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Hu Z, Tang L, Zhan Y. Depression, stress-related disorders and risk for dental caries and periodontitis: A bidirectional and multivariable Mendelian randomization study. J Affect Disord 2024; 361:285-290. [PMID: 38876316 DOI: 10.1016/j.jad.2024.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/14/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
AIMS Our Mendelian randomization (MR) analysis focused on investigating the bidirectional relationships between major depressive disorder (MDD), anxiety and stress-related disorder (ASRD), and dental caries as well as periodontitis. MATERIALS AND METHODS We used summary statistics from two studies: an MDD genome-wide association study (GWAS) including 135,458 cases with 344,901 controls and a Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) GWAS based on 12,655 ASRD individuals and 19,225 controls from Denmark. GWASs on dental caries and periodontitis were based on the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) consortium. We employed different MR approaches, such as inverse-variance weighted (IVW), MR-Egger, weighted median, and MR-PRESSO, to calculate causal effects. RESULTS Single-variable MR analysis revealed that ASRD was potentially significantly associated with decayed, missing, and filled tooth surfaces (DMFS) (β = 0.056; 95 % CI: 0.009, 0.103; p = 0.018). Periodontitis was suggested to be causally related to increased ASRD risk (OR = 1.143, 95 % CI: 1.008, 1.298; p = 0.038). According to the multivariable MR analysis, no significant associations were detected between MDD and ASRD with dental caries and periodontitis, and vice versa. CONCLUSIONS ASRD demonstrated a potential association with DMFS, and periodontitis was found to potentially impact ASRD according to single-variable MR analysis. Nevertheless, no significant associations were identified between MDD, ASRD, dental caries, or periodontitis after adjusting for smoking status and education level. Hence, more robust genetic instruments are required to validate and reinforce our findings.
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Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
| | - Lu Tang
- The Seventh Affiliated Hospital, Sun Yat-Sen University, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
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Ji Y, Baek W. Oral Health Differences Between Middle-Aged and Older Adults in South Korea. Int Dent J 2024:S0020-6539(24)00154-0. [PMID: 39030098 DOI: 10.1016/j.identj.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION AND AIMS The oral health characteristics of middle-aged and older adults exhibit variations. This study identifies the various factors associated with oral health among middle-aged and older adults through a subgroup analysis by age group of data representative of the South Korean population. METHODS We examined influencing factors: demographic, socioeconomic, dental, physical attributes, psychological, and mental attributes. Oral health was assessed using the Geriatric Oral Health Assessment Index. The participants were divided into two groups: those under 65 years of age (middle-aged) and those over 65 years of age (older adults). We used multiple linear regression analysis and dominance analysis to determine the dominant factors associated with oral health. RESULTS A total of 6369 participants were aged 69.2 ± 9.8 years on average, and 57.5% were women. Dominance analysis revealed that lower educational levels and activity difficulty caused by diseases were significantly associated with both groups. Moreover, depressive symptoms were the foremost adverse factor linked to oral health in the middle-aged (P < .001, standardized beta [β] = -4.30, general dominance index [GDI] = 19.00) and older (P < .001, β = -0.30, GDI = 10.70) adults. The number of teeth exhibited the most positive association with oral health in both middle-aged (P < .001, β = 0.20, GDI = 5.30) and older (P < .001, β = 0.23, GDI = 7.40) adults. However, cognitive function, dental visits, body mass index, severe pain, functional limitations, and cognitive function exhibited distinct patterns between the age groups. CONCLUSION Depressive symptoms and the number of teeth significantly influence oral health in middle-aged and older adults, though the impact varies by age. These findings stress the importance of tailored strategies considering age-specific attributes for effective oral health improvement. CLINICAL RELEVANCE Enhancing oral health requires healthcare providers to prioritize monitoring age-specific risk factors. Further, educational plans should highlight the importance of preventive oral care and regular dental visits.
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Affiliation(s)
- Yoonjung Ji
- Brain Korea 21 FOUR Project, Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - Wonhee Baek
- College of Nursing, Gyeongsang National University, Jinju, South Korea.
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Wang J, Wang Y, Li H, Wang W, Zhang D. Associations between oral health and depression and anxiety: A cross-sectional and prospective cohort study from the UK Biobank. J Clin Periodontol 2024. [PMID: 38952070 DOI: 10.1111/jcpe.14039] [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: 02/20/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort. MATERIALS AND METHODS Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety. RESULTS A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant. CONCLUSIONS Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
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Affiliation(s)
- Jingjing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Yani Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Huihui Li
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, China
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Dibello V, Custodero C, Cavalcanti R, Lafornara D, Dibello A, Lozupone M, Daniele A, Pilotto A, Panza F, Solfrizzi V. Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis. GeroScience 2024:10.1007/s11357-024-01243-8. [PMID: 38943006 DOI: 10.1007/s11357-024-01243-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/05/2024] [Indexed: 06/30/2024] Open
Abstract
A growing body of research suggested that there was a link between poor periodontal health and systemic diseases, particularly with the early development of cognitive disorders, dementia, and depression. This is especially true in cases of changes in diet, malnutrition, loss of muscular endurance, and abnormal systemic inflammatory response. Our study aimed to determine the extent of these associations to better target the multi-level healthy aging challenge investigating the impact of periodontal disease on cognitive disorders (cognitive impairment and cognitive decline), dementia, and depression. We conducted a comprehensive literature search up to November 2023 using six different electronic databases. Two independent researchers assessed the eligibility of 7363 records against the inclusion criteria and found only 46 records that met the requirements. The study is registered on PROSPERO (CRD42023485688). We generated random effects pooled estimates and 95% confidence intervals (CI) to evaluate whether periodontal disease increased the risk of the investigated outcomes. The quality assessment revealed moderate quality of evidence and risk of bias. Periodontal disease was found to be associated with both cognitive disorders (relative risk (RR) 1.25, 95% CI 1.11-1.40, in the analysis of cross-sectional studies); cognitive impairment (RR 3.01, 95% CI 1.52-5.95 for longitudinal studies, cognitive decline); and dementia (RR 1.22, 95% CI 1.10-1.36). However, no significant increased risk of depression among subjects with periodontal disease was found (RR 1.07, 95% CI 0.95-1.21). Despite the association with two of the three explored outcomes, the available evidence on periodontal diseases and dementia, cognitive disorders, and depression is controversial due to several limitations. Therefore, further investigations involving validated and standardized tools are required.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Carlo Custodero
- Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Raffaele Cavalcanti
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Domenico Lafornara
- Division of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Antonio Dibello
- Stella Maris Nursing Home and Day Care Center, Monopoli, Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine & Neuroscience 'DiBraiN', University of Bari Aldo Moro, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Alberto Pilotto
- Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Francesco Panza
- Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy.
| | - Vincenzo Solfrizzi
- Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
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Pereira RRDS, Castro GBD, Magalhães CODE, Costa KB, Garcia BCC, Silva G, Carvalho JDCL, Machado ART, Vieira ER, Cassilhas RC, Pereira LJ, Dias-Peixoto MF, Andrade EF. High-intensity interval training mitigates the progression of periodontitis and improves behavioural aspects in rats. J Clin Periodontol 2024. [PMID: 38798054 DOI: 10.1111/jcpe.14020] [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: 01/08/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
AIM To investigate the effects of high-intensity interval training (HIIT) on periodontitis (PD) progression and behavioural outcomes. MATERIALS AND METHODS Forty-eight Wistar rats were divided into four groups: non-trained (NT); non-trained with PD; HIIT with PD; and HIIT. The HIIT protocol, involving daily treadmill sessions, spanned 8 weeks, with PD induced by ligature after the 6th week. Behavioural tests were conducted to assess anxiety and memory. Post euthanasia, we evaluated the systemic inflammatory profile and oxidative stress markers in the hippocampus and amygdala. A morphological evaluation and elemental composition analysis of the mandibular alveolar bone were performed. RESULTS PD exacerbated alveolar bone level, bone surface damage and alterations in calcium and phosphorus percentages on the bone surface (p < .05), while HIIT attenuated these changes (p < .05). HIIT improved systemic inflammatory markers altered by PD (tumour necrosis factor [TNF]-α, interleukin [IL]-10, TNF-α/IL-10 and IL-1β/IL-10 ratios, p < .05). PD animals exhibited lower total antioxidant capacity and levels of thiobarbituric acid reactive substances in the amygdala and hippocampus, respectively (p < .05). HIIT maintained these parameters at levels similar to those in NT animals. HIIT improved anxiety and memory outcomes altered by PD (p < .05). CONCLUSIONS HIIT attenuates systemic inflammation, anxiety and memory outcomes promoted by PD.
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Affiliation(s)
| | - Giselle Bicalho de Castro
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Karine Beatriz Costa
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Gabriela Silva
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | | | - Etel Rocha Vieira
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Ricardo Cardoso Cassilhas
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Luciano José Pereira
- Department of Health Sciences, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Marco Fabrício Dias-Peixoto
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Eric Francelino Andrade
- Health Sciences Program, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Department of Health Sciences, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
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Saleki K, Alijanizadeh P, Javanmehr N, Rezaei N. The role of Toll-like receptors in neuropsychiatric disorders: Immunopathology, treatment, and management. Med Res Rev 2024; 44:1267-1325. [PMID: 38226452 DOI: 10.1002/med.22012] [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: 04/08/2022] [Revised: 10/20/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024]
Abstract
Neuropsychiatric disorders denote a broad range of illnesses involving neurology and psychiatry. These disorders include depressive disorders, anxiety, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorders, headaches, and epilepsy. In addition to their main neuropathology that lies in the central nervous system (CNS), lately, studies have highlighted the role of immunity and neuroinflammation in neuropsychiatric disorders. Toll-like receptors (TLRs) are innate receptors that act as a bridge between the innate and adaptive immune systems via adaptor proteins (e.g., MYD88) and downstream elements; TLRs are classified into 13 families that are involved in normal function and illnesses of the CNS. TLRs expression affects the course of neuropsychiatric disorders, and is influenced during their pharmacotherapy; For example, the expression of multiple TLRs is normalized during the major depressive disorder pharmacotherapy. Here, the role of TLRs in neuroimmunology, treatment, and management of neuropsychiatric disorders is discussed. We recommend longitudinal studies to comparatively assess the cell-type-specific expression of TLRs during treatment, illness progression, and remission. Also, further research should explore molecular insights into TLRs regulation and related pathways.
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Affiliation(s)
- Kiarash Saleki
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
- Department of e-Learning, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Parsa Alijanizadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Javanmehr
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Li Y, Yang Y, Guan X, Liu Z, Pan L, Wang Y, Jia X, Yang J, Hou T. SorCS2 is involved in promoting periodontitis-induced depression-like behaviour in mice. Oral Dis 2024. [PMID: 38568959 DOI: 10.1111/odi.14944] [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: 11/18/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Emerging evidence supports the association between periodontitis and depression, although the mechanisms are unclear. This study investigated the role of SorCS2 in the pathogenesis of periodontitis-induced depression. MATERIALS AND METHODS An experimental periodontitis model was established using SorCS2 knockout mice and their wild-type littermates, and depression-like behaviour was evaluated. The expression of proBDNF signalling, neuronal activity, and glutamate-associated signalling pathways were further measured by western blotting and immunofluorescence. In addition, neuroinflammatory status, astrocytic and microglial markers, and the expression of corticosterone-related factors were measured by immunofluorescence, western blotting, and enzyme-linked immunosorbent assays. RESULTS SorCS2 deficiency alleviated periodontitis-induced depression-like behaviour in mice. Further results suggested that SorCS2 deficiency downregulated the expression of pro-BDNF and glutamate signalling and restored neuronal activities in mice with periodontitis. Neuroinflammation in the mouse hippocampus was triggered by experimental periodontitis but was not affected by SorCS2 deficiency. The levels of corticosterone and the expression of glucocorticoid receptors were also not altered. CONCLUSION Our study, for the first time, reveals the critical role of SorCS2 in the pathogenesis of periodontitis-induced depression. The underlying mechanism involves proBDNF and glutamate signalling in the hippocampus, providing a novel therapeutic target for periodontitis-associated depression.
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Affiliation(s)
- Yingxue Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yao Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyue Guan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Zhijun Liu
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lifei Pan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuting Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Xiangbin Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Jianmin Yang
- Department of Medicine, Weill Cornell Medical School, Cornell University, New York, New York, USA
| | - Tiezhou Hou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Cariology and Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
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Tong S, Lyu Y, Huang W, Zeng R, Jiang R, Lian Q, Leung FW, Sha W, Chen H. Genetically predicted causal associations between periodontitis and psychiatric disorders. BMJ MENTAL HEALTH 2023; 26:e300864. [PMID: 37993283 PMCID: PMC10668133 DOI: 10.1136/bmjment-2023-300864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Psychiatric disorders have serious harm to individuals' lives with high disease burden. Observational studies reported inconsistent associations between periodontitis and some psychiatric disorders, and the causal correlations between them remain unknown. OBJECTIVE This study aims to explore the causal associations between periodontitis and psychiatric disorders. METHODS A series of two-sample Mendelian randomisation (MR) analyses were employed using genome-wide association study summary statistics for periodontitis in adults from Gene-Lifestyle Interactions in Dental Endpoints Consortium and 10 psychiatric disorders from Psychiatric Genomics Consortium. Causal effects were primarily estimated using the inverse-variance weighted (IVW) method. Various sensitivity analyses were also conducted to assess the robustness of our results. FINDINGS The MR analysis suggested that genetically determined periodontitis was not causally associated with 10 psychiatric disorders (IVW, all p>0.089). Furthermore, the reverse MR analysis revealed that 10 psychiatric disorders had no causal effect on periodontitis (IVW, all p>0.068). We discovered that all the results were consistent in the four MR analytical methods, including the IVW, MR-Egger, weighted median and weighted mode. Besides, we did not identify any heterogeneity or horizontal pleiotropy in the sensitivity analysis. CONCLUSIONS These results do not support bidirectional causal associations between genetically predicted periodontitis and 10 common psychiatric disorders. Potential confounders might contribute to the previously observed associations. CLINICAL IMPLICATIONS Our findings might alleviate the concerns of patients with periodontitis or psychiatric disorders. However, further research was warranted to delve into the intricate relationship between dental health and mental illnesses.
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Affiliation(s)
- Shuangshuang Tong
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou University, Shantou, Guangdong, China
| | - Yanlin Lyu
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou University, Shantou, Guangdong, China
| | - Wentao Huang
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Ruijie Zeng
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou University, Shantou, Guangdong, China
| | - Rui Jiang
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Qizhou Lian
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Cord Blood Bank, Guangzhou Institute of Eugenics and Perinatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Felix W Leung
- Sepulveda Ambulatory Care Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- School of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Weihong Sha
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou University, Shantou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Hao Chen
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou University, Shantou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
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9
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Wang M, Xu Y, Fang W, Pan W, Wang Q. Impact of COVID-19 on patient follow-up during supportive periodontal therapy: a retrospective study based on phone call survey. BMC Oral Health 2023; 23:811. [PMID: 37898758 PMCID: PMC10612285 DOI: 10.1186/s12903-023-03539-1] [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: 07/19/2023] [Accepted: 10/13/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND COVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up. METHODS A total of 1062 patients with periodontitis who visited the hospital from January 2019 to June 2022 were included in this study, and patient information was collected retrospectively in the form of a telephone questionnaire. The questionnaire consisted of 19 questions in four areas: demographic characteristics, clinical periodontal parameters, oral hygiene habits, and follow-up-related open-ended questions (specific reasons for loss to follow-up, attitudes toward follow-up and suggestions for increasing participation in future follow-ups). Regression analysis of factors influencing the follow-up of patients with periodontitis were analyzed by regression analysis using R (v4.2.3) software. RESULTS A total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.567, 95% confidence interval (CI): 0.393, 0.817, p = 0.002], as well as frequent use of dental devices (OR = 0.540, 95% CI: 0.375, 0.777, p = 0.001), were significantly associated with a "negative" attitude toward follow-up visits. CONCLUSION This survey suggests that the COVID-19 epidemic factor was an important cause contributed to the loss to follow-up during supportive periodontal therapy (SPT) among a variety of potential factors. Majority of patients had negative attitudes toward subsequent continued participation in supportive care.
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Affiliation(s)
- Mengli Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Yuxin Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Wen Fang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Weiyi Pan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Qianting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310000, China.
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10
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Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Relationship of Medication Intake and Systemic Conditions with Periodontitis: A Retrospective Study. J Pers Med 2023; 13:1480. [PMID: 37888091 PMCID: PMC10608268 DOI: 10.3390/jpm13101480] [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: 09/18/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES To examine the potential relationship of medication intake and systemic conditions with periodontitis. METHODS AND MATERIALS A total of 1985 patient records with a diagnosis of periodontal health and stage III and IV periodontitis were included in the analysis. Demographic characteristics, the number of missing teeth, patient-reported medical conditions and medication intake as well as smoking habits were recorded. Regression models were performed to explore the outcomes. RESULTS Older individuals, Hispanic ethnic groups, Black and Hispanic or Latino racial groups and non-White individuals in general were significantly more frequently diagnosed with periodontitis than health. Hypertension, glaucoma, anxiety and depression were significantly associated with periodontitis, while cancer, alcohol use, kidney problems, asthma, sleep apnea and gastrointestinal disorders were associated with periodontal health. Patients who reported taking anticoagulants, statins and ACE inhibitors demonstrated 3.546 (95% CI: 1.982, 6.343), 2.771 (95% CI: 1.877, 4.09) and 4.847 (95% CI: 2.785, 8.434) times higher odds of having periodontitis, respectively. CONCLUSION Within the limitations of this retrospective study that utilized the BigMouth dental data repository, there is a possible relationship between systemic medications including anticoagulants, ACE inhibitors and statins as well as systemic medical conditions including hypertension, glaucoma, anxiety and depression with periodontitis.
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Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA;
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ziou Jiang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA; (Z.J.); (N.M.)
| | - Nicholas Marka
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA; (Z.J.); (N.M.)
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA;
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11
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Frankenhaeuser F, Söder B, Källmén H, Korpi ER, Meurman JH. Periodontitis may predict the use of prescription medicines later in life, a database study. Front Pharmacol 2023; 14:1146475. [PMID: 36992840 PMCID: PMC10040546 DOI: 10.3389/fphar.2023.1146475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023] Open
Abstract
Medications used for the treatment of diseases also affect oral health. We investigated how having/not having periodontitis at baseline in 1985 was associated with purchases of medicines in the long term. The study paradigm is in the oral health-systemic health connections. We hypothesized that periodontitis links to purchases of medicines later in life. The study cohort consisted of 3,276 individuals from the greater Stockholm area, Sweden. Of them, 1,655 were clinically examined at baseline. Patients were followed-up for >35 years, using the national population and patient registers. The burden of systemic diseases and purchases of medicines were statistically analyzed comparing patients with (n = 285) and without (n = 1,370) periodontitis. The results showed that patients with periodontitis had purchased more of certain medications than non-periodontitis patients. Periodontitis patients purchased significantly more drugs used in diabetes (p = 0.035), calcium channel blockers (p = 0.016), drugs acting on the renin-angiotensin system (p = 0.024), and nervous system drugs (p = 0.001). Hence, patients with periodontitis indeed had purchased specific medications statistically significantly more than the periodontally healthy ones. This indicates that periodontitis, over time, might increase the risk for systemic diseases with the subsequent need for medication.
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Affiliation(s)
- Freja Frankenhaeuser
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Freja Frankenhaeuser,
| | - Birgitta Söder
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Esa R. Korpi
- Department of Pharmacology, University of Helsinki, Helsinki, Finland
| | - Jukka H. Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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12
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Recent Clinical Treatment and Basic Research on the Alveolar Bone. Biomedicines 2023; 11:biomedicines11030843. [PMID: 36979821 PMCID: PMC10044990 DOI: 10.3390/biomedicines11030843] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey’s fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research.
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13
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Slavich GM, Roos LG, Mengelkoch S, Webb CA, Shattuck EC, Moriarity DP, Alley JC. Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions. Health Psychol Rev 2023; 17:5-59. [PMID: 36718584 PMCID: PMC10161928 DOI: 10.1080/17437199.2023.2171900] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023]
Abstract
Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.
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Affiliation(s)
- George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lydia G. Roos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Christian A. Webb
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eric C. Shattuck
- Institute for Health Disparities Research and Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Daniel P. Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jenna C. Alley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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14
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Martín-Hernández D, Martínez M, Robledo-Montaña J, Muñoz-López M, Virto L, Ambrosio N, Marín MJ, Montero E, Herrera D, Sanz M, Leza JC, Figuero E, García-Bueno B. Neuroinflammation related to the blood-brain barrier and sphingosine-1-phosphate in a pre-clinical model of periodontal diseases and depression in rats. J Clin Periodontol 2023; 50:642-656. [PMID: 36644813 DOI: 10.1111/jcpe.13780] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/17/2023]
Abstract
AIM To explore the potential mechanisms of neuroinflammation (microglia, blood-brain barrier [BBB] permeability, and the sphingosine-1-phosphate [S1P] pathways) resulting from the association between periodontitis and depression in rats. MATERIALS AND METHODS This pre-clinical in vivo experimental study used Wistar rats, in which experimental periodontitis (P) was induced by using oral gavages with Porphyromonas gingivalis and Fusobacterium nucleatum. Then, a chronic mild stress (CMS) model was implemented to induce a depressive-like behaviour, resulting in four groups: P with CMS (P+CMS+), P without CMS (P+CMS-), CMS without P (P-CMS+), and control (P-CMS-). After harvesting brain samples, protein/mRNA expression analyses and fluorescence immunohistochemistry were performed in the frontal cortex (FC). Results were analysed by ANOVA. RESULTS CMS exposure increased the number of microglia (an indicator of neuroinflammation) in the FC. In the combined model (P+CMS+), there was a decrease in the expression of tight junction proteins (zonula occludens-1 [ZO-1], occludin) and an increase in intercellular and vascular cell adhesion molecules (ICAM-1, VCAM-1) and matrix metalloproteinase 9 (MMP9), suggesting a more severe disruption of the BBB. The enzymes and receptors of S1P were also differentially regulated. CONCLUSIONS Microglia, BBB permeability, and S1P pathways could be relevant mechanisms explaining the association between periodontitis and depression.
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Affiliation(s)
- David Martín-Hernández
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM (IUIN), Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - María Martínez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - Javier Robledo-Montaña
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM (IUIN), Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Marina Muñoz-López
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM (IUIN), Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Leire Virto
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Anatomy and Embryology, Faculty of Optics, UCM, Madrid, Spain
| | - Nagore Ambrosio
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - Maria José Marín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - Juan C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM (IUIN), Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, UCM, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, UCM, Madrid, Spain
| | - Borja García-Bueno
- Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid (UCM), Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute UCM (IUIN), Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
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15
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Yang B, Pang X, Guan J, Liu X, Li X, Wang Y, Chen Z, Cheng B. The association of periodontal diseases and Sjogren's syndrome: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 9:904638. [PMID: 36687426 PMCID: PMC9851607 DOI: 10.3389/fmed.2022.904638] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Background The relationship between periodontal diseases and Sjogren's syndrome were found inconsistent in current studies. Our objective is to clarify the relationship between periodontal diseases and Sjogren's syndrome. Methods A systematic review was performed and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Electronic databases (EMBASE, PubMed, Web of Science, and Cochrane Library, from inceptions until 24 November 2021) were searched. The Newcastle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) were applied to evaluate the quality of studies. Quality assessment of the certainty of evidence was performed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. When the output is the ratio, Odds ratio (OR) of periodontal diseases with Sjogren's syndrome were calculated. When the output is the mean, weighted mean difference (WMD) of periodontal diseases with Sjogren's syndrome was calculated. We conducted meta-analysis and estimated the pool sensitivity. Begg's test was used to test the possibility of publication bias. We also carried out meta-regression to clarify the source of heterogeneity (I2 > 50%). Finally, we performed a trial sequential analysis (TSA) to identify the false positive or false negative outcomes that might occur during repeated updates. Results 21 studies were included in this systematic review, with a total of 11435 subjects. Meta-analysis of 5 studies showed that there is a positive correlation between periodontitis and Sjogren's syndrome (OR = 2.12, 95% CI = 1.43-3.17; 5 studies, 6927 participants; low certainty of evidence). Meta-analysis of 16 studies showed that the periodontal condition of patients with Sjogren's syndrome was worse compared with the control group, and the scores of clinical periodontal parameters were relatively high. Conclusion Sjogren's syndrome patients seem to be more likely to be diagnosed with periodontal diseases. However, our results should be interpreted with caution considering the high heterogeneity. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021261322].
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Affiliation(s)
- Bo Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xuefei Pang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Jiazhong Guan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xu Liu
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Department of Infectious Disease, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Xiting Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yan Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China,Yan Wang,
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China,Zhuofan Chen,
| | - Bin Cheng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China,*Correspondence: Bin Cheng,
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16
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Abstract
Mental health disorders, particularly depression and anxiety, affect a significant number of the global population. Several pathophysiological pathways for these disorders have been identified, including the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and the immune system. In addition, life events, environmental factors, and lifestyle affect the onset, progression, and recurrence of mental health disorders. These may all overlap with periodontal and/or peri-implant disease. Mental health disorders are associated with more severe periodontal disease and, in some cases, poorer healing outcomes to nonsurgical periodontal therapy. They can result in behavior modification, such as poor oral hygiene practices, tobacco smoking, and alcohol abuse, which are also risk factors for periodontal disease and, therefore, may have a contributory effect. Stress has immunomodulatory effects regulating immune cell numbers and function, as well as proinflammatory cytokine production. Stress markers such as cortisol and catecholamines may modulate periodontal bacterial growth and the expression of virulence factors. Stress and some mental health disorders are accompanied by a low-grade chronic inflammation that may be involved in their relationship with periodontal disease and vice versa. Although the gut microbiome interacting with the central nervous system (gut-brain axis) is thought to play a significant role in mental illness, less is understood about the role of the oral microbiome. The evidence for mental health disorders on implant outcomes is lacking, but may mainly be through behaviourial changes. Through lack of compliance withoral hygiene and maintenance visits, peri-implant health can be affected. Increased smoking and risk of periodontal disease may also affect implant outcomes. Selective serotonin reuptake inhibitors have been linked with higher implant failure. They have an anabolic effect on bone, reducing turnover, which could account for the increased loss.
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Affiliation(s)
- Jake Ball
- Centre for Rural Dentistry and Oral HealthCharles Sturt UniversityOrangeNew South WalesAustralia
| | - Ivan Darby
- Periodontics, Melbourne Dental SchoolThe University of MelbourneMelbourneVictoriaAustralia
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17
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Chen D, Meng Z, Zhao T, Yu X, He H, Hua F, Dong W. Association between sleep-disordered breathing and periodontal diseases: A systematic review protocol. Front Med (Lausanne) 2022; 9:960245. [PMID: 36004374 PMCID: PMC9393785 DOI: 10.3389/fmed.2022.960245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSleep-disordered breathing (SDB) is a chronic sleep-related breathing disorder, considered associated with increased risk of cardiovascular disorders, metabolic disorders, cognitive dysfunction and behavior changes. Periodontal diseases are chronic infectious diseases that are also believed to be associated with cardiovascular diseases, metabolic syndrome and cognitive dysfunction. Several studies have indicated that SDB may be associated with periodontal diseases through certain mechanisms such as inflammation response, oxidative stress and oral dryness. The aim of this systematic review is to explore the association between SDB and periodontal diseases in an integrated approach.Materials and MethodsThis systematic review will include cohort studies, cross-sectional studies and case-control studies that are identified by electronic and manual searches. Electronic searches will be conducted in the following databases: PubMed, Embase, Scopus and Web of Science. Our search will cover articles published from inception of databases to March 2022 without restrictions in language and settings. Pre-determined eligibility criteria include: participants (participants without a history of respiratory diseases, history of periodontal treatment within the past 6 months and history of medication that is known to influence SDB or periodontal diseases); exposure (participants who have been diagnosed with SDB or at high-risk for SDB); comparison (participants without SDB); and outcome (periodontal parameters, such as probing depth, clinical attachment level, bleeding on probing, radiographic bone loss). Two authors will perform study screening and data extraction independently and in duplicate. All discrepancies will be solved by discussion. The methodological quality of included studies will be assessed using the Newcastle-Ottawa Scale.DiscussionThis systematic review will summarize the existing evidence on the association between SDB and periodontal diseases, a topic of controversy and clinical significance. Its findings can provide evidence for the development of relevant prevention and treatment strategies. The results will be disseminated through peer-reviewed journals.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022313024. Registered on March 28th 2022.
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Affiliation(s)
- Danyan Chen
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Periodontology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ziyan Meng
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Tingting Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xueqian Yu
- Library, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hong He
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- *Correspondence: Fang Hua
| | - Weili Dong
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Periodontology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Weili Dong
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18
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Choi J, Price J, Ryder S, Siskind D, Solmi M, Kisely S. Prevalence of dental disorders among people with mental illness: An umbrella review. Aust N Z J Psychiatry 2022; 56:949-963. [PMID: 34461748 DOI: 10.1177/00048674211042239] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Psychiatric patients have increased rates of comorbid physical illness. There are less data on dental disease, especially decay, despite risk factors including lifestyle and psychotropic side effects such as xerostomia. We therefore undertook an umbrella review of all meta-analyses on the association between mental illness and oral health. METHODS We searched PubMed, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Embase and CINAHL. Articles were independently assessed. Outcomes were caries, periodontal disease, erosion, and partial or total tooth loss (edentulism), measured where possible with standardised measures such as the mean number of decayed, missing and filled teeth or surfaces. Quality was assessed in line with National Institutes of Health guidelines. RESULTS We identified 11 meta-analyses. The most information and strongest association was between dental decay and severe mental illness or substance use, as well as erosion and eating disorders. Depressive, anxiety and eating disorders were also associated with caries, but the datasets were small. People with severe mental illness had nearly three times the odds of having lost all their teeth than the general community (odds ratio = 2.81, 95% confidence interval = [1.73, 4.57]) and those with depression between 1.17 and 1.32. Findings for periodontal disease were more equivocal, possibly because of study heterogeneity. CONCLUSION Mental health clinicians should screen for oral diseases when treating those with mental illness and facilitate referral to affordable dental clinics when indicated. Prevention should be a priority, including the promotion of dental care, as well as the management of xerostomia when psychopharmacologic agents are prescribed.
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Affiliation(s)
- Jisu Choi
- Jisu Choi - Faculty of Science, Dan Siskind & Steve Kisely - Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Josh Price
- Princess Alexandra Hospital Southside Clinical Unit, Metro South Health Service, Woolloongabba, QLD, Australia
| | - Samuel Ryder
- Princess Alexandra Hospital Southside Clinical Unit, Metro South Health Service, Woolloongabba, QLD, Australia
| | - Dan Siskind
- Jisu Choi - Faculty of Science, Dan Siskind & Steve Kisely - Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Princess Alexandra Hospital Southside Clinical Unit, Metro South Health Service, Woolloongabba, QLD, Australia
| | - Marco Solmi
- Department of Neuroscience, Università degli Studi di Padova, Padova, Italy
| | - Steve Kisely
- Jisu Choi - Faculty of Science, Dan Siskind & Steve Kisely - Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Princess Alexandra Hospital Southside Clinical Unit, Metro South Health Service, Woolloongabba, QLD, Australia
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19
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Nolde M, Holtfreter B, Kocher T, Alayash Z, Reckelkamm SL, Ehmke B, Baurecht H, Baumeister SE. No bidirectional relationship between depression and periodontitis: A genetic correlation and Mendelian randomization study. Front Immunol 2022; 13:918404. [PMID: 35935963 PMCID: PMC9355660 DOI: 10.3389/fimmu.2022.918404] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Observational and in-vivo research suggested a bidirectional relationship between depression and periodontitis. We estimated the genetic correlation and examined directionality of causation. Methods The study used summary statistics from published genome wide association studies, with sample sizes ranging from 45,563 to 797,563 individuals of European ancestry. We performed linkage disequilibrium score regression (LDSC) to estimate global correlation and used Heritability Estimation from Summary Statistics (ρ-HESS) to further examine local genetic correlation. Latent Heritable Confounder Mendelian randomization (LHC-MR), Causal Analysis using Summary Effect estimates (CAUSE), and conventional MR approaches assessed bidirectional causation. Results LDSC observed only weak genetic correlation (rg = 0.06, P-Value = 0.619) between depression and periodontitis. Analysis of local genetic correlation using ρ-HESS did not reveal loci of significant local genetic covariance. LHC-MR, CAUSE and conventional MR models provided no support for bidirectional causation between depression and periodontitis, with odds ratios ranging from 1.00 to 1.06 in either direction. Conclusions Results do not support shared heritability or a causal connection between depression and periodontitis.
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Affiliation(s)
- Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
- *Correspondence: Michael Nolde,
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Zoheir Alayash
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Münster, Münster, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. The additive effect of periodontitis with hypertension on risk of systemic disease and mortality. J Periodontol 2022; 93:1024-1035. [PMID: 35460076 PMCID: PMC9544472 DOI: 10.1002/jper.21-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that periodontitis (PD) causes hypertension, which is a precursor to development of other systemic diseases. The aim of this study was to examine the effect of hypertension and PD on the risk of subsequent systemic disease. METHODS This longitudinal cohort study included 244,393 UK Biobank participants who were free of systemic disease other than hypertension at baseline. Self-reported responses of painful gums or loose teeth were surrogates for PD. Hypertensives were identified by clinical diagnosis, or elevated blood pressure (≥140/90 mmHg). Systemic diseases including cancer, cardiovascular disease (CVD), and diabetes were identified from linked diagnostic codes. Multivariable Cox proportional hazard models were used to quantify the risk of systemic diseases and all-cause mortality, stratified by hypertensive and PD status. RESULTS The average age of the study population was 55.4 years (standard deviation [SD:] 8.1 years), and 130,220 (53.3%) participants were female. At baseline, 131,566 (53.8%) participants were hypertensive and 4.5% reported PD. The incidence rates of all systemic diseases were higher in hypertensive than non-hypertensive participants of the same PD status. In hypertensives, an additive effect was observed for PD on the risks of CVD (adjusted hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.21-1.53) and respiratory disease (HR: 1.11, 95% CI: 0.95-1.30) compared to hypertensive healthy controls. CONCLUSIONS Hypertensives with PD have exacerbated risks of several systemic diseases. Future interventional studies should consider the effect of periodontal treatment on systemic outcomes in targeted hypertensive populations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of DentistryUniversity of LeedsLeedsUK
| | | | - Sue Pavitt
- School of DentistryUniversity of LeedsLeedsUK
| | - Jianhua Wu
- School of DentistryUniversity of LeedsLeedsUK
- Leeds Institute for Data AnalyticsUniversity of LeedsLeedsUK
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21
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Cardiovascular Diseases and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:261-280. [PMID: 35612803 DOI: 10.1007/978-3-030-96881-6_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the tooth-supporting connective tissue and alveolar bone that is initiated by a bacterial biofilm in periodontal pockets. It affects about half of adults in the Western world, and is associated with a range of systemic comorbidities, e.g., cardiovascular disease (CVD), diabetes and rheumatoid arthritis, and these diseases share overlapping systemic and target tissue inflammatory mechanisms. Indeed, mounting evidence has indicated that their association is causal and built on the presence of systemic low-grade inflammation (LGI). Prior research linking periodontitis to CVD has mainly been derived from experimental studies, observational data, and small interventional trials with surrogate markers of CVD, e.g., endothelial dysfunction. However, recent data from randomised studies have demonstrated that intensive treatment of periodontitis can reduce blood pressure in patients with hypertension in conjunction with reduction of systemic inflammatory markers. Furthermore, targeted anti-inflammatory therapy has been shown to reduce recurrent events in patients with established CVD and LGI. Along this line, the concept of residual inflammatory risk has emerged as an independent new risk factor for atherothrombotic CVD. The present review summarizes translational evidence indicating that periodontitis is a risk factor for CVD dependent on LGI, and we conclude that treatment of periodontitis is likely to contribute importantly to reduction of residual inflammatory risk.
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22
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Ming P, Rao P, Wu T, Yang J, Lu S, Yang B, Xiao J, Tao G. Biomimetic Design and Fabrication of Sericin-Hydroxyapatite Based Membranes With Osteogenic Activity for Periodontal Tissue Regeneration. Front Bioeng Biotechnol 2022; 10:899293. [PMID: 35662836 PMCID: PMC9160433 DOI: 10.3389/fbioe.2022.899293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
The guided tissue regeneration (GTR) technique is a promising treatment for periodontal tissue defects. GTR membranes build a mechanical barrier to control the ingrowth of the gingival epithelium and provide appropriate space for the regeneration of periodontal tissues, particularly alveolar bone. However, the existing GTR membranes only serve as barriers and lack the biological activity to induce alveolar bone regeneration. In this study, sericin-hydroxyapatite (Ser-HAP) composite nanomaterials were fabricated using a biomimetic mineralization method with sericin as an organic template. The mineralized Ser-HAP showed excellent biocompatibility and promoted the osteogenic differentiation of human periodontal membrane stem cells (hPDLSCs). Ser-HAP was combined with PVA using the freeze/thaw method to form PVA/Ser-HAP membranes. Further studies confirmed that PVA/Ser-HAP membranes do not affect the viability of hPDLSCs. Moreover, alkaline phosphatase (ALP) staining, alizarin red staining (ARS), and RT-qPCR detection revealed that PVA/Ser-HAP membranes induce the osteogenic differentiation of hPDLSCs by activating the expression of osteoblast-related genes, including ALP, Runx2, OCN, and OPN. The unique GTR membrane based on Ser-HAP induces the differentiation of hPDLSCs into osteoblasts without additional inducers, demonstrating the excellent potential for periodontal regeneration therapy.
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Affiliation(s)
- Piaoye Ming
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
| | - Pengcheng Rao
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tianli Wu
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
| | - Jianghua Yang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
| | - Shi Lu
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
| | - Binbin Yang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
| | - Jingang Xiao
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Jingang Xiao, ; Gang Tao,
| | - Gang Tao
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Jingang Xiao, ; Gang Tao,
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Biomarkers common for inflammatory periodontal disease and depression: A systematic review. Brain Behav Immun Health 2022; 21:100450. [PMID: 35330865 PMCID: PMC8938251 DOI: 10.1016/j.bbih.2022.100450] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Dysregulated immune response arising in the periphery can induce depressive symptoms through neuroimmune interactions. Inflammatory oral pathology can be a potent inducer of chronic neuroimmune response relevant to depression. We aimed to synthesize available evidence for the association between inflammatory periodontal diseases (IPD) and major depression (MD) in relation to a broad range of biomarkers. Methods Medline, Embase, PsycInfo, Cochrane Library, Web of Science and Scopus databases were searched from inception until January 27, 2022. Search terms included subject headings and synonyms for inflammatory periodontal disease and depression. Studies that reported data on both depression and inflammatory periodontal disease as categories along with measurement of a biomarker were considered. Two reviewers independently selected the articles for inclusion, extracted data and assessed the quality of each study. The protocol for this study was registered with PROSPERO, CRD42021215524. Results Twenty-eight studies were included in the final review-eleven cross-sectional studies, seven case-control studies, and six prospective cohort studies conducted in humans; the remaining four were experimental animal studies. Eighteen studies including all animal studies reported a positive association between depression and periodontal disease; one study reported a negative association and another nine studies found no such associations. Twenty studies reported mixed associations between IPD and biomarkers (i.e, salivary, serum, urine or gingival crevicular fluid cortisol, C reactive protein, cytokines, etc.). Biomarkers related to depression were gingival crevicular fluid cortisol, interleukin 6 (IL-6), Il-1β, immunoglobulin G against Bacterioides forsythus; root canal lipopolysaccharides; blood IL-6, IL-1β, cortisol, advanced oxidation protein products, nitric oxide metabolites, lipid hydroperoxides and trapping antioxidant parameter; whereas five studies found no associations between depression and a biomarker. Although animal studies showed interaction of immune, inflammatory and neurotrophic biomarkers in the relationship between depression and periodontal disease, human studies showed mixed findings. In most studies, there were risks of bias due to the sample selection and assessment protocol. Study heterogeneity and limited number of comparable studies reporting on shared biomarkers precluded a meta-analysis. Conclusion Immune-inflammatory contribution to depression was evident in the context of inflammatory periodontal diseases, but whether biomarkers mediate the associations between IPD and MD needs to be tested through methodologically rigorous studies aiming specifically at this hypothesis.
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24
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Lenk M, Noack B, Weidner K, Lorenz K. Psychopathologies and socioeconomic status as risk indicators for periodontitis: a survey-based investigation in German dental practices. Clin Oral Investig 2021; 26:2853-2862. [PMID: 34748106 PMCID: PMC8898229 DOI: 10.1007/s00784-021-04263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/26/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Periodontitis is a highly prevalent multifactorial disease associated with various mental disorders. However, study results about this association are still contradictory. One methodological reason could be the neglect of potential confounders, such as socioeconomic factors or mental comorbidity. Our study examined a wide range of potential psychosocial risk indicators to identify those with relevant associations to periodontitis. MATERIALS AND METHODS In a cross-sectional study, 111 patients with periodontitis (PERIO) (> 30% teeth with approximal attachment loss ≥ 5 mm) and 110 patients without periodontitis (NON-PERIO) were recruited in four dental practices in Germany. Clinical attachment loss, pocket depth, plaque, bleeding on probing, and DMFT were measured. Psychopathologic symptoms and socioeconomic status were recorded using self-report questionnaires (DAS, PHQ-8, GAD-7, CTS, SCOFF, AUDIT, FTND, SSS-8, SES). RESULTS The PERIO group reported significantly lower socioeconomic status (Cohen's d = 0.49) and higher psychopathological symptom burden than the NON-PERIO regarding dental anxiety (d = 0.86) and avoidance behavior, nicotine dependency (d = 0.84), depressiveness (d = 0.46), general anxiety (d = 0.45), somatic symptoms (d = 0.42), and childhood traumatization (d = 0.34). No significant group differences existed for alcohol abuse and eating disorders. Dental anxiety was the strongest predictor of periodontitis and showed significant correlations with other psychopathologies and social status. CONCLUSIONS Out of all psychosocial factors, socioeconomic status and dental anxiety showed the greatest association with periodontitis. CLINICAL RELEVANCE Dentists should encourage socially disadvantaged and dentally anxious patients in the utilization of prevention and dental care. Furthermore, physicians and psychotherapists can contribute to the early detection of dental anxiety, oral diseases, and avoidance behavior.
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Affiliation(s)
- Maria Lenk
- Department of Psychotherapy and Psychosomatics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Barbara Noack
- Department of Periodontology, Technische Universität Dresden, Fetscherstr, 74, 01307, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Katrin Lorenz
- Department of Periodontology, Technische Universität Dresden, Fetscherstr, 74, 01307, Dresden, Germany.
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25
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Neuropeptides as the Shared Genetic Crosstalks Linking Periodontitis and Major Depression Disorder. DISEASE MARKERS 2021; 2021:3683189. [PMID: 34721734 PMCID: PMC8553477 DOI: 10.1155/2021/3683189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/01/2021] [Indexed: 12/21/2022]
Abstract
Background The aim of this study was at investigating the association between major depressive disorder (MDD) and periodontitis based on crosstalk genes and neuropeptides. Methods Datasets for periodontitis (GSE10334, GSE16134, and GSE23586) and MDD (GSE38206 and GSE39653) were downloaded from GEO. Following batch correction, a differential expression analysis was applied (MDD: ∣log2FC | >0 and periodontitis ∣log2FC | ≥0.5, p < 0.05). The neuropeptide data were downloaded from NeuroPep and NeuroPedia. Intersected genes were potential crosstalk genes. The correlation between neuropeptides and crosstalk genes in MDD and periodontitis was analyzed with Pearson correlation coefficient. Subsequently, regression analysis was performed to calculate the differentially regulated link. Cytoscape was used to map the pathways of crosstalk genes and neuropeptides and to construct the protein-protein interaction network. Lasso regression was applied to screen neuropeptides, whereby boxplots were created, and receiver operating curve (ROC) analysis was conducted. Results The MDD dataset contained 30 case and 33 control samples, and the periodontitis dataset contained 430 case and 139 control samples. 35 crosstalk genes were obtained. A total of 102 neuropeptides were extracted from the database, which were not differentially expressed in MDD and periodontitis and had no intersection with crosstalk genes. Through lasso regression, 9 neuropeptides in MDD and 43 neuropeptides in periodontitis were obtained. Four intersected neuropeptide genes were obtained, i.e., ADM, IGF2, PDYN, and RETN. The results of ROC analysis showed that IGF2 was highly predictive in MDD and periodontitis. ADM was better than the other three genes in predicting MDD disease. A total of 13 crosstalk genes were differentially coexpressed with four neuropeptides, whereby FOSB was highly expressed in MDD and periodontitis. Conclusion The neuropeptide genes ADM, IGF2, PDYN, and RETN were intersected between periodontitis and MDD, and FOSB was a crosstalk gene related to these neuropeptides on the transcriptomic level. These results are a basis for future research in the field, needing further validation.
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26
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Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179394. [PMID: 34501984 PMCID: PMC8431014 DOI: 10.3390/ijerph18179394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 01/10/2023]
Abstract
Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools.
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27
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Wolowski A, Schneider HJ, Eger T. [Dental disorders with a psychosocial background]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:951-958. [PMID: 34212207 PMCID: PMC8316243 DOI: 10.1007/s00103-021-03369-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
While the mouth and teeth play a lifelong central role in a person's development and wellbeing, psychosocial aspects of disease and health are still only reluctantly included in dental explanatory models. Only dental anxiety with its disease quality of a specific phobia is generally recognized as a mental disorder requiring intervention. It is interpreted as an emotional reaction to aspects of dental treatment, which results in distress for the affected person and appears to be unreasonably intense given the actual dangers involved. Apart from that, the tendency to provide a somatic explanation for symptoms in the dental context persists. This bears implications for the expectations of those affected as well as for interdisciplinary cooperation. In order to improve interdisciplinary support and mutual understanding, the following article introduces the clinical pictures of craniomandibular dysfunction, bruxism, occlusal dysaesthesia, and somatoform prosthesis intolerance alongside dental anxiety. Psychosocial factors can profoundly influence the development, course, and management of these conditions.
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Affiliation(s)
- Anne Wolowski
- Poliklinik für Prothetische Zahnmedizin & Biomaterialien, Zentrum für Zahn‑, Mund- und Kieferheilkunde, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
| | - Hans-Joachim Schneider
- Poliklinik für Prothetische Zahnmedizin & Biomaterialien, Zentrum für Zahn‑, Mund- und Kieferheilkunde, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - Thomas Eger
- Abt. XXIII Zahnmedizin, Parodontologie Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Deutschland
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28
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Aragão WAB, Souza-Monteiro DD, Frazão DR, Né YGDS, Ferreira RDO, Rivera LFS, Saito MT, Rösing CK, Fagundes NCF, Maia LC, Lima RR. Is There Any Association Between Chronic Periodontitis and Anxiety in Adults? A Systematic Review. Front Psychiatry 2021; 12:710606. [PMID: 34413802 PMCID: PMC8368723 DOI: 10.3389/fpsyt.2021.710606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/22/2021] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is a multifactorial disease triggered by dysbiotic biofilms, involving the host's immune response, systemic and behavioral factors, including psychosocial conditions. This systematic review aimed to investigate the possible association between periodontitis and anxiety in adults. Searches were performed in PubMed, Scopus, Web of Science, Lilacs, Cochrane, and OpenGrey databases, without language restrictions, considering studies in adults (P-Participants), with (E-Exposure) and without periodontitis (C- Comparison) in an outcome of association with anxiety (O-outcome). Methodological quality assessment was carried out using the Newcastle-Ottawa protocol for case-control and cross-sectional studies, followed by an analysis of the level of evidence using the GRADE tool. Metanalysis was not performed due to several differences in methods applied by authors in primary studies. Eleven observational studies were selected according to the inclusion criteria from the total of 6,380 studies retrieved from databases. Eight studies demonstrated higher anxiety levels in subjects with periodontitis, among which only one study presented a high risk of bias. The GRADE tool revealed a low level of evidence for the anxiety outcome measured by the State-Trait Anxiety Inventory (STAI), both for case-control and cross-sectional studies. However, since anxiety may affect the quality of life of many subjects, it reinforces the need for further studies that evaluate this association for more extended periods. Clinical Trial Registration:PROSPERO-CRD42020190445.
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Affiliation(s)
- Walessa Alana Bragança Aragão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - de Deiweson Souza-Monteiro
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Yago Gecy de Sousa Né
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Railson de Oliveira Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Miki Taketomi Saito
- School of Dentistry, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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29
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Martínez M, Postolache TT, García-Bueno B, Leza JC, Figuero E, Lowry CA, Malan-Müller S. The Role of the Oral Microbiota Related to Periodontal Diseases in Anxiety, Mood and Trauma- and Stress-Related Disorders. Front Psychiatry 2021; 12:814177. [PMID: 35153869 PMCID: PMC8833739 DOI: 10.3389/fpsyt.2021.814177] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
The prevalence of anxiety, mood and trauma- and stress-related disorders are on the rise; however, efforts to develop new and effective treatment strategies have had limited success. To identify novel therapeutic targets, a comprehensive understanding of the disease etiology is needed, especially in the context of the holobiont, i.e., the superorganism consisting of a human and its microbiotas. Much emphasis has been placed on the role of the gut microbiota in the development, exacerbation, and persistence of psychiatric disorders; however, data for the oral microbiota are limited. The oral cavity houses the second most diverse microbial community in the body, with over 700 bacterial species that colonize the soft and hard tissues. Periodontal diseases encompass a group of infectious and inflammatory diseases that affect the periodontium. Among them, periodontitis is defined as a chronic, multi-bacterial infection that elicits low-grade systemic inflammation via the release of pro-inflammatory cytokines, as well as local invasion and long-distance translocation of periodontal pathogens. Periodontitis can also induce or exacerbate other chronic systemic inflammatory diseases such as atherosclerosis and diabetes and can lead to adverse pregnancy outcomes. Recently, periodontal pathogens have been implicated in the etiology and pathophysiology of neuropsychiatric disorders (such as depression and schizophrenia), especially as dysregulation of the immune system also plays an integral role in the etiology and pathophysiology of these disorders. This review will discuss the role of the oral microbiota associated with periodontal diseases in anxiety, mood and trauma- and stress-related disorders. Epidemiological data of periodontal diseases in individuals with these disorders will be presented, followed by a discussion of the microbiological and immunological links between the oral microbiota and the central nervous system. Pre-clinical and clinical findings on the oral microbiota related to periodontal diseases in anxiety, mood and trauma- and stress-related phenotypes will be reviewed, followed by a discussion on the bi-directionality of the oral-brain axis. Lastly, we will focus on the oral microbiota associated with periodontal diseases as a target for future therapeutic interventions to alleviate symptoms of these debilitating psychiatric disorders.
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Affiliation(s)
- María Martínez
- Etiology and Therapy of Periodontal and Peri-Implant Diseases Research Group, University Complutense Madrid, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
| | - Borja García-Bueno
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Juan C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elena Figuero
- Etiology and Therapy of Periodontal and Peri-Implant Diseases Research Group, University Complutense Madrid, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Christopher A Lowry
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,inVIVO Planetary Health of the Worldwide Universities Network, New York, NY, United States
| | - Stefanie Malan-Müller
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
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