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Mayr A, Ciper N, Wahl G, Wildenhof J, Frede S, Kirschneck C, Jäger A, Götz W, Beisel-Memmert S. Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders - a pilot study. Clin Oral Investig 2024; 28:303. [PMID: 38714559 PMCID: PMC11076346 DOI: 10.1007/s00784-024-05686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/24/2024] [Indexed: 05/10/2024]
Abstract
OBJECTIVES We aimed to establish a risk profile for intraoral wound healing disorders based on measurements of microcirculation in gingival tissues. MATERIALS AND METHODS Oxygen saturation (SO2) and blood flow in gingival tissues were measured with tissue spectrometry and laser doppler spectroscopy in 37 patients before/after tooth extractions. Patients were assigned to four groups: anamnestically and periodontally healthy patients (n = 7), anamnestically healthy but suffering from periodontitis (n = 10), anamnestically healthy but smoking and suffering from periodontitis (n = 10) and suffering from diabetes and periodontitis (n = 10). Measurements were performed at three different time points: Baseline measurement (T0), one day post extractionem (p.e.) (T1) and seven days p.e. (T2). RESULTS Baseline SO2 values were higher in control patients (p = .038). This effect was most evident in comparison to smokers suffering from periodontitis (p = .042), followed by diabetics suffering from periodontitis (p = .09). An opposite trend was seen for blood flow. Patients suffering from periodontitis demonstrated higher blood flow values (p = .012). Five patients, which belonged to the group of smokers suffering from periodontitis, showed clinically a delayed wound healing. CONCLUSION Differences in SO2 and blood flow of gingival tissue could be detected in different groups of patients with existing periodontitis compared to control patients. CLINICAL RELEVANCE Lower baseline SO2 values could be a warning signal for possible wound healing disorders after oral surgery.
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Affiliation(s)
- Alexandra Mayr
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Nadja Ciper
- Center for Dental, Oral and Maxillofacial Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Gerhard Wahl
- Center for Dental, Oral and Maxillofacial Medicine, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Jan Wildenhof
- Private Clinic Schloss Schellenstein, Olsberg, Germany
| | - Stilla Frede
- Department of Anaesthesiology, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Werner Götz
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Svenja Beisel-Memmert
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Bonn, Germany.
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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3
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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4
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Tan J, Lamont GJ, Scott DA. Tobacco-enhanced biofilm formation by Porphyromonas gingivalis and other oral microbes. Mol Oral Microbiol 2024:10.1111/omi.12450. [PMID: 38229003 PMCID: PMC11250950 DOI: 10.1111/omi.12450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/08/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024]
Abstract
Microbial biofilms promote pathogenesis by disguising antigens, facilitating immune evasion, providing protection against antibiotics and other antimicrobials and, generally, fostering survival and persistence. Environmental fluxes are known to influence biofilm formation and composition, with recent data suggesting that tobacco and tobacco-derived stimuli are particularly important mediators of biofilm initiation and development in vitro and determinants of polymicrobial communities in vivo. The evidence for tobacco-augmented biofilm formation by oral bacteria, tobacco-induced oral dysbiosis, tobacco-resistance strategies, and bacterial physiology is summarized herein. A general overview is provided alongside specific insights gained through studies of the model and archetypal, anaerobic, Gram-negative oral pathobiont, Porphyromonas gingivalis.
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Affiliation(s)
- Jinlian Tan
- Department of Oral Immunology and Infectious Diseases,
University of Louisville, Louisville, KY, USA
| | - Gwyneth J. Lamont
- Department of Oral Immunology and Infectious Diseases,
University of Louisville, Louisville, KY, USA
| | - David A. Scott
- Department of Oral Immunology and Infectious Diseases,
University of Louisville, Louisville, KY, USA
- Center for Microbiomics, Inflammation and Pathogenicity,
University of Louisville, Louisville, KY, USA
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5
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Bingöl AC, Bingöl M, Pandis N, Stolz S, Beblo S, Jost-Brinkmann PG, Mönch E, Bartzela T. Dietary and metabolic effects on the oral status of patients with phenylketonuria: a nation-based cross-sectional study. Clin Oral Investig 2023; 27:1981-1991. [PMID: 36805804 PMCID: PMC9939867 DOI: 10.1007/s00784-022-04827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 12/06/2022] [Indexed: 02/23/2023]
Abstract
OBJECTIVES The aim of this study was to compare the prevalence of oral diseases (caries, periodontal disease, enamel defects) between patients with phenylketonuria (PKU), their siblings, and a matched control group. MATERIALS AND METHODS A total of 109 patients with PKU, 14 siblings of PKU patients, and 100 healthy individuals aged 6 to 68 years were recruited. All participants completed a questionnaire based on their health status. The patients' decayed/missing/filled teeth index (dmft/DMFT), gingival bleeding index (GBI), plaque control record (PCR), periodontal screening and recording index (PSR), and developmental enamel defects index (DDE) were recorded. Descriptive statistics and regression modeling were used to examine potential associations between the exposure and the outcomes of interest. RESULTS Patients with PKU had 1.6 times more caries (95% confidence interval (CI) 1.22 to 2.20; p = 0.001), seven times more enamel defects (95% CI 3.94 to 14.21; p < 0.001), and four times higher PSR values (95% CI 2.26 to 7.15; p < 0.001) than the control group. The siblings had significantly fewer enamel defects but no significant differences in caries and periodontal parameters compared to the PKU patients. CONCLUSIONS The results showed a higher risk for the development of caries, periodontitis, and enamel defects in PKU patients. CLINICAL RELEVANCE Implementation of preventive measures and regular dental care is necessary for patients with PKU.
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Affiliation(s)
- Anne Carolin Bingöl
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute for Oral Health Sciences, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Memduh Bingöl
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute for Oral Health Sciences, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Freiburgstr. 7, 3010, Bern, Switzerland
| | - Simone Stolz
- Department of Pediatric and Adolescent Medicine, Carl-Thiem-Klinikum Cottbus, Thiemstr. 111, 03048, Cottbus, Germany
| | - Skadi Beblo
- Department of Women and Child Health, Centre for Pediatric Research Leipzig, Hospital for Children and Adolescents, University of Leipzig, Liebigstr. 20a, Haus 6, 04103, Leipzig, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute for Oral Health Sciences, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Eberhard Mönch
- Interdisciplinary Metabolism Centre, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute for Oral Health Sciences, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
- Department of Orthodontics, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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6
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Hao CP, Cao NJ, Zhu YH, Wang W. The impact of smoking on periodontitis patients' GCF/serum cytokine profile both before and after periodontal therapy: a meta-analysis. BMC Oral Health 2023; 23:60. [PMID: 36726081 PMCID: PMC9893604 DOI: 10.1186/s12903-023-02768-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Smoking is an established modifying factor for the host immune response of periodontitis patients. However, its exact influence remains unclear. We aimed to compare the cytokine profile of periodontitis patients with and without smoking habits both before and after periodontal therapy to preliminarily explore its influence on the host immune response to periodontitis. METHODS The protocol of the present meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42021255656. Meta-analysis was performed for each cytokine if at least three studies were included. We synthesized the evidence to compare the cytokine profile of periodontitis with and without smoking both in gingival cervical fluid (GCF) and serum to explore the impact of smoking on periodontitis both locally and systemically. Moreover, we also compared the cytokine profile of the two groups of patients after periodontal therapy to explore the effect of smoking on the outcome of periodontal therapy. RESULTS Fifteen studies were included in this meta-analysis. We found that there was no significant difference between the two groups of patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients. DISCUSSION There was no significant difference between smoking and nonsmoking periodontitis patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients, which indicates that smoking may impair the response of periodontitis to periodontal treatment.
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Affiliation(s)
- Chun-Ping Hao
- grid.412449.e0000 0000 9678 1884School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning People’s Republic of China
| | - Nan-Jue Cao
- grid.412449.e0000 0000 9678 1884School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning People’s Republic of China
| | - Yu-He Zhu
- grid.412449.e0000 0000 9678 1884School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning People’s Republic of China
| | - Wei Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, People's Republic of China.
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7
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Dolah S, Mohd Adnan M, Abd Rahman N. Towards Healthy Adolescents: A Review of Smoking Impact According to Dental Perspectives. JANUARY 2023 2023; 19:316-324. [DOI: 10.47836/mjmhs.19.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Nowadays, tobacco companies target to recruit new smokers among adolescents due to this age group was easy to be influenced by smoking behaviours. This narrative review aimed to explore the possible impact of smoking among adolescents. Knowing the negative impacts of smoking might result in avoiding continuing the habit or preventing from initiation of the habit. The literature search on PubMed, SCOPUS, and Epistemonikos database with related search terms of “adolescents”, “smoking” and “impact”. Only papers published within the year 2017 to 2021 and in the English language were included. However, articles without full text were excluded from this review. Fourteen articles were selected and divided impacts into three categories which are effect on oral health, effect on general health and other impacts. Possible impacts of smoking among adolescents were identified, and it could be beneficial in the development of customized smoking prevention or smoking cessation intervention for adolescents.
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8
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Iskander MMZ, Lamont GJ, Tan J, Pisano M, Uriarte SM, Scott DA. Tobacco smoke exacerbates Filifactor alocis pathogenicity. J Clin Periodontol 2023; 50:121-130. [PMID: 36122937 PMCID: PMC9976951 DOI: 10.1111/jcpe.13729] [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: 05/26/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
Abstract
AIM Filifactor alocis has recently emerged as a periodontal pathobiont that appears to thrive in the oral cavity of smokers. We hypothesized that identification of smoke-responsive F. alocis genes would provide insight into adaptive strategies and that cigarette smoke would enhance F. alocis pathogenesis in vivo. MATERIALS AND METHODS F. alocis was grown in vitro and cigarette smoke extract-responsive genes determined by RNAseq. Mice were exposed, or not, to mainstream 1R6F research cigarette smoke and infected with F. alocis, or not, in an acute ligature model of periodontitis. Key clinical, infectious, and immune data were collected. RESULTS In culture, F. alocis growth was unaffected by smoke conditioning and only a small number of genes were specifically regulated by smoke exposure. Reduced murine mass, differences in F. alocis-cognizant antibody production, and altered immune profiles as well as altered alveolar bone loss were all attributable to smoke exposure and/or F. alocis infection in vivo. CONCLUSIONS F. alocis is well-adapted to tobacco-rich conditions and its pathogenesis is enhanced by tobacco smoke exposure. A smoke-exposed ligature model of periodontitis shows promise as a tool with which to further unravel mechanisms underlying tobacco-enhanced, bacteria-induced disease.
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Affiliation(s)
- Mina M Z Iskander
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Gwyneth J Lamont
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Jinlian Tan
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michele Pisano
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Silvia M Uriarte
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - David A Scott
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Muacevic A, Adler JR, Eguia A. On Peri-Implant Bone Loss Theories: Trying To Piece Together the Jigsaw. Cureus 2023; 15:e33237. [PMID: 36733558 PMCID: PMC9890078 DOI: 10.7759/cureus.33237] [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] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
This review aims to explore the plausibility of new theories on the etiopathogenesis of marginal bone loss (MBL) and peri-implantitis (PI) and to discuss possible underlying pathogenic mechanisms. The former concept of osteointegration of dental implants can now be conceptualized as a foreign body response histologically characterized by a bony demarcation in combination with chronic inflammation. Different risk factors can provoke additional inflammation and, therefore, pro-inflammatory cytokine release in soft tissues and bone, leading to an overpass of the threshold of peri-implant bone defensive and regenerative capacity. Progressive bone loss observed in MBL and PI is ultimately due to a localized imbalance in the receptor activator of nuclear factor kappaB ligand (RANKL)/Receptor activator of nuclear factor κ B (RANK)/osteoprotegerin (OPG) pathway in favor of increased catabolic activity. The genetic background and the severity and duration of the risk factors could explain differences between individuals in the threshold needed to reach an imbalanced scenario. MBL and PI pathogenesis could be better explained by the "inflammation-immunological balance" theory rather than a solely "infectious disease" conception. The link between the effect of biofilm and other risk factors leading to an imbalanced foreign body response lies in osteoclast differentiation and activation pathways (over)stimulation.
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10
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Zhu L, Zhou C, Chen S, Huang D, Jiang Y, Lan Y, Zou S, Li Y. Osteoporosis and Alveolar Bone Health in Periodontitis Niche: A Predisposing Factors-Centered Review. Cells 2022; 11:3380. [PMID: 36359775 PMCID: PMC9657655 DOI: 10.3390/cells11213380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/26/2023] Open
Abstract
Periodontitis is a periodontal inflammatory condition that results from disrupted periodontal host-microbe homeostasis, manifested by the destruction of tooth-supporting structures, especially inflammatory alveolar bone loss. Osteoporosis is characterized by systemic deterioration of bone mass and microarchitecture. The roles of many systemic factors have been identified in the pathogenesis of osteoporosis, including endocrine change, metabolic disorders, health-impaired behaviors and mental stress. The prevalence rate of osteoporotic fracture is in sustained elevation in the past decades. Recent studies suggest that individuals with concomitant osteoporosis are more vulnerable to periodontal impairment. Current reviews of worse periodontal status in the context of osteoporosis are limited, mainly centering on the impacts of menopausal and diabetic osteoporosis on periodontitis. Herein, this review article makes an effort to provide a comprehensive view of the relationship between osteoporosis and periodontitis, with a focus on clarifying how those risk factors in osteoporotic populations modify the alveolar bone homeostasis in the periodontitis niche.
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Affiliation(s)
| | | | | | | | | | | | | | - Yuyu Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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11
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Apatzidou DA. The role of cigarette smoking in periodontal disease and treatment outcomes of dental implant therapy. Periodontol 2000 2022; 90:45-61. [PMID: 35950749 DOI: 10.1111/prd.12449] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Tobacco smoking has been implicated in periodontal pathology through various mechanisms, including perturbations of the inflammatory and host responses to putative periodontal pathogens, alterations in the subgingival microbial communities, and a compromised healing potential of the tissues leading to imbalance of tissue homeostasis. This review provides the evidence for the relationship between cigarette smoking and periodontal disease in an attempt to explain possible mechanisms of how tobacco smoking may exert its negative effects on the periodontal tissues via systemic and localized pathways. Early and more recent studies explore cigarette smoking-induced changes in periodontal clinical indices; in subgingival microbial flora by employing traditional detection methods for selected microorganisms, in addition to modern techniques such as deep sequencing and bioinformatics analyses that are able to fully characterize the microbial communities; and in inflammatory and immune responses critically appraising study limitations and differences in study protocol designs. Periodontal treatment outcomes and implant therapy outcomes are reviewed in an attempt to shed light on possible mechanisms for the inferior treatment outcome noted in smokers. The potential harmful effects of passive smoking are also reviewed, providing evidence for the advantages of smoking cessation. Quitting cigarette smoking should be recommended by the dentist, and effort should be made to inform smokers about the negative effects of smoking on the periodontal status and implant therapy outcomes.
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Affiliation(s)
- Danae Anastasia Apatzidou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece
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12
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Pouly S, Ng WT, Blanc N, Hession P, Zanetti F, Battey JND, de La Bourdonnaye G, Heremans A, Haziza C. Effect of switching from cigarette smoking to the use of the tobacco heating system on periodontitis treatment outcome: Periodontal parameter results from a multicenter Japanese study. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.915079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ObjectivesWe conducted a 6-month randomized clinical study to evaluate the impact of exposure to the aerosol of the Tobacco Heating System (THS), a smoke-free alternative to cigarettes, on changes in periodontal parameters after scaling and root planing (SRP) for periodontitis in subjects who were either continuing to smoke cigarettes or had switched to THS.Material and methodsSmokers with generalized periodontitis were randomized to continue smoking cigarettes or switch to THS use. They underwent SRP for up to 8 weeks, with dental assessments conducted at baseline and at 3 and 6 months after the first treatment.ResultsAfter SRP treatment, all groups showed improvements in the mean full-mouth probing depth (PD), full-mouth clinical attachment level (CAL), gingival inflammation score, plaque control record (PCR), and bleeding on probing (BoP). There were no statistically significant intergroup differences. However, as compared to smokers, THS users showed a trend toward more favorable outcomes in BoP, PCR, and PD improvement at sites with higher initial PD (≥7 mm).ConclusionsOur results indicate that SRP improves the course of periodontitis similarly in cigarette smokers and THS users. The beneficial effects of this treatment might mask the favorable changes that may occur upon modifying one of the several periodontitis risk factors, such as cigarette smoking.Clinical trial registrationClinicalTrials.gov, identifer: NCT03364751.
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13
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Scott D, Dukka H, Saxena D. Potential Mechanisms Underlying Marijuana-Associated Periodontal Tissue Destruction. J Dent Res 2022; 101:133-142. [PMID: 34515556 PMCID: PMC8905217 DOI: 10.1177/00220345211036072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
While definitive evidence awaits, cannabis is emerging as a likely risk factor for periodontal tissue destruction. The mechanisms that underlie potential cannabis-induced or cannabis-enhanced periodontal diseases, however, remain to be elucidated. Herein, we 1) examine insights obtained from the endocannabinoid system, 2) summarize animal models of exposure to cannabinoid receptor agonists and antagonists, 3) review the evidence suggesting that cannabis and cannabis-derived molecules exert a profound influence on components of the oral microbiome, and 4) assess studies indicating that marijuana and phytocannabinoids compromise the immune response to plaque. Furthermore, we address how knowledge of cannabinoid influences in the oral cavity may be exploited to provide potential novel periodontal therapeutics, while recognizing that such medicinal approaches may be most appropriate for nonhabitual marijuana users. The suspected increase in susceptibility to periodontitis in marijuana users is multifaceted, and it is clear that we are only beginning to understand the complex toxicological, cellular, and microbial interactions involved. With marijuana consumption increasing across all societal demographics, periodontal complications of use may represent a significant, growing oral health concern. In preparation, an enhanced research response would seem appropriate.
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Affiliation(s)
- D.A. Scott
- Oral Immunology and Infectious
Diseases, School of Dentistry, University of Louisville, Louisville, KY,
USA
- D.A. Scott, School of Dentistry,
University of Louisville, 501 S. Preston St, Louisville, KY 40292,
USA.
| | - H. Dukka
- Diagnosis and Oral Health, School
of Dentistry, University of Louisville, Louisville, KY, USA
| | - D. Saxena
- Molecular Pathobiology, College
of Dentistry, New York University, New York, USA
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Chaffee BW, Couch ET, Vora MV, Holliday RS. Oral and periodontal implications of tobacco and nicotine products. Periodontol 2000 2021; 87:241-253. [PMID: 34463989 PMCID: PMC8444622 DOI: 10.1111/prd.12395] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tobacco use contributes to more mortality and morbidity globally than any other behavioral risk factor. Adverse effects do not spare the oral cavity, with many oral diseases more common, and treatments less successful, in the tobacco-using patient. Many of the oral health effects of cigarette smoking are well established, but other forms of tobacco, including cigars and smokeless tobacco, merit dental professionals' attention. Recently, an expanding variety of new or emerging tobacco and/or nicotine products has been brought to market, most prominently electronic cigarettes, but also including heated tobacco and other noncombustible nicotine products. The use of cannabis (marijuana) is increasing and also has risks for oral health and dental treatment. For the practicing periodontist, and all dental professionals, providing sound patient recommendations requires knowledge of the general and oral health implications associated with this wide range of tobacco and nicotine products and cannabis. This review provides an overview of selected tobacco and nicotine products with an emphasis on their implications for periodontal disease risk and clinical management. Also presented are strategies for tobacco use counselling and cessation support that dental professionals can implement in practice.
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Affiliation(s)
- Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Manali V. Vora
- Division of Periodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Richard S. Holliday
- NIHR Clinical Lecturer in Restorative Dentistry, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. BIOLOGY 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
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Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
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Escalda C, Botelho J, Mendes JJ, Machado V. Association of bacterial vaginosis with periodontitis in a cross-sectional American nationwide survey. Sci Rep 2021; 11:630. [PMID: 33436651 PMCID: PMC7803979 DOI: 10.1038/s41598-020-79496-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
To explore the association between bacterial vaginosis (BV) and periodontitis (PD) and to determine whether PD and BV might be linked with systemic serum alterations. We used the National Health and Nutrition Examination Survey 2001-2004, with women aged 18-49 years old and diagnosed with or without BV according to Nugent's method. PD was defined according to the 2012 case definition. We compared serum counts according to the presence of PD and the presence of BV. Multivariable regression was used to explore and identify relevant variables towards the presence of BV. 961 women fulfilled the inclusion criteria. In women with BV, PD was associated with higher inflammation, characterized by increased white blood cells (p = 0.006) and lymphocyte (p = 0.009) counts. Predictive models presented a statistically significant association between PD and BV [Odds Ratio (OD) = 1.69, 95% Confidence Interval (CI): 1.09-2.61 for periodontitis; OD = 2.37, 95% CI: 1.30-4.29 for severe PD]. Fully adjusted models for age, smoking, body mass index, diabetes mellitus and number of systemic conditions reinforced this association [OD = 1.71, 95% CI: 1.06-2.76 for PD; OD = 2.21, 95% CI: 1.15-4.25 for severe PD]. An association between BV and PD is conceivable. PD was associated with higher systemic markers of inflammation in women with BV. Our data is novel and could serve as a foundation to guide future studies in the confirmation of this association and the underlying mechanisms.
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Affiliation(s)
- Cláudia Escalda
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - João Botelho
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
- Periodontology Department, Egas Moniz Dental Clinic, Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center (EMIRC), IUEM, Egas Moniz University, Campus Universitário, Quinta da Granja, Monte de Caparica, Caparica, 2829 - 511, Almada, Portugal
| | - José João Mendes
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Vanessa Machado
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal.
- Periodontology Department, Egas Moniz Dental Clinic, Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center (EMIRC), IUEM, Egas Moniz University, Campus Universitário, Quinta da Granja, Monte de Caparica, Caparica, 2829 - 511, Almada, Portugal.
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17
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Macroscopic Changes in Oral Mucosa and Hygiene Indicators in Smokers. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:383-392. [PMID: 35003770 PMCID: PMC8679161 DOI: 10.12865/chsj.47.03.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/15/2021] [Indexed: 11/18/2022]
Abstract
Smoking is the most important factor affecting the oral cavity by components born in the tobacco combustion process and acting directly on the oral mucous membranes, dental arch and indirectly on the teeth support. Recent studies show the tobacco action on the oral cavity, manifestations in the form of gingivitis, bacterial plaque, dental plaque, papillary bleeding at drilling, periodontitis. PURPOSE OF THE STUDY In this study, we have set out to assess the macroscopic modifications of oral cavity on smokers. MATERIALS AND METHODS The participants in the study were divided into two groups, the first group of smokers with a smoking period over 5 years and the control group of nonsmokers. The patients in the two groups underwent a physical examination and an objective clinical examination, the resulting data being compared with the control group. RESULTS For the bacterial plaque indicatorin the smoker group there was obtained a mean value of 35.68±12.45, compared to a mean value of 16.32±6.61 for the nonsmoker group, the dental plaque indicatorfor the smoker group had a mean value of 2.24±1.02, higher than the one in the nonsmoker group, namely 0.94±0.68, and for the drilling bleeding indicator we obtained a mean value of 19.54±7.89 in the nonsmoker group, which is lower than that in the smoker group, namely 42.86±14.93. CONCLUSIONS Smoking is a cause that maintains and aggravates the periodontal disease, including the risk of periodontitis, allowing the aggravation of gingivitis, considered a reversible surface inflammation of the gum mucosa which, by accumulation of dental plaque, the dental plaque accompanied by incorrect oral hygiene, favors the progression to periodontitis.
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18
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Abstract
Periodontal diseases are chronic inflammatory, multifactorial diseases where the major triggering factors for disease onset are bacteria and their toxins, but the major part of tissue destruction occurs as a result of host response towards the periodontal microbiome. Periodontal microbiome consists of a wide range of microorganisms including obligate and facultative anaerobes. In health, there is a dynamic balance between the host, environment, and the microbiome. Environmental factors, mainly tobacco smoking and psychological stress, disrupt the symbiotic relationship. Tobacco smoke and its components alter the bacterial surface and functions such as growth. Psychological stressors and stress hormones may affect the outcome of an infection by changing the virulence factors and/or host response. This review aims to provide currently available data on the effects of the major environmental factors on the periodontal microbiome.
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Affiliation(s)
- Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
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19
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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20
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Holde GE, Jönsson B, Oscarson N, Müller H. To what extent does smoking affect gingival bleeding response to supragingival plaque? Site‐specific analyses in a population‐based study. J Periodontal Res 2020; 55:277-286. [DOI: 10.1111/jre.12713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/10/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Gro Eirin Holde
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Nils Oscarson
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
| | - Hans‐Peter Müller
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
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21
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Wang Y, Anderson EP, Tatakis DN. Whole transcriptome analysis of smoker palatal mucosa identifies multiple downregulated innate immunity genes. J Periodontol 2020; 91:756-766. [DOI: 10.1002/jper.19-0467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yun Wang
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
| | - Eric P. Anderson
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
- Private practice Aurora CO
| | - Dimitris N. Tatakis
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus OH
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22
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Gu Z, Singh S, Niyogi RG, Lamont GJ, Wang H, Lamont RJ, Scott DA. Marijuana-Derived Cannabinoids Trigger a CB2/PI3K Axis of Suppression of the Innate Response to Oral Pathogens. Front Immunol 2019; 10:2288. [PMID: 31681262 PMCID: PMC6804395 DOI: 10.3389/fimmu.2019.02288] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 09/10/2019] [Indexed: 12/18/2022] Open
Abstract
Cannabis use is an emergent risk factor for periodontitis, a chronic bacterial-induced disease of the supporting structures of the teeth. However, the mechanisms by which marijuana exposure predisposes to periodontal tissue destruction have yet to be elucidated. Therefore, we examined the influence of physiologically relevant doses of major marijuana-derived phytocannabinoid subtypes (cannabidiol [CBD]; cannabinol [CBN]; and tetrahydrocannabinol [THC], 1.0 μg/ml) on the interactions of three ultrastructurally variant oral pathogens, Porphyromonas gingivalis, Filifactor alocis, and Treponema denticola with the immune system. CBD, CBN, and THC each suppressed P. gingivalis-induced IL-12 p40, IL-6, IL-8, and TNF release while enhancing the anti-inflammatory cytokine, IL-10, from human innate cells. Similar phenomena were observed in F. alocis- and T. denticola-exposed human monocytes and human gingival keratinocytes. Higher phytocannabinoid doses (≥5.0 μg/ml) compromised innate cell viability and inhibited the growth of P. gingivalis and F. alocis, relative to unexposed bacteria. T. denticola, however, was resistant to all cannabinoid doses tested (up to 10.0 μg/ml). Pharmaceutical inhibition and efficient gene silencing indicated that a common CB2/PI3K axis of immune suppression is triggered by phytocannabinoids in vitro. This pathway does not appear to perpetuate through the canonical GSK3β-dependent cholinergic anti-inflammatory pathway, the predominant endogenous inflammatory control system. In a repetitive, transient oral infection model, CBD also suppressed P. gingivalis-induced innate immune markers in wild-type mice, but not in CB2−/− mice. If such phenomena occur in humans in situ, environmental cannabinoids may enhance periodontitis via direct toxic effects on specific oral bacteria; by compromising innate cell vitality; and/or through a suppressed innate response to periodontal pathogens involving a CB2/PI3K signaling lineage.
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Affiliation(s)
- Zhen Gu
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Shilpa Singh
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Rajarshi G Niyogi
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Gwyneth J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Huizhi Wang
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Richard J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - David A Scott
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
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Mumcu E, Dayan SÇ. Effect of Smoking and Locations of Dental Implants on Peri-Implant Parameters: 3-Year Follow-Up. Med Sci Monit 2019; 25:6104-6109. [PMID: 31414668 PMCID: PMC6707095 DOI: 10.12659/msm.916613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/26/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Smoking may be a risk factor for marginal bone loss (MBL) and oral mucosal inflammation surrounding dental implants. This retrospective study evaluated the effects of smoking on dental implants in patients with fixed implant-supported prostheses over a period of 36 months following loading. MATERIAL AND METHODS We assessed 120 patients (68 women, 52 men, ages 19-74 years (mean age: 55.10 years) with 315 implants. Implants were classified according to location in the upper and lower jaws and anterior (placed between canines) or posterior (placed between pre-molars and molars) as follows: 1=maxilla anterior, 2=maxilla posterior, 3=mandible anterior, 4=mandible posterior. We also measured MBL, plaque index (PI), sulcus bleeding index (SBI), and probing depth (PD). P-values less than 0.05 were considered statistically significant. RESULTS MBL was statistically greater in smokers (P<0.001) as compared to non-smokers in both jaws. MBL did not vary significantly by location in either group (smokers: p=0.415; non-smokers: p=0.175). Mean PI and PD scores were significantly higher in smokers as compared to non-smokers (P<0.001). A positive correlation was found between PI and PD scores in both groups. No statistically significant difference in SBI was observed between the 2 groups (P>0.05). CONCLUSIONS Smoking was associated with increases in marginal bone loss around implants, independent of their location in the jaws. Also, both plaque indices and probing depths were greater in smokers than in non-smokers.
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Affiliation(s)
- Emre Mumcu
- Department of Prosthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
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Zeller I, Malovichko MV, Hurst HE, Renaud DE, Scott DA. Cigarette smoke reduces short chain fatty acid production by a Porphyromonas gingivalis clinical isolate. J Periodontal Res 2019; 54:566-571. [PMID: 30982987 PMCID: PMC6776670 DOI: 10.1111/jre.12660] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/13/2019] [Accepted: 03/18/2019] [Indexed: 01/13/2023]
Abstract
Objectives We hypothesized that short chain fatty acid (SCFA) production by oral pathogens is suppressed by exposure to cigarette smoke extract (CSE). Background Tobacco smoking is a major risk factor for plaque‐induced periodontal diseases. Despite increased disease susceptibility, overt oral inflammation is suppressed in smokers, presenting a diagnostic conundrum. Bacterial‐derived SCFAs can penetrate into oral tissues where they influence multiple components of immune and healing responses. Indeed, the SCFA burden has been correlated with the inflammatory condition of the gingiva. However, the influence of cigarette consumption on SCFA production is unknown. Methods GC/MS was employed to monitor the production of several SCFAs (propionic acid, isobutyric acid, butyric acid, and isovaleric acid) by representative anaerobic oral pathogens (Filifactor alocis 35896, Fusobacterium nucleatum 25586, Porphyromonas gingivalis 33277) that were exposed, or not, to a physiologically relevant dose of CSE (2000 ng/ml nicotine equivalents) generated from 3R4F reference cigarettes. Results The growth of all three bacterial species was unaffected by CSE. The capacity to produce SCFAs by these bacteria was highly varied. F alocis produced the highest concentration of a specific SCFA (butyrate); P gingivalis provided the most robust overall SCFA signal, while F alocis and F nucleatum did not release detectable levels of isobutyrate or isovalerate. As P gingivalis 33277 was the broadest SCFA producer, three low‐passage clinical isolates (10208C, 5607, and 10512) were also examined. Compared to unconditioned microbes, reduced SCFA release was apparent in CSE‐exposed low‐passage clinical isolates of P gingivalis which reached significance for one of the three isolates (propionic, isobutyric, butyric, and isovaleric acids, all P < 0.05). Conclusions There is high disparity in the SCFA profiles of variant chronic periodontitis‐associated bacteria, while CSE exposure reduces SCFA production by a specific clinical strain of P gingivalis. If the latter phenomenon occurs in vivo, a reduced SCFA burden may help explain the reduced vascular response to dental plaque in tobacco smokers.
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Affiliation(s)
- Iris Zeller
- Departments of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky
| | - Marina V Malovichko
- University of Louisville Superfund Research Center and Envirome Institute, University of Louisville, Louisville, Kentucky.,American Heart Association Tobacco Regulatory Science and Addiction Center, University of Louisville, Louisville, Kentucky
| | - Harrell E Hurst
- Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky
| | - Diane E Renaud
- Departments of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky
| | - David A Scott
- Departments of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky
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Kanmaz B, Lamont G, Danacı G, Gogeneni H, Buduneli N, Scott DA. Microbiological and biochemical findings in relation to clinical periodontal status in active smokers, non-smokers and passive smokers. Tob Induc Dis 2019; 17:20. [PMID: 31582931 PMCID: PMC6751988 DOI: 10.18332/tid/104492] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/16/2019] [Accepted: 02/18/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Cigarette users are more susceptible than non-smokers to periodontitis, a bacterial-induced, inflammation-driven, destructive disease of the supporting tissues of the teeth. We hypothesized that clinical periodontal findings and microbiological and/or inflammatory marker levels would be intermediate in those exposed to environmental tobacco smoke compared to active smokers and non-smokers. METHODS Sixty individuals were recruited from a University periodontal clinic and assigned as non-smokers, active smokers or passive-smokers according to their self reports. Clinical periodontal measurements, comprising plaque index, probing depth (PD), clinical attachment level (CAL) and bleeding on probing, were recorded at six sites per tooth. Cotinine levels were determined in whole saliva samples by EIA. Treponema denticola and Porphyromonas gingivalis infection was determined by PCR, while matrix metalloproteinase-8 (MMP-8) and interleukin-8 (IL-8) concentrations were determined by ELISA. RESULTS Study groups were subsequently reassigned in accordance with the cotinine data. The smoker group exhibited higher mean PD and CAL values compared to the non-smoker group (p<0.05). Passive-smokers exhibited PD and CAL values smaller than those of the active smokers and greater than those of the non-smokers, but the differences were not statistically significant. PD and CAL values correlated with cotinine concentrations (p<0.05). P. gingivalis infection was noted in most subjects, irrespective of smoking status. T. denticola infection was noted in 4/23 (17.4%) smokers, 0/16 (0%) environmentally-exposed recruits and 2/21 (9.5%) non-smokers. Salivary MMP-8 and IL-8 levels were lower in smokers compared to both non-smokers and passive-smokers but the differences were not significant (all p>0.05). CONCLUSIONS The present clinical periodontal findings provide further support for a negative, dose-related effect of tobacco exposure on periodontal health. The tendency for a more prevalent detection of T. denticola and for a suppressed inflammatory response observed in the smokers may partly explain the increased susceptibility to periodontal tissue destruction, but needs to be verified in larger scale studies.
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Affiliation(s)
- Burcu Kanmaz
- Department of Periodontology, Faculty of Dentistry, İzmir Democracy University, İzmir, Turkey
| | - Gwyneth Lamont
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, United States
| | - Gülcan Danacı
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Himabindu Gogeneni
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, United States
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - David A Scott
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, United States
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