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Iwasaki M, Ohta Y, Furusho N, Kakuta S, Muraoka K, Ansai T, Awano S, Fukuhara M, Nakamura H. Association between oral frailty and nutritional status among hemodialysis patients aged ≥50 years. Geriatr Gerontol Int 2024. [PMID: 39091075 DOI: 10.1111/ggi.14947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/21/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
AIM Malnutrition is a prevalent health issue among hemodialysis patients. Oral frailty, a condition characterized by impairments in multiple oral health aspects and functions, has been associated with nutritional status in the general population. We aimed to determine whether oral frailty was associated with nutritional status in hemodialysis patients aged ≥50 years. Our secondary aim was to determine the prevalence of oral frailty in this population. METHODS This cross-sectional study included hemodialysis patients who were admitted to a single medical center. According to the Oral Frailty 5-item Checklist, oral frailty is characterized by the presence of two or more of the following criteria: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Patients' nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Multivariable ordinal logistic regression analysis was performed to assess the association between oral frailty and nutritional status (classified into three categories according to the GNRI: >98, 92-98, and <92). RESULTS In total, 152 hemodialysis patients (55 women and 97 men) with a mean age of 70.4 years were included. The prevalence of oral frailty was 61.2%. After adjusting for health characteristics and sociodemographic background, oral frailty was associated with poor nutritional status according to the GNRI (odds ratio = 2.04, 95% confidence interval = 1.02-4.09). CONCLUSIONS In this study, approximately 60% of hemodialysis patients aged ≥50 years exhibited oral frailty, and hemodialysis patients with oral frailty had poor nutritional status according to the GNRI. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuko Ohta
- Division of General Internal Medicine, Kyushu Dental University, Fukuoka, Japan
| | | | - Satoko Kakuta
- Division of Community Oral Health Development, Kyushu Dental University, Fukuoka, Japan
| | - Kosuke Muraoka
- Department of Clinical Education Development and Research, Kyushu Dental University, Fukuoka, Japan
| | - Toshihiro Ansai
- Division of Community Oral Health Development, Kyushu Dental University, Fukuoka, Japan
| | - Shuji Awano
- Department of Clinical Education Development and Research, Kyushu Dental University, Fukuoka, Japan
| | - Masayo Fukuhara
- Division of General Internal Medicine, Kyushu Dental University, Fukuoka, Japan
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Aminoshariae A, Nosrat A, Jakovljevic A, Jaćimović J, Narasimhan S, Nagendrababu V. Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-analyses. J Endod 2024:S0099-2399(24)00364-9. [PMID: 38945200 DOI: 10.1016/j.joen.2024.06.012] [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: 02/19/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality. METHODS A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias, and sensitivity analysis were performed. RESULTS Twelve articles met the eligibility criteria with an overall "Good" quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio was 1.66 (95% CI: 1.32-2.09), and there was high heterogeneity (I2 = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (P = .626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (hazard ratio = 1.52, 95% CI: 1.28-1.80), (I2 51.82%). CONCLUSION The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.
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Affiliation(s)
- Anita Aminoshariae
- Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio.
| | - Ali Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland
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Li W, Li T, Wei Y, Chen X, Lin S, Lin L. Associations of periodontitis with risk of all-cause and cause-specific mortality among us adults with chronic kidney disease. J Dent 2023; 138:104712. [PMID: 37741502 DOI: 10.1016/j.jdent.2023.104712] [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: 08/17/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVES To investigate the associations of periodontitis with risk of all-cause and cause-specific mortality in a nationally representative sample of adults with chronic kidney disease (CKD) in the United States. METHODS This prospective cohort study included 4,271 individuals aged ≥30 years at baseline with CKD participants in the National Health and Nutrition Examination Survey (NHANES) during 1988-1994, 1999-2004, and 2009-2014. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 and/or urinary albumin/creatinine ratio (uACR) ≥30 mg/g. Multivariate cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of all-cause and cause-specific mortality in participants with CKD according to periodontitis. The associations of the quartiles of mean clinical attachment loss (CAL) and mean periodontal probing depth (PPD) levels with mortality were examined using the first quartile as the reference group. RESULTS During a median of 8.67 years of follow-up, 2,146 deaths were documented. After multivariate adjustments, moderate/severe periodontitis was significantly associated with all-cause (HR:1.28; 95 % CI:1.11-1.47; P = 0.001) and cardiovascular disease (CVD)-related mortality (HR:1.44; 95 % CI:1.14-1.81; P = 0.002) in participants with CKD. Compared with the reference group of mean CAL and mean PPD levels, all-cause (CAL: HR, 1.58; 95 % CI, 1.32-1.89, P <0.001; PPD: HR, 1.35, 95 % CI, 1.09-1.67, P = 0.011) and CVD-related mortality (CAL: HR, 1.70, 95 % CI, 1.21-2.40, P = 0.001) were increased for participants in the highest quartile. CONCLUSIONS This study suggests that moderate/severe periodontitis and high levels of mean CAL and mean PPD are associated with an increased risk of all-cause mortality, and moderate/severe periodontitis and mean CAL associated with CVD-related mortality among adults with CKD in the US. CLINICAL SIGNIFICANCE This study details the association between periodontitis and the increased risk of all-cause mortality and CVD-related mortality in a large, representative sample of adults with CKD.
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Affiliation(s)
- Weiqi Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Scissences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, PR China
| | - Tian Li
- Department of Prosthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, PR China
| | - Yingming Wei
- Department of Oral Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou, Zhejiang, PR China
| | - Xuzhuo Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Shanfeng Lin
- Department of Oroamxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, PR. China
| | - Li Lin
- Department of Periodontology, School of Stomatology, China Medical University, Shenyang, Liaoning, PR. China.
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Lu J, Li H, Wang S. Interaction effect of psoriasis and chronic kidney disease on the risk of all-cause mortality: a prospective cohort study of NHANES data. Nephrol Dial Transplant 2023; 38:2474-2484. [PMID: 37173279 DOI: 10.1093/ndt/gfad089] [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: 11/21/2022] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The association between psoriasis, chronic kidney disease (CKD) and mortality remains unclear. This study aimed to examine the combined impact of psoriasis and CKD on mortality in a representative sample of US adults. METHODS The data for this analysis came from 13 208 participants of the National Health and Nutrition Examination Survey conducted between 2003-06 and 2009-14. Psoriasis was determined through self-reported questionnaire data, while CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or urinary albumin to creatinine ratio (UACR) ≥30 mg/g. A four-level variable was created using the information on psoriasis and CKD, and survival probability was estimated using the Kaplan-Meier method. The survival analysis was conducted using weighted Cox proportional hazards regression models. RESULTS In a 9.83-year average follow-up period, 539 deaths occurred, with a prevalence of psoriasis in CKD at 2.94% and an all-cause mortality rate of 33.30%. In the multivariable analyses, individuals with both psoriasis and CKD had hazard ratios (HRs) of 5.38 (95% CI 2.43-11.91) for all-cause mortality compared with those with neither psoriasis nor CKD. Participants with both psoriasis and low eGFR had an HR of 6.40 (95% CI 2.01-20.42), while those with both psoriasis and albuminuria had an HR of 5.30 (95% CI 2.24-12.52). A significant interaction between psoriasis, CKD and all-cause mortality was found in the fully adjusted model (P = .026), and a significant synergistic effect between psoriasis and albuminuria was discovered (P = .002). However, the interaction effects between psoriasis, low eGFR and all-cause mortality were only observed in the unadjusted model (P = .036). CONCLUSIONS Screening for psoriasis in individuals at risk for developing CKD may help in risk stratification for all-cause mortality related to psoriasis. The assessment of UACR may be useful in identifying psoriasis at increased risk for all-cause mortality.
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Affiliation(s)
- Jian Lu
- Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Han Li
- Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shixiang Wang
- Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Fan T, Guo K, Cao F, Deng Z, Liu B, Shi M, Liu Y, Ma Z. Study on the effect of periodontitis on renal tissue in atherosclerotic mice. J Periodontal Res 2023; 58:655-667. [PMID: 37051685 DOI: 10.1111/jre.13128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis is immune inflammatory disease, atherosclerosis (AS) and chronic kidney disease (CKD) are two common systemic diseases. Periodontitis promotes AS and CKD, and CKD interacts with AS. The objective of this animal study was to evaluate the changes of kidney when periodontitis and atherosclerosis exist separately and the degenerative effects of periodontitis on the kidney in atherosclerotic mice. MATERIALS AND METHODS A total of 40 male Apoe-/- mice were randomly divided into four groups: control (NC), periodontitis (PD), AS and AS with PD (AS + PD). AS was induced by high-fat diet feeding, and PD was induced by injection of Porphyromonas gingivalis-Lipopolysaccharide (P.g-LPS) (endotoxin suspension) into the buccal side of mouse maxillary molars. The right maxilla of mice was scanned with micro-CT to evaluate alveolar bone loss; aortic tissue was stained with HE and Oil-Red O to evaluate arterial plaque formation; serum was collected to detect the changes of blood lipids and serum renal function parameters (blood urea nitrogen [BUN], serum creatinine [Scr]); renal histopathological changes were evaluated by HE staining (glomerular and tubular damage scores), PAS staining (glomerular Mesangial matrix index) and Masson staining (percentage of renal fibrosis area); qRT-PCR and ELISA were used to evaluate the expression of renal inflammatory cytokines (tumor necrosis factor-α, Interleukin-1β, neutrophil surface marker Ly6G). RESULTS The amount of alveolar bone loss: PD group was significantly higher than NC group (p < .05); AS + PD group was higher than PD group, the difference was not statistically significant. Atherosclerotic plaque formation and serum lipid changes: AS group were significantly worse than NC group (p < .05), and AS + PD group were worse than AS group. The results of the corresponding qualitative and quantitative analyses of kidney tissue in experimental animals gradually deteriorated in the NC group, PD group, AS group and AS + PD group and worsened sequentially. Renal function parameters: the content of BUN in AS group was higher than that in PD group, the difference was not statistically significant; Scr in AS group was significantly higher than that in PD group (p < .05); the contents of BUN and Scr in AS + PD group were higher than those in AS group, the difference was not statistically significant. Glomerular and tubular damage scores: AS group were higher than PD group, the difference was not statistically significant; AS + PD group were significantly higher than AS group (p < .001). The ratio of glomerular mesangial matrix to glomerular area and the percentage of renal fibrosis area: AS group were significantly higher than PD group (p < .001), and AS + PD group were significantly higher than AS group (p < .001). Expression of inflammatory cytokines: AS group was higher than PD group, the difference was not statistically significant; AS + PD group was significantly higher than AS group (p < .05). CONCLUSION Both PD and AS can aggravate the inflammatory stress of kidney tissue and cause the damage of kidney tissue, and the inflammatory increase and damage effect of AS is stronger; PD can promote kidney damage of atherosclerotic mice by aggravating the renal inflammation in atherosclerotic mice; renal function parameters were not completely synchronized with the changes of renal inflammation and histopathology in each group of mice; PD can promote AS, periodontal inflammation in mice with AS is more severe, and the special changes of blood lipids in mice with AS are closely related to the above results.
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Affiliation(s)
- Tiantian Fan
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Kaili Guo
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Fengdi Cao
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Zhuohang Deng
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Bin Liu
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Mingyue Shi
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Yue Liu
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Zhe Ma
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
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Bond JC, McDonough R, Alshihayb TS, Kaye EK, Garcia RI, Heaton B. Periodontitis is associated with an increased hazard of mortality in a longitudinal cohort study over 50 years. J Clin Periodontol 2023; 50:71-79. [PMID: 36089889 DOI: 10.1111/jcpe.13722] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the association between periodontal disease and all-cause mortality in a longitudinal cohort study over 50 years. MATERIALS AND METHODS Participants (N = 1156) in the Veterans Affairs Dental Longitudinal Study, aged 25-85 years at enrollment in 1968, received comprehensive medical and oral exams approximately every 3 years through 2007. Periodontal status was defined using person-level, mean whole-mouth radiographic alveolar bone loss (ABL) scores using a five-point Schei ruler, each unit representing 20% increments of ABL. Time-varying Cox regression models estimated hazard ratios (HRs) for the association between continuous and categorical ABL and mortality, adjusting for covariates. RESULTS Each one-unit increase in mean ABL score was associated with a 14% increase in the hazard of mortality (adjusted HR = 1.14, 95% confidence interval [CI] 1.02, 1.27). When assessed categorically, HRs for average scores of 2 to <3 and 3 to ≤5 showed increasing associations with hazard of mortality, relative to 0 to <1 (adjusted HR = 1.17, 95% CI 0.94, 1.46; and HR = 1.65, 95% CI 0.94, 2.85, respectively). By contrast, we observed null associations for average scores of 1 to <2 relative to 0 to <1 (adjusted HR = 1.00, 95% CI 0.86, 1.17). CONCLUSIONS Time-varying periodontal status assessed using radiographic ABL was positively associated with all-cause mortality even after confounder adjustment.
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Affiliation(s)
- Julia C Bond
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Robert McDonough
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Talal S Alshihayb
- Department of Dental Public Health, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Elizabeth K Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Raul I Garcia
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA
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Abstract
Periodontitis, being a multifactorial disorder is found to be the most common oral disease denoted by the inflammation of gingiva and resorption of tooth supporting alveolar bone. The disease being closely linked with fast life style and determined by unhygienic behavioural factors, the internal milieu of oral cavity and formation of plaque biofilm on the dental and gingival surfaces. Porphyromonas gingivalis, being the major keystone pathogen of the periodontal biofilm evokes host immune responses that causes damage of gingival tissues and resorption of bones. The biofilm associated microbial community progressively aggravates the condition resulting in chronic inflammation and finally tooth loss. The disease often maintains bidirectional relationship with different systemic, genetic, autoimmune, immunodeficiency diseases and even psychological disorders. The disease can be diagnosed and predicted by various genetic, radiographic and computer-aided design (CAD) & computer-aided engineering (CAE) and artificial neural network (ANN). The elucidation of genetic background explains the inheritance of the disease. The therapeutic approaches commonly followed include mechanical removal of dental plaque with the use of systemic antibiotics. Awareness generation amongst local people, adoption of good practice of timely tooth brushing preferably with fluoride paste or with nanoconjugate pastes will reduce the chance of periodontal plaque formation. Modern tissue engineering technology like 3D bioprinting of periodontal tissue may help in patient specific flawless regeneration of tooth structures and associated bones.
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Affiliation(s)
- Rina Rani Ray
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, West Bengal, Haringhata, Nadia, India.
- Department of Biotechnology and Bioinformatics, Sambalpur University, FVHM+9QP, Jyoti Vihar, Burla, Odisha, 768019, India.
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Mehriz BM, Atteya MA, Skipina TM, Mostafa MA, Soliman EZ. Association between Periodontitis and Diabetes Mellitus in the General Population. J Diabetes Metab Disord 2022; 21:1249-1254. [PMID: 36404812 PMCID: PMC9672178 DOI: 10.1007/s40200-022-01010-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 10/14/2022]
Abstract
Purpose- This study aimed to examine the association between periodontitis and diabetes mellitus. Methods Participants with natural teeth in one jaw from the Third United States National Health and Nutrition Examination Survey (1988-1994) were included in this analysis. Participants with moderate (> 4mm attachment loss in ≥ 2 mesial sites or 5mm pocket depth in ≥ 2 mesial sites) or severe (> 6mm attachment loss in ≥ 2 mesial sites and > 5mm pocket depth in ≥ 1 mesial site) periodontitis were classified as having periodontal disease. The rest of the participants were considered without periodontal disease. Diabetes mellitus was defined as fasting glucose ≥ 126mg/dL, hemoglobin A1c ≥ 6.5% or the use of antihyperglycemic medications. Multivariable logistic regression was used to examine the association between periodontitis and diabetes mellitus in all study population and subgroups stratified by demographics and comorbidities. Results This analysis included 13,000 participants [mean age 43.8 ± 19.1 years, 47.5% male, 30% whites]. About 12.7% (n = 1,656) of the study population had periodontitis, and 9.2% (n = 1,200) had diabetes. In a multivariable-adjusted model, presence (vs. absence) of periodontitis was associated with 66% increased odds of diabetes (OR (95% CI):1.66 (1.43-1.94); p < 0.001). Compared to those without periodontitis, the odds of diabetes among those with severe periodontitis was much higher (OR (95% CI): 2.31(1.72-3.11); p < 0.001) than in those with moderate periodontitis (OR (95% CI): 1.54(1.30-1.82); p < 0.001). Conclusions Periodontitis is associated with prevalent diabetes in a dose-response fashion, suggesting a bidirectional relationship between those two diseases. Patients with periodontal disease should be counseled regarding their elevated risk of diabetes. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01010-6.
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Affiliation(s)
- Basant M. Mehriz
- Institute of Global Health and Human Ecology, School of Sciences and Engineering, American University in Cairo, New Cairo, Cairo, Egypt
| | - Mirna A. Atteya
- Institute of Global Health and Human Ecology, School of Sciences and Engineering, American University in Cairo, New Cairo, Cairo, Egypt
| | - Travis M. Skipina
- Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
| | - Mohamed A. Mostafa
- Epidemiological Cardiology Research Center, Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center, Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina United States
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Lu H, Wu H, Yang Y, Feng X, Ma X, Xie Y, Xie D, Wang W, Lo ECM, Ye W. Relationship between chronic periodontitis and inflammatory cytokines in patients undergoing maintenance hemodialysis. Clin Oral Investig 2022; 26:6699-6709. [PMID: 35861756 DOI: 10.1007/s00784-022-04629-0] [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: 03/18/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the correlation between serum and gingival crevicular fluid (GCF) levels of inflammatory cytokines and the association with periodontal parameters in patients with maintenance hemodialysis (MHD) and healthy control. MATERIALS AND METHODS Patients who were undergoing MHD were enrolled as the MHD group. Healthy individuals who underwent oral examination were selected as the control group after matching for the MHD group. All participants underwent a full-mouth periodontal evaluation, and the levels of eight inflammatory cytokines, including IL-1β, IL-17, IL-6, IL-8, and tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-8 (MMP-8), and C-reactive protein (CRP), in the GCF and serum were measured. RESULTS A total of 63 MHD patients and 75 healthy persons were included. The prevalence of moderate/severe periodontitis was significantly higher in the MHD group than in the control group (88.9 vs. 66.7%, P < 0.05). The GCF levels of CRP, TNF-α, MCP-1, and MMP-8 were higher in patients in the MHD group with moderate/severe periodontitis than in the control group (P < 0.05). Serum CRP, MCP-1, TNF-α, and MMP-8 levels were positively correlated with the GCF CRP levels (P < 0.05). The GCF and serum CRP levels were positively correlated with the periodontal clinical parameters (P < 0.05). CONCLUSIONS Serum CRP, MCP-1, TNF-α, and MMP-8 may relate with the GCF CRP levels. The GCF and serum CRP levels correlated positively with the periodontal clinical parameters, including the VPI, PPD, and CAL, indicating that CRP may play an important role between periodontitis and ESRD. CLINICAL RELEVANCE The present study indicated that GCF and serum CRP levels correlated positively with the periodontal clinical parameters, and the CRP levels may be selected as an indicator to evaluate the severity of inflammation and the effectiveness, prognosis of periodontal treatment in ESRD patients.
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Affiliation(s)
- Haixia Lu
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Hongyu Wu
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, 356 Beijingdong Road, Shanghai, China
| | - Yuanmeng Yang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiaoxin Ma
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Yingxin Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Danshu Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Wenji Wang
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, University of Hong Kong, 34 Hospital Road, Hong Kong, China
| | - Wei Ye
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China.
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10
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The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases. Nutrients 2022; 14:nu14102002. [PMID: 35631140 PMCID: PMC9143067 DOI: 10.3390/nu14102002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 02/01/2023] Open
Abstract
Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.
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11
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Mahendra J, Palathingal P, Mahendra L, Alzahrani KJ, Banjer HJ, Alsharif KF, Halawani IF, Muralidharan J, Annamalai PT, Verma SS, Sharma V, Varadarajan S, Bhandi S, Patil S. Impact of Red Complex Bacteria and TNF-α Levels on the Diabetic and Renal Status of Chronic Kidney Disease Patients in the Presence and Absence of Periodontitis. BIOLOGY 2022; 11:451. [PMID: 35336824 PMCID: PMC8945045 DOI: 10.3390/biology11030451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as Prophyromonas gingivalis (P.g), Treponema denticola (T.d), and Tonerella forsythia (T.f) were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as Pg, Td and Tf levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of P.g, T.d and T.f were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | - Plato Palathingal
- Department of Periodontics, PSM College of Dental Science and Research, Thrissur 680519, India;
| | - Little Mahendra
- Department of Periodontics, Dean, Maktoum Bin Hamdan Dental University, Dubai 122002, United Arab Emirates;
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Hamsa Jameel Banjer
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Khalaf F. Alsharif
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Ibrahim Faisal Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | | | - Shyam Sankar Verma
- Department of Nephrology, Jubilee Medical College Hospital, Thrissur 680005, India;
| | - Vivek Sharma
- Department of Periodontics, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh 114141, India;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
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12
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Palathingal P, Mahendra J, Annamalai PT, Varma SS, Mahendra L, Thomas L, Baby D, Jose A, Srinivasan S, R A. A Cross-Sectional Study of Serum Glutathione Peroxidase: An Antioxidative Marker in Chronic Periodontitis and Chronic Kidney Disease. Cureus 2022; 14:e22016. [PMID: 35340502 PMCID: PMC8913512 DOI: 10.7759/cureus.22016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background and aim: Oxidative stress as an individual risk for periodontitis and chronic kidney disease (CKD) has been elaborated through various mechanical pathways, yet its role in association with both diseases remains unexplored. Thus, the current study aims in evaluating serum glutathione peroxidase, an oxidative stress marker in CKD patients with periodontitis, and compare it with the healthy controls. Methodology: One hundred and twenty subjects were divided into four groups as control (C=30 subjects), periodontitis and non-CKD patients (CP=30 patients), non-periodontitis and CKD patients (CKD=30 patients), and periodontitis and CKD patients (CKD+CP=30 patients). Demographic variables, periodontal parameters, such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), percentage proportion of sites with probing pocket depth more than 5 mm, clinical attachment loss (CAL), percentage proportion of sites with clinical attachment loss more than 3 mm and serum stress marker, and glutathione peroxidase were compared between the groups and the results were statistically analyzed. Results: The demographic variables did not differ significantly between the groups, except for age. The means PI, GI, PPD, percentage proportion of sites with probing pocket depth more than 5 mm, CAL, percentage proportion of sites with clinical attachment loss were higher in CKD+CP. The glutathione peroxidase was significantly higher in CP group (p=0.001) and significantly correlated with periodontal parameters. Conclusion: The oxidative stress marker glutathione peroxidase was higher in CP, followed by the CKD groups. This could pave a strong link of oxidative stress as a risk factor for chronic periodontitis, as well as chronic kidney disease.
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13
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Min HJ, Park JS, Yang J, Yang J, Oh SW, Jo SK, Cho WY, Gwon JG, Jung CW, Seol YJ, Park SY, Kim MG. The effect of periodontitis on recipient outcomes after kidney transplantation. Kidney Res Clin Pract 2022; 41:114-123. [PMID: 35108770 PMCID: PMC8816407 DOI: 10.23876/j.krcp.21.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Recent several reports have demonstrated that periodontitis is prevalent and adversely affects the survival in patients with chronic kidney disease (CKD) or end-stage kidney disease. However, its impact on transplant outcomes remains uncertain.Methods: This retrospective cohort study included 136 and 167 patients, respectively, who underwent living donor kidney transplantation (KT) at Seoul National University Hospital from July 2012 to August 2016 and Korea University Hospital from April 2008 to October 2018. We divided patients into three groups according to stages of periodontitis based on a new classification system. Results: Patients with severe periodontitis were older, had a higher prevalence of diabetes, a higher body mass index and C-reactive protein level, a lower cardiac output, and were more likely to be smokers, indicating its association with chronic systemic inflammation. After KT, stage IV periodontitis was independently associated with a lower incidence of acute T cell-mediated rejection, suggesting the possible effect of periodontitis on immune function. However, 1-year and 3-year estimated glomerular filtration rates were not different. Among the KT recipients followed up more than 3 years, new-onset cardiovascular disease occurred in nine patients, and coronary artery disease occurred more frequently in patients with stage IV periodontitis. However, diabetes was the independent predictor of new-onset coronary artery disease in multivariate logistic regression analysis.Conclusion: Our findings showed that periodontitis might be an important player in determining posttransplant outcomes in recipients. Further interventional trials to test whether treating periodontitis could modify transplant outcome are needed.
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Affiliation(s)
- Hyeon-Jin Min
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jung-Soo Park
- Department of Periodontology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jaeseok Yang
- Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jihyun Yang
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Se Won Oh
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Sang-Kyung Jo
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Won Yong Cho
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jun Gyo Gwon
- Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Shin-Young Park
- Department of Dentistry, Seoul National Dental Hospital, Seoul, Republic of Korea
- Shin-Young Park Department of Dentistry, Seoul National Dental Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. E-mail:
| | - Myung-Gyu Kim
- Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
- Correspondence: Myung-Gyu Kim Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea. E-mail:
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14
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Sun K, Shen H, Liu Y, Deng H, Chen H, Song Z. Assessment of Alveolar Bone and Periodontal Status in Peritoneal Dialysis Patients. Front Physiol 2021; 12:759056. [PMID: 34966288 PMCID: PMC8710660 DOI: 10.3389/fphys.2021.759056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic kidney disease (CKD) affects 8-13% of the global population and has become one of the largest burdens on healthcare systems around the world. Peritoneal dialysis is one of the ultimate treatments for patients with severe CKD. Recently, increasing severe periodontal problems have been found in CKD patients. Periodontitis has been identified as a new variable risk factor for CKD. The aim of this study was to investigate the periodontal status and severity of alveolar bone loss in CKD patients with peritoneal dialysis (PD). One hundred and six patients undergoing PD (PD group) and 97 systemically healthy periodontitis patients (control group) were enrolled. The differences in the dimensions of the alveolar bone between two groups were compared, and the distribution of alveolar bone defects was analyzed by cone-beam computed tomography (CBCT). Gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and attachment loss (AL) were recorded. The levels of inflammatory factors in gingival crevicular fluid were assessed by ELISA. Compared to control group, there was a higher degree of alveolar bone loss in maxillary premolars, maxillary 2nd molar and mandibular 1st molar in patients with PD (p < 0.05). A comparison of bone loss in different sites revealed that the area with the highest degree of bone loss were on the mesial-buccal, mid-buccal, distal-buccal, and mesial-lingual site in PD patients. The expression levels of inflammatory factors were higher in PD group (p < 0.01). In conclusion, PD patients presented more severe periodontal and inflammatory status than systemically healthy periodontitis patients. The loss of the alveolar bone differed between the two groups. Different sites and teeth exhibited a diverse degree of bone loss. This study highlights that clinicians should pay close attention to periodontal status of peritoneal dialysis patients and provides a new thinking to improve healthcare for CKD.
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Affiliation(s)
- Kristine Sun
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hui Shen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yingli Liu
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai Deng
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiwen Chen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhongchen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
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15
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Ma KSK, Lai JN, Veeravalli JJ, Chiu LT, Van Dyke TE, Wei JCC. Fibromyalgia and periodontitis: Bidirectional associations in population-based 15-year retrospective cohorts. J Periodontol 2021; 93:877-887. [PMID: 34542911 DOI: 10.1002/jper.21-0256] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND To determine the bidirectional link between periodontitis and fibromyalgia. METHODS In this cohort study, 196,428 periodontitis patients and 196,428 propensity score-matched non-periodontitis controls were enrolled. A Cox proportional hazard model was utilized to estimate the risk of fibromyalgia and survival analysis was adopted to assess the time-dependent effect of periodontitis on fibromyalgia. Subgroup analyses stratified by age, sex, and tracking period were conducted to identify susceptible populations. A parallel and symmetrical cohort that recruited 141,439 fibromyalgia patients and 141,439 propensity score-matched non-fibromyalgia controls ascertained the inverse effect of fibromyalgia on incident periodontitis. RESULTS Patients with periodontitis were more likely to develop fibromyalgia than non-periodontitis controls (HR = 1.42, 95% CI = 1.39-1.44, P < 0.001), which persisted in the survival analysis (log-rank test P < 0.0001). This effect was significant in both sexes and all age subgroups, and was particularly evident in males (HR = 1.52, 95% CI = 1.48-1.56, P < 0.001) and younger periodontitis patients (HR = 1.55, 95% CI = 1.50-1.60, P < 0.001). Fibromyalgia patients who never had periodontitis presented with greater risk for periodontitis over time (HR = 1.43, 95% CI = 1.40 - 1.45, P < 0.001; log-rank test P < 0.0001). CONCLUSIONS Patients of both sexes and all age subgroups with periodontitis presented with a greater risk of fibromyalgia. Subgroups that were the most susceptible to periodontitis-associated fibromyalgia were periodontitis patients that were males and below 30 years old. Risks of periodontitis were also greater in fibromyalgia patients who never had periodontitis.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jung-Nien Lai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - John Jims Veeravalli
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Lu-Ting Chiu
- Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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16
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Valenzuela-Narváez RV, Valenzuela-Narváez DR, Valenzuela-Narváez DAO, Córdova-Noel ME, Mejía-Ruiz CL, Salcedo-Rodríguez MN, Gonzales-Aedo O. Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. J Int Med Res 2021; 49:3000605211033266. [PMID: 34311597 PMCID: PMC8320556 DOI: 10.1177/03000605211033266] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. Methods A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. Results In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83–1.55), 1.47 (1.13–1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14–1.93), 1.37 (1.02–1.78), 3.07 (2.81–3.25), and 3.65 (3.49–3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47–5.21), and 5.23 (5.14–5.47), respectively. Conclusion The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.
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Affiliation(s)
- Rocío Violeta Valenzuela-Narváez
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Faculty of Dentistry, San Luis Gonzaga National University of Ica, Perú.,National Council for Science and Technology, CONCYTEC, Lima, Perú
| | - Daniel Raùl Valenzuela-Narváez
- Department of Gastroenterology, Geriatric Military Hospital, Lima, Perú.,National Council for Science and Technology, CONCYTEC, Lima, Perú
| | | | - María Elena Córdova-Noel
- Postgraduate School, National University José Faustino Sánchez Carrión, Huacho, Perú.,National Council for Science and Technology, CONCYTEC, Lima, Perú
| | - Cris Lisseth Mejía-Ruiz
- Postgraduate School, National University José Faustino Sánchez Carrión, Huacho, Perú.,National Council for Science and Technology, CONCYTEC, Lima, Perú
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17
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Zhang X, Wang M, Wang X, Qu H, Zhang R, Gu J, Wu Y, Ni T, Tang W, Li Q. Relationship between periodontitis and microangiopathy in type 2 diabetes mellitus: a meta-analysis. J Periodontal Res 2021; 56:1019-1027. [PMID: 34254680 DOI: 10.1111/jre.12916] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Whether periodontitis increases the risk of diabetic microangiopathy remains controversial. The present meta-analysis aims to investigate the relationship between periodontitis and diabetic microangiopathy in patients with type 2 diabetes mellitus. METHODS PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, and WanFang data were searched without language restrictions. The methodological quality of the studies included was assessed using Newcastle-Ottawa Scale method, and meta-analysis was performed by Review Manager 5.3. Odds ratio (OR) and 95% confidence interval (CI) were used to assess the risk of periodontitis for diabetic microangiopathy among patients with type 2 diabetes. RESULTS Thirteen cross-sectional studies, covering 10 570 participants, were included in the present meta-analysis. The results demonstrated that periodontitis was associated with increased risk of type 2 diabetic microangiopathy (OR: 2.43, 95% CI: 1.65-3.56), diabetic retinopathy (OR: 4.33, 95% CI: 2.19-8.55), and diabetic nephropathy (OR: 1.75, 95% CI: 1.07-2.85), while periodontitis was not associated with diabetic neuropathy (OR: 0.99, 95% CI: 0.19-5.12). Subgroup analysis among the studies in Asian (OR: 3.06, 95% CI: 1.94-4.84) and North American (OR: 1.42, 95% CI: 1.08-1.86) populations confirmed the existed association between periodontitis and type 2 diabetic microangiopathy. The relationship still existed in groups with sample size larger than 500 (OR: 1.77, 95% CI: 1.34-2.34) and smaller than 500 (OR: 3.33, 95% CI: 1.38-8.03). A sensitivity analysis confirmed the stability of the results by excluding moderate quality studies or removing articles one after the other. CONCLUSION Current evidences have proved that periodontitis is associated with increased risk of diabetic microangiopathy in patients with type 2 diabetes mellitus. This conclusion may provide useful evidence for correlated clinical researches. PROSPERO registration number CRD42021247773.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Miaoran Wang
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Hua Qu
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Jiyu Gu
- Beijing University of Chinese Medicine, Beijing, China
| | - Yufei Wu
- Beijing University of Chinese Medicine, Beijing, China
| | - Tian Ni
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Tang
- Beijing University of Chinese Medicine, Beijing, China
| | - Qiuyan Li
- Xiyuan hospital, China Academy of Chinese Medical Sciences, Beijing, China
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18
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Zeng J, Jia N, Ji C, Zhong S, Chai Q, Zou C, Chen L. Plaque control alleviated renal damage that was aggravated by experimental periodontitis in obese rats. Oral Dis 2021; 28:1228-1239. [PMID: 33660360 DOI: 10.1111/odi.13813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 02/09/2021] [Accepted: 02/23/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to evaluate the influence of experimental periodontitis on renal damage in obese rats. MATERIALS AND METHODS Thirty-two male Sprague Dawley rats were randomly allocated into 4 groups with 8 animals each: obese rats (obese group), obese rats with periodontitis (periodontitis obese group), obese rats with periodontitis that underwent plaque control (plaque-control obese group), and healthy rats (healthy group). Rats were fed a high-fat diet to establish an obesity model. Experimental periodontitis was induced by local ligation with silk around the bilateral maxillary second molars. The plaque control was accomplished by removing ligations and local wiping with an antiseptic rinse. Histology was used to observe the gingival inflammation and clinical attachment level (CAL) to further assess bone loss and to also observe renal structure. Serum creatinine, urea nitrogen, and kidney injury molecule-1 (KIM-1) levels were measured to evaluate renal function. Renal Toll-like receptor 4 (TLR4), nuclear factor-kappa B (NF-κB), serum C-reactive protein (CRP), lipopolysaccharides (LPS), and interleukin-1β (IL-1β) were measured to evaluate renal and systemic inflammation. RESULTS Periodontal histology showed that in the periodontitis obese group, the epithelial barrier was considerably eroded by inflammatory cells, which infiltrated into the subepithelial connective tissue and lamina propria. A periodontal pocket was forming accompanied by the loss of attachment. The extent of infiltration of inflammatory cells and the CAL were significantly higher than those of the obese group (p < .001). In the plaque-control obese group, although the inflammatory condition was significantly improved than in the periodontitis obese group, the clinical attachment level with the presence of fiber hyperplasia could not be restored. Renal histology showed that renal tubular structural damage was aggravated in the periodontitis obese group, including vacuolar degeneration, exfoliation of the proximal tubular epithelial cell lining, multifocal loss of the brush border, and movement of several nuclei from the basement membrane to the lumen. These alterations were improved in the plaque-control obese group. Kidney TLR4 and NF-κB mRNA levels increased significantly in the periodontitis obese group compared to the obese group (p = .015 and p = .015, respectively) and decreased significantly in the plaque-control obese group (p = .028 and p = .021, respectively). Kidney TLR4 and NF-κB protein expression in the plaque-control obese group were significantly lower than those in the periodontitis obese group (p < .001 and p = .043, respectively). Serum creatinine and KIM-1 levels significantly decreased in the plaque-control obese group compared to the periodontitis obese group (p = .001 and p = .002, respectively). At 21 weeks (1 week after periodontal ligation), serum CRP levels in the periodontitis obese group were significantly higher than that in the healthy group (p = .017). Other serum inflammatory markers (LPS and IL-1β) did not change significantly. CONCLUSION Experimental periodontitis induced dysfunction and structural destruction of the kidney in obese rats. Plaque control relieved renal damage.
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Affiliation(s)
- Jiahao Zeng
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China.,Department of Stomatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ni Jia
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Chunlan Ji
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Sulan Zhong
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Qiaoxue Chai
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Chuan Zou
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Lei Chen
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China
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Folayan MO, Tantawi ME, Chukwumah NM, Alade M, Mapayi B, Oginni O, Arowolo O, Sam-Agudu NA. Associations between depression and gingivitis among adolescents resident in semi-urban South-West Nigeria. BMC Oral Health 2021; 21:55. [PMID: 33557820 PMCID: PMC7869244 DOI: 10.1186/s12903-021-01421-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/28/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE None of the past studies that had showed a linked between oral and mental health among adolescents was conducted in Nigeria. The objective of this study was to determine the association between gingivitis and depression among adolescents in Ile-Ife, South-West Nigeria. METHODS This cross-sectional study collected data through a household survey conducted between December 2018 and January 2019. Adolescents aged 10 to 19 years old were identified using multistage sampling. The study outcome measure was gingivitis, measured by the Löe and Silness gingival index. The explanatory variable was depression, measured by the Patient Health Questionnair. Confounders considered were age, sex, socioeconomic status, frequency of daily tooth brushing, oral hygiene status (measured by the plaque index), consumption of refined carbohydrates in-between meals, use of dental floss, and history of dental service utilization in the past 12 months. A logistic regression model was constructed to determine risk indicators for moderate/severe gingivitis. Additionally, modification of associations between dependent variables and the significant risk indicators of depression was assessed. RESULTS Mean plaque index for the 1,087 adolescent participants enrolled in the study was 0.80. We found a prevalence of 8.5% for moderate/severe gingivitis and 7.9% for depression. In adjusted regression, there were significant associations between the presence of moderate/severe gingivitis and consumption of refined carbohydrates in-between meals (OR 1.94, 95% CI 1.14, 3.28) and plaque index (OR 16.56, 95% CI 10.03, 27.33). Depression also significantly modified the association between plaque index and the presence of moderate/severe gingivitis (P < 0.0001), with a stronger association observed with mild depression (OR 24.75, 95% CI 3.33, 184.00) compared with no depression (OR 15.47, 95% CI 9.31, 25.69), with no significant modification for the association with frequent consumption of refined carbohydrates (P = 0.06). CONCLUSION Although there was no significant association between gingivitis and depression among our adolescent Nigerian cohort, depression significantly modified the association between plaque index score and moderate/severe gingivitis.
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Affiliation(s)
| | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Michael Alade
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olaniyi Arowolo
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria.,Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, USA
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20
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Wu HQ, Wei X, Yao JY, Qi JY, Xie HM, Sang AM, Jiang K. Association between retinopathy, nephropathy, and periodontitis in type 2 diabetic patients: a Meta-analysis. Int J Ophthalmol 2021; 14:141-147. [PMID: 33469496 DOI: 10.18240/ijo.2021.01.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/22/2020] [Indexed: 12/28/2022] Open
Abstract
AIM To verify the association between retinopathy, nephropathy, and periodontitis in type 2 diabetic (T2D) patients. METHODS Several electronic databases were available for our comprehensive search including China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang, Web of Science, ScienceDirect and PubMed and were queried for relevant citations (updated to Mar. 2019). RevMan was utilized to perform Meta analysis and publication bias detection. After evaluation of the methodological quality of included studies, a fixed or random effect model was utilized to analyze data from included studies. RESULTS A total of eight articles were finally included in this Meta analysis. In all 3987 subjects, there were 1207 T2D patients accompanying with microvascular complications and 1734 patients with periodontitis as well. The Meta forest plot presented little heterogeneity of the eight studies (P<0.00001, I 2=89%). The total effect demonstrated periodontitis was associated with overall microvascular complications (OR: 1.96, 95%CI: 1.67-2.30, Z=8.25, P<0.00001). Subgroup investigations among the studies in Asian (OR: 2.33, 95%CI: 1.91-2.85) and North American (OR: 1.42, 95%CI: 1.08-1.86) populations confirmed the existed association between retinopathy, nephropathy, and periodontitis. While the strength of such associations between periodontitis and diabetic microvascular complications were more obvious in the Asians than North Americans. All the results indicated that periodontitis was associated with diabetic retinopathy (OR: 3.77, 95%CI: 2.71-5.24), diabetic nephropathy (OR: 1.55, 95%CI: 1.24-1.94) in T2D patients. CONCLUSION The periodontitis is associated with diabetic retinopathy, diabetic nephropathy among T2D patients and further large sample size clinical trials are in need to confirm the findings.
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Affiliation(s)
- Hui-Qun Wu
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Xiao Wei
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Jin-Yi Yao
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Jian-Yan Qi
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Hui-Min Xie
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Ai-Min Sang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Kui Jiang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
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21
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Lai J, Bai YL, Bai Y, Mei J, Zhang ZW, Tang WJ, Huang J. [A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:672-680. [PMID: 33377346 PMCID: PMC7738908 DOI: 10.7518/hxkq.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/23/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. METHODS We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. RESULTS Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. CONCLUSIONS Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.
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Affiliation(s)
- Jing Lai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yuan-Liang Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Yin Bai
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Jie Mei
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
| | - Zhi-Wei Zhang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Wen-Jing Tang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China;Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China
| | - Jiao Huang
- Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China;Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
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22
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Sadiq N, Probst JC, Merchant AT, Martin AB, Shrestha D, Khan MM. The role of dental insurance in mitigating mortality among working-age U.S. adults with periodontitis. J Clin Periodontol 2020; 47:1294-1303. [PMID: 32939782 DOI: 10.1111/jcpe.13366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 07/28/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
AIM To assess the relationship of dental insurance with all-cause mortality and mortality due to cardiovascular diseases (CVD), diabetes mellitus (DM), and cerebrovascular diseases (CBD) among those with periodontitis. MATERIALS AND METHODS NHANES III and its associated mortality data set were used in this study. The outcome variables were "all-cause mortality" and "combined mortality" due to CVD, DM, and CBD. The independent variable was dental insurance stratified over periodontitis status. Unweighted frequencies with weighted column percentages were used for descriptive statistics, and chi-square test was applied for significance. Cox proportional hazard models were used for stratified multivariable analyses. All analyses were performed in SAS v9.4 accounting for survey data complexities. Significance level was kept at 5%. RESULTS The mortality was 14.58% for all-cause mortality and 4.06% for combined mortality among those with periodontitis in this study. Dental insurance significantly reduced the hazard of all-cause mortality among those with periodontitis (HR: 0.75; 95% CI: 0.61 - 0.93), adjusted for covariates. However, no association of dental insurance with combined mortality was observed among periodontitis group. CONCLUSIONS Dental insurance reduces hazard of all-cause mortality among those with periodontitis. Dental insurance ensures access to dentists and improves oral and dental health. Longitudinal study is needed to establish causality.
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Affiliation(s)
- Naveed Sadiq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.,Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Janice C Probst
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Amy B Martin
- College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Deepika Shrestha
- Data Management and Analysis Division, Center for Policy, Planning and Evaluation, DC Department of Health, Washington, DC, USA
| | - M Mahmud Khan
- Department of Health Policy & Management, University of Georgia, Athens, GA, USA
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23
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Li A, Thomas RZ, van der Sluis L, Tjakkes G, Slot DE. Definitions used for a healthy periodontium-A systematic review. Int J Dent Hyg 2020; 18:327-343. [PMID: 32330350 PMCID: PMC7687205 DOI: 10.1111/idh.12438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/07/2020] [Accepted: 04/20/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the explicitness and variability of the definition of periodontal health in the current scientific literature. MATERIAL AND METHODS The authors conducted a systematic literature review using PubMed and CENTRAL (2013-01/2019-05) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the guidelines of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. RESULTS A total of 51 papers met the predefined inclusion criteria. Of these, 13 papers did not report any explicit definitions of periodontal health. Out of the 38 remaining articles, half of them used a reference to support their definition and half of them not. The studies published in periodontics-related journals or those that scored a low risk of bias for the methodical quality presented more explicit and valid definitions. Probing pocket depth was the most frequently used individual parameter for defining periodontal health. However, there were substantial variations in the methods of measurement and cut-off values. CONCLUSIONS Given the diversity of periodontal health definitions, a cross-study comparison is difficult. The results of this review may be useful in making others aware of the significance of standardizing the definition of a healthy periodontium.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Renske Z. Thomas
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
- Department of DentistryRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Luc van der Sluis
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Geerten‐Has Tjakkes
- Center for Dentistry and Oral HygieneUniversity Medical Center Groningen (UMCG)University of GroningenGroningenThe Netherlands
| | - Dagmar Else Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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24
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Duan X, Chen X, Gupta M, Seriwatanachai D, Xue H, Xiong Q, Xu T, Li D, Mo A, Tang X, Zhou X, Li Y, Yuan Q. Salivary microbiome in patients undergoing hemodialysis and its associations with the duration of the dialysis. BMC Nephrol 2020; 21:414. [PMID: 32993533 PMCID: PMC7523083 DOI: 10.1186/s12882-020-02009-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/04/2020] [Indexed: 02/08/2023] Open
Abstract
Background Chronic kidney disease (CKD) patients, especially those with end stage renal disease (ESRD) undergoing hemodialysis (HD), exhibit high prevalence of periodontitis. This cross-sectional study aimed to investigate the periodontal status of HD patients and its relationship with salivary microbiome. Methods One hundred eight HD patients and one hundred healthy control individuals were recruited. They were subjected to periodontal examination followed by saliva samples collection for 16S rRNA gene sequencing. Results The HD patients were with worse periodontal health status, and exhibited higher salivary microbial diversity and lower richness. The periodontal pathogens were significantly enriched in the HD patients. The inferred functional analyze showed microbes enriched in the HD patients were mainly related to metabolism. Despite the periodontal status and overall structure of the microbiome were not significantly altered as the HD duration prolonged, the abundance of Lachnospiraceae [G-2] sp. |HMT_096| is positively correlated with the duration of HD and the community periodontal index (CPI). Five OTUs (operational taxonomic units) belonging to the phyla Firmicutes were enriched as the duration prolonged, and four OTUs originated from the phyla Proteobacteria were negatively related with the CPI index. ESRD patients undergoing HD exhibited microbiota structural, compositional and functional differences compared with the healthy controls. And the species changed as the duration of hemodialysis prolonged. Conclusions End stage renal disease changes salivary microbiome and is a risk factor for oral dysbiosis.
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Affiliation(s)
- Xiaobo Duan
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Xiaolei Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Megha Gupta
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Al-Showajra Academic Campus, Jazan University, Jazan, Kingdom of Saudi Arabia
| | | | - Hanxiao Xue
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Qiuchan Xiong
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Tong Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Dan Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Anchun Mo
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xi Tang
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
| | - Quan Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China. .,Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Al-Showajra Academic Campus, Jazan University, Jazan, Kingdom of Saudi Arabia.
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25
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Wynimko M, Walicka M, Sanchak Y, Gozdowski D, Błach A, Więcek A, Śliwczyński A, Franek E, Kolonko A. Influence of Chronic Periodontitis on the Long-Term Mortality and Cardiovascular Events in Kidney Transplant Recipients. J Clin Med 2020; 9:jcm9061968. [PMID: 32585986 PMCID: PMC7355563 DOI: 10.3390/jcm9061968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic periodontitis (CP) is associated with cardiovascular disease and mortality in different populations. The aim of this study was to examine an association of CP with hard endpoints in patients after kidney transplantation during a 15-year follow-up period. Study group consist of 117 patients (77M/40F, median age 44 years) divided into two subgroups: those with initially advanced CP (CPITN 3-4) and those with no or moderate CP (CPITN 0-2). All cardiovascular events, graft losses, and re-transplantations were recorded. All deaths were noted and verified, including those occurred after the return to dialysis therapy, the causes of death were identified. Cox regression with Firth's penalized maximum likelihood models were used for data analysis. During the observation period, 49 deaths occurred. Advanced CP (n = 35) was not associated with overall mortality but was associated with increased risk of death with functioning graft (DWFG) [HR 3.54 (1.20-10.45); p < 0.05]. Risk of graft loss was not associated with CP status. In conclusion, an advanced CP was independently associated with increased risk of DWFG, but not all-cause or cardiovascular mortality after renal transplantation.
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Affiliation(s)
- Marta Wynimko
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Yaroslav Sanchak
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Dariusz Gozdowski
- Department of Biometry, Warsaw University of Life Sciences, Nowoursynowska 166, 02-787 Warsaw, Poland;
| | - Anna Błach
- Department of Cardiology, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Voxel SA Nuclear Medicine Center, Ceglana 35, 40-514 Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
| | - Andrzej Śliwczyński
- Sattelite Campus, University of Humanities and Economics in Lodz, Wolność 2a, 01-018 Warsaw, Poland;
- National Health Fund, Grójecka 186, 02-390 Warsaw, Poland
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106 Warsaw, Poland
| | - Aureliusz Kolonko
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Correspondence: ; Tel.: +48-32-259-1429
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26
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Chung PC, Chan TC. Association between periodontitis and all-cause and cancer mortality: retrospective elderly community cohort study. BMC Oral Health 2020; 20:168. [PMID: 32517780 PMCID: PMC7285774 DOI: 10.1186/s12903-020-01156-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/01/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Periodontal infection induces inflammation, which may increase the risk of tumor-promoting effects. The aim of this study was to assess the association between periodontitis and all-cause mortality, and all-cancer and specific cancers' mortality in a health examination cohort of the elderly in the communities. METHODS A dataset of health examinations for the elderly with cause of death from 2005 to 2012 was obtained from the Department of Health, Taipei City Government. We enrolled 82,548 study participants with 262,035 visits. A Cox proportional hazards model and Cox frailty model were used for calculating the hazard ratios under different periodontal status by using SAS and Rstudio. RESULTS Being male, elderly, having a low education level, and smoking were risk factors for mortality in this retrospective elderly community cohort study. Participants with periodontitis followed across time had significantly higher hazard ratios (HRs) for all-cause mortality and all-cancer mortality (HR = 1.092, 95% confidence interval (CI):1.038 to 1.149, HR = 1.114, 95% CI:1.032 to 1.203, respectively) in the Cox frailty models after adjusting for age, marital status, education level, sex, and smoking status. After adjusting for age and sex, the hazard ratio was 1.185 (95% CI: 1.027 to 1.368) for lung cancer mortality, and 1.340 (95% CI: 1.019 to 1.762) for prostate cancer mortality in the periodontitis group with each visit. CONCLUSIONS The findings indicated that being male, having a low education level, and daily smoking were risk factors for mortality, and showed mixed evidence that periodontal disease is associated with all-cause, all-cancer and specific-cancer mortality including lung and prostate cancer. We suggest the importance of regular health screening in order to achieve early disease detection and lower mortality risk.
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Affiliation(s)
- Ping-Chen Chung
- Department of Dentistry, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 115, Taiwan. .,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Choi SE, Sima C, Pandya A. Impact of Treating Oral Disease on Preventing Vascular Diseases: A Model-Based Cost-effectiveness Analysis of Periodontal Treatment Among Patients With Type 2 Diabetes. Diabetes Care 2020; 43:563-571. [PMID: 31882408 DOI: 10.2337/dc19-1201] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/27/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Previous randomized trials found that treating periodontitis improved glycemic control in patients with type 2 diabetes (T2D), thus lowering the risks of developing T2D-related microvascular diseases and cardiovascular disease (CVD). Some payers in the U.S. have started covering nonsurgical periodontal treatment for those with chronic conditions, such as diabetes. We sought to identify the cost-effectiveness of expanding periodontal treatment coverage among patients with T2D. RESEARCH DESIGN AND METHODS A cost-effectiveness analysis was conducted to estimate lifetime costs and health gains using a stochastic microsimulation model of oral health conditions, T2D, T2D-related microvascular diseases, and CVD of the U.S. POPULATION Model parameters were obtained from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2009-2014) and randomized trials of periodontal treatment among patients with T2D. RESULTS Expanding periodontal treatment coverage among patients with T2D and periodontitis would be expected to avert tooth loss by 34.1% (95% CI -39.9, -26.5) and microvascular diseases by 20.5% (95% CI -31.2, -9.1), 17.7% (95% CI -32.7, -4.7), and 18.4% (95% CI -34.5, -3.5) for nephropathy, neuropathy, and retinopathy, respectively. Providing periodontal treatment to the target population would be cost saving from a health care perspective at a total net savings of $5,904 (95% CI -6,039, -5,769) with an estimated gain of 0.6 quality-adjusted life years per capita (95% CI 0.5, 0.6). CONCLUSIONS Providing nonsurgical periodontal treatment to patients with T2D and periodontitis would be expected to significantly reduce tooth loss and T2D-related microvascular diseases via improved glycemic control. Encouraging patients with T2D and poor oral health conditions to receive periodontal treatment would improve health outcomes and still be cost saving or cost-effective.
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Affiliation(s)
- Sung Eun Choi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA
| | - Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA
| | - Ankur Pandya
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
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Chen J, Yu M, Li X, Sun QF, Yang CZ, Yang PS. Progranulin promotes osteogenic differentiation of human periodontal ligament stem cells via tumor necrosis factor receptors to inhibit TNF-α sensitized NF-kB and activate ERK/JNK signaling. J Periodontal Res 2019; 55:363-373. [PMID: 31854464 DOI: 10.1111/jre.12720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/08/2019] [Accepted: 11/12/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate the molecular mechanism of Progranulin (PGRN) in promoting osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) in inflammatory environment. BACKGROUND Progranulin is an antagonist of tumor necrosis factor (TNF) receptors (TNFRs) and is known to promote inflammatory periodontal bone defect regeneration. METHODS TNFR1- and TNFR2-silenced hPDLSCs designed as hPDLSCs-sh-TNFR1 and hPDLSCs-sh-TNFR2 were cultured with osteoinductive medium containing TNF-α and (or) PGRN. Immunofluorescence, quantitative real-time PCR, and western blot were used to, respectively, detect expressions of TNFR1\TNFR2 and osteogenic differentiation markers as well as phosphorylation level in NF-κB\MAPK-related pathways. RESULTS Immunofluorescence and real-time PCR showed that TNFR1 and TNFR2 positively expressed in hPDLSCs. TNF-α stimulation could significantly decrease the expressions of ALP and RUNX2 in hPDLSCs, whereas PGRN treatment could significantly enhance their expressions, and reverse TNF-α-mediated expression suppression of ALP and RUNX2 in hPDLSCs. In hPDLSCs-sh-TNFR1, TNF-α mediated osteogenic inhibition decreased, but both TNF-α + PGRN and alone PGRN significantly promoted expression of ALP and RUNX2. PGRN significantly enhanced expression of P-ERK1/2 and P-JNK, while corresponding inhibitors eliminated PGRN-stimulated osteogenic differentiation. In hPDLSCs-sh-TNFR2, no significant difference existed in osteogenic markers and P-JNK expression between the PGRN group and the control group. However, PGRN still activated P-ERK1/2 expression. Besides, PGRN antagonized TNF-α-enhanced NF-κB P65 expression. CONCLUSION Progranulin promotes osteogenic differentiation of hPDLSCs via TNFR1 to inhibit TNF-α-sensitized NF-κB and via TNFR2 to activate JNK signaling. The mechanism by which PGRN activates ERK signaling remains to be explored.
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Affiliation(s)
- Jing Chen
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, China.,Department of Periodontology, School of Stomatology, Shandong University, Jinan, China
| | - Miao Yu
- Department of Stomatology, Weifang People's Hospital, Weifang, China
| | - Xiao Li
- Department of Periodontology, Jinan Stomatological Hospital, Jinan, China
| | - Qin-Feng Sun
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, China
| | - Cheng-Zhe Yang
- Department of Oral and Maxillofacial Surgery, Qilu Hospital and Institute of Stomatology, Shandong University, Jinan, China
| | - Pi-Shan Yang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, China.,Department of Periodontology, School of Stomatology, Shandong University, Jinan, China
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Lertpimonchai A, Rattanasiri S, Tamsailom S, Champaiboon C, Ingsathit A, Kitiyakara C, Limpianunchai A, Attia J, Sritara P, Thakkinstian A. Periodontitis as the risk factor of chronic kidney disease: Mediation analysis. J Clin Periodontol 2019; 46:631-639. [PMID: 30993705 PMCID: PMC6593715 DOI: 10.1111/jcpe.13114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 01/29/2023]
Abstract
AIM To determine sequences and magnitude of causality among periodontitis, diabetes and chronic kidney disease (CKD) by mediation analysis. METHODS Ten-year-data were retrieved from the Electric Generation Authority of Thailand (EGAT) study. A cohort of 2,635 subjects was identified with no CKD at baseline. The interested outcome was CKD incidence defined as glomerular filtration rate <60 ml/min/1.73 m2 . The percentage of proximal sites with clinical attachment loss ≥5 mm was used to represent periodontitis. Mediation analysis with 1,000-replication bootstrapping was applied to two causal diagrams, diagram A (Periodontitis → Diabetes → CKD) and diagram B (Diabetes → Periodontitis → CKD). RESULTS The cumulative incidence of CKD was 10.3 cases per 100 persons during 10-year period. In diagram A, each increasing percentage of proximal sites with severe periodontitis increased the adjusted odds ratio of CKD 1.010 (95% CI: 1.005, 1.015) and 1.007 (95% CI: 1.004, 1.013), by direct and indirect effect through diabetes, respectively. In diagram B, diabetes increased the odds of CKD twofold, with 6.5% of this effect mediated via periodontitis. CONCLUSIONS Periodontitis had significant direct effect, and indirect effect through diabetes, on the incidence of CKD. Awareness about systemic morbidities from periodontitis should be emphasized.
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Affiliation(s)
- Attawood Lertpimonchai
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suphot Tamsailom
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chantrakorn Champaiboon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiporn Ingsathit
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chagriya Kitiyakara
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anusorn Limpianunchai
- Medical and Health Division, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Piyamitr Sritara
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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30
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Schütz JDS, de Azambuja CB, Cunha GR, Cavagni J, Rösing CK, Haas AN, Thomé FS, Fiorini T. Association between severe periodontitis and chronic kidney disease severity in predialytic patients: A cross-sectional study. Oral Dis 2019; 26:447-456. [PMID: 31742816 DOI: 10.1111/odi.13236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/22/2019] [Accepted: 11/10/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients. MATERIALS AND METHODS Demographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full-mouth six-sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m2 ) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS Patients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25-6.62) and 3.4 (95% CI: 1.27-9.09) times higher risk of being in stages 4 and 5 of CKD, respectively. Having ≥ 2 teeth with clinical attachment loss (CAL) ≥6 mm increased 3.9 times the risk of being in stage 5 of CKD. Patients with severe periodontitis and ≥2 teeth with CAL ≥ 6 mm had 4.4 ml/min/1.732 and 5.2 ml/min/1.732 lower eGFR (p-values < .05), respectively. CONCLUSION Severe periodontitis was associated with poor renal conditions in predialytic CKD patients, strengthening the importance of periodontal evaluation in such patient population.
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Affiliation(s)
- Jasper da Silva Schütz
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Barrera de Azambuja
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliano Cavagni
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Tiago Fiorini
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Kopić V, Barbić J, Petrović S, Šahinović I, Mihaljević D, Kopić A, Bošnjak A. PERIODONTAL DISEASE IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE. Acta Clin Croat 2019; 58:709-715. [PMID: 32595256 PMCID: PMC7314301 DOI: 10.20471/acc.2019.58.04.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Periodontal disease is a chronic multifactorial disease the worldwide incidence of which is higher than the incidence of caries and represents one of the leading problems in dental medicine. It is manifested by the loss of the attachment apparatus of the tooth and leads to the loss of teeth. Numerous studies have shown the association of periodontal disease and various chronic systemic diseases such as diabetes mellitus and cardiovascular disease. It is believed that low-grade level of chronic inflammation and release of bacterial toxins and inflammatory mediators in the bloodstream aggravate a chronic systemic disease. The purpose of our research was to investigate the possible association of periodontal disease and chronic kidney disease via the inflammatory cytokines path. In this cross-sectional study, we surveyed a total of 80 subjects divided into two groups. First group included subjects with chronic renal disease stages III and IV, and the second group included patients with chronic renal disease stage V that were on hemodialysis. We compared periodontal status, as well as serum levels of different cytokines, interleukin 6, interleukin 17A and tumor necrosis factor α between the two groups. The results showed no significant between-group differences in periodontal status, but interleukin 6 levels were significantly higher in the hemodialysis group of patients and were also associated with a poorer periodontal status.
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Affiliation(s)
| | - Jerko Barbić
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
| | - Sanjin Petrović
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
| | - Ines Šahinović
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
| | - Dubravka Mihaljević
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
| | - Andrijana Kopić
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
| | - Andrija Bošnjak
- 1Department of Maxillofacial and Oral Surgery, Osijek University Hospital Centre, Osijek, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Nephrology and Dialysis, Osijek University Hospital Centre, Osijek, Croatia; 4Department of Clinical Laboratory Diagnostics, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Ophthalmology, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia; 7Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia
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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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Khouja T, Miller RG, Moore PA, Orchard TJ, Costacou T. Periodontal disease, smoking, cardiovascular complications and mortality in type 1 diabetes. J Diabetes Complications 2019; 33:603-609. [PMID: 31235433 PMCID: PMC6690769 DOI: 10.1016/j.jdiacomp.2019.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 12/16/2022]
Abstract
AIM To assess the role of periodontal disease (PD) as a predictor of coronary artery disease (CAD) and mortality in a prospective type 1 diabetes (T1D) cohort and to evaluate the role of smoking in this relationship. METHODS Data were based on 320 participants of the Pittsburgh Epidemiology of Diabetes Complications study of T1D who, during 1992-94, received a partial mouth periodontal exam, and who were followed for up to 19 years to ascertain complication incidence. PD was defined as clinical attachment loss of ≥4 mm for at least 10% of the examined sites. Predictors of all-cause mortality; Hard CAD (CAD death, myocardial infarction or revascularization), and Total CAD (Hard CAD, angina, ischemic ECG) were assessed using Cox models. RESULTS During 19 years of follow-up, 33.7% (97/288) developed CAD, 27.3% (83/304) developed Hard CAD, and 16.9% (54/320) died. Among current smokers, 46.4% (26/56) developed CAD, 42.7% (24/56) developed Hard CAD and 29.5% (18/61) died. PD was not associated with all-cause mortality, although it was a significant predictor of both CAD (HR = 1.12, CI = 1.01-1.23) and Hard CAD (HR = 1.30, CI = 1.11-1.51). As smoking modified the PD-CAD and PD-Hard CAD associations, analyses were stratified by smoking status. PD was associated with an increased risk of CAD (HR = 1.25, CI = 1.03-1.50) and Hard CAD (HR = 1.85, CI = 1.17-2.93) only among smokers. CONCLUSION PD was a significant predictor of CAD and Hard CAD among current smokers with T1D.
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Affiliation(s)
- Tumader Khouja
- University of Pittsburgh, Graduate School of Public Health, Department of Health Policy and Management, Pittsburgh, PA, United States
| | - Rachel G Miller
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, United States
| | - Paul A Moore
- University of Pittsburgh, School of Dental Medicine, Department of Dental Public Health, Pittsburgh, PA, United States
| | - Trevor J Orchard
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, United States
| | - Tina Costacou
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, United States.
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Thanakun S, Pawaputanon Na Mahasarakham C, Pornprasertsuk-Damrongsri S, Izumi Y. Correlation of plasma osteopontin and osteocalcin with lower renal function in dental patients with carotid artery calcification and tooth loss. J Oral Biosci 2019; 61:183-189. [PMID: 31400547 DOI: 10.1016/j.job.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/23/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate plasma osteopontin (OPN) and osteocalcin (OCN) levels in dental patients with carotid artery calcification (CAC) and determine the correlations between these proteins and renal function and tooth loss. METHODS The health parameters and number of teeth of 99 participants were recorded. Panoramic radiographs were taken for CAC evaluation, and OPN and OCN levels were measured. RESULTS None of the participants had overt kidney disease, and 14 (14.14%) had CAC. The age, sex, and health profiles of patients with CAC were not different from those without CAC. The OPN and OCN levels in participants with CAC were higher than in those without (p = 0.026 and p = 0.025, respectively). The OPN levels were correlated with the estimated glomerular filtration rate (eGFR) (p = 0.021) and tooth loss (p = 0.027). The OCN levels were correlated with the eGFR (p = 0.002), tooth loss (p = 0.023), blood urea nitrogen (p = 0.040), and creatinine levels (p = 0.031). The median tooth loss in individuals with an eGFR <60 mL/min/1.73 m2 was higher than that of individuals with an eGFR ≥60 mL/min/1.73 m2 (p = 0.033). In individuals with CAC, tooth loss correlated more strongly with the eGFR, and the correlation between OPN and OCN levels was more apparent. CONCLUSION Dental patients with CAC and increased tooth loss have a greater tendency for decreased renal function, which may be associated with OPN and OCN; thus, these patients should be referred for investigation.
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Affiliation(s)
- Supanee Thanakun
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; Oral Diagnosis and Oral Medicine Clinic, Dental Hospital, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
| | | | | | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan.
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35
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Kitamura M, Mochizuki Y, Miyata Y, Obata Y, Mitsunari K, Matsuo T, Ohba K, Mukae H, Yoshimura A, Nishino T, Sakai H. Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation. Int J Mol Sci 2019; 20:ijms20143413. [PMID: 31336777 PMCID: PMC6678374 DOI: 10.3390/ijms20143413] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.
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Affiliation(s)
- Mineaki Kitamura
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yasushi Mochizuki
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
| | - Yoko Obata
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hideki Sakai
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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36
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Atuegwu NC, Perez MF, Oncken C, Thacker S, Mead EL, Mortensen EM. Association between Regular Electronic Nicotine Product Use and Self-reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1263. [PMID: 30970567 PMCID: PMC6479961 DOI: 10.3390/ijerph16071263] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 12/11/2022]
Abstract
Electronic nicotine product use is increasing in the U.S., but few studies have addressed its effects on oral health. The goal of this work was to determine the association between electronic nicotine product use and periodontal disease. Population Assessment of Tobacco and Health adult survey data from 2013⁻2016 (waves 1, 2 and 3) was used for the analysis. Longitudinal electronic nicotine product users used electronic nicotine products regularly every day or somedays in all three waves. Participants with new cases of gum disease reported no history of gum disease in wave 1 but reported being diagnosed with gum disease in waves 2 or 3. Odds ratios (OR) were calculated to determine the association between electronic nicotine product use and new cases of gum disease after controlling for potential cofounders. Compared to never users, longitudinal electronic nicotine product users had increased odds of being diagnosed with gum disease (OR 1.76, 95% Confidence Interval (CI) 1.12⁻2.76) and bone loss around teeth (OR 1.67, 95% CI 1.06⁻2.63). These odds were higher for participants with a history of marijuana and a history of illicit or non-prescribed drug use. Our findings show that e-cigarettes may be harmful to oral health.
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Affiliation(s)
- Nkiruka C Atuegwu
- Department of Medicine, UConn Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
| | - Mario F Perez
- Department of Medicine, UConn Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
| | - Cheryl Oncken
- Department of Medicine, UConn Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
| | - Sejal Thacker
- Division of Periodontology, UConn Health, University of Connecticut School of Dental Medicine, Farmington, CT 06030, USA.
| | - Erin L Mead
- Department of Medicine, UConn Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
| | - Eric M Mortensen
- Department of Medicine, UConn Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
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Iwasaki M, Taylor GW, Sato M, Minagawa K, Ansai T, Yoshihara A. Effect of chronic kidney disease on progression of clinical attachment loss in older adults: A 4‐year cohort study. J Periodontol 2019; 90:826-833. [DOI: 10.1002/jper.18-0464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/09/2019] [Accepted: 01/27/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Masanori Iwasaki
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - George W. Taylor
- Department of Preventive and Restorative Dental SciencesUniversity of California San Francisco San Francisco CA USA
| | - Misuzu Sato
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
| | - Kumiko Minagawa
- Division of Preventive DentistryDepartment of Oral Health ScienceGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
| | - Toshihiro Ansai
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health PromotionDepartment of Oral Health and WelfareGraduate School of Medical and Dental SciencesNiigata University Niigata Japan
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38
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Chopra A, Sivaraman K. An update on possible pathogenic mechanisms of periodontal pathogens on renal dysfunction. Crit Rev Microbiol 2019; 45:514-538. [PMID: 30729832 DOI: 10.1080/1040841x.2018.1553847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontitis is a potential source of permanent systemic inflammation that initiates renal dysfunction and contributes to the development of chronic kidney diseases (CKDs). Although numerous studies have confirmed the bidirectional role of periodontal infection and renal inflammation, no literature has yet highlighted the sophisticated pathogenic mechanisms by which periodontal pathogens, particularly Porphynomonas Gingivalis, induce renal dysfunction and contributed in the development of CKDs. The present review aims to critically analyze and highlight the novel pathogenesis of periodontitis induced CKDs.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Asadoorian J, Forget EL, Grace J, Torabi M. Exploring dental hygiene decision making: A quantitative study of potential organizational explanations. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2019; 53:7-22. [PMID: 33240338 PMCID: PMC7533817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/17/2018] [Accepted: 01/01/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND To improve public access to oral health care, dental hygienists have been identified for practice expansion, and, therefore, they must demonstrate decision-making capacity. This study aimed to identify and test potentially influential factors in dental hygiene decision making. Organizational and gender factors were hypothesized to be most influential and focused the study. METHODS A 2-phase mixed methods approach was used. In Phase I, a qualitative decision-making model was developed and subsequently published in 2012. Phase II tested aspects of the model through an electronic survey instrument and key informant interviews. This article reports on the statistical results of the quantitative survey. A third article will report on the qualitative thematic analyses and merged interpretation. RESULTS The Phase I qualitative model guided the development of the survey instrument. The survey had a 38% response rate; moderate to weak correlations between predictor variables (structural and individual) and clinical decision making were shown. The final statistical model demonstrated that individual characteristics and graduating from a 3-year dental hygiene program were together significantly associated with decision-making capacity. DISCUSSION AND CONCLUSIONS Individual characteristics and longer education were together shown to be associated with increased decision-making capacity. These findings did not show the organization or gender to be important in influencing decision-making capacity. However, the merging of the quantitative survey and qualitative key informant data will potentially inform how the organization influences the individual dental hygienist.
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Affiliation(s)
| | | | - Joan Grace
- University of Winnipeg, Winnipeg, Manitoba, Canada
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40
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Czesnikiewicz-Guzik M, Nosalski R, Mikolajczyk TP, Vidler F, Dohnal T, Dembowska E, Graham D, Harrison DG, Guzik TJ. Th1-type immune responses to Porphyromonas gingivalis antigens exacerbate angiotensin II-dependent hypertension and vascular dysfunction. Br J Pharmacol 2018; 176:1922-1931. [PMID: 30414380 PMCID: PMC6534780 DOI: 10.1111/bph.14536] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/15/2018] [Accepted: 10/09/2018] [Indexed: 12/18/2022] Open
Abstract
Background and Purpose Emerging evidence indicates that hypertension is mediated by immune mechanisms. We hypothesized that exposure to Porphyromonas gingivalis antigens, commonly encountered in periodontal disease, can enhance immune activation in hypertension and exacerbate the elevation in BP, vascular inflammation and vascular dysfunction. Experimental Approach Th1 immune responses were elicited through immunizations using P. gingivalis lysate antigens (10 μg) conjugated with aluminium oxide (50 μg) and IL‐12 (1 μg). The hypertension and vascular endothelial dysfunction evoked by subpressor doses of angiotensin II (0.25 mg·kg−1·day−1) were studied, and vascular inflammation was quantified by flow cytometry and real‐time PCR. Key Results Systemic T‐cell activation, a characteristic of hypertension, was exacerbated by P. gingivalis antigen stimulation. This translated into increased aortic vascular inflammation with enhanced leukocyte, in particular, T‐cell and macrophage infiltration. The expression of the Th1 cytokines, IFN‐γ and TNF‐α, and the transcription factor, TBX21, was increased in aortas of P. gingivalis/IL‐12/aluminium oxide‐immunized mice, while IL‐4 and TGF‐β were unchanged. These immune changes in mice with induced T‐helper‐type 1 immune responses were associated with an enhanced elevation of BP and endothelial dysfunction compared with control mice in response to 2 week infusion of a subpressor dose of angiotensin II. Conclusions and Implications These results support the concept that Th1 immune responses induced by bacterial antigens such as P. gingivalis can increase sensitivity to subpressor pro‐hypertensive insults such as low‐dose angiotensin II, thus providing a mechanistic link between chronic infection, such as periodontitis, and hypertension. Linked Articles This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc
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Affiliation(s)
- Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School and Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.,Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University School of Medicine, Kraków, Poland
| | - Ryszard Nosalski
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Tomasz P Mikolajczyk
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Francesca Vidler
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Tomasz Dohnal
- Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University School of Medicine, Kraków, Poland
| | - Elzbieta Dembowska
- Department of Periodontology, Pomeranian Medical University, Szczecin, Poland
| | - Delyth Graham
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - David G Harrison
- Department of Clinical Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Kraków, Poland
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Pietropaoli D, Del Pinto R, Ferri C, Wright JT, Giannoni M, Ortu E, Monaco A. Poor Oral Health and Blood Pressure Control Among US Hypertensive Adults. Hypertension 2018; 72:1365-1373. [DOI: 10.1161/hypertensionaha.118.11528] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Davide Pietropaoli
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Rita Del Pinto
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Claudio Ferri
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Jackson T. Wright
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Case Western Reserve University, OH (J.T.W.)
| | - Mario Giannoni
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Eleonora Ortu
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Annalisa Monaco
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
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Shin HS. Number of existing permanent teeth is associated with chronic kidney disease in the elderly Korean population. Korean J Intern Med 2018; 33:1150-1159. [PMID: 28407463 PMCID: PMC6234409 DOI: 10.3904/kjim.2016.386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/01/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/AIMS The aim of this study was to assess the association between the number of existing permanent teeth and chronic kidney disease (CKD) in a representative sample of the elderly Korean population. METHODS A total of 2,519 subjects who participated in the Korean National Health and Nutrition Examination Survey were cross-sectionally examined. The number of existing permanent teeth was evaluated by clinical oral examination. CKD was defined based on definition and classification by Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines. Multivariable logistic regression analyses were performed controlling for age, gender, income, education, tooth-brushing frequency, periodontitis, state of dentition, smoking, alcohol consumption, hypertension, obesity, diabetes mellitus, and hypercholesterolemia. Subgroup analyses by age and gender were also performed. RESULTS The number of teeth was significantly associated with CKD after controlling for all potential confounders (adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.04 to 2.70 for lower number of teeth; AOR, 1.59; 95% CI, 1.14 to 2.23 for moderate number of teeth). In the subgroup analyses, the association was highlighted in females aged 75 years over (AOR, 2.55; 95% CI, 1.05 to 6.20 for lower number of teeth; AOR, 1.95; 95% CI, 1.01 to 3.80 for moderate number of teeth). CONCLUSION Our findings suggest that the number of existing permanent teeth may be associated with CKD among Korean elderly.
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Affiliation(s)
- Hye-Sun Shin
- Correspondence to Hye-Sun Shin, Ph.D. Department of Dental Hygiene, Eulji University College of Health Science, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea Tel: +82-31-740-7247 Fax: +82-31-740-7352 E-mail:
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43
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Yonel Z, Sharma P. The Role of the Dental Team in the Prevention of Systemic Disease: the Importance of Considering Oral Health As Part of Overall Health. Prim Dent J 2018; 6:24-27. [PMID: 30188311 DOI: 10.1308/205016817821930980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The global burden of non-communicable disease (NCD) is significant and the World Health Organization highlighted tackling non-communicable diseases (NCDs) as a key strategic objective in their 'Global action plan for the prevention and control of noncommunicable diseases, 2013-2020'. Dental teams see a large proportion of the UK population at regular intervals, including when patients deem themselves to be in good dental health. Given that many NCDs have shared risk factors, often behavioural with implications for oral and general health, dental teams are ideally placed to provide preventative advice for diseases beyond the oral environment. This article aims to assess the key risk factors for NCDs and oral diseases as well as assess the potential for dental care professionals (DCPs) to provide patients with general health advice based on their individual risk factors.
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Affiliation(s)
- Zehra Yonel
- College of Medical and Dental Sciences, University of Birmingham School of Dentistry, Birmingham, UK
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44
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Kim HY, Park SY, Choung SY. Enhancing effects of myricetin on the osteogenic differentiation of human periodontal ligament stem cells via BMP-2/Smad and ERK/JNK/p38 mitogen-activated protein kinase signaling pathway. Eur J Pharmacol 2018; 834:84-91. [DOI: 10.1016/j.ejphar.2018.07.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 01/12/2023]
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45
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Zhao D, Khawaja AT, Jin L, Li KY, Tonetti M, Pelekos G. The directional and non-directional associations of periodontitis with chronic kidney disease: A systematic review and meta-analysis of observational studies. J Periodontal Res 2018; 53:682-704. [PMID: 29777531 DOI: 10.1111/jre.12565] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
This systematic review aimed to assess the current evidence on the directional and non-directional associations of periodontitis with chronic kidney disease (CKD). Electronic search for observational studies on the association of periodontitis with CKD was performed in MEDLINE, EMBASE, PubMed, Open GREY and Cochrane library up to June 5, 2017. Two reviewers conducted study selection, data collection and assessment of methodological quality using the original and modified Newcastle-Ottawa Scale. Cohort, case-control and cross-sectional studies were included, which clearly defined periodontitis and CKD or reported acceptable clinical parameters of these 2 diseases in adults. Meta-analysis was employed to estimate the pooled odds ratio on the non-directional association and the incidence rate ratio (IRR) for the directional association. Among 2530 potential eligible articles, 47 were finally included. Most of them investigated a non-directional association of periodontitis with CKD, including 7 case-control studies and 38 cross-sectional studies; 24 studies had statistical analysis on the non-directional association and 75% of them reported significant results, which were supported further by the meta-analysis (random: odds ratio = 2.12, P < .001; χ2 = 25.74, I2 = 88.3%). None of the studies focused on the directional association of CKD (as the exposure) with periodontitis (as the outcome), whereas 2 retrospective cohort studies explored a directional association of periodontitis (as the exposure) with CKD (as the outcome) (random: IRR=2.10, P > .05; fixed: IRR=1.76, P < .05; χ2 = 4.65, I2 = 78.3%). Overall, the high heterogeneity of studies limits the significance of these results. There is substantial evidence on the non-directional association of periodontitis with CKD, while there are limited studies on the directional association. Well-designed prospective studies with longer follow-ups in representative communities are needed to clarify the directional association and enhance the quality of the evidence on this topic.
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Affiliation(s)
- D Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - A T Khawaja
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - L Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - K-Y Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - M Tonetti
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - G Pelekos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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46
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Hu Z, Zhang Y, Li Z, Yu Y, Kang W, Han Y, Geng X, Ge S, Sun Y. Effect of Helicobacter pylori infection on chronic periodontitis by the change of microecology and inflammation. Oncotarget 2018; 7:66700-66712. [PMID: 27602578 PMCID: PMC5341831 DOI: 10.18632/oncotarget.11449] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 08/11/2016] [Indexed: 12/13/2022] Open
Abstract
Helicobacter pylori (H. pylori), a pathogen inducing peptic disease, is recently found to be binding to the progress of periodontitis. Most previous studies are case-controlled, and they investigate the risk of H. pylori infection in disease the development of while few studies evaluate the correlation between H. pylori and periodontal pathogens. Therefore, we investigated the correlation between H. pylori infection with periodontal parameters, periodontal pathogens and inflammation. The results indicated that patients with H. pylori showed significantly higher probing depth and attachment loss than those without (p < 0.05). Among 28 subgingival plaque samples from 14 patients, the frequencies of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Treponema denticola were significantly higher with H. pylori infection than those without H. pylori infection (p < 0.05). However, the frequency of Aggregatibacter actinomycetemcomitans was lower (p < 0.05). Furthermore, after human acute monocytic leukemia cell line (THP-1) was stimulated with cagA-positive standard strains (cagA+ H. pylori 26695), the expression of periodontitis-related molecules Wnt5a, interleukin 8 (IL-8), interleukin 6 (IL-6) and interferon gamma (IFN-γ) significantly increased (p < 0.05). Conversely, the expression of tumor necrosis factor alpha (TNF-α) was almost stable. Meanwhile, cagA+ H. pylori promoted significantly higher expression of IL-8 and Wnt5a than isogenic cagA mutants strains (cagA− H. pylori 26695) did. Taken together, our data suggested that H. pylori might promote the growth of some periodontal pathogens and aggravate the progress of chronic periodontitis.
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Affiliation(s)
- Zhekai Hu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Yu Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Zhiyu Li
- Department of Microbiology, Key Laboratory for Experimental Teratology of Chinese Ministry of Education, School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Yuedi Yu
- Shanghai Southwest Weiyu Middle School, Shanghai 200233, People's Republic of China.,Laboratory of Oral Tumor Biology, Shanghai Research Institute of Stomatology Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, People's Republic of China
| | - Wenyan Kang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Yingnan Han
- Department of Microbiology, Key Laboratory for Experimental Teratology of Chinese Ministry of Education, School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Xiwen Geng
- Department of Microbiology, Key Laboratory for Experimental Teratology of Chinese Ministry of Education, School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Shaohua Ge
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Yundong Sun
- Department of Microbiology, Key Laboratory for Experimental Teratology of Chinese Ministry of Education, School of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
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Feng L, Wang H, Lin M. Effect of painless STA on tooth extraction of elderly patients with periodontal diseases. Exp Ther Med 2018. [PMID: 29541167 PMCID: PMC5838287 DOI: 10.3892/etm.2018.5776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study compared the effects of tooth extractions under novel painless single tooth anesthesia (STA) and conventional anesthesia on elderly patients with periodontal diseases, and the impact of painless STA on clinical indicators of the patients. Elderly patients (n=116) with periodontal diseases who were treated in Jinan Central Hospital were selected to undergo extraction operation on loose teeth; all the patients were randomly divided into two groups. The tooth extraction operations were performed after painless STA and cartridge anesthesia; the effects of the tooth extraction operations and the operation time were recorded; Visual Analogue Scale (VAS), Kuttner facial expression scale, Frankl treatment compliance scale and Houpt behavior rating scale were utilized to assess and record the clinical indicators of the patients during the operations; the impacts of the two anesthesia techniques on the effect of the tooth extraction of patients with periodontal diseases were comprehensively analyzed. Compared with conventional cartridge anesthesia, painless STA could effectively shorten the operation time (P<0.01); the Frankl treatment compliance score and Houpt behavior rating score of patients receiving painless STA were remarkably higher than those of patients receiving conventional cartridge anesthesia (P<0.01); during the operation, painless STA could effectively reduce the blood pressure and slow the heart rate by comparing with cartridge anesthesia (P<0.01, P<0.05); the scores of STA and Kuttner facial expressions in patients receiving painless STA were significantly lower than those in patients receiving conventional cartridge anesthesia (P<0.01); after the operation, the incidence of adverse reactions, such as pain and swelling, in patients receiving painless STA was obviously decreased compared with that in patients receiving conventional cartridge anesthesia (P<0.01). The novel painless STA can notably shorten the time of tooth extraction of elderly patients with periodontal diseases, reduce postoperative pain and swelling, increase the compliance of the operation, alleviate the impact of tooth extraction operation on the clinical indicators of the patients and relieve the pain of patients caused by the operation.
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Affiliation(s)
- Li Feng
- Customer Service Management Office, Shandong University Affiliated to Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Haiming Wang
- Department of Stomatology, Jinan Hospital, Jinan, Shandong 250013, P.R. China
| | - Ming Lin
- Department of Stomatology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
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Zhang J, Jiang H, Sun M, Chen J. Association between periodontal disease and mortality in people with CKD: a meta-analysis of cohort studies. BMC Nephrol 2017; 18:269. [PMID: 28814274 PMCID: PMC5558661 DOI: 10.1186/s12882-017-0680-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Periodontal disease occurs relatively prevalently in people with chronic kidney disease (CKD), but it remains indeterminate whether periodontal disease is an independent risk factor for premature death in this population. Interventions to reduce mortality in CKD population consistently yield to unsatisfactory results and new targets are necessitated. So this meta-analysis aimed to evaluate the association between periodontal disease and mortality in the CKD population. METHODS Pubmed, Embase, Web of Science, Scopus and abstracts from recent relevant meeting were searched by two authors independently. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was explored by chi-square test and quantified by the I2 statistic. RESULTS Eight cohort studies comprising 5477 individuals with CKD were incorporated. The overall pooled data demonstrated that periodontal disease was associated with all-cause death in CKD population (RR, 1.254; 95% CI 1.046-1.503; P = 0.005), with a moderate heterogeneity, I2 = 52.2%. However, no evident association was observed between periodontal disease and cardiovascular mortality (RR, 1.30, 95% CI, 0.82-2.06; P = 0.259). Besides, statistical heterogeneity was substantial (I2 = 72.5%; P = 0.012). Associations for mortality were similar between subgroups, such as the different stages of CKD, adjustment for confounding factors. Specific to all-cause death, sensitivity and cumulative analyses both suggested that our results were robust. As for cardiovascular mortality, the association with periodontal disease needs to be further strengthened. CONCLUSIONS We demonstrated that periodontal disease was associated with an increased risk of all-cause death in CKD people. Yet no adequate evidence suggested periodontal disease was also at elevated risk for cardiovascular death.
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Affiliation(s)
- Jian Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China
| | - Hong Jiang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Min Sun
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, People's Republic of China
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
- Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of PR China, Hangzhou, People's Republic of China.
- Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Key Laboratory of Nephropathy, Hangzhou, Zhejiang Province, People's Republic of China.
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49
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França LFC, Vasconcelos ACCG, da Silva FRP, Alves EHP, Carvalho JS, Lenardo DD, de Souza LKM, Barbosa ALR, Medeiros JVR, de Oliveira JS, Vasconcelos DFP. Periodontitis changes renal structures by oxidative stress and lipid peroxidation. J Clin Periodontol 2017; 44:568-576. [DOI: 10.1111/jcpe.12729] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Luiz Felipe C. França
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Any Carolina C. G. Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
- Medicine School; Education Institute of Parnaiba Valley (IESVAP); Parnaiba PI Brazil
| | - Felipe R. P. da Silva
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Even H. P. Alves
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Joaquina S. Carvalho
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - David D. Lenardo
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
| | - Luan K. M. de Souza
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - André L. R. Barbosa
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - Jand-Venes R. Medeiros
- Laboratory of Experimental Physiopharmacology (LAFFEX); Federal University of Piauí; Parnaíba PI Brazil
| | - Jefferson S. de Oliveira
- Laboratory of Biology and Biochemistry Plants (BIOqPLANT); Federal University of Piauí; Parnaíba PI Brazil
| | - Daniel F. P. Vasconcelos
- Laboratory of Histological Analysis and Preparation (LAPHIS); Federal University of Piauí; Parnaíba PI Brazil
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50
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Ruospo M, Palmer SC, Wong G, Craig JC, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Tonelli M, Natale P, Saglimbene V, Pellegrini F, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Del Castillo D, Schon S, Bernat AG, Hegbrant J, Wollheim C, Gargano L, Bots CP, Strippoli GF. Periodontitis and early mortality among adults treated with hemodialysis: a multinational propensity-matched cohort study. BMC Nephrol 2017; 18:166. [PMID: 28532432 PMCID: PMC5440912 DOI: 10.1186/s12882-017-0574-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/05/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Periodontitis is associated with cardiovascular mortality in the general population and adults with chronic diseases. However, it is unclear whether periodontitis predicts survival in the setting of kidney failure. METHODS ORAL-D was a propensity matched analysis in 3338 dentate adults with end-stage kidney disease treated in a hemodialysis network in Europe and South America designed to examine the association between periodontitis and all-cause and cardiovascular-related mortality in people on long-term hemodialysis. Participants were matched 1:1 on their propensity score for moderate to severe periodontitis assessed using the World Health Organization Community Periodontal Index. A random-effects Cox proportional hazards model was fitted with shared frailty to account for clustering of mortality risk within countries. RESULTS Among the 3338 dentate participants, 1355 (40.6%) had moderate to severe periodontitis at baseline. After using propensity score methods to generate a matched cohort of participants with periodontitis similar to those with none or mild periodontal disease, moderate to severe periodontitis was associated with a lower risk of all-cause (9.1 versus 13.0 per 100 person years, hazard ratio 0.74, 95% confidence interval 0.61 to 0.90) and cardiovascular (4.3 versus 6.9 per 100 person years, hazard ratio 0.67, 0.51 to 0.88) mortality. These associations were not changed substantially when participants were limited to those with 12 or more natural teeth and when accounting for competing causes of cardiovascular death. CONCLUSION In contrast to the general population, periodontitis does not appear to be associated with an increased risk of early death in adults treated with hemodialysis.
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Affiliation(s)
- Marinella Ruospo
- Diaverum Medical Scientific Office, Lund, Sweden.,Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | | | | | | | - Massimo Petruzzi
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | - Michele De Benedittis
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | | | - David W Johnson
- University of Queensland, Brisbane, Australia.,Translational Research Institute, Brisbane, Australia
| | | | | | - Valeria Saglimbene
- Diaverum Medical Scientific Office, Lund, Sweden.,University of Sydney, Sydney, Australia
| | | | | | | | | | | | | | | | - Jan Dulawa
- Diaverum Medical Scientific Office, Lund, Sweden.,SHS, Medical University of Silesia, Katowice, Poland
| | - Luc Frantzen
- Diaverum Medical Scientific Office, Lund, Sweden
| | | | | | | | | | | | | | - Casper P Bots
- Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Giovanni Fm Strippoli
- Diaverum Medical Scientific Office, Lund, Sweden. .,University of Sydney, Sydney, Australia. .,Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy. .,Diaverum Academy, Lund, Sweden.
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