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Nicolosi G, Donzella M, Polizzi A, Angjelova A, Santonocito S, Zanoli L, Annunziata M, Isola G. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients. Open Med (Wars) 2024; 19:20241003. [PMID: 39034949 PMCID: PMC11260002 DOI: 10.1515/med-2024-1003] [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: 03/04/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives This narrative review aims to update the current evidence and offer insight into the new non-invasive ultrasound techniques used to early identify degenerative vascular changes in subjects with periodontitis and to investigate if these methodologies could be useful to identify subclinical cardiovascular disease (CVD) dysfunction in periodontitis patients and to monitor changes in CVD risk after periodontal treatment. Methods Studies examining the assessment of vascular endothelial function through the latest methodologies were analyzed. Systematic reviews, observational studies, and clinical trials in the English language were identified using PubMed, Web of Science, and Google Scholar databases with key search terms such as "periodontitis," "endothelial dysfunction (ED)," "arterial stiffness," and "periodontal therapy." Results Several mechanisms are involved in the association between periodontitis and CVD. The key players are periodontal bacteria and their toxins, which can enter the circulation and infiltrate blood vessel walls. The increase in proinflammatory molecules such as interleukins and chemokines, c-reactive protein, fibrinogen, and oxidative stress also plays a decisive role. In addition, an increase in parameters of ED, arterial stiffness, and atherosclerosis, such as carotid intima-media thickness, pulse wave velocity, and flow-mediated dilatation, has been shown in periodontal patients. Conclusions The literature today agrees on the association of periodontitis and CVD and the positive role of periodontal therapy on systemic inflammatory indices and cardiovascular outcomes. Hopefully, these non-invasive methodologies could be extended to periodontal patients to provide a comprehensive understanding of the CVD-periodontitis link from the perspective of a personalized medicine approach in periodontology.
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Affiliation(s)
- Giada Nicolosi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Martina Donzella
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Angela Angjelova
- University Dental Clinical Center St. Pantelejmon, Faculty of Dentistry, Ss. Cyril and Methodius University in Skopje, 1000, Skopje, North Macedonia
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
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Batista JET, Figueiredo ACMG, Souza ES, Lyrio AO, Passos-Soares JS, Trindade SC, Alves CMC, Vianna MIP, Coelho JMF, Conceição SDS, Cerqueira EDMM, Hintz AM, Seymour GJ, Scannapieco FA, Loomer PM, Gomes-Filho IS, Cruz SSD. Excessive weight in pregnant women increases the chance of diagnosing periodontitis combined with tooth loss. J Periodontol 2024. [PMID: 38982971 DOI: 10.1002/jper.23-0745] [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: 12/07/2023] [Revised: 04/30/2024] [Accepted: 06/03/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Excess weight (EW), especially in women of childbearing age, those who are pregnant, as well as postpartum, is a problem worldwide. Fat accumulation deregulates the inflammatory response, contributing to the development of health problems, such as periodontitis. This study investigated the association between EW and periodontitis during pregnancy. METHODS A cross-sectional, multicenter study involved 1745 postpartum women in Brazil. Socioeconomic-demographic data, gestational history, lifestyle behavior, and general and oral health conditions were obtained. Pre-pregnancy body mass index (BMI) was collected from medical records with EW being the exposure. Both tooth loss and clinical attachment level (CAL) were evaluated, and the presence of periodontitis was the outcome. Logistic regression, odds ratio (OR) and 95% confidence interval (95% CI), and quantile regression, beta coefficient and 95% CI, estimated the association between EW (BMI) and periodontitis and its combined effect with tooth loss ≥3, as dichotomous and continuous variables (CAL and tooth loss), with 5% significance level. RESULTS The EW was 27.7% prevalent and periodontitis was 11.7%. There was a positive association between EW and periodontitis: ORadjusted:1.39; 95% CI:1.01;1.92 and between EW and periodontitis combined with tooth loss ≥3: ORadjusted:1.73; 95% CI:1.36;2.20. The adjusted association between EW and periodontitis as continuous variables was also positive, showing that for each unit of increased BMI, there was an elevation in the mean CAL (p = 0.04) and tooth loss (p < 0.01), with statistical significance. CONCLUSIONS There was a moderate association between EW and periodontitis during pregnancy, with an even greater association of pregnant women with EW presenting periodontitis combined with tooth loss.
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Affiliation(s)
| | - Ana Claudia Morais Godoy Figueiredo
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Epidemiology Surveillance, Federal District Health State Department, Distrito Federal, Brasília, Brazil
| | - Elivan Silva Souza
- Faculty of Health Sciences, University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Amanda Oliveira Lyrio
- Faculty of Health Sciences, University of Brasilia, Brasília, Distrito Federal, Brazil
| | | | - Soraya Castro Trindade
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | | | | | | | | | | | | | | | | | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, Texas, USA
| | | | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
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Zhuang J, Zhang S, Chen H, Qiu C, Feng T, Zhou W, Han X, Song Z. Evidence of microbiota-host dysbiosis between periodontitis and cerebral small vessel disease. Oral Dis 2024. [PMID: 38923260 DOI: 10.1111/odi.15041] [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: 02/14/2024] [Revised: 05/30/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To investigate the correlation between periodontitis and cerebral small vessel disease (CSVD) from the clinical and microbiological aspects. SUBJECTS AND METHODS Periodontitis patients (CP group, n = 31) and CSVD patients (CSVD group, n = 30) were examined for neurological and periodontal condition. Subgingival plaque was collected and performed using 16S rRNA sequencing. Logistic regression and LASSO regression were used to analyze the periodontal parameters and subgingival microbiota related to CSVD, respectively. Inflammatory factors in gingival crevicular fluid (GCF) were also detected and compared between the two groups. RESULTS Clinical attachment level (CAL), teeth number and plaque index demonstrated a significant difference between CP and CSVD group, meanwhile, CAL was independently associated with CSVD. Besides, the microbial richness and composition were distinct between two groups. Five genera related to periodontal pathogens (Treponema, Prevotella, Streptococcus, Fusobacterium, Porphyromonas) were screened out by LASSO regression, suggesting a potential association with CSVD. Finally, the levels of inflammatory factors in GCF were statistically higher in CSVD group than those in CP group. CONCLUSIONS Cerebral small vessel disease patients demonstrated worse periodontal condition, meanwhile the interaction between microbiota dysbiosis and host factors (inflammation) leading to a better understanding of the association between periodontitis and CSVD.
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Affiliation(s)
- Jiabao Zhuang
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shufan Zhang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwen Chen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Che Qiu
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Tienan Feng
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Zhou
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiang Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongchen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
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Chen Y, Zheng J, Ni D, Zhang D, Zhu H. The correlation between periodontitis and uncontrolled hypertension is mediated by inflammatory markers: results from a cross-sectional study of urban elderly population in southeast China. BMC Oral Health 2023; 23:919. [PMID: 38001437 PMCID: PMC10675948 DOI: 10.1186/s12903-023-03680-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Periodontal diseases is considered the most important global oral health burden according to the world health organization (WHO) (Oral health. https://www.who.int/news-room/fact-sheets/detail/oral-health#Overviewth (who.int). Accessed 21 Sep 2023). It is a common local inflammatory disease associated with hypertension, this study aims to explore the relationship between periodontitis and uncontrolled hypertension and whether inflammation indication such as white blood cell (WBC) count or neutrophil count is a mediator of this relationship. METHODS One thousand four hundred eighty-eight elders attending annual physical and oral examinations in Zhejiang province were included in this study. The staging of Periodontitis was classified as none, mild-moderate and severe. Participants are categorized into two groups based on blood pressure: hypertensive( positive high blood pressure( HBP) history or underwent HBP medication or blood pressure( BP) ≥ 140/90 mmHg) and uncontrolled hypertensive (systolic blood pressure( SBP) ≥ 140 mmHg or distolic blood pressure( DBP) ≥ 90 mmHg). Peripheral blood samples were collected, information on hypertension history and potential confounders (age, sex, smoking, alcohol consumption, exercise frequency, diabetes) was collected in questionnaires. The correlation between periodontitis and hypertension was investigated using logistics regression analyses, mediation analysis was assessed for the effect of inflammation on hypertension. RESULTS The study population includes 1,488 participants aged 55-90 years. Odds of uncontrolled hypertension increased significantly along with periodontitis in the regression models both in unadjusted model (odds ratio( OR): 1.407, 95% confidence intervals( CI): 1.037 ~ 1.910) and fully adjusted model (OR: 1.950, 95% CI: 1.127 ~ 3.373). Mediation analysis confirmed that WBC and neutrophic count function as a full mediator of the association between periodontitis and uncontrolled hypertension either in the unadjusted or the adjusted model. CONCLUSIONS In a study of urban elderly population in southeast China, periodontitis is found to be significantly associated with uncontrolled hypertension, such relation is mediated by WBC and neutrophil count. Periodontitis can increase the difficulty of controlling hypertension. Promotion of periodontal health strategies in the dental setting could help reduce the burden of hypertension and its complications.
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Affiliation(s)
- Yue Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Jiaoer Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Da Ni
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Denghui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Haihua Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China.
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Dain CP, Ganapathi S, Ranjithkumar A, Geevar Z, Harikrishnan S, Ammu JV. Prevalence and Risk Factors of Periodontal Disease among Rural and Urban Residents of a South Indian City: A Cross-Sectional Study. J Int Soc Prev Community Dent 2023; 13:458-468. [PMID: 38304530 PMCID: PMC10829280 DOI: 10.4103/jispcd.jispcd_77_23] [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: 05/23/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
Background The prevalence of oral diseases has been increasing alarmingly in the state of Kerala. Screening for periodontal disease (PD) is crucial due to its negative impact on oral and overall health. Since the occurrence and severity of PD depend on its risk factors, a structured survey in randomly selected districts in the state can be a valuable tool for policymakers to envisage strategies to enhance oral health care and control shared systemic illnesses. Data on the prevalence and risk factors of PD among the residents of the Thiruvananthapuram district of Kerala is not currently available in the public domain. This data could also be representative of the other 13 districts with more or less similar topographical, cultural, and lifestyle characteristics. Aim To study the prevalence of PD and its risk factors among the residents of the Thiruvananthapuram district of Kerala and to compare the urban-rural differences. Materials and Methods In this community-based cross-sectional study, a multistage cluster random sampling method was used to select the participants. Among the 1285 participants, 560 were from urban areas, and 725 were from rural areas. A modification of the Ramfjord PD index was used to assess periodontal health. The epidemiological risk factors were evaluated using sociodemographic data, personal histories, and physical and biochemical parameters. Multivariate logistic regression was used to determine the relationship of PD with independent variables. Mediation analysis was performed to examine the mediating effects of independent factors. Results The rural population (61.4%) had a higher frequency of PD than the urban (35.5%) and an overall prevalence of 50%. Aging, poor oral hygiene, and low educational level (EL) were significant risk factors for PD in urban and rural settings, with hypertension only being significant in the latter. A higher odds ratio (9.07-29.68) with a confidence interval of (5.45-48.94) for poor oral hygiene was noted. Poor oral hygiene and tobacco use had mediating effects between low EL and PD. Conclusions In this study, the overall prevalence of PD was 50%, with the rural population being more afflicted. Poor oral hygiene has been identified as a modifiable risk factor for PD in urban and rural populations. Poor oral hygiene and tobacco use have been demonstrated to be mediators of the strong link between low EL and PD. Therefore, this study reiterates the need for better oral health awareness and treatment facilities to minimize the impact of the above risk factors on the periodontium. A shared risk relationship between PD and hypertension in the rural population emphasizes the need for an integrated approach to public health by including oral health as part of noncommunicable disease prevention and intervention programs.
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Affiliation(s)
- Chacko Pearl Dain
- Department of Oral and Maxillofacial Surgery, Government Dental College, Medical College, Thiruvananthapuram, India
| | - Sanjay Ganapathi
- Sree Chitra Tirunal Institute for Medical Sciences and Technology (Institute of National Importance under the Government of India), Thiruvananthapuram, India
| | | | | | - Sivadasanpillai Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology (Institute of National Importance under the Government of India), Thiruvananthapuram, India
| | - Jayanthi Viswanathan Ammu
- Division of Biostatistics and Cancer Epidemiology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Etta I, Kambham S, Girigosavi KB, Panjiyar BK. Mouth-Heart Connection: A Systematic Review on the Impact of Periodontal Disease on Cardiovascular Health. Cureus 2023; 15:e46585. [PMID: 37933364 PMCID: PMC10625740 DOI: 10.7759/cureus.46585] [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: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Periodontal diseases (PDs) and cardiovascular diseases (CVDs) are highly prevalent global diseases with increasing percentages of morbidity and mortality. Both PD and CVDs independently have multifactorial causation, and emerging evidence shows an association between PD and CVDs. Periodontal diseases like gingivitis and periodontitis are chronic inflammatory conditions that eventually cause systemic inflammation, leading to many systemic diseases like rheumatoid arthritis, cardiovascular diseases, and others. In this study, we followed a systematic review approach to give an overview of the current evidence on the association between PD and CVDs. We used a relevant search strategy to retrieve articles from databases such as PubMed and Google Scholar from 2013 to July 2023. Upon applying filters and screening through titles and abstracts, we could narrow down articles to 21. On full-text screening, we selected 10 articles for in-depth analysis. This study showed a significant correlation between PD and CVDs. Poor oral hygiene, infection, and inflammation in the oral cavity lead to systemic inflammation, causing endothelial dysfunction. There are controversial views about PD acting as an independent risk factor for CVD development, as there are other risk factors such as age, gender, smoking, etc. acting as confounding factors while establishing the link between PD and CVDs. Knowledge about oral health, maintaining good oral hygiene, and proper treatment for PD could reduce the incidence of CVDs. Further research is needed to prove that PD is an independent risk factor for CVDs.
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Affiliation(s)
- Indu Etta
- Internal Medicine, Kakatiya Medical College, Warangal, IND
| | - Saisravika Kambham
- Internal Medicine, Dr. Bhim Rao Ambedkar Medical College and Hospital, Bangalore, IND
| | - Khushal B Girigosavi
- Neurology, Dr. Vasantrao Pawar Medical College, Hospital and Research Center, Nashik, IND
| | - Binay K Panjiyar
- Internal Medicine, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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7
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Li Y, Yuan X, Zheng Q, Mo F, Zhu S, Shen T, Yang W, Chen Q. The association of periodontal disease and oral health with hypertension, NHANES 2009-2018. BMC Public Health 2023; 23:1122. [PMID: 37308938 DOI: 10.1186/s12889-023-16012-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 05/29/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Hypertension is a worldwide public health problem. We sought to explore the interaction of oral health and smoking on hypertension, and periodontal disease and smoking on hypertension. METHODS We included 21,800 participants aged ≧ 30 years from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Information of oral health and periodontal disease were self-reported. Blood pressure was taken by trained personnel and/or physicians at mobile testing center. Multiple logistic regression was used to estimate the association between oral health, periodontal disease and the prevalence of hypertension. The effects of oral health and periodontal disease on hypertension under smoking status and age were analyzed by stratified and interaction analysis. RESULTS A total of 21,800 participants were investigated, including 11,017 (50.54%) in hypertensive group and 10,783 (49.46%) in non-hypertensive group. Compared with the excellent/very good of oral health, the multivariable-adjusted OR of good, fair, and poor were 1.13 (95% CI, 1.02-1.27), 1.30 (95% CI, 1.15-1.47), and 1.48 (95% CI, 1.22-1.79) (p for trend < 0.001) for hypertension, respectively. Compared without periodontal disease group, the multivariable-adjusted OR of periodontal disease for hypertension was 1.21 (95% CI ,1.09-1.35) (p for trend < 0.001). Furthermore, we found the interactions between periodontal disease and smoking, oral health and smoking, periodontal disease and age, oral health and age were p < 0.001. CONCLUSIONS An association between oral health and periodontal disease with the prevalence of hypertension was identified. There exists interactive effect of periodontal disease and smoking, oral health and smoking, periodontal disease and age, oral health and age on hypertension in American population over 30 years of age and older.
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Affiliation(s)
- Yuting Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Xiaojing Yuan
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Qiutong Zheng
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Fengxin Mo
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Shiheng Zhu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Tianran Shen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China
| | - Wenhan Yang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China.
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China.
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, Guangdong Province, China.
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment(2019GCZX012), Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong Province, China.
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Zhan Y, Jiao J, Jing W, Feng X, Tai B, Hu D, Lin HC, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Wang X, Si Y, Meng H. Association between periodontitis and hypertension: cross-sectional survey from the Fourth National Oral Health Survey of China (2015-2016). BMJ Open 2023; 13:e068724. [PMID: 36972967 PMCID: PMC10069577 DOI: 10.1136/bmjopen-2022-068724] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVES To evaluate the association between periodontitis severity and hypertension based on Chinese epidemiological data. DESIGN This cross-sectional survey enrolled adults from the Fourth National Oral Health Survey of China (2015-2016). SETTING The data were obtained from the Fourth National Oral Health Survey of China (2015-2016). PARTICIPANTS The study included individuals aged 35-44 years (n=4409), 55-64 years (n=4568) and 65-74 years (n=4218). PRIMARY AND SECONDARY OUTCOME MEASURES Periodontal status, defined on the basis of the 2017 classification scheme, and periodontal parameters (eg, bleeding on probing (BOP)) were compared between individuals with hypertension and individuals with normotension. Smoothed scatterplots were constructed to demonstrate the associations of periodontal parameters and periodontal status with hypertension. RESULTS Severe periodontitis (stages III and IV) was present in 41.4% of individuals with hypertension and 28.0% of individuals with normotension, respectively (p<0.001). The prevalence of severe periodontitis was higher in individuals with hypertension than that in individuals with normotension among participants aged 35-44 years (18.0% vs 10.1%, p<0.001) and 55-64 years (40.2% vs 36.7%, p=0.035), but not in participants aged 65-74 years (46.4% vs 45.1%, p=0.429). Therefore, the difference in periodontal status between individuals with hypertension and individuals with normotension decreased with age. There were higher prevalences of BOP, probing depth (PD) ≥4 mm and PD ≥6 mm in individuals with hypertension than in individuals with normotension (52.1% vs 49.2%, 19.6% vs 14.7% and 1.8% vs 1.1%, respectively). Periodontitis severity and the proportion of teeth with PD ≥4 or ≥6 mm were positively associated with hypertension. CONCLUSION Periodontitis is associated with hypertension in Chinese adults. Hypertension prevalence increased with periodontitis severity, particularly among young participants. Accordingly, it is necessary to improve the education, awareness of periodontal treatment and preventive management among individuals at risk of hypertension, particularly in the younger population.
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Affiliation(s)
- Yalin Zhan
- First Clinical Division & Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Jian Jiao
- First Clinical Division & Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Wudi Jing
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, People's Republic of China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Huan-Cai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, People's Republic of China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Xuenan Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Wensheng Rong
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Weijian Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, People's Republic of China
| | - Yan Si
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, People's Republic of China
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Pereira PR, Storniolo de Souza JM, Foratori-Junior GA. Knowledge, attitudes and practices of undergraduate students and dentists about dental prenatal care. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:36-45. [PMID: 35051303 DOI: 10.1111/eje.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/05/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Prenatal care is a fundamental moment for health promotion to be carried out, since at that moment women are more receptive to new knowledge, with the aim of providing better healthcare for the baby. This study aimed to evaluate the knowledge, attitudes and practices of undergraduate students and professionals, both from the public and from private sectors in Brazil, regarding dental prenatal care. MATERIALS AND METHODS This study corresponded to an online questionnaire survey, via Google Forms, consisting of 17 general questions for undergraduates (n = 103) and 16 for professionals (n = 227) for demographic and school mapping, and 18 specific questions about the importance and protocol of dental prenatal care. T-test, Mann-Whitney U-test and multiple linear regression were adopted (p < .05). RESULTS The average total score of the questionnaire for students and professionals was 12.40 and 15.65, respectively (p < .0001), indicating moderate knowledge. Professionals showed a higher prevalence of moderate (77%) and high (2%) knowledge of the subject when compared to undergraduate students (51% and 0% respectively). The graduation period in which the students were enrolled was a predictor of the total score of the questionnaire [F (1, 101) = 21.21; p < .0001; R2 = .165]. The female gender and the lower weekly workload were the main predictors of the total score of the questionnaire for professionals [F (3, 223) = 6.74; p < .0001; R2 = .083]. CONCLUSIONS Although professionals have greater knowledge about dental prenatal care than students, there are still deficiencies in the knowledge and practices of them in respect of dental management during pregnancy. Higher education institutions need to change the teaching-learning plan regarding the holistic dental approach for women during pregnancy.
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Affiliation(s)
| | | | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Centre for Host-microbiome Interactions, Faculty of Dental, Oral and Craniofacial Sciences, King's College London, London, UK
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10
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Tong F, Wang P, Chen Z, Liu Y, Wang L, Guo J, Li Z, Cai H, Wei J. Combined Ferromagnetic Nanoparticles for Effective Periodontal Biofilm Eradication in Rat Model. Int J Nanomedicine 2023; 18:2371-2388. [PMID: 37192894 PMCID: PMC10182795 DOI: 10.2147/ijn.s402410] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Introduction The critical challenge for periodontitis therapy is thoroughly eliminating the dental plaque biofilm, particularly penetrating the deep periodontal tissue. Regular therapeutic strategies are insufficient to penetrate the plaque without disturbing the commensal microflora of the oral cavity. Here, we constructed a Fe3O4 magnetic nanoparticle loading minocycline (FPM NPs) to penetrate the biofilm physically and effectively eliminate periodontal biofilm. Methods In order to penetrate and remove the biofilm effectively, Fe3O4 magnetic nanoparticles were modified with minocycline using a co-precipitation method. The particle size and dispersion of the nanoparticles were characterized by transmission electron microscopy, scanning electron microscopy, and dynamic light scattering. The antibacterial effects were examined to verify the magnetic targeting of FPM NPs. Confocal laser scanning microscopy was employed to check the effect of FPM + MF and develop the best FPM NPs treatment strategy. Additionally, the therapeutic effect of FPM NPs was investigated in periodontitis rat models. The expression of IL-1β, IL-6, and TNF-α in periodontal tissues was measured by qRT-PCR and Western blot. Results The multifunctional nanoparticles exhibited intense anti-biofilm activity and good biocompatibility. The magnetic forces could pull FMP NPs against the biofilm mass and kill bacteria deep in the biofilms both in vivo and in vitro. The integrity of the bacterial biofilm is disrupted under the motivation of the magnetic field, allowing for improved drug penetration and antibacterial performance. The periodontal inflammation recovered well after FPM NPs treatment in rat models. Furthermore, FPM NPs could be monitored in real-time and have magnetic targeting potentials. Conclusion FPM NPs exhibit good chemical stability and biocompatibility. The novel nanoparticle presents a new approach for treating periodontitis and provides experimental support for using magnetic-targeted nanoparticles in clinic applications.
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Affiliation(s)
- Fei Tong
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, Jiangxi Province, 330031, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Pei Wang
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Ziqiang Chen
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Yifan Liu
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Lianguo Wang
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Jun Guo
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Zhihua Li
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
| | - Hu Cai
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, Jiangxi Province, 330031, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
- Correspondence: Hu Cai, School of Chemistry and Chemical Engineering, Nanchang University, 999# Xuefu Road, Honggutan District, Nanchang, Jiangxi, 330031, People’s Republic of China, Tel +86 791 83969514, Email
| | - Junchao Wei
- School of Stomatology, Nanchang University, Nanchang, 330006, People’s Republic of China
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, Jiangxi Province, 330031, People’s Republic of China
- The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi Province, 330006, People’s Republic of China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, 330006, People’s Republic of China
- Junchao Wei, School of Stomatology, Nanchang University, 49# Fuzhou Road, Donghu District, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +86 791 86236950, +86 791 6361141, Email
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Zhong M, Huang J, Wu Z, Chan KG, Wang L, Li J, Lee LH, Law JWF. Potential Roles of Selectins in Periodontal Diseases and Associated Systemic Diseases: Could They Be Targets for Immunotherapy? Int J Mol Sci 2022; 23:ijms232214280. [PMID: 36430760 PMCID: PMC9698067 DOI: 10.3390/ijms232214280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Periodontal diseases are predisposing factors to the development of many systemic disorders, which is often initiated via leukocyte infiltration and vascular inflammation. These diseases could significantly affect human health and quality of life. Hence, it is vital to explore effective therapies to prevent disease progression. Periodontitis, which is characterized by gingival bleeding, disruption of the gingival capillary's integrity, and irreversible destruction of the periodontal supporting bone, appears to be caused by overexpression of selectins in periodontal tissues. Selectins (P-, L-, and E-selectins) are vital members of adhesion molecules regulating inflammatory and immune responses. They are mainly located in platelets, leukocytes, and endothelial cells. Furthermore, selectins are involved in the immunopathogenesis of vascular inflammatory diseases, such as cardiovascular disease, diabetes, cancers, and so on, by mediating leukocyte recruitment, platelet activation, and alteration of endothelial barrier permeability. Therefore, selectins could be new immunotherapeutic targets for periodontal disorders and their associated systemic diseases since they play a crucial role in immune regulation and endothelium dysfunction. However, the research on selectins and their association with periodontal and systemic diseases remains limited. This review aims to discuss the critical roles of selectins in periodontitis and associated systemic disorders and highlights the potential of selectins as therapeutic targets.
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Affiliation(s)
- Mei Zhong
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Jiangyong Huang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Zhe Wu
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Kok-Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China
- Correspondence: (K.-G.C.); (L.-H.L.)
| | - Lijing Wang
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Vascular Biology Research Institute, School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jiang Li
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510180, China
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
- Correspondence: (K.-G.C.); (L.-H.L.)
| | - Jodi Woan-Fei Law
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
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12
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The relationship between tooth loss and hypertension: a systematic review and meta-analysis. Sci Rep 2022; 12:13311. [PMID: 35922537 PMCID: PMC9349209 DOI: 10.1038/s41598-022-17363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
As tooth loss is the high end of periodontal problems and edentulous individuals are at higher risk of nutritional problems like obesity, understanding the association between tooth loss and hypertension is important for improving cardiovascular health. We searched for publications from the last two decades using three electronic databases (PubMed, Web of Science and Scopus) and conducted a systematic review and meta-analysis on the association between tooth loss and hypertension according to PRISMA-P guidelines. Quality assessments were performed using the Newcastle–Ottawa Scale and the GRADE approach. Twenty-four studies (20 cross-sectional, and 4 cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that subjects with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Meta-analyses revealed a statistically significant association between tooth loss and hypertension. The pooled odds ratios of hypertension for having tooth loss with no tooth loss and for edentulous with dentate were 2.22 (95% CI 2.00–2.45) and 4.94 (95% CI 4.04–6.05), respectively. In cohort studies, subjects with more tooth loss had a greater incidence of hypertension than those with less tooth loss during the follow-up period. The present systematic review and meta-analysis suggests that tooth loss is associated with an increased risk of hypertension and higher systolic blood pressure.
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Abdulwahab M, Kamal M, Akbar A. Screening for High Blood Pressure at the Dentist's Office. Clin Cosmet Investig Dent 2022; 14:79-85. [PMID: 35399622 PMCID: PMC8986194 DOI: 10.2147/ccide.s358890] [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: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background High blood pressure is a worldwide issue that can go undetected. Many are unaware of such a problem due to the lack of symptoms in early stages. Visiting the dentist can be a good place to screen for such health issues. Screening dental patients at every dental visit can be of great benefit. The aim of this study was to determine if screening for blood pressure at the dental office is efficient and beneficial for patients. Methods The HEYER VizOR Digital Blood Pressure Monitor was used to measure the blood pressure of all the patients visiting the dental clinic, ranging in age from 18 to 85. The study was comprised of patients who had never been diagnosed as hypertensive by a physician or if they had been diagnosed before. Results A total of 273 participants met the inclusion criteria. One hundred and thirty-seven (50.1%) patients had high blood pressure readings compared to 136 (49.8%) patients with normal blood pressure readings. It also showed that 54 (38%) of patients with high blood pressure readings had never been diagnosed by a physician with hypertension and were unaware of their blood pressure status. In addition, 83 (63.3%) of patients who had been diagnosed with hypertension by a physician had high blood pressure readings. The data also showed that 5.3% of patients diagnosed by their physician do not take their prescribed medication. Conclusion In this study, we showed that screening blood pressure at the dental office can detect high blood pressure readings in dental patients. It is also a useful screening tool for blood pressure for diagnosed and undiagnosed patients. Screening dental patients at the dental office is a useful tool that can help in the screening for blood pressure and should be implemented at every visit.
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Affiliation(s)
- Mohammad Abdulwahab
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabryia, Kuwait
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabryia, Kuwait
| | - Ali Akbar
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabryia, Kuwait
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Skipina TM, Elhawary MM, Soliman EZ. Periodontal disease is associated with elevated atherosclerotic cardiovascular disease risk score. Am J Med Sci 2022; 364:327-332. [DOI: 10.1016/j.amjms.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
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15
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Monsarrat P, Bernard D, Marty M, Cecchin-Albertoni C, Doumard E, Gez L, Aligon J, Vergnes JN, Casteilla L, Kemoun P. Systemic Periodontal Risk Score Using an Innovative Machine Learning Strategy: An Observational Study. J Pers Med 2022; 12:jpm12020217. [PMID: 35207705 PMCID: PMC8879877 DOI: 10.3390/jpm12020217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 11/16/2022] Open
Abstract
Early diagnosis is crucial for individuals who are susceptible to tooth-supporting tissue diseases (e.g., periodontitis) that may lead to tooth loss, so as to prevent systemic implications and maintain quality of life. The aim of this study was to propose a personalized explainable machine learning algorithm, solely based on non-invasive predictors that can easily be collected in a clinic, to identify subjects at risk of developing periodontal diseases. To this end, the individual data and periodontal health of 532 subjects was assessed. A machine learning pipeline combining a feature selection step, multilayer perceptron, and SHapley Additive exPlanations (SHAP) explainability, was used to build the algorithm. The prediction scores for healthy periodontium and periodontitis gave final F1-scores of 0.74 and 0.68, respectively, while gingival inflammation was harder to predict (F1-score of 0.32). Age, body mass index, smoking habits, systemic pathologies, diet, alcohol, educational level, and hormonal status were found to be the most contributive variables for periodontal health prediction. The algorithm clearly shows different risk profiles before and after 35 years of age and suggests transition ages in the predisposition to developing gingival inflammation or periodontitis. This innovative approach to systemic periodontal disease risk profiles, combining both ML and up-to-date explainability algorithms, paves the way for new periodontal health prediction strategies.
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Affiliation(s)
- Paul Monsarrat
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
- Correspondence:
| | - David Bernard
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
| | - Mathieu Marty
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
| | - Chiara Cecchin-Albertoni
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
| | - Emmanuel Doumard
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
| | - Laure Gez
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
| | - Julien Aligon
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France;
| | - Jean-Noël Vergnes
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
- CERPOP, UMR1295 (Axe MAINTAIN), Université P. Sabatier, 31000 Toulouse, France
- Population Oral Health Research Cluster of the McGill Faculty of Dental Medicine and Oral Health Sciences, Montreal, QC H3A 1G1, Canada
| | - Louis Casteilla
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
| | - Philippe Kemoun
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, 31100 Toulouse, France; (D.B.); (C.C.-A.); (E.D.); (L.C.); (P.K.)
- Dental Faculty and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France; (M.M.); (L.G.); (J.-N.V.)
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Li L, Li L, Zhou Y, Chen X, Xu Y. Association Between Triglyceride-Glucose Index and Risk of Periodontitis: A Cross-Sectional Study. Int J Gen Med 2021; 14:9807-9816. [PMID: 34938103 PMCID: PMC8687520 DOI: 10.2147/ijgm.s339863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/01/2021] [Indexed: 12/20/2022] Open
Abstract
Background The purpose of this study was to investigate the TyG index in the occurrence of periodontitis among the United States (US) population. Methods We analyzed clinical data from 4813 participants in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014. the TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Dose-response curves, univariate and multivariate logistic analyses were used to analyze the adjusted odds ratio (aOR) and 95% confidence interval (CI) between TyG index and periodontitis. In addition, we performed 1:1 propensity score matching (PSM) for periodontitis and no periodontitis participants to further explore the relationship between TyG and periodontitis. Results A total of 4813 participants were included in our study, of which 1353 (28.1%) reported periodontitis and 3460 (71.9%) no periodontitis. The dose-response curves showed a non-linear positive association between TyG and periodontitis, with the risk of periodontitis increased with increasing TyG. In addition, similar results were still observed after subgroup analysis and PSM analysis. After adjusting for confounding variables, multivariate logistic analysis showed that TyG was associated with an increased risk of periodontitis (aOR =1.153; 95% CI 1.006-1.322, p=0.034). Conclusion Elevated TyG index was significantly associated with a high risk of periodontitis, and people with a high TyG index should be aware of the risk of periodontitis progression in order to establish lifestyle changes at an early stage.
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Affiliation(s)
- Lili Li
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People's Republic of China
| | - Lu Li
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People's Republic of China
| | - Yi Zhou
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People's Republic of China
| | - Xu Chen
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People's Republic of China
| | - Yan Xu
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu Province, People's Republic of China
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Velosa-Porras J, E. Arregoces FM, L. Uriza C, Ruiz AJ. Endothelial Dysfunction, its Relationship with Chronic Periodontal Disease, and other Associated Risk Factors. Open Dent J 2021. [DOI: 10.2174/1874210602115010377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Chronic periodontitis is related to individual characteristics. However, it is precisely infectious in nature with the possibility of generating a chronic systemic inflammatory response that could favour its association with diseases, such as endothelial dysfunction, hypertension, CVD, and diabetes.
Purpose:
The aim of the study was to analyze the relationship of endothelial dysfunction measured by flow-mediated vasodilation in the brachial artery with periodontal disease and other possible factors.
Methods:
A case-control study was carried out in which those who had periodontitis were defined as cases, and those who were periodontally healthy or had gingivitis were defined as controls. A clinical history was obtained from all patients, and all patients underwent biofilm control and periodontal examinations. Blood tests were performed to determine CBC, glycaemia, total cholesterol, HDL-C, and LDL-C levels, and standardized procedures were used to measure flow-mediated dilation.
Results:
A total of 202 patients were included in this study: 101 controls [healthy/gingivitis] and 101 cases [periodontitis]. Regarding sex, glycaemia [p = 0.019] and triglycerides [p = 0.001] levels and initial flow-mediated vasodilation [p = 0.001] and final flow-mediated vasodilation [p = 0.001] values were higher in men, while HDL values were lower [p = 0.001. The average age was higher for those in the group that presented dysfunction than for those in the group without dysfunction [p = 0.014]. When analyzing the percentage of patients with endothelial dysfunction in each of the groups, there were very few positive results obtained [5 per group].
Conclusion:
Initial and final arterial vasodilation was lower in women than in men. Likewise, there were more cases of endothelial dysfunction in women. In this study, patients with endothelial dysfunction were older. Periodontitis was not associated with endothelial dysfunction.
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Milojevic Samanovic A, Jakovljevic V, Vasovic M, Mitrovic S, Rankovic M, Mihajlovic K, Bolevich S, Zivkovic V. Cardiac, biochemical and histopathological analysis reveals impaired heart function in hypertensive rats with apical periodontitis. Int Endod J 2021; 54:1581-1596. [PMID: 33987853 DOI: 10.1111/iej.13562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
AIM To investigate the association between experimentally induced apical periodontitis (AP) and heart function in hypertensive rats. METHODOLOGY Forty-eight normotensive Wistar albino and spontaneously hypertensive (SHR) rats were divided into four equal groups: control (C), normotensive with AP (AP), SHR and SHR with AP (SHR + AP). AP was induced on the first right mandibular molars by exposing the pulp chambers to the oral environment for four weeks and confirmed radiographically. Thereafter, the animals were sacrificed by cervical dislocation, whilst hearts were isolated and perfused according to the Langendorff technique gradually increasing coronary perfusion pressures 40-120 cmH2 O. The hemimandibles were analysed radiographically (mm2 and pixels) to verify the presence of AP. Biomarkers of cardiac oxidative stress (OS) were determined in coronary venous effluent and cardiac tissue homogenate. Cardiac tissue was analysed histopathologically for signs of heart damage (oedema, fibrosis and necrosis). All data were analysed by Kruskal-Wallis and one-way anova tests (p < .05). RESULTS The levels of the maximum left ventricular pressure development rate of the SHR + AP group were significantly increased compared to the AP and C groups, and of the SHR group compared with the C group (p < .05). The levels of the minimum left ventricular pressure development rate of the SHR + AP group were significantly decreased compared to the AP, SHR and C groups, and of the SHR group compared to the C group (p < .05). The radiographic AP area was significantly larger in the SHR + AP group than in the AP group (p < .01). The levels of superoxide anion were significantly higher in the SHR + AP group than in the AP, SHR and C groups (p < .05). The activities of superoxide dismutase in cardiac tissue homogenate were significantly lower in the SHR + AP and AP groups compared with the SHR and C groups (p < .05). CONCLUSIONS In rats, AP was associated with impaired cardiodynamics, disturbed cardiac OS, antioxidant defence and cardiac pathologic changes in hypertensive conditions. Hypertension was associated with an increase in the AP radiographic area. Further studies should confirm whether root canal treatment can have a cardioprotective effect and reduce cardiac OS in hypertensive conditions.
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Affiliation(s)
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Miroslav Vasovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Slobodanka Mitrovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marina Rankovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Mihajlovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Sergey Bolevich
- Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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19
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Periodontitis, Blood Pressure, and the Risk and Control of Arterial Hypertension: Epidemiological, Clinical, and Pathophysiological Aspects-Review of the Literature and Clinical Trials. Curr Hypertens Rep 2021; 23:27. [PMID: 33961166 PMCID: PMC8105217 DOI: 10.1007/s11906-021-01140-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Abstract
Purpose of Review Arterial hypertension is an important risk factor for cardiovascular disease. In the world, about 45% of people suffer from arterial hypertension, while good blood pressure control is achieved by only approximately 50% of all hypertensive patients treated. The reason for the high prevalence of arterial hypertension and its poor control is low knowledge of hypertensinogenic factors. One such factor is periodontitis, which is a disease of social importance. Recent Findings It has been shown that the occurrence of periodontitis leads to an increase in blood pressure, increasing the risk of arterial hypertension. Periodontitis can also lead to ineffectiveness of antihypertensive treatment. Some interventional studies have shown that treatment of periodontitis reduced blood pressure in patients with arterial hypertension. The pathogenesis of arterial hypertension in periodontitis is complex and concerns mainly the impairment of the vasodilatation properties of the endothelium. Summary Hygiene and periodontitis treatment should be a method of preventing arterial hypertension and a method of increasing the effectiveness of antihypertensive treatment.
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20
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Yang Q, Ding H, Wei W, Liu J, Wang J, Ren J, Chan W, Wang M, Hao L, Li J, Yue Y. Periodontitis aggravates kidney injury by upregulating STAT1 expression in a mouse model of hypertension. FEBS Open Bio 2021; 11:880-889. [PMID: 33448153 PMCID: PMC7931221 DOI: 10.1002/2211-5463.13081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/11/2021] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is an autoimmune disease of periodontal tissues initiated by plaque. It is known that there is a close connection between periodontitis and CKD with hypertension, but the underlying mechanisms are unknown. STAT1 has been reported to play a regulatory role in hypertension and chronic kidney disease (CKD). Here, we investigated whether STAT1 regulates periodontitis-mediated aggravation of kidney injury with accompanying hypertension. A hypertensive renal injury mouse model was established with Nos3 knockout mice, and a periodontitis model was established by implantation with the oral bacteria Porphyromonas gingivalis. The mice were intraperitoneally injected with a STAT1 inhibitor. Periodontitis aggravated kidney injury in hypertensive mice, and upregulation of STAT1 was observed when both periodontitis and hypertension were present; furthermore, STAT1 inhibitor moderated this effect. Moreover, we observed that periodontitis promoted the upregulation of inflammatory and fibrosis gene expression in the kidneys of hypertensive mice. In addition, STAT1 inhibition decreased the expression of pro-inflammatory and pro-fibrotic cytokines in the kidney lesion area. Periodontitis augmented the expression of inflammatory and fibrosis genes by upregulating the expression of STAT1, thereby aggravating kidney injury in the hypertensive mouse model.
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Affiliation(s)
- Qin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | | | - Wei Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Jie Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Jiajia Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Jie Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Weicheng Chan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Min Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Liang Hao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Jinle Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
| | - Yuan Yue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, China
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21
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Foratori-Junior GA, Máscoli LS, Marchese CC, Orenha ES, Sales-Peres SHDC. Association Between Arterial Hypertension and Periodontal Status in Morbidly Obese Patients Who Are Candidates for Bariatric Surgery. Int Dent J 2021; 71:242-249. [PMID: 34024333 PMCID: PMC9275335 DOI: 10.1111/idj.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective This study aimed to compare the systemic and periodontal conditions between morbidly obese patients with and without hypertension who were candidates for bariatric surgery. Methods The study cohort had 111 morbidly obese patients stratified into two groups: patients with (G1 = 54) and without (G2 = 57) arterial hypertension. The following characteristics were compared between the two groups: (i) education level; (ii) anthropometric parameters [weight, height, body mass index (BMI), waist and hip circumferences and waist-to-hip ratio (WHR)]; (iii) risk of developing cardiovascular diseases (based on patients’ sex, age and WHR); (iv) behaviours regarding oral hygiene; and (v) periodontal status. The t-test, Mann–Whitney U-test, chi-square test and logistic regression were applied, with a significance level of 5%. Results Patients in G1 had a lower level of education (P = 0.002). There were no intergroup differences for weight (P = 0.211), height (P = 0.126), BMI (P = 0.551), waist circumference (P = 0.859) and WHR (P = 0.067); however, patients in G2 had a smaller hip circumference (P = 0.029), and 78% of patients in G1 had a high/very high risk of developing cardiovascular diseases. The prevalence of periodontitis was 72.2% (n = 39) in G1 and 38.6% (n = 22) in G2. On logistic regression analysis, age [adjusted odds ratio (OR) = 1.07; 95% CI = 1.01–1.13; P = 0.008) and the presence of arterial hypertension (OR = 2.77; 95% CI = 1.17–6.56; P = 0.019) were identified as the independent variables associated with periodontitis. Conclusion Morbid obesity and arterial hypertension are associated with a higher prevalence of cardiovascular diseases. Moreover, morbidly obese patients with hypertension have a higher prevalence of periodontitis and greater severity of periodontal disease than those without hypertension.
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Affiliation(s)
- Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil; University of Integrated Faculties of Ourinhos, Ourinhos, Brazil
| | - Leonardo Silva Máscoli
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Carolina Cordeiro Marchese
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Eliel Soares Orenha
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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22
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Ngan WB, Belinga LEE, Nlo'o SE, Mbozo'o EA, Otsomoti E, Ndongo JM, Lele EB, Hupin D, Mandengue SH, Roche F, Bongue B. Oral health status and cardiovascular risk profile in Cameroonian military population. AIMS Public Health 2021; 8:100-109. [PMID: 33575410 PMCID: PMC7870389 DOI: 10.3934/publichealth.2021008] [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: 10/02/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Periodontal diseases (PD) seem to appear today as predictors of some cardiovascular diseases (CVD). There is a lack of data on the oral health among Cameroonian military population, and its relationship with CVD. Purpose Investigate on the link between oral health of Cameroonian military from the Ngaoundéré garrison and their cardiovascular risk profile. Participants and methods A cross-sectional study at the Fifth Military Sector Health Center in Ngaoundéré was conducted. General health parameters assessment was done according to the World Health Organization STEPS manual for surveillance of risk factors for non-communicable chronic diseases and the Alcohol Use Disorders Identification Test. The periodontal status was assessed using Dutch Periodontal Screening Index. Results Two hundred and five participants who were officers and non-commissioned officers (aged 47 ± 08 and 32 ± 08 years respectively), with 86.4% of men were included. Smoking was associated to periodontitis (OR = 4.44 [1.73–11.43], p = 0.0031). Quality of oral hygiene was associated to high cardiovascular risk profile, poor/good (OR = 3.96 [1.07–14.57], p = 0.0386) and medium/good (OR = 3.44 [1.11–10.66], p = 0.0322). Conclusion Lifestyle as tobacco consumption and poor oral hygiene were associated to CVD among military, and this call for change.
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Affiliation(s)
- W Bell Ngan
- Department of Military Health, Yaoundé, Cameroon.,Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Cameroon.,INSERM, U1059, Sainbiose, Dysfonction Vasculaire et Hémostase, Université de Lyon, Université Jean Monnet, Saint-Etienne, France.,Fifth Military Sector Health Center, Ngaoundéré, Cameroon
| | - L Essama Eno Belinga
- Douala General Hospital, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | | | - E Abeng Mbozo'o
- Department of Military Health, Yaoundé, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - E Otsomoti
- Fifth Military Sector Health Center, Ngaoundéré, Cameroon
| | - J Mekoulou Ndongo
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - Ec Bika Lele
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - D Hupin
- INSERM, U1059, Sainbiose, Dysfonction Vasculaire et Hémostase, Université de Lyon, Université Jean Monnet, Saint-Etienne, France.,Cetaf, St-Etienne, France
| | - S H Mandengue
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | - F Roche
- INSERM, U1059, Sainbiose, Dysfonction Vasculaire et Hémostase, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - B Bongue
- INSERM, U1059, Sainbiose, Dysfonction Vasculaire et Hémostase, Université de Lyon, Université Jean Monnet, Saint-Etienne, France.,Cetaf, St-Etienne, France
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23
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Ostalska-Nowicka D, Paszyńska E, Dmitrzak-Węglarz M, Neyman-Bartkowiak A, Rabiega A, Zachwieja J, Nowicki M. Dental caries-related primary hypertension in children and adolescents: Cross-sectional study. Oral Dis 2020; 27:1822-1833. [PMID: 33128414 DOI: 10.1111/odi.13700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/27/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypertension is a growing clinical problem in pediatric population. Also, the cause of hypertension is usually unknown and it may result from systemic inflammation related to tooth decay. AIM To estimate the potential association in cross-sectional study between tooth decay and hypertension in children and adolescents. PATIENTS AND METHODS Study group-65 children diagnosed with primary arterial hypertension; control subjects-44 normotensive children. Blood pressure, dental examination, measurement of salivary cortisol, alpha-amylase, secretory IgA, and lysozyme concentrations were performed in all of the children. RESULTS Hyper- and normotensive children had similar peripheral blood morphology and serum biochemical parameters, except of uric acid concentration, which was significantly higher in the study group (p = .047). Salivary evening concentrations of cortisol and alpha-amylase were significantly higher in hypertensive children (p = .002 and p = .004, respectively). Although 24-hr systolic blood pressure (SBP), including daytime and nighttime SBP, correlated with "decay," "microalbuminuria," "BMI," and "glomerular filtration rate" (r > .75, r > .7, r < .68, and r < .43, respectively), in multivariate analysis only "decay" was associated with hypertension both in children and in adolescents (p < .0001). CONCLUSION Tooth decay in children/adolescents might be regarded as a potent trigger factor of hypertension in individuals in whom all other causes of secondary arterial hypertension have been excluded.
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Affiliation(s)
- Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Paszyńska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Dmitrzak-Węglarz
- Department of Genetics in Psychiatry, Psychiatric Genetics Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Neyman-Bartkowiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Alina Rabiega
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
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24
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Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses 2020; 144:109969. [PMID: 32592918 PMCID: PMC7303044 DOI: 10.1016/j.mehy.2020.109969] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.
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Affiliation(s)
- Viviana Pitones-Rubio
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - E G Chávez-Cortez
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Angélica Hurtado-Camarena
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Anna González-Rascón
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Nicolás Serafín-Higuera
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico.
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25
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Paszynska E, Dmitrzak-Weglarz M, Ostalska-Nowicka D, Nowicki M, Gawriolek M, Zachwieja J. Association of Oral Status and Early Primary Hypertension Biomarkers among Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217981. [PMID: 33143057 PMCID: PMC7662220 DOI: 10.3390/ijerph17217981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
The aim of this case-control study was the evaluation of the association between biomarkers of early primary arterial hypertension (HA) and oral diseases among children and adolescents. Material and methods. Subjects suspected of primary HA (n = 180) underwent a complex evaluation of their vascular status: blood pressure, heart rate, vascular stiffness, sympathetic activity in a 24 h ambulatory examination, followed by measurement of serum uric acid (UA), cystatin C, and creatinine. This procedure allowed the identification of children with primary (n = 58) and secondary HA (n = 74), as well as of children with normal arterial blood pressure, who served as a control group (n = 48). All subjects with secondary HA were excluded from further investigation. Oral examination included the measurement of caries intensity (using the decayed, missing, filled index for permanent teeth DMFT /primary teeth dmft), bacterial plaque (by the plaque control record index, PCR%), and gingivitis (by the bleeding on probing index, BOP%). For statistical analysis, a linear regression model and Spearman rank correlation were used. Results. UA, cystatin C, and creatinine were not altered in the HA group. However, the number of decayed permanent teeth (DT) and the DMFT, PCR%, and BOP% indexes were significantly higher in the primary HA group compared to the control group (p = 0.0006; p = 0.02; p = 0.0009; p = 0.003). Our results are not sufficient to prove the important role of caries and gingival inflammation in the modulation of HA symptoms, although they prove the association of oral diseases with primary HA symptoms. This may indicate future strategies for preventive measures for hypertensive children and adolescents.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
- Correspondence:
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
| | - Michal Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland;
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
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26
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Almoznino G, Kedem R, Turgeman R, Bader T, Yavnai N, Zur D, Shay B. The Dental, Oral, Medical Epidemiological (DOME) Study: Protocol and Study Methods. Methods Inf Med 2020; 59:119-130. [PMID: 33080627 DOI: 10.1055/s-0040-1718582] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To develop and present the methods utilized for the Dental, Oral, Medical Epidemiological (DOME) study. METHODS The DOME is an electronic record-based cross-sectional study, that was conducted to measure the dental, periodontal, and oral morbidities and their associations with systemic morbidities, among a nationally representative sample of young to middle-aged adults military personnel from the IDF (Israel Defense Forces). To that end, we developed a strict protocol including standardized terminology, data collection, and handling. RESULTS Data for the DOME study was derived simultaneously from three electronic records of the IDF: (1) a central demographic database, (2) the dental patient record (DPR), and (3) the medical computerized patient record (CPR). The established DOME repository includes socio-demographic, dental and medical records of 132,354 young to middle-age military personnel from the IDF, who attended the dental clinics during the year 2015. Records of general military personnel (N > 50,000), with no recorded dental visits during the study period, served as a control group regarding all other parameters except dental. The DOME study continues and is currently collecting longitudinal data from the year 2010 until 2020. The IDF employs a standardized uniform administrative and clinical work-up and treatment protocols as well as uniform computerized codes. We describe the standardized definitions for all the parameters that were included: socio-demographics, health-related habits, medical and dental attendance patterns, and general and dental health status. Multicollinearity analysis results of the sociodemographic and medical study parameters are presented. CONCLUSION Standardized work-up and definitions are essential to establish the centralized DOME data repository to study the extent of dental and systemic morbidities and their associations.
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Affiliation(s)
- Galit Almoznino
- Big Biomedical Data Research Laboratory, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.,Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.,Department of Endodontics, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Ron Kedem
- Medical Information Department, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Ronit Turgeman
- Chief Dental Surgeon Headquarters, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Tarif Bader
- Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan and Department of Military Medicine, Hebrew University, Jerusalem, Israel
| | - Nirit Yavnai
- Medical Research and Academy Section, Medical Corps, Israel Defense Forces, Israel
| | - Dorit Zur
- Medical Information Department, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
| | - Boaz Shay
- Department of Endodontics, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
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27
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Jesuino BG, Foratori-Junior GA, Missio ALT, Mascoli LS, Sales-Peres SHDC. Periodontal status of women with excessive gestational weight gain and the association with their newborns' health. Int Dent J 2020; 70:396-404. [PMID: 32501575 PMCID: PMC9379182 DOI: 10.1111/idj.12580] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess the association between high gestational weight gain and systemic and periodontal status of women between the 32nd and 36th gestational weeks of pregnancy (T1) and after delivery (T2), and the association of these factors with newborns' health. METHODS The sample was divided into excessive gestational weight gain (GE = 25) and normal gestational weight gain (GN = 25) and was evaluated regarding: (i) socio-economic status; (ii) systemic and periodontal status; and (iii) newborns' health. The results were analysed using the Mann-Whitney U-test, the t-test, the Friedman test, analysis of variance (ANOVA) and Cochran's Q test (P < 0.05). RESULTS Women with GE had lower household income (P = 0.010) and higher body mass index (BMI) at both T1 and T2. The prevalence of hypertension at T1 was higher in women with GE, but the condition resolved post-delivery (P = 0.001). Worsening in oral hygiene was observed at T2 in both groups (P < 0.001). Sixty-eight percent of women with GE and 16% of women with GN had periodontitis at T1, and 52% and 12%, respectively, had periodontitis at T2. In women with GE, the BMI of newborns was higher (P = 0.031). CONCLUSIONS Women with high gestational weight gain also showed a high prevalence of hypertension and periodontitis during pregnancy, and persistent periodontitis after delivery. High gestational weight gain was related to high BMI of newborns.
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Affiliation(s)
- Bruno Gualtieri Jesuino
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Alana Luiza Trenhago Missio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Leonardo Silva Mascoli
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Caracho RA, Foratori-Junior GA, Fusco NDS, Jesuino BG, Missio ALT, Sales-Peres SHDC. Systemic conditions and oral health-related quality of life of pregnant women of normal weight and who are overweight. Int Dent J 2020; 70:287-295. [PMID: 32107768 PMCID: PMC9379178 DOI: 10.1111/idj.12547] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/27/2019] [Accepted: 11/20/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE This study evaluated systemic and periodontal conditions and their association with quality of life in women in the third trimester of pregnancy, assisted by the Brazilian public health-care system, with excessive and normal weight. METHODS Fifty pregnant women were allocated into two groups according to their pre-pregnancy body mass index (BMI): excessive (GE; n = 25; BMI ≥ 25.00 kg/m2 ); and normal (GN; n = 25; 18.00 ≤ BMI ≤ 24.99 kg/m2 ). Thereafter, variables such as socio-economic level, anthropometric parameters (body mass index and gestational weight gain), systemic conditions, periodontal status, and oral health-related quality of life using the short version of the Oral Health Impact Profile (OHIP-14), were evaluated. RESULTS There was no significant difference between groups in schooling level, monthly household income and gestational weight gain (P > 0.05). The GE group showed a higher frequency of arterial hypertension (P = 0.018), sought dental services less frequently (P = 0.035), had a higher prevalence of periodontitis (P = 0.011), and had a higher OHIP-14 overall score (P = 0.004) characterised by physical and psychological impact. In the final binary logistic regression models, high maternal BMI was associated with arterial hypertension and periodontitis during pregnancy, while periodontitis was strongly associated with moderate and high impact on quality of life. CONCLUSION Pregnant women in the third trimester with excessive weight, assisted by the Brazilian public health-care system, presented with a higher prevalence of arterial hypertension, worse periodontal conditions and consequent high impact on quality of life.
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Affiliation(s)
- Rafaela Aparecida Caracho
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nathalia dos Santos Fusco
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Bruno Gualtieri Jesuino
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Alana Luiza Trenhago Missio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Kolesnikova LR, Darenskaya MA, Pogodina AV, Grebenkina LA, Natyaganova LV, Kolesnikova LI, Kolesnikov SI. [The relationship of hemodynamic parameters of periodontal microvascular bed and lipid peroxidation products in adolescents with arterial hypertension]. STOMATOLOGII︠A︡ 2020; 99:9-14. [PMID: 32692513 DOI: 10.17116/stomat2020990419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
THE AIM Of the study was to establish the relationship of hemodynamic parameters of periodontal tissues and lipid peroxidation products in adolescents with arterial hypertension (AH). METHODS The study included 132 adolescents (average age 14.51±1.91 years), from which 2 clinical groups (1 - the group with AH without periodontal disease (n=19, average age - 15±1.53 years) and 2 - the group with AH with periodontal diseases (n=57, average age - 14.7±1.89 years)) and 2 comparison groups (3 - the comparison group without AH and periodontal diseases (n=19, average age - 13.82±1.89 years) and 4 - comparison group without AH and with periodontal diseases (n=37, mean age - 14.57±2.01 years)) were formed. Hemodynamic analysis of the periodontal microcirculatory bed using the Doppler ultrasound method and the level of lipid peroxidation products using spectrophotometric and fluorometric methods was performed. RESULTS In adolescents with hypertension without and with inflammatory periodontal diseases as a whole, unidirectional changes in the hemodynamics of the vascular bed of the periodontium were observed in the form of increased values of the maximum blood flow velocity in systole and an increase in the peripheral resistance index. At the same time, the group with hypertension and periodontal disease was distinguished by lower values of these indicators. In the system of lipid peroxidation, increased values of ketodienes and conjugated trienes occurred in patients with hypertension without periodontal disease and end products that actively reacting with thiobarbituric acid in patients with hypertension and periodontal disease. Correlation analysis showed the presence of intersystem relationships between the hemodynamic parameters of the vascular bed of periodontal adolescents with hypertension without periodontal disease. In the group of adolescents with arterial hypertension and periodontal disease, there was a decrease in the correlation coefficients between intersystem parameters by almost two times, as well as the appearance of pathological dependencies between toxic metabolites of the lipid peroxidation process - products that actively reacting with thiobarbituric acid and vascular blood flow indicators. CONCLUSION It has been noted that in adolescent patients with hypertension and periodontal diseases on the background of lower vascular blood flow and accumulation of end toxic metabolites, pathological dependencies occur between them, which may contribute to more intense damage to the tissues of the periodontal complex in the presence of hypertension.
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Affiliation(s)
- L R Kolesnikova
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia.,Federal State Public Educational Institution of Higher Education «Irkutsk State Medical University» of the Ministry of Health of the Russian Federation, Irkutsk, Russia
| | - M A Darenskaya
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia
| | - A V Pogodina
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia
| | - L A Grebenkina
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia
| | - L V Natyaganova
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia
| | - L I Kolesnikova
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia.,Federal State Public Educational Institution of Higher Education «Irkutsk State University»
| | - S I Kolesnikov
- Federal State Public Scientific Institution «Scientific Centre for Family Health and Human Reproduction Problems», Irkutsk, Russia.,Moscow State University Lomonosov M.V., Moscow, Russia.,Moscow State Regional University, Moscow, Russia
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Wei W, Xiao X, Li J, Ding H, Pan W, Deng S, Yin W, Xue L, Lu Q, Yue Y, Tian Y, Wang M, Hao L. Activation of the STAT1 Pathway Accelerates Periodontitis in Nos3-/- Mice. J Dent Res 2020; 98:1027-1036. [PMID: 31329047 DOI: 10.1177/0022034519858063] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Early studies on the etiology and pathogenesis of hypertension have shown that it has a considerable association with inflammation and the immune response as well as periodontitis. Clinical studies have also shown that hypertension can promote the periodontal tissue destruction caused by periodontitis. However, the underlying mechanisms remain unclear. This study aimed to explore the possible mechanisms of how hypertension aggravates periodontitis. Treatment with or without the signal transducer and activator of transcription 1 (STAT1) inhibitor fludarabine was performed in an endothelial nitric oxide synthase gene knockout-related (Nos3-/-) mouse model with the hypertension phenotype of periodontitis induced by bacteria. Micro-computed tomography, immunohistochemistry, Western blot, quantitative reverse transcription polymerase chain reaction, immunofluorescence, and ELISA were performed. We demonstrated that Nos3-/--related hypertension increases bone resorption and periodontal destruction in periodontitis lesion areas, which can be inhibited by the STAT1 inhibitor. Experimental data also showed that Nos3-/- significantly increased macrophage infiltration and proinflammatory cytokine expression in the periodontitis lesion area, which is dependent on the angiotensin II-induced STAT1 pathway. Inhibition of STAT1 in vivo can decrease the expression of proinflammatory cytokines and macrophage infiltration. Furthermore, data in this study showed that Nos3-/--related hypertension further downregulated the STAT3 anti-inflammatory function and its downstream chemokine expression in a STAT1-dependent manner. By applying RAW 264.7 and L929 cell lines and monocytes isolated from Nos3-/- mice, we confirmed that activation of the STAT1 pathway inhibits STAT3 and its downstream pathway and promotes inflammatory cytokine expression in vitro. Collectively, our current study demonstrated that STAT1 plays an indispensable role in the Nos3-/--related hypertension with aggravation of periodontitis, suggesting that STAT1 may be a key target for the treatment of periodontitis with hypertension.
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Affiliation(s)
- W Wei
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - X Xiao
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - J Li
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - H Ding
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - W Pan
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - S Deng
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - W Yin
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - L Xue
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Q Lu
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Y Yue
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Y Tian
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - M Wang
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - L Hao
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
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Wang IC, Askar H, Ghassib I, Wang CW, Wang HL. Association between periodontitis and systemic medication intake: A case-control study. J Periodontol 2020; 91:1245-1255. [PMID: 32077489 DOI: 10.1002/jper.19-0593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/19/2020] [Accepted: 01/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND To investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis. METHODS A total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age- and gender-matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression. RESULTS The top three most common medications were angiotensin-converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid-lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally, intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity-dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively. CONCLUSION There was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity-dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis.
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Affiliation(s)
- I-Ching Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Houssam Askar
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Iya Ghassib
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Chin-Wei Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
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Hosadurga R, Kyaw Soe HH, Peck Lim AT, Adl A, Mathew M. Association between tooth loss and hypertension: A cross-sectional study. J Family Med Prim Care 2020; 9:925-932. [PMID: 32318447 PMCID: PMC7114063 DOI: 10.4103/jfmpc.jfmpc_811_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Cardiovascular diseases (CVD) are one of the leading causes of premature deaths among noncommunicable disease. Hypertension increases the risk of cardiovascular events. In addition to well-known risk factors for hypertension like obesity, lack of physical activity, studies have shown independent association between tooth loss and increased blood pressure and stroke. However, the relevant literature is not conclusive. AIMS Aim of our study was to investigate the association between tooth loss and increased blood pressure among adult patients. METHODS AND MATERIAL A cross-sectional study among 270 adults aged 20-59 years was conducted. The dependent variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). The main exploratory variable was the number of self-reported natural teeth for each dental arch. They were recorded as 10 or more natural teeth, less than 10 natural teeth, and no natural teeth. Data were analyzed using descriptive statistics, independent t-test, ANOVA, and multiple linear regression analysis. RESULTS Mean SBP was 125.3 mmHg and DBP was 78.9 mmHg. Moreover, 29.3% of participants had hypertension, 8.9% were edentulous, 22.8% had lost more than 10 teeth, and 68.3% had lost less than 10 teeth. Increased SBP was seen with increased tooth loss among participants. After adjusting for all covariates, no significant association between tooth loss and SBP and DBP was seen. CONCLUSIONS The mean SBP was higher among the participants who were edentulous than partially edentulous. However, there was no significant association between tooth loss and SBP and DBP after adjusting for confounding factors.
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Affiliation(s)
- Rajesh Hosadurga
- Department of Periodontics, Faculty of Dentistry, Melaka-Manipal Medical College, Malaysia
| | - Htoo Htoo Kyaw Soe
- Deprtment of Community Medicine, Faculty of Medicine, Melaka-Manipal Medical College, Malaysia
| | | | - Abdul Adl
- Faculty of Dentistry, Melaka-Manipal Medical College, Malaysia
| | - Melwin Mathew
- Department of Periodontics, Faculty of Dentistry, Melaka-Manipal Medical College, Malaysia
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Helmi M, Goodson JM, Hasturk H, Natto ZS. Annual alveolar bone loss in subjects with cardiovascular disease adjusting for associated systemic diseases and risk factors: a retrospective study. BMC Oral Health 2020; 20:28. [PMID: 32000769 PMCID: PMC6993352 DOI: 10.1186/s12903-020-1015-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/20/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To detect annual alveolar bone loss in subjects with cardiovascular disease (CVD) adjusting for associated systemic diseases and risk factors. METHODS A total number of 132 subjects that reported having CVD from 2008 to 2015 (N = 132). For longitudinal data analysis, 58 subjects eligible for inclusion with at least two exposures of complete mouth set or repeated BW radiographs with at least one-year interval compared with a control group. Alveolar bone level on mesial and distal sites of posterior teeth was measured on bitewing (BW) radiographs available in the electronic health records of each subject. RESULTS Subjects who reported having cardiovascular diseases experienced higher annual mean alveolar bone loss (0.062 mm per year) compared to Subjects with no cardiovascular diseases (0.022 mm per year). CONCLUSION Subjects who have reported CVD had higher rate of annual bone loss compared to subjects who did not have any CVD. This observation indicates that targeting high-risk individuals for risk assessment is fundamental to provide the best healthcare possible to those who are the most in need. Periodic examination and assessment of periodontal health is an essential key factor for better oral health, however, it has to be more emphasized and prioritized for individuals that are more prone to the disease.
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Affiliation(s)
- Mohammad Helmi
- Periodontics and Community Dentistry Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - J Max Goodson
- Department of Oral Medicine, Infection, and Immunity, School of Dental Medicine, Harvard University, Boston, MA, USA
- Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Hatice Hasturk
- Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, P.O.BOX 40311, Jeddah, 21499, Saudi Arabia.
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Fish oil diet effects on alveolar bone loss, in hypercholesterolemic rats. Arch Oral Biol 2020; 109:104553. [PMID: 31563004 DOI: 10.1016/j.archoralbio.2019.104553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 11/20/2022]
Abstract
This study evaluated the effects of replacing a saturated fat diet by n-3 polyunsaturated fatty acids (n-3PUFA), on alveolar bone loss in hypercholesterolemic rats with experimental periodontitis (PD). METHODS Eight week old Wistar rats were assigned according to dietary intake. Control group (C, n = 15) fed a commercial diet throughout the experiment. Atherogenic group (AT, n = 30) fed AT diet for 3 weeks; thereafter, AT was randomized to receive either a n-3PUFA (n = 15) or to continue with AT (n = 15) diet. Subsequently, PD was induced in all groups by unilateral ligature (L) of the first molar (M1) of the left mandible, non-ligated contralateral molars served as controls. After every week of PD induction, 5 rats per group were euthanized. Serum was collected for lipids assays and hemi-mandibles were subjected to histomorphometric (% upper and lower interradicular bone volume and periodontal ligament height, hPDL) and radiographic analyses (periodontal bone support, PBS, in ligated teeth, between M1-M2). RESULTS Rats fed n-3PUFA diet rapidly induced a significant reduction in the serum lipids (p < 0.001). In all rats the ligated teeth showed a greater bone loss as compared with the unligated molars. At the end of the experiment the AT + L was the worst in % lower bone volume (p < 0.01), hPDL and PBS (p < 0.05). In contrast, rats fed n-3PUFA + L was similar to those rats fed C diet (p > 0.05). CONCLUSION Alveolar bone and dyslipidemia improved by substituting saturated fat intake for a n-3PUFA rich diet, in hypercholesterolemic rats with PD.
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Tan OL, Safii SH, Razali M. Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges. Antibiotics (Basel) 2019; 9:E11. [PMID: 31905889 PMCID: PMC7169417 DOI: 10.3390/antibiotics9010011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit-cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable.
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Affiliation(s)
- Oi Leng Tan
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Faculty of Dentistry, Department of Restorative Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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Furuta M, Fukai K, Aida J, Shimazaki Y, Ando Y, Miyazaki H, Kambara M, Yamashita Y. Periodontal status and self-reported systemic health of periodontal patients regularly visiting dental clinics in the 8020 Promotion Foundation Study of Japanese Dental Patients. J Oral Sci 2019; 61:238-245. [PMID: 31217373 DOI: 10.2334/josnusd.18-0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This nationwide cross-sectional survey investigated the association between periodontal disease and self-reported systemic health in periodontal patients who regularly visited private dental clinics in Japan. Data from 999 patients of 444 dental clinics were analyzed; the patients were aged 40 years or older, regularly visited dentists, and had diagnosed periodontal disease (defined as two or more teeth with a clinical attachment level ≥6 mm). Medical history was collected with a self-reported questionnaire. Number of teeth with a probing pocket depth (PPD) ≥5 mm was used to define periodontal status, and the highest quartile was used as the dependent variable. A Poisson regression model showed that histories of diabetes and hypertension were associated with a larger number of teeth with a PPD ≥5 mm (diabetes: prevalence rate ratio [PRR] 1.36, 95% confidence interval [CI] 1.00-1.85; hypertension: PRR 1.27, 95% CI 1.02-1.58) after adjusting for potential periodontal risk factors. These findings suggest that diabetes and hypertension are associated with worse periodontal disease. Dentists should confirm the diabetes and hypertension status of patients who receive maintenance care, because these conditions could affect periodontal management of patients.
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Affiliation(s)
- Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | | | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University
| | - Yuichi Ando
- Department of Health Promotion, National Institute of Public Health
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Niigata University Graduate School of Medical and Dental Sciences
| | | | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
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Fusco NDS, Foratori-Junior GA, Missio ALT, Jesuino BG, Sales-Peres SHDC. Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system. Int Dent J 2019; 69:472-479. [PMID: 31368161 DOI: 10.1111/idj.12507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This observational cross-sectional study aimed to evaluate systemic and oral conditions in pregnant women with excessive pre-pregnancy weight (PEW) and normal pre-pregnancy weight (PNW) who underwent follow-up in the private healthcare system during the third trimester of pregnancy. METHODS Fifty pregnant women were evaluated from August 2017 to February 2018 and divided into two groups: women with PEW (n = 25); and those with PNW (n = 25). Their weight and body mass index (BMI), periodontal disease status, stimulated salivary flow, and systemic condition were evaluated. Statistical analyses were conducted using t-test, Mann-Whitney test, chi-square test and binary logistic regression (P < 0.05). RESULTS The groups did not differ in age, educational level or monthly household income (P > 0.05). The PEW group had a higher frequency of arterial hypertension (P = 0.019) and excessive weight gain during gestation (P = 0.010), sought dental services less frequently, and had increased severity of periodontitis (P < 0.0001). Both groups presented low salivary flow, with no intergroup difference. In the final binary logistic regression models, high maternal pre-pregnancy BMI was a significant predictor of arterial hypertension and periodontitis during the third trimester of gestation; maternal excessive weight gain was also a significant predictor of periodontitis during pregnancy. CONCLUSION Women with PEW who underwent follow-up in a private healthcare system had a higher prevalence of arterial hypertension and worse periodontal status during the third trimester of pregnancy as compared to women with normal weight.
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Affiliation(s)
- Nathalia Dos Santos Fusco
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Alana Luiza Trenhago Missio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Bruno Gualtieri Jesuino
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Bawankule R, Singh A, Kumar K, Pedgaonkar S. Oral problems and associated risk indicators in adults in the Russian Federation, India, and China. BMC Oral Health 2019; 19:114. [PMID: 31200707 PMCID: PMC6570855 DOI: 10.1186/s12903-019-0811-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/31/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Oral problems, known as a neglected epidemic, have become prevalent in Brazil, the Russian Federation, India, China, and South Africa (BRICS) countries in last decade. The objective of the study is to examine the prevalence and associated risk indicators of oral problems in adults in the Russian Federation, India, and China in BRICS countries. METHODS We used data from the first round of the Study of Global AGEing and Adult Health (SAGE), conducted by WHO in 2007-10 in selected BRICS countries. Oral problems are defined as if an adult had any mouth and/or teeth related problems including swallowing problems in last 1 year of the survey. We estimated the mean age of adults who had oral problems and used a t-test for comparing it by sex of adults. We determined the prevalence of oral problems in adults. We designed a hierarchical conceptual model to identify associated risk indicators with oral problems. Finally, we applied a multivariable binary logistic regression model based on a conceptual model to examine associated socioeconomic and demographic, behavioral and nutritional risk indicators and systemic diseases - diabetes, hypertension, and angina pectoris/angina with oral problems in adults. RESULTS The mean age of adults who had oral problems is lowest in India (57 years; SD: 15) and highest in China (65 years; SD: 11). However, it does not vary by sex of adults except India. The prevalence of oral problems is highest in the Russian Federation (35%) and lowest in China (9%). Adults with body mass index (BMI) less than 25 kg/m2, age 45 years or more, diabetes, hypertension, and angina pectoris/angina have a higher risk of oral problems. Females and adults using alcohol are also more likely to have oral problems in selected countries. CONCLUSIONS The study concludes that females, adults using alcohol and those having any systemic disease are at higher risk of oral problems in the Russian Federation, India, and China. A one-third of adults had oral problems in particularly, in the Russian Federation; thus there is an urgent need to formulate oral policy and program, which the country currently lacks in.
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Affiliation(s)
- Rahul Bawankule
- International Institute for Population Sciences, Mumbai, 400088 India
| | - Abhishek Singh
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Kaushalendra Kumar
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Sarang Pedgaonkar
- Department of Population Policies and Programme, International Institute for Population Sciences, Mumbai, India
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Foratori-Junior GA, da Silva BM, da Silva Pinto AC, Honório HM, Groppo FC, de Carvalho Sales-Peres SH. Systemic and periodontal conditions of overweight/obese patients during pregnancy and after delivery: a prospective cohort. Clin Oral Investig 2019; 24:157-165. [PMID: 31069540 DOI: 10.1007/s00784-019-02932-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/30/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the systemic and periodontal conditions, as well as the determinants of health in pregnant women with and without obesity/overweight during the second and third trimesters of pregnancy and after delivery. MATERIALS AND METHODS In the second trimester (T1), 93 pregnant women were divided into two groups with either excessive weight (G1, n = 53) or normal weight (G2, n = 40) and subsequently examined them in the third trimester of pregnancy (T2) and at least 2 months after delivery (T3). The following variables were analyzed: (a) systemic impairments during pregnancy-arterial hypertension (AH) and gestational diabetes mellitus (GDM); (b) oral hygiene behavior; (c) periodontal conditions; (d) anthropometric data and systemic health condition after pregnancy. The Mann-Whitney test, chi-squared test, ANOVA, and binary logistic regression were adopted (p < 0.05). RESULTS G1 showed higher frequency of GDM and AH in T1 and T2, respectively (p = 0.047; p = 0.004). Both groups had worse oral hygiene behaviors after delivery. A higher frequency of periodontitis was found in all periods for G1 (p < 0.05). G2 showed improvement of all periodontal parameters after delivery, whereas G1 showed no difference regarding these parameters between time periods. CONCLUSION Pregnant women with excessive weight presented worse systemic and periodontal conditions during pregnancy and after delivery. CLINICAL RELEVANCE Low socioeconomic level and overweight/obesity were significant predictors of periodontitis during pregnancy and after delivery.
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Affiliation(s)
- Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Bruna Machado da Silva
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana Carolina da Silva Pinto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Heitor Marque Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Area of Pharmacology, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
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Abdalla-Aslan R, Findler M, Levin L, Zini A, Shay B, Twig G, Almoznino G. Where periodontitis meets metabolic syndrome-The role of common health-related risk factors. J Oral Rehabil 2019; 46:647-656. [PMID: 30958576 DOI: 10.1111/joor.12798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/25/2019] [Accepted: 04/03/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To analyse and compare associations between metabolic syndrome (MetS) and its components in periodontitis compared to control patients. METHODS This 7-year cross-sectional study retrospectively analysed medical records of 504 individuals aged 18-90 who attended the student dental clinic between 2008 and 2014. Demographics, smoking habits, blood pressure, waist circumference, as well as presence of: periodontitis, MetS, diabetes, hypertension, hyperlipidaemia, stroke, heart disease, cancer and psychiatric disorders were recorded. RESULTS The study population composed of 231 (45.8%) males and 273 (54.2%) females, with an average age of 55.79 ± 16.91 years. A patient profile associated with periodontitis was identified and included male sex, older age, smoking, higher smoking pack-years, abdominal obesity, higher systolic and diastolic blood pressures, the presence of MetS or its components, hypertension, hyperlipidaemia, diabetes or diseases associated with its consequences such as ischaemic heart disease and stroke. Following multivariate logistic regression analysis, age and smoking retained a significant association with periodontitis, whereas the systemic disorders did not. CONCLUSIONS The association between periodontitis and MetS may be explained by shared common profile and risk factors. An appropriate risk factors management approach should be adopted by both dental and general health clinicians and health authorities, to control common high-risk behaviours.
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Affiliation(s)
- Ragda Abdalla-Aslan
- Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.,Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Mordechai Findler
- Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.,Department of Oral Medicine, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Liran Levin
- Division of Periodontology, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Avraham Zini
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Boaz Shay
- Department of Endodontics, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel.,The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel.,The Israel Defense Forces Medical Corps, Ramat-Gan, Israel.,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galit Almoznino
- Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Zhao MJ, Qiao YX, Wu L, Huang Q, Li BH, Zeng XT. Periodontal Disease Is Associated With Increased Risk of Hypertension: A Cross-Sectional Study. Front Physiol 2019; 10:440. [PMID: 31105578 PMCID: PMC6494953 DOI: 10.3389/fphys.2019.00440] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/01/2019] [Indexed: 01/22/2023] Open
Abstract
Objective: Published evidence showed that periodontal disease is associated with hypertension. However, relevant findings remain controversial, with few evidences focusing on Chinese population. Therefore, the aim of this study was to investigate the association between periodontal disease and hypertension in Chinese population. Methods: A total of 4,930 participants from an available health examination that was carried out in 2017 were selected for this retrospective study. The correlations between periodontal disease and hypertension were investigated using univariate and multiple logistic regression analyses and propensity score adjusted analysis. Interaction and subgroup analyses were also used to detect variable factors. Results: Finally, a total of 3,952 participants aged 30–68 years were eligible for this study. The results showed that hypertension risk was statistically significant associated with periodontal disease either in unadjusted (OR = 1.28, 95%CI = 1.14–1.47) or in adjusted (OR = 1.34, 95%CI = 1.14–1.58) model. Result from propensity score adjusted analysis also demonstrated a similar association (OR = 1.23, 95%CI = 1.06–1.42). Conclusion: Periodontal disease is significantly and positively correlated with increased risk of hypertension in Chinese population, and exact mechanisms of this association should be explored in future.
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Affiliation(s)
- Ming-Juan Zhao
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University, Wuhan, China.,Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China.,Department of Cardiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Yi-Xin Qiao
- Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China.,Department of Innovation Laboratory, The Affiliated High School of Henan University, Kaifeng, China
| | - Lan Wu
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University, Wuhan, China.,Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University, Wuhan, China
| | - Bing-Hui Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University, Wuhan, China.,Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, The Second Clinical College of Wuhan University, Wuhan, China.,Center for Evidence-Based Medicine, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, China
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Sehirli AÖ, Aksoy U, Kermeoglu F, Kalender A, Savtekin G, Ozkayalar H, Sayiner S. Protective effect of alpha-lipoic acid against apical periodontitis-induced cardiac injury in rats. Eur J Oral Sci 2019; 127:333-339. [PMID: 30995351 DOI: 10.1111/eos.12618] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study was designed to assess the possible protective effect of alpha-lipoic acid (ALA) on apical periodontitis (AP)-induced cardiac injury. Wistar albino rats were randomized into four groups: control; ALA; AP; and ALA + AP. Rats of the control and ALA groups were not endodontically treated, but saline and ALA (100 mg kg-1 ) were administered. In rats of the AP and ALA + AP groups, the pulp chambers of mandibular first molar teeth were exposed and left open for 30 d to induce AP. Saline and ALA (100 mg kg-1 ) were administered intraperitoneally every 24 h during the experiment. At the end of the experiment, the rats were killed. Establishment of AP was verified by radiographic and histopathological evaluation. Serum alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatine kinase (CK), and superoxide dismutase (SOD) activities were determined using an automated biochemical analyzer, and the structural cardiac injury was assessed pathologically. Serum ALP, LDH, and CK activities were elevated, and SOD activities were decreased, in the AP group. The changed enzyme activities were significantly normalized by treatment with ALA. We conclude that ALA administration alleviated the AP-induced heart injury and improved cardiac structure and function, and therefore this agent may be of potential therapeutic value in protecting cardiac tissue from systemic injury caused by AP.
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Affiliation(s)
- Ahmet Ö Sehirli
- Department of Pharmacology, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Fatma Kermeoglu
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Atakan Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Gokce Savtekin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Nicosia, Mersin 10, Turkey
| | - Hanife Ozkayalar
- Department of Medical Pathology, Faculty of Medicine, Near East University, Nicosia, Mersin 10, Turkey
| | - Serkan Sayiner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Nicosia, Mersin 10, Turkey
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Lee CY, Kuan YH, Tsai YF, Tai CJ, Tsai TH, Huang KH. Correlation between diabetes mellitus and periodontitis in Taiwan: A nationwide cohort study. Diabetes Res Clin Pract 2019; 150:245-252. [PMID: 30880092 DOI: 10.1016/j.diabres.2019.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/01/2019] [Accepted: 03/07/2019] [Indexed: 12/15/2022]
Abstract
AIMS The mechanism underlying the association of diabetes mellitus (DM) and periodontitis is not clear. This study aimed to investigate the correlation between DM and periodontitis. METHODS This study was a retrospective cohort study, which conducted based on the Taiwan National Health Insurance Research Database. The study subjects were 39,384 new-onset DM patients who aged above 20 years old from 2005 to 2012. To avoid selection bias, we applied propensity score matching to obtain patients without DM, as the control group. Cox proportional hazard model was used to analyze the risk of periodontitis in patients with DM. RESULTS After controlling for related variables, Patients with DM had a higher risk for periodontitis compared with the patients without DM (adjusted hazard ratios [aHR] = 1.04, 95% confidence interval [CI]: 1.01-1.08). Patients with hypertension (HTN) had no higher risk for periodontitis (aHR = 0.96, 95% CI: 0.92-1.00). Patients with dyslipidemia and rheumatoid arthritis (RA) patients both had a higher risk for periodontitis (aHR = 1.26, 95% CI: 1.19-1.34; aHR = 1.41, 95% CI: 1.19-1.67). CONCLUSIONS There is a correlation between DM and periodontitis. Patients with DM may have a higher risk of incident periodontitis. Besides, age, HTN, dyslipidemia, and RA are also associated with incident periodontitis.
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Affiliation(s)
- Chien-Ying Lee
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ya-Fang Tsai
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Jaan Tai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan.
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Huang JL, Chen WK, Lin CL, Lai CY, Kao CH, Chiang HH, Yang TY, Shih HM. Association between intensive periodontal treatment and spontaneous intracerebral hemorrhage-a nationwide, population-based cohort study. Medicine (Baltimore) 2019; 98:e14814. [PMID: 30855503 PMCID: PMC6417639 DOI: 10.1097/md.0000000000014814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Periodontal disease is a chronic inflammation of periodontium and has a high prevalence. Periodontal disease has been discovered to be a possible risk factor for cerebrovascular diseases. The available evidence are not enough to set up a causal relationship between periodontal disease and cerebrovascular diseases. Patients with spontaneous intracerebral hemorrhage have high mortality rates. The present study investigated whether intensive periodontal treatment is a protective factor of spontaneous intracerebral hemorrhage and can reduce the risk of spontaneous intracerebral hemorrhage.In total, 64,960 patients with a history of periodontal disease were picked out from the National Health Insurance Research Databases as a case-cohort from January 01, 2000 to December 31, 2010. They were divided on the basis of whether periodontal disease patients received intensive surgical treatment (treatment cohort) or not (control cohort). The periodontal disease patients in treatment and control cohorts were selected by propensity score matching at a ratio of 1:1. Incidences of spontaneous intracerebral hemorrhage in both cohorts were analyzed and compared.The total hazard of spontaneous intracerebral hemorrhage was significantly decreased in the treatment cohorts compared with the control cohorts (adjusted hazard ratio = 0.60, 95% confidence interval = 0.45-0.79).Compared with the control cohort, intensive periodontal treatment may reduce the overall incidence of spontaneous intracerebral hemorrhage, particularly in elderly patients, males, and those who received more than 2 intensive treatments.
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Affiliation(s)
- Jia-Lun Huang
- Department of Emergency Medicine, China Medical University Hospital
- School of Medicine, College of Medicine, China Medical University
| | - Wei-Kung Chen
- Department of Emergency Medicine, China Medical University Hospital
- School of Medicine, College of Medicine, China Medical University
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University
| | - Ching-Yuan Lai
- Department of Emergency Medicine, China Medical University Hospital
- School of Medicine, College of Medicine, China Medical University
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University
- Department of Nuclear Medicine and PET Center, China Medical University Hospital
| | - Hsien-Hsiung Chiang
- School of Dentistry, College of Medicine, China Medical University
- Department of Dentistry, China Medical University and Hospital
| | - Tse-Yen Yang
- Molecular and Genomic Epidemiology Center, China Medical University Hospital
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Hong-Mo Shih
- Department of Emergency Medicine, China Medical University Hospital
- School of Medicine, College of Medicine, China Medical University
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Abstract
Erythritol belongs chemically to the family of polyols (or sugar alcohols), yet it is metabolized by animals and humans very differently compared to all other polyols. While polyols have been used traditionally (for about 80 y) to replace sugar in sweet foods to reduce demineralization of tooth enamel and to reduce postprandial blood glucose levels, benefits achieved merely through the absence of sugar, emerging evidence shows that erythritol can play a number of functional roles to actively support maintenance of oral and systemic health. Oral health studies revealed that erythritol can reduce dental plaque weight, reduce dental plaque acids, reduce counts of mutans streptococci in saliva and dental plaque, and reduce the risk for dental caries better than sorbitol and xylitol, resulting in fewer tooth restorations by dentist intervention. Systemic health studies have shown that erythritol, unlike other polyols, is readily absorbed from the small intestine, not systemically metabolized, and excreted unchanged within the urine. This metabolic profile renders erythritol to be noncaloric, to have a high gastrointestinal tolerance, and not to increase blood glucose or insulin levels. Published evidence also shows that erythritol can act as an antioxidant and that it may improve endothelial function in people with type 2 diabetes. This article reviews the key research demonstrating erythritol's oral and systemic health functionalities and underlying mechanisms.
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Affiliation(s)
- P de Cock
- 1 DGH Nutrition Innovation, Keerbergen, Belgium
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46
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Small HY, Migliarino S, Czesnikiewicz-Guzik M, Guzik TJ. Hypertension: Focus on autoimmunity and oxidative stress. Free Radic Biol Med 2018; 125:104-115. [PMID: 29857140 DOI: 10.1016/j.freeradbiomed.2018.05.085] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 12/25/2022]
Abstract
Understanding the causal role of the immune and inflammatory responses in hypertension has led to questions regarding the links between hypertension and autoimmunity. Immune pathology in primary hypertension mimics several autoimmune mechanisms observed in the pathogenesis of systemic lupus erythematosus, psoriasis, systemic sclerosis, rheumatoid arthritis and periodontitis. More importantly, the prevalence of hypertension in patients with these autoimmune diseases is significantly increased, when compared to control populations. Clinical and epidemiological evidence is reviewed along with possible mechanisms linking hypertension and autoimmunity. Inflammation and oxidative stress are linked in a self-perpetuating cycle that significantly contributes to the vascular dysfunction and renal damage associated with hypertension. T cell, B cell, macrophage and NK cell infiltration into these organs is essential for this pathology. Effector cytokines such as IFN-γ, TNF-α and IL-17 affect Na+/H+ exchangers in the kidney. In blood vessels, they lead to endothelial dysfunction and loss of nitric oxide bioavailability and cause vasoconstriction. Both renal and vascular effects are, in part, mediated through induction of reactive oxygen species-producing enzymes such as superoxide anion generating NADPH oxidases and dysfunction of anti-oxidant systems. These mechanisms have recently become important therapeutic targets of novel therapies focused on scavenging oxidative (isolevuglandin) modification of neo-antigenic peptides. Effects of classical immune targeted therapies focused on immunosuppression and anti-cytokine treatments are also reviewed.
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Affiliation(s)
- Heather Y Small
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Serena Migliarino
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marta Czesnikiewicz-Guzik
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK; Department of Dental Prophylaxis and Experimental Dentistry, Dental School of Jagiellonian University, Krakow, Poland
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland.
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Dietary Polyphenols and Periodontitis-A Mini-Review of Literature. Molecules 2018; 23:molecules23071786. [PMID: 30036945 PMCID: PMC6099717 DOI: 10.3390/molecules23071786] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 07/14/2018] [Accepted: 07/18/2018] [Indexed: 01/18/2023] Open
Abstract
Periodontitis, which is a chronic infection and disease of the periodontium, is a significant global health burden and is linked to other chronic health conditions such as diabetes and cardiovascular diseases. Dietary polyphenols present in a wide variety of plant-based foods, herbs, and botanicals have been shown to exert antimicrobial, anti-inflammatory, and reduced osteoclast and alveolar bone loss activities in animal models of periodontitis. Polyphenol-containing beverages and foods especially green tea and its active catechin epigallocatechin-3-gallate, cranberries, pomegranates, and fruit and vegetable extracts have reported bacteriostatic/bactericidal activity against microbial species such as P. gingivalis and shown total bacterial burden in clinical studies. These polyphenols also exhibit anti-inflammatory and antioxidant effects, which have the potential to impact various biological mechanisms for reducing the initiation and progression of periodontitis. The main objective of this mini-review is to focus on the mechanisms of action of dietary polyphenols in improving the pathophysiology underlying chronic inflammatory diseases like periodontitis based on pre-clinical and clinical models.
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Belinga LEE, Ngan WB, Lemougoum D, Nlo'o ASPE, Bongue B, Ngono A, Mandengue SH, Sembene M. Association between periodontal diseases and cardiovascular diseases in Cameroon. J Public Health Afr 2018; 9:761. [PMID: 30079167 PMCID: PMC6057715 DOI: 10.4081/jphia.2018.761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 05/22/2018] [Indexed: 02/07/2023] Open
Abstract
To assess the association between periodontal diseases and cardiovascular diseases in dental patients in Cameroon, a prospective observational study was carried out in 3 hospitals in Cameroon from January 2013 to December 2015. Data on general condition, age, gender and lifestyle were collected during medical history taking. The Dutch Periodontal Screening Index assessed periodontal health during oral examination. The Wilcoxon test, the Fisher test and logistic regression analysis were performed. 558 patients (53.9% women) were included in the study. The mean age was 44±13 years (30 to 85). In terms of overall health, 161 (28.9%) had cardiovascular diseases (CVD) and 73 (13.1%) had diabetes. Hypertension accounted for 87.6% of CVD. In terms of periodontal diseases (PD), 431 (77.2%) patients had PD, the break-down by PD was 347 (62.2%) gingivitis and 84 (15%) periodontitis. Statistical associations were found between CVD and gingivitis [OR=4.30 (1.85-10.00), P=0.001], and CVD and periodontitis [OR=2.87 (1.04-7.93); P=0.04].
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Affiliation(s)
- Lawrence Essama Eno Belinga
- Douala General Hospital, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.,Department of Biochemistry, Faculty of Science, University of Douala, Cameroon.,Université Cheik Anta DIOP, Dakar, Senegal
| | - Williams Bell Ngan
- Direction of Military Health Services, Yaoundé, Cameroon.,Department of animal biology, Faculty of Science, University of Douala, Cameroon.,EA 4607, Laboratory SNAEPIS, Université Jean Monnet St- Etienne, France
| | - Daniel Lemougoum
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
| | | | | | - Annie Ngono
- Department of Biochemistry, Faculty of Science, University of Douala, Cameroon
| | - Samuel Honoré Mandengue
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.,Department of animal biology, Faculty of Science, University of Douala, Cameroon
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Alexander MR, Norlander AE, Elijovich F, Atreya RV, Gaye A, Gnecco JS, Laffer CL, Galindo CL, Madhur MS. Human monocyte transcriptional profiling identifies IL-18 receptor accessory protein and lactoferrin as novel immune targets in hypertension. Br J Pharmacol 2018; 176:2015-2027. [PMID: 29774543 DOI: 10.1111/bph.14364] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/30/2018] [Accepted: 04/30/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Monocytes play a critical role in hypertension. The purpose of our study was to use an unbiased approach to determine whether hypertensive individuals on conventional therapy exhibit an altered monocyte gene expression profile and to perform validation studies of selected genes to identify novel therapeutic targets for hypertension. EXPERIMENTAL APPROACH Next generation RNA sequencing identified differentially expressed genes in a small discovery cohort of normotensive and hypertensive individuals. Several of these genes were further investigated for association with hypertension in multiple validation cohorts using qRT-PCR, regression analysis, phenome-wide association study and case-control analysis of a missense polymorphism. KEY RESULTS We identified 60 genes that were significantly differentially expressed in hypertensive monocytes, many of which are related to IL-1β. Uni- and multivariate regression analyses of the expression of these genes with mean arterial pressure (MAP) revealed four genes that significantly correlated with MAP in normotensive and/or hypertensive individuals. Of these, lactoferrin (LTF), peptidoglycan recognition protein 1 and IL-18 receptor accessory protein (IL18RAP) remained significantly elevated in peripheral monocytes of hypertensive individuals in a separate validation cohort. Interestingly, IL18RAP expression associated with MAP in a cohort of African Americans. Furthermore, homozygosity for a missense single nucleotide polymorphism in LTF that decreases antimicrobial function and increases protein levels (rs1126478) was over-represented in patients with hypertension relative to controls (odds ratio 1.16). CONCLUSIONS AND IMPLICATIONS These data demonstrate that monocytes exhibit enhanced pro-inflammatory gene expression in hypertensive individuals and identify IL18RAP and LTF as potential novel mediators of human hypertension. LINKED ARTICLES This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
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Affiliation(s)
- Matthew R Alexander
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Allison E Norlander
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Fernando Elijovich
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ravi V Atreya
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amadou Gaye
- Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Juan S Gnecco
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
| | - Cheryl L Laffer
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cristi L Galindo
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Meena S Madhur
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.,Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
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Marchi-Alves LM, Freitas D, de Andrade D, de Godoy S, Toneti AN, Mendes IAC. Characterization of Oral Microbiota in Removable Dental Prosthesis Users: Influence of Arterial Hypertension. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3838640. [PMID: 28713826 PMCID: PMC5497639 DOI: 10.1155/2017/3838640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/28/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Studies have described the possible relation between oral infections and atherosclerotic events. OBJECTIVE To characterize the oral microbiota of normotensive and hypertensive users of dental prostheses. METHODS The sample consisted of 41 complete dental prosthesis users, divided into groups: 21 participants with systemic arterial hypertension and 20 normotensive participants. The data collection included the characteristics of the sociodemographic variables and the determination of the microbial load in the saliva. For the descriptive analyses, Statistical Package for the Social Sciences was used. The description of the proportional differences between the groups was based on the application of Mann-Whitney's statistical test. Statistical significance was set at 5% (p < 0.05). RESULTS The analysis of the oral microbiota showed the vast growth of aerobic microorganisms in all samples from both groups. The microbial load of streptococci and staphylococci was significantly higher among hypertensive participants. Candida yeasts were detected in the saliva culture of most samples. The hypertensive participants rank in the category of very high colonization index/high risk of infection related to this microorganism. CONCLUSIONS The mouth of dental prosthesis users, especially when hypertensive, can constitute an important reservoir of pathogens, indicating an established inflammatory or infectious condition or risk for developing this condition.
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Affiliation(s)
| | - Dayana Freitas
- Clinical Hospital, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Denise de Andrade
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Simone de Godoy
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
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