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Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Luján-Urviola E, Farje-Gallardo CA. Association between Periodontal Disease and Obesity: Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:621. [PMID: 38674267 PMCID: PMC11051919 DOI: 10.3390/medicina60040621] [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: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Faculty of Dentistry, Dentistry School, San Martin de Porres University, Chiclayo 14012, Peru;
- Faculty of Human Medicine, Human Medicine School, San Martín de Porres University, Chiclayo 14012, Peru
| | - Fredy Hugo Cruzado-Oliva
- Faculty of Stomatology, Stomatology School, Nacional University of Trujillo, Trujillo 13001, Peru;
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Eduardo Luján-Urviola
- Faculty of Dentistry, Néstor Cáceres Velásquez Andean University, Juliaca 21104, Peru;
| | - Carlos Alberto Farje-Gallardo
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
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Qu X, Wang X, Shen D. Visceral adipose tissue increases the risk of periodontal disease: Results from the 2011-2014 National Health and Nutrition Examination Survey and Mendelian randomization analysis. J Clin Periodontol 2023; 50:1633-1643. [PMID: 37726246 DOI: 10.1111/jcpe.13876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
AIM This study aimed to investigate the relationship and potential causal effect of visceral adipose tissue (VAT) on periodontal disease (PD). Despite prior research on this, there has been no definitive conclusion. Therefore, this study aimed to provide additional insight into these associations. MATERIALS AND METHODS This study used data from the National Health and Nutrition Examination Survey 2011-2014 to examine the association between VAT and PD in a cross-sectional study design. Various analytical methods were employed, such as multivariable logistic regression, restricted cubic spline analysis, and p-value for trend. Additionally, two-sample Mendelian randomization (MR) analysis was performed to evaluate the potential causal effect of VAT on PD risk. These methods enabled us to evaluate the association between VAT and PD and to establish whether VAT could be a causal factor in PD development. RESULTS The study examined a sample of 3535 participants, and the findings suggested that higher VAT levels were associated with an increased risk of PD. In addition, multivariable regression analysis conducted in six models revealed a statistically significant association between VAT and PD risk. Restricted cubic spline analysis showed an inverted U-shaped association between VAT and PD, with a turning point at 733 g of VAT. Finally, a two-sample MR analysis provided evidence for a potential causal relationship between VAT and PD risk, with an odds ratio of 1.16 (95% confidence interval: 1.02-1.33, p = .027) per kg increase in genetically predicted VAT. CONCLUSIONS The results of this study suggest that there is a significant association between VAT and PD and that VAT could be a potential causal factor in PD risk. Our results also suggest that although there is a potential link between VAT levels and PD risk, the effect size is modest. Therefore, interventions designed to reduce VAT levels should not be considered a primary strategy for PD risk reduction but could be one of many strategies used in a comprehensive approach to PD risk management.
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Affiliation(s)
- Xiaoying Qu
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaolin Wang
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Danfeng Shen
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
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Ramírez V, Weber L, Hernández M, Realini O, Bendek MJ, Busso D, Hoare A, Illanes SE, Chaparro A. Obesity is related to maternal periodontitis severity in pregnancy: a cross-sectional study. Clin Oral Investig 2023; 27:5509-5518. [PMID: 37505241 DOI: 10.1007/s00784-023-05170-4] [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: 03/07/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES To evaluate the relationship between obesity and periodontitis staging compared with periodontal healthy or gingivitis in pregnant women. MATERIALS AND METHODS An analytical cross-sectional study was conducted on pregnant women between 11 and 14 weeks of pregnancy. Sociodemographic, clinical, obstetric, and periodontal variables were studied. The exposure variable was obesity (body mass index [BMI] ≥ 30), and the primary outcome was periodontitis staging versus periodontal healthy/gingivitis. Data were analysed and estimated by multinomial logistic regression models. RESULTS The present study screened 1086 pregnancies and analysed 972 women with a median age of 29 years; 36.8% were diagnosed as obese. 26.9% of patients were diagnosed as periodontal healthy or gingivitis, 5.5% with stage I periodontitis, 38.6% with stage II periodontitis, 24% with stage III periodontitis, and 5.1% with stage IV periodontitis. After identifying and adjusting for confounding variables (educational level and plaque index), obesity had a relative risk ratio (RRR) of 1.66 (95% CI: 1.05-2.64; p = 0.03) and 1.57 (95% CI: 1.09-2.27; p = 0.015) for stage III periodontitis compared to periodontal healthy/gingivitis and stage II periodontitis, respectively. CONCLUSION Besides the already known risk indicators for periodontitis (age, smoking, and educational level), our study suggests a relationship between obesity and periodontitis staging in pregnancy. CLINICAL RELEVANCE Obesity can alter host immune responses, leading to increased susceptibility to infections and overactive host immunity, which could influence the prevalence and severity of maternal periodontitis in pregnancy.
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Affiliation(s)
- Valeria Ramírez
- Department of Biomedical Sciences, Ethics, Research and Education, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Laura Weber
- Department of Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los Andes, Av. Plaza 2501, Las Condes, 7620157, Santiago, Chile
| | - Marcela Hernández
- Department of Pathology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Ornella Realini
- Department of Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los Andes, Av. Plaza 2501, Las Condes, 7620157, Santiago, Chile
| | - María José Bendek
- Department of Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los Andes, Av. Plaza 2501, Las Condes, 7620157, Santiago, Chile
- PhD Program in Biomedicine, School of Medicine, Universidad de los Andes, Santiago, Chile
| | - Dolores Busso
- Laboratory of Reproductive Biology, Biomedical Research and Innovation Center, Universidad de los Andes, Santiago, Chile
| | - Anilei Hoare
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Sebastián Enrique Illanes
- Laboratory of Reproductive Biology, Biomedical Research and Innovation Center, Universidad de los Andes, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Alejandra Chaparro
- Department of Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los Andes, Av. Plaza 2501, Las Condes, 7620157, Santiago, Chile.
- Biomedical Research and Innovation Center, Santiago, Chile.
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Minne X, Mbuya Malaïka Mutombo J, Chandad F, Fanganiello RD, Houde VP. Porphyromonas gingivalis under palmitate-induced obesogenic microenvironment modulates the inflammatory transcriptional signature of macrophage-like cells. PLoS One 2023; 18:e0288009. [PMID: 37384642 PMCID: PMC10309636 DOI: 10.1371/journal.pone.0288009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/16/2023] [Indexed: 07/01/2023] Open
Abstract
Metabolic diseases and low-grade chronic inflammation are interconnected: obese persons are at higher risk of developing periodontitis. However, the molecular mechanisms involved in the development and progression of periodontitis in an obesogenic microenvironment in response to periodontopathogens are still lacking. This study aims to investigate the combined effects of palmitate and Porphyromonas gingivalis on the secretion of pro-inflammatory cytokines and on transcriptional landscape modifications in macrophage-like cells. U937 macrophage-like cells were treated with palmitate and stimulated with P. gingivalis for 24h. Cytokines IL-1β, TNF-α and IL-6 were measured by ELISA in the culture medium and cell extracted RNA was submitted to a microarray analysis followed by Gene Ontology analyses. P. gingivalis, in presence of palmitate, potentiated IL-1β and TNF-α secretion in comparison to palmitate alone. Gene Ontology analyses also revealed that the combination palmitate-P. gingivalis potentiated the number of gene molecular functions implicated in the regulation of immune and inflammatory pathways compared to macrophages treated with palmitate alone. Our results provide the first comprehensive mapping of gene interconnections between palmitate and P. gingivalis during inflammatory responses in macrophage-like cells. These data highlight the importance of considering systemic conditions, specifically obesogenic microenvironment, in the management of periodontal disease in obese patients.
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Affiliation(s)
- Xavier Minne
- Faculty of Dentistry, Oral Ecology Research Group (GREB), Université Laval, Quebec City, Quebec, Canada
| | | | - Fatiha Chandad
- Faculty of Dentistry, Oral Ecology Research Group (GREB), Université Laval, Quebec City, Quebec, Canada
| | - Roberto D. Fanganiello
- Faculty of Dentistry, Oral Ecology Research Group (GREB), Université Laval, Quebec City, Quebec, Canada
| | - Vanessa P. Houde
- Faculty of Dentistry, Oral Ecology Research Group (GREB), Université Laval, Quebec City, Quebec, Canada
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Parveen S, Alhazmi YA. Impact of Intermittent Fasting on Metabolic Syndrome and Periodontal Disease-A Suggested Preventive Strategy to Reduce the Public Health Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114536. [PMID: 36361416 PMCID: PMC9657467 DOI: 10.3390/ijerph192114536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 05/27/2023]
Abstract
Metabolic syndrome (MetS) prevalence continues to climb significantly worldwide in today's ad libitum society. MetS has tremendous societal and economic ramifications, making it imperative to develop effective strategies for preventing and controlling it to alleviate this growing burden. Periodontal disease and MetS are associated with several risk factors. Studies in the past have demonstrated that obesity, cardiovascular illness, and type 2 diabetes mellitus have a negative effect on the severity of the periodontal disease. Patients with metabolic syndrome have elevated serum levels of proinflammatory mediators such as tumor necrosis factor-alpha interleukin-6 and C-reactive protein. Similar inflammatory mediators, such as interleukin-6, tumor necrosis factor-alpha, and C-reactive protein, are increased in patients with severe periodontal disease. Remarkably, intermittent fasting is underpinned by scientific evidence, claiming to be the most effective non-pharmacological, potential therapeutic alternative for combating a wide range of metabolic, inflammatory, and lifestyle-related diseases. Nonetheless, an insufficient investigation has been performed to determine whether intermittent fasting has therapeutic benefits on periodontal inflammation and diseases. Here, we show the interrelationship between metabolic syndrome and periodontal disease and contextualize the beneficial impact of intermittent fasting in modulating the chronic metabolic and periodontal inflammatory response. We also anticipate that this review paves the way for further exploration of intermittent fasting as a unique research paradigm representing a cost-effective alternative strategy to conventional disease management in patients with periodontal diseases and metabolic syndrome which may serve as the foundation for an integrative vision relevant to primary, diagnostic, and therapeutic purposes.
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Abu-Shawish G, Betsy J, Anil S. Is Obesity a Risk Factor for Periodontal Disease in Adults? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12684. [PMID: 36231983 PMCID: PMC9566678 DOI: 10.3390/ijerph191912684] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 05/14/2023]
Abstract
There is inconclusive evidence about the link between the severity and prevalence of periodontitis in obese adults. Therefore, this systematic review aims to explore the possibility of significant evidence on the association between obesity and periodontitis and to determine the necessity to consider obesity as a risk factor for periodontitis. We followed the PRISMA protocol, and studies that met the eligibility criteria were included in this review. The risk of bias in individual studies was also evaluated. This review included 15 observational studies (9 cross-sectional studies, 2 case-control, and 4 cohort studies). The total study subjects from these studies were 6603 (males = 3432; females = 3171). Most studies showed a significant association between obesity and periodontitis. Among these studies, a few showed obese females to be at a higher risk, and one study found no association between obesity and periodontal disease at all. Based on the evidence obtained from this review, the body mass index (BMI) should be routinely assessed in patients to assess the risk for periodontal disease and to offer personalized management of periodontitis. Based on the findings of this review, we recommend the need to initiate awareness among clinicians and implement dental hygiene care prevention measures for obese patients.
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Affiliation(s)
- Ghadah Abu-Shawish
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar University, Doha 3050, Qatar
| | - Joseph Betsy
- Department of Periodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
| | - Sukumaran Anil
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar University, Doha 3050, Qatar
- Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences and Research Centre Thiruvalla, Pathanamthitta 689101, India
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Hayashi M, Morino K, Harada K, Miyazawa I, Ishikawa M, Yasuda T, Iwakuma Y, Yamamoto K, Matsumoto M, Maegawa H, Ishikado A. Real-world evidence of the impact of obesity on residual teeth in the Japanese population: A cross-sectional study. PLoS One 2022; 17:e0274465. [PMID: 36103495 PMCID: PMC9473396 DOI: 10.1371/journal.pone.0274465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Tooth loss is associated with nutritional status and significantly affects quality of life, particularly in older individuals. To date, several studies reveal that a high BMI is associated with tooth loss. However, there is a lack of large-scale studies that examined the impact of obesity on residual teeth with respect to age and tooth positions. OBJECTIVE We assessed the impact of obesity on the number and position of residual teeth by age groups using large scale of Japanese database. METHODS This was a cross-sectional study of 706150 subjects that were included in the database that combined the data from health insurance claims and health check-up, those lacking information about BMI, HbA1c level, smoking status, and the number of residual teeth were excluded. Thus, a total of 233517 aged 20-74 years were included. Subjects were classified into 4 categories based on BMI, and the number of teeth was compared between age-groups. The percentage of subjects with residual teeth in each position was compared between groups with obesity (BMI ≥25.0 kg/m2) and non-obesity. Logistic regression analysis was performed to clarify whether obesity predicts having <24 teeth. RESULTS Higher BMI was associated with fewer teeth over 40s (P for trend <0.0001 when <70s). Obesity was associated with the reduction of residual teeth in the maxillary; specifically, the molars were affected over the age 30. Smoking status further affected tooth loss at positions that were not affected by obesity alone. After adjusting for age, sex, smoking status, and HbA1c ≥6.5%, obesity remained an independent predictive factor for having <24 teeth (ORs: 1.35, 95% CIs: 1.30-1.40). CONCLUSIONS We found that an increase in BMI was associated with a decrease in the number of residual teeth from younger ages independently of smoking status and diabetes in the large scale of Japanese database.
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Affiliation(s)
- Mayu Hayashi
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Katsutaro Morino
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kayo Harada
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Itsuko Miyazawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Ishikawa
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Takako Yasuda
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Yoshie Iwakuma
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Kazushi Yamamoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Motonobu Matsumoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Hiroshi Maegawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Atsushi Ishikado
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
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Pamuk F, Kantarci A. Inflammation as a link between periodontal disease and obesity. Periodontol 2000 2022; 90:186-196. [PMID: 35916870 DOI: 10.1111/prd.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.
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Affiliation(s)
- Ferda Pamuk
- Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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Kim CM, Lee S, Hwang W, Son E, Kim TW, Kim K, Kim YH. Obesity and periodontitis: A systematic review and updated meta-analysis. Front Endocrinol (Lausanne) 2022; 13:999455. [PMID: 36353241 PMCID: PMC9637837 DOI: 10.3389/fendo.2022.999455] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A previous 2014 meta-analysis reported a positive association between obesity and periodontitis. It was considered necessary to update the recently published papers and to analyse subgroups on important clinical variables that could affect the association between obesity and periodontitis. Therefore, we updated the latest studies and attempted to derive more refined results. METHODS All observational studies were eligible for inclusion. The Newcastle-Ottawa scale was used to qualitatively evaluate the risk of bias. Subgroup analyses were conducted for patients aged 18-34, 35-54, and 55+ years and the countries (European countries, USA, Brazil, Japan, Korea, and other Asian countries). RESULTS Thirty-seven full-text articles were included. Obesity conferred increased odds of periodontal disease with an odds ratio (1.35, 95% CI: 1.05-1.75). In the subgroup analysis by age, the odds ratio was the highest in the 18-34 years group (2.21, 95% CI: 1.26-3.89). In the subgroup analysis by country, European countries had the highest odds ratio (2.46, 95% CI: 1.11-5.46). CONCLUSION Despite the differences in degree, a positive association between obesity and periodontitis was found regardless of country or age. Therefore, medical professionals should try to prevent periodontitis by controlling patient weights, and more studies should be conducted to determine the association between obesity and oral health. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42022301343.
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Affiliation(s)
- Chang Min Kim
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Soobin Lee
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Wonjun Hwang
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Eunjeong Son
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Tae Woo Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, South Korea
- *Correspondence: Kihun Kim, ; Yun Hak Kim,
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, South Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, South Korea
- *Correspondence: Kihun Kim, ; Yun Hak Kim,
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Fathima K, Rajendran V, Sekhar P, Sivasubramaniam H. Evaluation of Level of TNF-α among Obese Patients with and without Chronic Periodontitis. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S765-S768. [PMID: 36110730 PMCID: PMC9469453 DOI: 10.4103/jpbs.jpbs_145_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/30/2022] Open
Abstract
Aim: The purpose of this case-control study was to evaluate the role of TNF-α in gingival crevicular fluid among obese women with chronic periodontitis. Materials and Methods: A total of 60 subjects were randomly selected for the study. The study population was further divided into three groups (Group 1, Obese women without periodontitis; Group 2, Non-obese women without periodontitis; Group 3, Obese with chronic periodontitis). Gingival crevicular fluid samples were taken for assessment based on clinical parameters like probing depth, bleeding on probing, and BMI. Results: There was significant increase in the level of TNF-α in gingival crevicular fluid from obese patients with chronic periodontitis and a positive correlation was found between TNF-α levels and values of the plaque index, OHI –I and BMI. Conclusion: Based on these results, it can be concluded that GCF level of TNF-α was significantly higher in obese patients with and without chronic periodontitis, and highest in obese patients with chronic periodontitis group.
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Çetin MB, Sezgin Y, Önder C, Bakirarar B. The relationship between body mass index and stage/grade of periodontitis: a retrospective study. Clin Oral Investig 2021; 26:1937-1945. [PMID: 34709456 DOI: 10.1007/s00784-021-04172-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/30/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Possible impact of obesity on stage and grade of periodontitis has never been investigated before. This study aimed to examine the association between body mass index (BMI) and stage/grade of periodontitis per the current classification of periodontal diseases. MATERIAL AND METHODS A total of 142 patients (82 males/60 females) were included in this study. "2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions" was taken as basis to characterize the stage/grade of periodontitis. Age, gender, smoking status, and frequency of tooth brushing, and medical data of the patients including hypertension, hyperlipidemia, BMI, and diabetes mellitus were obtained from the patient's hospital records. Obesity was assessed by BMI using the "World Health Organization" criteria. For estimating the association between BMI and periodontitis, logistic regression analysis was utilized. RESULTS BMI was statistically associated with clinical attachment loss (CAL), probing pocket depth (PPD), Plaque index (PI), stage and grade of periodontitis, and number of remaining teeth (p < 0.001, p < 0.05, p < 0.05, p < 0.05, p < 0.001, respectively). According to the multiple regression analysis results, those with BMI 25-29.9 were found to be at risk of being stage III-IV 3.977 times (95% CI: 1.831-8.640, p < 0.001) higher than those with BMI < 25, and similarly, those with BMI ≥ 30 were found to be at risk of being stage III-IV 4.062 times (95% CI: 1.315-12.549, p = 0.015) higher than those with BMI < 25. No relationship was found between obesity and grade of periodontitis according to multivariate analysis. CONCLUSIONS BMI increases the likelihood of stage III and stage IV periodontitis; however, it does not have an impact on the grade of periodontitis. CLINICAL RELEVANCE It seems that obesity is related to the severity of periodontitis.
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Affiliation(s)
- Mehtap Bilgin Çetin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Bahçelievler, Ankara, 06790, Turkey.
| | - Yasemin Sezgin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Bahçelievler, Ankara, 06790, Turkey
| | - Canan Önder
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
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Abstract
Eating disorders such as anorexia nervosa, female athlete triad, bulimia nervosa, obesity, and binge eating initially emerge during adolescence. These disorders are present primarily in females, but males may also present with these conditions. Dentistry has a pivotal role in the management of patients with such diet-related disorders. Because dentists examine their patients at frequent intervals and may be the health care professionals with whom patients feel more comfortable discussing eating disorders, dentists must have knowledge of the etiology, diagnostic criteria, systemic effects, and intraoral manifestations of eating disorders. In addition, the dental professional may be the first health care provider to identify the condition and refer the patient appropriately to medical colleagues for subsequent treatment. This chapter provides dentists with current and relevant information to recognize, diagnose, and integrate dental treatment for their adolescent patients who may exhibit manifestations of an eating disorder.
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Kurt-Bayrakdar S, Kose O, Altin A, Akyildiz K, Mercantepe T, Bostan SA, Kose TE, Tumkaya L, Yilmaz A. Periodontitis exacerbates the renal degenerative effects of obesity in rats. J Periodontal Res 2021; 56:1058-1069. [PMID: 34328646 DOI: 10.1111/jre.12919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/21/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Obesity and periodontitis are systemic subclinical inflammatory diseases with established negative renal effects. The aim of this animal study was to thoroughly investigate the possible effects of these two diseases on renal structure and function. METHODS Thirty-two male Sprague Dawley rats were divided into four groups: control (C), obesity (Ob), experimental periodontitis (Ep), and Ob + Ep. The first 16 weeks of the experiment were aimed for the induction of obesity and the last 5 weeks for the induction of periodontitis. Throughout the experimental period, the C and Ep groups were fed standard rat chow, while the Ob groups (Ob and Ob + Ep) were fed high-fat rat chow. Right after the establishment of obesity, periodontal tissue destruction was achieved by placing 3.0 silk sutures in sub-paramarginal position around the cervices of mandibular right-left first molar teeth and preserving them for 5 weeks. On the last day of the 22nd week, following blood collection, all rats were euthanized, and kidneys and mandibles were collected. Alveolar bone loss was measured on microcomputed tomographic slices. Histopathological evaluations (light microscopy, semi-quantitative analysis of renal corpuscle area, and immunohistochemical analysis of caspase-3 activity) were done on right kidneys and biochemical evaluations (malonyl-aldehyde [MDA], glutathione [GSH], total oxidant status [TOS], total antioxidant status [TAS], oxidative stress [OSI], tumor necrosis factor-α [TNF-α], interleukin-1β [IL-1β], matrix metalloproteinase [MMP]-8, MMP-9, and cathepsin D [CtD] levels) were done on left kidneys. Renal functional status was evaluated with levels of serum creatinine, urea, and cystatin C. RESULTS Periodontal bone loss was significantly higher in the Ep and Ob + Ep groups, compared with the C and Ob groups (p < .05). All parameters except TAS and GSH were highest in the Ob + Ep group, and the differences were statistically significant compared with the control group (p < .05). Although the mean TAS and GSH levels were lower in the Ob + Ep group than the other groups, the differences were not statistically significant (p > .05). While the atypical glomeruli score was significantly higher in the Ob + Ep group than in all other groups (p < .05), the acute tubular necrosis and histopathological scores were significantly different only compared with the control group (p < .05). CONCLUSION This experimental study showed that the negative effects of the co-existence of periodontitis and obesity on inflammatory stress and apoptotic changes in the kidneys together with the functional parameters were significantly more severe, compared with the presence of one of these diseases alone. TNF-α could have a central role in the periodontitis and obesity-related structural and functional renal changes.
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Affiliation(s)
- Sevda Kurt-Bayrakdar
- Department of Periodontology, School of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Oğuz Kose
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ahmet Altin
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Kerimali Akyildiz
- Department of Medical Services and Techniques, School of Health Care Services Vocational, Recep Tayyip Erdogan University, Rize, Turkey
| | - Tolga Mercantepe
- Department of Histology and Embryology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Semih Alperen Bostan
- Department of Periodontology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Taha Emre Kose
- Department of Dentomaxillofacial Radiology, School of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Levent Tumkaya
- Department of Histology and Embryology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- Department of Biochemistry, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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14
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Ikbariyeh B, Al Habashneh R, Khassawneh B, Alrawashdeh M, Elsalim L, Al-Nusair J. Clinical and Biological Indicators of Periodontal Disease in Obese and non-Obese adults with and without Bronchial Asthma. J Asthma 2021; 59:1758-1766. [PMID: 34324826 DOI: 10.1080/02770903.2021.1962907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The present study aims to assess clinical and inflammatory parameters as indicators for periodontal disease in obese and non-obese adults with and without bronchial asthma (BA).Methods: 168 patients visiting the outpatient pulmonary clinics were divided into four groups according to BA and obesity. Obesity was defined by body mass index (BMI) and BA was diagnosed by a pulmonary consultant and being on inhaled asthma medication for at least 12 months. Participants were examined for clinical periodontal parameters and samples of gingival crevicular fluid (GCF) were taken and analyzed for the levels of 5 different inflammatory cytokines.Results: Compared with controls, obese asthmatic group had significant higher mean clinical attachment loss (CAL) (2.64 vs. 1.00, p<.001). Also, the occurrence of periodontitis was significantly higher among obese patients compared to non-obese patients (p = 0.003). Multivariate logistic regression model showed that age was the strongest predictor of periodontitis (aOR =1.23). The levels of IL-1β and IL-8 were significantly higher in the non-obese asthmatic group compared to the control group (p < 0.05). The level of IL-6 was significantly lower in the control group compared to the other groups (p < 0.001). Obese patients had significantly higher concentration of hsCRP compared to non-obese patients (p < 0.001). There was no significant difference in the level of TNF- α between groups.Conclusions: BA and obesity combined did not seem to be associated with a significant increased risk of having periodontitis. BA and obesity are associated with increased levels of some local proinflammatory cytokines which adds to the local and systemic inflammatory burden.
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Affiliation(s)
- Bader Ikbariyeh
- Faculty of Dentistry, Preventive Dentistry, Jordan University of Science & Technology, Irbid, Jordan
| | - Rola Al Habashneh
- Faculty of Dentistry, Preventive Dentistry, Jordan University of Science & Technology, Irbid, Jordan
| | - Basheer Khassawneh
- Faculty of Medicine, Internal Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammad Alrawashdeh
- Faculty of Nursing, Community and Mental Health Nursing, Jordan University of Science & Technology, Irbid, Jordan
| | - Lina Elsalim
- Faculty of Medicine, Department of Pharmacology, Jordan University of Science & Technology, Irbid, Jordan
| | - Jowan Al-Nusair
- Medical Student, College of Medicine, Jordan University of Science & Technology, Irbid, Jordan
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15
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Tegelberg P, Saxlin T, Tervonen T, Knuuttila M, Jokelainen J, Auvinen J, Ylöstalo P. Association of long-term obesity and weight gain with periodontal pocketing: Results of the Northern Finland Birth Cohort 1966 study. J Clin Periodontol 2021; 48:1344-1355. [PMID: 34288019 DOI: 10.1111/jcpe.13524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 12/01/2022]
Abstract
AIM To investigate whether obesity, central obesity, and weight gain are associated with periodontal pocketing. MATERIALS AND METHODS A never-smoking sub-population (n = 725) of the Northern Finland Birth Cohort 1966 was categorized based on body mass index (BMI; participants with normal weight, overweight, and obesity) and waist circumference (WC; participants without central obesity and with central obesity) at ages 31 and 46. The categories were combined to define whether the participants stayed in the respective BMI and WC categories or moved on to a higher category during follow-up. A periodontal examination was done at age 46. RESULTS WC was more consistently associated with periodontal pocketing than BMI. The relative risks for the number of sites with periodontal pocket depth (PPD) ≥4 mm and bleeding PPD ≥4 mm in participants with central obesity both at age 31 and at age 46 were 1.7 (95% confidence interval [CI] 1.4-2.0) and 2.1 (95% CI 1.6-2.6). The corresponding values for participants who had no central obesity at age 31 but had central obesity at age 46 were 1.6 (95% CI 1.4-1.8) and 1.9 (95% CI 1.6-2.3). CONCLUSION Of all the studied measures, central obesity appeared to be most strongly associated with the inflammatory condition of the periodontium.
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Affiliation(s)
- Paula Tegelberg
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Epidemiology and Systems Medicine, University of Oulu and Unit of Primary Care, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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16
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Obesity Drives an Oral Microbiota Signature of Female Patients with Periodontitis: A Pilot Study. Diagnostics (Basel) 2021; 11:diagnostics11050745. [PMID: 33919425 PMCID: PMC8143370 DOI: 10.3390/diagnostics11050745] [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: 03/11/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to analyze the link between oral microbiota and obesity in humans. We conducted a pilot study including 19 subjects with periodontitis divided into two groups: normo-weighted subjects (NWS) with a body mass index (BMI) between 20 and 25 (n = 9) and obese subjects (OS) with a BMI > 30 (n = 10). Obesity was associated with a poor oral health status characterized by an increased number of missing teeth and a higher score of periodontal-support loss associated with dysbiotic oral microbiota (39.45 ± 3.74 vs. 26.41 ± 11.21, p = 0.03 for the Chao 1 index). Oral microbiota taxonomic analysis showed that the abundance of the Capnocytophaga genus was higher (2.47% ± 3.02 vs. 0.27% ± 0.29, p = 0.04) in OS compared to NWS. Obese females (OF) were characterized by an increase in the Streptococcus genus (34.12% ± 14.29 vs. 10.55% ± 10.42, p = 0.05) compared to obese males (OM), where the Neisseria genus was increased (5.75% ± 5.03 vs. 58.05% ± 30.64, p = 0.008). These first data suggest that sex/gender is determinant in the link between oral dysbiotic microbiota and obesity in patients with periodontitis. Our results could lead to recommendations concerning therapeutic strategies for obese patients with periodontitis following the sex/gender.
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17
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Wadhawan A, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, Brenner LA, Dagdag A, Lowry CA, Dwivedi Y, Postolache TT. Periodontal Pathogens and Neuropsychiatric Health. Curr Top Med Chem 2021; 20:1353-1397. [PMID: 31924157 DOI: 10.2174/1568026620666200110161105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/08/2023]
Abstract
Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.
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Affiliation(s)
- Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Department of Psychiatry, Saint Elizabeths Hospital, Washington, D.C. 20032, United States
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, United States
| | - Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Alison J Scott
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, United States
| | - Eileen Potocki
- VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, United States
| | - Andrew J Hoisington
- Air Force Institute of Technology, Wright-Patterson Air Force Base, United States
| | - Lisa A Brenner
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Christopher A Lowry
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Department of Integrative Physiology, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, United States
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, United States
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, United States
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18
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Association of overweight/obesity with the severity of periodontitis using BPE code in an iraqi population. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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19
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The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa. Healthcare (Basel) 2020; 8:healthcare8030290. [PMID: 32846888 PMCID: PMC7551417 DOI: 10.3390/healthcare8030290] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/10/2020] [Accepted: 08/15/2020] [Indexed: 01/08/2023] Open
Abstract
The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.
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20
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Suzuki S, Onose Y, Yoshino K, Takayanagi A, Kamijo H, Sugihara N. Relationship between Obesity Indicators and Gingival Inflammation in Middle-aged Japanese Men. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:153-160. [PMID: 32801262 DOI: 10.2209/tdcpublication.2019-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to investigate the relationship among the waist-to-height ratio (WHtR) and the body mass index (BMI) as obesity indicators and gingival inflammation as determined by bleeding on probing (BOP). The participants comprised employees of a milk products company based in Tokyo, Japan. A total of 159 non-diabetic men aged 40 to 59 yr and with a minimum of 28 teeth were included. Multiple logistic regression analysis controlling for age, smoking status, pocket depth, frequency of daily brushing, frequency of weekly interdental brushing, and regular dental attendance was performed to compare the relationships among the obesity indicators and BOP. Participants with good oral hygiene had significantly less BOP than those with poor oral hygiene (p<0.001). No significant differences were observed among the other items investigated. A significant association was observed between WHtR and BOP (odds ratio: 2.40, 95% confidence interval: 1.11-5.22); no such association was observed with the BMI, however. The present results showed that obesity, as determined according to a visceral fat index, was associated with BOP, but not with BMI. This suggests that the WHtR is a more accurate index of obesity than the BMI in studies on BOP.
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Affiliation(s)
- Seitaro Suzuki
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Yuki Onose
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Koichi Yoshino
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | - Hideyuki Kamijo
- Department of Social Security for Dentistry, Tokyo Dental College
| | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental College
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21
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Beck JD, Papapanou PN, Philips KH, Offenbacher S. Periodontal Medicine: 100 Years of Progress. J Dent Res 2020; 98:1053-1062. [PMID: 31429666 DOI: 10.1177/0022034519846113] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Periodontal medicine is a term used to describe how periodontal infection/inflammation may impact extraoral health. Periodontitis has been linked to over 50 systemic diseases and conditions. As part of the Journal of Dental Research's Centennial Celebration, this narrative review discusses periodontal medicine research done over the past 100 y, with particular focus on the effects of periodontal disease on 3 pathological conditions: cardiovascular disease, diabetes mellitus, and adverse pregnancy outcomes. We selected 29 total studies that were the "first" of their kind, as they provided novel observations or contributed to shifting paradigms as well as important studies that made strong contributions to progress in understanding relationships to the systemic conditions. These studies were organized in an overview timeline and broken down into timelines by topic: cardiovascular disease (n = 10), diabetes (n = 12), and adverse pregnancy outcomes (n = 7). Overall, the majority of cross-sectional, case-control, and longitudinal studies have revealed positive associations between poor periodontal status and cardiovascular disease, diabetes metabolic control, and a number of adverse pregnancy outcomes, and these associations are upheld in systematic reviews. Findings from randomized controlled trials testing the effects of periodontal therapy on systemic health outcomes were conflicting and inconsistent. While there has been a great deal of progress, we highlight lessons learned and make comments and suggestions on a number of key aspects, including the heterogeneity of case definitions of periodontal disease across studies, accounting for features of the periodontal phenotype that are most relevant to the biological link between periodontitis and systemic outcomes, the role of other comorbid inflammatory conditions, selection of study participants, and timing and intensity of the periodontal intervention.
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Affiliation(s)
- J D Beck
- 1 Department of Periodontology, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
| | - P N Papapanou
- 2 Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York City, NY, USA
| | - K H Philips
- 3 Department of Oral and Craniofacial Health Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
| | - S Offenbacher
- 1 Department of Periodontology, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
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22
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Khan MS, Alasqah M, Alammar LM, Alkhaibari Y. Obesity and periodontal disease: A review. J Family Med Prim Care 2020; 9:2650-2653. [PMID: 32984101 PMCID: PMC7491813 DOI: 10.4103/jfmpc.jfmpc_283_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/14/2020] [Accepted: 04/09/2020] [Indexed: 12/31/2022] Open
Abstract
Periodontal diseases usually refer to inflammatory disorders that are caused by pathogenic bacteria in the subgingival biofilm in association with impaired host immune response and connective tissue breakdown. The bacterial challenge exacerbates the cytokine production by the gingival epithelium, resulting in an uncontrolled inflammation that leads to tooth loss in adults from different populations. The prevalence of these diseases increases with aging, longer retention of teeth, and increased incidence of obesity and diabetes among the population. The prevalence demonstrates an increasing trend and a correlation with numerous comorbidities. Hence, as a family physician one should have the in-depth knowledge regarding the relationship between obesity and periodontitis to create awareness among people to provide primary care. Thus, it is relevant to develop new methods capable of detecting these diseases in the early stages and following up on their progression.
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Affiliation(s)
- Mohammad Shoyab Khan
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | - Yousef Alkhaibari
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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23
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Thomas JT, Thomas T, Ahmed M, Kannan S K, Abdullah Z, Alghamdi SA, Joseph B. Prevalence of Periodontal Disease among Obese Young Adult Population in Saudi Arabia-A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E197. [PMID: 32344600 PMCID: PMC7231025 DOI: 10.3390/medicina56040197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 12/19/2022]
Abstract
Background and objectives: We aimed to assess the prevalence of periodontal disease among obese young adults in Saudi Arabia and to analyze the association between different body mass indexes and the severity of periodontal disease. Materials and methods: This descriptive cross-sectional study consisted of 307 obese patients aged 18-39 years, with body mass index (BMI) ≥30. Demographic variables for periodontal disease, anthropometric parameters such as BMI along with clinical parameters such as oral hygiene index-simplified, community periodontal index (CPI) score and loss of attachment (LOA), were assessed. Multivariate binary logistic regression analysis was used to identify the predictors for chronic periodontitis in obese young adults between 18-40 years of age. Results: The majority of the participants (71.3%) had periodontal disease. Obese and extremely obese patients together showed a statistically significant difference in the age group of 21-30 years in terms of CPI score for inflammation (p < 0.05) and LOA (p < 0.001). Logistic regression analysis showed age (OR: 3.180; 95%CL: 1.337-7.561; p <.001), occasional dental visit (OR: 5.965; 95%CL: 3.130-11.368; p < 0.001), smoking >10 cigarettes (OR: 11.868; 95%CL: 3.588-39.254; p < 0.001) and poor oral hygiene status (OR: 17.250; 95%CL: 6.958-42.764; p < 0.001) were associated with a significantly higher risk of having periodontal disease. Conclusions: This study showed a high prevalence of periodontal disease in obese patients among the Saudi Arabian population.
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Affiliation(s)
- Julie Toby Thomas
- Department of Preventive Dental Sciences, College of Dentistry, Majmaah University, Al Zulfi 11952, Saudi Arabia
| | - Toby Thomas
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, Al Zulfi 11952, Saudi Arabia
| | - Masood Ahmed
- Department of Preventive Dental Sciences, College of Dentistry, Majmaah University, Al Zulfi 11952, Saudi Arabia
| | - Karthiga Kannan S
- Department of Maxillofacial Dental Sciences, College of Dentistry, Majmaah University, Al Zulfi 11952, Saudi Arabia
| | - Zoha Abdullah
- Department of Public Health Dentistry, Asan Memorial Dental College, Chengalpettu 6000094, India
| | - Sara Ayid Alghamdi
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al Zulfi 11952, Saudi Arabia
| | - Betsy Joseph
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 62521, Saudi Arabia
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24
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Zuza EC, Pires JR, de Almeida AA, Toledo BEC, Guimaraes-Stabili MR, Junior CR, Barroso EM. Evaluation of recurrence of periodontal disease after treatment in obese and normal weight patients: Two-year follow-up. J Periodontol 2020; 91:1123-1131. [PMID: 32010963 DOI: 10.1002/jper.19-0534] [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: 09/19/2019] [Revised: 12/30/2019] [Accepted: 01/21/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Obesity may represent a chronic low-grade inflammation, but there is a lack of long-term longitudinal studies. The aim of this longitudinal study was to evaluate the recurrence of periodontal disease in obese and normal weight patients submitted to scaling and root planing. METHODS The study included 22 patients who had received periodontal treatment 2 years previously, 13 obese and nine non-obese. The patients were evaluated for anthropometric measurements of body mass index, waist circumference, waist-to-hip ratio, and fat percentage through bioimpedance. The following periodontal parameters were recorded: visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). The immunological evaluation analyzed the proinflammatory cytokines interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) in the gingival crevicular fluid (GCF). RESULTS Obese and normal weight patients did not differ in relation to the periodontal parameters of VPI, GBI, PD, CAL, or BOP 2 years after completion of the periodontal therapy. Sites with periodontitis in obese individuals showed higher levels of IL-6 and TNF-α in the gingival fluid (P <0.05). CONCLUSION Obese and normal weight individuals had similar periodontal behaviors, with low recurrence of the periodontal disease; however, obesity was related to increased inflammatory activity in gingival fluid, which may become a risk indicator for future greater recurrence of the disease in the presence of inadequate plaque control.
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Affiliation(s)
- Elizangela C Zuza
- Postgraduate Program in Dentistry of the Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, São Paulo, Brazil
| | - Juliana R Pires
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
| | - Ana Alice de Almeida
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
| | - Benedicto E C Toledo
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Morgana R Guimaraes-Stabili
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Carlos Rossa Junior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Eliane M Barroso
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
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25
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Gulati NN, Masamatti SS, Chopra P. Association between obesity and its determinants with chronic periodontitis: A cross-sectional study. J Indian Soc Periodontol 2020; 24:167-172. [PMID: 32189846 PMCID: PMC7069116 DOI: 10.4103/jisp.jisp_157_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/25/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022] Open
Abstract
Background Various systemic disorders such as cardiovascular, diabetes, and osteoporosis are linked to periodontitis. Obesity is one such epidemic, and although many studies have addressed its relationship with periodontitis, the mechanism still remains unclear. Aim This study aims to assess the association between obesity and its determinants with clinical periodontal parameters in adult patients visiting a dental college in Haryana. Materials and Methods This cross-sectional study was performed in 317 patients visiting a dental college in Gurugram. Obesity parameters such as body mass index (BMI), body fat percentage (BF%), waist circumference (WC), and waist-hip ratio (WHR) were assessed using body fat analyzer (Omron HBF 701). Depending on their BMI, individuals were stratified as overweight (OW), Class 1, Class 2, and Class 3 obese. Periodontal status was assessed by plaque index, gingival index, probing pocket depth (PPD), and clinical attachment level. These periodontal parameters were correlated with BMI, BF%, WC, and WHR. Statistical analysis was done, and P ≤ 0.05 was considered as statistically significant. Results The prevalence of periodontitis in OW, Class 1, Class 2, and Class 3 obese was 16.4%, 79.2%, 2.8%, and 1.6%, respectively. PPD was significantly associated with obesity determinants, especially among Class 2 and Class 3 obese individuals. Similarly, BF% was associated with all the periodontal parameters. Conclusion Within the restrictions of the study, it can be concluded that obesity and chronic periodontitis are interlinked.
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Affiliation(s)
- Neha Nasa Gulati
- Department of Periodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | | | - Priyanka Chopra
- Department of Periodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
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26
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Morita T, Yamazaki Y, Seto M, Yamamoto T, Nakai K, Tanaka H, Ozaki M, Koshi R, Maeno M, Kawato T. Effect of Periodontitis and Toothbrushing Frequency on Obesity Onset: A Cohort Study. Med Sci Monit 2019; 25:9712-9720. [PMID: 31852008 PMCID: PMC6930697 DOI: 10.12659/msm.917356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The interplay between obesity and periodontitis has been widely examined. While obesity was reported as a risk factor for periodontitis, the inverse relationship is still little explored. Therefore, we aimed to determine whether periodontitis and toothbrushing frequency affect the onset of obesity. Material/Methods This cohort study included 1619 employees of a business enterprise headquartered in Tokyo, who in 2002 and 2006 underwent in prescribed annual health checks, both general and dental-specific, and who were not obese in 2002 (body mass index <25). The response variable was obesity (or absence) at 4 years, while the explanatory variables were presence/absence of periodontal pockets and toothbrushing frequency in 2002; their relationships were examined by multiple logistic regression analysis. Results Subjects with periodontal pockets ≥4 mm showed a significantly higher odds ratio (OR) for onset of obesity at 4 years than those without periodontal pockets [OR: 1.59, 95% CI (confidence interval): 1.08–2.35, p<0.05]. Similarly, subjects who brushed their teeth ≥3 times/day had a significantly lower obesity OR than those who brushed ≤1 time/day (OR: 0.49, 95% CI: 0.28–0.85, p<0.01). Conclusions The presence of periodontal pockets and toothbrushing frequency are significantly associated with the onset of obesity. Periodontal pockets ≥4 mm are associated with increased risk of obesity, while frequent toothbrushing (≥3 times/day) appears to reduce the risk of obesity.
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Affiliation(s)
- Toyoko Morita
- The Lion Foundation for Dental Health, Tokyo, Japan.,Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | | | | | | | - Kumiko Nakai
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Hideki Tanaka
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Manami Ozaki
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Ryosuke Koshi
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takayuki Kawato
- Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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27
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Arboleda S, Vargas M, Losada S, Pinto A. Review of obesity and periodontitis: an epidemiological view. Br Dent J 2019; 227:235-239. [PMID: 31399683 DOI: 10.1038/s41415-019-0611-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obesity and periodontitis are among the most common non-communicable diseases, and epidemiological studies report the influence of obesity in the onset and progression of periodontitis. Data indicate that increased body mass index, waist circumference, percentage of subcutaneous body fat, and serum lipid levels are associated with increased risk to develop periodontitis. The underlying biological mechanisms of this association involve adipose tissue-derived cytokines, such as tumour necrosis factor-α and interleukin-6, which affect whole-body metabolism and contribute to the development of a low-grade systemic inflammation. Multiple studies report a positive association between these two diseases across diverse populations. Obesity does not appear to impair the success of periodontal therapy. However, currently available evidence is variable and therefore inconclusive. Despite the limited evidence about recommendations on treatment planning, oral healthcare professionals need to be aware of the complexity of obesity to counsel their patients about the importance of maintaining healthy body weight and performing good oral hygiene procedures.
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Affiliation(s)
- Silie Arboleda
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia.
| | - Miguel Vargas
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - Sergio Losada
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - Andres Pinto
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University, School of Dental Medicine and University Hospitals Cleveland Medical Centre, Cleveland, Ohio, USA
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28
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Bazyar H, Adibmanesh A, Javid AZ, Maghsoumi-Norouzabad L, Gravand E, Alipour M, Sadeghi N. The relationship between metabolic factors and anthropometric indices with periodontal status in type 2 diabetes mellitus patients with chronic periodontitis. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.obmed.2019.100138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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29
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Kim JS, Kim SY, Byon MJ, Lee JH, Jeong SH, Kim JB. Association between Periodontitis and Metabolic Syndrome in a Korean Nationally Representative Sample of Adults Aged 35-79 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2930. [PMID: 31443217 PMCID: PMC6720168 DOI: 10.3390/ijerph16162930] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 12/25/2022]
Abstract
This study aimed to evaluate the association between periodontitis and metabolic syndrome (MetS) and to investigate risk factors associated with MetS in Korean adults aged 35 to 79 years. Among individuals aged 35-79 years who participated in the Korea National Health and Nutrition Examination Survey 2013-2015, 8314 participants who completed the required examinations and questionnaires were included. Confounding variables related to demographic and socioeconomic status and systemic and oral health-related behaviors were age, gender, household income, education level, smoking, alcohol intake, physical activity, and frequency of daily toothbrushing. Of the 8314 participants, 32.2% were diagnosed with MetS. The prevalence of MetS was 26.6% and 41.6% in those without and with periodontitis, respectively. Among individuals with periodontitis, the prevalence of MetS was 44.3% in males and 36.9% in females. Compared to non-periodontitis, periodontitis was associated with MetS (adjusted OR = 1.422, 95% CI: 1.26-1.61). Age, frequency of daily toothbrushing, and periodontitis were associated with MetS in both males and females. While current smoking and alcohol intake more than twice a week were significantly associated with MetS in males, household income and education level were significantly associated with MetS in females. The findings suggest that periodontitis can be associated with MetS.
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Affiliation(s)
- Ji-Soo Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- BK21 PLUS Project, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- Periodontal Disease Signaling Network Research Center, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
| | - Se-Yeon Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- Periodontal Disease Signaling Network Research Center, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
| | - Min-Ji Byon
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- BK21 PLUS Project, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- Periodontal Disease Signaling Network Research Center, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
| | - Jung-Ha Lee
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
| | - Seung-Hwa Jeong
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
- BK21 PLUS Project, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea
| | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea.
- BK21 PLUS Project, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea.
- Periodontal Disease Signaling Network Research Center, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup Yangsan, Gyeongsangnam-do 626-870, Korea.
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Abstract
The purpose of this paper was to identify and summarize current evidence describing periodontal complications associated with obesity. Electronic searches supplemented with manual searches were carried out to identify relevant systematic reviews. Identification, screening, eligibility, and inclusion of studies were performed independently by two reviewers. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess the quality and risk of bias of the included reviews. From 430 titles and abstracts screened, 14 systematic reviews were considered as eligible for inclusion in this meta-review. Eight reviews reported on cross-sectional studies investigating the association of obesity and periodontal diseases, 4 included longitudinal studies, 5 addressed response to periodontal therapy, 5 reported on studies investigating biomarkers, and only 2 were related to pediatric population samples. Systematic review summaries in the various study design domains (cross-sectional, longitudinal and experimental) report that obese individuals are more likely to have periodontal diseases, with more severe periodontal conditions, than nonobese individuals, with cross-sectional evidence congruent with longitudinal studies showing that obesity or weight gain increases the risk of periodontitis onset and progression. Published research on the effect of obesity on responses to periodontal therapy, or systemic or local biomarkers of inflammation, is variable and therefore inconclusive based on the evidence currently available, which suggests that overweight/obesity contributes to periodontal complications independently of other risk factors, such as age, gender, smoking, or ethnicity. This evidence supports the need for risk assessments for individual patients to facilitate personalized approaches in order to prevent and treat periodontal diseases.
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Affiliation(s)
- Jean E Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Nicholas Finer
- National Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science, London, UK
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31
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Kitagawa M, Kurahashi T, Matsukubo T. Relationship between General Health, Lifestyle, Oral Health, and Periodontal Disease in Adults: A Large Cross-sectional Study in Japan. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 58:1-8. [PMID: 28381729 DOI: 10.2209/tdcpublication.2016-2100] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to investigate how general health, oral conditions, and lifestyle were associated with periodontal disease in adults, as clarifying this relationship may be useful in preventing periodontal disease. Medical checkups were conducted on individuals aged 40, 50, or 60 years. Data were obtained for analysis on a total of 36,110 patients (men, 12,784; women, 22,896). A stepwise logistic regression model was used to calculate the odds ratio (OR) for patients who were ≥code 3 according to the Community Periodontal Index (CPI). Approximately 40, 60, and 70% of men aged 40, 50, and 60 years, respectively, had a CPI score of ≥3. There were 10% fewer women than men at each age. Stepwise logistic regression revealed a BMI score of ≥30 kg/m2(OR, 1.44; 95% confidence interval [95%CI], 1.20-1.73); systolic blood pressure of ≥140 mmHg (OR, 1.09; 95%CI, 1.02-1.18); a fasting blood sugar level of ≥110 mg/dl (OR, 1.17; 95%CI, 1.04-1.30); high-density lipoprotein cholesterol level of <40 mg/dl (OR, 1.21; 95%CI, 1.06-1.37); smoker (OR, 1.59; 95%CI, 1.48-1.71); drinking ≥3 cups of Japanese sake per day (OR, 1.09; 95%CI, 1.05-1.14); use of salts for seasoning (OR, 1.17; 95%CI, 1.07-1.28); and fair and poor oral hygiene (OR, 2.27; 95%CI, 2.08-2.47) as significant risk factors for a CPI score of ≥3. These results suggest that smoking, oral hygiene status, and factors associated with metabolic syndrome are associated with periodontitis. This indicates that health guidance on tooth brushing, the importance of quitting smoking, and control of obesity may be effective in preventing the development of periodontal disease in adults.
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Affiliation(s)
- Miki Kitagawa
- Department of Epidemiology and Public Health, Tokyo Dental College
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32
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Vivekananda L, Faizuddin M. Effect of Weight Reduction on the Serum Adiponectin and Tumor Necrosis Factor-α Levels and the Clinical Parameters of Obese Patients with and without Periodontal Disease. J Int Soc Prev Community Dent 2019; 9:166-171. [PMID: 31058067 PMCID: PMC6489511 DOI: 10.4103/jispcd.jispcd_447_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 01/15/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The objective of the current study was to assess the impact of weight reduction on the attenuation of obesity-related periodontal inflammation. METHODS This study was conducted enrolling 60 obese subjects. They were divided into three groups of 20 each. Group 1-healthy group, Group 2-gingivitis group, and Group 3-periodontitis group. The body mass index and waist/hip ratio, periodontal parameters such as plaque index, bleeding index, full mouth periodontal probing depth (PPD) using the University of North Carolina 15 (UNC 15) probe and full mouth clinical attachment loss (CAL) with cementoenamel junction as the reference using UNC 15 probe was evaluated at baseline and after the attainment of ≥10% weight loss by the subjects. Adiponectin and tumor necrosis factor-alpha (TNF-α) levels were measured in the serum at baseline and after attainment of ≥10% reduction in weight in a period of 3-18 months. RESULTS Adherence to weight reduction program until the achievement of ≥10% reduction in body weight resulted in statistically significant (P < 0.0001) elevated serum adiponectin and reduced serum TNF-α levels in all three groups. Furthermore, elevations of adiponectin following weight reduction showed significant negative correlations with PPD in all the three groups and in patients with periodontitis, (Group 3) serum adiponectin levels showed significant negative correlations (P = 0.0001) with CAL in Group 3. CONCLUSIONS Controlling obesity presents a good opportunity to alleviate the burden of periodontal disease. Simple weight reduction programs with diet and exercise-related lifestyle modifications may be an efficacious and barrier-free option.
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Affiliation(s)
- Lalith Vivekananda
- Department of Periodontics, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Mohamed Faizuddin
- Department of Periodontics, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
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33
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Li LW, Wong HM, McGrath CP. Longitudinal association between obesity and periodontal diseases among secondary school students in Hong Kong: a prospective cohort study. BMC Oral Health 2018; 18:189. [PMID: 30458748 PMCID: PMC6247631 DOI: 10.1186/s12903-018-0659-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/08/2018] [Indexed: 01/21/2023] Open
Abstract
Background There is no consensus opinion regarding the association between obesity and periodontal diseases among children and adolescents in the literature. Methods A prospective observational cohort study was conducted in a Hong Kong cohort at age 12, 15 and 18. CPI and various obesity indices including BMI, WC, WHR, WHtR, and TRSKF were recorded during each wave of data collection. Information on socioeconomic status and oral health behaviors were collected through self-completed questionnaires. Results Two hundred and eighty-two (male: 122 and female: 160) participants completed all three rounds of data collection. Prevalence of overweight/obesity was 27.0, 19.1, and 14.2% at 12, 15, and 18 years, respectively. 19.9% participants had healthy periodontal conditions at age 12. While the percentage dropped to 10.3% at 15 years and 5.7% at 18 years. The proportion of 15-year-old adolescents who brushed teeth more than twice a day was significantly higher among participants belonging to the lower BMI, WC, WHR, and WHtR category (P < 0.05). The fully adjusted model revealed that participants with lower BMI at age 15 had higher probability of having more than 50% index teeth free from periodontal diseases at age 18 (OR: 2.78; 95% CI: 1.16, 6.64; P = 0.022). Conclusions Although higher BMI at 15 years was associated with more extensive periodontal inflammation at age 18, this was believed to be an indirect association confounded by the poor oral health care among overweight/obese individuals. Oral health promotions should be directed to improve periodontal conditions of overweight/obese secondary school students.
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Affiliation(s)
- Ling-Wei Li
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China
| | - Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
| | - Colman P McGrath
- Periodontology & Public health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Khan S, Barrington G, Bettiol S, Barnett T, Crocombe L. Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review. Obes Rev 2018; 19:852-883. [PMID: 29349893 DOI: 10.1111/obr.12668] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years). METHODS A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. RESULTS Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. CONCLUSION There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.
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Affiliation(s)
- S Khan
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - G Barrington
- School of Medicine, University of Tasmania, Hobart, Tas., Australia
| | - S Bettiol
- School of Medicine, University of Tasmania, Hobart, Tas., Australia
| | - T Barnett
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia
| | - L Crocombe
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia
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36
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Culebras-Atienza E, Silvestre FJ, Silvestre-Rangil J. Possible association between obesity and periodontitis in patients with Down syndrome. Med Oral Patol Oral Cir Bucal 2018; 23:e335-e343. [PMID: 29680852 PMCID: PMC5945240 DOI: 10.4317/medoral.22311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/07/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The present study was carried out to evaluate the possible association between obesity and periodontitis in patients with DS, and to explore which measure of obesity is most closely correlated to periodontitis. MATERIAL AND METHODS A prospective observational study was made to determine whether obesity is related to periodontal disease in patients with DS. The anthropometric variables were body height and weight, which were used to calculate BMI and stratify the patients into three categories: < 25(normal weight), 25-29.9 (overweight) and ≥ 30.0 kg/m2 (obese). Waist circumference and hip circumference in turn was recorded as the greatest circumference at the level of the buttocks, while the waist/hip ratio (WHR) was calculated. Periodontal evaluation was made of all teeth recording the plaque index (PI), pocket depth (PD), clinical attachment level (CAL) and the gingival index. We generated a multivariate linear regression model to examine the relationship between PD and the frequency of tooth brushing, gender, BMI, WHI, WHR, age and PI. RESULTS Significant positive correlations were observed among the anthropometric parameters BMI, WHR, WHI and among the periodontal parameters PI, PD, CAL and GI. The only positive correlation between the anthropometric and periodontal parameters corresponded to WHR. Upon closer examination, the distribution of WHR was seen to differ according to gender. Among the women, the correlation between WHR and the periodontal variables decreased to nonsignificant levels. In contrast, among the males the correlation remained significant and even increased. In a multivariate linear regression model, the coefficients relating PD to PI, WHR and age were positive and significant in all cases. CONCLUSIONS Our results suggest that there may indeed be an association between obesity and periodontitis in male patients with DS. Also, we found a clear correlation with WHR, which was considered to be the ideal adiposity indicator in this context.
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Affiliation(s)
- E Culebras-Atienza
- Dentistry and Medicine Faculty, University of Valencia, C/ Gasco Oliag n 1, Valencia 46010, SPAIN,
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37
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Silva-Boghossian CM, Cesário PC, Leão ATT, Colombo APV. Subgingival microbial profile of obese women with periodontal disease. J Periodontol 2018. [PMID: 29520825 DOI: 10.1002/jper.17-0236] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study compared the composition of subgingival microbiota between obese and non-obese women with or without periodontal disease. METHODS Full-mouth periodontal clinical assessments were carried out in 76 obese women (17 periodontally healthy and 59 with periodontal disease), and 34 non-obese women (12 periodontally healthy, 22 with periodontal disease). Subgingival biofilm samples were individually obtained from seven sites of each individual, and the prevalence and counts of 40 bacterial taxa were determined by the checkerboard method. The frequency and counts of each species were computed for each individual and across the groups. Differences among and between groups were sought by the Kruskal-Wallis and Mann-Whitney tests, respectively. Possible correlations between obesity and clinical and microbiologic parameters were tested with Spearman correlation coefficient. RESULTS Streptococcus sanguinis, Streptococcus oralis, and Capnocytophaga ochracea were found in significantly higher levels in obese compared with non-obese women (P < 0.01). In patients with periodontal health, Porphyromonas gingivalis and Leptotrichia buccalis were detected in higher mean frequency and/or counts in obese women than in non-obese women, whereas in patients with periodontal disease, obese women harbored greater levels of C. ochracea than non-obese women (P < 0.01). Moreover, obese women with periodontal disease presented significantly greater mean counts of P. gingivalis and Tannerella forsythia than non-obese women with periodontal health (P < 0.01). When the conditions obesity and periodontal disease are present at the same time, significant positive correlations were detected with C. ocharcea, P. gingivalis, S. sanguinis, and T. forsythia. CONCLUSION Few differences in the composition of the subgingival microbiota of obese and non-obese women with periodontal health or disease were found. However, a high prevalence of P. gingivalis in obese women with periodontal health was observed.
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Affiliation(s)
- Carina M Silva-Boghossian
- Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Medical Microbiology, Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Periodontics and Postgraduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil
| | - Paola C Cesário
- Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anna Thereza T Leão
- Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Paula V Colombo
- Department of Medical Microbiology, Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Sonoda C, Fukuda H, Kitamura M, Hayashida H, Kawashita Y, Furugen R, Koyama Z, Saito T. Associations among Obesity, Eating Speed, and Oral Health. Obes Facts 2018; 11:165-175. [PMID: 29669358 PMCID: PMC5981670 DOI: 10.1159/000488533] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/17/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study was conducted to understand how eating speed and oral health condition are associated with obesity in Japanese working men. METHODS We studied a total of 863 men attending an annual medical checkup of the Japanese Maritime Self Defense Force in Sasebo City, Japan. Participants answered a questionnaire about their eating speed, and we examined their anthropometric status in terms of BMI, waist circumference, and oral health condition, especially periodontal disease and number of functional teeth. Multivariate logistic regression analyses adjusting for potential confounding variables were performed. RESULTS The multivariate-adjusted odds ratio for waist circumference greater than 90 cm of the 'very fast' group compared to the 'slow, very slow' group was 5.22 (95% confidence interval 1.81-15.06) after adjusting for potential confounding factors. Individuals were more likely to have waist circumference greater than 90 cm if they had a larger 'number of missing functional teeth' (odds ratio 1.14; 95% confidence interval 1.01-1.28) and severe periodontal disease (odds ratio 2.74; 95% confidence interval, 1.46-5.13). CONCLUSION Eating speed, the number of missing functional teeth, and severe periodontal disease are associated independently with larger waist circumference.
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Affiliation(s)
- Chikanobu Sonoda
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Japan Maritime Self-Defense Force, Tokyo, Japan
| | - Hideki Fukuda
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- *Hideki Fukuda, PhD, Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City,
| | - Masayasu Kitamura
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hideaki Hayashida
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yumiko Kawashita
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Reiko Furugen
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Zenya Koyama
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Martinez-Herrera M, Silvestre-Rangil J, Silvestre FJ. Association between obesity and periodontal disease. A systematic review of epidemiological studies and controlled clinical trials. Med Oral Patol Oral Cir Bucal 2017; 22:e708-e715. [PMID: 29053651 PMCID: PMC5813989 DOI: 10.4317/medoral.21786] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/15/2017] [Indexed: 12/11/2022] Open
Abstract
Background Obesity is a very prevalent chronic disease worldwide and has been suggested to increase susceptibility of periodontitis. The aim of this paper was to provide a systematic review of the association between obesity and periodontal disease, and to determine the possible mechanisms underlying in this relationship. Material and Methods A literature search was carried out in the databases PubMed-Medline and Embase. Controlled clinical trials and observational studies identifying periodontal and body composition parameters were selected. Each article was subjected to data extraction and quality assessment. Results A total of 284 articles were identified, of which 64 were preselected and 28 were finally included in the review. All the studies described an association between obesity and periodontal disease, except two articles that reported no such association. Obesity is characterized by a chronic subclinical inflammation that could exacerbate other chronic inflammatory disorders like as periodontitis. Conclusions The association between obesity and periodontitis was consistent with a compelling pattern of increased risk of periodontitis in overweight or obese individuals. Although the underlying pathophysiological mechanism remains unclear, it has been pointed out that the development of insulin resistance as a consequence of a chronic inflammatory state and oxidative stress could be implicated in the association between obesity and periodontitis. Further prospective longitudinal studies are needed to define the magnitude of this association and to elucidate the causal biological mechanisms. Key words:Periodontal disease, periodontitis, periodontal infection, obesity, abdominal obesity.
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Affiliation(s)
- M Martinez-Herrera
- Clínica Odontológica Universitaria, Unidad de Odontología en Pacientes Especiales, Gascó Oliag 1, 46021 -Valencia, Spain,
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Martinez-Herrera M, Silvestre FJ, Silvestre-Rangil J, Bañuls C, Rocha M, Hernández-Mijares A. Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross-sectional study. J Clin Periodontol 2017; 44:981-988. [DOI: 10.1111/jcpe.12773] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Mayte Martinez-Herrera
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | - Francisco Javier Silvestre
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | | | - Celia Bañuls
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Institute of Health Research INCLIVA; University of Valencia; Valencia Spain
| | - Milagros Rocha
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- CIBER CB06/04/0071 Research Group; CIBER Hepatic and Digestive Diseases; University of Valencia; Valencia Spain
| | - Antonio Hernández-Mijares
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Institute of Health Research INCLIVA; University of Valencia; Valencia Spain
- Department of Medicine; University of Valencia; Valencia Spain
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Panny A, Glurich I, Haws RM, Acharya A. Oral and Craniofacial Anomalies of Bardet-Biedl Syndrome: Dental Management in the Context of a Rare Disease. J Dent Res 2017; 96:1361-1369. [PMID: 28662344 DOI: 10.1177/0022034517716913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Standardized guidelines for the oral health management of patients with rare diseases exhibiting morphologic anomalies are currently lacking. This review considers Bardet-Biedl syndrome (BBS), a monogenic autosomal recessive nonmotile ciliopathy, as an archetypal condition. Dental anomalies are present in a majority of individuals affected by BBS due to abnormal embryonic orofacial and tooth development. Genetically encoded intrinsic oral structural anomalies and heterogeneous BBS clinical phenotypes and consequent oral comorbidities confound oral health management. Since the comorbid spectrum of BBS phenotypes spans diabetes, renal disease, obesity, sleep apnea, cardiovascular disease, and cognitive disorders, a broad spectrum of collateral oral disease may be encountered. The genetic impact of BBS on the anatomic development of oral components and oral pathology encountered in the context of various BBS phenotypes and their associated comorbidities are reviewed herein. Challenges encountered in managing patients with BBS are highlighted, emphasizing the spectrum of oral pathology associated with heterogeneous clinical phenotypic expression. Guidelines for provision of care across the spectrum of BBS clinical phenotypes are considered. Establishment of integrated medical-dental delivery models of oral care in the context of rare diseases is emphasized, including involvement of caregivers in the context of managing these patients with special needs.
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Affiliation(s)
- A Panny
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - I Glurich
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - R M Haws
- 2 Center for Clinical Research, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - A Acharya
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
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Triglyceride to high density lipoprotein cholesterol ratio and its association with periodontal disease in Korean adults: findings based on the 2012-2014 Korean national health and nutrition examination survey. Clin Oral Investig 2017; 22:515-522. [PMID: 28589474 DOI: 10.1007/s00784-017-2140-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 05/29/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aim of this study is to evaluate whether the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is associated with periodontal disease in Korean adults. MATERIALS AND METHODS This cross-sectional study included 12,249 individuals (4,941 men and 7,308 women) who took part in the 2012-2014 Korean National Health and Nutrition Examination Survey. We categorized the TG/HDL-C ratio into three groups. Periodontal disease was defined as a community pocket index score ≥3 with at least one affected site. Multiple logistic analyses were used to analyze the association between TG/HDL-C ratio and periodontal disease. RESULTS In the study population, prevalence of periodontal disease was 31.6% in men and 21% in women. Compared to the lowest tertile group, OR (95% CI) of the highest tertile group for periodontal disease was 1.474 (1.220-1.780) in men and 1.259 (1.041-1.522) in women after adjusting for age, waist circumference, systolic blood pressure, fasting glucose, current smoking, alcohol drinking, physical activity, household income, oral health behavior, and use of anti-dyslipidemia medication. CONCLUSION Our study suggests that the TG/HDL-C ratio is associated with periodontal disease in Korean adults. CLINICAL RELEVANCE TG/HDL-C ratio is a simple and useful marker to reflect insulin resistance. And periodontal disease is also known to be related with insulin resistance. This study indicates that TG/HDL-C ratio was associated with periodontal disease in Korean adults.
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Le Sage F, Meilhac O, Gonthier MP. Porphyromonas gingivalis lipopolysaccharide induces pro-inflammatory adipokine secretion and oxidative stress by regulating Toll-like receptor-mediated signaling pathways and redox enzymes in adipocytes. Mol Cell Endocrinol 2017; 446:102-110. [PMID: 28216438 DOI: 10.1016/j.mce.2017.02.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/21/2022]
Abstract
Gut microbiota LPS contributes to obesity-related chronic inflammation and oxidative stress, promoting insulin resistance. Periodontal disease also represents a risk factor for type 2 diabetes and is associated with obesity. This study compared the effect of LPS from P. gingivalis periodontopathogen and E. coli enterobacteria on inflammatory adipokine secretion and redox status of 3T3-L1 adipocytes. We found that both LPS activated TLR2- and TLR4-mediated signaling pathways involving MyD88 adaptor and NFκB transcription factor, leading to an increased secretion of leptin, resistin, IL-6 and MCP-1. These effects were partly blocked by inhibitors targeting p38 MAPK, JNK and ERK. Moreover, P. gingivalis LPS reduced adiponectin secretion. Both LPS also enhanced ROS production and the expression of NOX2, NOX4 and iNOS genes. P. gingivalis LPS altered catalase gene expression. Collectively, these results showed that LPS of periodontal bacteria induced pro-inflammatory adipokine secretory profile and oxidative stress in adipocytes which may participate to obesity-related insulin resistance.
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Affiliation(s)
- Fanny Le Sage
- Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Plateforme CYROI, Sainte-Clotilde, F-97490, France; Université de La Réunion, UMR 1188, Sainte-Clotilde, F-97490, France
| | - Olivier Meilhac
- Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Plateforme CYROI, Sainte-Clotilde, F-97490, France; Université de La Réunion, UMR 1188, Sainte-Clotilde, F-97490, France; CHU de La Réunion, Saint-Denis, F-97400, France
| | - Marie-Paule Gonthier
- Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Plateforme CYROI, Sainte-Clotilde, F-97490, France; Université de La Réunion, UMR 1188, Sainte-Clotilde, F-97490, France.
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Kangas S, Timonen P, Knuuttila M, Jula A, Ylöstalo P, Syrjälä AMH. Waist circumference and waist-to-height ratio are associated with periodontal pocketing-results of the Health 2000 Survey. BMC Oral Health 2017; 17:48. [PMID: 28100211 PMCID: PMC5244610 DOI: 10.1186/s12903-017-0336-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease. Methods The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30–49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals. Results Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2–1.9 and in WHtR 1.4, CI: 1.1–1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9–6.1 for WC and 1.9, CI: 0.8–4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets. Conclusion Both central adipose measures—WC and WHtR—seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30–49 years old.
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Affiliation(s)
- Sanna Kangas
- Private Dental Office Viisaudenhammas, Rovaniemi, Finland
| | - Petra Timonen
- Dental Training Clinic, Social and Health Services, Oulu, Finland
| | - Matti Knuuttila
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti Jula
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Ylöstalo
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Periodontology and Geriatric Dentistry, Unit of Oral Health Sciences Research, P.O. Box 5281, FI-90014, Oulu, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.,Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland
| | - Anna-Maija Hannele Syrjälä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Periodontology and Geriatric Dentistry, Unit of Oral Health Sciences Research, P.O. Box 5281, FI-90014, Oulu, Finland.
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P. Kolte A, A. Kolte R, N. Lathiya V. Association between anxiety, obesity and periodontal disease in smokers and non-smokers: A cross-sectional study. J Dent Res Dent Clin Dent Prospects 2016; 10:234-240. [PMID: 28096949 PMCID: PMC5237670 DOI: 10.15171/joddd.2016.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 09/13/2016] [Indexed: 11/09/2022] Open
Abstract
Background. Psychological stress is known to be a relevant risk factor for many inflammatory conditions, including periodontal disease. A few studies have probed the relationship between obesity and periodontal disease. Therefore this cross-sectional study was aimed to examine the relationship between psychological stress and obesity and periodontal disease in smokers and non-smokers. Methods. The participants included 90 patients, equally divided into three groups of non-smokers and periodontally healthy, non-smokers and smokers with untreated moderate-to-severe chronic periodontitis. Socioeconomic data, psychosocial measurements, physical parameters and clinical findings of PPD, CAL, PI and GI were recorded. Results. The clinical parameters were assessed for three groups in three different anxiety levels of mild, moderate and severe. Intra-group comparison of PPD and CAL in the three anxiety levels showed increased periodontal destruction with an increase in anxiety levels, the results being statistically highly significant for PPD differences in smokers (P < 0.0001). The mean differences in PPD and CAL in severe anxiety levels between smokers and non-smokers were 0.68 mm and 0.70 mm and both the findings were statistically significant. The mean PPD and CAL in smoker and non-smoker groups in obese patients was higher as compared to non-obese patients and the differences were highly significant (P < 0.001). Conclusion. The results of our study indicated a positive and strong correlation between anxiety, obesity and periodontal disease in smokers and non-smokers. Smoking appears to further attenuate this association.
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Affiliation(s)
- Abhay P. Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Rajashri A. Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Vrushali N. Lathiya
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
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Akinkugbe AA, Sanders AE, Preisser JS, Cai J, Salazar CR, Beck JD. Environmental tobacco smoke exposure and periodontitis prevalence among nonsmokers in the hispanic community Health Study/Study of Latinos. Community Dent Oral Epidemiol 2016; 45:168-177. [PMID: 27978596 DOI: 10.1111/cdoe.12275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 11/20/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe self-reported exposure to environmental tobacco smoke (ETS) and its association with periodontitis prevalence in a diverse group of Hispanics/Latinos. METHODS Data came from 8675 lifetime nonsmokers in the 2008-2011 Hispanic Community Health Study/Study of Latinos. Exposure to ETS was self-reported, while periodontitis was defined using the Centers for Disease Control and Prevention-American Academy of Periodontology criteria and the proportion of sites affected by clinical attachment level of ≥3 mm or pocket depth of ≥4 mm. Survey logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI). In addition, we assessed whether greater hours of exposure to ETS in the past year was associated with greater periodontitis prevalence, and lastly, we conducted a simple sensitivity analysis of ETS misclassification. RESULTS Age-standardized prevalence estimates (95% CI) for ETS exposure and periodontitis were 57.6% (55.9, 59.4) and 39.8% (38.1, 41.4), respectively. After adjusting for confounders and periodontitis risk factors, we estimated an overall adjusted POR (95% CI) for the ETS-periodontitis association as 1.09 (0.95-1.26) with a confidence limit ratio (CLR) of 1.34. This association varied in magnitude by Hispanic/Latino background, ranging from 1.04 (0.75, 1.43 with a CLR = 1.91) among Central Americans to 1.76 (1.16, 2.66 with a CLR = 2.29) in Puerto Ricans. CONCLUSIONS Previously reported associations between ETS and periodontitis appear weak in this study. However, the magnitude of the association differs according to Hispanic/Latino background.
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Affiliation(s)
- Aderonke A Akinkugbe
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne E Sanders
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christian R Salazar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - James D Beck
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Rosenberg M, Knaan T, Cohen D. Association among Bad Breath, Body Mass Index, and Alcohol Intake. J Dent Res 2016; 86:997-1000. [PMID: 17890678 DOI: 10.1177/154405910708601015] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Bad breath is a common condition, difficult to assess in the general population. In the present study, we tested the hypothesis that a self-administered questionnaire can help identify factors associated with greater risk of oral malodor. Persons (n = 88) undergoing routine medical check-ups completed a questionnaire including 38 questions on general and oral health, dietary habits, and their own oral malodor levels. Oral malodor assessments included odor judge scores, volatile sulfide levels ( via a Halimeter®, Interscan Corp.), and salivary β-galactosidase. Among the questionnaire results, 9 responses were significantly associated with odor judge scores (p < 0.05, unpaired t test), including questions on alcohol intake and body mass index (BMI). Predictions of odor judge scores based on these 9 questions (linear multiple regression analysis) yielded R = 0.601; when introduced together with Halimeter® and β-galactosidase scores, the correlation rose to R = 0.843. The results suggest that alcohol intake and BMI may be factors that help predict oral malodor.
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Affiliation(s)
- M Rosenberg
- Department of Oral Biology, Goldschleger School of Dental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
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Shimazaki Y, Saito T, Yonemoto K, Kiyohara Y, Iida M, Yamashita Y. Relationship of Metabolic Syndrome to Periodontal Disease in Japanese Women: The Hisayama Study. J Dent Res 2016; 86:271-5. [PMID: 17314261 DOI: 10.1177/154405910708600314] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Recent studies have suggested that several systemic conditions—such as obesity, hypertension, hyperlipidemia, and diabetes—are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome—abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level—in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6–16.4) and 4.2 (95% confidence interval = 1.2–14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.
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Affiliation(s)
- Y Shimazaki
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, 3-1-1 Maidashi, Fukuoka, Japan.
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ASSI SP, PIRES JR, PONTES AEF, BARROSO EM, ZUZA EP. Oral conditions and body weight in children from a public school in Manaus, AM, Brazil. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.09816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Some studies have pointed to links between the prevalence of caries and periodontal disease, and the occurrence of overweight or obesity; but, few studies have been conducted in children. Objective To assess the relationship between periodontal disease, tooth decay and body weight in children from a public school in Manaus, AM, Brazil. Material and method The study included one hundred and sixty-nine children. Records were obtained of decayed, missing and filled (DMFT) permanent teeth, and of decayed, extracted, or filled (DEF) deciduous teeth, as well as the record of the community periodontal index (CPI). The classification of body weight category was obtained in percentile using the z-Score table. Result Higher averages of weight and body mass index (BMI) were seen in the overweight and obesity groups (p<0.05). All groups were similar regarding the DMFT /DEF and CPI codes from 0 to 4 (p>0.05). All groups showed higher averages of CPI 0 in comparison with other CPI codes from 1 to 4 (p<0.05), and most of the children showed sites with probing depth <3.5 mm and without bleeding on probing. Conclusion There was no relationship between body weight and the occurrence of dental caries and periodontal disease in the studied population. Obesity and overweight showed no negative influence on the increase in the prevalence of these diseases.
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Affiliation(s)
- Samara Pinho ASSI
- Centro Universitário da Fundação Educacional de Barretos, Brasil; Faculdade do Amazonas, Brasil
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Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, Inflammation, and Periodontal Disease. J Dent Res 2016; 86:400-9. [PMID: 17452558 DOI: 10.1177/154405910708600503] [Citation(s) in RCA: 249] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The prevalence of obesity has increased substantially over the past decades in most industrialized countries. Obesity is a systemic disease that predisposes to a variety of co-morbidities and complications that affect overall health. Cross-sectional studies suggest that obesity is also associated with oral diseases, particularly periodontal disease, and prospective studies suggest that periodontitis may be related to cardiovascular disease. The possible causal relationship between obesity and periodontitis and potential underlying biological mechanisms remain to be established; however, the adipose tissue actively secretes a variety of cytokines and hormones that are involved in inflammatory processes, pointing toward similar pathways involved in the pathophysiology of obesity, periodontitis, and related inflammatory diseases. We provide an overview of the definition and assessment of obesity and of related chronic diseases and complications that may be important in the periodontist’s office. Studies that have examined the association between obesity and periodontitis are reviewed, and adipose-tissue-derived hormones and cytokines that are involved in inflammatory processes and their relationship to periodontitis are discussed. Our aim is to raise the periodontist’s awareness when treating obese individuals.
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Affiliation(s)
- N Pischon
- Dept. of Periodontology, Charité University Medical Center, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
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