Cannabis use and the risk of periodontitis: A two-sample Mendelian randomization study

Cannabis Uses in Dentistry: A Bibliometric Analysis

Background: This bibliometric review seeks to understand metrics of papers, authors, journals, and universities, about the benefits of the therapeutic application of Cannabis sativa (CS), as well as the most harmful effects associated to its use. Methods: The main search strategy applied to the topic was conducted in Web Of Science Core Collection on February 2024. A crossmatch of the number of citations was performed in Scopus and Google Scholar. The analyses were carried out in VOSviewer and Altmetric for PubMed and Google Scholar. Results: Of a total of 196 records, 53 articles were included for analysis. There were 25 publications on either therapeutic or harmful effects. In the ranking of subjects, those of greatest interest were general oral health and periodontics, with 53% of the total. The most cited paper was authored by Thomson et al. (2008) with 85 citations, allowing the University of Otago to be the most cited. Although JAMA was the most cited journal, in the dental field this corresponded to the Journal of Clinical Periodontology. In relation to the distribution by country, the United States received the largest number of citations and New Zealand second. Related to dentistry, in the cluster analysis, keywords more occurrent were "periodontal disease" and "periodontitis". Conclusions: In the past 4 years, there has been a superlative growth in CS papers related to oral health effects. This growth follows the social and political events related to CS legalization in some countries and reveals that the use of CS in dentistry is an emerging research field.

A Mendelian randomization study on the association of bone mineral density with periodontitis

OBJECTIVE

Observational studies indicated that individuals with osteoporosis could be at an increased risk of periodontitis. This study aimed to investigate whether there is a causal association of bone mineral density (BMD) with periodontitis using Mendelian randomization (MR).

MATERIALS AND METHODS

Summary statistics were sourced from genome-wide association study on BMD measured at different skeletal sites, including estimated heel BMD (eBMD, N = 426,824), forearm BMD (FA-BMD, N = 8143), femoral neck BMD (FN-BMD, N = 32,735), and lumbar spine BMD (LS-BMD, N = 28,498). Genetic variants of periodontitis (N = 45,563) and loose teeth (N = 461,031) were used as outcome surrogates. Inverse variance weighted meta-analysis (IVW) was adopted as main analyses. Other sensitivity MR approaches were used to boost power and account for pleiotropy.

RESULTS

IVW results suggested no evidence for a causal association of any phenotypes of BMD with periodontitis (eBMD, odds ratio [OR] = 0.984, 95% confidence interval [CI] = 0.885-1.083; FA-BMD, OR = 1.028, 95%CI = 0.864-1.193; FN-BMD, OR = 1.033, 95%CI = 0.896-1.169; LS-BMD, OR = 0.991, 95%CI =0.878-1.103; all P > 0.65). Such null associations were consistent through other sensitivity MR approaches. Similarly, no significant causal effects of BMD on loose teeth were found.

CONCLUSIONS

Within the limitation of the study, our MR estimates suggested that a decreased BMD is unlikely to substantially increase the risk of periodontitis.

Illegal drugs and periodontal conditions

In recent years, the practice of dentistry and periodontology has become complicated by several risk factors, including the treatment of an increasing number of patients with substance use disorder. This review presents an update in the current literature of the impact of illegal drug use on periodontal conditions and their possible effect as risk factors or indicators. The main illegal drugs that may have an impact on periodontal health and conditions are described, including their effect, medical manifestations, risks, and the overall effect on oral health and on the periodontium. Where available, data from epidemiologic studies are analyzed and summarized. The clinical management of periodontal patients using illegal drugs is reported in a comprehensive approach inclusive of the detection of illicit drug users, screening, interviewing and counseling, the referral to treatment, and the dental and periodontal management. With regard to the impact of illegal substance use on periodontal conditions, there is moderate evidence that regular long-term use of cannabis is a risk factor for periodontal disease, manifesting as a loss of periodontal attachment, deep pockets, recessions, and gingival enlargements. Limited evidence also shows that the use of cocaine can cause a series of gingival conditions that mostly presents as chemical induced-traumatic lesions (application of cocaine on the gingiva) or necrotizing ulcerative lesions. There is a scarcity of data regarding the impact of other drug use on periodontal health. There is evidence to suggest that regular long-term use of cannabis is a risk factor for periodontal disease and that the use of cocaine can cause a series of periodontal conditions. The dental treatment of subjects that use illegal substances is becoming more common in the daily clinical practice of periodontists and other dental clinicians. When the clinicians encounter such patients, it is essential to manage their addiction properly taking into consideration the impact of it on comprehensive dental treatment. Further studies and clinical observations are required to obtain sound and definitive information.