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Hensel ALJ, Nicholson K, Anderson KK, Gomaa NA. Biopsychosocial factors in oral and systemic diseases: a scoping review. FRONTIERS IN ORAL HEALTH 2024; 5:1378467. [PMID: 38872985 PMCID: PMC11169703 DOI: 10.3389/froh.2024.1378467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background The association between chronic oral diseases and other major systemic health conditions, commonly referred to as the oral-systemic health connection, has been previously studied with several underlying common risk factors and pathways linking both groups of diseases. Psychosocial factors contribute to an increased susceptibility to chronic oral and non-oral diseases. The aim of this review is to summarize the current state of knowledge on the role of psychosocial stress in chronic oral and systemic diseases. Methods A search strategy was built and a literature search was conducted using four databases (CINAHL, Embase, Medline, PsycINFO). A combination of search terms related to psychosocial stress, systemic disease, and oral conditions were used. Studies were eligible for inclusion if they included human adults (aged 18 years and older), included psychosocial factors as an exposure measure, and outcome measures of both an oral and systemic condition. Only English-language articles were considered. Pilot testing of the data extraction form and calibration were conducted and data were extracted independently by one researcher. Results A total of fifteen articles out of eighty full-text articles screened were determined to be eligible for inclusion in this review. Periodontal disease was the most commonly studied oral disease, measured in 53% of included articles, with the most commonly studied systemic diseases being of mental health conditions (40%) and diabetes (47%). Psychosocial stress was measured using a range of psychometric indicators and/or biomarkers, including perceived stress, individual behaviours, childhood adversity, and cortisol. In total, fourteen studies found a positive association between measures of psychosocial stress and oral-systemic health. Conclusion Psychosocial stress may be a common contributor to both chronic oral and non-oral diseases.
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Affiliation(s)
- Abby L. J. Hensel
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kathryn Nicholson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kelly K. Anderson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
| | - Noha A. Gomaa
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
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Bijla M, Saini SK, Pathak AK, Bharadwaj KP, Sukhavasi K, Patil A, Saini D, Yadav R, Singh S, Leeuwenburgh C, Kumar P. Microbiome interactions with different risk factors in development of myocardial infarction. Exp Gerontol 2024; 189:112409. [PMID: 38522483 DOI: 10.1016/j.exger.2024.112409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/10/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
Among all non-communicable diseases, Cardiovascular Diseases (CVDs) stand as the leading global cause of mortality. Within this spectrum, Myocardial Infarction (MI) strikingly accounts for over 15 % of all deaths. The intricate web of risk factors for MI, comprising family history, tobacco use, oral health, hypertension, nutritional pattern, and microbial infections, is firmly influenced by the human gut and oral microbiota, their diversity, richness, and dysbiosis, along with their respective metabolites. Host genetic factors, especially allelic variations in signaling and inflammatory markers, greatly affect the progression or severity of the disease. Despite the established significance of the human microbiome-nutrient-metabolite interplay in associations with CVDs, the unexplored terrain of the gut-heart-oral axis has risen as a critical knowledge gap. Moreover, the pivotal role of the microbiome and the complex interplay with host genetics, compounded by age-related changes, emerges as an area of vital importance in the development of MI. In addition, a distinctive disease susceptibility and severity influenced by gender-based or ancestral differences, adds a crucial insights to the association with increased mortality. Here, we aimed to provide an overview on interactions of microbiome (oral and gut) with major risk factors (tobacco use, alcohol consumption, diet, hypertension host genetics, gender, and aging) in the development of MI and therapeutic regulation.
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Affiliation(s)
- Manisha Bijla
- Department of Biotechnology, Guru Nanak Dev University, Amritsar, India
| | - Sunil Kumar Saini
- Department of Zoology, Swami Shraddhanand College, Delhi University, India
| | - Ajai Kumar Pathak
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia; Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | | | - Katyayani Sukhavasi
- Department of Cardiac Surgery and The Heart Clinic, Tartu University Hospital & Department of Cardiology, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Ayurshi Patil
- ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Diksha Saini
- ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Rakesh Yadav
- Department of Cardiology, AIIMS, New Delhi, India
| | - Shalini Singh
- ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | | | - Pramod Kumar
- ICMR-National Institute of Cancer Prevention and Research, Noida, India.
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Ghanem AS, Németh O, Móré M, Nagy AC. Role of oral health in heart and vascular health: A population-based study. PLoS One 2024; 19:e0301466. [PMID: 38635852 PMCID: PMC11025934 DOI: 10.1371/journal.pone.0301466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/17/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND AND AIM Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors. MATERIALS AND METHODS Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings' validity. RESULTS Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01-2.77]); dental prosthetics had an OR of 1.45 [1.20-1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09-1.81]). CONCLUSIONS Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health's role in multidisciplinary disease management.
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Affiliation(s)
- Amr Sayed Ghanem
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Marianna Móré
- Institute of Social and Sociological Sciences, Faculty of Health Sciences, University of Debrecen, Nyíregyháza, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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Huh Y, Yoo JE, Park S, Han K, Kim SM, Park HS, Cho KH, Ahn J, Jun SH, Nam GE. Association of Dental Diseases and Oral Hygiene Care With the Risk of Heart Failure in Patients With Type 2 Diabetes: A Nationwide Cohort Study. J Am Heart Assoc 2023; 12:e029207. [PMID: 37548156 PMCID: PMC10492939 DOI: 10.1161/jaha.122.029207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/27/2023] [Indexed: 08/08/2023]
Abstract
Background To evaluate the association of dental diseases and oral hygiene care with incidence of heart failure (HF) among patients with type 2 diabetes. Methods and Results This study included 173 927 patients with type 2 diabetes aged ≥40 years, who underwent Korean National Health Insurance Service health examinations in 2008 and were followed up until the end of 2017. Hazard ratios (HRs) and 95% CIs for HF were estimated using multivariable Cox proportional hazards regression analysis. During a median follow-up of 9.3 years, 1.94% of participants developed HF. An increased number of missing teeth was associated with a higher risk of HF (P<0.001). HRs of HF increased among individuals with ≥15 missing teeth (HR, 1.37 [95% CI, 1.14-1.64]) compared with those without missing teeth. Decreased risk of HF was observed in individuals with ≥1 time/year of professional dental cleaning (HR, 0.93 [95% CI, 0.87-0.99]) and in those with ≥2 times/d of toothbrushing (HR, 0.90 [95% CI, 0.82-0.98]) compared with those without these practices. While combined presence of missing teeth and periodontal disease (P=0.004) or dental caries (P=0.007) increased HF risk, combined oral hygiene care was associated with further HF risk reduction (P=0.024). Better oral hygiene care was associated with decreased HF risk, even as the number of missing teeth increased (P<0.001). Conclusions Among patients with type 2 diabetes, dental diseases and oral hygiene care are important determinants of HF development. Dental disease management and good oral care may prevent HF in patients with type 2 diabetes.
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Affiliation(s)
- Youn Huh
- Department of Family MedicineUijeongbu Eulji Medical CenterEulji UniversityUijeongbuGyeonggi‐doRepublic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam CenterSeoul National University HospitalSeoulRepublic of Korea
| | - Sang‐Hyun Park
- Department of Medical StatisticsCollege of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulRepublic of Korea
| | - Seon Mee Kim
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Hye Soon Park
- Department of Family MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Kyung Hwan Cho
- Department of Family MedicineKorea University Anam HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Jin‐Soo Ahn
- Department of Dental Biomaterials Science and Dental Research InstituteSchool of DentistrySeoul National UniversitySeoulRepublic of Korea
| | - Sang Ho Jun
- Department of Oral & Maxillofacial SurgeryKorea University Anam HospitalSeoulRepublic of Korea
| | - Ga Eun Nam
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
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Self-Reported Gum Bleeding, Perception, Knowledge, and Behavior in Working-Age Hong Kong Chinese-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095749. [PMID: 35565144 PMCID: PMC9103544 DOI: 10.3390/ijerph19095749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022]
Abstract
Gingivitis and periodontitis are highly prevalent in Hong Kong, where the provision of oral health services is predominantly private. This cross-sectional study aimed to investigate the association between the oral symptoms of gum bleeding and self-reported behavioral factors, beliefs, and knowledge among Hong Kong Chinese. The research team commissioned the Public Opinion Programme of The University of Hong Kong to conduct a structured, population-based, computer-assisted telephone interview (CATI), which covered questions related to the demography, perception, and knowledge (including traditional Cantonese beliefs) of gum health, dental attendance, oral health behavior, and dental anxiety. A total of 1,265 individuals aged 25−60 years old were successfully contacted, and 704 (55.7%) reported prior gum bleeding experience. A total of 516 individuals (64.9% females, median 55−60 years) completed the CATI satisfactorily, and 321 (62.2%) experienced gum bleeding in the past 12 months. The factors that were significantly associated with reports of gum bleeding in the past 12 months include having periodontitis, sensitive teeth, having tertiary or higher education, flossing/interdental cleaning, not cleaning teeth well enough, lack of sleep, consuming too much ‘heaty’ food, avoiding going to the dentist when gums are bleeding, and waiting for gum bleeding to subside (p < 0.05, r2 =0.198; forward stepwise logistic regression). Within the limitations of this study, approximately half of the Hong Kong working-age adults surveyed reported experiencing gum bleeding, and 62.2% of the participants experienced it within the past 12 months. Members of Hong Kong’s working-age population who reported having higher levels of education appeared more readily aware of their gum problems. Those with bleeding gums, especially those who have discernable periodontitis, poor dental awareness/behaviors, and/or a poor lifestyle should be targeted to receive education and encouragement, which will allow them to take action and improve their own gum health.
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Jiang W, Chen H, Liao J, Yang X, Yang B, Zhang Y, Pan X, Lian L, Yang L. The short-term effects and burden of particle air pollution on hospitalization for coronary heart disease: a time-stratified case-crossover study in Sichuan, China. Environ Health 2022; 21:19. [PMID: 35045878 PMCID: PMC8767695 DOI: 10.1186/s12940-022-00832-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/11/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Coronary heart disease (CHD), the leading cause of death globally, might be developed or exacerbated by air pollution, resulting high burden to patients. To date, limited studies have estimated the relations between short-term exposure to air pollution and CHD disease burden in China, with inconsistent results. Hence, we aimed to estimate the short-term impact and burden of ambient PM pollutants on hospitalizations of CHD and specific CHD. METHODS PM10 and PM2.5 were measured at 82 monitoring stations in 9 cities in Sichuan Province, China during 2017-2018. Based on the time-stratified case-crossover design, the effects of short-term exposure to particle matter (PM) pollution on coronary heart disease (CHD) hospital admissions were estimated. Meanwhile, the linked burden of CHD owing to ambient PM pollution were estimated. RESULTS A total of 104,779 CHD records were derived from 153 hospitals from these 9 cities. There were significant effects of PM pollution on hospital admissions (HAs) for CHD and specific CHD in Sichuan Province. A 10 μg/m3 increase of PM10 and PM2.5 was linked with a 0.46% (95% CI: 0.08, 0.84%), and 0.57% (95% CI: 0.05, 1.09%) increments in HAs for CHD at lag7, respectively. The health effects of air pollutants were comparable modified by age, season and gender, showing old (≥ 65 years) and in cold season being more vulnerable to the effects of ambient air pollution, while gender-specific effects is positive but not conclusive. Involving the WHO's air quality guidelines as the reference, 1784 and 2847 total cases of HAs for CHD could be attributable to PM10 and PM2.5, separately. The total medical cost that could be attributable to exceeding PM10 and PM2.5 were 42.04 and 67.25 million CNY from 2017 to 2018, respectively. CONCLUSIONS This study suggested that the short-term exposure to air pollutants were associated with increased HAs for CHD in Sichuan Province, which could be implications for local environment improvement and policy reference.
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Affiliation(s)
- Wanyanhan Jiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Han Chen
- State Key Laboratory of Grassland and Agro-ecosystem, School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Jiaqiang Liao
- West China School of Public Health, Sichuan University, No. 17 People's South Road, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Xi Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Biao Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xiaoqi Pan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lulu Lian
- Collaborative Innovation Center for Western Ecological Safety, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Raju K, Taylor GW, Tahir P, Hyde S. Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review. BMC Endocr Disord 2021; 21:205. [PMID: 34663281 PMCID: PMC8524900 DOI: 10.1186/s12902-021-00830-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults. BACKGROUND Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status. MATERIAL AND METHODS Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements. RESULTS Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. CONCLUSIONS/PRACTICAL IMPLICATIONS This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.
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Affiliation(s)
- Karen Raju
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - Peggy Tahir
- University of California, UCSF Library, 530 Parnassus Ave, San Francisco, CA 94143-0840 USA
| | - Susan Hyde
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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Boese S, Gill HS. Coated floss for drug delivery into the gum pocket. Int J Pharm 2021; 606:120855. [PMID: 34224840 DOI: 10.1016/j.ijpharm.2021.120855] [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: 03/06/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to develop a drug-coated floss to allow delivery of therapeutics into diseased gum pocket. Periodontal (gum) disease affects nearly 45% of adults over 30 years of age. Bacterial persistence makes treatment challenging. Drug-coated floss is expected to provide a self-administrable and targeted method for drug delivery into the diseased gum pockets. We investigated various types of floss and sutures as potential candidates to coat drug. An un-waxed nylon braided floss was selected and dip-coated with model hydrophilic and hydrophobic drugs either in free form or after encapsulation in poly(lactic-co-glycolic acid) particles. By tuning the drug concentration or the number of times a floss is dipped into the coating solution we were able to coat from as little as 0.4 μg to as high as 1.6 mg of drug. Coated floss was passed within the gum pocket of excised porcine mandibles to demonstrate delivery efficiency up to 91%. Utilizing the porcine jaw in an ex-vivo condition we illustrated the ability of the delivered drug to diffuse into the tissue. Overall, the data illustrates the potential of coated floss as an innovative modality for drug delivery to the gum pocket.
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Affiliation(s)
- Seth Boese
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Harvinder Singh Gill
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA.
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Osugue R, Castro dos Santos NC, Araujo CF, de Almeida FX, Feres M, Santamaria MP. Periodontitis Is Associated With Risk of Conventional Stent Restenosis: Pilot Case-Control Study. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.673626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Percutaneous coronary angioplasty with stent implantation has been established as the main form of treatment of atherosclerosis. However, 16 to 44% of patients may evolve with stent restenosis. Periodontitis is an inflammatory condition associated with bacterial infection, that may lead to periodontal tissue destruction and tooth loss. This study aimed to evaluate the association between stent restenosis and periodontitis.Materials and Methods: Coronary angiography exams presenting stent imaging with and without restenosis were analyzed. Patients meeting the inclusion and exclusion criteria were selected and allocated in 2 groups: case (restenosis) and control (without restenosis). We evaluated if systemic and periodontal variables were predictors of restenosis (primary outcome) using a multivariable stepwise logistic regression. Additionally, we compared clinical and periodontal conditions between the control and case groups (secondary outcomes) using Chi-square test and ANOVA test.Results: Data from 49 patients (case n = 15; control n = 34) were analyzed. The results showed that stages III and IV periodontitis and lack of physical activity were significant predictors of stent restenosis (OR 5.82 and 5.98, respectively). Comparisons regarding the diagnosis of periodontal conditions between control and case groups did not present significant differences in the incidence of periodontitis and alveolar bone loss.Conclusion: Stages III and IV periodontitis increased the incidence of stent restenosis. These findings suggest that advanced stages of periodontal disease might lead to the occurrence of negative outcomes after coronary angioplasty with stent placement.
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Meisel P, Nauck M, Kocher T. Individual predisposition and the intricate interplay between systemic biomarkers and periodontal risk in a general population. J Periodontol 2021; 92:844-853. [PMID: 33315240 DOI: 10.1002/jper.20-0591] [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: 08/04/2020] [Revised: 10/16/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Increasing age is associated with systemic diseases as well as with periodontal diseases. We wondered whether a biological age score constructed exclusively from systemic biomarkers would reflect periodontal risk factors at baseline and tooth loss as well as periodontal outcome during 10 years follow-up. METHODS From the Study of Health in Pomerania (SHIP) 2256 participants (1072 male, 1184 female) were studied for the relationship of the systemic biomarkers glycated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL), fibrinogen, white blood cell count, blood pressure, and waist circumference to their age. Construction of a biological age (BA) score allowed its comparison with the participants' actual chronological age (CA) and their predisposition to periodontal disease. RESULTS Though nearly identical in CA, participants appearing younger than their true age had a significantly reduced burden of periodontal risk factors. If BA > CA, then risk factors were more frequent including smoking, oral hygiene, dental visits, education, and income. After 10 years, in participants with identical CA, tooth loss followed their BA calculated at baseline, that is, with BA > CA fewer teeth were preserved. Similarly, periodontal measures varied according to BA; sex differences were obvious. Most significant were BA-related differences in inflammatory and anthropometry parameters. CONCLUSIONS The results support the assumption that risk profiles aggregated in BA constitute a characteristic susceptibility pattern unique to each individual, common to both systemic and periodontal diseases. Although BA was constructed exclusively from systemic measures at baseline, BA reflects the oral conditions at follow-up.
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Affiliation(s)
- Peter Meisel
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Diagnostics, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
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Zardawi F, Gul S, Abdulkareem A, Sha A, Yates J. Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited. Front Cardiovasc Med 2021; 7:625579. [PMID: 33521070 PMCID: PMC7843501 DOI: 10.3389/fcvm.2020.625579] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/17/2020] [Indexed: 01/15/2023] Open
Abstract
Atherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, it has been suggested that improvement in the condition of one disease positively impact the condition of the other one. Highlighting the association between these two diseases, the importance of early diagnosis and treatment of PD and its impact on cardiovascular status may be of great value in reducing the complications associated with ACVDs. Further in vitro and in vivo studies with longer follow up are necessary to confirm the causal relationship between PD and ACVDs.
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Affiliation(s)
- Faraedon Zardawi
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Sarhang Gul
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Ali Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Aram Sha
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Julian Yates
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
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Lindsey ML, Deleon-Pennell KY, Bradshaw AD, Larue RAC, Anderson DR, Thiele GM, Baicu CF, Jones JA, Menick DR, Zile MR, Spinale FG. Focusing Heart Failure Research on Myocardial Fibrosis to Prioritize Translation. J Card Fail 2020; 26:876-884. [PMID: 32446948 PMCID: PMC7584737 DOI: 10.1016/j.cardfail.2020.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 01/05/2023]
Abstract
Heart failure (HF) has traditionally been defined by symptoms of fluid accumulation and poor perfusion, but it is now recognized that specific HF classifications hold prognostic and therapeutic relevance. Specifically, HF with reduced ejection fraction is characterized by reduced left ventricular systolic pump function and dilation and HF with preserved ejection fraction is characterized primarily by abnormal left ventricular filling (diastolic failure) with relatively preserved left ventricular systolic function. These forms of HF are distributed equally among patients with HF and likely require distinctly different strategies to mitigate the morbidity, mortality, and medical resource utilization of this disease. In particular, HF is a significant medical issue within the US Department of Veterans Affairs (VA) hospital system and constitutes a major translational research priority for the VA. Because a common underpinning of both HF with reduced ejection fraction and HF with preserved ejection fraction seems to be changes in the structure and function of the myocardial extracellular matrix, a conference was convened sponsored by the VA, entitled, "Targeting Myocardial Fibrosis in Heart Failure" to explore the extracellular matrix as a potential therapeutic target and to propose specific research directions. The conference was conceptually framed around the hypothesis that although HF with reduced ejection fraction and HF with preserved ejection fraction clearly have distinct mechanisms, they may share modifiable pathways and biological mediators in common. Inflammation and extracellular matrix were identified as major converging themes. A summary of our discussion on unmet challenges and possible solutions to move the field forward, as well as recommendations for future research opportunities, are provided.
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Affiliation(s)
- Merry L Lindsey
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska; Research Service, Nebraska-Western Iowa Health Care System, Omaha, Nebraska.
| | - Kristine Y Deleon-Pennell
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Amy D Bradshaw
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - R Amanda C Larue
- Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina; Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Daniel R Anderson
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Geoffrey M Thiele
- Research Service, Nebraska-Western Iowa Health Care System, Omaha, Nebraska; Division of Rheumatology and Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Catalin F Baicu
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Jeffrey A Jones
- Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina; Department of Surgery, Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Donald R Menick
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Michael R Zile
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Francis G Spinale
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine, Columbia, SC and William Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina
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14
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Porphyromonas gingivalis disrupts vascular endothelial homeostasis in a TLR-NF-κB axis dependent manner. Int J Oral Sci 2020; 12:28. [PMID: 32999278 PMCID: PMC7527479 DOI: 10.1038/s41368-020-00096-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 08/15/2020] [Accepted: 08/23/2020] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease is still the leading cause of mortality worldwide. Vascular endothelial dysfunction is viewed as the initial step of most cardiovascular diseases. Many studies have indicated that periodontal pathogens, especially Porphyromonas gingivalis, are closely correlated with vascular endothelial homeostasis, but the function of P. gingivalis and the underlying mechanisms are still elusive. To illuminate the effects and elucidate the mechanisms of P. gingivalis on endothelial structural integrity, we developed P. gingivalis infection models in vivo and in vitro. Endothelial cell proliferation, differentiation and apoptosis were detected. Here, we showed that P. gingivalis can impair endothelial integrity by inhibiting cell proliferation and inducing endothelial mesenchymal transformation and apoptosis of endothelial cells, which reduce the cell levels and cause the endothelium to lose its ability to repair itself. A mechanistic analysis showed that TLR antagonist or NF-κB signalling inhibitor can largely rescue the damaged integrity of the endothelium caused by P. gingivalis, suggesting that TLR-NF-κB signalling plays a vital role in vascular endothelial homeostasis destroyed by P. gingivalis. These results suggest a potential intervention method for the prevention and treatment of cardiovascular disease.
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Abstract
PURPOSE OF THE REVIEW The purpose of this review is to provide an update on the data regarding periodontitis and its association with cardiovascular disease (CVD), as well as a closer look at the connection between periodontitis and valvular heart disease. RECENT FINDINGS The body of literature that demonstrates an association between periodontitis and CVD is growing, and there is increasing evidence that periodontal disease (PD) can have negative cardiovascular effects. Far less data is available for the management of periodontitis specifically in those with valvular heart disease. However, recent studies suggest that routine preoperative dental evaluation practices may not be necessary in all patients and, similar to changes in antibiotic prophylaxis, may only be indicated for a select group of individuals. There is a strong association between PD and CVD, although a causal relationship is yet to be elucidated. Further data is needed in this regard, as well as in determining the appropriate management of PD in those with valvular heart disease.
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Affiliation(s)
- Sahar Naderi
- Division of Cardiology, Kaiser Permanente, 2238 Geary Boulevard 8th Floor, San Francisco, CA, 94115, USA.
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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16
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Herrera D, Molina A, Buhlin K, Klinge B. Periodontal diseases and association with atherosclerotic disease. Periodontol 2000 2020; 83:66-89. [PMID: 32385870 DOI: 10.1111/prd.12302] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases still account for the majority of deaths worldwide, although significant improvements in survival, after being affected by cardiovascular disease, have been achieved in the last decades. Periodontal diseases are also a common global burden. Several studies have shown a link between cardiovascular disease and periodontitis, although evidence is still lacking regarding the direct cause-effect relation. During the 2012 "Periodontitis and systemic diseases" workshop, the available evidence on the association between cardiovascular and periodontal diseases was discussed, covering biologic plausibility and clinical studies. The objective of the present narrative review was to update the previous reviews presented at the 2012 workshop, following similar methodological approaches, aiming to critically assess the available evidence. With regard to biologic plausibility, two aspects were reviewed: (a) for microbiologic mechanisms, assessing periodontal bacteria as a contributing factor to atherosclerosis based on seven "proofs," substantial evidence was found for Proofs 1 through 6, but not for Proof 7 (periodontal bacteria obtained from human atheromas can cause atherosclerosis in animal models), concluding that periodontal pathogens can contribute to atherosclerosis; (b) mechanistic studies, addressing five different inflammatory pathways that could explain the links between periodontitis and cardiovascular disease with the addition of some extra pathways , suggest an association between both entities, based on the presence of higher levels of these inflammatory markers in patients with periodontitis and cardiovascular disease, vs healthy controls, as well as on the evidence that periodontal treatment reduces serum levels of these mediators. When evidence from clinical studies was analyzed, two aspects were covered: (a) epidemiologic studies support the estimation that the incidence of atherosclerotic disease is higher in individuals with periodontitis than in individuals with no reported periodontitis, irrespective of many common risk factors, but with a substantial variability in the definitions used in reporting of exposure to periodontal diseases in different studies; (b) intervention trials have shown that periodontal therapy can reduce serum inflammatory mediators, improve the lipids profile, and induce positive changes in other cardiovascular disease surrogate measures, but no evidence is available to support that adequate periodontal therapy is able to reduce the risk for cardiovascular diseases, or the incidence of cardiovascular disease events in periodontitis patients.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Kare Buhlin
- Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bjorn Klinge
- Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
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Nomura Y, Kakuta E, Okada A, Otsuka R, Shimada M, Tomizawa Y, Taguchi C, Arikawa K, Daikoku H, Sato T, Hanada N. Effects of self-assessed chewing ability, tooth loss and serum albumin on mortality in 80-year-old individuals: a 20-year follow-up study. BMC Oral Health 2020; 20:122. [PMID: 32316955 PMCID: PMC7175538 DOI: 10.1186/s12903-020-01113-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/13/2020] [Indexed: 12/16/2022] Open
Abstract
Background The association between dental status and mortality in community-dwelling older adults has been documented by several studies. The aim of this study was to analyze the contribution of self-assessed chewing ability, number of remaining teeth and serum albumin levels to mortality and the interactions between the three factors. Methods A 20-year follow-up study was conducted with 666 subjects aged 80 years (from 1996 to 2017) who resided in the 8 areas served by one health center in Iwate Prefecture. Health check-ups including physical fitness measurements were conducted at a meeting place or gymnasium. Medical interview and blood sampling were conducted by physician. Oral examination was examined by dentist. The number of remaining teeth, serum albumin levels, and self-assessed chewing ability were used as predictors of mortality. Results Among the 608 subjects (233 men and 375 women) included in this study, only 12 subjects (1.97%) survived after 20 years of follow-up. For men, dental status and serum levels of albumin were significantly associated with mortality. The hazard ratios of self-assessed chewing ability calculated by item response theory analysis and the inability to chew at least one food adjusted for serum albumin and tooth conditions were statistically significant in men. When adjusted by health status evaluated by blood tests, self-assessed chewing ability was statistically significant in men. According to path analysis, self-assessed chewing ability and serum albumin independently affected mortality in men. Conclusion Masticatory dysfunction may be an important risk factor for mortality in men, even though it was self-assessed. Retaining chewing ability might be a useful predictor of longevity in older male adults.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
| | - Erika Kakuta
- Department of Oral bacteriology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
| | - Ayako Okada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Mieko Shimada
- Chiba Prefecture University of Health Sciences, Chiba, Japan
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Chieko Taguchi
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Kazumune Arikawa
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | | | | | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
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18
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Dwibedi N, Wiener RC, Findley PA, Shen C, Sambamoorthi U. Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States: 2016 Behavioral Risk Factor Surveillance System survey. J Am Dent Assoc 2019; 151:735-744.e1. [PMID: 31732091 DOI: 10.1016/j.adaj.2019.07.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 06/24/2019] [Accepted: 07/23/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Adults with chronic respiratory conditions, specifically asthma or chronic obstructive pulmonary disease (COPD), may be at risk of experiencing poor oral health due to systemic inflammation, challenges in routine oral health care, and adverse effects of medications used to treat these conditions. The authors examined the association of asthma, COPD, and coexisting asthma and COPD (asthma-COPD overlap syndrome [ACOS]) with tooth loss among US adults. METHODS The authors conducted a cross-sectional study using 2016 Behavioral Risk Factor Surveillance System data (N = 387,217). The authors categorized the participants with missing permanent teeth into 4 groups: asthma only (n = 38,817), COPD only (n = 19,819), ACOS (n = 13,494), no asthma, no COPD (n = 315,087). The authors used adjusted multinomial logistic regressions to examine the associations between asthma and COPD categories and tooth loss. RESULTS According to the authors, 5.3% of study participants reported they were edentulous; 10.7% reported 6 or fewer missing teeth. Participants with asthma only, COPD only, and ACOS had higher odds of reporting tooth loss (6 or more teeth) than those in the no asthma, no COPD group; adjusted odds ratios were 1.12 (95% confidence interval, 1.00 to 1.26) to 2.04 (95% confidence interval, 1.85 to 2.26). A lower percentage of participants with COPD and ACOS visited dentists in the past year than those with no asthma and no COPD. Interactive associations suggested participants with asthma or COPD with dental visits were less likely to report edentulism than those with neither asthma nor COPD and no dental visits. CONCLUSIONS Participants with asthma or COPD had higher odds of tooth loss compared with those with neither asthma nor COPD. PRACTICAL IMPLICATIONS People with asthma or COPD should maintain routine dental visits to reduce the risk of experiencing tooth loss.
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19
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Kim K, Choi S, Chang J, Kim SM, Kim SJ, Kim RJY, Cho HJ, Park SM. Severity of dental caries and risk of coronary heart disease in middle-aged men and women: a population-based cohort study of Korean adults, 2002-2013. Sci Rep 2019; 9:10491. [PMID: 31324851 PMCID: PMC6642137 DOI: 10.1038/s41598-019-47029-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/26/2019] [Indexed: 11/09/2022] Open
Abstract
We aimed to evaluate the risk of coronary heart disease (CHD) according to dental caries status in middle-aged patients using a population-based cohort database containing medical/dental claims, health examination, and death records in the Republic of Korea. A total of 234,597 patients were identified in the database who were without history of cardiovascular disease, including 104,638 patients without dental caries, 41,696 with incipient/moderate stage dental caries, and 88,262 advanced/severe dental caries. We used Cox proportional hazards model adjusted for sociodemographic, lifestyle, and medical characteristics to compute hazard ratio (HR) and 95% confidence intervals (95% CI) for CHD according to severity of dental caries. During 1,491,190 person-years of follow-up, there were a total of 6,015 CHD events. After adjustment for potential confounders, patients in the highest quartile of outpatient visits for advanced/severe stage dental caries was associated with an increase in CHD risk (HR = 1.13; 95% CI: 1.04-1.22) as compared with patients without dental caries. When the analysis was restricted to the patients with advanced/severe dental caries, dose-response relationship between number of outpatient visits for dental caries and risk of CHD was observed (Ptrend: <0.001). Prevention and control of dental caries might be worth promoting in clinical practice to prevent CHD.
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Affiliation(s)
- Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Seon Jip Kim
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ryan Jin-Young Kim
- Department of Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea. .,Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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20
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Chen C, Feng X, Li YT, Zhang Q, Jin YS. Development and validation of a self-management ability questionnaire for patients with chronic periodontitis. Int J Nurs Sci 2019; 6:259-265. [PMID: 31508444 PMCID: PMC6722469 DOI: 10.1016/j.ijnss.2019.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 05/21/2019] [Accepted: 06/11/2019] [Indexed: 12/03/2022] Open
Abstract
Objective This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis. Methods A questionnaire was developed through theoretical research, literature review, semi-structured interview, and expert consultation. A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling. Validity and reliability were analyzed. Results The questionnaire consisted of 24 items. Exploratory factor analysis identified three principal factors, which explained 66.949% of the total variance. The item-level content validity was between 0.800 and 1.000, and the scale-level content validity was 0.969. The coefficient of correlation between the gold standard and the whole questionnaire was 0.869. Cronbach's α of the whole questionnaire was 0.931, and the test–retest reliability coefficient was 0.825. Conclusion The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity. It is useful for clinical work to measure self-management among patients with chronic periodontitis.
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Affiliation(s)
- Chen Chen
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue Feng
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yan-Ting Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qi Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ying-Shu Jin
- Stomatological Hospital, Tianjin Medical University, Tianjin, China
- Corresponding author. Department of Nursing, Stomatological Hospital, Tianjin, 300070, China.
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Strömberg N, Esberg A, Sheng N, Mårell L, Löfgren-Burström A, Danielsson K, Källestål C. Genetic- and Lifestyle-dependent Dental Caries Defined by the Acidic Proline-rich Protein Genes PRH1 and PRH2. EBioMedicine 2017; 26:38-46. [PMID: 29191562 PMCID: PMC5832611 DOI: 10.1016/j.ebiom.2017.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/10/2017] [Accepted: 11/20/2017] [Indexed: 12/27/2022] Open
Abstract
Dental caries is a chronic infectious disease that affects billions of people with large individual differences in activity. We investigated whether PRH1 and PRH2 polymorphisms in saliva acidic proline-rich protein (PRP) receptors for indigenous bacteria match and predict individual differences in the development of caries. PRH1 and PRH2 variation and adhesion of indigenous and cariogenic (Streptococcus mutans) model bacteria were measured in 452 12-year-old Swedish children along with traditional risk factors and related to caries at baseline and after 5-years. The children grouped into low-to-moderate and high susceptibility phenotypes for caries based on allelic PRH1, PRH2 variation. The low-to-moderate susceptibility children (P1 and P4a−) experienced caries from eating sugar or bad oral hygiene or infection by S. mutans. The high susceptibility P4a (Db, PIF, PRP12) children had more caries despite receiving extra prevention and irrespective of eating sugar or bad oral hygiene or S. mutans-infection. They instead developed 3.9-fold more caries than P1 children from plaque accumulation in general when treated with orthodontic multibrackets; and had basic PRP polymorphisms and low DMBT1-mediated S. mutans adhesion as additional susceptibility traits. The present findings thus suggest genetic autoimmune-like (P4a) and traditional life style (P1) caries, providing a rationale for individualized oral care. Allelic PRH1, PRH2 variation group children into high, moderate and low susceptibility phenotypes for caries. Low susceptibility phenotypes experience caries from eating sugar and bad oral hygiene and infection by cariogenic S. mutans. High susceptibility phenotypes may represent an autoimmune condition susceptible to bacteria in general.
Dental caries is a chronic infectious disease affecting billions of people with large individual differences in activity. The present study provides the first evidence of variation in specific human genes, PRH1 and PRH2, that matches and predicts individual experiences with caries in children. The high susceptibility phenotype (Db, PIF, PRP12) suggests an autoimmune-like condition, whereas those with low susceptibility (PIF2, PRP12) experiences caries from eating sugar and bad oral hygiene. These genetic and traditional life style sub types of caries suggest novel approaches for their diagnosis, prevention and treatment.
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Affiliation(s)
- Nicklas Strömberg
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden.
| | - Anders Esberg
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Nongfei Sheng
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Lena Mårell
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden
| | | | - Karin Danielsson
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Carina Källestål
- Department of Odontology/Cariology, Umeå University, SE-901 87 Umeå, Sweden; Department of Women's and Children's Health/International Maternal and Child Health, Uppsala University, SE-751 85 Uppsala, Sweden
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22
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Rijkschroeff P, Loos BG, Nicu EA. Impaired polymorphonuclear neutrophils in the oral cavity of edentulous individuals. Eur J Oral Sci 2017; 125:371-378. [PMID: 28833699 PMCID: PMC5601278 DOI: 10.1111/eos.12367] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 12/29/2022]
Abstract
Oral health is characterized by functional oral polymorphonuclear neutrophils (oPMNs). Edentulism might be associated with a loss of oPMNs because these cells enter the oral cavity primarily through the gingival crevices. The main aim of this study was to investigate the numbers of oPMNs in rinse samples obtained from edentulous (n = 21) and dentate (n = 20) subjects. A second study aim was to investigate possible differences between oPMNs and peripheral blood polymorphonuclear neutrophils (cPMNs). Apoptosis/necrosis and cell-activation markers (CD11b, CD63 and CD66b) were analyzed using flow cytometry. Reactive oxygen species (ROS) production was determined either without stimulation (constitutive) or in response to 10 μM phorbol myristate acetate or Fusobacterium nucleatum. The edentulous subjects presented with lower oPMN counts and higher percentages of apoptotic/necrotic oPMNs compared with dentate subjects. Furthermore, oPMNs from edentulous donors expressed low levels of all three activation markers and low constitutive ROS. In contrast, oPMNs from dentate subjects expressed high levels of all three activation markers and a higher level of constitutive ROS than cPMNs. When challenged, oPMNs from edentulous subjects showed no upregulation in ROS production, whereas oPMNs from dentate subjects retained their ability to respond to stimulation. The functional characteristics of cPMNs were comparable between edentulous and dentate subjects. This study demonstrates that despite having functional cPMNs, edentulous subjects have low oPMN numbers that are functionally impaired.
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Affiliation(s)
- Patrick Rijkschroeff
- Department of PeriodontologyAcademic Centre for Dentistry AmsterdamAmsterdamthe Netherlands
| | - Bruno G. Loos
- Department of PeriodontologyAcademic Centre for Dentistry AmsterdamAmsterdamthe Netherlands
| | - Elena A. Nicu
- Department of PeriodontologyAcademic Centre for Dentistry AmsterdamAmsterdamthe Netherlands
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23
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Esberg A, Sheng N, Mårell L, Claesson R, Persson K, Borén T, Strömberg N. Streptococcus Mutans Adhesin Biotypes that Match and Predict Individual Caries Development. EBioMedicine 2017; 24:205-215. [PMID: 28958656 PMCID: PMC5652290 DOI: 10.1016/j.ebiom.2017.09.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 12/21/2022] Open
Abstract
Dental caries, which affects billions of people, is a chronic infectious disease that involves Streptococcus mutans, which is nevertheless a poor predictor of individual caries development. We therefore investigated if adhesin types of S.mutans with sucrose-independent adhesion to host DMBT1 (i.e. SpaP A, B or C) and collagen (i.e. Cnm, Cbm) match and predict individual differences in caries development. The adhesin types were measured in whole saliva by qPCR in 452 12-year-old Swedish children and related to caries at baseline and prospectively at a 5-year follow-up. Strains isolated from the children were explored for genetic and phenotypic properties. The presence of SpaP B and Cnm subtypes coincided with increased 5-year caries increment, and their binding to DMBT1 and saliva correlated with individual caries scores. The SpaP B subtypes are enriched in amino acid substitutions that coincided with caries and binding and specify biotypes of S. mutans with increased acid tolerance. The findings reveal adhesin subtypes of S. mutans that match and predict individual differences in caries development and provide a rationale for individualized oral care. Adhesin subtypes of Streptococcus mutans match and predict individual caries development. Adhesin binding to salivary DMBT1 correlates with individual caries scores. The adhesin types coincide with distinct biotypes of S. mutans.
Dental caries, which affects billions of people, involves the bacterium Streptococcus mutans, which is nevertheless a poor predictor of caries development. The present findings provide the first evidence that S. mutans adhesin subtypes match and predict individual 5-year caries development in Swedish children. The binding strength of the adhesin subtypes correlates with individual caries scores, and the adhesin subtypes specify biotypes of S. mutans that also differ in acid tolerance. The present findings provide a rationale for individualized oral care and improved systemic health because chronic caries infection and carrying high-virulence strains pose a systemic disease risk.
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Affiliation(s)
- Anders Esberg
- Department of Odontology/cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Nongfei Sheng
- Department of Odontology/cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Lena Mårell
- Department of Odontology/cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Rolf Claesson
- Department of Odontology/cariology, Umeå University, SE-901 87 Umeå, Sweden
| | - Karina Persson
- Department of Chemistry, Umeå University, SE-901 87 Umeå, Sweden
| | - Thomas Borén
- Department of Medical Biochemistry and Biophysics, Umeå University, SE-901 87 Umeå, Sweden
| | - Nicklas Strömberg
- Department of Odontology/cariology, Umeå University, SE-901 87 Umeå, Sweden.
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Gittaboyina S, Koduganti RR, Aedula SD, Panthula VNR, Jammula SP, Dasari R, Gireddy H, Ambati M. Estimation of Pentraxin 3 and Porphyromonas Gingivalis Levels in Patients with Rheumatoid Arthritis and Periodontitis- An Observational Study. J Clin Diagn Res 2017; 11:ZC09-ZC12. [PMID: 28658898 PMCID: PMC5483800 DOI: 10.7860/jcdr/2017/24412.9792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/20/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Periodontal diseases are inflammatory in nature involving interplay between the bacterial plaque and the micro-organisms, with the response of the host playing a pivotal role in either attenuating or eliminating the disease. Rheumatoid Arthritis (RA) is also a chronic inflammatory disease which shares common risk factors with periodontitis. Porphyromonas Gingivalis and Pentraxin 3 (an acute inflammatory protein) have been observed to be associated with both the diseases. AIM This study was done to determine if there was any association between Pophyromonas Gingivalis and Pentraxin 3 levels in patients with RA and Chronic Periodontitis in comparison with Healthy controls. MATERIALS AND METHODS This observational study was conducted on 90 subjects (42 Males and 48 Females) aged between 30-60 years. The subjects were selected from the out patient ward of a tertiary referral care hospital. The selected subjects were equally divided into three groups. Group I: Comprising of 30 patients with RA and chronic periodontitis who were in turn, subdivided into Group I- A (n=15) -Patients just diagnosed with RA and Group I- B (n=15) Patients under medications for more than three months. Group II: Patients with Chronic Periodontitis (n=30) and Group III: Healthy Controls (n=30) Intergroup comparison for continuous data was done by One-way analysis of variance test followed by Bonferroni's post-hoc test. Intragroup comparison for continuous data was done by paired t-test. RESULTS Intergroup comparison between Group I and Group II did not show any statistical difference pertaining to the clinical parameters except for the Gingival Index (GI) which was found to be higher in Group II (Mean= 2.07) when compared to Group I (Mean=1.59). Intragroup comparison between Group IA and Group IB was statistically significant for GI, Plaque Index (PI), and Clinical Attachment Levels (CAL). Intragroup comparison between Group I-A and Group I-B showed that both Porphyromonas gingivalis and Pentraxin 3 Levels were higher in Group I- A. CONCLUSION In this study, it was observed that there was a positive association between Porphyromonas gingivalis and Pentraxin 3 levels in patients with rheumatoid arthritis and periodontitis.
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Affiliation(s)
- Shankar Gittaboyina
- Postgraduate Student, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Rekha Rani Koduganti
- Professor and Head, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Srisaila Datta Aedula
- Professor and Head, Department of Rheumatology, KIMS, Secunderabad, Hyderabad, Telangana, India
| | - Veerendra Nath Reddy Panthula
- Professor, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Surya Prasanna Jammula
- Professor, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Rajashree Dasari
- Reader, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Himabindu Gireddy
- Reader, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Manasa Ambati
- Senior Lecturer, Department of Periodontics, Panineeya Mahavidhyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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Sayar F, Akhondi N, Fallah S, Moalemnia AA, Cheraghi A. Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status. J Periodontol 2017; 88:457-463. [DOI: 10.1902/jop.2016.160366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ferena Sayar
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
| | - Nasrin Akhondi
- Department of Mathematics, South Tehran Branch, Islamic Azad University
| | | | | | - Azra Cheraghi
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
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Wu YC, Lin LK, Song CJ, Su YX, Tu YK. Comparisons of periodontal regenerative therapies: A meta-analysis on the long-term efficacy. J Clin Periodontol 2017; 44:511-519. [PMID: 28278363 DOI: 10.1111/jcpe.12715] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
AIM We conducted a meta-analysis for the long-term differences in treatment outcomes between periodontal regeneration therapies and flap operation. METHODS A systematic literature search was conducted using the EMBASE, PubMed and Cochrane databases up to June 2016. Treatment outcomes were changes in probing pocket depth and clinical attachment level. We extracted data reported at different time points after periodontal surgery and incorporated all data into the same model. The restricted cubic spline regression was used to estimate the non-linear trend in treatment outcomes. As some studies reported outcomes at multiple time points, we considered several correlation structures for data reported by the same study. RESULTS A total of 52 randomized controlled trials were included in our longitudinal meta-analysis. The follow-up length ranged from 0.5 year to 10 years. The trends in the treatment outcomes were similar under different correlation structures. Enamel matrix derivatives (EMD) and guided tissue regeneration (GTR) achieved greater probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain than flap operation (FO) in the long-term follow up, but no differences were found between EMD and GTR. CONCLUSION Compared with FO, periodontal regeneration surgeries achieved greater PPD reduction and gain in CAL after 1 year, and its effects may last for 5-10 years.
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Affiliation(s)
- Yun-Chun Wu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Liang-Ko Lin
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Cheng-Jie Song
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Xuan Su
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Cao X, Wang D, Zhou J, Yuan H, Chen Z. Relationship between dental caries and metabolic syndrome among 13 998 middle-aged urban Chinese. J Diabetes 2017; 9:378-385. [PMID: 27147550 DOI: 10.1111/1753-0407.12424] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The association between dental caries and metabolic syndrome (MetS) is inconsistent. The aim of the present study was to assess the relationship between dental caries and MetS and its components in a middle-aged Chinese population. METHODS A cross-sectional analysis was performed of 13 998 participants aged 45-65 years undergoing a health check during 2013-14. An index variable of decayed, missing, and filled teeth (DMFT) was calculated. Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) after adjustment for sex, age, education level, dietary habits, alcohol use, smoking, physical activity, and periodontitis. RESULTS Of the 13 998 participants, 6164 had dental caries and 7834 did not; 3571 had MetS, whereas 10 427 did not. Participants with severe caries showed a higher prevalence of MetS, abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia than those with mild or no caries (all P < 0.01). Adjusted ORs for MetS for those with two or more dental caries and those with two or more DMFT were 1.12 (95 % CI 1.14-1.74) and 1.09 (95 % CI, 0.89-1.21), respectively (P trend < 0.001). Stratified analysis by individual MetS components showed that caries were associated with MetS among subjects with hyperglycemia (OR 1.14 [95%CI, 0.98-1.34]; P < 0.001). However, there was no significant relationship between caries and abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure (adjusted ORs [95 % CIs] 0.98 [0.82-1.16], 1.01 [0.85-1.19], 0.84 [0.70-1.00], and 0.96 [0.86-1.13], respectively; all P > 0.05). CONCLUSIONS Dental caries were associated with MetS among middle-aged Chinese in the present study.
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Affiliation(s)
- Xia Cao
- Department of Health Management, The Third Xiangya Hospital, Changsha, China
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, State University of New York, Upstate Medical University, Syracuse, New York, USA
| | - Jiansong Zhou
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong Yuan
- Department of Clinical Pharmacology Center, The Third Xiangya Hospital, Changsha, China
| | - Zhiheng Chen
- Department of Health Management, The Third Xiangya Hospital, Changsha, China
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Holmlund A, Lampa E, Lind L. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease. J Dent Res 2017; 96:768-773. [PMID: 28363032 DOI: 10.1177/0022034517701901] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P < 0.001). When adjusting for calendar time, age, sex, educational level, smoking, and baseline values for bleeding on probing, probing pocket depth >4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.
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Affiliation(s)
- A Holmlund
- 1 Department of Periodontology, County Hospital of Gävle; Center for Research and Development, Uppsala University/Region of Gävleborg, Gävle, Sweden
| | - E Lampa
- 2 Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - L Lind
- 2 Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Aarabi G, Zeller T, Seedorf H, Reissmann D, Heydecke G, Schaefer A, Seedorf U. Genetic Susceptibility Contributing to Periodontal and Cardiovascular Disease. J Dent Res 2017; 96:610-617. [DOI: 10.1177/0022034517699786] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Periodontal disease (PD) and coronary artery disease (CAD) are common diseases characterized by an overaggressive inflammatory response to diverse stimuli. Whereas PD leads to destruction of the tooth-supporting structures, CAD is a chronic inflammatory condition ultimately causing myocardial infarction via narrowing and occluding of blood vessels. Classical twin studies led to the conclusion that both complex diseases have a similar degree of heritability and that a significant fraction of the genetic factors accounting for this heritability is shared. Recent genome-wide association and large-scale candidate gene studies highlight that variations in >50 genes are associated with premature CAD, while variations in only 4 genes showing nominally significant associations with aggressive periodontitis and/or chronic periodontitis have so far been identified. Remarkably, 3 of the PD loci (75%) show shared associations with CAD ( ANRIL/CDKN2B-AS1, PLG, CAMTA1/VAMP3), suggesting involvement of common pathogenic mechanisms. In this critical review, we highlight recent progress in identifying genetic markers and variants associated with PD, present their overlap with CAD, and discuss functional aspects. In addition, we answer why a significant fraction of the heritability of PD is still missing, and we suggest approaches that may be taken to close the gap.
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Affiliation(s)
- G. Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T. Zeller
- Department of General and Interventional Cardiology, University Heart Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | - H. Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D.R. Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G. Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A.S. Schaefer
- Department of Periodontology and Synoptic Dentistry, Center of Dento-Maxillo-Facial Medicine, Charité–Universitätsmedizin Berlin, Research Center ImmunoSciences, Berlin, Germany
| | - U. Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Joshy G, Arora M, Korda RJ, Chalmers J, Banks E. Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172 630 participants from the prospective 45 and Up Study. BMJ Open 2016; 6:e012386. [PMID: 27577588 PMCID: PMC5013478 DOI: 10.1136/bmjopen-2016-012386] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/23/2016] [Accepted: 08/05/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the relationship between oral health and incident hospitalisation for ischaemic heart disease (IHD), heart failure (HF), ischaemic stroke and peripheral vascular disease (PVD) and all-cause mortality. DESIGN Prospective population-based study of Australian men and women aged 45 years or older, who were recruited to the 45 and Up Study between January 2006 and April 2009; baseline questionnaire data were linked to hospitalisations and deaths up to December 2011. Study exposures include tooth loss and self-rated health of teeth and gums at baseline. SETTING New South Wales, Australia. PARTICIPANTS Individuals aged 45-75 years, excluding those with a history of cancer/cardiovascular disease (CVD) at baseline; n=172 630. PRIMARY OUTCOMES Incident hospitalisation for IHD, HF, ischaemic stroke and PVD and all-cause mortality. RESULTS During a median follow-up of 3.9 years, 3239 incident hospitalisations for IHD, 212 for HF, 283 for ischaemic stroke and 359 for PVD, and 1908 deaths, were observed. Cox proportional hazards models examined the relationship between oral health indicators and incident hospitalisation for CVD and all-cause mortality, adjusting for potential confounding factors. All-cause mortality and incident CVD hospitalisation risk increased significantly with increasing tooth loss for all outcomes except ischaemic stroke (ptrend<0.05). In those reporting no teeth versus ≥20 teeth left, risks were increased for HF (HR, 95% CI 1.97, 1.27 to 3.07), PVD (2.53, 1.81 to 3.52) and all-cause mortality (1.60, 1.37 to 1.87). The risk of IHD, PVD and all-cause mortality (but not HF or ischaemic stroke) increased significantly with worsening self-rated health of teeth and gums (ptrend<0.05). In those reporting poor versus very good health of teeth and gums, risks were increased for IHD (1.19, 1.03 to 1.38), PVD (1.66, 1.13 to 2.43) and all-cause mortality (1.76, 1.50 to 2.08). CONCLUSIONS Tooth loss and, to a lesser extent, self-rated health of teeth and gums, are markers for increased risk of IHD, PVD and all-cause mortality. Tooth loss is also a marker for increased risk of HF.
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Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Manish Arora
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
- Department of Preventive Medicine and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rosemary J Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - John Chalmers
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- The Sax Institute, Sydney, New South Wales, Australia
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Kamak G, Yildirim E, Rencber E. Evaluation of the relationship between periodontal risk and carotid artery calcifications on panoramic radiographs. Eur J Dent 2016; 9:483-489. [PMID: 26929685 PMCID: PMC4745228 DOI: 10.4103/1305-7456.172614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective: To evaluate if there is a relationship between findings of carotid artery calcification (CAC) and periodontal risk in nonsmoker subjects by using panoramic radiographs (DPR). Materials and Methods: A total of 1146 DPRs were investigated. Gender, age, severity of bone loss, tooth loss, periodontal risk, and findings of carotid calcification were recorded. The periodontal risk was evaluated and classified according to the degree of alveolar bone loss. Results: CAC was diagnosed in %13.6 (n: 156) of DPRs. Of 1146 patients, 338 (29.5%) had low, 668 (60%) had moderate, and 120 (10.5%) had high periodontal risk. A statistically significant relation was observed between carotid calcification and periodontal risk. Conclusion: Positive findings of carotid calcification may be related with periodontal problems. Clinicians must be careful about diagnosing CACs on DPRs during routine examinations. In the case of positive findings of CAC and periodontitis together, the patient may be consulted to a specialist for further investigation.
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Affiliation(s)
- Gulen Kamak
- Department of Periodontology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkiye
| | - Eren Yildirim
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkiye
| | - Emin Rencber
- Department of Public Health, School of Medicine, Ondokuz Mayıs University, Samsun, Turkiye
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Affiliation(s)
- E E van der Wall
- Netherlands Society of Cardiology/Holland Heart House, Moreelsepark 1, 3511 EP, Utrecht, The Netherlands.
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33
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Pussinen PJ, Könönen E. Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association? Eur J Prev Cardiol 2016; 23:834-8. [PMID: 26915578 DOI: 10.1177/2047487316636506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of Turku and City of Turku, Welfare Division, Turku, Finland
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Vedin O, Hagström E, Budaj A, Denchev S, Harrington RA, Koenig W, Soffer J, Sritara P, Stebbins A, Stewart RH, Swart HP, Viigimaa M, Vinereanu D, Wallentin L, White HD, Held C. Tooth loss is independently associated with poor outcomes in stable coronary heart disease. Eur J Prev Cardiol 2015; 23:839-46. [PMID: 26672609 DOI: 10.1177/2047487315621978] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/21/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We investigated associations between self-reported tooth loss and cardiovascular outcomes in a global stable coronary heart disease cohort. METHODS We examined 15,456 patients from 39 countries with stable coronary heart disease (prior myocardial infarction, prior revascularisation or multivessel coronary heart disease) in the STABILITY trial. At baseline, patients reported number of teeth (26-32 (all), 20-25, 15-19, 1-14 and no teeth) and were followed for 3.7 years. Cox regression models adjusted for cardiovascular risk factors and socioeconomic status, determined associations between tooth loss level (26-32 teeth: lowest level; no teeth: highest level) and cardiovascular outcomes. RESULTS After adjustment, every increase in tooth loss level was associated with an increased risk of the primary outcome, the composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke (hazard ratio 1.06; 95% confidence interval 1.02-1.10), cardiovascular death (1.17; 1.10-1.24), all-cause death (1.16; 1.11-1.22) and non-fatal or fatal stroke (1.14; 1.04-1.24), but not with non-fatal or fatal myocardial infarction (0.99; 0.94-1.05). Having no teeth, compared to 26-32 teeth, entailed a significantly higher risk of the primary outcome (1.27 (1.08, 1.49)), cardiovascular death (1.85 (1.45, 2.37), all-cause death (1.81 (1.50, 2.20)) and stroke (1.67 (1.15, 2.39)). CONCLUSIONS In this large global cohort of patients with coronary heart disease, self-reported tooth loss predicted adverse cardiovascular outcomes and all-cause death independent of cardiovascular risk factors and socioeconomic status.
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Affiliation(s)
- Ola Vedin
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Andrzej Budaj
- Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
| | - Stephan Denchev
- Clinic of Cardiology, Medical Institute of Ministry of Interior, Sofia, Bulgaria
| | | | - Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany Deutsches Herzzentrum München, Technische Universität München, Munich, Germany DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Joseph Soffer
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, Pennsylvania, USA
| | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amanda Stebbins
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - Ralph Ha Stewart
- Green Lane Cardiovascular Service, Auckland City Hospital and University of Auckland, Auckland, New Zealand
| | - Henk P Swart
- Department of Cardioresearch, Antonius Ziekenhuis Sneek, The Netherlands
| | - Margus Viigimaa
- Tallinn University of Technology, North Estonia Medical Centre, Tallinn, Estonia
| | - Dragos Vinereanu
- University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania
| | - Lars Wallentin
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Harvey D White
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Claes Held
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
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Kulkarni V, Uttamani JR, Bhatavadekar NB. Comparison of clinical periodontal status among habitual smokeless-tobacco users and cigarette smokers. Int Dent J 2015; 66:29-35. [PMID: 26581836 DOI: 10.1111/idj.12192] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIM Investigating the comparative effect of cigarette smoking and smokeless-tobacco use on periodontal health. BACKGROUND There is a dearth of studies comparing the effects of smoking and smokeless tobacco on periodontal health. Smokeless tobacco is emerging as a major public health hazard, but is often neglected as a risk factor by many clinicians. MATERIALS AND METHODS A cross-sectional study of 286 subjects was conducted. The participants were divided into mutually exclusive groups (i.e. any subject who had the habit of both smoking as well as smokeless tobacco usage was excluded from the study), as follows: a smoking group (SG; n=121); a smokeless-tobacco group (ST; n=81); and a non-tobacco-consuming group (NT; n=84). Data were obtained using a questionnaire and by clinical examination. The Periodontal Disease Index (PDI) and Oral Hygiene Index-Simplified (OHI-S) were used to clinically evaluate the periodontal and dental health status of the subjects. Multivariate analysis was performed to identify statistical correlations. RESULTS The Plaque Index was higher in the ST group than in the SG group and was statistically significantly higher in the ST group than in the NT group. Probing depth and gingival inflammation (components of the PDI) were also higher in the ST group than in the SG and NT groups, but this was not statistically significant. CONCLUSIONS Within the limits of the study, and for this study population, the impact on the periodontium as a result of smokeless tobacco use appeared to be comparable with that of smoking tobacco. The results of this study affirm the need to consider smokeless tobacco as a possible contributory factor to periodontal disease, in addition to smoking, and to counsel patients accordingly. Further randomised clinical trials are necessary to validate the long-term impact of smokeless tobacco on periodontal disease.
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Affiliation(s)
- Varun Kulkarni
- Department of Periodontics, University of Illinois at Chicago, Chicago, IL, USA
| | - Juhi Raju Uttamani
- Department of Periodontics, University of Illinois at Chicago, Chicago, IL, USA
| | - Neel B Bhatavadekar
- Clarus Dental Specialities, Pune, India.,University of Texas Health Science Center, Houston, TX, USA
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Friman G, Hultin M, Nilsson GH, Wårdh I. Medical screening in dental settings: a qualitative study of the views of authorities and organizations. BMC Res Notes 2015; 8:580. [PMID: 26478099 PMCID: PMC4610051 DOI: 10.1186/s13104-015-1543-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/05/2015] [Indexed: 01/01/2023] Open
Abstract
Background The practice of identifying individuals with undiagnosed diabetes mellitus type II or undiagnosed hypertension by medical screening in dental settings has been received positively by both patients and dentistry professionals. This identification has also shown to be cost-effective by achieving savings and health benefits, but no investigation has been made of the attitudes of authorities and organizations. The aim of this study was to describe the views of authorities and organizations. Results Thirteen authorities and organizations were interviewed of the sample of 20 requested. Seven approached authorities and organizations did not believe it was relevant to participate in the study. The manifest analysis resulted in four categories: medical screening ought to be established in the society; dentistry must have relevant competence to perform medical screening; medical screening requires cooperation between dentistry and health care; and dentistry is not the only context where medical screening could be performed. The latent analysis resulted in an emerging theme: positive to, but uncertain about, the concept of medical screening in dental settings. The spokespersons for the approached authorities and organizations had a positive view of medical screening but the respondents experienced a lack of facts concerning the scientific communities’ position, guidelines and procedures in the topic. Conclusions and implications Approached authorities and organizations generally had a positive view of medical screening in dental settings but were uncertain about the concept. Further scientific knowledge and guidelines concerning the topic are needed before it can be commonly introduced and additional research on implementation strategies and long-term follow-up of medical screening are needed.
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Affiliation(s)
- Göran Friman
- Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institutet, Stockholm, Sweden. .,Department of Health and Environmental Sciences, Karlstad University, Karlstad, Sweden.
| | - Margareta Hultin
- Department of Dental Medicine/Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
| | - Inger Wårdh
- Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institutet, Stockholm, Sweden.
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Oluwagbemigun K, Dietrich T, Pischon N, Bergmann M, Boeing H. Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years. PLoS One 2015; 10:e0123879. [PMID: 25945503 PMCID: PMC4422697 DOI: 10.1371/journal.pone.0123879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/23/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of dental status is associated with incident chronic diseases in a cohort setting. METHODS We conducted a cohort study among 24,313 middle-aged Germans followed up for 13 years. Data on number of teeth as a measure of dental status were obtained through self-reports. Outcomes were clinically-verified incident non-fatal myocardial infarction, stroke, type 2 diabetes mellitus, and cancer. Hazard ratio (HR) and 95% confidence intervals (CI) were obtained from Cox regression models. RESULTS Increasing number of teeth is inversely related to risk of myocardial infarction (HR: 0.97; 95% CI: 0.96, 0.99). The full multivariate model of teeth groups showed a strong linear trend for myocardial infarction, a less strong trend for stroke, and no relation with type 2 diabetes mellitus and cancer in a competing risk model. Participants with 18-23 teeth and those without teeth were at 76% (95%CI: 1.04, 3) and 2.93 times (95%CI: 1.61, 5.18) higher risk of myocardial infarction compared to those with nearly all teeth (28-32 teeth). CONCLUSIONS Number of teeth is specifically associated with myocardial infarction and not with other chronic disease indicating that dental status further strengthens the link between oral health and cardiovascular diseases.
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Affiliation(s)
- Kolade Oluwagbemigun
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
| | - Thomas Dietrich
- Department of Oral Surgery, the School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Nicole Pischon
- Department of Periodontology, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam–Nuthetal, Germany
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Aarabi G, Eberhard J, Reissmann DR, Heydecke G, Seedorf U. Interaction between periodontal disease and atherosclerotic vascular disease--Fact or fiction? Atherosclerosis 2015; 241:555-60. [PMID: 26100678 DOI: 10.1016/j.atherosclerosis.2015.04.819] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/22/2015] [Accepted: 04/30/2015] [Indexed: 12/23/2022]
Abstract
C-reactive protein (CRP) level is associated with the 10-year risk of an atherosclerotic vascular disease (ASVD), suggesting presence of systemic inflammation probably long before ASVD is present. Where, however, does this systemic inflammation come from? One active area of research has been the study of dental infection and various forms of periodontal disease (PD), both of which are highly prevalent in populations at risk for ASVD. Recent data show that ASVD and PD interact with each other via systemic release of specific pro- and anti-inflammatory cytokines, small signal molecules and enzymes which modulate initiation and progression of the chronic inflammatory reaction involved in both diseases. In addition, periodontal pathogens were identified within atherosclerotic lesions and thrombi isolated from myocardial infarction patients. LDL cholesterol, a strong risk factor for ASVD, is also associated with PD; and statins, used to treat ASVD, are also active to prevent or reduce PD. Finally, there is growing evidence for common genetic susceptibility factors involved in both diseases. These findings support commonalities with respect to the pathogenic mechanisms involved in both inflammatory diseases. Conversely, a causative relationship cannot yet be concluded in the absence of data from large longitudinal cohort and randomized controlled intervention trials.
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Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Jörg Eberhard
- Periimplant and Oral Infections, Department of Prosthetic Dentistry and Biomaterial Sciences, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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Ardila CM, Perez-Valencia AY, Rendon-Osorio WL. Tannerella forsythia is associated with increased levels of atherogenic low density lipoprotein and total cholesterol in chronic periodontitis. J Clin Exp Dent 2015; 7:e254-60. [PMID: 26155342 PMCID: PMC4483333 DOI: 10.4317/jced.52128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/05/2015] [Indexed: 12/29/2022] Open
Abstract
Background Accumulating evidence suggests that acute and chronic infections with periodontopathogens are associated with an increased risk of cardiovascular disease. The objective of this study was to assess whether Tanerella forsythia and Porphyromonas gingivalis are associated with increased levels of atherogenic low-density lipoprotein (LDL), high-density lipoprotein, total cholesterol (TC), triglycerides and body mass index (BMI) in chronic periodontitis patients. Material and Methods Medical history and clinical and radiographic examination were conducted in 80 chronic periodontitis patients and 28 healthy individuals. Fasting blood samples were drawn for the measurement of the parameters of dyslipidemia. Anthropometric measurements such as height in meters and weight in kilograms were recorded. Both periodontitis and control subjects were asked to answer a questionnaire with regard to their socio-demographic and smoking status. The presence of T. forsythia, and P. gingivalis was detected using primers designed to target the respective 16S rRNA gene sequences. Results The occurrence of T. forsythia and P. gingivalis was higher in the group of subjects with periodontitis. Superior levels of triglycerides were observed in chronic periodontitis patients compared to healthy individuals. High levels of TC in periodontitis persons were significantly associated with increased bleeding on probing. Greater mean levels of TC and LDL were shown in the presence of T. forsythia (P<0.05). Likewise, higher proportions of patients with BMI ≥25 kg/m2 related with T. forsythia (P<0.05). T. forsythia was a significant discriminating factor in the multivariate linear regression model emerging as significant explanatory of increased levels of TC (β=17,879, 95% CI = 4,357-31,401; p=0.01) and LDL (β=17,162, 95% CI= 4,009-30,316; p=0.01). Conclusions Higher levels of serum total cholesterol and LDL were observed in the occurrence of T. forsythia and the presence of this periodontopathogen may increase the atherogenic potency of low-density lipoprotein that may augment the risk for atherosclerosis in periodontal disease patients. Key words:Periodontitis, dyslipidemia, Tannerella forsythia, cardiovascular disease.
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Affiliation(s)
- Carlos M Ardila
- Periodontist. Ph.D in Epidemiology, Biomedical Stomatology Group, Universidad de Antioquia U de A, Medellín, Colombia, Department of Periodontology, School of Dentistry, Universidad de Antioquia
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Largest study of its kind connects tooth loss with heart disease. Br Dent J 2014; 216:612. [DOI: 10.1038/sj.bdj.2014.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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