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Shen R, Chen S, Shen J, Lv L, Wei T. Association between missing teeth number and all-cause and cardiovascular mortality: NHANES 1999-2004 and 2009-2014. J Periodontol 2024; 95:571-581. [PMID: 37793053 DOI: 10.1002/jper.23-0277] [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: 04/28/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The association between tooth loss and all-cause and cardiovascular mortality requires further investigation. METHODS This study included 17993 participants from the National Health and Nutrition Examination Surveys (NHANES) 1999-2004 and 2009-2014. Weighted multivariable Cox proportional hazard models were used to assess the association between tooth loss and all-cause and cardiovascular mortality. Restricted cubic splines (RCS) were incorporated in the models to explore potential nonlinear relationships. RESULTS Over a median follow-up of 116 months, 2152 participants died, including 625 cardiovascular deaths. Compared to participants without missing teeth, participants with 11-19 missing teeth had the highest risk of all-cause mortality (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.43-2.51), while participants with 6-10 missing teeth had the highest risk of cardiovascular mortality (HR 2.51, 95% CI 1.68-3.76). RCS analyses revealed nonlinear associations between number of missing teeth and all-cause (p < 0.001) and cardiovascular (p = 0.001) mortality. With < 10 missing teeth, each additional missing tooth increased all-cause and cardiovascular mortality by 6% (HR 1.06, 95% CI 1.03-1.09) and 9% (HR 1.09, 95% CI 1.03-1.15), respectively. However, when the number of missing teeth was ≥10, the risk of mortality did not continue to increase with more missing teeth. A significant interaction was found between tooth loss and age (p < 0.001 for both outcomes). CONCLUSION We observed an inverted L-shaped association between tooth loss and mortality, wherein risks increased with more missing teeth until 10, but did not continue increasing thereafter. The association was stronger in adults < 65 years old.
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Affiliation(s)
- Ruming Shen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuaijie Chen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiayi Shen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingchun Lv
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tiemin Wei
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Qiao F, Guo H, Zhang J, Zhang Q, Liu L, Meng G, Wu H, Gu Y, Song K, Li C, Niu K. Association Between Number of Missing Teeth and Hyperlipidemia: The TCLSIH Cohort Study. J Inflamm Res 2024; 17:1095-1104. [PMID: 38384373 PMCID: PMC10880458 DOI: 10.2147/jir.s443940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
Background To explore the association between the number of missing teeth and the prevalence of hyperlipidemia in a Chinese adult population. Methods 13,932 adults were investigated in the TCLSIH cohort study. The number of missing teeth was determined at baseline through a self-reported questionnaire, and then classified into three categories: 0, 1-2, and ≥3. We defined hyperlipidemia as total cholesterol (TC) ≥ 5.17 mmol/L or triglycerides (TG) ≥ 1.7 mmol/L or low-density lipoprotein (LDL) cholesterol ≥ 3.37 mmol/L or a self-report of physician-diagnosed hyperlipidemia during follow-up visits. Cox proportional-hazards regression models were employed to assess the relationship between the number of missing teeth and incident hyperlipidemia. Results A total of 6756 first-incident cases of hyperlipidemia occurred during 42,048 person-years of follow-up (median follow-up, 4.2 years). After adjusted confounders, multivariable HRs and 95% CI for incident of hyperlipidemia across the categories of missing teeth were as follows: in male participants, 1.00 (reference), 1.10 (0.98, 1.22), and 1.03 (0.91, 1.16) (P for trend = 0.30); in female participants, 1.00 (reference), 1.09 (0.99, 1.19), and 1.18 (1.04, 1.33) (P for trend < 0.01). Conclusion The number of missing teeth is associated with an increased risk of hyperlipidemia in female participants but not in male participants. Systemic chronic inflammation may potentially mediate this association.
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Affiliation(s)
- Feng Qiao
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Hong Guo
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Jing Zhang
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, People’s Republic of China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Changyi Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
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Herrero F, de Souza RF, Feine JS, Alexander PP, Green AV, Oates TW. The impact of implant-retained overdentures on type-2 diabetic and non-diabetic edentulous patients: Satisfaction and quality of life in a prospective cohort study. J Dent 2022; 127:104357. [PMID: 36351489 PMCID: PMC9691604 DOI: 10.1016/j.jdent.2022.104357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration. MATERIALS AND METHODS This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025). RESULTS At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups. CONCLUSIONS Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion. CLINICAL SIGNIFICANCE As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.
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Affiliation(s)
- Frances Herrero
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States
| | - Raphael F de Souza
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Peggy P Alexander
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Adriana Vargas Green
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Thomas W Oates
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States.
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袁 临, 马 利, 刘 润, 齐 伟, 张 栌, 王 贵, 王 宇. [Computer simulation of molecular docking between methylene blue and some proteins of Porphyromonas gingivalis]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:23-30. [PMID: 35165464 PMCID: PMC8860636 DOI: 10.19723/j.issn.1671-167x.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To study the binding target of photosensitizer and bacteria in antimicrobial photodynamic therapy with computer-simulated target prediction and molecular docking research methods and to calculate the binding energy. METHODS The protein names of Porphyromonas gingivalis (Pg) were obtained and summarized in Uniprot database and RCSB PDB database; the structure diagrams of methy-lene blue were screened in SciFinder database, PubChem database, ChemSpider database, and Chemical Book, and ChemBioDraw software was used to draw and confirm the three-dimensional structure for target prediction and Cytoscape software was used to build a visual network diagram; a protein interaction network was searched and built between the methylene blue target and the common target of Pg in the String database; then we selected FimA, Mfa4, RgpB, and Kgp K1 proteins, used AutoDock software to calculate the docking energy of methylene blue and the above-mentioned proteins and performed molecular docking. RESULTS The target prediction results showed that there were 19 common targets between the 268 potential targets of methylene blue and 1 865 Pg proteins. The 19 targets were: groS, radA, rplA, dps, fabH, pyrG, thyA, panC, RHO, frdA, ileS, bioA, def, ddl, TPR, murA, lepB, cobT, and gyrB. The results of the molecular docking showed that methylene blue could bind to 9 sites of FimA protein, with a binding energy of -6.26 kcal/mol; with 4 sites of Mfa4 protein and hydrogen bond formation site GLU47, and the binding energy of -5.91 kcal/mol, the binding energy of LYS80, the hydrogen bond forming site of RgpB protein, was -5.14 kcal/mol, and the binding energy of 6 sites of Kgp K1 protein and the hydrogen bond forming site GLY1114 of -5.07 kcal/mol. CONCLUSION Computer simulation of target prediction and molecular docking technology can initially reveal the binding, degree of binding and binding sites of methylene blue and Pg proteins. This method provides a reference for future research on the screening of binding sites of photosensitizers to cells and bacteria.
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Affiliation(s)
- 临天 袁
- 北京大学口腔医学院·口腔医院综合科, 国家口腔疾病临床医学研究中心, 口腔数字化医疗技术和材料国家工程实验室, 口腔数字医学北京市重点实验室,北京 100081Department of General Medicine, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 利沙 马
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 润园 刘
- 大连医科大学口腔医学院牙体牙髓科,辽宁大连 116044Department of Endodontics, College of Stomatology, Dalian Medical University, Dalian 116044, Liaoning, China
| | - 伟 齐
- 北京大学口腔医学院·口腔医院综合科, 国家口腔疾病临床医学研究中心, 口腔数字化医疗技术和材料国家工程实验室, 口腔数字医学北京市重点实验室,北京 100081Department of General Medicine, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 栌丹 张
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院门诊部,北京 100081First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 贵燕 王
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院儿童口腔科,北京 100081Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 宇光 王
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Salhi L, Rijkschroeff P, Van Hede D, Laine ML, Teughels W, Sakalihasan N, Lambert F. Blood Biomarkers and Serologic Immunological Profiles Related to Periodontitis in Abdominal Aortic Aneurysm Patients. Front Cell Infect Microbiol 2022; 11:766462. [PMID: 35096635 PMCID: PMC8798408 DOI: 10.3389/fcimb.2021.766462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background Periodontitis is a chronic inflammatory gum disease associated with systemic diseases such as cardiovascular diseases. Aim To investigate the association of systemic blood biomarkers, C-reactive protein (CRP), levels of lipopolysaccharide (LPS), and IgG levels against periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) with the stability, based on the aortic diameter, the growth rate and the eligibility for surgical intervention, of patients with abdominal aortic aneurysm (AAA). Methods Patients with stable AAA (n = 30) and unstable AAA (n = 31) were recruited. The anti-A. actinomycetemcomitans and anti-P. gingivalis IgG levels were analyzed by ELISA, the LPS analysis was performed by using the limulus amebocyte lysate (LAL) test, and plasma levels of CRP were determined using an immune turbidimetric method. The association between these blood systemic biomarkers, AAA features, periodontal clinical parameters and oral microbial profiles were explored. Regression models were used to test the relationship between variables. Results The presence of antibodies against Pg and Aa, LPS and high CRP concentrations were found in all AAA patients. The IgG levels were similar in patients with stable and unstable AAA (both for Aa and Pg). Among investigated blood biomarkers, only CRP was associated with AAA stability. The amount of LPS in saliva, supra, and subgingival plaque were significantly associated with the systemic LPS (p <0.05). Conclusions This post-hoc study emphasizes the presence of antibodies against Pg and Aa, LPS and high CRP concentrations in all AAA patients. The presence of Pg in saliva and subgingival plaque was significantly associated with the blood LPS levels. For further studies investigating periodontitis and systemic diseases, specific predictive blood biomarkers should be considered instead of the use of antibodies alone.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
- *Correspondence: Leila Salhi, ; orcid.org/0000-0003-3529-8452
| | - Patrick Rijkschroeff
- Department of Periodontology , Academic Centre for Dentistry Amsterdam, Vrije Universiteit (VU) Amsterdam, Amsterdam, Netherlands
| | - Dorien Van Hede
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
| | - Marja L. Laine
- Department of Periodontology , Academic Centre for Dentistry Amsterdam, Vrije Universiteit (VU) Amsterdam, Amsterdam, Netherlands
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Liège, Belgium
| | - France Lambert
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
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Fukushima T, Yonetsu T, Aoyama N, Tashiro A, Niida T, Shiheido-Watanabe Y, Maejima Y, Isobe M, Iwata T, Sasano T. Effect of Periodontal Disease on Long-Term Outcomes After Percutaneous Coronary Intervention for De Novo Coronary Lesions in Non-Smokers. Circ J 2021; 86:811-818. [PMID: 34789614 DOI: 10.1253/circj.cj-21-0720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to investigate the effect of periodontal disease (PD) on the outcomes of patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI).Methods and Results:The study included 77 consecutive non-smoking patients with de novo coronary lesions treated with a drug-eluting stent (DES). Periodontal measurements, including the community periodontal index (CPI), were performed by independent periodontists. A CPI score of ≥3 was used to define PD. The occurrence of major adverse cardiac events (MACEs), which were defined as a composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization, or non-target lesion revascularization, was compared between patients with and without PD. Of the 77 patients, 49 (63.6%) exhibited a CPI score of 3 or 4 and were assigned to the PD group. The remaining 28 patients (36.4%) were assigned to the non-PD group. Baseline clinical characteristics and angiographic findings were comparable between the 2 groups. MACEs occurred in 13 (26.5%) of the PD patients and 2 (7.1%) of the non-PD patients. Kaplan-Meier analysis showed a significantly lower MACE-free survival rate in the PD group than for the non-PD group (P=0.034). CONCLUSIONS PD at baseline was associated with an increased risk of MACEs in CAD patients who were treated with a DES for de novocoronary lesions.
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Affiliation(s)
- Taku Fukushima
- Department of Cardiovascular Medicine, Shin-Yurigaoka General Hospital.,Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University
| | - Akira Tashiro
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Takayuki Niida
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | | | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University.,Sakakibara Heart Institute
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
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Raju K, Taylor GW, Tahir P, Hyde S. Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review. BMC Endocr Disord 2021; 21:205. [PMID: 34663281 PMCID: PMC8524900 DOI: 10.1186/s12902-021-00830-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults. BACKGROUND Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status. MATERIAL AND METHODS Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements. RESULTS Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. CONCLUSIONS/PRACTICAL IMPLICATIONS This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.
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Affiliation(s)
- Karen Raju
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - Peggy Tahir
- University of California, UCSF Library, 530 Parnassus Ave, San Francisco, CA 94143-0840 USA
| | - Susan Hyde
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
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Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke. Stroke Res Treat 2021; 2021:5402764. [PMID: 34531969 PMCID: PMC8440111 DOI: 10.1155/2021/5402764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Methods Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology (p = 0.028). There was a trend (OR 7.122; p = 0.083) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.
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Gao S, Tian J, Li Y, Liu T, Li R, Yang L, Xing Z. Periodontitis and Number of Teeth in the Risk of Coronary Heart Disease: An Updated Meta-Analysis. Med Sci Monit 2021; 27:e930112. [PMID: 34421117 PMCID: PMC8394608 DOI: 10.12659/msm.930112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background A positive link between periodontitis and chronic systemic disease has been indicated. However, few studies focused on the loss of teeth. Our analysis aims to analyze the relationship of periodontitis and number of teeth with the risk of coronary heart disease (CHD). Material/Methods A meta-analysis was conducted on qualified data extracted from the PubMed, Embase, and Cochrane Library databases. Only cohort studies were included in this study. We screened articles that assessed the periodontal condition and teeth number as well as the incidence or mortality of CHD. Hazard ratio (HR) and relative risk (RR) were calculated by Stata SE software. Results A total of 11 prospective studies with over 200 000 total participants were analyzed. Ten studies reported on periodontitis and CHD, and 4 studies included data on number of teeth. After adjusting for multivariate factors, there was a significant association between periodontitis and the risk of CHD (RR, 1.18; 95% confidence interval [CI], 1.10–1.26); the RR of CHD in the edentulous population was 1.20 (95% CI, 1.08–1.34). Moreover, results on the RR values for number of teeth were as follows: 24–17 teeth (RR, 1.12; 95% CI, 1.05–1.19); 16–11 (RR, 1.28; 95% CI, 1.15–1.42); and ≤10 (RR, 1.55; 95% CI, 1.43–1.69). Conclusions Our study showed that periodontitis is a risk factor for CHD and that the number of removed teeth is positively correlated with the risk of CHD. During clinical assessment, both factors need to be considered as factors associated with cardiovascular risks.
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Affiliation(s)
- Shuting Gao
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Jinhui Tian
- Center of Evidence-Based Medicine, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Yiting Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Tingjie Liu
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Ruiping Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Lan Yang
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Zhankui Xing
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
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10
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Association between periodontal disease and tooth loss and mortality in an elderly Chinese population. Aging Clin Exp Res 2020; 32:2375-2382. [PMID: 32020486 DOI: 10.1007/s40520-019-01446-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/11/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Poor oral health is a risk indicator of poor quality of life and mortality. However, whether these associations remain potent in elderly subjects after adequately considering the confounding factors is not yet clearly elucidated. The present study aimed to investigate the associations between periodontal disease and tooth loss and total mortality and cardiovascular disease (CVD) outcomes in the elderly > 75 years old. METHODS A total of 1385 individuals, receiving periodontal treatment in Shanghai, participated in this retrospective study. Data on oral status were obtained from radiographs to calculate the proportion of residual bone. The information about mortality was collected from the Shanghai Municipal Center for Disease Control and Prevention (SCDC). Univariate Cox proportional hazards model, multivariable-adjusted model, and competing risk hazard model were used to analyze the association between periodontal disease or tooth loss and mortality. RESULTS Those with severe periodontitis were associated with higher risk of total mortality than healthy individuals [hazard ratio (HR) = 1.48, 95% confidence interval (95% CI) 1.11-1.98]. Further, missing teeth increased the risk of total mortality (HR = 1.02, 95% CI 1.01-1.03). However, no significant difference was detected in the association between periodontitis or tooth loss and CVD mortality. In competing risk hazard model, an increased risk was observed for other-cause mortality, not CVD mortality, in those with severe periodontitis and missing teeth. CONCLUSION Periodontal diseases and tooth loss were the potential predictors of total mortality even after adjustment for confounding factors. However, these were not independent indicators for CVD mortality.
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11
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Herrera D, Molina A, Buhlin K, Klinge B. Periodontal diseases and association with atherosclerotic disease. Periodontol 2000 2020; 83:66-89. [PMID: 32385870 DOI: 10.1111/prd.12302] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases still account for the majority of deaths worldwide, although significant improvements in survival, after being affected by cardiovascular disease, have been achieved in the last decades. Periodontal diseases are also a common global burden. Several studies have shown a link between cardiovascular disease and periodontitis, although evidence is still lacking regarding the direct cause-effect relation. During the 2012 "Periodontitis and systemic diseases" workshop, the available evidence on the association between cardiovascular and periodontal diseases was discussed, covering biologic plausibility and clinical studies. The objective of the present narrative review was to update the previous reviews presented at the 2012 workshop, following similar methodological approaches, aiming to critically assess the available evidence. With regard to biologic plausibility, two aspects were reviewed: (a) for microbiologic mechanisms, assessing periodontal bacteria as a contributing factor to atherosclerosis based on seven "proofs," substantial evidence was found for Proofs 1 through 6, but not for Proof 7 (periodontal bacteria obtained from human atheromas can cause atherosclerosis in animal models), concluding that periodontal pathogens can contribute to atherosclerosis; (b) mechanistic studies, addressing five different inflammatory pathways that could explain the links between periodontitis and cardiovascular disease with the addition of some extra pathways , suggest an association between both entities, based on the presence of higher levels of these inflammatory markers in patients with periodontitis and cardiovascular disease, vs healthy controls, as well as on the evidence that periodontal treatment reduces serum levels of these mediators. When evidence from clinical studies was analyzed, two aspects were covered: (a) epidemiologic studies support the estimation that the incidence of atherosclerotic disease is higher in individuals with periodontitis than in individuals with no reported periodontitis, irrespective of many common risk factors, but with a substantial variability in the definitions used in reporting of exposure to periodontal diseases in different studies; (b) intervention trials have shown that periodontal therapy can reduce serum inflammatory mediators, improve the lipids profile, and induce positive changes in other cardiovascular disease surrogate measures, but no evidence is available to support that adequate periodontal therapy is able to reduce the risk for cardiovascular diseases, or the incidence of cardiovascular disease events in periodontitis patients.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Kare Buhlin
- Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bjorn Klinge
- Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
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12
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Beck JD, Philips K, Moss K, Sen S, Morelli T, Preisser J, Pankow J. Periodontal disease classifications and incident coronary heart disease in the Atherosclerosis Risk in Communities study. J Periodontol 2020; 91:1409-1418. [PMID: 32449797 DOI: 10.1002/jper.19-0723] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/13/2020] [Accepted: 03/25/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Periodontal disease has been linked to coronary heart disease (CHD), but studies have been inconclusive. This study investigates the link between periodontal disease and incident CHD. METHODS Baseline periodontal data from a full-mouth periodontal exam (N = 6,300) and CHD outcomes through 2017 were obtained from the Atherosclerosis Risk in Communities Study. Periodontitis was defined by the Periodontal Profile Class System adapted to Stages (PPC stages) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) index. Competing risk models were used to determine hazard ratios (HR) for incident CHD, congestive heart failure (CHF), and other causes of death. Secondary analysis included myocardial infarction (MI) and fatal CHD. RESULTS Females comprised 56% of participants and males 44% with a combined mean age of 62.3 years (range: 52 to 74). Participants were followed for an average of 16.7 (SD: 5.5) years. In a fully adjusted model, PPC stage VII (Severe Tooth Loss) was moderately significantly related to incident CHD, (HR 1.51 [1.11 to 2.09]). PPC stage V (Mild Tooth Loss/High Gingival Inflammation) was significant for fatal CHD (HR, 5.27 [1.80 to 15.4]) and PPC stage VII was significant for incident MI (HR, 1.59 [1.13 to 2.23]). The CDC/AAP definition was not significantly associated with incident CHD. CONCLUSIONS Incident CHD was moderately significantly associated with a specific stage of periodontal disease characterized by severe tooth loss, while none of the categories of the CDC/AAP were significantly associated. Thus, while periodontal therapy may improve oral health, it may be effective at impacting CHD incidence in only certain groups of people.
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Affiliation(s)
- James D Beck
- Division of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kamaira Philips
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Souvik Sen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Thiago Morelli
- Division of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - John Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - James Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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13
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Lund Håheim L, Schwarze PE, Thelle DS, Nafstad P, Rønningen KS, Olsen I. Low levels of antibodies for the oral bacterium Tannerella forsythia predict cardiovascular disease mortality in men with myocardial infarction: A prospective cohort study. Med Hypotheses 2020; 138:109575. [PMID: 32088522 DOI: 10.1016/j.mehy.2020.109575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/01/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Abstract
Antibody levels to periodontal pathogens in prediction of cardiovascular disease (CVD) mortality were explored using data from a health survey in Oslo in 2000 (Oslo II-study) with 12 1/2 years follow-up. IgG antibodies to four common periodontal pathogens; Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD) all termed collectively the "red complex", and Aggregatibacter actinomycetemcomitans(AA) were analysed. The study sample consisted of 1172 men drawn from a cohort of 6,530 men who participated in the Oslo II-study, where they provided information on medical and dental history. Of the study sample, 548 men had reported prior myocardial infarction (MI) at baseline whereas the remaining 624 men were randomly drawn from the ostensibly healthy participants for comparative analyses. Dental anamnestic information included tooth extractions and oral infections. An inverse relation was found for trend by the quartile risk level of TF predicting CVD mortality, p-value for trend = 0.017. Comparison of the first to fourth quartile of TF antibodies resulted in hazard ratio (HR) = 1.82, 95% confidence interval 1.12-2.94, p = 0.015, adjusted for age, education, diabetes, daily smoking, and systolic blood pressure. Specificity comparing decile 1 to deciles 2-10 of TF predicting mortality was 92.3%. We found an increased HR by low levels of antibodies to the bacterium T. forsythia predicting CVD mortality in a 12 ½ years follow-up in persons who had experienced an MI but not among non-MI men. This novel finding constitutes a plausible causal link between oral infections and CVD mortality.
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Affiliation(s)
- Lise Lund Håheim
- Department of Oral Biology, Dental Faculty, University of Oslo, Norway.
| | - P E Schwarze
- Norwegian Institute for Public Health, Oslo, Norway
| | - D S Thelle
- Institute of Basic Medical Sciences, Medical Faculty, University of Oslo, Norway; Department of Community Medicine and Public Health, University of Gothenburg, Sweden
| | - P Nafstad
- Norwegian Institute for Public Health, Oslo, Norway; Institute of Health and Society, Medical Faculty, University of Oslo, Norway
| | - K S Rønningen
- Department of Paediatric Research, Division for Women and Children, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - I Olsen
- Department of Oral Biology, Dental Faculty, University of Oslo, Norway
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14
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Pietropaoli D, Del Pinto R, Ferri C, Ortu E, Monaco A. Definition of hypertension‐associated oral pathogens in NHANES. J Periodontol 2019; 90:866-876. [DOI: 10.1002/jper.19-0046] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Davide Pietropaoli
- Department of LifeHealth and Environmental SciencesSan Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
| | - Rita Del Pinto
- Department of LifeHealth and Environmental SciencesSan Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
| | - Claudio Ferri
- Department of LifeHealth and Environmental SciencesSan Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
| | - Eleonora Ortu
- Department of LifeHealth and Environmental SciencesSan Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
| | - Annalisa Monaco
- Department of LifeHealth and Environmental SciencesSan Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
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15
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Yang S, Zhao LS, Cai C, Shi Q, Wen N, Xu J. Association between periodontitis and peripheral artery disease: a systematic review and meta-analysis. BMC Cardiovasc Disord 2018; 18:141. [PMID: 29980169 PMCID: PMC6035462 DOI: 10.1186/s12872-018-0879-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/02/2018] [Indexed: 12/26/2022] Open
Abstract
Background Inflammation is a common feature of both peripheral arterial disease (PAD) and periodontitis. Some studies have evaluated the association between PAD and periodontitis. However, there is still no specialized meta-analysis that has quantitatively assessed the strength of the association. Thus, we conducted this meta-analysis to critically assess the strength of the association between PAD and periodontitis. Methods PubMed, Embase, and the Cochrane Library were searched for observational studies of the association between periodontitis and PAD in February 2018. Risk ratios (RRs) and their 95% confidence intervals (CIs) from included studies were pooled to evaluate the strength of the association between periodontitis and PAD. Weighted mean differences (WMDs) and their 95% CIs were pooled to compare the difference in periodontal-related parameters between PAD and non-PAD patients. Results Seven studies including a total of 4307 participants were included in the meta-analysis. The pooled analysis showed that there was a significant difference in the risk of periodontitis between PAD patients and non-PAD participants (RR = 1.70, 95% CI = 1.25–2.29, P = 0.01). There was also a significant difference in number of missing teeth between PAD patients and non-PAD participants (WMD = 3.75, 95% CI = 1.31–6.19, P = 0.003). No significant difference was found in clinical attachment loss between PAD patients and non-PAD participants (WMD = − 0.05, 95% CI = − 0.03–0.19, P = 0.686). Conclusion In conclusion, the results of this meta-analysis revealed a significant relationship between periodontitis and PAD. Moreover, our study indicated that PAD patients had more missing teeth than control subjects did. Further high-quality and well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusions of this study. Electronic supplementary material The online version of this article (10.1186/s12872-018-0879-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shuo Yang
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Li Sheng Zhao
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Chuan Cai
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Quan Shi
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ning Wen
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Juan Xu
- Department of Stomatology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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