Cross-talk between clinical and host-response parameters of periodontitis in smokers

Effectiveness of photodynamic therapy adjunct to oral debridement in improving clinical, microbiological, and pain in necrotizing ulcerative gingivitis

To evaluate the efficacy of photodynamic therapy (PDT) as adjunctive to oral debridement (OD) in the improvement of clinical, microbiological, and pain in patients with necrotizing ulcerative gingivitis (NUG). Patients with NUG were split into two groups: Group-OD + PDT received PDT with OD, while Group-OD underwent OD alone. Clinical inflammatory parameters including full mouth plaque scores (FMPS), full mouth bleeding scores (FMBS), and probing depth (PD) were assessed. Fusobacterium nucleatum and Prevotella intermedia were analyzed using the polymerase chain reaction technique. Pain examination was done using various pain scales. Group PDT + OD showed more reduction in FMPS, FMBS, and greater reduction in F. nucleatum and P. intermedia count compared to group OD at 12 weeks follow up (p < 0.01). Group PDT + OD showed significantly lower pain scores at 12 weeks (p < 0.05). PDT was more effective in improving clinical parameters, and reducing bacterial counts and pain in NUG patients than dental scaling alone.

A Cross-Sectional Study for Association between Periodontitis and Benign Prostatic Hyperplasia Using the Korean Genome and Epidemiology Study Data

Recently, several studies have suggested the relationship between periodontitis and prostatic disease. However, epidemiological studies on the association between periodontitis and benign prostatic hyperplasia (BPH) are scarce. Hence, we aimed to identify the association between the two diseases using data from the Korean Genome and Epidemiology Study. Among the 173,209 participants, 3297 men with periodontitis and 35,292 controls (without periodontitis) were selected. The history of BPH in participants with periodontitis and the controls were also investigated. Two-tailed analyses, independent t-tests, and chi-square tests were used for statistical analysis. The adjusted odds ratio (OR) for BPH was 1.50 (95% confidence interval, 1.35–1.68; p < 0.001) after adjusting for past medical histories. The adjusted OR for BPH was 1.57 (95% confidence interval, 1.41–1.76; p < 0.001) after adjusting for anthropometric and laboratory data. Collectively, this study provides evidence that periodontitis is associated with BPH. This finding supports the use of regular dental checkups and periodontal treatments to reduce the prevalence and progression of BPH.

Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis

The lack of access to a balanced diet, rich in vitamins and minerals, can predispose people to inflammatory diseases such as obesity, diabetes mellitus, and periodontitis. We aimed to evaluate the relationship between micronutrient intake, sociodemographic behavioral characteristics, and periodontal health in adults assisted by a public health care system. Participants (n = 450) answered a food frequency questionnaire and were submitted to anthropometric and oral clinical examinations. Principal component analysis was used to summarize the number of components emerging from 17-micronutrient intake. Subsequently, cluster analysis was employed. The prevalence of at least one periodontal pocket ≥ 4 mm was 67.4%. Three clusters were identified according to periodontal status. Cluster 1 "poor periodontal status" was characterized by older individuals (n = 202; 85% females) with poor periodontal status, lower education level, mainly smokers with non-transmissible chronic diseases (NTCD), with lower energy, omega-3, fiber, Zn, K, Cu, and vitamin C intake. Cluster 3 "healthy periodontal status" included younger individuals (n = 54) with the healthiest periodontal status, a higher education level, without NTCD, and with higher energy, omega-3, fiber, Zn, calcium, retinol, and riboflavin intake. Cluster 2 was labeled as "intermediate periodontal status". Micronutrient ingestion was associated with periodontal status and may be considered in health promotion actions for low-income populations.

Bactericidal and clinical efficacy of photochemotherapy in acute necrotizing ulcerative gingivitis

AIM

This study was designed to investigate the clinical and microbiological parameters with photochemotherapy (PCT) against conventional debridement (CD) among patients with necrotizing ulcerative gingivitis (NUG).

MATERIALS AND METHODS

Patients with a diagnosis of NUG were divided into two groups: 'Group-PCT' that underwent indocyanine green-mediated PCT with adjunctive mechanical debridement, and Group-CD that underwent mechanical debridement with adjunctive 3 % hydrogen peroxide/chlorhexidine rinse. Clinical inflammatory gingival parameters including full-mouth plaque scores (FMPS), bleeding scores (FMBS), and probing depth (PD) were measured. Counts of Treponema microdentium, Fusobacterium nucleatum and Prevotella intermedia were assessed using polymerase chain reaction technique. All assessments were done at baseline, 3 weeks and 6 weeks.

RESULTS

Twenty-six participants were contacted and agreed to participate in the trial. The mean age of participants in group-PCT was 24.5 years while the mean age of patients in group-CD was 26.7 years. FMPS showed significant but equal reduction in both the groups at 3 weeks and 6 weeks (p < 0.01). The reduction in mean FMBS was higher in the group-PCT at 6 weeks follow-up (p < 0.05). All bacterial levels reduced from baseline to follow-up with both PCT and CD groups (p < 0.05). Group-PCT showed significantly reduced counts of T. microdentium and F. nucleatum at 3 weeks and 6 weeks compared with group-CD (p = 0.024). Equal reduction was shown for P. intermedia between both the groups at 3 and 6 weeks, respectively.

CONCLUSION

Application of adjunctive photochemotherapy was both clinically and microbiologically effective in the treatment of NUG.

[Correlation between cigarette smoking and periodontal status: A survey on the population of a community above 35-year-old in Beijing]

OBJECTIVE

To survey the cigarette smoking status and periodontal status, and to study the correlation between cigarette smoking and periodontal status.

METHODS

Questionnaires were distributed (including self-assessed periodontal status, such as bleeding while brushing teeth, oral odor, tooth loosening, gum swelling, etc.) and clinical periodontal examinations performed for parameters including probing depth (PD), bleeding index (BI), attachment loss (AL), plaque index (PLI) and amount of teeth loss, which was recorded in the population above 35 years of a community in Beijing. A total of 974 subjects were recruited in the study. The population was divided into current smokers and non-smokers, and the differences of self-assessed periodontal status and periodontal parameters between the groups analyzed.

RESULTS

The smokers had significantly less bleeding during toothbrushing, and in the meantime, had significantly more self-reported tooth loosening compared with the non-smokers. The smokers brushed their teeth less than the non-smokers (P<0.05). The self-reported gum swelling and oral odor had no significant difference between the smokers and non-smokers. The smokers had 0.565 times and 1.572 times the risk of bleeding during toothbrushing, self-reported tooth loosening and from Logistic regression analyses, respectively (P<0.05). The mean PD, AL, PLI and the amount of tooth loss of the smokers were significant higher than the non-smokers (P<0.05). However, the mean BI of the smokers was slightly less than the non-smokers' (1.93±0.540 vs. 1.94±0.512, P=0.707). The smokers had 2.129 times, 1.698 times and 1.933 times the risk of the mean PD>3 mm, the mean AL>3 mm, and the amount of tooth loss above 8, respectively compared with the non-smokers (P<0.05) from Logistic regression analyses.

CONCLUSION

The self-assessed periodontal status is different between smokers and non-smokers in the population of a community in Beijing. Smokers have less bleeding during toothbrushing but no significant difference with BI. Smokers also have more self-reported tooth loosening. Compared with non-smokers, smokers have more severe periodontal destruction.

[Correlation between cigarette smoking and periodontal status: A survey on the population of a community above 35-year-old in Beijing]

OBJECTIVE

To survey the cigarette smoking status and periodontal status, and to study the correlation between cigarette smoking and periodontal status.

METHODS

Questionnaires were distributed (including self-assessed periodontal status, such as bleeding while brushing teeth, oral odor, tooth loosening, gum swelling, etc.) and clinical periodontal examinations performed for parameters including probing depth (PD), bleeding index (BI), attachment loss (AL), plaque index (PLI) and amount of teeth loss, which was recorded in the population above 35 years of a community in Beijing. A total of 974 subjects were recruited in the study. The population was divided into current smokers and non-smokers, and the differences of self-assessed periodontal status and periodontal parameters between the groups analyzed.

RESULTS

The smokers had significantly less bleeding during toothbrushing, and in the meantime, had significantly more self-reported tooth loosening compared with the non-smokers. The smokers brushed their teeth less than the non-smokers (P<0.05). The self-reported gum swelling and oral odor had no significant difference between the smokers and non-smokers. The smokers had 0.565 times and 1.572 times the risk of bleeding during toothbrushing, self-reported tooth loosening and from Logistic regression analyses, respectively (P<0.05). The mean PD, AL, PLI and the amount of tooth loss of the smokers were significant higher than the non-smokers (P<0.05). However, the mean BI of the smokers was slightly less than the non-smokers' (1.93±0.540 vs. 1.94±0.512, P=0.707). The smokers had 2.129 times, 1.698 times and 1.933 times the risk of the mean PD>3 mm, the mean AL>3 mm, and the amount of tooth loss above 8, respectively compared with the non-smokers (P<0.05) from Logistic regression analyses.

CONCLUSION

The self-assessed periodontal status is different between smokers and non-smokers in the population of a community in Beijing. Smokers have less bleeding during toothbrushing but no significant difference with BI. Smokers also have more self-reported tooth loosening. Compared with non-smokers, smokers have more severe periodontal destruction.

Effects of colchicine on gingival inflammation, apoptosis, and alveolar bone loss in experimental periodontitis

BACKGROUND

The aim of the study was to investigate the effects of colchicine on cytokine production, apoptosis, alveolar bone loss, and oxidative stress in an experimental model of periodontitis in rats.

METHODS

Forty-eight rats were divided equally into four groups: healthy (H); periodontitis (P); periodontitis+colchicine low dose (CL, 30 μg/kg/day), and periodontitis+colchicine high dose (CH, 100 μg/kg/day). After 11 days, interleukin (IL) -1β, IL-8, and IL-10 were analyzed in gingival samples using Enzyme-Linked ImmunoSorbent Assay. Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), total oxidative stress (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were measured in gingiva and serum. Alveolar bone volume was evaluated via micro-CT. Apoptotic cells were detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay in histological sections.

RESULTS

Colchicine treatment significantly reduced IL-1β, IL-8, RANKL, RANKL/OPG, TOS, OSI, and bone volume ratio levels, and increased TAS levels compared to group P (p < 0.05). High dose colchicine treatment (CH) significantly decreased TUNEL+ cell counts compared to group P (p < 0.05).

CONCLUSIONS

These finding suggest that colchicine has a prophylactic potential for the prevention of periodontal tissue destruction through anti-inflammatory, anti-oxidative, anti-apoptotic, and bone-protective effects.

Smoking and periodontal microorganisms

Resolution of dysbiosis following treatment for periodontal disease and tobacco dependence has been reported in longitudinal intervention studies. In the present report, we evaluated the biological findings regarding the effect of smoking on the periodontal microbiome. A standardized electronic search was conducted using MEDLINE; overall, 1099 papers were extracted. Studies that addressed the relationship between tobacco and periodontal pathogens were included. Finally, 42 papers were deemed appropriate for the present review. Functional changes in periodontal pathogens exposed to nicotine and cigarette smoke extract support the clinical findings regarding dysbiosis of the subgingival microbiome. Dysbiosis of the periodontal microbiome was presented in smokers regardless of their periodontal condition (healthy, gingivitis, or periodontitis) and remained significant only in smokers even after the resolution of experimentally-induced gingivitis and following reduction of clinical signs of periodontitis with non-surgical periodontal treatment and over 3 months post-therapy. Based on these findings, smoking cessation in periodontitis patients is beneficial for promoting a health-compatible subgingival microbial community. To maximize the benefits of these interventions in dental settings, further studies on periodontal microbiome are needed to elucidate the impact of tobacco intervention on preventing recurrence of periodontal destruction in the susceptible subjects.

Ageing effects on humoral immune responses in chronic periodontitis

Periodontal disease is a dominant global bacterial infection that increases with ageing.

AIM

This report focuses on host adaptive immune responses in periodontitis. While experimental models and humans diagnosed with periodontitis demonstrate an antigenic specificity for particular oral bacteria, we have a limited understanding of (i) how ageing affects the adaptive immune responses to these bacteria that chronically colonize the oral cavity for decades prior to disease expression and (ii) how the magnitude and specificity of the response interface with pathogens that emerge within the bacterial ecology during exacerbations of disease.

MATERIALS AND METHODS

Serum antibody levels to a group of pathogenic and commensal oral bacteria were measured in a population of individuals from 21 to 74 years of age, stratified based on clinical status of the periodontium, smoking and sex.

RESULTS

Clinical parameters were not significantly different within health, gingivitis or periodontitis groups related to age. Antibody to oral pathogens and commensals was similar in different age groups in each of the clinical categories, with no age correlation noted in the periodontitis patients.

CONCLUSIONS

The adaptive immune responses to oral bacteria that chronically colonize the oral cavity appear generally unaffected by age, but clearly are linked to the extent of disease.

The influence of KIR gene presence/absence polymorphisms on the development of periodontal disease in smokers and non-smokers

Introduction

Periodontal diseases are highly prevalent inflammatory, multifactorial diseases. Smoking is one of the most important environmental risk factors for the development and severity of periodontal disease. Killer cell immunoglobulin-like receptors (KIRs) are members of the immunoglobulin (Ig) superfamily and play an essential role in the regulation of NK cell activity, allowing natural killer (NK) cells to sense and respond to human leukocyte antigen (HLA) class I. The aim of this study was to evaluate the influence of KIR gene presence/absence polymorphisms on the development of periodontal disease in smokers and non-smokers.

Material and methods

This study enrolled 400 Caucasian subjects (age range 25-69 years) from the West Pomeranian region of Poland. The subjects were categorized into four subgroups (smoking and non-smoking patients with periodontal disease; smoking and non-smoking subjects without periodontal disease - control subjects).

Results

The differences of KIR gene frequencies between non-smoking patients and non-smoking control subjects as well as smoking patients and control subjects were not statistically significant. In multivariate regression analysis advanced age of patients and smoking were independent factors associated with increased frequency of periodontal disease.

Conclusions

The results of this study suggest that the main factor associated with increased risk of periodontal disease is smoking, whereas KIR presence/absence polymorphism is not a significant factor involved in the pathogenesis of periodontal disease.

Integrated biomarker profiling of smokers with periodontitis

BACKGROUND

In the context of precision medicine, understanding patient-specific variation is an important step in developing targeted and patient-tailored treatment regimens for periodontitis. While several studies have successfully demonstrated the usefulness of molecular expression profiling in conjunction with single classifier systems in discerning distinct disease groups, the majority of these studies do not provide sufficient insights into potential variations within the disease groups.

AIM

The goal of this study was to discern biological response profiles of periodontitis and non-periodontitis smoking subjects using an informed panel of biomarkers across multiple scales (salivary, oral microbiome, pathogens and other markers).

MATERIAL & METHODS

The investigation uses a novel ensemble classification approach (SVA-SVM) to differentiate disease groups and patient-specific biological variation of systemic inflammatory mediators and IgG antibody to oral commensal and pathogenic bacteria within the groups.

RESULTS

Sensitivity of SVA-SVM is shown to be considerably higher than several traditional independent classifier systems. Patient-specific networks generated from SVA-SVM are also shown to reveal crosstalk between biomarkers in discerning the disease groups. High-confidence classifiers in these network abstractions comprised of host responses to microbial infection elucidated their critical role in discerning the disease groups.

CONCLUSIONS

Host adaptive immune responses to the oral colonization/infection contribute significantly to creating the profiles specific for periodontitis patients with potential to assist in defining patient-specific risk profiles and tailored interventions.