9365217 DOI: 10.1007/s11136-022-03215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Periodontitis, as a chronic, multifactorial inflammatory disease, has complex relationships with other diseases and ultimately with well-being. The aim of this cross-sectional study was to investigate the association between self-report periodontitis, as measured with the recently developed and validated modified Periodontal Screening Score (mPESS), and oral health-related quality of life (OHRQol) in a large population-based sample derived from the French NutriNet-Santé e-cohort. METHODS The sample was composed of 32,714 adults (75.5% women) with a mean age of 48.8 ± 13.9 years. Periodontitis was assessed based on age, smoking, and oral health status data obtained in 2011-2012, which allowed calculating the mPESS. An mPESS ≥ 5 was used to identify individuals at risk of severe periodontitis (main exposure). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) (main outcome) and the total score was dichotomized for analysis. Multivariable logistic regression analyses, considering physical health status, dietary and lifestyle confounding variables, were performed. RESULTS Overall, 6407 participants (19.6%) were at a high risk of severe periodontitis. A total of 7383 participants (22.6%) presented a relatively poor OHRQoL (OHIP-14 > 8, highest quartile). In the multivariable model, each of the following variables was independently and significantly associated with lower OHRQoL: older age (50-64 years), female sex, obesity, snacking between meals, frequent consumption of soft drinks and sweets/chocolate, risk of severe periodontitis, and having < 20 natural teeth were significantly. An mPESS ≥ 5 showed the highest odds for relatively poor OHRQoL (OR = 3.45; 95% CI 3.21-3.72). CONCLUSION The results support the association between periodontitis and OHRQoL in non-clinical samples. The use of mPESS could be tested in future prevention programs aiming at improving OHRQoL.
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Affiliation(s)
- Lauranne Jaumet
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Zeineb Hamdi
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Chantal Julia
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Serge Hercberg
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Mathilde Touvier
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Laboratory URP 2496 Orofacial Pathologies, Imaging and Biotherapies, University of Paris Cité, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Population-Based Epidemiologic Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Valentina A. Andreeva
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
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15
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Jiaxin H, Zhu C, Jing Y, Qianhui S, Fuqian J, Qiyuan P, Yi L, Jukun S. Plasma elaidic acid level is associated with periodontal health in American adults: A cross-sectional study. Front Nutr 2022; 9:1034841. [PMID: 36570162 PMCID: PMC9773206 DOI: 10.3389/fnut.2022.1034841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background Whether there is an association between TFAs and periodontitis is unclear. The purpose of this study was to investigate the relationship between moderate/severe periodontitis and plasma level of elaidic acid, a major trans-fatty acid component, in American adults. Methods The National Health and Nutrition Examination Survey (NHANES) years 2009-2010 were used to screen a total of 1,610 people. The independent variable of interest is plasma elaidic acid level, the dependent variable is periodontitis, and the covariates include socio-demographic variables, lifestyle variables, systemic diseases, etc. The distribution of variables in the covariate differences between the different independent groups according to tertile was investigated using a multiple linear regression model. To examine the association between plasma elaidic acid levels and moderate/severe periodontitis, three models were used. Results Multiple logistic regression analysis showed a significant association between plasma elaidic acid level and moderate/severe periodontitis after adjustment for potential confounders (OR = 1.021, 95%CI: 1.004-1.039, P = 0.01394). Subjects with the highest tertile of plasma elaidic acid levels were 51.9% more likely to have periodontitis compared with subjects with the lowest tertile of plasma elaidic acid levels (OR = 1.519, 95% CI: 1.136-2.030, P = 0.00477). No possible sources of heterogeneity were identified in the subgroup analyses. Conclusion Plasma elaidic acid levels are associated with periodontal disease in American adults.
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Affiliation(s)
- Hu Jiaxin
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Chen Zhu
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Yang Jing
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Shi Qianhui
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Jin Fuqian
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Pang Qiyuan
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Luo Yi
- Guiyang Hospital of Stomatology, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China,*Correspondence: Luo Yi,
| | - Song Jukun
- The Affiliated Stomatological Hospital and Stomatology of Guizhou Medical University, Guizhou Medical University, Guiyang, China,Song Jukun,
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16
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Maybodi FR, Fakhari M, Tavakoli F. Effects of omega-3 supplementation as an adjunct to non-surgical periodontal therapy on periodontal parameters in periodontitis patients: a randomized clinical trial. BMC Oral Health 2022; 22:521. [DOI: 10.1186/s12903-022-02569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/07/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Objectives
This study aimed to assess the effects of omega-3 fatty acid supplementation as an adjunct to non-surgical periodontal therapy in patients with periodontitis.
Materials and methods
This randomized clinical trial was conducted on 30 patients with periodontitis. All patients received standard non-surgical periodontal therapy, and were randomly divided into two groups of intervention and control by a table of random numbers (n = 15). The intervention group consumed 1000 mg natural fish oil soft-gels daily (300 mg Omega-3 marine triglycerides, 180 mg Eicosapentaenoic acid and 120 mg Docosahexaenoic acid) while the control group used soft-gels contained only some soybean oil for 3 months. Clinical attachment loss (CAL), probing depth (PD), and bleeding index (BI) were recorded at baseline (before the intervention) and after 3 months. The two groups were compared regarding the clinical parameters by t-test (alpha = 0.05).
Results
All three clinical parameters decreased in both groups at 3 months compared with baseline (P = 0.001). The improvement in PD and CAL in the intervention group was significantly greater than that in the control group (P = 0.001); however, the difference in BI was not significant between the two groups (P = 0.283).
Conclusion
Omega-3 supplementation as an adjunct to non-surgical periodontal therapy significantly improved the clinical parameters in periodontitis patients compared to soybean oil supplements.
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17
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Effect of Periodontal Interventions on Characteristics of the Periodontal Microbial Profile: A Systematic Review and Meta-Analysis. Microorganisms 2022; 10:microorganisms10081582. [PMID: 36014000 PMCID: PMC9416518 DOI: 10.3390/microorganisms10081582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 12/02/2022] Open
Abstract
Our systematic review aimed to evaluate the effect of periodontal interventions on the diversity and composition of periodontal microbiota assessed by high throughput sequencing (HTS) metagenomics analysis. An electronic search was conducted from database inception to November 2021. All clinical trials that evaluated the effect of periodontal interventions on the gingival microbiota through HTS were selected. The measures of alpha diversity, richness, Shannon diversity index, and the Chao1 index, were used as the primary outcome, whereas relative abundances of bacterial genera were considered as the secondary outcome. Overall, 24 studies were eligible for the systematic review, of which 13 studies were included in the meta-analysis. Periodontal intervention for the test group decreased Shannon diversity, richness, and Chao1 index (alpha diversity), as observed from baseline to post-treatment. The most common genera that increased after periodontal therapy were Rothia, Actinomyces, Streptococcus, Veillonella, and Hemophilus, whilst Porphyromonas, Tannerella, Fusobacterium, and Treponema decreased after periodontal therapy. Periodontal interventions may decrease the bacterial diversity and richness and alter the composition of oral microbiota in the short term. Periodontal microbiota signatures could potentially be used for the assessment of periodontal disease development, progression, and success of the intervention.
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18
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Reckelkamm SL, Hannemann A, Kocher T, Nauck M, Völzke H, Ehmke B, Rauner M, Alayash Z, Baumeister SE, Nolde M, Holtfreter B. Association between bone turnover markers and periodontitis: A population-based cross-sectional study. J Clin Periodontol 2022; 49:633-641. [PMID: 35569034 DOI: 10.1111/jcpe.13649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/26/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022]
Abstract
AIM To examine the associations between bone turnover markers and periodontitis in two cross-sectional population-based studies. MATERIALS AND METHODS We used data from two independent adult samples (N = 4993), collected within the Study of Health in Pomerania project, to analyse cross-sectional associations of N-procollagen type 1 amino-terminal propeptide (P1NP), C-terminal cross-linking telopeptide, osteocalcin, bone-specific alkaline phosphatase (BAP), fibroblast growth factor 23, wingless-type mouse mammary tumour virus integration site family member 5a (WNT5A), and sclerostin values with periodontitis. Confounder-adjusted gamma and fractional response regression models were applied. RESULTS Positive associations were found for P1NP with mean pocket probing depth (PPD; e β = 1.008 ; 95% confidence interval [CI]: 1.001-1.015), mean clinical attachment loss (mean CAL; e β = 1.027 ; 95% CI: 1.011-1.044), and proportion of sites with bleeding on probing (%BOP; e β = 1.055 ; 95% CI: 1.005-1.109). Similar associations were seen for BAP with %BOP ( e β = 1.121 ; 95% CI: 1.042-1.205), proportion of sites with PPD ≥4 mm (%PPD4) ( e β = 1.080 ; 95% CI: 1.005-1.161), and sclerostin with %BOP ( e β = 1.308 ; 95% CI: 1.005-1.704). WNT5A was inversely associated with mean PPD ( e β = 0.956 ; 95% CI: 0.920-0.993) and %PPD4 ( e β = 0.794 ; 95% CI: 0.642-0.982). CONCLUSIONS This study revealed scattered associations of P1NP, BAP, WNT5A, and sclerostin with periodontitis, but the results are contradictory in the overall context. Associations reported in previous studies could not be confirmed.
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Affiliation(s)
- Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Münster, Münster, Germany
| | - Martina Rauner
- Department of Medicine III and Center for Healthy Aging, Technical University of Dresden, Dresden, Germany
| | - Zoheir Alayash
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | | | - Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Gao J, Cai S, Wang Z, Li D, Ou M, Zhang X, Tian Z. The optimization of ligature/bone defect-induced periodontitis model in rats. Odontology 2022; 110:697-709. [PMID: 35654915 DOI: 10.1007/s10266-022-00715-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/10/2022] [Indexed: 01/12/2023]
Abstract
The destruction of alveolar bone is a crucial manifestation of severe chronic periodontitis, which stem cell-based bioengineered therapies are expected to cure. Therefore, a cost-effective, reproducible, quantifiability and easier to administrate animal model that mimics human periodontitis is of great importance for further endeavor. In this study, we created periodontitis rat models in silk ligation group, bone defect group and bone defect/silk ligation group, respectively. Obvious periodontal inflammation but slight alveolar bone resorption was observed in the ligation group, while surgical trauma was not robust enough to continually worsen the constructed bone defect area in the bone defect group. In the bone defect/ligature group, significant and stable periodontal inflammation was the most enduring with similar evolving pathological patterns of human periodontitis. It also exhibited enhanced clinical similarity and confirmed its superiority in quantitativeness. The present rat model is the first study to reproduce a pathological process similar to human periodontitis with reliable stability and repeatability, manifesting a priority to previous methods. Day 9-12 is the best time for reproducing severe periodontitis syndromes with vertical bone resorption in this model.
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Affiliation(s)
- Jingyi Gao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Simin Cai
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Zijie Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China.,School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China.,Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Dan Li
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Minyi Ou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Xinlu Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Zhihui Tian
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Shatainan Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
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Hwang SY, Jang JH, Park JE. Association between Healthy Lifestyle (Diet Quality, Physical Activity, Normal Body Weight) and Periodontal Diseases in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073871. [PMID: 35409556 PMCID: PMC8998121 DOI: 10.3390/ijerph19073871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to investigate the association between healthy lifestyle (HLS; i.e., diet quality, physical activity, normal weight) and periodontal diseases in Korean adults. Studying this association may help inform future intervention programs aimed at preventing the development of periodontal diseases. Raw data of the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016–2018) were used. Data from 12,689 adults aged 19 years and over who had a periodontal examination were analyzed. The associations between HLS and periodontal diseases were analyzed using multivariate logistic regression after adjusting for demographic and health factors as covariates. We found that each of the HLS (diet quality, physical activity, normal body weight) practices was significantly associated with periodontal diseases (OR: 1.32, 95% CI: 1.13–1.55; OR: 1.16, 95% CI: 1.04–1.30; OR: 1.26, 95% CI: 1.14–1.40, respectively). In particular, having poor HLS practices was identified as a risk factor for periodontal diseases (OR: 1.54, 95% CI: 1.10–2.15). HLS was associated with periodontal diseases. Thus, in addition to improving oral hygiene—the primary focus in the past—improving HLS should be emphasized for patients with periodontal diseases.
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Affiliation(s)
- Su-Yeon Hwang
- Research Institute for Future Medical Science, Chungnam National University Sejong Hospital, Sejong 30099, Korea
| | - Jong-Hwa Jang
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan-si 31116, Korea
| | - Jung-Eun Park
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan-si 31116, Korea
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Gheisary Z, Mahmood R, Harri shivanantham A, Liu J, Lieffers JRL, Papagerakis P, Papagerakis S. The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14051036. [PMID: 35268009 PMCID: PMC8912513 DOI: 10.3390/nu14051036] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Periodontal diseases are a global health concern. They are multi-stage, progressive inflammatory diseases triggered by the inflammation of the gums in response to periodontopathogens and may lead to the destruction of tooth-supporting structures, tooth loss, and systemic health problems. This systematic review and meta-analysis evaluated the effects of probiotic supplementation on the prevention and treatment of periodontal disease based on the assessment of clinical, microbiological, and immunological outcomes. (2) Methods: This study was registered under PROSPERO (CRD42021249120). Six databases were searched: PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, and Dentistry and Oral Science Source. The meta-analysis assessed the effects of probiotic supplementation on the prevention and treatment of periodontal diseases and reported them using Hedge’s g standardized mean difference (SMD). (3) Results: Of the 1883 articles initially identified, 64 randomized clinical trials were included in this study. The results of this meta-analysis indicated statistically significant improvements after probiotic supplementation in the majority of the clinical outcomes in periodontal disease patients, including the plaque index (SMD = 0.557, 95% CI: 0.228, 0.885), gingival index, SMD = 0.920, 95% CI: 0.426, 1.414), probing pocket depth (SMD = 0.578, 95% CI: 0.365, 0.790), clinical attachment level (SMD = 0.413, 95% CI: 0.262, 0.563), bleeding on probing (SMD = 0.841, 95% CI: 0.479, 1.20), gingival crevicular fluid volume (SMD = 0.568, 95% CI: 0.235, 0.902), reduction in the subgingival periodontopathogen count of P. gingivalis (SMD = 0.402, 95% CI: 0.120, 0.685), F. nucleatum (SMD = 0.392, 95% CI: 0.127, 0.658), and T. forsythia (SMD = 0.341, 95% CI: 0.050, 0.633), and immunological markers MMP-8 (SMD = 0.819, 95% CI: 0.417, 1.221) and IL-6 (SMD = 0.361, 95% CI: 0.079, 0.644). (4) Conclusions: The results of this study suggest that probiotic supplementation improves clinical parameters, and reduces the periodontopathogen load and pro-inflammatory markers in periodontal disease patients. However, we were unable to assess the preventive role of probiotic supplementation due to the paucity of studies. Further clinical studies are needed to determine the efficacy of probiotic supplementation in the prevention of periodontal diseases.
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Affiliation(s)
- Zohre Gheisary
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Razi Mahmood
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Aparna Harri shivanantham
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Juxin Liu
- Department of Mathematics and Statistics, College of Arts and Science, University of Saskatchewan, 106 Wiggins Road, Saskatoon, SK S7N 5E6, Canada;
| | - Jessica R. L. Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada;
| | - Petros Papagerakis
- Laboratory of Precision Oral Health and Chronobiology, College of Dentistry, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada;
| | - Silvana Papagerakis
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
- Correspondence: ; Tel.: +1-3069661960
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Schulz S, Stein JM, Schumacher A, Kupietz D, Yekta-Michael SS, Schittenhelm F, Conrads G, Schaller HG, Reichert S. Nonsurgical Periodontal Treatment Options and Their Impact on Subgingival Microbiota. J Clin Med 2022; 11:jcm11051187. [PMID: 35268280 PMCID: PMC8911148 DOI: 10.3390/jcm11051187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different periodontal treatment methods (quadrant-wise debridement, scaling and root planing (Q-SRP), full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP)) were applied in periodontitis patients (stage III/IV). The study objective (substudy of ClinicalTrials.gov Identifier: NCT03509233) was to compare the impact of treatments on subgingival colonization. METHODS Forty patients were randomized to the treatment groups. Periodontal parameters and subgingival colonization were evaluated at baseline and 3 and 6 months after treatment. RESULTS Positive changes in clinical parameters were recorded in every treatment group during the 3-month follow-up period, but did not always continue. In three groups, specific bacteria decreased after 3 months; however, this was associated with a renewed increase after 6 months (FMS: Porphyromonas gingivalis; FMD: Eubacterium nodatum, Prevotella dentalis; and FMDAP: uncultured Prevotella sp.). CONCLUSIONS The benefit of all clinical treatments measured after 3 months was associated with a decrease in pathogenic bacteria in the FMS, FMD, and FMDAP groups. However, after 6 months, we observed further improvement or some stagnation in clinical outcomes accompanied by deterioration of the microbiological profile. Investigating the subgingival microbiota might help appraise successful periodontal treatment and implement individualized therapy.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
- Correspondence:
| | - Jamal M. Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
- Private Practice, 52062 Aachen, Germany
| | - Anne Schumacher
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - David Kupietz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - Sareh S. Yekta-Michael
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
| | - Florian Schittenhelm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
- Private Practice, 52062 Aachen, Germany
| | - Georg Conrads
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
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Guan J, Zhang D, Wang C. Identifying periodontitis risk factors through a retrospective analysis of 80 cases. Pak J Med Sci 2022; 38:293-296. [PMID: 35035442 PMCID: PMC8713243 DOI: 10.12669/pjms.38.1.5205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 08/19/2021] [Accepted: 09/12/2021] [Indexed: 12/16/2022] Open
Abstract
Objectives: To investigate periodontitis risk factors and to establish a reference framework for identifying factors that place individuals at greater risk for periodontitis. Methods: Clinical data from 80 periodontitis patients admitted in the Department of Stomatology at Hebei Provincial People’s Hospital and treated between March 2020 and March 2021 were retrospectively analyzed. Results: Univariate analysis showed that lower daily brushing frequencies, decreased tooth brushing duration, decreased scaling frequency, dietary habits, smoking and drinking, genetic factors, diabetes, hypertension, and obesity were more prevalent among periodontitis patients than healthy controls. Multivariate binary logistic analysis showed that daily brushing frequency, routine scaling, smoking, drinking, heredity, diabetes, hypertension, and obesity were all risk factors for periodontitis. Conclusions: There are many risk factors for periodontitis. Clinicians need to be aware of these factors for early detection and treatment of the disease.
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Affiliation(s)
- Jing Guan
- Jing Guan M.D. Department of Stomatology, Hebei General Hospital; No. 348, Heping West Road, Shijiazhuang, 050051, Hebei Province, P.R. China
| | - Dong Zhang
- Dong Zhang M.D. Department of Stomatology, Hebei General Hospital; No. 348, Heping West Road, Shijiazhuang, 050051, Hebei Province, P.R. China
| | - Cailing Wang
- Cailing Wang M.D. Department of Stomatology, Hebei General Hospital; No. 348, Heping West Road, Shijiazhuang, 050051, Hebei Province, P.R. China
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Lisetska I, Rozhko M. Features of microbiocenosis and production of hydrogen peroxide by gum symbionts in adolescents with catarrhal gingivitis and chronic gastroduodenitis. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-31515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. The key links in the etiology and pathogenesis of periodontal tissue diseases are the quantitative and qualitative changes in the composition of the microflora of the oral cavity, with the simultaneous deterioration of oral hygiene, and reduction of local and general immunity, which occurs more often in the presence of somatic diseases. Aims. The aim of the paper was to study the features of the microbiocenosis of periodontal tissues and the production of hydrogen peroxide by gum symbionts in adolescents with catarrhal gingivitis and chronic gastroduodenitis. Methods. The condition of the microbiocenosis of the gums of 83 adolescents from 12 to 18 years, which was divided into groups depending on the diagnosed catarrhal gingivitis and chronic gastroduodenitis, was studied. Bacteriological examination was performed to isolate pure cultures of microorganisms and to identify them according to generally accepted microbiological methods. The ability of the selected cultures to produce hydrogen peroxide was studied on an indicator medium with potassium-iodine-starch system, by the iodometric method. Results. The results of microbiological studies showed significant changes in qualitative and quantitative indicators of the microbiocenosis of the gingival mucosa in the affected area of patients with gingivitis, compared with dentally and somatically healthy individuals in the control group. In the group of clinically healthy adolescents, hydrogen peroxide producers were found on the mucous membrane of the gums only in 5.0 ± 1.15% of the examinees. In catarrhal gingivitis, hydrogen peroxide producers were found in 52.4 ± 2.4 % of the examined main group subjects (p < 0.01) and in the 50.0 ± 2.5 % of the examined comparison group subjects (p < 0.01). Conclusion. Among adolescents with catarrhal gingivitis, which occurs on the background of chronic gastroduodenitis, there were more pronounced quantitative and qualitative changes in the microbiocenosis of the gums. The hydrogen peroxide produced by them can act as an additional damaging factor in the pathogenesis of the inflammatory process of the gingival area.
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Alshibani N. Resolvins as a Treatment Modality in Experimental Periodontitis: A Systematic Review of Preclinical Studies. Cureus 2022; 14:e21095. [PMID: 35036235 PMCID: PMC8754062 DOI: 10.7759/cureus.21095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
This systematic review aimed to assess scientific data of existing literature to identify the efficacy of resolvins (Rv) in the treatment of periodontitis. The electronic databases, Web of Science (WOS), Medline/PubMed, The Cochrane Library, Scopus, and Saudi digital library (SDL), were searched for eligible studies in the field of periodontics. A thorough analysis of the retrieved literature provided five articles that were assessed and included in this systematic review. The quality of these studies was assessed by updated Essential Animal Research: Reporting of In-Vivo Experiments (ARRIVE) guidelines. The five included studies were published between 2005 and 2018 and investigated resolvins as a treatment approach in experimental periodontitis of animals. Among the study animals employed, New Zealand white rabbits were used in three studies, Wistar rats and Albino mice in two studies, respectively. Four studies have evaluated eicosapentaenoic acid-derived RvE1, and one study evaluated docosahexaenoic acid-derived RvD2. Oral-topical application of Rv was followed in four studies, and intra-peritoneal Rv injection was administered in one study. The study duration in these studies have ranged between 4-12 weeks, and the Rv dose was between 0.1 μg to 0.5 μg. One study evaluated the influence of RvE1 topical application on both the prevention and treatment of experimental periodontitis. Resolvins (RvE1 and RvD2) have been studied in periodontitis-induced animal models to assess their potential role in periodontal inflammation resolution. There are promising preclinical data of using resolvins as a treatment modality in experimental periodontitis. Resolvins have been demonstrated to inhibit the destructive inflammatory process and alveolar bone loss in laboratory-induced periodontitis under controlled experimental conditions.
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Affiliation(s)
- Nouf Alshibani
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
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Madi M, Tabasum A, Elakel A, Aleisa D, Alrayes N, Alshammary H, Siddiqui IA, Almas K. Periodontal risk assessment in a teaching hospital population in Saudi Arabia's Eastern Province. Saudi Dent J 2021; 33:853-859. [PMID: 34938025 PMCID: PMC8665182 DOI: 10.1016/j.sdentj.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/10/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE With this cross-sectional study, we aimed to evaluate factors associated with moderate and high risk of periodontal disease (PD) progression in the Saudi population. METHODS We reviewed 281 patients' clinical charts from predoctoral periodontal clinics at the dental teaching hospital in the College of Dentistry (COD) at Imam Abdulrahman Bin Faisal University (IAU) in Dammam, Saudi Arabia. After obtaining ethical approval, we determined the Periodontal Risk Assessment (PRA) of the included patients based on the modified criteria developed by Lang and Tonetti (2003). We used logistic regression on stratified data and divided the results into two categories (low-moderate and high risk) to assess the effect modifier for potential risk factors. We used SPSS version 22 for data analysis, and considered a P-value ≤ 0.05 to be statistically significant. RESULTS Out of the 281 patients, 104 (37.0%) were male and 177 (63.0%) were female, with a mean age of 39.9 ± 14.0 years; 78.1% were Saudi nationals, 77% were married, and 44.6% were in the age group of 30 to 49. The PRA revealed 86 (30.5%) to represent high risk, 108 (38.3%) denoted moderate risk, and 88 (31.2%) signaled low risk for periodontitis. Logistic regression analysis showed that males were three times more likely to have high PRA (OR = 3.24) and to be married (OR = 2.77), as well as to be active smokers (OR = 8.87). The highest predictive factors of high PRA were 8 or more pockets ≥ 5 mm (OR = 29.0), those with active diabetes mellitus (DM; OR = 10.2), and those with 8 or more missing teeth (OR = 9.15). CONCLUSION Saudi males who are married and have residual periodontal pockets, are actively diabetic, and with missing teeth are at high risk of PD. Further research is needed with a larger sample size comparing the general population with and without PD.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Afsheen Tabasum
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Ahmed Elakel
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Deamah Aleisa
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Nabras Alrayes
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Hend Alshammary
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Intisar Ahmad Siddiqui
- Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
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Cao J, Su Y, Chen Z, Ma C, Xiong W. The risk factors for Graves' ophthalmopathy. Graefes Arch Clin Exp Ophthalmol 2021; 260:1043-1054. [PMID: 34787691 DOI: 10.1007/s00417-021-05456-x] [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: 08/09/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE This review aimed to provide an overview of current research into the risk factors for Graves' ophthalmopathy (GO). METHODS To find information about the risk factors for GO, the research database PubMed was searched and relevant articles were obtained to extract information about risk factors. RESULTS Smoking has been widely accepted as an important risk factor and cigarette smoking cessation has been shown to improve the outcome and decrease the onset of GO. Radioactive iodine on the thyroid may induce hyperthyroidism and increase the occurrence of GO. Selenium deficiency is a risk factor for GO and the supplementation of selenium has been an adjuvant therapy. Decreasing stressful life events (SLE) may help improve GO. Imbalance in intestinal flora is essential to GO, with Yersinia enterocolitica and Escherichia coli both increased in the digestive tract of the individual with GO. In addition, controlling serum cholesterol may help improve GO since adipogenesis is an important pathological change in its pathogenesis. Considering the correlation between Graves' disease and GO, maintaining normal thyroid function hormone level is the first-line therapeutic strategy to prevent progression of GO. An increase in antibodies such as TSHR and IGF-1R is the main predictor of GO. Besides, gender and gene polymorphism are also risk factors towards GO. CONCLUSIONS Risk factors for GO arise from five sources: physical and chemical environment, social-psychological environment, biological environment, the human organism, and genetic codes. Risk factors within these categories may interact with each other and their mechanisms in promoting the development of GO are complex. Research into risk factors for GO may promote emerging fields related to GO such as control of autoantibodies and intestinal microbiota.
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Affiliation(s)
- Jiamin Cao
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Yuelu District, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Yuhe Su
- Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Changsha, China
| | - Zhuokun Chen
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Yuelu District, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Chen Ma
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Yuelu District, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Wei Xiong
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Yuelu District, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China.
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Baima G, Romandini M, Citterio F, Romano F, Aimetti M. Periodontitis and Accelerated Biological Aging: A Geroscience Approach. J Dent Res 2021; 101:125-132. [PMID: 34609209 DOI: 10.1177/00220345211037977] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As the whole world is epidemically aging, the burden of periodontitis and tooth loss is becoming a major health concern. Growing meta-epidemiological data implicate chronic systemic inflammation/infection due to periodontitis as an independent risk factor for aging-related diseases and mortality. However, because people age differently, chronological age is not a reliable marker of an individual's functional status. Recent advances in geroscience have shown that various biomarker signatures of biological aging are longitudinally associated with declined physical function, morbidity, and mortality due to major age-related diseases, including periodontitis. Here, we emphasize novel research developments bidirectionally linking periodontitis to accelerated biological aging. Using a composite biomarker age estimator, a striking increase in periodontitis and tooth loss was observed in subjects whose biological age at baseline was higher than their chronological age. Moreover, significantly shortened telomeres were encountered in populations affected by severe periodontitis. Second, we elucidate the cellular and molecular pillars of the aging process at the periodontal level. Accumulating evidence suggests that cellular senescence, stem cell exhaustion, and immunoaging are hallmarks of biological aging implicated in the impairment of periodontal homeostasis and the pathophysiology of periodontitis. Indeed, persistent bacteria-derived lipopolysaccharide stimulation influences cellular senescence in osteocytes, driving alveolar bone resorption. Moreover, inflammaging status induced by chronic hyperglycemia elevates the burden of senescent cells in gingival tissues, impairing their barrier function. Lastly, we reviewed a recent breakthrough in senotherapy to directly target the mechanisms of aging at the periodontal level. Physical exercise and intermittent fasting, together with natural compounds, senolytic drugs, and cell therapy, are increasingly being evaluated to rejuvenate the oral cavity. Following these innovations in geroscience, further advancements could provide oral clinicians the chance to intercept biological aging when still "subclinical" and set interventions for halting or delaying the trajectory toward aging-related diseases while patients are still chronologically young.
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Affiliation(s)
- G Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - M Romandini
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - F Citterio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - F Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - M Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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Haas AN, Furlaneto F, Gaio EJ, Gomes SC, Palioto DB, Castilho RM, Sanz M, Messora MR. New tendencies in non-surgical periodontal therapy. Braz Oral Res 2021; 35:e095. [PMID: 34586209 DOI: 10.1590/1807-3107bor-2021.vol35.0095] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.
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Affiliation(s)
- Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Flavia Furlaneto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
| | - Eduardo José Gaio
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Daniela Bazan Palioto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
| | - Rogerio Moraes Castilho
- Michigan University, School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
| | - Mariano Sanz
- Complutense University of Madrid, Etiology and Therapy of Periodontal and Peri-implant Diseases Research Group, Madrid, Spain
| | - Michel Reis Messora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
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Cota LOM, Villar CC, Vettore MV, Campos JR, Amaral GCLSD, Cortelli JR, Cortelli SC. Periodontal diseases: is it possible to prevent them? A populational and individual approach. Braz Oral Res 2021; 35:e098. [PMID: 34586212 DOI: 10.1590/1807-3107bor-2021.vol35.0098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.
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Affiliation(s)
- Luís Otávio Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Mario Vianna Vettore
- University of Agder - UiA, Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, Kristiansand, Norway
| | - Julya Ribeiro Campos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
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Fujimori K, Yoneda T, Tomofuji T, Ekuni D, Azuma T, Maruyama T, Sugiura Y, Morita M. Detection of Salivary miRNAs That Predict Chronic Periodontitis Progression: A Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158010. [PMID: 34360304 PMCID: PMC8345340 DOI: 10.3390/ijerph18158010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/15/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022]
Abstract
The aim of this two-year cohort study was to investigate salivary microRNAs (miRNAs) that predict periodontitis progression. A total of 120 patients who underwent supportive periodontal therapy were recruited. Unstimulated whole saliva was collected at baseline. Two years later, 44 patients were followed up (median age, 67.1 years) and divided into two groups: progression group (n = 22), with one or more sites with clinical attachment level (CAL) progression (>3 mm compared with baseline) or tooth extraction due to periodontitis progression; and the control group (n = 22), which did not exhibit CAL progression. In the microarray analysis of salivary miRNAs, hsa-miR-5571-5p, hsa-miR-17-3p, hsa-let-7f-5p, hsa-miR-4724-3p, hsa-miR-99a-5p, hsa-miR-200a-3p, hsa-miR-28-5p, hsa-miR-320d, and hsa-miR-31-5p showed fold change values <0.5 or ≥2.0 in the progression group compared with the control group (p < 0.05). On receiver operating characteristic curve analysis, areas under the curves of hsa-miR-5571-5p, hsa-let-7f-5p, hsa-miR-99a-5p, hsa-miR-28-5p, and hsa-miR-320d were >0.7, indicating fair discrimination power. The expressions of salivary hsa-miR-5571-5p, hsa-let-7f-5p, hsa-miR-99a-5p, hsa-miR-28-5p, and hsa-miR-320d were associated with periodontitis progression in patients with chronic periodontitis. These salivary miRNAs may be new biomarkers for progression of periodontitis, and monitoring them may contribute to new diagnostics and precision medicine for periodontitis.
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Affiliation(s)
- Kohei Fujimori
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
| | - Toshiki Yoneda
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851-1 Hozumi, Mizuho 501-0296, Japan; (T.T.); (T.A.)
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851-1 Hozumi, Mizuho 501-0296, Japan; (T.T.); (T.A.)
| | - Takayuki Maruyama
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
- Advanced Research Center for Oral and Craniofacial Sciences, Dental School, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yoshio Sugiura
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
| | - Manabu Morita
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (K.F.); (T.Y.); (D.E.); (T.M.); (Y.S.)
- Correspondence: ; Tel.: +81-86-235-6712; Fax: +81-86-235-6714
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Self-reported periodontal health and incident hypertension: longitudinal evidence from the NutriNet-Santé e-cohort. J Hypertens 2021; 39:2422-2430. [PMID: 34261955 DOI: 10.1097/hjh.0000000000002941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension. METHODS We analyzed data from the French population-based e-cohort NutriNet-Santé, selecting participants who had completed two oral health questionnaires in 2011-2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used. RESULTS The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012--December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66-2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03-1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80-0.97). CONCLUSION Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual's risk of arterial hypertension. TRIAL REGISTRATION # NCT03335644.
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Hallikainen J, Pyysalo M, Keränen S, Kellokoski J, Koivisto T, Suominen AL, Pussinen P, Pessi T, Frösen J. Systemic immune response against the oral pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans is associated with the formation and rupture of intracranial aneurysms. Eur J Neurol 2021; 28:3089-3099. [PMID: 34145948 DOI: 10.1111/ene.14986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Periodontal infections are associated with the formation and rupture of intracranial aneurysms (IAs). This study investigated the role of two key periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. METHODS Immunoglobulin A (IgA) and IgG antibodies against P. gingivalis and A. actinomycetemcomitans were measured with enzyme immune assay from the serum of 227 IA patients, of whom 64 also underwent clinical oral examination. As a control group, 1096 participants in a cross-sectional health survey, Health 2000, underwent serological studies and oral examination. Logistic regression was used for multivariate analysis. Immunohistochemistry was performed to demonstrate bacteria-derived epitopes in the IA wall. RESULTS Widespread gingivitis and severe periodontitis were more common in IA patients than in controls (2× and 1.5×, respectively). IgA antibodies against P. gingivalis and A. actinomycetemcomitans were 1.5× and 3-3.4× higher, respectively, in both unruptured and ruptured IA patients compared to controls (p ≤ 0.003). IgG antibodies against P. gingivalis were 1.8× lower in unruptured IA patients (p < 0.001). In multivariate analysis, high IgA, but low IgG, antibody levels against P. gingivalis (odds ratio [OR] = 1.4, 95% confidence interval [Cl] = 1.1-1.8 and OR = 1.5, 95% Cl = 1.1-1.9; OR = 0.6, 95% Cl = 0.4-0.7 and OR = 0.5, 95% Cl = 0.4-0.7) and against A. actinomycetemcomitans (OR = 2.3, 95% Cl = 1.7-3.1 and OR = 2.1, 95% Cl = 1.5-2.9; OR = 0.6, 95% Cl = 0.4-0.8 and OR = 0.6, 95% Cl = 0.5-0.9) were associated with the risk of IA formation and rupture. Immunohistochemistry showed P. gingivalis epitopes in the IA wall. CONCLUSIONS Exposure to the periodontal pathogens P. gingivalis and A. actinomycetemcomitans and dysfunctional acquired immune response against them may increase the risk of IA formation and IA rupture.
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Affiliation(s)
- Joona Hallikainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Mikko Pyysalo
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Sara Keränen
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland.,A. I. Virtanen Institute, University of Eastern Finland, Kuopio, Finland
| | - Jari Kellokoski
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Timo Koivisto
- Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tanja Pessi
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Juhana Frösen
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland.,Department of Neurosurgery, Tampere University Hospital, Tampere, Finland
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Carra MC, Detzen L, Kitzmann J, Woelber JP, Ramseier CA, Bouchard P. Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review. J Clin Periodontol 2021; 47 Suppl 22:72-89. [PMID: 31912530 DOI: 10.1111/jcpe.13234] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases. METHODS A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups. RESULTS Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes. CONCLUSIONS Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time.
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Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
| | - Laurent Detzen
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France
| | - Julia Kitzmann
- Private Practice, Hamburg, Germany.,Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Philippe Bouchard
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,EA 2496, U.F.R. of Odontology, University of Paris, Paris, France
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Ekuni D, Kato S, Kawakami S, Maruyama T, Kataoka K, Uchida-Fukuhara Y, Fukuhara D, Toyama N, Yokoi A, Islam MM, Khair SB, Kodama N, Morita M. Parafunctional masseter muscle activity during waking is related to periodontitis progression: A pilot prospective cohort study. J Clin Periodontol 2021; 48:785-794. [PMID: 33484572 DOI: 10.1111/jcpe.13432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/03/2021] [Accepted: 01/15/2021] [Indexed: 12/16/2022]
Abstract
AIM The purpose of this pilot prospective cohort study was to investigate the effects of parafunctional masseter muscle activity on periodontitis progression among patients receiving supporting periodontal therapy (SPT). MATERIALS AND METHODS We collected data of patients treated at Okayama University Hospital from August 2014 to September 2018. The progression group was defined as patients with ≥2 teeth demonstrating a longitudinal loss of proximal attachment of ≥3 mm during the 3-year study period and/or at least one tooth extraction due to periodontitis progression. Surface electromyography of masseter muscles at baseline was continuously recorded while patients were awake and asleep. RESULTS We analysed 48 patients (36 females) aged 66.8 ± 9.1 years (mean ± SD). The rate of parafunctional masseter muscle activity during waking hours and sleeping hours at baseline was 60.4% and 52.1%, respectively. Cox's proportional hazards regression model showed that the incidence of periodontitis progression was significantly associated with number of teeth present (p = 0.001) and parafunctional masseter muscle activity during waking hours (p = 0.041). CONCLUSION Our results suggest that parafunctional masseter muscle activity during waking hours is a risk factor for periodontitis progression among patients receiving SPT.
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Affiliation(s)
- Daisuke Ekuni
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Seiya Kato
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Shigehisa Kawakami
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Takayuki Maruyama
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,Advanced Research Center for Oral and Craniofacial Sciences, Okayama University, Okayama, Japan
| | - Kota Kataoka
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yoko Uchida-Fukuhara
- Department of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Daiki Fukuhara
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Naoki Toyama
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Aya Yokoi
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Md Monirul Islam
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Subrina Binta Khair
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Naoki Kodama
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Meisel P, Nauck M, Kocher T. Individual predisposition and the intricate interplay between systemic biomarkers and periodontal risk in a general population. J Periodontol 2021; 92:844-853. [PMID: 33315240 DOI: 10.1002/jper.20-0591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/16/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Increasing age is associated with systemic diseases as well as with periodontal diseases. We wondered whether a biological age score constructed exclusively from systemic biomarkers would reflect periodontal risk factors at baseline and tooth loss as well as periodontal outcome during 10 years follow-up. METHODS From the Study of Health in Pomerania (SHIP) 2256 participants (1072 male, 1184 female) were studied for the relationship of the systemic biomarkers glycated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL), fibrinogen, white blood cell count, blood pressure, and waist circumference to their age. Construction of a biological age (BA) score allowed its comparison with the participants' actual chronological age (CA) and their predisposition to periodontal disease. RESULTS Though nearly identical in CA, participants appearing younger than their true age had a significantly reduced burden of periodontal risk factors. If BA > CA, then risk factors were more frequent including smoking, oral hygiene, dental visits, education, and income. After 10 years, in participants with identical CA, tooth loss followed their BA calculated at baseline, that is, with BA > CA fewer teeth were preserved. Similarly, periodontal measures varied according to BA; sex differences were obvious. Most significant were BA-related differences in inflammatory and anthropometry parameters. CONCLUSIONS The results support the assumption that risk profiles aggregated in BA constitute a characteristic susceptibility pattern unique to each individual, common to both systemic and periodontal diseases. Although BA was constructed exclusively from systemic measures at baseline, BA reflects the oral conditions at follow-up.
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Affiliation(s)
- Peter Meisel
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Diagnostics, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
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Dubar M, Clerc-Urmès I, Baumann C, Clément C, Alauzet C, Bisson C. Relations of Psychosocial Factors and Cortisol with Periodontal and Bacterial Parameters: A Prospective Clinical Study in 30 Patients with Periodontitis Before and After Non-Surgical Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207651. [PMID: 33092182 PMCID: PMC7588876 DOI: 10.3390/ijerph17207651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022]
Abstract
(1) Background: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factors such as stress or anxiety affecting host response. The purpose of this study is to evaluate the potential associations between psychosocial factors scores or salivary cortisol levels with clinical periodontal parameters and bacterial environment in patients with periodontitis; (2) Methods: Subgingival microbiota was collected in two pathological and one healthy sites from thirty diseased patients (before/after scaling and root planing (SRP)) and from one healthy site from thirty control patients. Usual clinical periodontal parameters were recorded, and a saliva sample was harvested. Patients completed stress and anxiety self-assessment questionnaires. Cortisol concentrations were determined by ELISA and bacteria were identified by PCR; (3) Results: No correlation between salivary cortisol and the stress-anxiety self-declared was found (p > 0.05), but high concentrations of this molecule were associated positively and linearly with periodontal pocket depth (p = 0.04). It appeared that certain psychosocial stressors are associated with a modulation of the bacterial colonization of pockets of diseased group (before/after SRP), notably concerning Tannerella forsythia (p = 0.02), Porphyromonas gingivalis (p = 0.03), Fusobacterium nucleatum (p = 0.049) and Campylobacter rectus (p = 0.01). (4) Conclusion: This study reveals associations between bacteria colonization and psychosocial parameters in periodontitis that needs to be further investigated.
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Affiliation(s)
- Marie Dubar
- Department of Periodontology, School of Dentistry, Lille University Hospital, 59000 Lille, France
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- Correspondence:
| | - Isabelle Clerc-Urmès
- Department of Methodology, Promotion and Investigation, UMDS, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (I.C.-U.); (C.B.)
| | - Cédric Baumann
- Department of Methodology, Promotion and Investigation, UMDS, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France; (I.C.-U.); (C.B.)
| | - Céline Clément
- CHRU Nancy, Department of Public Health Dentistry, University Hospital, 54000 Nancy, France;
- “Interpsy” Laboratory, University of Lorraine, EA 4432, CEDEX 54015 Nancy, France
- «Health Systemic Process» Laboratory, University Lyon 1, EA 4129, 69008 Lyon, France
| | - Corentine Alauzet
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- CHRU Nancy, Microbiology Department, University Hospital, F-54000 Nancy, France
| | - Catherine Bisson
- Stress Immunity Pathogens Unit (SIMPA), EA 7300, University of Lorraine, F-54000 Nancy, France; (C.A.); (C.B.)
- Department of Periodontology, Nancy University Hospital, Lorraine University, 54500 Vandoeuvre-lès-Nancy, France
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Schulz S, Zimmer P, Pütz N, Jurianz E, Schaller HG, Reichert S. rs2476601 in PTPN22 gene in rheumatoid arthritis and periodontitis-a possible interface? J Transl Med 2020; 18:389. [PMID: 33059697 PMCID: PMC7559817 DOI: 10.1186/s12967-020-02548-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/24/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) and periodontitis (PD) are proven to share common risk markers, including genetic factors. In the present study we focused on genetic variants in PTPN22 (rs2476601), PADI4 (rs2240340), CTLA4 genes (rs3087243) and its impact on RA and PD. MATERIALS AND METHODS In the study 111 RA patients and 256 systemically healthy controls were involved. A subdivision of patients and controls was carried out according the severity of periodontitis (no/level 1 PD vs. level 2 PD). RESULTS I. Evaluating the genetic impact on the occurrence of RA the T allele of rs2476601 (PTPN22) (bivariate: p < 0.001; multivariate: p = 0.018) and T allele of rs2240340 (PADI4) (bivariate: p = 0.006; multivariate: p = 0.070) were associated with an increased vulnerability to RA. II. Investigating the genetic influence on level 2 PD the T allele of rs2476601 (PTPN22) was shown to be associated with a higher susceptibility to PD within the RA group (bivariate: p = 0.043; multivariate: p = 0.024). III. The T allele of rs2476601 (PTPN22) was proven to be a significant marker of RA and level 2 PD comorbidity (bivariate: p < 0.001; multivariate: p = 0.028). CONCLUSIONS These results support the thesis that genetic variations may represent a possible link between PD and RA. The study increases knowledge about disease-specific and cross-disease genetic pattern.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany.
| | - Pauline Zimmer
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Natalie Pütz
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Elisa Jurianz
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin Luther University Halle-Wittenberg, Halle, Germany
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The Effects of 6-Month Vitamin D Supplementation during the Non-Surgical Treatment of Periodontitis in Vitamin-D-Deficient Patients: A Randomized Double-Blind Placebo-Controlled Study. Nutrients 2020; 12:nu12102940. [PMID: 32992785 PMCID: PMC7600700 DOI: 10.3390/nu12102940] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study assessed the effects of weekly vitamin D (VD) supplementation on clinical and biological parameters after scaling and root planning (SRP) in the treatment of periodontitis and served to validate the VD dosage regimen. METHODS It was a monocentric, randomized, double-blind, placebo-controlled clinical trial with 6 months follow-up. Healthy Caucasian periodontitis patients presenting serum 25(OH) vitamin D3 below 30 ng/mL were randomly allocated to test group (SRP + VD 25,000 international units (IU)/week) or the control group (SRP + placebo). RESULTS A total of 59 patients were screened, 27 were included and 26 completed 3 months (M) and 21 completed 6M control. Test (n = 13) and control groups (n = 14) had similar 25(OH) vitamin D3 levels at baseline (17.6 ± 7.4 vs. 14.4 ± 5.2, respectively). After one month, there was a significant difference between groups (32.9 ± 5.2 vs. 16.1 ± 4.7), also seen at M3 and M6 (t-test, p < 0.001). Periodontal treatment was successful in both groups, since it resulted in a reduction of all measured clinical parameters at M3 and M6 (probing pocket depth (PPD), full mouth bleeding and plaque). However, the reduction in PPD was greater in the test group. CONCLUSIONS In this short-term pilot study, no significant differences were observed between two groups. However, supplementation with VD tended to improve the treatment of periodontitis in patients with initial 25(OH) vitamin D3 < 30 ng/mL and proved safe and efficacious. NCT03162406.
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Aldossri M, Farmer J, Saarela O, Rosella L, Quiñonez C. Oral Health and Cardiovascular Disease: Mapping Clinical Heterogeneity and Methodological Gaps. JDR Clin Trans Res 2020; 6:390-401. [PMID: 32886582 DOI: 10.1177/2380084420953121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Numerous studies have examined the associations between poor oral health and the incidence of cardiovascular disease (CVD) over the past 25 y. This long history of research has resulted in a broad and heterogenous epidemiological field whose implications are difficult to understand and whose methodological gaps are hard to track. OBJECTIVES This systematic mapping review aims to systematically map clinical heterogeneity and methodological gaps in assessing the relationship between poor oral health and CVD outcomes. METHODS Medline, Embase, and Cochrane Library were searched to identify longitudinal studies that examined the relationship between any oral health indicator and CVD outcomes. Each database was searched from its inception date and June 27, 2018. Extracted data assess the clinical heterogeneity (participants' characteristics, exposure and outcome measures, length of follow-up) and methodological gaps (availability of randomized controlled trials, utilization of time-varying exposures, propensity methods, mediation analysis, and competing risks analysis). RESULTS Eighty-five studies met the inclusion criteria. Clinical heterogeneity is evident in participants' characteristics (age, clinical status, and occupation) and in the definitions of oral health indicators and CVD outcomes. More important, a significant proportion of studies reported unclear definitions for CVD outcomes. The search strategy did not reveal any randomized controlled trials. Time-varying exposures, propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. CONCLUSION There is a need for a universally accepted conceptual framework on the association between oral health and CVD to derive more consistent definitions for oral health and CVD outcomes that are aligned with the investigated research questions. There is also a need to use emerging research methods to maximize the impact of research in this area. KNOWLEDGE TRANSFER STATEMENT Clinical heterogeneity is evident in the definitions of oral health indicators and cardiovascular disease outcomes. Propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. The identified clinical heterogeneity and methodological gaps interfere with summarizing existing evidence and understanding their practical implications. Advancing the current understanding of the associations between oral health and cardiovascular disease goes hand in hand with minimizing clinical heterogeneity and closing the identified methodological gaps.
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Affiliation(s)
- M Aldossri
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - J Farmer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - O Saarela
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - L Rosella
- Division of Epidemiology, Dalla Lana School of Public Health, Toronto, ON, Canada.,Populations & Public Health Research Program, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Research and Ethics Program, Public Health Ontario, Toronto, ON, Canada
| | - C Quiñonez
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Populations & Public Health Research Program, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, ON, Canada
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Li A, Chen Y, van der Sluis LWM, Schuller AA, Tjakkes GH. White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults. J Gerontol A Biol Sci Med Sci 2020; 76:1309-1315. [DOI: 10.1093/gerona/glaa223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.
Methods
We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001–2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.
Results
Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = −0.091; 95% confidence interval [CI] = −0.174 to −0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = −0.059; 95% CI = −0.087 to −0.031) and mediated 20.3% of the total association.
Conclusion
Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Luc W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
- Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Geerten-Has Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
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Paksoy T, Ustaoğlu G, Peker K. Association of socio-demographic, behavioral, and comorbidity-related factors with severity of periodontitis in Turkish patients. Aging Male 2020; 23:232-241. [PMID: 32281459 DOI: 10.1080/13685538.2020.1748002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: To assess the prevalence of comorbidities and periodontal diseases severity in dental patients and to determine the socio-demographic, behavioral, and comorbidity-related predictors of periodontal diseases severity.Material and methods: This retrospective study sample consisted of 2458 patients who referred to faculty dentistry clinic. Socio-demographic, behavioral, and comorbidity characteristics of study participants were collected using hospital database and self-reported questionnaire. Descriptive, bivariate, and multivariate analyses were used to analyze study data.Results: Of these patients, 55.2% had mild-to-moderate periodontitis and 44.8% had severe periodontitis. The severity of periodontal disease was significantly associated with the presence of comorbidity, the number of comorbidities, age, gender, income level, smoking, and alcohol consumption. Patients with severe periodontitis were more likely being a current smoker, to report drinking alcohol sometimes or every day, to be a male, to have a pulmonary disease, to have an endocrinological and metabolic disorder, to have a cardiovascular disorder and to have a neurological disorder than those with mild/moderate periodontitis. Having a hematological disorder, having a muscle, skeletal and connective tissue disorder, to be a current smoker and lower age were found to be predictors of moderate periodontitis whereas being a female and lower number of comorbidities were predictors of mild periodontitis.Conclusions: The severity of periodontitis was associated with socio-demographic, behavioral, and comorbidity characteristics of periodontal patients.
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Affiliation(s)
- Tuğçe Paksoy
- Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey
| | - Gülbahar Ustaoğlu
- Faculty of Dentistry, Department of Periodontology, Abant Izzet Baysal University, Bolu, Turkey
| | - Kadriye Peker
- Division of Basic Sciences, Faculty of Dentistry, Department of Dental Public Health, Istanbul University, Istanbul, Turkey
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Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol 2020; 47 Suppl 22:90-106. [DOI: 10.1111/jcpe.13240] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Private Practice Hamburg Germany
| | - Laurent Detzen
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
| | - Maria Clotilde Carra
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- Population‐based Epidemiologic Cohorts Unit INSERM UMS 011 Villejuif France
| | - Philippe Bouchard
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- EA 2496 Université de Paris U.F.R. of Odontology Paris France
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Plaque Index, Oral Hygiene Habits, and Depressive Symptomatology as Predictors of Clinical Attachment Loss: A Pilot Study. Int J Dent 2020. [DOI: 10.1155/2020/3257937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background. The effect of depressive symptomatology on periodontitis is not clear in its path of action. Objective. To test a model to predict clinical attachment loss by direct effect of the dental plaque accumulation, which is a direct effect of worse oral hygiene habits and an indirect effect of greater depressive symptomatology. Methods. Three incidental samples were collected: 35 dental patients with periodontitis, 26 mental health patients with depressive symptomatology, and 29 people from the general population. The Beck Depression Inventory-II and the Oral Hygiene Habits Scale were applied. Plaque index and clinical attachment loss were assessed. Path analysis was used to test the model. The parameters were estimated by the maximum-likelihood method. Results. Depressive symptomatology had no direct effect on oral hygiene habits nor an indirect effect (mediated by oral hygiene habits) on the plaque index in any of the 3 samples. Oral hygiene habits had a large-size direct effect on plaque index and a medium-size indirect effect on clinical attachment loss in the general population sample. The plaque index had a direct effect on clinical attachment loss with a large effect size in general population sample and with a medium effect size in dental patients and depressive symptomatology patients. Conclusion. The model shows that dental plaque accumulation has a direct effect on clinical attachment loss in the 3 samples, and oral hygiene habits have an indirect effect on attachment loss mediated by dental plaque accumulation only in the general population sample. However, depressive symptomatology is not a relevant variable.
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Sayad A, Taheri M, Sadeghpour S, Omrani MD, Shams B, Mirzajani S, Arsang-Jang S, Houshmand B, Amid R, Gholami L, Ghafouri-Fard S. Exploring the role of long non-coding RNAs in periodontitis. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100687] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Kruse AB, Kowalski CD, Leuthold S, Vach K, Ratka-Krüger P, Woelber JP. What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis. Lipids Health Dis 2020; 19:100. [PMID: 32438906 PMCID: PMC7240972 DOI: 10.1186/s12944-020-01267-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Host modulation therapy has gained increasing interest in periodontal therapy. This systematic review aimed to evaluate the effects of adjunctive administration of omega-3 fatty acids in periodontal therapy. Methods The search strategy was determined using the “patient, intervention, comparison, outcome” model. A resulting search term was generated using keywords, and the databases were fed. The databases PubMed, Cochrane Library, and LIVIVO were used. Studies were selected for the literature review based on previously specified inclusion and exclusion criteria. Randomized, controlled, blinded studies, longitudinal studies, comparative studies, and clinical studies were included in the review. Additionally, they used omega-3 fatty acids in the treatment of periodontitis. The following parameters were observed: clinical attachment level (CAL), probing depth (PD), gingival index (GI), bleeding on probing (BOP) and plaque index (PI). A meta-analysis was performed for PD and CAL after 3 months. By analyzing the risk of bias, the validity of the results of each study was demonstrated, and its credibility and quality were assessed. Results Of 14 studies found, six were included. The results showed a significant reduction in PD and CAL compared to that in the placebo groups in four out of six involved studies, which was confirmed by the meta-analysis. In one study, a significant reduction in BOP was found. GI was significantly reduced in three included studies. PI also showed a significant reduction in three studies. Conclusions Within the study limitations, omega-3 fatty acids appear to have a positive effect on periodontal wound healing with regard to reduction in CAL and PD. Based on the results, patients receiving periodontal treatment might benefit from nutritional counseling.
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Affiliation(s)
- Anne B Kruse
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Carolyn D Kowalski
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Private Dental Practice zahngenehm Grenzweg 28, Reinbek, DE, Germany
| | - Sylvia Leuthold
- Private Dental Practice Dr. med. dent. Theres Wyss AG, Löwenstrasse 65 / Bahnhofplatz, Zürich, Switzerland
| | - Kirstin Vach
- Department of Medical Biometry and Medical Informatics, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Shazam H, Shaikh F, Hussain Z. Bone Turnover Markers in Chronic Periodontitis: A Literature Review. Cureus 2020; 12:e6699. [PMID: 32104633 PMCID: PMC7032598 DOI: 10.7759/cureus.6699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/19/2020] [Indexed: 12/11/2022] Open
Abstract
Chronic periodontitis (CP) is a multifactorial oral inflammatory disease characterized by progressive destruction of bone and ultimate tooth loss. The alarming rise in the prevalence of periodontitis has led to the development of innovative diagnostic techniques. Several quantifiable biomarkers in the gingival crevicular fluid (GCF) and saliva of chronic periodontitis patients have been detected in the field of oral fluid diagnostics. Bone turnover biomarkers hold a valuable diagnostic potential in determining the extent of alveolar bone destruction and the risk of future bone loss. This review article highlights the importance of bone turnover markers in facilitating earlier detection, accurate diagnosis, and effective treatment strategies, leading to optimal clinical management of chronic periodontitis.
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Affiliation(s)
- Hamda Shazam
- Department of Oral Pathology, Ziauddin College of Dentistry, Ziauddin University, Karachi, PAK
| | - Fouzia Shaikh
- Department of Pathology, Ziauddin University, Karachi, PAK
| | - Zaheer Hussain
- Department of Periodontology, Altamash Institute of Dental Medicine, Karachi, PAK
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Garyga V, Pochelu F, Thivichon-Prince B, Aouini W, Santamaria J, Lambert F, Maucort-Boulch D, Gueyffier F, Gritsch K, Grosgogeat B. GoPerio - impact of a personalized video and an automated two-way text-messaging system in oral hygiene motivation: study protocol for a randomized controlled trial. Trials 2019; 20:699. [PMID: 31823812 PMCID: PMC6905095 DOI: 10.1186/s13063-019-3738-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/21/2019] [Indexed: 12/30/2022] Open
Abstract
Background Oral hygiene is of paramount importance for the preservation of oral health, and for patients affected by periodontal disease establishing an effective oral hygiene routine is the first step of therapy. Several clinical frameworks have been developed to foster behavior change, such as motivational interviewing. However, two obstacles can be identified. First, patients tend to forget the advice they were given during the consultation. Second, it is hard to maintain motivation in the long term, thus leading to relapse. An innovative eHealth solution was designed with the aim to tackle both obstacles and supplement the current clinical standard of care. The primary objective is to compare the full mouth plaque scores of study groups (eHealth plus standard of care versus standard of care only) at 8 weeks of follow up. The main secondary objective is to compare the full mouth bleeding score at 8 weeks of follow up. Methods/design The “GoPerio” study is a multicenter, randomized, controlled trial assessing the impact of a novel eHealth concept for oral hygiene motivation (personalized video of oral hygiene routine available for the patient via a cloud server plus interactive text messages) in addition to the current standard of care (motivational interviewing plus tooth scaling and polishing). The minimum sample size required is 86 patients. Participants will be randomized (allocation ratio 1:1): test group (eHealth plus standard of care) versus control group (standard of care only). The primary outcome is oral hygiene as measured by the full mouth (six sites per tooth) plaque control record (PCR) index. The main secondary outcome is gingival inflammation as measured by the full mouth (six sites per tooth) bleeding on probing (BOP) index. Both the primary and the main secondary outcomes are evaluated by blinded and calibrated examiners at 8 weeks of follow up. The other secondary outcomes are patient satisfaction and patient behavior change and motivation. Discussion The study will investigate the value of an innovative eHealth approach to strengthen patient motivation for oral hygiene. If proven effective, such an approach would supplement the current clinical standard of care, resulting in improved clinical outcomes with negligible impact on productivity in a dental practice. Trial registration ClinicalTrials.gov, NCT03109808. Registered on 12 April 2017. Sponsor: Hospices Civils de Lyon. BP 2251, 3 quai des Célestins, 69,229 Lyon cedex 02. Protocol version: 1.0 as of 21 September 2016.
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Affiliation(s)
- Valentin Garyga
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Florian Pochelu
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Béatrice Thivichon-Prince
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France.,Université de Lyon, IGFL UMR 5242, Lyon, France
| | - Walid Aouini
- Université de Monastir, Monastir, Tunisia.,CHU de Liège, Liège, Belgium
| | - Julie Santamaria
- Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France
| | - France Lambert
- CHU de Liège, Liège, Belgium.,Université de Liège, Liège, Belgium.,Dental Biomaterials Research Unit, Liège, Belgium
| | - Delphine Maucort-Boulch
- Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Département Biostatistiques et Modélisation pour la Santé et l'environnement, Université de Lyon, CNRS UMR 5558, Villeurbanne, France
| | - Francois Gueyffier
- Université de Lyon, Université Lyon 1, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Département Biostatistiques et Modélisation pour la Santé et l'environnement, Université de Lyon, CNRS UMR 5558, Villeurbanne, France
| | - Kerstin Gritsch
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France.,Université de Lyon, LMI UMR CNRS 5615, Lyon, France
| | - Brigitte Grosgogeat
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France. .,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France. .,Université de Lyon, LMI UMR CNRS 5615, Lyon, France.
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Haririan H, Andrukhov O, Böttcher M, Pablik E, Wimmer G, Moritz A, Rausch-Fan X. Salivary neuropeptides, stress, and periodontitis. J Periodontol 2019; 89:9-18. [PMID: 28914594 DOI: 10.1902/jop.2017.170249] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/20/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Scientific evidence for psychologic stress as a risk factor for periodontitis is fragmentary and relies mostly on either questionnaire-based or biomarker studies. The aim of this study is to investigate brain-derived neurotrophic factor, substance P, vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), calcitonin gene-related peptide, and adrenomedullin as well as cortisol in saliva and serum in periodontal health and disease combined with different aspects of stress and possible associations with clinical parameters. METHODS In total, 56 patients with aggressive and chronic periodontitis and 44 healthy controls were screened by enzyme-linked immunosorbent assay and mass spectrometry for presence of neuropeptides and cortisol in saliva and serum. Psychologic stress was evaluated by validated questionnaires. All substances were explored for a possible relationship to periodontitis, clinical parameters, and stress. RESULTS VIP and NPY showed significantly higher levels in saliva but not in serum of patients with periodontitis. These neuropeptides correlated with the extent, severity, and bleeding on probing scores in patients with periodontitis. Females had significantly lower salivary VIP levels. There were no differences among participants regarding psychologic stress. CONCLUSION VIP and NPY in saliva could be potential sex-specific salivary biomarkers for periodontitis regardless of psychologic stress.
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Affiliation(s)
- Hady Haririan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, Division of Conservative Dentistry and Periodontology, Medical University of Vienna
| | | | - Eleonore Pablik
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna
| | - Gernot Wimmer
- Division of Prosthodontics, Restorative Dentistry, Periodontology, and Implantology, School of Dentistry, Medical University of Graz, Graz, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.,Competence Center for Periodontal Research, Division of Conservative Dentistry and Periodontology, Medical University of Vienna
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Fleming EB, Nguyen D, Afful J, Carroll MD, Woods PD. Prevalence of daily flossing among adults by selected risk factors for periodontal disease-United States, 2011-2014. J Periodontol 2019; 89:933-939. [PMID: 29644699 DOI: 10.1002/jper.17-0572] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/16/2018] [Accepted: 02/16/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Daily flossing prevalence was determined among adults ≥30 years old in the United States, by demographic and risk factors for periodontal disease, including current tobacco use and diabetes. METHODS Data from the 2011-2014 National Health and Nutrition Examination Survey were analyzed for 8,356 adults. Flossing prevalence was estimated. Logistic regression analysis examined the association between daily flossing and demographic and risk factors for periodontal diseases. RESULTS Daily flossing among adults was 31.6% (standard error [SE] = 0.8). There were significant differences among the categories of flossing according to age, sex, race/Hispanic origin, poverty status, education, current tobacco use, and diabetes status. In adjusted analyses, current tobacco users (odds ratio [OR]: 0.82; 95% confidence index [CI] 0.68, 0.99) had lower odds of daily flossing than non-tobacco users; there was no significant difference between adults with and without diabetes (OR 0.75; 95% CI 0.52, 1.08). CONCLUSION Approximately one-third of adults in the United States reported that they floss daily. Daily flossing was higher among women, those with higher income, and non-Hispanic Asian and Hispanic adults, but it was lower among current tobacco users.
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Affiliation(s)
- Eleanor B Fleming
- Analysis Branch, Division of Health and Nutrition Examination Surveys, National Centers for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, MD
| | - Duong Nguyen
- Operations Branch, Division of Health and Nutrition Examination Surveys, National Centers for Health Statistics, U.S. Centers for Disease Control and Prevention
| | - Joseph Afful
- Peraton, under contract from the Center for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD
| | - Margaret D Carroll
- Analysis Branch, Division of Health and Nutrition Examination Surveys, National Centers for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, MD
| | - Phillip D Woods
- Dental Devices Branch, Division of Anesthesiology, General Hospital, Infection Control, and Dental Devices, Office of Device Evaluation, Center for Devices and Radiological Health, U.S. Food and Drug Administration, White Oak, MD
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