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Parsegian K, Himmelfarb J, Fares G, Ioannidou E. Fistula first, catheter last: can the mouth be second? FRONTIERS IN NEPHROLOGY 2024; 4:1385544. [PMID: 38846514 PMCID: PMC11153809 DOI: 10.3389/fneph.2024.1385544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/15/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Karo Parsegian
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jonathan Himmelfarb
- Center for Kidney Disease Innovation Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - George Fares
- Baystate Medical Center, Springfield, MA, United States
| | - Effie Ioannidou
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
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Menezes CCD, Barbirato DDS, Fogacci MF, Marañón-Vásquez GA, Carneiro JRI, Maia LC, Barros MCMD. Systemic benefits of periodontal therapy in patients with obesity and periodontitis: a systematic review. Braz Oral Res 2024; 38:e031. [PMID: 38597549 DOI: 10.1590/1807-3107bor-2024.vol38.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/09/2023] [Indexed: 04/11/2024] Open
Abstract
This systematic review aimed to answer the focused question: "What are the benefits of subgingival periodontal therapy on blood hematological and biochemical index, biomarkers of inflammation and oxidative stress, quality of life, and periodontal pathogen counts in patients with obesity and periodontitis?". A systematic literature search was performed in six databases: PubMed, Embase, LILACS, Web of Science, Cochrane and SCOPUS and other sources, and a manual search was conducted as well. Inclusion criteria were randomized and non-randomized clinical trials, and before-and-after studies on patients with obesity subjected to periodontal therapy. The results were synthesized qualitatively. Risk of bias within studies was assessed using RoB 2 and ROBINS-I tools. The certainty of evidence was evaluated following the GRADE approach. Three randomized controlled trials and 15 before-and-after studies were included. Randomized controlled trials were considered to have a low risk of bias, as compared to before-and-after studies assessed as having low, serious, and critical risks of bias. Non-surgical periodontal therapy plus azithromycin, chlorhexidine, and cetylpyridinium chloride reduced blood pressure and decreased serum levels of HbA1c, hsCRP, IL-1β, and TNF-α. Salivary resistin level also decreased in patients with obesity and periodontitis after therapy and chlorhexidine mouth rinse. Before-and-after data suggest an improvement in total cholesterol, LDL, triglycerides, insulin resistance, C3, GCF levels of TNF-α, chemerin, vaspin, omentin-1, visfatin, 8-OHdG, and periodontal pathogen counts after therapy.
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Affiliation(s)
- Cláudia Callegaro de Menezes
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Davi da Silva Barbirato
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Mariana Fampa Fogacci
- Universidade Federal de Pernambuco - UFPE, Department of Clinical and Preventive Dentistry, Recife, PE, Brazil
| | | | - João Régis Ivar Carneiro
- Universidade Federal do Rio de Janeiro - UFRJ, Clementino Fraga Filho Hospital University, Department of Nutrology/Bariatric Surgery, Rio de Janeiro, RJ, Brazil
| | - Lucianne Copple Maia
- Universidade Federal do Rio de Janeiro - UFRJ, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
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Yin X, Wu Y, Song J. Investigating the causal relationship between human blood/urine metabolites and periodontal disease using two-sample Mendelian randomization. Health Sci Rep 2024; 7:e1895. [PMID: 38469110 PMCID: PMC10925816 DOI: 10.1002/hsr2.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/07/2023] [Accepted: 01/31/2024] [Indexed: 03/13/2024] Open
Abstract
Background and Aims The aim is to investigate the cause-and-effect connection between metabolites found in blood/urine and the likelihood of developing periodontal disease (PD) through the utilization of a two-sample Mendelian randomization (MR) method. Methods Using an inverse variance weighted (IVW) method and two additional two-sample MR models, we examined the relationship between blood/urine metabolites and PD by analyzing data from a comprehensive metabolome-based genome-wide association study and the Genome-Wide Association Studies (GWAS) of PD. To assess the consistency and dependability of the findings, diversity, cross-effects, and sensitivity analyses were conducted. Results Out of the 35 metabolites found in blood and urine, a total of eight metabolites (C-reactive protein, Potassium in urine, Urea, Cystatin C, Non-albumin protein, Creatinine, estimated Glomerular Filtration Rate, and Phosphate) displayed a possible causal connection with the risk of dental caries/PD using the inverse variance weighted (IVW) method (p < 0.05). This includes five metabolites in the blood and three in the urine. No metabolites were statistically significant in IVW MR models (p < 3.68 × 10- 4). Even after conducting sensitivity analysis with the leave-one-out method and removing the confounding instrumental variables, the impact of these factors on dental caries/PD remained significant. Conclusion Based on the available evidence, it is not possible to establish a significant causal link between the 35 blood metabolites and the likelihood of developing dental caries and PD.
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Affiliation(s)
- Xinhai Yin
- Department of Oral and Maxillofacial SurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Yadong Wu
- Department of Oral and Maxillofacial SurgeryThe Affiliated Stomatological Hospital of Guizhou Medical UniversityGuiyangChina
| | - Jukun Song
- Department of Oral and Maxillofacial SurgeryThe Affiliated Stomatological Hospital of Guizhou Medical UniversityGuiyangChina
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Aguiar ILS, Santos-Lins LS, Brasil-Oliveira R, Cotrim HP, Lins-Kusterer L. Non-alcoholic fatty liver disease and periodontal disease: A systematic review and meta-analysis of cross-sectional studies. Arab J Gastroenterol 2023; 24:198-203. [PMID: 37993376 DOI: 10.1016/j.ajg.2023.09.005] [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: 03/23/2022] [Revised: 08/13/2022] [Accepted: 09/07/2023] [Indexed: 11/24/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, comprising hepatic steatosis, and non-alcoholic steatohepatitis. Periodontal disease (PD) may be a risk factor for the evolution of liver cirrhosis. This study aimed to evaluate the association between NAFLD and PD.We searched in Pubmed, Scopus, Cochrane, and Lilacs databases with descriptors (Non-alcoholic Fatty Liver Disease OR (non-alcoholic AND Fatty Liver AND disease) OR Nonalcoholic Steatohepatitis) AND (Periodontal Disease OR Gingivitis OR Periodontitis) from January 2021 to September 2021. We selected, by the abstract, cross-sectional, cohort (prospective and retrospective), and case-control studies that address periodontal disease in patients with Non-alcoholic Fatty Liver Disease, and aged ≥ 18 years. The search was without the restriction of language and publication time.The search resulted in 954 articles. After applying the selection criteria, five cross-sectional studies remained. A metanalysis combined the study estimates of periodontal disease in NAFLD, by using the random effects. The Odds Ratio (1.91; 95% CI 1.21-3.02; P = 0.006) indicates that the chance of presenting Periodontal disease is 91% higher in individuals with NAFLD when compared with individuals without NAFLD. There are few studies with appropriate methodology to produce sound evidence about the causal relationship between the use of NAFLD and PD, however, studies support the association. So, dental staff must be aware of this association for better management of periodontal disease in patients with NAFLD.
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Affiliation(s)
- Inácio Lima Silva Aguiar
- Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Larissa Souza Santos-Lins
- Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rebeca Brasil-Oliveira
- Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Helma Pinchemel Cotrim
- Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Liliane Lins-Kusterer
- Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.
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Bunte K, Wiessner C, Bahat G, Erdogan T, Cruz-Jentoft AJ, Zapf A. Association of periodontitis with handgrip strength and skeletal muscle mass in middle-aged US adults from NHANES 2013-2014. Aging Clin Exp Res 2023; 35:1909-1916. [PMID: 37386343 PMCID: PMC10460310 DOI: 10.1007/s40520-023-02471-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES The relationship between periodontitis and sarcopenia parameters in middle-aged adults is largely unexplored. This study investigated the association between periodontitis and combined handgrip strength and skeletal muscle mass in middle-aged adults. MATERIALS AND METHODS A sub-cohort of 1912 individuals with complete periodontal and whole-body dual X-ray absorptiometry examinations from the 2013-2014 wave of the National Health and Nutrition Examination Survey (n = 10,175) were analyzed using fully adjusted multiple linear regression models for associations between periodontitis and skeletal muscle mass index (kg/m2) and combined handgrip strength (kg). RESULTS The mean age of the study cohort was 43 (± 8.4) years and 49.4% of the participants were male. In total, 612 participants (32%) were determined to have periodontitis, of which 513 (26.8%) had non-severe (mild or moderate) periodontitis, and 99 (5.2%) had severe periodontitis. In unadjusted regression models, both non-severe and severe periodontitis were associated with SMMI (βnon-severe = 1.01, 95% CI 0.50; 1.52 and βsevere = 1.42, 95% CI 0.59; 2.25) but not with cHGS. After adjusting for age, sex, education, body mass index, bone mineral density, diabetic status, education, total energy intake, total protein intake, and serum vitamin D2 + D3, periodontitis was associated with cHGS (βnon-severe = -2.81, 95% CI - 4.7; - 1.15 and βsevere = - 2.73, 95% CI - 6.31; 0.83). The association between periodontitis and SMMI remained for non-severe periodontitis (βnon-severe = 0.07, 95% CI - 0.26; 0.40 and βsevere = 0.22, 95% CI - 0.34; 0.78). CONCLUSION The present study highlights the need of further prospective research to investigate the nature and direction of the relationship between periodontitis and sarcopenia indicators. Future studies can support the screening, prevention and clinical management of sarcopenia and periodontitis, and emphasize the interdisciplinary and complementary approach between the disciplines of geriatric medicine and periodontology.
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Affiliation(s)
- Kübra Bunte
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany.
| | - Christian Wiessner
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany
| | - Gülistan Bahat
- Department of Internal Medicine, Istanbul Medical Faculty, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Tugba Erdogan
- Department of Internal Medicine, Istanbul Medical Faculty, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | | | - Antonia Zapf
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany
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Chen Z, Deng H, Sun K, Huang Z, Wei S, Lin Y, Song Z, Liu Y. Prevalence of chronic periodontitis in patients undergoing peritoneal dialysis and its correlation with peritoneal dialysis-related complications. BMC Nephrol 2023; 24:71. [PMID: 36964507 PMCID: PMC10039550 DOI: 10.1186/s12882-023-03102-8] [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: 10/09/2022] [Accepted: 03/02/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVE The microinflammatory state can influence the occurrence of dialysis-related complications in dialysis patients. Chronic periodontitis (CP), in which plaque biofilm is considered to be the initiating factor, is a chronic infectious disease in the oral cavity. It is still uncertain whether CP affects the microinflammatory state in peritoneal dialysis (PD) and the occurrence of dialysis-related complications. The purpose of this study was to investigate the correlation between the periodontal index and clinical parameters in peritoneal dialysis patients with CP and dialysis-related complications, including peritoneal dialysis-associated peritonitis (PDAP) and cardiovascular and cerebrovascular events (CCEs). METHODS This was a retrospective cohort study, and 76 patients undergoing PD were enrolled. Clinical parameters, the occurrence of PD-related complications and periodontitis-related indicators, including the gingival index (GI), plaque index (PLI), probing depth (PPD) and clinical attachment loss (CAL), were collected. Correlation analysis was used to explore the correlation between periodontal or clinical parameters and the occurrence of PD-related complications. RESULTS All the patients had different degrees of periodontitis (mild 9.2%, moderate 72.4%, severe 18.4%); PPD was inversely related to serum albumin (r = - 0.235, p = 0.041); CAL has a positive correlation with serum C-reactive protein (rs = 0.242, p = 0.035); PLI was positively correlated with serum calcium (r = 0.314, p = 0.006). ANOVA, multivariate logistic regression analysis and Kaplan-Meier Survival curve suggested that CAL was a risk factor for the occurrence of PDAP. There was no correlation between periodontal parameters and CCEs or poor prognosis. CONCLUSION CP is universally present in PD patients, and the presentation of periodontitis influences the systemic inflammatory state in PD patients. CP is a risk factor for PDAP.
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Affiliation(s)
- Zhihao Chen
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hai Deng
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kristine Sun
- Department of Periodontology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zehui Huang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shan Wei
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunyao Lin
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhongchen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yingli Liu
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Nakai S, Suzuki F, Okamoto S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Nakamura H. Association between Bone Mineral Density and Oral Frailty on Renal Function: Findings from the Shika Study. Healthcare (Basel) 2023; 11:314. [PMID: 36766889 PMCID: PMC9913924 DOI: 10.3390/healthcare11030314] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
The association between oral frailty (OFr) and body action has been investigated, but its association with systemic function remains unclear. Therefore, this cross-sectional study examined the association between OFr with decreased bone mineral density (BMD) and renal function in residents of Shika town, Ishikawa Prefecture, Japan aged ≥40 years. This study included 400 inhabitants. The OFr total score was assessed using three oral domains in the Kihon Checklist (a self-reported comprehensive health checklist), the number of teeth, and brushing frequency per day. Measurements were the estimated glomerular filtration rate (eGFR) and the osteo-sono assessment index (OSI). Using a two-way analysis of covariance (p = 0.002), significantly lower OSI was indicated in the eGFR < 60 and OFr group than in the eGFR of < 60 and non-OFr group after adjusting for age, body mass index, and drinking and smoking status as confounding factors. Multiple logistic regression analysis confirmed this relationship (p = 0.006). Therefore, lower BMD seems to be associated with lower renal function only when accompanied by OFr. Further longitudinal studies are needed to confirm these results.
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Affiliation(s)
- Shingo Nakai
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Japan
| | - Shigefumi Okamoto
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa 920-0942, Japan
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, 14-1 Mukaimotorimachi, Komatsu 923-0961, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, 2500 Hassaka-cho, Hikone 522-8533, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kohasu, Oko-cho, Nankoku 783-8505, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
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Baciu SF, Mesaroș AȘ, Kacso IM. Chronic Kidney Disease and Periodontitis Interplay-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1298. [PMID: 36674052 PMCID: PMC9859404 DOI: 10.3390/ijerph20021298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Periodontitis (PO), a chronic microbially-induced inflammation of the supporting tissues of the tooth, is linked to various systemic diseases. We analyze its bidirectional relationship to chronic kidney disease (CKD), a major health-care problem with impressive excess mortality. Overwhelming associative relationship between CKD and PO are analyzed. Major pathophysiologic mechanisms that link CKD to PO are then presented: systemic inflammation, endothelial dysfunction, and imbalance of oxidative stress characteristic of CKD have a role in PO development and might influence escape mechanisms of oral microbiota. Subclinical local and systemic inflammation induced by PO might influence in turn CKD outcomes. Homeostatic changes induced by CKD such as mineral bone disorders, acidosis, uremic milieu, or poor salivary flow are also relevant for the occurrence of PO. There is insufficient evidence to recommend a standardized diagnostic and therapeutic approach regarding association of PO to CKD.
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Affiliation(s)
- Sorana Florica Baciu
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Anca-Ștefania Mesaroș
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Ina Maria Kacso
- Department of Nephrology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Babes Street, 400012 Cluj-Napoca, Romania
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Localized periodontitis and kidney function for the risk of proteinuria in young adults in the CHIEF oral health study. Sci Rep 2022; 12:19006. [PMID: 36347995 PMCID: PMC9643363 DOI: 10.1038/s41598-022-23843-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022] Open
Abstract
This study aimed to investigate the association of localized periodontitis with proteinuria in 1281 military young adults in Taiwan. Localized periodontitis was classified as Healthy/Stage I (N = 928) or Stage II/III (N = 353). Stage 2 chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) of 60-89 mL/min/1.73 m2. Proteinuria was defined as protein levels of 2+ or 3+ on the dipstick test. Multiple logistic regression analysis with adjustments for age, sex, body mass index, remaining teeth number and other potential covariates were used to determine the association between localized Stage II/III periodontitis and dipstick proteinuria in patients with and without CKD. Localized stage II/III periodontitis was associated with a higher risk of dipstick proteinuria [odds ratio (OR) and 95% confidence interval: 1.89 (1.04-3.42)], but not with stage 2 CKD. However, the association between localized stage II/III periodontitis and dipstick proteinuria was observed only in patients with stage 2 CKD [OR: 3.80 (1.56-9.27)], while the association was null in participants without stage 2 CKD [OR: 1.02 (0.42-2.45)]. Our findings suggest that among young adults, especially those with a mildly impaired eGFR, localized periodontitis might contribute to acute or chronic kidney injury, which manifests as proteinuria.
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Ptasiewicz M, Bębnowska D, Małkowska P, Sierawska O, Poniewierska-Baran A, Hrynkiewicz R, Niedźwiedzka-Rystwej P, Grywalska E, Chałas R. Immunoglobulin Disorders and the Oral Cavity: A Narrative Review. J Clin Med 2022; 11:jcm11164873. [PMID: 36013115 PMCID: PMC9409910 DOI: 10.3390/jcm11164873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
The oral mucosa is a mechanical barrier against the penetration and colonization of microorganisms. Oral homeostasis is maintained by congenital and adaptive systems in conjunction with normal oral flora and an intact oral mucosa. Components contributing to the defense of the oral cavity include the salivary glands, innate antimicrobial proteins of saliva, plasma proteins, circulating white blood cells, keratinocyte products of the oral mucosa, and gingival crevicular fluid. General disturbances in the level of immunoglobulins in the human body may be manifested as pathological lesions in the oral mucosa. Symptoms of immunoglobulin-related general diseases such as mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), linear IgA bullous dermatosis (LABD), Epidermolysis Bullosa Aquisita (EBA), and Hyper-IgE syndrome (HIES) may appear in the oral cavity. In this review, authors present selected diseases associated with immunoglobulins in which the lesions appear in the oral cavity. Early detection and treatment of autoimmune diseases, sometimes showing a severe evolution (e.g., PV), allow the control of their dissemination and involvement of skin or other body organs. Immunoglobulin disorders with oral manifestations are not common, but knowledge, differentiation and diagnosis are essential for proper treatment.
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Affiliation(s)
- Maja Ptasiewicz
- Department of Oral Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | | | - Paulina Małkowska
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
- Doctoral School, University of Szczecin, 71-412 Szczecin, Poland
| | - Olga Sierawska
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
- Doctoral School, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Rafał Hrynkiewicz
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, 20-093 Lublin, Poland
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11
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Lu H, Wu H, Yang Y, Feng X, Ma X, Xie Y, Xie D, Wang W, Lo ECM, Ye W. Relationship between chronic periodontitis and inflammatory cytokines in patients undergoing maintenance hemodialysis. Clin Oral Investig 2022; 26:6699-6709. [PMID: 35861756 DOI: 10.1007/s00784-022-04629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the correlation between serum and gingival crevicular fluid (GCF) levels of inflammatory cytokines and the association with periodontal parameters in patients with maintenance hemodialysis (MHD) and healthy control. MATERIALS AND METHODS Patients who were undergoing MHD were enrolled as the MHD group. Healthy individuals who underwent oral examination were selected as the control group after matching for the MHD group. All participants underwent a full-mouth periodontal evaluation, and the levels of eight inflammatory cytokines, including IL-1β, IL-17, IL-6, IL-8, and tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-8 (MMP-8), and C-reactive protein (CRP), in the GCF and serum were measured. RESULTS A total of 63 MHD patients and 75 healthy persons were included. The prevalence of moderate/severe periodontitis was significantly higher in the MHD group than in the control group (88.9 vs. 66.7%, P < 0.05). The GCF levels of CRP, TNF-α, MCP-1, and MMP-8 were higher in patients in the MHD group with moderate/severe periodontitis than in the control group (P < 0.05). Serum CRP, MCP-1, TNF-α, and MMP-8 levels were positively correlated with the GCF CRP levels (P < 0.05). The GCF and serum CRP levels were positively correlated with the periodontal clinical parameters (P < 0.05). CONCLUSIONS Serum CRP, MCP-1, TNF-α, and MMP-8 may relate with the GCF CRP levels. The GCF and serum CRP levels correlated positively with the periodontal clinical parameters, including the VPI, PPD, and CAL, indicating that CRP may play an important role between periodontitis and ESRD. CLINICAL RELEVANCE The present study indicated that GCF and serum CRP levels correlated positively with the periodontal clinical parameters, and the CRP levels may be selected as an indicator to evaluate the severity of inflammation and the effectiveness, prognosis of periodontal treatment in ESRD patients.
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Affiliation(s)
- Haixia Lu
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Hongyu Wu
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, 356 Beijingdong Road, Shanghai, China
| | - Yuanmeng Yang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiaoxin Ma
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Yingxin Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Danshu Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Wenji Wang
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, University of Hong Kong, 34 Hospital Road, Hong Kong, China
| | - Wei Ye
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China.
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12
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Murtomaa H, Varenne B, Phantumvanit P, Chikte U, Khoshnevisan MH, Fatemi NM, Hessari H, Khami MR. Neglected epidemics: The role of oral public health to advance global health. J Glob Health 2022; 12:02001. [PMID: 35594383 PMCID: PMC9122238 DOI: 10.7189/jogh.12.02001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Heikki Murtomaa
- Department of Oral and Maxillo-facial Diseases, University of Helsinki, Helsinki, Finland
| | - Benoit Varenne
- Department of Non-Communicable diseases, World Health Organization, Geneva, Switzerland
| | | | - Usuf Chikte
- Department of Global Health, University of Stellenbosch, Stellenbosch, South Africa
| | | | | | - Hossein Hessari
- Research Center for Caries Prevention, Dentistry Research Institute, and Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khami
- Research Center for Caries Prevention, Dentistry Research Institute, and Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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13
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The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases. Nutrients 2022; 14:nu14102002. [PMID: 35631140 PMCID: PMC9143067 DOI: 10.3390/nu14102002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 02/01/2023] Open
Abstract
Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.
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14
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Mahendra J, Palathingal P, Mahendra L, Alzahrani KJ, Banjer HJ, Alsharif KF, Halawani IF, Muralidharan J, Annamalai PT, Verma SS, Sharma V, Varadarajan S, Bhandi S, Patil S. Impact of Red Complex Bacteria and TNF-α Levels on the Diabetic and Renal Status of Chronic Kidney Disease Patients in the Presence and Absence of Periodontitis. BIOLOGY 2022; 11:451. [PMID: 35336824 PMCID: PMC8945045 DOI: 10.3390/biology11030451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as Prophyromonas gingivalis (P.g), Treponema denticola (T.d), and Tonerella forsythia (T.f) were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as Pg, Td and Tf levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of P.g, T.d and T.f were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | - Plato Palathingal
- Department of Periodontics, PSM College of Dental Science and Research, Thrissur 680519, India;
| | - Little Mahendra
- Department of Periodontics, Dean, Maktoum Bin Hamdan Dental University, Dubai 122002, United Arab Emirates;
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Hamsa Jameel Banjer
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Khalaf F. Alsharif
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Ibrahim Faisal Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | | | - Shyam Sankar Verma
- Department of Nephrology, Jubilee Medical College Hospital, Thrissur 680005, India;
| | - Vivek Sharma
- Department of Periodontics, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh 114141, India;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
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15
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Toniazzo MP, Amorim PS, Rost JF, Feldman JV, Beretta MV, Rodrigues TC, Weidlich P. Oral condition as a predictor of risk for malnutrition during hospitalization: A cross-sectional study. Nutr Clin Pract 2022; 37:1438-1447. [PMID: 35271739 DOI: 10.1002/ncp.10851] [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: 04/02/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Malnutrition and poor oral health are common conditions in patients in the hospital. Both conditions are associated with poor systemic health. The present study aimed to assess the relationship between the oral condition and the nutrition status of individuals admitted to a large tertiary hospital. METHODS This cross-sectional study evaluated 364 patients who received a comprehensive dental examination at their hospital bed. An examiner recorded visible plaque index, gingival bleeding index, plaque retentive factors, probing depth, clinical attachment loss, bleeding on probing, number of existing teeth, and prosthesis use. Medical status was assessed by the Charlson Comorbidity Index. The nutrition status was evaluated by the Subjective Global Assessment. Crude and adjusted prevalence ratios were estimated by Poisson regression analysis with robust variance. RESULTS Patients with moderate to severe malnutrition presented worse oral hygiene (55.83 ± 25.16 vs 64.90 ± 24.28; P < 0.001), more gingival inflammation (24.31 ± 24.13 vs 33.43 ± 27.36; P < 0.001), higher levels of attachment loss (4.22 ± 1.81 vs 4.80 ± 1.83; P < 0.001), and a lower mean number of teeth (14.58 ± 7.45 vs 10.94 ± 6.85; P < 0.001) than patients without malnutrition. In the multivariable analysis, the number of teeth and higher comorbidity index were associated with malnutrition. CONCLUSIONS Poor oral health and medical condition were associated with malnutrition in this single-institution study, and oral condition may be considered an indicator of malnutrition in patients in the hospital. The implications of this study include the need to raise awareness among health professionals of the importance of oral health and nutrition status in adults.
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Affiliation(s)
- Mirian Paola Toniazzo
- Department of Periodontology, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | - Paula Sant'na Amorim
- Department of Periodontology, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Franciele Rost
- Department of Periodontology, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Mileni Vanti Beretta
- Department of Nutrition, Federal University Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Patricia Weidlich
- Department of Periodontology, Federal University Rio Grande do Sul, Porto Alegre, Brazil
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16
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TNF-α, IL-1β, MMP-8 Crevicular Profile in Patients with Chronic Kidney Disease and Periodontitis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Increasing evidence sustains the potential of periodontitis as a risk factor for chronic kidney disease (CKD). Our study aimed to analyze several periodontal specific inflammatory biomarkers within the gingival crevicular fluid (GCF) of patients with CKD, compared to patients with normal kidney function, providing an inflammatory profile of the dialysis patient. The study comprised 79 patients divided into: group 1 (59 subjects with periodontitis and CKD) and group 2 (20 patients with periodontitis, without other systemic conditions). Clinical diagnosis was performed via dental and periodontal examination. GCF samples were collected from each patient, and the levels of TNF-α, IL-1β and MMP-8 were determined by using ELISA assay. In group 1, the average values were: 22.85 ± 5.87 pg/mL for TNF-α, 33.00 ± 39.68 pg/mL for IL-1β and 18.80 ± 27.75 ng/mL for MMP-8. In group 2, the mean values were: 2.10 ± 1.34 pg/mL for TNF-α, 0.71 ± 2.42 pg/mL for IL-1β and 5.35 ± 0.37 ng/mL for MMP-8. Statistical analysis revealed significant differences between groups as referring to all three biomarkers and, TNF-α and MMP-8, in certain stages of periodontitis. The level of TNF-α, IL-1β and MMP-8 points out the increased inflammatory status of the dialysis patient with PD, supporting the mutual connection of the two pathologies.
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17
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Handsley-Davis M, Kapellas K, Jamieson LM, Hedges J, Skelly E, Kaidonis J, Anastassiadis P, Weyrich LS. Heritage-specific oral microbiota in Indigenous Australian dental calculus. Evol Med Public Health 2022; 10:352-362. [PMID: 36032329 PMCID: PMC9400808 DOI: 10.1093/emph/eoac024] [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: 08/01/2021] [Accepted: 03/26/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objectives
Aboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience a high burden of chronic non-communicable diseases (NCDs). Increased NCD risk is linked to oral diseases mediated by the oral microbiota, a microbial community influenced by both vertical transmission and lifestyle factors. As an initial step towards understanding the oral microbiota as a factor in Indigenous health, we present the first investigation of oral microbiota in Indigenous Australian adults.
Methodology
Dental calculus samples from Indigenous Australians with periodontal disease (PD; n = 13) and non-Indigenous individuals both with (n = 19) and without PD (n = 20) were characterized using 16S ribosomal RNA gene amplicon sequencing. Alpha and beta diversity, differentially abundant microbial taxa and taxa unique to different participant groups were analysed using QIIME2.
Results
Samples from Indigenous Australians were more phylogenetically diverse (Kruskal–Wallis H = 19.86, P = 8.3 × 10−6), differed significantly in composition from non-Indigenous samples (PERMANOVA pseudo-F = 10.42, P = 0.001) and contained a relatively high proportion of unique taxa not previously reported in the human oral microbiota (e.g. Endomicrobia). These patterns were robust to stratification by PD status. Oral microbiota diversity and composition also differed between Indigenous individuals living in different geographic regions.
Conclusions and implications
Indigenous Australians may harbour unique oral microbiota shaped by their long relationships with Country (ancestral homelands). Our findings have implications for understanding the origins of oral and systemic NCDs and for the inclusion of Indigenous peoples in microbiota research, highlighting the microbiota as a novel field of enquiry to improve Indigenous health.
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Affiliation(s)
- Matilda Handsley-Davis
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
- Centre for Australian Biodiversity and Heritage (CABAH), University of Adelaide , Adelaide, SA, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Emily Skelly
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
| | - John Kaidonis
- Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | | | - Laura S Weyrich
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
- Centre for Australian Biodiversity and Heritage (CABAH), University of Adelaide , Adelaide, SA, Australia
- Department of Anthropology and Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park, PA, USA
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18
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Fungi—A Component of the Oral Microbiome Involved in Periodontal Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:113-138. [DOI: 10.1007/978-3-030-96881-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sun K, Shen H, Liu Y, Deng H, Chen H, Song Z. Assessment of Alveolar Bone and Periodontal Status in Peritoneal Dialysis Patients. Front Physiol 2021; 12:759056. [PMID: 34966288 PMCID: PMC8710660 DOI: 10.3389/fphys.2021.759056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic kidney disease (CKD) affects 8-13% of the global population and has become one of the largest burdens on healthcare systems around the world. Peritoneal dialysis is one of the ultimate treatments for patients with severe CKD. Recently, increasing severe periodontal problems have been found in CKD patients. Periodontitis has been identified as a new variable risk factor for CKD. The aim of this study was to investigate the periodontal status and severity of alveolar bone loss in CKD patients with peritoneal dialysis (PD). One hundred and six patients undergoing PD (PD group) and 97 systemically healthy periodontitis patients (control group) were enrolled. The differences in the dimensions of the alveolar bone between two groups were compared, and the distribution of alveolar bone defects was analyzed by cone-beam computed tomography (CBCT). Gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and attachment loss (AL) were recorded. The levels of inflammatory factors in gingival crevicular fluid were assessed by ELISA. Compared to control group, there was a higher degree of alveolar bone loss in maxillary premolars, maxillary 2nd molar and mandibular 1st molar in patients with PD (p < 0.05). A comparison of bone loss in different sites revealed that the area with the highest degree of bone loss were on the mesial-buccal, mid-buccal, distal-buccal, and mesial-lingual site in PD patients. The expression levels of inflammatory factors were higher in PD group (p < 0.01). In conclusion, PD patients presented more severe periodontal and inflammatory status than systemically healthy periodontitis patients. The loss of the alveolar bone differed between the two groups. Different sites and teeth exhibited a diverse degree of bone loss. This study highlights that clinicians should pay close attention to periodontal status of peritoneal dialysis patients and provides a new thinking to improve healthcare for CKD.
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Affiliation(s)
- Kristine Sun
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hui Shen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yingli Liu
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai Deng
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiwen Chen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhongchen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
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20
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Lapo S, Leonardo C, Luigi B, Michele N, Sergio S, Calogero Lino C, Francesco C. Association between chronic kidney disease and periodontitis. A systematic review and metanalysis. Oral Dis 2021; 29:40-50. [PMID: 34726333 DOI: 10.1111/odi.14062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Aims of this SR were to assess the association of Periodontitis (PD) with Chronic Kidney Disease (CKD) and with different CKD stages. MATERIALS AND METHODS MEDLINE, Cochrane Central Register of Trials and EMBASE, up to April 4, 2021 were searched. RCTs, prospective and retrospective cohort studies, case-control studies and cross-sectional studies were considered. JBI's Critical Appraisal Tool for risk of bias assessment was used. The risk of PD was calculated using the Mantel-Haenszel odds ratios (MH-OR); weighted mean difference for clinical attachment level (CAL) and periodontal probing depth (PPD) were also evaluated. RESULTS Out of 1949 titles screened, 142 full texts were evaluated and 17 studies were included. CKD was associated to higher risk of PD (MH-OR = 2.36, [95% C.I. 1.25, 4.44]; p = 0.008), higher mean CAL (WMD = 0.41 mm [95% C.I. 0.22, 0.60]; p < 0.0001) and mean PPD (WMD = 0.25 mm [95% C.I. 0.03, 0.47]; p = 0.02) compared to healthy individuals. Severe CKD (stages 4-5 vs 2-3) resulted at higher risk of PD (MH-OR = 2.21, [95% C.I. 1.07, 4.54]; p = 0.03). Heterogeneity and risk of bias were high. CONCLUSIONS An association between PD and CKD was found. It could be appropriate to consider PD a frequent CKD comorbidity.
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Affiliation(s)
- Serni Lapo
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | | | - Barbato Luigi
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Nieri Michele
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Serni Sergio
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | | | - Cairo Francesco
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
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21
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Wu Z, O'Brien KM, Lawrence KG, Han Y, Weinberg CR, Sandler DP, Vogtmann E. Associations of periodontal disease and tooth loss with all-cause and cause-specific mortality in the Sister Study. J Clin Periodontol 2021; 48:1597-1604. [PMID: 34605056 DOI: 10.1111/jcpe.13557] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/07/2021] [Accepted: 09/19/2021] [Indexed: 11/26/2022]
Abstract
AIM Studies have found that periodontal disease and tooth loss are associated with increased mortality; however, associations with cause-specific mortality and all-cause mortality within specific subgroups have not been thoroughly investigated. MATERIALS AND METHODS We examined the association of self-reported periodontal disease and disease/decay-related tooth loss with subsequent all-cause and cause-specific mortality in the Sister Study, a prospective cohort study of 50,884 women aged 35-74 years at baseline, whose sister was diagnosed with breast cancer. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations were calculated with adjustment for relevant confounders. RESULTS With a mean follow-up of 10.9 years (range 0.1-14.3), 2058 women died. Participants with periodontal disease had a slightly higher rate of all-cause mortality (HR = 1.08, 95% CI 0.98-1.19), while participants with tooth loss had an increased rate of all-cause mortality (HR = 1.15, 95% CI 1.05-1.26). For cause-specific mortality, women with tooth loss had increased rates of death from circulatory system diseases, respiratory system diseases, and endocrine/metabolic diseases. Results varied in stratified models, but no heterogeneity across strata was found. CONCLUSIONS In this large prospective study, periodontal disease and tooth loss were associated with all-cause and certain specific cause-specific mortality outcomes.
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Affiliation(s)
- Zeni Wu
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Yongli Han
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Emily Vogtmann
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Kurt-Bayrakdar S, Kose O, Altin A, Akyildiz K, Mercantepe T, Bostan SA, Kose TE, Tumkaya L, Yilmaz A. Periodontitis exacerbates the renal degenerative effects of obesity in rats. J Periodontal Res 2021; 56:1058-1069. [PMID: 34328646 DOI: 10.1111/jre.12919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/21/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Obesity and periodontitis are systemic subclinical inflammatory diseases with established negative renal effects. The aim of this animal study was to thoroughly investigate the possible effects of these two diseases on renal structure and function. METHODS Thirty-two male Sprague Dawley rats were divided into four groups: control (C), obesity (Ob), experimental periodontitis (Ep), and Ob + Ep. The first 16 weeks of the experiment were aimed for the induction of obesity and the last 5 weeks for the induction of periodontitis. Throughout the experimental period, the C and Ep groups were fed standard rat chow, while the Ob groups (Ob and Ob + Ep) were fed high-fat rat chow. Right after the establishment of obesity, periodontal tissue destruction was achieved by placing 3.0 silk sutures in sub-paramarginal position around the cervices of mandibular right-left first molar teeth and preserving them for 5 weeks. On the last day of the 22nd week, following blood collection, all rats were euthanized, and kidneys and mandibles were collected. Alveolar bone loss was measured on microcomputed tomographic slices. Histopathological evaluations (light microscopy, semi-quantitative analysis of renal corpuscle area, and immunohistochemical analysis of caspase-3 activity) were done on right kidneys and biochemical evaluations (malonyl-aldehyde [MDA], glutathione [GSH], total oxidant status [TOS], total antioxidant status [TAS], oxidative stress [OSI], tumor necrosis factor-α [TNF-α], interleukin-1β [IL-1β], matrix metalloproteinase [MMP]-8, MMP-9, and cathepsin D [CtD] levels) were done on left kidneys. Renal functional status was evaluated with levels of serum creatinine, urea, and cystatin C. RESULTS Periodontal bone loss was significantly higher in the Ep and Ob + Ep groups, compared with the C and Ob groups (p < .05). All parameters except TAS and GSH were highest in the Ob + Ep group, and the differences were statistically significant compared with the control group (p < .05). Although the mean TAS and GSH levels were lower in the Ob + Ep group than the other groups, the differences were not statistically significant (p > .05). While the atypical glomeruli score was significantly higher in the Ob + Ep group than in all other groups (p < .05), the acute tubular necrosis and histopathological scores were significantly different only compared with the control group (p < .05). CONCLUSION This experimental study showed that the negative effects of the co-existence of periodontitis and obesity on inflammatory stress and apoptotic changes in the kidneys together with the functional parameters were significantly more severe, compared with the presence of one of these diseases alone. TNF-α could have a central role in the periodontitis and obesity-related structural and functional renal changes.
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Affiliation(s)
- Sevda Kurt-Bayrakdar
- Department of Periodontology, School of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Oğuz Kose
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ahmet Altin
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Kerimali Akyildiz
- Department of Medical Services and Techniques, School of Health Care Services Vocational, Recep Tayyip Erdogan University, Rize, Turkey
| | - Tolga Mercantepe
- Department of Histology and Embryology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Semih Alperen Bostan
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Taha Emre Kose
- Department of Dentomaxillofacial Radiology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Levent Tumkaya
- Department of Histology and Embryology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- Department of Biochemistry, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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Validation of a self-report questionnaire for periodontitis in a Japanese population. Sci Rep 2021; 11:15078. [PMID: 34301979 PMCID: PMC8302714 DOI: 10.1038/s41598-021-93965-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022] Open
Abstract
We aimed to assess the validity of the self-report questionnaire for periodontitis in a Japanese population. A Japanese 9-item self-report questionnaire, developed by translating English-version questions that were used to detect periodontitis, was validated against full-mouth clinically-assessed periodontitis in 949 Japanese adults (average age = 43.2 years). Multivariable logistic regression modeling was used to calculate the area under the receiver operating characteristic curve (AUC), wherein the periodontitis case definition of the Centers for Disease Control and Prevention/American Academy of Periodontology was considered the gold standard. Severe, moderate, and mild periodontitis were identified in 6.2%, 30.0%, and 6.7% of the study population, respectively. Self-reported oral health questions combined with socio-demographic and health-related variables had an AUC > 0.70 (range, 0.71-0.87) for any periodontitis category. Four oral health questions ("have gum disease," "loose tooth," "lost bone," and "bleeding gums") were selected in the parsimonious model for severe periodontitis. The periodontitis screening score generated by the responses to these four questions had an AUC, sensitivity, and specificity of 0.82, 73.1%, and 74.3%, respectively, where the cut-off was set at 2 points. In conclusion, a locally adapted version of the self-report questionnaire had an acceptable diagnostic capacity for the detection of periodontitis in this study population.
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da Silva TA, Abreu LG, Esteves Lima RP. A meta-analysis on the effect of periodontal treatment on the glomerular filtration rate of chronic kidney disease individuals: A systematic review and meta-analysis was conducted to assess the impact of the periodontal treatment on the glomerular filtration rate of individuals with chronic kidney disease. SPECIAL CARE IN DENTISTRY 2021; 41:670-678. [PMID: 34231240 DOI: 10.1111/scd.12625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/06/2021] [Indexed: 12/11/2022]
Abstract
AIMS The purpose of the present systematic review and meta-analysis was to assess the impact of periodontal treatment on the glomerular filtration rate (GFR) of individuals with chronic kidney disease (CKD). METHODS Searches were conducted in five databases. Restrictions on publication date or language were not imposed. Studies reporting the GFR of CKD individuals before and after periodontal treatment were included. Studies' selection, extraction of data and assessment of risk of bias were performed by two reviewers independently. The Methodological Index for non-randomized studies was employed for risk of bias assessment. Meta-analysis was carried out. RESULTS One hundred ninety-two references were retrieved and three studies were included. In all studies included, the periodontal intervention performed was non-surgical therapy. The three studies together assessed 77 individuals. The follow-up of participants after periodontal treatment varied between 3 and 6 months. Meta-analysis demonstrated that the GFR of individuals with CKD increased (improvement) after periodontal treatment (mean difference = 7.01, confidence interval = 0.66 - 13.36, I2 = 0%). Overall, included studies presented low risk of bias. CONCLUSION Despite the limited evidence of this systematic review and meta-analysis, periodontal treatment seems to improve the GFR of CKD individuals, with positive repercussions on their renal function.
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Affiliation(s)
- Thales Araújo da Silva
- Division of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Division of Pediatric Dentistry, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Brazil
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25
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Ma X, Wang Y, Wu H, Li F, Feng X, Xie Y, Xie D, Wang W, Lo ECM, Lu H. Periodontal health related-inflammatory and metabolic profiles of patients with end-stage renal disease: potential strategy for predictive, preventive, and personalized medicine. EPMA J 2021; 12:117-128. [PMID: 33903806 PMCID: PMC8060784 DOI: 10.1007/s13167-021-00239-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/10/2021] [Indexed: 01/16/2023]
Abstract
Objectives To compare the periodontal health related–inflammatory and metabolic differences between patients with end-stage renal disease (ESRD) and healthy controls (HC), and to identify potential biomarkers in gingival crevicular fluid (GCF) and serum of ESRD patients for predictive, preventive, and personalized medicine (PPPM). Methods Patients with ESRD (ESRD group; n = 52) and healthy controls (HC group; n = 44) were recruited. Clinical periodontal parameters were recorded. The differential metabolites in the GCF and serum were identified by liquid chromatography/mass spectrometry (LC/MS). Inflammatory markers including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP) were also assessed. Results In the ESRD group, IL-8 and CRP were significantly higher in GCF, whereas IL-6 and CRP were significantly higher in serum, compared with HC group (all P < 0.05). In the case of GCF, taurine levels were positively correlated with IL-8 levels in both groups (all P < 0.05). In the case of serum, l-phenylalanine and p-hydroxyphenylacetic acid levels were positively correlated with CRP levels in both groups (all P < 0.05). Significant positive correlations were observed between metabolites (including pseudouridine, l-phenylalanine, and p-hydroxyphenylacetic acid) and IL-6 levels only in ESRD group. Conclusions IL-8 and CRP are potential inflammatory makers that reflect the periodontal health of ESRD individual, which may be considered the valuable predictive diagnostics in the agreement with PPPM philosophy. Besides, metabolites of taurine in GCF as well as l-phenylalanine and p-hydroxyphenylacetic acid in serum are possible biomarkers correlated with inflammatory markers. All these biomarkers may also be highly recommended as a novel predictive/diagnostic tool for the assessment of inflammatory status from the perspectives of PPPM in view of susceptible population and individual screening.
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Affiliation(s)
- Xiaoxin Ma
- Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Yongli Wang
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hongyu Wu
- Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Fei Li
- Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Yingxin Xie
- Department of Nephrology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Danshu Xie
- Department of Nephrology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Wenji Wang
- Department of Nephrology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, University of Hong Kong, 34 Hospital Road, Hong Kong, China
| | - Haixia Lu
- Department of Preventive Dentistry, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
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26
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Kapellas K, Ali A, Jamieson LM. Modelling the Validity of Periodontal Disease Screening Questions in a Nondental Clinical Setting. Int Dent J 2021; 71:407-413. [PMID: 33610307 PMCID: PMC9275349 DOI: 10.1016/j.identj.2020.12.013] [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] [Indexed: 11/27/2022] Open
Abstract
Objective Periodontal examinations are time-consuming and potentially uncomfortable for recipients. We modelled if self-reported questions alone, or combined with objective evidence of periodontal bone loss observable from radiographs, are accurate predictors of periodontitis. Methods Self-reported data from the Australian National Survey of Adult Oral Heath 2004-06 were compared with clinical periodontal examinations to assess the validity of 8 periodontitis screening questions in predicting moderate/severe periodontitis. To model alveolar bone loss, a proxy variable simulating radiographic clinical attachment level (rCAL) was created. Three multivariable binary logistic regression models were constructed: responses to 8 screening questions alone (Model 1), screening questions combined with 5 classic periodontitis risk indicators (age, sex, smoking status, country of birth, and diabetes status) (Model 2), and the addition of rCAL (Model 3). Predictive validity was determined via sensitivity (Se) and specificity (Sp) scores and graphically represented using area under the receiver operator characteristic curves (AUROC). Results Data from 3630 participants periodontally examined determined that 32.4% exhibited periodontitis. Periodontitis risk indicators were all significantly associated with periodontitis case status. Six of 8 screening questions (Model 1) were weak periodontitis predictors (Se = 0.28; Sp = 0.89; AUROC = 0.61). Combining 13 variables for (Model 2) improved prediction (Se = 0.55; Sp = 0.81; AUROC = 0.77). The addition of rCAL (Model 3) improved diagnostic capacity considerably (AUROC = 0.86). Conclusions Self-reported questions combined with classic risk indicators are “useful” for periodontitis screening. Addition of radiographs markedly improved diagnostic validity. Based on modelling, nondental health care professionals may provisionally screen for periodontitis with minimal training.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia
| | - Anna Ali
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia; Robinson Research Institute, University of Adelaide, South Australia, Australia.
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, South Australia, Australia
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27
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Kapellas K, Hughes JT, Cass A, Maple-Brown LJ, Skilton MR, Harris D, Askie LM, Hoy W, Pawar B, McKenzie K, Sajiv CT, Arrow P, Brown A, Jamieson LM. Oral health of aboriginal people with kidney disease living in Central Australia. BMC Oral Health 2021; 21:50. [PMID: 33541341 PMCID: PMC7863237 DOI: 10.1186/s12903-021-01415-4] [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: 08/26/2020] [Accepted: 01/28/2021] [Indexed: 12/12/2022] Open
Abstract
Background Associations between kidney disease and periodontal disease are not well documented among Aboriginal people of Australia. The purpose of this investigation was to report and compare demographic, oral health, anthropometric and systemic health status of Aboriginal Australians with kidney disease and to compare against relevant Aboriginal Australians and Australian population estimates. This provides much needed evidence to inform dental health service provision policies for Aboriginal Australians with kidney disease.
Methods Sample frequencies and means were assessed in adults represented in six datasets including: (1) 102 Aboriginal Australians with kidney disease residing in Central Australia who participated in a detailed oral health assessment; (2) 312 Aboriginal participants of the Northern Territory’s PerioCardio study; (3) weighted estimates from 4775 participants from Australia’s National Survey of Adult Oral Health (NSAOH); (4) Australian 2016 Census (all Australians); (5) National Health Survey 2017–2018 (all Australians) and; (6) Australian Health Survey: Biomedical Results for Chronic Diseases, 2011–2012 (all Australians). Oral health status was described by periodontal disease and experience of dental caries (tooth decay). Statistically significant differences were determined via non-overlapping 95% confidence intervals. Results Aboriginal Australians with kidney disease were significantly older, less likely to have a tertiary qualification or be employed compared with both PerioCardio study counterparts and NSAOH participants. Severe periodontitis was found in 54.3% of Aboriginal Australians with kidney disease, almost 20 times the 2.8% reported in NSAOH. A higher proportion of Aboriginal Australians with kidney disease had teeth with untreated caries and fewer dental restorations when compared to NSAOH participants. The extent of periodontal attachment loss and periodontal pocketing among Aboriginal Australians with kidney disease (51.0%, 21.4% respectively) was several magnitudes greater than PerioCardio study (22.0%, 12.3% respectively) and NSAOH (5.4%, 1.3% respectively) estimates. Conclusions Aboriginal Australians with kidney disease exhibited more indicators of poorer oral health than both the general Australian population and a general Aboriginal population from Australia’s Northern Territory. It is imperative that management of oral health among Aboriginal Australians with kidney disease be included as part of their ongoing medical care.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Jaquelyne T Hughes
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Australia
| | - Alan Cass
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Michael R Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - David Harris
- Department of Renal Medicine, Westmead Centre for Medical Research, Westmead Hospital, University of Sydney, Westmead, Australia
| | - Lisa M Askie
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Wendy Hoy
- Griffith University, Brisbane, Australia
| | | | - Kirsty McKenzie
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | | | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
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Effect of periodontal treatment on the glomerular filtration rate, reduction of inflammatory markers and mortality in patients with chronic kidney disease: A systematic review. PLoS One 2021; 16:e0245619. [PMID: 33481920 PMCID: PMC7822280 DOI: 10.1371/journal.pone.0245619] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Aim To assess the effect of periodontal treatment (PT) on glomerular filtration rate (GFR), systemic inflammation, or mortality in patients with chronic kidney disease (CKD). Methods A literature search was performed on PubMed and Web of Science databases on articles published until December 2019. The PRISMA guidelines were used throughout the manuscript. Results Of the total studies found, only 18 met the inclusion criteria; four retrospective and 14 prospective studies (including 3 randomized controlled trials–RCT). After PT, 3 studies investigated GFR, 2 found significant improvement; 11 (including 2 RCTs) investigated C-reactive protein levels, 9 found a significant improvement (including the 2 RCTs); 5 (including 3 RCTs) investigated Interleukine-6 level, 4 found a significant improvement (including 2 RCTs) and 2 studies evaluated mortality, one (retrospective study) found a significant difference. Conclusions Within the limitations of the present study, PT seems to improve CKD status, especially by reducing the systemic inflammation. Further RCTs are needed to confirm the results and specifically assess the influence of different types of PT in CKD patients. Taking into consideration the ability of PT to prevent further tooth loss and denutrition, early management of periodontitis is extremely important in patients with impaired renal function.
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Balasubramanian M, Keuskamp D, Amarasena N, Brennan D. Predictors for oral and general health outcomes and quality of life among older people attending general practice clinics in South Australia. Gerodontology 2021; 38:395-403. [PMID: 33475189 DOI: 10.1111/ger.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 12/15/2020] [Accepted: 01/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases. OBJECTIVE To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ years.) attending general practice (GP) clinics in South Australia. METHODS Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures. RESULTS A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β = -0.08), age (β = -0.09) and number of chronic conditions (β = -0.12) were negatively associated with EQ-5D, while living arrangement (β = 0.07) was positively associated. Further, having four or more chronic conditions (RR:1.47) was significantly associated with self-rated general health. CONCLUSION Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics.
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Affiliation(s)
- Madhan Balasubramanian
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Dominic Keuskamp
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Najith Amarasena
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - David Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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A Paradigm Gap in Host–Pathogen Interaction Studies: Lesson from the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1353:47-70. [DOI: 10.1007/978-3-030-85113-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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31
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Galeno JG, França LFDC, da Silva FRP, Alves EHP, Di Lenardo D, Nascimento HMS, Cardoso Guimarães Vasconcelos AC, Carneiro Gomes PR, Dias de Souza Filho M, Caetano VDS, de Oliveira AP, de Alencar MVOB, Barbosa ALDR, Medeiros JVR, Fahimipou F, Barros SP, Alves Diniz IM, Vasconcelos DFP. Renal alterations caused by ligature-induced periodontitis persist after ligature removal in rats. J Periodontal Res 2020; 56:306-313. [PMID: 33296521 DOI: 10.1111/jre.12822] [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: 03/26/2020] [Revised: 10/19/2020] [Accepted: 11/12/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis may crosstalk with renal diseases, yet that remains unclear. We investigated whether the renal alterations caused by induced periodontitis are reversible after removal of the ligatures in experimental ligature-induced periodontitis. MATERIAL AND METHODS Twenty-four female rats were divided into three groups: control (without periodontitis), periodontitis (20 days of ligature-induced periodontitis), and P20-20 (20 days of ligature-induced periodontitis and 20 days after ligature removal). The following periodontal parameters were assessed: gingival bleeding index, probing pocket depth, myeloperoxidase activity, and alveolar bone height. For renal tissues, histopathology, malonaldehyde (MDA) levels, glutathione (GSH) content, and renal weight were evaluated. In the blood, creatinine, uric acid, albumin, total cholesterol, total protein, and glucose levels were assessed. Total protein and creatinine levels in urine were also investigated. RESULTS Rat renal tissues did not demonstrate reversal of periodontitis-related changes in the P20-20 group in terms of MDA, GSH, and histopathological evaluations when compared to the periodontitis group. Accordingly, only total cholesterol levels were reversible in the P20-20. CONCLUSION Renal alterations caused by ligature-induced periodontitis persisted even after removal of ligatures in rats.
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Affiliation(s)
- Juliana Gomes Galeno
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Luiz Felipe de Carvalho França
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Felipe Rodolfo Pereira da Silva
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Even Herlany Pereira Alves
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - David Di Lenardo
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Hélio Mateus Silva Nascimento
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Any Carolina Cardoso Guimarães Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil.,Medicine School, Education Institute of Parnaiba Valley (IESVAP - AFYA), Parnaiba, Brazil
| | - Paulo Roberto Carneiro Gomes
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Manoel Dias de Souza Filho
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Vinícius da Silva Caetano
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Ana Patrícia de Oliveira
- Laboratory of Experimental Physiopharmacology (LAFFEX), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | | | - André Luiz Dos Reis Barbosa
- Laboratory of Experimental Physiopharmacology (LAFFEX), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Jand-Venes Rolim Medeiros
- Laboratory of Experimental Physiopharmacology (LAFFEX), Federal University of the Parnaiba Delta (UFDPar), Parnaíba, Brazil
| | - Farahnaz Fahimipou
- Center for Oral and Systemic Diseases, Department of Periodontology, UNC School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Silvana Pereira Barros
- Center for Oral and Systemic Diseases, Department of Periodontology, UNC School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Ivana Márcia Alves Diniz
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Lai J, Bai YL, Bai Y, Mei J, Zhang ZW, Tang WJ, Huang J. [A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:672-680. [PMID: 33377346 PMCID: PMC7738908 DOI: 10.7518/hxkq.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/23/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. METHODS We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. RESULTS Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. CONCLUSIONS Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.
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Affiliation(s)
- Jing Lai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yuan-Liang Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yin Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Jie Mei
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Zhi-Wei Zhang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Wen-Jing Tang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Jiao Huang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
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Taylor HL, Rahurkar S, Treat TJ, Thyvalikakath TP, Schleyer TK. Does Nonsurgical Periodontal Treatment Improve Systemic Health? J Dent Res 2020; 100:253-260. [PMID: 33089733 DOI: 10.1177/0022034520965958] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Clinicians frequently stress the importance of maintaining good oral health for multiple reasons, including its link to systemic health. Because periodontal treatment reduces inflammation in oral tissues, some hypothesize it may positively affect systemic outcomes by reducing inflammation in the body. A significant number of systematic reviews (SRs) and meta-analyses (MAs) have evaluated the effect of periodontal treatment on systemic outcomes. However, inconsistent findings and questionable methodological rigor make drawing conclusions difficult. We conducted a systematic review of reviews that studied the effect of nonsurgical periodontal treatment on systemic disease outcomes. We report on outcomes evaluated, categorizing them as biomarkers, and surrogate or clinical endpoints. In addition, we used A MeaSurement Tool to Access systematic Reviews 2 (AMSTAR 2) to evaluate the methodological quality of the reviews. Of the 52 studies included in our review, 21 focused on diabetes, 15 on adverse birth outcomes, 8 on cardiovascular disease, 3 each on obesity and rheumatoid arthritis, and 2 on chronic kidney disease. Across all studies, surrogate endpoints predominated as outcomes, followed by biomarkers and, rarely, actual disease endpoints. Ninety-two percent of studies had "low" or "critically low" AMSTAR 2 confidence ratings. Criteria not met most frequently included advance registration of the protocol, justification for excluding individual studies, risk of bias from individual studies being included in the review, and appropriateness of meta-analytical methods. There is a dearth of robust evidence on whether nonsurgical periodontal treatment improves systemic disease outcomes. Future reviews should adhere more closely to methodological guidelines for conducting and reporting SRs/MAs than has been the case to date. Beyond improved reviews, additional rigorous research on whether periodontal treatment affects systemic health is needed. We highlight the potential of large-scale databases containing matched medical and dental record data to inform and complement future clinical research studying the effect of periodontal treatment on systemic outcomes.
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Affiliation(s)
- H L Taylor
- Department of Health Policy and Management, NLM Public and Population Health Informatics Fellow, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - S Rahurkar
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA.,The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), The Ohio State University College of Medicine, Columbus, OH, USA
| | - T J Treat
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - T P Thyvalikakath
- Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, IUPUI, Indianapolis, IN, USA.,Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA
| | - T K Schleyer
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA.,Indiana University School of Medicine, Indianapolis, IN, USA
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Duan X, Chen X, Gupta M, Seriwatanachai D, Xue H, Xiong Q, Xu T, Li D, Mo A, Tang X, Zhou X, Li Y, Yuan Q. Salivary microbiome in patients undergoing hemodialysis and its associations with the duration of the dialysis. BMC Nephrol 2020; 21:414. [PMID: 32993533 PMCID: PMC7523083 DOI: 10.1186/s12882-020-02009-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/04/2020] [Indexed: 02/08/2023] Open
Abstract
Background Chronic kidney disease (CKD) patients, especially those with end stage renal disease (ESRD) undergoing hemodialysis (HD), exhibit high prevalence of periodontitis. This cross-sectional study aimed to investigate the periodontal status of HD patients and its relationship with salivary microbiome. Methods One hundred eight HD patients and one hundred healthy control individuals were recruited. They were subjected to periodontal examination followed by saliva samples collection for 16S rRNA gene sequencing. Results The HD patients were with worse periodontal health status, and exhibited higher salivary microbial diversity and lower richness. The periodontal pathogens were significantly enriched in the HD patients. The inferred functional analyze showed microbes enriched in the HD patients were mainly related to metabolism. Despite the periodontal status and overall structure of the microbiome were not significantly altered as the HD duration prolonged, the abundance of Lachnospiraceae [G-2] sp. |HMT_096| is positively correlated with the duration of HD and the community periodontal index (CPI). Five OTUs (operational taxonomic units) belonging to the phyla Firmicutes were enriched as the duration prolonged, and four OTUs originated from the phyla Proteobacteria were negatively related with the CPI index. ESRD patients undergoing HD exhibited microbiota structural, compositional and functional differences compared with the healthy controls. And the species changed as the duration of hemodialysis prolonged. Conclusions End stage renal disease changes salivary microbiome and is a risk factor for oral dysbiosis.
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Affiliation(s)
- Xiaobo Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Xiaolei Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Megha Gupta
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Al-Showajra Academic Campus, Jazan University, Jazan, Kingdom of Saudi Arabia
| | | | - Hanxiao Xue
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Qiuchan Xiong
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Tong Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Dan Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Anchun Mo
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xi Tang
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
| | - Quan Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China. .,Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Al-Showajra Academic Campus, Jazan University, Jazan, Kingdom of Saudi Arabia.
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Kosaka S, Ohara Y, Naito S, Iimori S, Kado H, Hatta T, Yanishi M, Uchida S, Tanaka M. Association among kidney function, frailty, and oral function in patients with chronic kidney disease: a cross-sectional study. BMC Nephrol 2020; 21:357. [PMID: 32819288 PMCID: PMC7441609 DOI: 10.1186/s12882-020-02019-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 08/13/2020] [Indexed: 12/19/2022] Open
Abstract
Background Chronic kidney disease (CKD) involves many factors that can cause frailty and oral hypofunction. We aimed to investigate the prevalence of frailty and oral hypofunction and to examine the associations among kidney function, frailty, and oral function in adults with CKD in Japan. Methods This cross-sectional study was conducted at two institutions. The participants included 109 patients with CKD stages 3–5 who visited outpatient clinics or were admitted for inpatient treatment. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study frailty criteria. Oral function was evaluated by assessing oral motor skills [oral diadochokinesis (ODK) rate], masticatory ability, and the repetitive saliva swallowing test. The estimated glomerular filtration rate (eGFR) was used to indicate kidney function. We examined the associations among kidney function, frailty, and oral function using binomial logistic regression analysis. Results In total, 31 participants (28.4%) were classified as being frail. Univariate analysis showed that age, body mass index, eGFR, and haemoglobin level were significantly associated with frailty. ODK and swallowing function were significantly associated with frailty. Multivariate analysis revealed that frailty was significantly associated with eGFR [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92–1.00, p = 0.048] and ODK rate (OR 0.68, CI 0.47–0.98, p = 0.038). However, no significant association was found between CKD severity and masticatory or swallowing function. Conclusion We found a high prevalence of frailty in patients with CKD and a significant association between frailty and oral motor skills, affecting the swallowing function of patients with nondialysis CKD. The high prevalence of frailty among patients with CKD suggests that routine assessment of frailty is necessary to prevent the development of severe complications. In addition, oral and kidney function should be carefully evaluated, and oral health education and interventions should be performed for patients with CKD.
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Affiliation(s)
- Shiho Kosaka
- Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shotaro Naito
- Department of Nephrology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Soichiro Iimori
- Department of Nephrology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hiroshi Kado
- Omihachiman Community Medical Center, 1379 Tuchida-cho, Omihachiman-city, Shiga, 523-0082, Japan
| | - Tsuguru Hatta
- Omihachiman Community Medical Center, 1379 Tuchida-cho, Omihachiman-city, Shiga, 523-0082, Japan
| | - Masaaki Yanishi
- Kansai Medical University, 2-3-1 Shinmachi, Hirakata-city, Osaka, 573-1191, Japan
| | - Shinichi Uchida
- Department of Nephrology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Makoto Tanaka
- Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Wynimko M, Walicka M, Sanchak Y, Gozdowski D, Błach A, Więcek A, Śliwczyński A, Franek E, Kolonko A. Influence of Chronic Periodontitis on the Long-Term Mortality and Cardiovascular Events in Kidney Transplant Recipients. J Clin Med 2020; 9:jcm9061968. [PMID: 32585986 PMCID: PMC7355563 DOI: 10.3390/jcm9061968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic periodontitis (CP) is associated with cardiovascular disease and mortality in different populations. The aim of this study was to examine an association of CP with hard endpoints in patients after kidney transplantation during a 15-year follow-up period. Study group consist of 117 patients (77M/40F, median age 44 years) divided into two subgroups: those with initially advanced CP (CPITN 3-4) and those with no or moderate CP (CPITN 0-2). All cardiovascular events, graft losses, and re-transplantations were recorded. All deaths were noted and verified, including those occurred after the return to dialysis therapy, the causes of death were identified. Cox regression with Firth's penalized maximum likelihood models were used for data analysis. During the observation period, 49 deaths occurred. Advanced CP (n = 35) was not associated with overall mortality but was associated with increased risk of death with functioning graft (DWFG) [HR 3.54 (1.20-10.45); p < 0.05]. Risk of graft loss was not associated with CP status. In conclusion, an advanced CP was independently associated with increased risk of DWFG, but not all-cause or cardiovascular mortality after renal transplantation.
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Affiliation(s)
- Marta Wynimko
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Yaroslav Sanchak
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Dariusz Gozdowski
- Department of Biometry, Warsaw University of Life Sciences, Nowoursynowska 166, 02-787 Warsaw, Poland;
| | - Anna Błach
- Department of Cardiology, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Voxel SA Nuclear Medicine Center, Ceglana 35, 40-514 Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
| | - Andrzej Śliwczyński
- Sattelite Campus, University of Humanities and Economics in Lodz, Wolność 2a, 01-018 Warsaw, Poland;
- National Health Fund, Grójecka 186, 02-390 Warsaw, Poland
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106 Warsaw, Poland
| | - Aureliusz Kolonko
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Correspondence: ; Tel.: +48-32-259-1429
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Kesmez Ö, Frøjk MJ, Eidemak I, Jensen SB, Kragelund C. Oral symptoms and pathologies in Danish patients with chronic kidney disease- a pilot study. APMIS 2020; 128:401-405. [PMID: 32202674 DOI: 10.1111/apm.13042] [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: 01/14/2020] [Accepted: 03/04/2020] [Indexed: 01/07/2023]
Abstract
The aim was to investigate oral health in randomly selected patients with chronic kidney disease (CKD). Data obtained by structured interview (self-reported lifestyle, oral symptoms and regularity of dental visits) and oral examination of patients with CKD from the Copenhagen University Hospital. Fourteen patients with CKD were screened. Only half of the patients reported regular dental visits and poor dental status was registered in half of the patients. Oral mucosal changes were registered in thirteen patients (93%). Eleven patients (79%) had gingival inflammatory disease. Twelve patients (86%) were carriers of Candida, and three (21%) had oral candidosis. Six patients (43%) had low whole saliva flow rate. Twelve patients (86%) reported at least one oral symptom. Overall, there was no differences in oral symptoms or findings related to kidney transplanted or not transplanted patients. The small sample size most likely influences the results. However, the vast majority of patients with CKD reported oral symptoms and only half consulted a dentist regularly. Poor dental status, oral mucosal changes and gingival disease were prevalent findings. Patients with CKD need focus on daily oral healthcare and regular dental visits. Interdisciplinary cooperation could encourage patients with CKD to focus on oral health.
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Affiliation(s)
- Özlem Kesmez
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Metha Juhl Frøjk
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Siri Beier Jensen
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Camilla Kragelund
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Dwibedi N, Wiener RC, Findley PA, Shen C, Sambamoorthi U. Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States: 2016 Behavioral Risk Factor Surveillance System survey. J Am Dent Assoc 2019; 151:735-744.e1. [PMID: 31732091 DOI: 10.1016/j.adaj.2019.07.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 06/24/2019] [Accepted: 07/23/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Adults with chronic respiratory conditions, specifically asthma or chronic obstructive pulmonary disease (COPD), may be at risk of experiencing poor oral health due to systemic inflammation, challenges in routine oral health care, and adverse effects of medications used to treat these conditions. The authors examined the association of asthma, COPD, and coexisting asthma and COPD (asthma-COPD overlap syndrome [ACOS]) with tooth loss among US adults. METHODS The authors conducted a cross-sectional study using 2016 Behavioral Risk Factor Surveillance System data (N = 387,217). The authors categorized the participants with missing permanent teeth into 4 groups: asthma only (n = 38,817), COPD only (n = 19,819), ACOS (n = 13,494), no asthma, no COPD (n = 315,087). The authors used adjusted multinomial logistic regressions to examine the associations between asthma and COPD categories and tooth loss. RESULTS According to the authors, 5.3% of study participants reported they were edentulous; 10.7% reported 6 or fewer missing teeth. Participants with asthma only, COPD only, and ACOS had higher odds of reporting tooth loss (6 or more teeth) than those in the no asthma, no COPD group; adjusted odds ratios were 1.12 (95% confidence interval, 1.00 to 1.26) to 2.04 (95% confidence interval, 1.85 to 2.26). A lower percentage of participants with COPD and ACOS visited dentists in the past year than those with no asthma and no COPD. Interactive associations suggested participants with asthma or COPD with dental visits were less likely to report edentulism than those with neither asthma nor COPD and no dental visits. CONCLUSIONS Participants with asthma or COPD had higher odds of tooth loss compared with those with neither asthma nor COPD. PRACTICAL IMPLICATIONS People with asthma or COPD should maintain routine dental visits to reduce the risk of experiencing tooth loss.
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Dannewitz B, Sommerer C, Stölzel P, Baid‐Agrawal S, Nadal J, Bärthlein B, Wanner C, Eckardt K, Zeier M, Schlagenhauf U, Krane V, Jockel‐Schneider Y. Status of periodontal health in German patients suffering from chronic kidney disease—Data from the GCKD study. J Clin Periodontol 2019; 47:19-29. [DOI: 10.1111/jcpe.13208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/03/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Bettina Dannewitz
- Department of Periodontology Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Private Dental Practice Weilburg Germany
| | - Claudia Sommerer
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | - Peggy Stölzel
- Division of Periodontology University Hospital of Würzburg Würzburg Germany
| | - Seema Baid‐Agrawal
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Transplant Center Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Jennifer Nadal
- Department of Medical Biometry, Informatics, and Epidemiology (IMBIE) University Hospital Bonn Germany
| | - Barbara Bärthlein
- Chair of Medical Informatics University of Erlangen‐Nürnberg Erlangen Germany
| | - Christoph Wanner
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
| | - Kai‐Uwe Eckardt
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Hypertension Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU) University Hospital Erlangen Erlangen Germany
| | - Martin Zeier
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | | | - Vera Krane
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
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Kitamura M, Mochizuki Y, Miyata Y, Obata Y, Mitsunari K, Matsuo T, Ohba K, Mukae H, Yoshimura A, Nishino T, Sakai H. Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation. Int J Mol Sci 2019; 20:ijms20143413. [PMID: 31336777 PMCID: PMC6678374 DOI: 10.3390/ijms20143413] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.
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Affiliation(s)
- Mineaki Kitamura
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yasushi Mochizuki
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
| | - Yoko Obata
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hideki Sakai
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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Chopra A, Sivaraman K. An update on possible pathogenic mechanisms of periodontal pathogens on renal dysfunction. Crit Rev Microbiol 2019; 45:514-538. [PMID: 30729832 DOI: 10.1080/1040841x.2018.1553847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontitis is a potential source of permanent systemic inflammation that initiates renal dysfunction and contributes to the development of chronic kidney diseases (CKDs). Although numerous studies have confirmed the bidirectional role of periodontal infection and renal inflammation, no literature has yet highlighted the sophisticated pathogenic mechanisms by which periodontal pathogens, particularly Porphynomonas Gingivalis, induce renal dysfunction and contributed in the development of CKDs. The present review aims to critically analyze and highlight the novel pathogenesis of periodontitis induced CKDs.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Sun Y, Wang Y, Yu W, Zhuo Y, Yuan Q, Wu X. Association of Dose and Frequency on the Survival of Patients on Maintenance of Hemodialysis in China: A Kaplan-Meier and Cox-Proportional Hazard Model Analysis. Med Sci Monit 2018; 24:5329-5337. [PMID: 30063696 PMCID: PMC6083938 DOI: 10.12659/msm.909404] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Dialysis frequency and dose are controversial prognostic factors of hemodialysis morbidity and mortality. The aim of this study was to find out the effect of frequency and dosage of dialysis on mortality and survival in a group of Chinese hemodialysis patients. Material/Methods In total, 183 patients seen from February 2008 to January 2018, who were on maintenance hemodialysis for at least 3 months, were included in the study cohort. An anonymized database of age, gender, diabetic status, comorbidities, date of initiation of dialysis, hematological characters, biochemical variables, and status of survived or died was established from DICOM (Digital Imaging and Communications in Medicine) files of patients. Kaplan-Meier and Cox-proportional hazard model was used for calculation of survival over time at 95% confidence level. Results Overall, the 10-year survival rate was 27%. Kaplan-Meier analysis showed patient survival as 94% at one-year, 59% at 5-years, and 27% at 10-years. Hemoglobin, serum albumin, calcium, potassium, phosphorous, calcium-phosphorous-products, and hemodialysis frequency and the dose had a significant effect on survival. Cox regression proportional hazard model showed that patients with serum albumin level of >4 g/dL were better associated with survival. Patients who underwent twice-weekly hemodialysis had 4.26 times less chance of survival as compared to patients with thrice-weekly hemodialysis. A higher dialysis dose of >1.2 spKt/V offered better survival as compared to a lower dose of <1.2 spKt/V. Conclusions Hypoalbuminemia, hemodialysis time, and hemodialysis frequency were significantly associated with mortality.
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Affiliation(s)
- Yan Sun
- Department of Nephrology, East Campus, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (mainland).,Department of Nephrology, Urological Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Yankui Wang
- Department of Nephrology, East Campus, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (mainland)
| | - Wenhong Yu
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Yan Zhuo
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Qian Yuan
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing, China (mainland)
| | - Xiongfei Wu
- Department of Nephrology, East Campus, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (mainland)
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