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Pecher AC, Günaydin B, Finke H, Henes J. Evaluation of oral health in 148 patients with systemic sclerosis-data from a prospective interdisciplinary monocentric cohort. Rheumatol Int 2024; 44:1567-1573. [PMID: 38874787 PMCID: PMC11222211 DOI: 10.1007/s00296-024-05635-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
In daily rheumatology practice, systemic sclerosis is primarily regarded as a potentially life-threatening disease characterized by fibrosis of various organs. Therefore, other manifestations, such as orofacial involvement, are often not of primary concern. Furthermore, due to its rarity, the disease might not be well known by dentists, which contrasts with the increased risk of various problems in the oral cavity. Periodontitis in particular is a known risk factor for morbidity and mortality and is associated with various systemic diseases. The risk of periodontitis appears to be increased in patients with systemic sclerosis, but little is known about the gender-specific differences. This study aims to elucidate the health-conscious behaviour of patients, their dental care and the risk of periodontitis with regard to gender-specific differences. This descriptive study of the Interdisciplinary Centre of Rheumatic Diseases (INDIRA) in collaboration with the Department of Orthodontics at the University Hospital of Tuebingen, Germany, examined the data of 148 patients with systemic sclerosis with regard to their oral health using a questionnaire and evaluating the risk of periodontitis with the DG Paro self-assessment score in this cohort. Among the participating patients, 90% reported regular visits to the dentist and good dental care. Nevertheless, more than half of the patients had missing teeth and problems opening their mouths. Sicca symptoms in the oral cavity were also common (40%). The risk of periodontitis among female participants was high (around 60%), and even higher among male study participants (around 80%). Gingival bleeding as a surrogate parameter for periodontitis was associated with salivary flow and the modified Rodnan skin score (mRSS). Despite a high awareness of dental health, we observed a high risk of periodontitis, especially in male patients with systemic sclerosis. In addition, the association between xerostomia and missing teeth as well as gingival bleeding and mRSS may indicate an increased risk in patients with a more progressive disease. We would therefore recommend regular dental consultations and careful oral hygiene for patients with systemic sclerosis in addition to the-more organ-focused-regular examinations of patients.
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Affiliation(s)
- Ann-Christin Pecher
- Interdisciplinary Center of Rheumatic Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany
| | - Bahar Günaydin
- Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Hannah Finke
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany.
| | - Jörg Henes
- Interdisciplinary Center of Rheumatic Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany
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Ashford JR. Impaired oral health: a required companion of bacterial aspiration pneumonia. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1337920. [PMID: 38894716 PMCID: PMC11183832 DOI: 10.3389/fresc.2024.1337920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
Laryngotracheal aspiration has a widely-held reputation as a primary cause of lower respiratory infections, such as pneumonia, and is a major concern of care providers of the seriously ill orelderly frail patient. Laryngeal mechanical inefficiency resulting in aspiration into the lower respiratory tract, by itself, is not the cause of pneumonia. It is but one of several factors that must be present simultaneously for pneumonia to develop. Aspiration of oral and gastric contentsoccurs often in healthy people of all ages and without significant pulmonary consequences. Inthe seriously ill or elderly frail patient, higher concentrations of pathogens in the contents of theaspirate are the primary catalyst for pulmonary infection development if in an immunocompromised lower respiratory system. The oral cavity is a complex and ever changing eco-environment striving to maintain homogeneity among the numerous microbial communities inhabiting its surfaces. Poor maintenance of these surfaces to prevent infection can result inpathogenic changes to these microbial communities and, with subsequent proliferation, can altermicrobial communities in the tracheal and bronchial passages. Higher bacterial pathogen concentrations mixing with oral secretions, or with foods, when aspirated into an immunecompromised lower respiratory complex, may result in bacterial aspiration pneumonia development, or other respiratory or systemic diseases. A large volume of clinical evidence makes it clear that oral cleaning regimens, when used in caring for ill or frail patients in hospitals and long-term care facilities, drastically reduce the incidence of respiratory infection and death. The purpose of this narrative review is to examine oral health as a required causative companionin bacterial aspiration pneumonia development, and the effectiveness of oral infection control inthe prevention of this disease.
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T G P, Athul A, D H, Thasneem S, I N, Benedict C, Vijayarangan A, Balachandran A, Muthukali S. Clinical Incorporation of the 2017 Classification of Periodontal Diseased Conditions: Part I (Diagnosis of Periodontitis Involving Data From 4,993 Patients). Cureus 2024; 16:e63423. [PMID: 39077300 PMCID: PMC11284269 DOI: 10.7759/cureus.63423] [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: 06/28/2024] [Indexed: 07/31/2024] Open
Abstract
Background The new classification system for periodontal and peri-implant diseases mentioned a few key points, including (1) "clinical gingival health," which was defined for the first time, and (2) staging and grading system. Thus, the present study defines the practicability of using the current classification system in day-to-day practice. Aim The primary aim of this study is to determine the effectiveness of the new classification system for periodontal and peri-implant diseases and its application in routine dental practices. Materials and methods This is a cross-sectional retrospective, non-interventional study consisting of 4,993 patients who were under active periodontal therapy as well as supportive periodontal therapy. Results Among patients diagnosed with dental biofilm-induced gingivitis with no underlying risk factors, 1105 (73.3%) exhibited bleeding on probing and 897 (45%) showed supragingival or subgingival calculus. Among the stage II grade B periodontitis group, 488 (28.9%) showed beginning destructive periodontal disease and 197 (50.4%) showed established destructive periodontal disease. Conclusion The implementation of the new classification system in routine dental practice has been readily accepted by clinicians. Staging and grading system of classification helps in assessing the severity, extent, and progression of disease.
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Affiliation(s)
- Priyanka T G
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Ashwini Athul
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Harini D
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Shiba Thasneem
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nasser I
- Periodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Cyril Benedict
- Public Health Dentistry, Chettinad Dental College and Research Institute, Chennai, IND
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Amaechi BT, Mohseni S, Dillow AM, Abdul Azees PA, Movaghari Pour F, Kataoka Y, Restrepo MC. Investigation of the effects of Bipolar Radiofrequency Energy on the Structural Morphology of Dental Plaque. Eur J Dent 2024; 18:243-252. [PMID: 37172943 PMCID: PMC10959635 DOI: 10.1055/s-0043-1764427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. MATERIALS AND METHODS Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. STATISTICAL ANALYSIS Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. RESULTS At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. CONCLUSION The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.
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Affiliation(s)
- Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Sahar Mohseni
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Andrew M. Dillow
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Parveez Ahamed Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Fatemeh Movaghari Pour
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Yuko Kataoka
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
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Gürbüz S, Altıkat M. The association between periodontitis patients' chief complaints and the stage of periodontitis: A clinical retrospective study. Clin Oral Investig 2023; 27:6261-6272. [PMID: 37704915 DOI: 10.1007/s00784-023-05258-x] [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: 02/12/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES The purposes of this retrospective study were to investigate the prevalence of various periodontal chief complaints (pCCs) of patients, diagnosed with periodontitis, as well as to identify the association between pCCs and periodontal parameters or periodontitis staging according to AAP/EFP 2017 classification. MATERIALS AND METHODS Five hundred eighty-nine patients, applied to the clinic with pCCs, were screened. The demographic characteristics, smoking status, brushing behaviors, history of periodontal therapy, medical data, and periodontal parameters were obtained. A multinomial logistic regression analysis was performed to determine the most common pCCs and co-variables among the indicators of Stage III and IV periodontitis. RESULTS In Stage IV periodontitis, patients with pCC of mobility were observed the most (26.8%), and pCC of halitosis were the least (7.3%). Among all pCCs of patients, those with the pCC of gingival enlargement and tooth mobility had the highest percentage of sites with PPD ≥ 4 mm and CAL ≥ 5 mm, respectively (p < .001). According to regression analysis, those with pCC of gingival bleeding, recession and mobility were more likely to be in Stage IV than those in Stage I/II. CONCLUSION Among pCCs, only patients with pCCs of mobility, gingival recession and bleeding are related to periodontitis staging. Moreover, the extent of periodontal pockets in patients with pCC of gingival enlargement, and the extent of attachment loss in patients with pCC of mobility are greater than other patients. CLINICAL RELEVANCE New machine-learning technology models can be developed with the aim of classifying the patients based on their chief complaints, to support diagnosing the severity of periodontal diseases.
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Affiliation(s)
- Sühan Gürbüz
- Department of Periodontology, Gazi University Faculty of Dentistry, Bişkek Caddesi, 1.Sokak No. 4, 06490, Ankara, Türkiye.
| | - Merve Altıkat
- Vocational School of Health Care Services, İstinye University, İstanbul, Türkiye
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Lee YH, Shin SI, Hong JY. Investigation of volatile sulfur compound level and halitosis in patients with gingivitis and periodontitis. Sci Rep 2023; 13:13175. [PMID: 37580412 PMCID: PMC10425441 DOI: 10.1038/s41598-023-40391-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023] Open
Abstract
This study aimed to measure the levels of volatile sulfur compounds and investigate the occurrence of halitosis in patients with gingivitis and periodontitis. Additionally, the incidence rates of gingivitis and periodontitis in patients with halitosis were investigated. Through various statistical analyses, we attempted to determine the relationship between periodontal disease and halitosis. One-hundred-and-four participants (52 females and 52 males, mean age: 46.49 ± 16.03 years) were enrolled in this cross-sectional study, comprising 33 healthy controls, 43 patients with gingivitis, and 28 patients with periodontitis. Gas chromatography was used to measure hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), which are representative VSCs. The VSC cut-off values for diagnosing halitosis were 65.79 ppb for women and 79.94 ppb for men. Total VSC level was significantly higher in the gingivitis than the healthy control group (186.72 ± 374.83 ppb vs. 19.80 ± 40.19 ppb, p = 0.035). There was no significant difference between the gingivitis and periodontitis (153.79 ± 278.51 ppb) groups. H2S level was significantly higher in the gingivitis (100.51 ± 183.69 ppb) and periodontitis (91.57 ± 132.06 ppb) groups than in healthy controls (14.97 ± 31.22 ppb), and CH3SH level was significantly higher in gingivitis group (29.31 ± 59.16 ppb) than in the healthy control (5.73 ± 14.10 ppb) (all p < 0.05). Halitosis was found in 3% of healthy controls and 39.5% and 42.9% of patients with gingivitis and periodontitis patients, respectively, making it significantly higher in the gingivitis and periodontitis groups than the healthy controls (p = 0.005). Conversely, among participants with halitosis, 53.1% had gingivitis, 37.5% had periodontitis, and 90.6 incidence had periodontal disease. Multivariate logistic regression analysis to predict the presence of halitosis, found periodontal disease was a significant predictor of halitosis (OR = 3.607, 95% CI 1.023-12.718, p = 0.046). Considering area under curve value for halitosis, the cut-off value of healthy control (H2S:61.5 ppb, CH3SH:3.5 ppb), gingivitis (H2S:50.0 ppb, CH3SH:6 ppb), and periodontitis (H2S:62.0 ppb, CH3SH:3.5 ppb) were (all p < 0.05). Our results emphasize the close and strong relationship between periodontal disease and halitosis through human clinical evidence based on the high co-occurrence rate of mutual diseases. Additionally, the presence of periodontal disease increased the probability of halitosis by 3.607 times. These results suggest that H2S can be used as a biomarker of halitosis in patients with periodontal disease.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
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Paczkowska-Walendowska M, Szymanowska D, Cielecka-Piontek J. Mechanochemical Properties of Mucoadhesive Tablets Based on PVP/HPβCD Electrospun Nanofibers as Local Delivery of Polygoni cuspidati Extract for Treating Oral Infections. Pharmaceuticals (Basel) 2023; 16:ph16040579. [PMID: 37111336 PMCID: PMC10145533 DOI: 10.3390/ph16040579] [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: 03/10/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
This study investigated the ability of PVP/HPβCD-based electrospun nanofibers to enhance the dissolution rate of poorly soluble polydatin and resveratrol, the main active components of Polygoni cuspidati extract. To make a solid unit dosage form that would be easier to administer, extract-loaded nanofibers were ground. SEM examination was used to analyze the nanostructure of the fibers, and the results of the cross-section of the tablets showed that they had maintained their fibrous structure. The release of the active compounds (polydatin and resveratrol) in the mucoadhesive tablets was complete and prolonged in time. Additionally, the possibility of staying on the mucosa for a prolonged time has also been proven for both tablets from PVP/HPβCD-based nanofibers and powder. The appropriate physicochemical properties of the tablets, along with the proven antioxidant, anti-inflammatory, and antibacterial properties of P. cuspidati extract, highlight the particular benefits of the mucoadhesive formulation for use as a drug delivery system for periodontal diseases.
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Affiliation(s)
| | - Daria Szymanowska
- Department of Biotechnology and Food Microbiology, Poznan University of Life Sciences, 48 Wojska Polskiego Street, 60-627 Poznan, Poland
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland
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Azzola LG, Fankhauser N, Srinivasan M. Influence of the vegan, vegetarian and omnivore diet on the oral health status in adults: a systematic review and meta-analysis. Evid Based Dent 2023; 24:43-44. [PMID: 36894675 DOI: 10.1038/s41432-023-00853-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/23/2022] [Indexed: 03/11/2023]
Abstract
OBJECTIVE This systematic review aimed to evaluate the influence of the nature of diet (vegan, vegetarian, and omnivore) on the oral health status in adults. METHODS This systematic review and meta-analysis was performed using the PRISMA guidelines. Electronic databases [PubMed, Embase, CENTRAL], online search engines (Google Scholar), research portals, and hand searches were performed systematically to identify studies. The last literature search was performed February 1st, 2021. Studies were included if they reported on the influence of the nature of diet on the oral health status (oral hygiene, periodontal health, dental status, and salivary function) in adults, by two investigators. Inter-investigator reliability was evaluated using Kappa (κ) statistics. PROSPERO registration number: CRD42020211567. RESULTS Twenty-two studies were included for data extraction and final analysis. The meta-analysis revealed that the bleeding on probing measure was higher in omnivores (Z = -4.057, p < 0.0001; 95% CI: -0.684, -0.238; I2 = 0.0%) and the overall periodontal health was significantly better in vegan/vegetarians than omnivores (Z = -2.632, p = 0.008; 95% CI: -0.274, -0.073; I2 = 29.7%). Vegan/vegetarians demonstrated more dental erosion (Z = 3.325, p = 0.001; 95% CI: 0.170, 0.659; I2 = 0.0%). In adults over 60 years old, the prevalence of caries was higher in omnivores (Z = 3.244, p = 0.001; 95% CI: 0.092, 0.371; I2 = 0.0%), while complete edentulism was more prevalent in vegetarians (Z = -4.147, p < 0.0001; 95% CI: -0.550, -0.197; I2 = 0.0%). CONCLUSIONS This review reveals that adults on an omnivore diet may be associated with a higher risk for periodontal problems and dental caries, while vegetarians/vegans may be associated with a higher risk for dental erosion.
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Affiliation(s)
- Luana Giò Azzola
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Nicolas Fankhauser
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Murali Srinivasan
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland.
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Buzza KM, Pluen A, Doherty C, Cheesapcharoen T, Singh G, Ledder RG, Sreenivasan PK, McBain AJ. Modulation of Biofilm Formation and Permeability in Streptococcus mutans during Exposure To Zinc Acetate. Microbiol Spectr 2023; 11:e0252722. [PMID: 36809043 PMCID: PMC10100724 DOI: 10.1128/spectrum.02527-22] [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: 07/29/2022] [Accepted: 01/06/2023] [Indexed: 02/23/2023] Open
Abstract
The penetration of biofilms by antimicrobials is a potential limiting factor in biofilm control. This is relevant to oral health, as compounds that are used to control microbial growth and activities could also affect the permeability of dental plaque biofilm with secondary effects on biofilm tolerance. We investigated the effects of zinc salts on the permeability of Streptococcus mutans biofilms. Biofilms were grown with low concentrations of zinc acetate (ZA), and a transwell transportation assay was applied to test biofilm permeability in an apical-basolateral direction. Crystal violet assays and total viable counts were used to quantify the biofilm formation and viability, respectively, and short time frame diffusion rates within microcolonies were determined using spatial intensity distribution analysis (SpIDA). While the diffusion rates within biofilm microcolonies were not significantly altered, exposure to ZA significantly increased the overall permeability of S. mutans biofilms (P < 0.05) through decreased biofilm formation, particularly at concentrations above 0.3 mg/mL. Transport was significantly lower through biofilms grown in high sucrose conditions. IMPORTANCE Zinc salts are added to dentifrices to improve oral hygiene through the control of dental plaque. We describe a method for determining biofilm permeability and show a moderate inhibitory effect of zinc acetate on biofilm formation, and that this inhibitory effect is associated with increases in overall biofilm permeability.
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Affiliation(s)
- Kara M. Buzza
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Alain Pluen
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Christopher Doherty
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Tanaporn Cheesapcharoen
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Gurdeep Singh
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Ruth G. Ledder
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Prem K. Sreenivasan
- HITLAB, New York, New York, USA
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Andrew J. McBain
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Kumar A, Grover V, Satpathy A, Jain A, Grover HS, Khatri M, Kolte A, Dani N, Melath A, Chahal GS, Thomas B, Pradeep AR, Pandit N, Pillai BRM, Manjunath RGS, Nandkeoliar T, Puri K, Singhal R, Dodwad V, Bhardwaj A, Thakur R, Jalaluddin M, Boyapati R, Singh MK, Bansal M. ISP good clinical practice recommendations for gum care. J Indian Soc Periodontol 2023; 27:4-30. [PMID: 36873963 PMCID: PMC9979817 DOI: 10.4103/jisp.jisp_561_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 03/07/2023] Open
Abstract
Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to "Gum Care for All", is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.
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Affiliation(s)
- Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Vishakha Grover
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed to be University), KIIT University, Bhubaneswar, Odisha, India
| | - Ashish Jain
- Department of Periodontology, Dental Institute, RIMS, Ranchi, Jharkhand, India
| | | | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Abhay Kolte
- Department of Periodontics, VSPM Dental College and Research Centre, Nagpur, India
| | | | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Puducherry, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Biju Thomas
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Mangaluru, India
| | - Avni Raju Pradeep
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Nymphea Pandit
- Department of Periodontology, D.A.V Dental College and Hospital, Yamunanagar, Haryana, India
| | | | - R. G. Shiva Manjunath
- Department of Periodontics, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Tanya Nandkeoliar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Komal Puri
- Department of Periodontology, Faculty of Dental Sciences, PDM University, Bahadurgarh, Haryana, India
| | - Rameshwari Singhal
- Department of Periodontology, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Vidya Dodwad
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, India
| | - Amit Bhardwaj
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, Maharashtra, India
| | - Mohammad Jalaluddin
- Department of Periodontics and Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Ramanarayana Boyapati
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Manoj Kumar Singh
- Department of Periodontics, Guru Nanak Institute of Dental Science and Research, Kolkata, West Bengal, India
| | - Mansi Bansal
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
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11
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Gain a Baby Lose a Tooth-Is There an Association between Periodontitis and Preterm Birth? J Clin Med 2022; 11:jcm11237183. [PMID: 36498757 PMCID: PMC9739114 DOI: 10.3390/jcm11237183] [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: 11/02/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Preterm birth serves as one of the leading causes of neonatal mortality worldwide. The underlying mechanisms that contribute to preterm birth are not yet fully understood. However, an association between periodontitis and preterm birth has been proposed. The periodontal status and presence of periodontal pathogens in women with different birth outcomes have been previously examined. However, varying definitions of periodontitis and different microbiological methods make their interpretation challenging. The aim of this case-control study on women with and without preterm birth was to investigate their periodontal status using the current classification system for periodontal diseases. Moreover, differences in the periodontal microbiome of the study participants were investigated. Therefore, we collected data on oral and periodontal parameters in 77 puerperal women divided into two groups based on gestational age at delivery: 33 patients with preterm birth (PTB, <37 weeks) and 44 patients with term birth (TB, >37 weeks). These data included pocket probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), gingival-bleeding index, DMFT index, and gynecologic and dental history. In addition, their oral microbiome was explored. Median CAL and percentage PPD ≥ 4 mm were significantly higher in the PTB group than in the TB group (p = 0.0128 and p = 0.047, respectively). Birth weight was significantly higher in periodontally healthy women than in those with gingivitis (p = 0.0078) or periodontitis (p = 0.0127). The periodontal microbiome differed significantly between groups. Our results are underlining the possible association between periodontitis and preterm delivery. Women with periodontitis had babies with significantly lower birth weights. The microbiome varied between the groups.
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12
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Claydon N, Thomas DW, Adams RJ, West N, Hodge S. BSP implementation of the 2017 classification of periodontal diseases: a practice retrospective. Br Dent J 2022:10.1038/s41415-022-5220-8. [PMID: 36434084 DOI: 10.1038/s41415-022-5220-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/23/2022] [Indexed: 11/27/2022]
Abstract
Introduction The new world classification of periodontal diseases and conditions was developed in 2017. The British Society of Periodontology and Implant Dentistry (BSP) implemented the classification in a series of papers published in the British Dental Journal in January 2019.Aims and objectives This study aimed to investigate if the BSP implementation was workable in general dental practice and to reveal if any lessons were learnt from its regular use two years following its release.Materials and methods This was a cross-sectional, retrospective, non-intervention analysis of a patient population (n = 891) drawn from a complete list of a private dental surgeon. Diagnostic and demographic data were drawn from the patient records, collated and analysed using SPSS Statistics v26.Results Diagnoses derived from the new classification were identified for 92% of subjects, indicating a high level of implementation. In total, 20.9% of subjects were diagnosed with periodontitis, and of these, 57% were unstable, 39% stable and 4% in remission. The mean bleeding on probing score across the cohort was 7.7%. Moreover, 76% of the non-periodontitis patients were diagnosed with 'clinical gingival health', 23% with localised gingivitis and 1% with generalised gingivitis.Conclusion The new classification has been found to be readily implemented in a general practice setting. Use of the new classification allows for close monitoring of periodontal status, and as a result, close monitoring of the effectiveness of pathways of care.
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Affiliation(s)
- Nicholas Claydon
- Specialist in Periodontology, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK
| | - Dave W Thomas
- College of Medicine, University of Wales, Cardiff, CF14 4XY, UK
| | - Robert J Adams
- Specialist in Oral Surgery, School of Dentistry, Cardiff, CF14 4XY, UK
| | - Nicola West
- Periodontology Clinical Trials Group, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK
| | - Shaun Hodge
- Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
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13
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Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth? J Clin Med 2021; 10:jcm10194578. [PMID: 34640596 PMCID: PMC8509337 DOI: 10.3390/jcm10194578] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023] Open
Abstract
Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.
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Tirumalasetty SSM, Chinniswami Doraisami D, Konathala SVR, Penmetsa SG, Gottumukkala NVSSS. Comparison of efficacy and pain perception using 0.5% Bupivacaine and 2% Lidocaine in periodontal Surgery - A split mouth randomized clinical trial. Eur Oral Res 2021; 55:139-145. [PMID: 34746785 PMCID: PMC8547754 DOI: 10.26650/eor.2021853507] [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: 01/19/2021] [Revised: 02/05/2021] [Accepted: 04/30/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of bupivacaine and lidocaine local anesthesia on the intra-surgical and post-surgical pain control in patients undergoing periodontal flap surgery. MATERIALS AND METHODS A randomized, single-blind, split-mouth design was employed in patients who are scheduled for periodontal flap surgery for at least two similar sextants with similar anesthetic techniques. Fifty patients (age range 16-65 years, 32 males and 28 females) enrolled in the present study. On one-site, the flap surgery was performed using 2% lidocaine with 1:200000 epinephrine and on the other with 0.5% bupivacaine with 1:200000 epinephrine. Base line clinical parameters, probing pocket depth, clinical attachment level were recorded. Pain during intra operative period, at the time of loss of numbness and for three consecutive days was measured using visual analog scale (VAS). RESULTS Significant differences were observed between the two groups in the intra operative pain scores (p=0.0045) and pain scores at the time of loss of numbness (p=0.0005) but not at the 1st, 2nd and 3rd day after the surgery. CONCLUSION Bupivacaine was markedy more effective than the lidocaine. Thus the usage of bupivacaine can be substantiated for periodontal surgeries for the control of pain in the intra operative and immediate post-operative period to increase patients' comfort.
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15
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Kaur M, Geurs NC, Cobb CM, Otomo-Corgel J, Takesh T, Lee JH, Lam TM, Lin K, Nguyen A, Nguyen BL, Wilder-Smith P. Evaluating efficacy of a novel dentifrice in reducing probing depths in Stage I and II periodontitis maintenance patients: A randomized, double-blind, positive controlled clinical trial. J Periodontol 2021; 92:1286-1294. [PMID: 33331040 PMCID: PMC9984250 DOI: 10.1002/jper.20-0721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Compliance to periodontal maintenance therapy (PMT) is essential for long-term periodontal health. Between PMT visits, patients must maintain good oral hygiene. A dentifrice with demonstrable clinical benefits for use between PMT visits would be highly desirable. The aim of this clinical study was to investigate the effect of a novel dental gel on probing depths (PD) and inflammation when used as a home care dentifrice in Stage I and II periodontitis patients. METHODS This double-blind clinical study randomized 65 subjects with Stage I and II periodontitis to the novel dental gel containing 2.6% EDTA, and a commercially available anti-gingivitis dentifrice with 0.454% stannous fluoride. Primary endpoint was PD at 6 months for those sites with baseline PD ≥ 4 mm and secondary endpoints included whole mouth mean scores of modified gingival index (MGI), modified sulcus bleeding index (mSBI) and plaque index (PI). No SRP was performed at baseline. RESULTS Subjects using the novel dentifrice showed significant PD reductions of 1.18 mm (from 4.27 mm at baseline to 3.09 mm at 6 months) compared to 0.93 mm (from 4.23 mm at baseline to 3.30 mm at 6 months) shown for those using the positive control dentifrice. Difference between treatments at 6 months was 0.21 mm with P-value = 0.0126. Significant improvements in MGI (P = 0.0000), mSBI (P = 0.0000), and PI (P = 0.0102) were also observed in 6 months. CONCLUSION The novel dentifrice showed significant reductions in PD and gingival inflammation over 6 months solely as a home care dentifrice without baseline SRP in Stage I and II periodontitis maintenance patients.
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Affiliation(s)
- Maninder Kaur
- School of Dentistry, Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicolaas C. Geurs
- School of Dentistry, Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Charles M. Cobb
- School of Dentistry, Department of Periodontology, University of Missouri-Kansas City, Kansas, Missouri, USA
| | - Joan Otomo-Corgel
- School of Dentistry, Department of Periodontology, University of California at Los Angles, Los Angeles, California, USA
| | - Thair Takesh
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - June H. Lee
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - Tracie M. Lam
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - Kairong Lin
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - Audrey Nguyen
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - Brian L. Nguyen
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
| | - Petra Wilder-Smith
- Beckman Laser Institute and Medical Clinic, Department of Dentistry, University of California at Irvine, Irvine, California, USA
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16
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Multimorbid disease trajectories for people with periodontitis. J Clin Periodontol 2021; 48:1587-1596. [PMID: 34409647 DOI: 10.1111/jcpe.13536] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Abstract
AIM Periodontitis is a multifactorial condition linked to increased risk of systemic diseases. This study aimed to identify disease trajectories of people with periodontitis using the process mining technique as a heuristic approach. MATERIALS AND METHODS A total of 188,863 participants from the UK Biobank cohort were included. Self-reported oral health indicators (bleeding gums, painful gums, loose teeth) were surrogates for periodontitis at baseline. Systemic disease diagnoses and dates formed the process mining event log. Relative risk (RR) of systemic diseases, disease trajectories, and Cox proportional hazard ratio models for mortality were compared to age- and sex-matched controls who did not report a history of periodontitis. RESULTS Participants with loose teeth had shorter median time to most systemic diseases, and crude RR was increased for several diseases including cardiovascular disease (crude RR: 1.15, 95% CI: 1.03-1.28), hypertension (crude RR: 1.14, 95% CI: 1.05-1.24), and depression (crude RR: 1.33, 95% CI: 1.09-1.61). Participants with loose teeth had increased RR for 20 disease trajectories, though these were not significant after adjustments. Participants with bleeding/painful gums had similar disease trajectories as those of matched controls. CONCLUSIONS Self-reported periodontitis may be associated with early and frequent multimorbidity development, though further evidence is required to confirm this hypothesis. People with periodontitis should be informed of the risks of disease progression and be targeted in prevention initiatives.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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17
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Abdulkareem AA, Imran NK, Abdulraheam RH, Gul SS. Prevalence and factors influencing reporting of true periodontal chief complaints: A retrospective analysis. Clin Exp Dent Res 2021; 7:443-449. [PMID: 33354853 PMCID: PMC8404502 DOI: 10.1002/cre2.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of true periodontal chief complaints (CC) and the factors affecting their reporting by patients with periodontal diseases (PD). MATERIALS AND METHODS This cross-sectional study was based on retrospective analysis of available periodontal records. Different personal and demographic variables were obtained from these records including CC, age, gender, working status, past medical/dental history, smoking status and diagnosis. In addition, clinical parameters of plaque index, gingival index, probing pocket depth (PPD), and number of missing teeth. Periodontal CC were retrieved and divided either into true periodontal (bleeding, tooth mobility, and alteration in gingival color/shape) or others (emergency and esthetic-related) CC. RESULTS A total of 1161 records were included in the final analysis. Results showed that only 287 (24.7%) of patients reported true periodontal CC whereas the remaining 874 (75.3%) patients were not aware about symptoms of PD. Regression modeling indicated that reporting of true CC was positively associated with smoking and PPD but negatively associated with number of missing teeth and gender (male). CONCLUSIONS Results suggested that recognition of true periodontal CC by the patients was low. Reporting of true periodontal CC was significantly associated with smoking, PPD, female and lower number of missing teeth. These results shed light on the importance of increasing public knowledge about PD which is essential to aid people in recognizing these diseases at early stages.
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Affiliation(s)
- Ali A. Abdulkareem
- Department of Periodontics, College of DentistryUniversity of BaghdadBaghdadIraq
| | - Nada K. Imran
- Department of Periodontics, College of DentistryUniversity of BaghdadBaghdadIraq
| | | | - Sarhang S. Gul
- Periodontics Department, College of DentistryUniversity of SulaimaniSulaymaniyahIraq
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18
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Design and characterization of digluconate and diacetate chlorhexidine loaded-PLGA microparticles for dental applications. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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19
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Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review. Antibiotics (Basel) 2020; 9:antibiotics9090609. [PMID: 32948018 PMCID: PMC7559429 DOI: 10.3390/antibiotics9090609] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.
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20
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Wijetunge SS, Wen J, Yeh CK, Sun Y. Wheat germ agglutinin liposomes with surface grafted cyclodextrins as bioadhesive dual-drug delivery nanocarriers to treat oral cells. Colloids Surf B Biointerfaces 2019; 185:110572. [PMID: 31654890 DOI: 10.1016/j.colsurfb.2019.110572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/12/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
Topical management of oral infection requires combined use of multiple classes of drugs and frequent dosing due to low drug retention rates. The sustained, co-delivery of drugs with different solubilities to cells using nanoparticle drug delivery systems remains a challenge. Here, we developed wheat germ agglutinin (WGA) conjugated liposomes with surface grafted cyclodextrin (WGA-liposome-CD) as bioadhesive dual-drug nanocarriers. We effectively encapsulated two physiochemically different drugs (ciprofloxacin and betamethasone) and demonstrated sustained co-drug release in saliva over a 24 h period in vitro. As proof of therapeutic utility in oral cells, we infected oral keratinocytes with Aggregatibacter actinomycetemcomitans, a bacterial pathogen responsible for chronic periodontal disease. Drug release, resulting from nanocarrier cell binding, produced a significant increase in oral cell survival and synergistically reduced inflammation. These results suggest that WGA-liposome-CD nanocarriers are novel cyto-adhesive candidates for delivering multiple drugs with sustained therapeutic activity for localized drug delivery to oral cells.
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Affiliation(s)
- Sashini S Wijetunge
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States
| | - Jianchuan Wen
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio and Geriatric Research Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, United States
| | - Yuyu Sun
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States.
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21
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Rosenbaum J, Usyk M, Chen Z, Zolnik CP, Jones HE, Waldron L, Dowd JB, Thorpe LE, Burk RD. Evaluation of Oral Cavity DNA Extraction Methods on Bacterial and Fungal Microbiota. Sci Rep 2019; 9:1531. [PMID: 30728424 PMCID: PMC6365504 DOI: 10.1038/s41598-018-38049-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 11/29/2018] [Indexed: 12/12/2022] Open
Abstract
The objective of this study was to evaluate the most effective method of DNA extraction of oral mouthwash samples for use in microbiome studies that utilize next generation sequencing (NGS). Eight enzymatic and mechanical DNA extraction methods were tested. Extracted DNA was amplified using barcoded primers targeting the V6 variable region of the bacterial 16S rRNA gene and the ITS1 region of the fungal ribosomal gene cluster and sequenced using the Illumina NGS platform. Sequenced reads were analyzed using QIIME and R. The eight methods yielded significantly different quantities of DNA (p < 0.001), with the phenol-chloroform extraction method producing the highest total yield. There were no significant differences in observed bacterial or fungal Shannon diversity (p = 0.64, p = 0.93 respectively) by extraction method. Bray-Curtis beta-diversity did not demonstrate statistically significant differences between the eight extraction methods based on bacterial (R2 = 0.086, p = 1.00) and fungal (R2 = 0.039, p = 1.00) assays. No differences were seen between methods with or without bead-beating. These data indicate that choice of DNA extraction method affect total DNA recovery without significantly affecting the observed microbiome.
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MESH Headings
- Biodiversity
- DNA Barcoding, Taxonomic
- DNA, Bacterial/analysis
- DNA, Bacterial/genetics
- DNA, Bacterial/isolation & purification
- DNA, Fungal/analysis
- DNA, Fungal/genetics
- DNA, Fungal/isolation & purification
- DNA, Ribosomal Spacer/analysis
- DNA, Ribosomal Spacer/genetics
- High-Throughput Nucleotide Sequencing/methods
- Humans
- Microbiota
- Mouth/microbiology
- Mycobiome
- Pilot Projects
- RNA, Ribosomal, 16S/analysis
- RNA, Ribosomal, 16S/genetics
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Affiliation(s)
- Jennifer Rosenbaum
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mykhaylo Usyk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Zigui Chen
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Christine P Zolnik
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Biology, Long Island University, Brooklyn, NY, USA
| | - Heidi E Jones
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Levi Waldron
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Jennifer B Dowd
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Lorna E Thorpe
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Robert D Burk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
- Departments of Obstetrics & Gynecology and Women's Health, Epidemiology and Population Health, and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA.
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22
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Liu F, Ma R, Wang Y, Zhang L. The Clinical Importance of Campylobacter concisus and Other Human Hosted Campylobacter Species. Front Cell Infect Microbiol 2018; 8:243. [PMID: 30087857 PMCID: PMC6066527 DOI: 10.3389/fcimb.2018.00243] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/25/2018] [Indexed: 12/14/2022] Open
Abstract
Historically, Campylobacteriosis has been considered to be zoonotic; the Campylobacter species that cause human acute intestinal disease such as Campylobacter jejuni and Campylobacter coli originate from animals. Over the past decade, studies on human hosted Campylobacter species strongly suggest that Campylobacter concisus plays a role in the development of inflammatory bowel disease (IBD). C. concisus primarily colonizes the human oral cavity and some strains can be translocated to the intestinal tract. Genome analysis of C. concisus strains isolated from saliva samples has identified a bacterial marker that is associated with active Crohn's disease (one major form of IBD). In addition to C. concisus, humans are also colonized by a number of other Campylobacter species, most of which are in the oral cavity. Here we review the most recent advancements on C. concisus and other human hosted Campylobacter species including their clinical relevance, transmission, virulence factors, disease associated genes, interactions with the human immune system and pathogenic mechanisms.
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Affiliation(s)
- Fang Liu
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Rena Ma
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Yiming Wang
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Li Zhang
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
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Shizuma Y, Zaitsu T, Ueno M, Ohnuki M, Kawaguchi Y. Relationship between self-assessment and clinical evaluation of dental plaque and gingival condition in Japanese adolescents. Int J Dent Hyg 2017; 16:144-150. [DOI: 10.1111/idh.12281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Y Shizuma
- Department of Oral Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
| | - T Zaitsu
- Department of Oral Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
| | - M Ueno
- Department of Oral Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
| | - M Ohnuki
- Department of Oral Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
| | - Y Kawaguchi
- Department of Oral Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
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24
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Hulme C, Robinson P, Douglas G, Baxter P, Gibson B, Godson J, Vinall-Collier K, Saloniki E, Meads D, Brunton P, Pavitt S. The INCENTIVE study: a mixed-methods evaluation of an innovation in commissioning and delivery of primary dental care compared with traditional dental contracting. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BackgroundOver the past decade, commissioning of primary care dentistry has seen contract currency evolving from payment for units of dental activity (UDAs) towards blended contracts that include key performance indicators such as access, quality and improved health outcome.ObjectivesThe aim of this study was to evaluate a blended/incentive-driven model of dental service provision. To (1) explore stakeholder perspectives of the new service delivery model; (2) assess the effectiveness of the new service delivery model in reducing the risk of and amount of dental disease and enhancing oral health-related quality of life (OHQoL) in patients; and (3) assess cost-effectiveness of the new service delivery model.MethodsUsing a mixed-methods approach, the study included three dental practices working under the blended/incentive-driven (incentive) contract and three working under the UDAs (traditional) contract. All were based in West Yorkshire. The qualitative study reports on the meaning of key aspects of the model for three stakeholder groups [lay people (patients and individuals without a dentist), commissioners and the primary care dental teams], with framework analysis of focus group and semistructured interview data. A non-randomised study compared clinical effectiveness and cost-effectiveness of treatment under the two contracts. The primary outcome was gingivitis, measured using bleeding on probing. Secondary outcomes included OHQoL and cost-effectiveness.ResultsParticipants in the qualitative study associated the incentive contract with more access, greater use of skill mix and improved health outcomes. In the quantitative analyses, of 550 participants recruited, 291 attended baseline and follow-up. Given missing data and following quality assurance, 188 were included in the bleeding on probing analysis, 187 in the caries assessment and 210 in the economic analysis. The results were mixed. The primary outcome favoured the incentive practices, whereas the assessment of caries favoured the traditional practices. Incentive practices attracted a higher cost for the service commissioner, but were financially attractive for the dental provider at the practice level. Differences in generic health-related quality of life were negligible. Positive changes over time in OHQoL in both groups were statistically significant.LimitationsThe results of the quantitative analysis should be treated with caution given small sample numbers, reservations about the validity of pooling, differential dropout results and data quality issues.ConclusionsA large proportion of people in this study who had access to a dentist did not follow up on oral care. These individuals are more likely to be younger males and have poorer oral health. Although access to dental services was increased, this did not appear to facilitate continued use of services.Future workFurther research is required to understand how best to promote and encourage appropriate dental service attendance, especially among those with a high level of need, to avoid increasing health inequalities, and to assess the financial impact of the contract. For dental practitioners, there are challenges around perceptions about preventative dentistry and use of the risk assessments and care pathways. Changes in skill mix pose further challenges.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Claire Hulme
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Peter Robinson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Gail Douglas
- School of Dentistry, University of Leeds, Leeds, UK
| | - Paul Baxter
- Division of Biostatistics, University of Leeds, Leeds, UK
| | - Barry Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Jenny Godson
- Division of Population Health and Care, Health and Wellbeing Directorate, Public Health England, London, UK
| | | | - Eirini Saloniki
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - David Meads
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Paul Brunton
- School of Dentistry, University of Leeds, Leeds, UK
| | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
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Ren W, Baig A, White DJ, Li SK. Characterization of cornified oral mucosa for iontophoretically enhanced delivery of chlorhexidine. Eur J Pharm Biopharm 2016; 99:35-44. [DOI: 10.1016/j.ejpb.2015.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/03/2015] [Accepted: 11/09/2015] [Indexed: 12/21/2022]
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Trtić N, Bošnjak A, Arbutina R, Kojić Ž, Veselinović V. Efficacy of subgingival air polishing in patients with aggressive periodontitis. BALKAN JOURNAL OF DENTAL MEDICINE 2016. [DOI: 10.1515/bjdm-2016-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Aggressive periodontitis is one of the most severe forms of periodontal disease, resulting in the destruction of junctional epithelium and alveolar bone around teeth in a very short period of time. The early diagnosis of aggressive periodontitis and timely therapy is of outmost importance in controlling the progress of the disease. Application of the techniques of subgingival air polishing of periodontal pockets (pflow) with glycine powder has contributed to reduce damage to the root surface of the teeth and surrounding soft tissue. Aim: The goal of this paper was to determine the effectiveness of two different types of subgingival air polishing therapy for the periodontal tissue status at the patients with aggressive periodontitis Methods and materials: the study included 46 patients of both sexes diagnosed with aggressive peridontitis. The patients were divided into two groups: test group (PFLOW), and control group (sonic SRP). The size of the destruction of periodontal tissue was estimated by CAL and assessment of oral hygiene and gingival inflammation was performed using FMPS and FMBS. Results: Monitored indexes values in both groups were reduced. Conclusion: Subgingival air polishing showed equally good results as the SRP, while pflow was more advantageous with respect to patients acceptability, time usability and safety for the soft tissue.
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Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2015; 65:149-77. [PMID: 24738591 DOI: 10.1111/prd.12022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Abstract
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case.
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Duran-Pinedo AE, Frias-Lopez J. Beyond microbial community composition: functional activities of the oral microbiome in health and disease. Microbes Infect 2015; 17:505-516. [PMID: 25862077 DOI: 10.1016/j.micinf.2015.03.014doi|] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 05/25/2023]
Abstract
The oral microbiome plays a relevant role in the health status of the host and is a key element in a variety of oral and non-oral diseases. Despite advances in our knowledge of changes in microbial composition associated with different health conditions the functional aspects of the oral microbiome that lead to dysbiosis remain for the most part unknown. In this review, we discuss the progress made towards understanding the functional role of the oral microbiome in health and disease and how novel technologies are expanding our knowledge on this subject.
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Affiliation(s)
- Ana E Duran-Pinedo
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
| | - Jorge Frias-Lopez
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA.
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Cueno ME, Kamio N, Seki K, Kurita-Ochiai T, Ochiai K. High butyric acid amounts induce oxidative stress, alter calcium homeostasis, and cause neurite retraction in nerve growth factor-treated PC12 cells. Cell Stress Chaperones 2015; 20:709-13. [PMID: 25808460 PMCID: PMC4463921 DOI: 10.1007/s12192-015-0584-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 01/11/2023] Open
Abstract
Butyric acid (BA) is a common secondary metabolite by-product produced by oral pathogenic bacteria and is detected in high amounts in the gingival tissue of patients with periodontal disease. Previous works have demonstrated that BA can cause oxidative stress in various cell types; however, this was never explored using neuronal cells. Here, we exposed nerve growth factor (NGF)-treated PC1(2) cells to varying BA concentrations (0.5, 1.0, 5.0 mM). We measured total heme, H(2)O(2), catalase, and calcium levels through biochemical assays and visualized the neurite outgrowth after BA treatment. Similarly, we determined the effects of other common periodontal short-chain fatty acids (SCFAs) on neurite outgrowth for comparison. We found that high (1.0 and 5.0 mM) BA concentrations induced oxidative stress and altered calcium homeostasis, whereas low (0.5 mM) BA concentration had no significant effect. Moreover, compared to other SCFAs, we established that only BA was able to induce neurite retraction.
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Affiliation(s)
- Marni E. Cueno
- />Department of Microbiology, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310 Japan
| | - Noriaki Kamio
- />Department of Microbiology, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310 Japan
| | - Keisuke Seki
- />Department of Microbiology, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310 Japan
| | - Tomoko Kurita-Ochiai
- />Department of Microbiology and Immunology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba 271-8587 Japan
| | - Kuniyasu Ochiai
- />Department of Microbiology, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310 Japan
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Duran-Pinedo AE, Frias-Lopez J. Beyond microbial community composition: functional activities of the oral microbiome in health and disease. Microbes Infect 2015; 17:505-16. [PMID: 25862077 PMCID: PMC4495649 DOI: 10.1016/j.micinf.2015.03.014] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 01/05/2023]
Abstract
The oral microbiome plays a relevant role in the health status of the host and is a key element in a variety of oral and non-oral diseases. Despite advances in our knowledge of changes in microbial composition associated with different health conditions the functional aspects of the oral microbiome that lead to dysbiosis remain for the most part unknown. In this review, we discuss the progress made towards understanding the functional role of the oral microbiome in health and disease and how novel technologies are expanding our knowledge on this subject.
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Affiliation(s)
- Ana E Duran-Pinedo
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
| | - Jorge Frias-Lopez
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA.
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Cardenas PA, Cookson WO. The Microbiome at Other Mucosal Sites. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yasui H, Yamaguchi M, Ichimiya M, Yoshikawa Y, Hamamoto Y, Muto M. A Case of Cutaneous Odontogenic Sinus. J Dermatol 2014; 32:852-5. [PMID: 16361742 DOI: 10.1111/j.1346-8138.2005.tb00859.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2004] [Accepted: 05/18/2005] [Indexed: 11/26/2022]
Abstract
Despite the fact that cutaneous sinus tracts of odontogenic origin are well documented, the condition is still commonly misdiagnosed, because chronic periapical periodontitis may be asymptomatic and is rarely open to the skin. A 75-year-old Japanese woman presented to our clinic with the chief complaint of a left cheek skin lesion with mild pain. Physical examination revealed a subcutaneous nodule covered with erythematous skin on her left buccal region. Cultures from the subcutaneous nodule grew Bacteroides species and Peptostreptococcus micros but did not yield acid-fast bacilli, fungi, or Actinomyces. Stains of smeared pus showed a considerable number of Gram-negative rods. The histopathological examination revealed a focal abscess formation in the lower dermis and subcutaneous tissue. Dental evaluation, including an orthopantogram, showed a radiolucent alveolar area at the left lower first molar apex, suggesting a periapical abscess. Antibiotic therapy for three weeks associated with surgical root canal therapy eliminated the subcutaneous nodule. A high degree of suspicion is required to correctly diagnose a lower facial lesion as being of odontogenic origin, and prompt dental evaluation should be considered.
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Affiliation(s)
- Hiroo Yasui
- Department of Dermatology, Kanmon Medical Center National Hospital Organization, 1-1-1 Ushiroda-Cho, Shimonoseki, Yamaguchi, Japan
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The association between periodontal disease and seizure severity in refractory epilepsy patients. Seizure 2014; 23:227-30. [PMID: 24456623 DOI: 10.1016/j.seizure.2013.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 12/09/2013] [Accepted: 12/26/2013] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Periodontal diseases are common in most populations and affect people at all socioeconomic levels. Evidence suggests that patients with epilepsy actually have higher risks of dental disease and increased oral health needs, but the frequency and consequences of poor controlled seizures on dental and periodontal health have not been reported before. We aimed to assess the impact of seizure frequency on periodontal status and oral hygiene in a sample of epilepsy patients. METHODS One hundred and nine consecutive patients treated for epilepsy at the outpatient clinic of our University Hospital were invited to take part in an oral examination to determine their periodontal disease status, together with a control group. In addition, seizure frequency and use of medication were documented. RESULTS In logistic regression model, patients were significantly more susceptible to bad oral hygiene, gingivitis and periodontitis that controls (p<0.001); seizure frequency was significantly related to bad oral hygiene (p=0.010), gingivitis (p<0.001) and periodontitis (p<0.001). Tooth brushing habits and presence of caries were associated with oral health in patients group. CONCLUSION Our study found a significant positive correlation between periodontal disease and seizure severity. Epilepsy patients need to focus more on their oral health and quality of oral hygiene.
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Konermann A, Winter J, Novak N, Allam JP, Jäger A. Verification of IL-17A and IL-17F in oral tissues and modulation of their expression pattern by steroid hormones. Cell Immunol 2013; 285:133-40. [DOI: 10.1016/j.cellimm.2013.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/23/2013] [Accepted: 10/10/2013] [Indexed: 01/13/2023]
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Abstract
The human mouth harbours one of the most diverse microbiomes in the human body, including viruses, fungi, protozoa, archaea and bacteria. The bacteria are responsible for the two commonest bacterial diseases of man: dental caries (tooth decay) and the periodontal (gum) diseases. Archaea are restricted to a small number of species of methanogens while around 1000 bacterial species have been found, with representatives from the phyla Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria, Spirochaetes, Synergistetes and Tenericutes and the uncultured divisions GN02, SR1 and TM7. Around half of oral bacteria are as yet uncultured and culture-independent methods have been successfully used to comprehensively describe the oral bacterial community. The human oral microbiome database (HOMD, www.homd.org) provides a comprehensive resource consisting of descriptions of oral bacterial taxa, a 16S rRNA identification tool and a repository of oral bacterial genome sequences. Individuals' oral microbiomes are highly specific at the species level, although overall the human oral microbiome shows few geographical differences. Although caries and periodontitis are clearly bacterial diseases, they are not infectious diseases in the classical sense because they result from a complex interaction between the commensal microbiota, host susceptibility and environmental factors such as diet and smoking. Periodontitis, in particular, appears to result from an inappropriate inflammatory reaction to the normal microbiota, exacerbated by the presence of some disease-associated bacterial species. In functional terms, there appears to considerable redundancy among the oral microbiota and a focus on functional rather than phylogenetic diversity may be required in order to fully understand host-microbiome interactions.
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Affiliation(s)
- William G Wade
- King's College London Dental Institute, Microbiology Unit, Floor 17, Tower Wing, Guy's Campus, London SE1 9RT, UK.
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Konermann A, Stabenow D, Knolle PA, Held SAE, Deschner J, Jäger A. Regulatory role of periodontal ligament fibroblasts for innate immune cell function and differentiation. Innate Immun 2012; 18:745-52. [PMID: 22436844 DOI: 10.1177/1753425912440598] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Innate immunity is crucial for an effective host defense against pathogenic microorganisms in periodontal tissues. As periodontal ligament (PDL) cells synthesize immunomodulatory cytokines, the aim of this in vitro study was to investigate whether these cells can interact with innate immune cells. Resting and inflammatory primed (IL-1β, TNF-α, HMGB1) human PDL cells were co-cultured with human monocyte-derived dendritic cells or macrophages. Migration, phenotypic maturation and modulation of phagocytosis of Porphyromonas gingivalis by immune cells were investigated upon co-culture with PDL cells and/or their released soluble factors. PDL cells interacted with immune cells under both non-inflammatory and inflammatory conditions. Immune cell migration was significantly enhanced by co-culture with PDL cells, which also affected their phenotypic maturation both through cell-cell contact and through released soluble mediators. The dendritic cell maturation markers CD83 and CD86 were upregulated as much as both 'alternatively activated' M2 macrophage maturation markers CD23 and CD163. In contrast, the 'classically activated' M1 macrophage maturation marker CD64 was downregulated. Finally, PDL cells significantly enhanced the phagocytosis of Porphyromonas gingivalis by immune cells. Our experiments revealed that PDL cells are not only structural elements of the periodontium, but actively influence immune responses by interaction with innate immune cells.
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Un ostéome maxillaire ? Presse Med 2012; 41:100-2. [DOI: 10.1016/j.lpm.2011.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 04/14/2011] [Accepted: 04/19/2011] [Indexed: 11/21/2022] Open
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Franchini R, Petri A, Migliario M, Rimondini L. Poor oral hygiene and gingivitis are associated with obesity and overweight status in paediatric subjects. J Clin Periodontol 2011; 38:1021-8. [PMID: 21793868 DOI: 10.1111/j.1600-051x.2011.01770.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The association between obesity and periodontitis has been extensively investigated in adults but not in young people. Our aim is to evaluate whether overweight/obese paediatric patients have a greater chance of being affected by gingivitis than those of normal weight. SUBJECTS AND METHODS Ninety-eight subjects ranging between 10 and 17 years of age were classified as obese/overweight or normal weight on the basis of body mass index. Auxological data, blood pressure, insulin resistance, psychological profile, oral hygiene habits, plaque and gingival indices were collected. RESULTS Anthropometric measurements and blood pressure were significantly higher in overweight/obese subjects than in the normal-weight subjects (p<0001). The overweight/obese subjects showed a worse attitude towards oral hygiene. Two-way anova revealed a significant effect of obesity status (p<0001) on the gingival index. Logistic and linear regression analyses identified gingivitis as dependent on insulin resistance and bad oral hygiene rather than on the overweight/obese status simply defined. Negative psychological features related to physical and academic self-concept were also risk factors for gingivitis probably because they were related to a generic poor self-awareness. CONCLUSION The gingivitis observed in overweight and obese young subjects is probably due to a combination of metabolic and inflammatory profiles and neglected attitude towards oral hygiene.
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Affiliation(s)
- Roberto Franchini
- Department of Medical Sciences, Universitá del Piemonte Orientale Amedeo Avogadro, Novara, Italy
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de Sousa FO, Blanco-Méndez J, Pérez-Estévez A, Seoane-Prado R, Luzardo-Álvarez A. Effect of zein on biodegradable inserts for the delivery of tetracycline within periodontal pockets. J Biomater Appl 2011; 27:187-200. [DOI: 10.1177/0885328211398968] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Treatment with antibiotics within the periodontal pocket against bacterial infections represents a useful and adjunctive tool to conventional therapy for healing and teeth preservation. With this function in view, an implantable, tetracycline delivery device for the treatment of periodontal disease was developed. The aim of this study was to develop biodegradable, tetracycline-loaded microparticles made of two polymers: PLGA and zein which were compressed into monolithic devices. In this polymer delivery system, the encapsulation efficiency, release characteristics, drug–polymer interaction, and antibacterial activity of loaded drug were investigated. The interaction of tetracycline with the corn protein zein was studied by nuclear magnetic resonance (NMR), Fourier transform infrared, and X-ray diffraction. The hydrophobic interaction of tetracycline with zein in the formulations was deduced from the NMR studies, whereas X-ray diffraction studies showed a new crystalline state of the drug in the presence of the protein. Zein was not denatured by preparation of inserts. Sustained release of tetracycline was obtained, and the proportion of zein in the inserts had a great impact on the drug release. Finally, an effective tetracycline release from inserts against Staphylococcus aureus was achieved over 30 days. In conclusion, the PLGA:zein delivery system described in this study was found to be effective in controlled delivery of tetracycline, and hence may be suitable for intra-pocket delivery of antimicrobial agents in the treatment of periodontitis.
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Affiliation(s)
- Fábio Oliveira de Sousa
- The Capes Foundation, Ministry of Education of Brazil, Cx. Postal 365, Brasília DF 70359-970, Brazil
| | - Jose Blanco-Méndez
- Department of Pharmacy and Pharmaceutical Technology, School of Sciences, University of Santiago de Compostela, Avda. Alfonso X el Sabio s/n, 27002, Lugo, Spain
| | - Antonio Pérez-Estévez
- Departament of Microbiology and Parasitology, Medical School, University of Santiago de Compostela, R/ de San Francisco, s/n, 15782, Santiago de Compostela, Spain
| | - Rafael Seoane-Prado
- Departament of Microbiology and Parasitology, Medical School, University of Santiago de Compostela, R/ de San Francisco, s/n, 15782, Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacy and Pharmaceutical Technology, School of Sciences, University of Santiago de Compostela, Avda. Alfonso X el Sabio s/n, 27002, Lugo, Spain
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Abstract
The immune system faces the arduous task of defending the mucosal surfaces from invading pathogens, but must simultaneously repress responses against commensal organisms and other inert antigens that are abundant in the external environment, as inappropriate immune activation might expose the host to increased risk of autoimmunity. The behavior of individual immune cells is governed by the expression of transcription factors that are responsible for switching immune response genes on and off. T-bet (T-box expressed in T cells) has emerged as one of the key transcription factors responsible for controlling the fate of both innate and adaptive immune cells, and its expression in different immune cells found at mucosal surfaces is capable of dictating the critical balance between permitting robust host immunity and limiting susceptibility to autoimmunity and allergy.
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Sasaki H, Suzuki N, Kent R, Kawashima N, Takeda J, Stashenko P. T Cell Response Mediated by Myeloid Cell-Derived IL-12 Is Responsible forPorphyromonas gingivalis-Induced Periodontitis in IL-10-Deficient Mice. THE JOURNAL OF IMMUNOLOGY 2008; 180:6193-8. [DOI: 10.4049/jimmunol.180.9.6193] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Alto WA, Colt H. Oral Cavity. Fam Med 2003. [DOI: 10.1007/978-0-387-21744-4_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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