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Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Luján-Urviola E, Farje-Gallardo CA. Association between Periodontal Disease and Obesity: Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:621. [PMID: 38674267 PMCID: PMC11051919 DOI: 10.3390/medicina60040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Faculty of Dentistry, Dentistry School, San Martin de Porres University, Chiclayo 14012, Peru;
- Faculty of Human Medicine, Human Medicine School, San Martín de Porres University, Chiclayo 14012, Peru
| | - Fredy Hugo Cruzado-Oliva
- Faculty of Stomatology, Stomatology School, Nacional University of Trujillo, Trujillo 13001, Peru;
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Eduardo Luján-Urviola
- Faculty of Dentistry, Néstor Cáceres Velásquez Andean University, Juliaca 21104, Peru;
| | - Carlos Alberto Farje-Gallardo
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
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Menezes CCD, Barbirato DDS, Fogacci MF, Marañón-Vásquez GA, Carneiro JRI, Maia LC, Barros MCMD. Systemic benefits of periodontal therapy in patients with obesity and periodontitis: a systematic review. Braz Oral Res 2024; 38:e031. [PMID: 38597549 DOI: 10.1590/1807-3107bor-2024.vol38.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/09/2023] [Indexed: 04/11/2024] Open
Abstract
This systematic review aimed to answer the focused question: "What are the benefits of subgingival periodontal therapy on blood hematological and biochemical index, biomarkers of inflammation and oxidative stress, quality of life, and periodontal pathogen counts in patients with obesity and periodontitis?". A systematic literature search was performed in six databases: PubMed, Embase, LILACS, Web of Science, Cochrane and SCOPUS and other sources, and a manual search was conducted as well. Inclusion criteria were randomized and non-randomized clinical trials, and before-and-after studies on patients with obesity subjected to periodontal therapy. The results were synthesized qualitatively. Risk of bias within studies was assessed using RoB 2 and ROBINS-I tools. The certainty of evidence was evaluated following the GRADE approach. Three randomized controlled trials and 15 before-and-after studies were included. Randomized controlled trials were considered to have a low risk of bias, as compared to before-and-after studies assessed as having low, serious, and critical risks of bias. Non-surgical periodontal therapy plus azithromycin, chlorhexidine, and cetylpyridinium chloride reduced blood pressure and decreased serum levels of HbA1c, hsCRP, IL-1β, and TNF-α. Salivary resistin level also decreased in patients with obesity and periodontitis after therapy and chlorhexidine mouth rinse. Before-and-after data suggest an improvement in total cholesterol, LDL, triglycerides, insulin resistance, C3, GCF levels of TNF-α, chemerin, vaspin, omentin-1, visfatin, 8-OHdG, and periodontal pathogen counts after therapy.
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Affiliation(s)
- Cláudia Callegaro de Menezes
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Davi da Silva Barbirato
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Mariana Fampa Fogacci
- Universidade Federal de Pernambuco - UFPE, Department of Clinical and Preventive Dentistry, Recife, PE, Brazil
| | | | - João Régis Ivar Carneiro
- Universidade Federal do Rio de Janeiro - UFRJ, Clementino Fraga Filho Hospital University, Department of Nutrology/Bariatric Surgery, Rio de Janeiro, RJ, Brazil
| | - Lucianne Copple Maia
- Universidade Federal do Rio de Janeiro - UFRJ, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
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Lafaurie GI, Sabogal MA, Contreras A, Castillo DM, Gualtero DF, Avila JD, Trujillo TG, Duque A, Giraldo A, Duarte S, Gutierrez SJ, Ardila CM. Factors Associated with the Extent of Clinical Attachment Loss in Periodontitis: A Multicenter Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7043. [PMID: 37998274 PMCID: PMC10671280 DOI: 10.3390/ijerph20227043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
Periodontitis has significant public health implications, affecting individuals' overall health, well-being, and quality of life. This study aimed to assess the risk factors associated with the extent of clinical attachment loss (CAL) in a population diagnosed with periodontitis. Six hundred and sixty-seven patients with different degrees of CAL (mild, n = 223; moderate, n = 256; and advanced, n = 188) were enrolled. Socio-demographics, lifestyle, microbiological profiles, specific immune response, obesity, and single-nucleotide polymorphism of the IL1 gene were determined. Unconditional logistic regression models were conducted to determine the factors associated with the extent of CAL. Aging, smoking, microbial factors, plaque index, and IgG2 antibodies against Aggregatibacter actinomycetemcomitans were associated with advanced CAL. IgG2 antibodies against A. actinomycetemcomitans (OR 1.50; CI 95% 1.23-1.81), plaque accumulation (OR 2.69; CI 95% 2.20-3.29), Porphyromonas gingivalis (OR 1.93; CI 95% 1.35-2.76), Tanerella forsythia (OR 1.88; CI 95%1.30-2.70), and current smoking (OR 1.94; CI 95% 1.31-2.87) were associated with advanced CAL. Gene IL polymorphisms, obesity, and stress were not associated with the extent of CAL. Aging, plaque accumulation, smoking, and having antibodies against A. actinomycetemcomitans were the most critical factors associated with advanced CAL. In contrast, obesity, stress, and gene polymorphisms were not associated with the extent of CAL.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - María Alejandra Sabogal
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Adolfo Contreras
- Periodontal Medicine Group, Universidad del Valle, Cali 760042, Colombia; (A.C.); (S.J.G.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Diego Fernando Gualtero
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Juliette De Avila
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Tamy Goretty Trujillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, El Bosque University, Bogota 11001, Colombia or (G.I.L.); (M.A.S.); (D.M.C.); (D.F.G.); (J.D.A.); (T.G.T.)
| | - Andrés Duque
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Astrid Giraldo
- Research Group in Basic Sciences and Clinical Dentistry, CES University, Medellin 050021, Colombia; (A.D.); (A.G.)
| | - Silvia Duarte
- Dental Research Center-CIO, Pontificia Universidad Javeriana, Bogota 110311, Colombia;
| | | | - Carlos Martín Ardila
- Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia UdeA, Medellin 050010, Colombia
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Paranhos K, Oliveira S, Bonato R, Niknami N, Vinayak S, Loomer P. The impact of obesity on the outcome of periodontal disease treatment: Systematic review and meta-analysis. Dent Res J (Isfahan) 2023; 20:108. [PMID: 38020246 PMCID: PMC10680074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/25/2022] [Accepted: 07/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world's population. Several studies have mentioned that there may be a link between the two. The purpose of this systematic review was to determine whether there was a difference in response to nonsurgical periodontal therapies (NSPTs) between obese and nonobese individuals. Materials and Methods An online search was assembled with a combination of Medical Subject Headings terms and free-text words of the literature published up to December 2020, to identify interventional studies limited to an adult human population. Titles, abstracts, and finally full texts were scrutinized for possible inclusion by two independent investigators. Reduction in periodontal pocket depth was the primary parameter used to assess the outcome of NSPT. Results The primary search yielded 639 significant titles and abstracts. After filtering, data extraction, and quality assessment, 34 full-text studies were selected. All studies matching inclusion criteria, suggest a positive association between obesity and periodontal disease. Conclusion Although a possible correlation exists between periodontitis and obesity, as with other oral-systemic disease implications, some controversy exists. While some studies have reported a distinct correlation between periodontitis and obesity, other papers have suggested only moderate or no association between the two conditions at all. These results advise of a difference between response to NSPT amid obese and nonobese individuals. However, with few quality studies and variable reported findings, there is limited evidence of any significant difference in clinical practice. However, it can be a positive warning that obesity is a risk factor toward the outcome of periodontal disease treatment.
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Affiliation(s)
- Klenise Paranhos
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, NY, USA
| | | | | | - Neda Niknami
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, NY, USA
| | | | - Peter Loomer
- Dental Science Department at UT Health San Antonio, San Antonio, Texas, USA
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Lê S, Laurencin-Dalicieux S, Minty M, Assoulant-Anduze J, Vinel A, Yanat N, Loubieres P, Azalbert V, Diemer S, Burcelin R, Canceill T, Thomas C, Blasco-Baque V. Obesity Is Associated with the Severity of Periodontal Inflammation Due to a Specific Signature of Subgingival Microbiota. Int J Mol Sci 2023; 24:15123. [PMID: 37894804 PMCID: PMC10606428 DOI: 10.3390/ijms242015123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the link between periodontal microbiota and obesity in humans. We conducted a cohort study including 45 subjects with periodontitis divided into two groups: normo-weighted subjects with a body mass index (BMI) between 20 and 25 kg/m2 (n = 34) and obese subjects with a BMI > 30 kg/m2 (n = 11). Our results showed that obesity was associated with significantly more severe gingival inflammation according to Periodontal Inflamed Surface Area (PISA index). Periodontal microbiota taxonomic analysis showed that the obese (OB) subjects with periodontitis were characterized by a specific signature of subgingival microbiota with an increase in Gram-positive bacteria in periodontal pockets, associated with a decrease in microbiota diversity compared to that of normo-weighted subjects with periodontitis. Finally, periodontal treatment response was less effective in OB subjects with persisting periodontal inflammation, reflecting a still unstable periodontal condition and a risk of recurrence. To our knowledge, this study is the first exploring both salivary and subgingival microbiota of OB subjects. Considering that OB subjects are at higher periodontal risk, this could lead to more personalized preventive or therapeutic strategies for obese patients regarding periodontitis through the specific management of oral microbiota of obese patients.
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Affiliation(s)
- Sylvie Lê
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Sara Laurencin-Dalicieux
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- INSERM U1295, CERPOP, Epidémiologie et Analyse en Santé Publique, Risques, Maladies Chroniques et Handicaps, 37 Allées Jules Guesdes, 31000 Toulouse, France
| | - Matthieu Minty
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Justine Assoulant-Anduze
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Alexia Vinel
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR 1297 Inserm, Team ESTER, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France
| | - Noor Yanat
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Pascale Loubieres
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Azalbert
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Swann Diemer
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Remy Burcelin
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Thibault Canceill
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Charlotte Thomas
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
| | - Vincent Blasco-Baque
- Département d’Odontologie, Faculté de Santé, Université Paul Sabatier Toulouse III, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France; (S.L.); (S.L.-D.); (M.M.); (A.V.); (N.Y.); (P.L.)
- Service d’Odontologie Toulouse Rangueil, CHU Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR1297 Inserm, Team InCOMM/Intestine ClinicOmics Metabolism & Microbiota, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Paul Sabatier, 1 Avenue Jean Poulhes, 31432 Toulouse, France; (J.A.-A.); (V.A.); (S.D.); (R.B.)
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Lee Y, Jung BH, Yoo KY, Lim HJ, Shin KJ, Lee JK. Lactobacillus fermentum attenuates the alveolar bone loss in ligature-induced periodontitis in mice. Oral Dis 2023. [PMID: 37724481 DOI: 10.1111/odi.14739] [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: 05/01/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE This study investigated the effects of Lactobacillus fermentum BELF11 on periodontitis in mice (LIP). METHODS Sixty mice were randomly assigned to a control group (CTL), LIP/PBS group (LIP and PBS applied), or LIP/BELF11 group (LIP and L. fermentum BELF11 applied). For 14 days, PBS or L. fermentum BELF11 was applied twice daily to the mice in the LIP/PBS or LIP/BELF11 group, respectively. After 14 days, radiographic, histological, and pro-inflammatory cytokine assessments were conducted. RESULTS The LIP/PBS and LIP/BELF11 groups demonstrated greater alveolar bone loss than the CTL group (p < 0.05). The LIP/BELF11 group showed significantly reduced alveolar bone loss on the mesial side compared to the LIP/PBS group. Histologically, the LIP/BELF11 group showed consistent patterns of connective tissue fiber arrangement, lower levels of inflammatory infiltration, less alveolar bone loss, and higher alveolar bone density than the LIP/PBS group, despite showing more signs of destruction than the CTL group. The LIP/BELF11 group also exhibited significantly lower levels of pro-inflammatory cytokines than the LIP/PBS group. CONCLUSIONS L. fermentum BELF11 inhibits alveolar bone loss and periodontitis progression by regulating pro-inflammatory cytokine production. These findings suggest that L. fermentum BELF11 may be a potential adjunctive therapy in periodontal treatment.
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Affiliation(s)
- Yuni Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Bo Hyun Jung
- Department of Anatomy and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Ki-Yeon Yoo
- Department of Anatomy and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
| | - Hye Ji Lim
- R&D Center, Hecto Healthcare Co., Ltd, Seoul, Republic of Korea
| | - Kum-Joo Shin
- R&D Center, Hecto Healthcare Co., Ltd, Seoul, Republic of Korea
| | - Jae-Kwan Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Republic of Korea
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Kaye E, McDonough R, Singhal A, Garcia RI, Jurasic M. Effect of Overweight and Obesity on Periodontal Treatment Intensity. JDR Clin Trans Res 2023; 8:158-167. [PMID: 35148660 PMCID: PMC10029136 DOI: 10.1177/23800844221074354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Obesity is associated with greater utilization of medical resources, but it is unclear if a similar relationship exists for dental care. OBJECTIVES This retrospective cohort study compared periodontal disease treatment among obese, overweight, and normal-weight patients attending an urban US dental school clinic. METHODS Periodontal, demographic, and medical history data for 3,443 adult patients examined between July 1, 2010, and July 31, 2019, were extracted from electronic health records. Body mass index (BMI) was computed from self-reported height and weight and categorized as obese (≥30 kg/m2), overweight (25-29.9 kg/m2), or normal (18-24.9 kg/m2). Periodontal disease was categorized using clinical probing measures. Procedure codes defined treatment type (surgical, nonsurgical, local chemotherapeutics, or none). Logistic regression models controlling for initial periodontal disease severity, age, gender, tobacco use, history of diabetes, dental insurance type, and follow-up (log of days) estimated odds ratios (ORs) and 95% confidence intervals (CIs) of any treatment among obese and overweight relative to normal-weight patients. The association between BMI and a periodontal treatment intensity score, based on treatment type, number of teeth treated, and number of visits, was evaluated with multivariable negative binomial regression. RESULTS Mean age at baseline was 44 ± 15 y, and severe periodontal disease was present in 32% of obese, 31% of overweight, and 21% of normal-weight patients. Average follow-up was 3.9 ± 1.6 y. Obese and overweight patients were more likely to have nonsurgical scaling and root planing or surgical procedures than normal-weight patients. Adjusted odds of any treatment were higher among obese (OR = 1.34; 95% CI, 1.14-1.72) and overweight (OR = 1.18; 95% CI, 0.97-1.42) relative to normal weight. Obese and overweight patients had 40% and 24% higher treatment intensity scores, respectively, than normal-weight patients. CONCLUSION These results indicate obese and overweight individuals require more intensive periodontal treatment compared to normal-weight individuals, independent of initial disease severity. KNOWLEDGE OF TRANSFER STATEMENT The results of this study can be used by dental providers and policymakers to better understand patient characteristics that influence the variability in frequency and length of periodontal treatment. Knowledge of a patient's body mass index may be useful in identifying patients who possibly will have a poorer periodontal prognosis.
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Affiliation(s)
- E Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - R McDonough
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - A Singhal
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - R I Garcia
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - M Jurasic
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
- Department of General Dentistry, Director of the Center for Clinical Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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8
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Čolak D, Cmok Kučič A, Pintar T, Gašperšič R. Periodontal Therapy in Bariatric Surgery Patients with Periodontitis: Randomized Control Clinical Trial. J Clin Med 2022; 11:jcm11226837. [PMID: 36431314 PMCID: PMC9693218 DOI: 10.3390/jcm11226837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Bariatric surgery (BS) patients may experience the progression of periodontitis during recovery. We aimed to determine whether non-surgical periodontal therapy before BS improves the periodontal and systemic health parameters after the surgery. Methods: BS candidates with periodontitis were randomized into the test (TG) and control group (CG). One month before BS (pre-BS), patients in the TG (n = 15) received non-surgical periodontal therapy, while patients in the CG (n = 15) received only mechanical plaque removal. Patients were re-examined 3 and 6 months after BS. Differences between the TG and CG in clinical periodontal parameters, systemic health-related serum biomarkers, parameters of obesity, and prevalence of obesity-related diseases were evaluated. Results: From the 30 included patients, 26 were re-examined at 3 months and 20 patients at 6 months. Periodontal parameters bleeding on probing (p = 0.015), periodontal pocket dept (PPD, p = 0.0015), % PPD > 4 mm (p < 0.001), and full-mouth plaque levels (p = 0.002) were lower in the TG than in the CG at 6 months after BS. There is a general improvement in systemic health after BS without significant differences (p > 0.05) between the TG and CG at the 6-month follow-up. The TG shows a tendency for improvement in metabolic syndrome components at the 6-month follow-up compared to pre-BS (p < 0.05). Conclusions: Non-surgical periodontal therapy in periodontitis patients before the BS may improve periodontal health 3 and 6 months after the surgery. The possible benefits of periodontal therapy on the overall health of BS patients should be further explored.
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Affiliation(s)
- Dejana Čolak
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
| | - Alja Cmok Kučič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tadeja Pintar
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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9
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Lavigne SE. Evolving evidence for relationships between periodontitis and systemic diseases: Position paper from the Canadian Dental Hygienists Association. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2022; 56:155-171. [PMID: 36451995 PMCID: PMC9674001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 06/17/2023]
Abstract
AIM The aim of this position paper is to investigate the current state of the evidence for proposed associations between periodontitis and rheumatoid arthritis, Alzheimer's disease, obesity, inflammatory cancers, and renal disease using a narrative review approach. This is the last of a series of 5 position papers from the Canadian Dental Hygienists Association (CDHA) on the relationship between periodontitis and systemic conditions. METHODS Individual literature searches were conducted for each of the 5 proposed linkages and limited to human studies, with a preference for systematic reviews (SRs) and prospective studies, in the English language, published between 2015 and 2021, focused on associations between 1) periodontitis and rheumatoid arthritis; 2) periodontitis and Alzheimer's disease/cognitive impairment; 3) periodontitis and obesity; 4) periodontitis and inflammatory cancers; and 5) periodontitis and chronic kidney disease. Databases searched were PubMed, MEDLINE/OVID, CINAHL, Scopus, Cochrane Registry of Systematic Reviews, and Web of Science. RESULTS A total of 39 papers were selected for discussion, including 6 SRs for rheumatoid arthritis; 7 SRs for Alzheimer's disease/cognitive impairment; 11 SRs, 1 meta-review of SRs, and 1 population-based cohort study for obesity; 9 SRs for inflammatory cancers; and 4 SRs for kidney disease. CONCLUSIONS The evidence for the 5 proposed associations varied in strength, with obesity being most strongly associated with periodontal disease. More robust studies are recommended to clarify the exact nature of these associations.
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Affiliation(s)
- Salme E Lavigne
- Senior scholar and retired professor, School of Dental Hygiene, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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10
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Zhao P, Xu A, Leung WK. Obesity, Bone Loss, and Periodontitis: The Interlink. Biomolecules 2022; 12:biom12070865. [PMID: 35883424 PMCID: PMC9313439 DOI: 10.3390/biom12070865] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity and periodontitis are both common health concerns that have given rise to considerable economic and societal burden worldwide. There are established negative relationships between bone metabolism and obesity, obesity and diabetes mellitus (DM), and DM and periodontitis, to name a few, with osteoporosis being considered a long-term complication of obesity. In the oral cavity, bone metabolic disorders primarily display as increased risks for periodontitis and alveolar bone loss. Obesity-driven alveolar bone loss and mandibular osteoporosis have been observed in animal models without inoculation of periodontopathogens. Clinical reports have also indicated a possible association between obesity and periodontitis. This review systematically summarizes the clinical periodontium changes, including alveolar bone loss in obese individuals. Relevant laboratory-based reports focusing on biological interlinks in obesity-associated bone remodeling via processes like hyperinflammation, immune dysregulation, and microbial dysbiosis, were reviewed. We also discuss the potential mechanism underlying obesity-enhanced alveolar bone loss from both the systemic and periodontal perspectives, focusing on delineating the practical considerations for managing periodontal disease in obese patients.
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Affiliation(s)
- Pengfei Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Aimin Xu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
- Correspondence: ; Tel.: +852-2859-0417
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11
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Pereira KKY, Jara CM, Antunes GL, Gomes MS, Rösing CK, Cavagni J, Haas AN. Effects of periodontitis and periodontal treatment on systemic inflammatory markers and metabolic profile in obese and non-obese rats. J Periodontol 2022; 93:1411-1420. [PMID: 35289404 DOI: 10.1002/jper.21-0575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/03/2022] [Accepted: 02/14/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about a synergistic effect of periodontitis and obesity on systemic biomarkers and a possible effect periodontal treatment may exert. This study aimed to evaluate the impact of periodontitis and periodontal treatment on systemic inflammation and metabolic profile in obese and non-obese rats. METHODS 60 male Wistar rats were randomly divided in six groups differentiated by diet and periodontal status: no periodontitis (G1 and G4), untreated ligature-induced periodontitis (G2 and G5) and treated ligature-induced periodontitis (G3 and G6). Groups G4, G5 and G6 were exposed to cafeteria diet to induce obesity. Periodontitis was induced by silk ligatures over 4 weeks (G2, G3, G5, G6). Rats in G3 and G6 received scaling and root planning and were followed for additional 4 weeks. After sacrifice, serum levels of C-reactive protein (CRP), interleukin (IL)-1β, IL-6, IL-10, IL-17a, tumor necrosis factor alfa (TNF-α), glucose, triglycerides, and total cholesterol (TC) were compared between groups. RESULTS CRP was significantly higher in obese rats with than without periodontitis (G5 = 10.15μg/L vs. G4 = 4.47μg/L, p = 0.01). No beneficial effects of periodontal treatment were observed for CRP levels, IL-6, IL-1β, IL-17a, TNF-α, glucose and triglycerides. Treated periodontitis (G6) exhibited significantly lower TC than the periodontitis group (G5) in obese rats. CONCLUSION Periodontitis increased serum CRP in obese rats, indicating a synergistic role of periodontitis in the systemic inflammatory burden triggered by obesity. The treatment of induced periodontitis reduced TC levels in obese rats. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Karina Kimiko Yamashina Pereira
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cynthia Mireya Jara
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Faculty of Dentistry, National University of Assunción, Assunción, Paraguay
| | - Géssica Luana Antunes
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maximiliano Schünke Gomes
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Medical and Dental Center of the Military Police of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliano Cavagni
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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12
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Ganesan SM, Vazana S, Stuhr S. Waistline to the gumline: Relationship between obesity and periodontal disease-biological and management considerations. Periodontol 2000 2021; 87:299-314. [PMID: 34463987 DOI: 10.1111/prd.12390] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obesity is a pandemic and periodontitis is the sixth most prevalent disease in the world. These two noncommunicable diseases share several risk determinants. Epidemiologic evidence from the last 2 decades has established an increase in periodontitis prevalence in obese and overweight individuals. Biologic mechanisms potentially linking obesity and periodontal disease are adiposity-associated hyperinflammation, microbial dysbiosis, altered immune response, specific genetic polymorphisms, and increased stress. However, because of the lack of longitudinal interventional studies and randomized clinical trials, there is insufficient evidence to determine the cause-effect relationship between these two diseases. Despite this, the negative impact of obesity on oral health is well established. Several logistic and physiologic complications are associated with treating obese patients in a dental setting, and it requires an interprofessional team approach. Oral health care professionals need to be aware of the specific management considerations while rendering for this cohort, including modified practice facility and equipment, tailored supportive periodontal therapy, and heightened precaution during conscious sedation and surgical procedures.
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Affiliation(s)
- Sukirth M Ganesan
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Stephanie Vazana
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Sandra Stuhr
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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13
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Silva-Boghossian CM, Dezonne RS. What Are the Clinical and Systemic Results of Periodontitis Treatment in Obese Individuals? ACTA ACUST UNITED AC 2021; 8:48-65. [PMID: 34367878 PMCID: PMC8327900 DOI: 10.1007/s40496-021-00295-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 12/24/2022]
Abstract
Purpose of Review Periodontitis and obesity are characterized by a dysregulated inflammatory state. Obese individuals have a higher chance of presenting periodontitis. Clinical studies in different populations demonstrate that individuals with obesity have worse periodontal conditions. This current review aims to explore recent literature to understand what the impacts of obesity on periodontal treatment outcomes are and to learn whether periodontal treatment can improve systemic biomarkers in obese individuals. Recent Findings Short- and long-term evaluations demonstrated that non-surgical periodontal treatment could improve clinical parameters in obese individuals, represented as the reduction in mean probing depth, sites with probing depth ≥ 4 mm, and extension of bleeding on probing. However, obese individuals may have less clinical improvement when compared to normal-weight individuals with a similar periodontal profile. Additionally, periodontal treatment may contribute to a reduction in systemic levels of retinol-binding protein 4 and leptin, while promoting an increase in systemic levels of adiponectin. Summary Overall, obese individuals with periodontitis can significantly benefit from non-surgical periodontal treatment. However, clinical improvements seem to be less prominent in obese individuals with periodontitis compared to non-obese individuals with similar periodontal status. Nevertheless, periodontal treatment may impact significantly on the reduction of several biochemical biomarkers of obesity with or without weight reduction. Further investigations are needed to improve our comprehension of the mechanisms underlying those findings.
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Affiliation(s)
- Carina M. Silva-Boghossian
- Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitaria, Rio de Janeiro, RJ CEP 21941-617 Brazil
| | - Romulo S. Dezonne
- Postgraduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, RJ Brazil
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14
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Krongbaramee T, Zhu M, Qian Q, Zhang Z, Eliason S, Shu Y, Qian F, Akkouch A, Su D, Amendt BA, Yang L, Hong L. Plasmid encoding microRNA-200c ameliorates periodontitis and systemic inflammation in obese mice. MOLECULAR THERAPY-NUCLEIC ACIDS 2021; 23:1204-1216. [PMID: 33664998 PMCID: PMC7899952 DOI: 10.1016/j.omtn.2021.01.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/28/2021] [Indexed: 02/08/2023]
Abstract
The present study was conducted to characterize microRNA-200c (miR-200c) and its regulators in adipogenic differentiation, obesity, and periodontitis in obese subjects (PiOSs), and to determine the therapeutic efficacy of plasmid DNA encoding miR-200c as a treatment for PiOSs. We report that highly expressed miR-200c in gingival tissues was downregulated in diet-induced obese (DIO) mice and during adipogenic differentiation of human bone marrow mesenchymal stromal cells (hBMSCs). Local injection of Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) in the maxilla interdental gingiva of DIO mice reduced miR-200c in gingival and adipose tissues and induced periodontal inflammation associated with systemic elevation of interleukin-6 (IL-6) and impaired glucose tolerance. The inhibitory functions of Pg-LPS and IL-6 on miR-200c and their effectiveness on Zeb1 were confirmed in vitro. Injection of naked plasmid DNA encoding miR-200c into the gingiva effectively rescued miR-200c downregulation, prevented periodontal and systemic inflammation, and alleviated the impaired glucose metabolism in obese mice with LPS-induced periodontitis. Increased circulating exosomal miR-200c and its function on suppressing proinflammatory cytokines and adipogenesis explained the mechanism(s) of gingival application of miR-200c in attenuating systemic inflammation in PiOSs. These results demonstrated that miR-200c reduced by Pg-LPS and IL-6 in periodontitis and obesity might lead to the pathogenesis of PiOSs, and upregulation of miR-200c in the gingiva presents a therapeutic approach for PiOSs.
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Affiliation(s)
- Tadkamol Krongbaramee
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA
| | - Min Zhu
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA
| | - Qingwen Qian
- Department of Anatomy and Cell Biology, Fraternal Order of Eagles Diabetes Research Center, Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Zeyuan Zhang
- Department of Anatomy and Cell Biology, Fraternal Order of Eagles Diabetes Research Center, Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Steven Eliason
- Department of Anatomy and Cell Biology, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA
| | - Yi Shu
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA
| | - Fang Qian
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA
| | - Adil Akkouch
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA
| | - Dan Su
- Department of Anatomy and Cell Biology, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA
| | - Brad A Amendt
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA.,Department of Anatomy and Cell Biology, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA.,Center for Craniofacial Anomalies Research, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA
| | - Ling Yang
- Department of Anatomy and Cell Biology, Fraternal Order of Eagles Diabetes Research Center, Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Liu Hong
- Iowa Institute for Oral Health Research, College of Dentistry, the University of Iowa, Iowa City, IA, USA.,Center for Craniofacial Anomalies Research, Carver College of Medicine, the University of Iowa, Iowa City, IA, USA
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15
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Periodontal Treatment Improves Serum Levels of Leptin, Adiponectin, and C-Reactive Protein in Thai Patients with Overweight or Obesity. Int J Dent 2021; 2021:6660097. [PMID: 33603787 PMCID: PMC7872757 DOI: 10.1155/2021/6660097] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/24/2020] [Accepted: 01/02/2021] [Indexed: 12/21/2022] Open
Abstract
Periodontitis and overweight or obesity independently change serum levels of leptin, adiponectin, and C-reactive protein (CRP). The aim of this study is to investigate the alterations of serum levels of leptin, adiponectin, and CRP after nonsurgical periodontal treatment (NSPT) in Thai patients with overweight or obesity (Owt/Ob) who did or did not exhibit severe periodontitis (SP) and normal weight (Nwt) patients with or without SP. Two hundred sixty patients were screened; 29 patients were included in this study. The study participants comprised 6 patients with Owt/Ob who exhibited SP, 11 patients with Owt/Ob who did not exhibit SP, 5 Nwt patients with SP, and 7 Nwt patients without SP. Periodontal disease status was evaluated; serum levels of leptin, adiponectin, and CRP were determined by enzyme-linked immunosorbent assay at baseline, as well as at 3 and 6 months after NSPT. At 3 months after NSPT, periodontal status was improved in all groups (p < 0.05), except Nwt patients without SP. Serum levels of leptin and CRP were significantly reduced, while serum levels of adiponectin were elevated after NSPT, regardless of bodyweight or waist circumference (p < 0.05). Improvement in serum levels of leptin after NSPT was also observed in the Nwt with SP group (p = 0.015); these levels did not significantly differ in Nwt patients without SP. NSPT reduces serum levels of leptin and CRP and enhances serum levels of adiponectin in Thai patients with Owt/Ob, irrespective of periodontitis severity. These results suggest a role for periodontal treatment in the systemic inflammatory response of Thai people with Owt/Ob.
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16
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Association of overweight/obesity with the severity of periodontitis using BPE code in an iraqi population. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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17
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Sczepanik FSC, Grossi ML, Casati M, Goldberg M, Glogauer M, Fine N, Tenenbaum HC. Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way. Periodontol 2000 2020; 84:45-68. [PMID: 32844417 DOI: 10.1111/prd.12342] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis is a highly prevalent disease. As it progresses, it causes serious morbidity in the form of periodontal abscesses and tooth loss and, in the latter stages, pain. It is also now known that periodontitis is strongly associated with several nonoral diseases. Thus, patients with periodontitis are at greater risk for the development and/or exacerbation of diabetes, chronic obstructive pulmonary disease, and cardiovascular diseases, among other conditions. Although it is without question that specific groups of oral bacteria which populate dental plaque play a causative role in the development of periodontitis, it is now thought that once this disease has been triggered, other factors play an equal, and possibly more important, role in its progression, particularly in severe cases or in cases that prove difficult to treat. In this regard, we allude to the host response, specifically the notion that the host, once infected with oral periodontal pathogenic bacteria, will mount a defense response mediated largely through the innate immune system. The most abundant cell type of the innate immune system - polymorphonuclear neutrophils - can, when protecting the host from microbial invasion, mount a response that includes upregulation of proinflammatory cytokines, matrix metalloproteinases, and reactive oxygen species, all of which then contribute to the tissue damage and loss of teeth commonly associated with periodontitis. Of the mechanisms referred to here, we suggest that upregulation of reactive oxygen species might play one of the most important roles in the establishment and progression of periodontitis (as well as in other diseases of inflammation) through the development of oxidative stress. In this overview, we discuss both innate and epigenetic factors (eg, diabetes, smoking) that lead to the development of oxidative stress. This oxidative stress then provides an environment conducive to the destructive processes observed in periodontitis. Therefore, we shall describe some of the fundamental characteristics of oxidative stress and its effects on the periodontium, discuss the diseases and other factors that cause oxidative stress, and, finally, review potentially novel therapeutic approaches for the management (and possibly even the reversal) of periodontitis, which rely on the use of therapies, such as resveratrol and other antioxidants, that provide increased antioxidant activity in the host.
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Affiliation(s)
| | - Márcio Lima Grossi
- School of Health Sciences, Dentistry, Post-Graduate Program in Dentistry, Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Márcio Casati
- Dental Research Division, School of Dentistry, Paulista University (UNIP), Sao Paulo, Brazil.,Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Michael Goldberg
- Discipline of Periodontology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, University of Toronto, Toronto, ON, Canada.,Division of Periodontology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Howard C Tenenbaum
- Department of Dentistry, Mount Sinai Hospital, Thodupuzha, India.,Faculty of Dentistry, Centre for Advanced Dental Research and Care, University of Toronto, Toronto, ON, Canada
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18
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Can Periodontal Disease Be Considered Linked to Obesity and Lipoinflammation? Mechanisms Involved in the Pathogenesis Occurrence. Clin Rev Bone Miner Metab 2020. [DOI: 10.1007/s12018-020-09273-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractObesity is a systemic disease, associated with an increased risk of cardiovascular disorders, type 2 diabetes, cancer, asthma, and osteoarthritis. Overweight and obesity have been suggested to be associated with periodontitis as published in studies and narrative summaries. Obesity and periodontal diseases are very prevalent in the world, and both can lead to severe chronic health conditions and impair people’s life quality. Knowledge of how immune mechanisms and inflammatory responses are regulated is critical for understanding the pathogenesis of complex diseases, such as periodontitis. In conditions of overweight, it has been demonstrated that approximately 70–80% of individuals present an adipose tissue turnover that is both structurally and functionally causing of the systemic inflammatory reaction. The objective of this review is to explore the influence of lipoinflammation. The effects of lipoinflammation and obesity on development of periodontal disease are reported together with the exploration of the mechanisms of interaction between these two diseases.
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19
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Jepsen S, Suvan J, Deschner J. The association of periodontal diseases with metabolic syndrome and obesity. Periodontol 2000 2020; 83:125-153. [PMID: 32385882 DOI: 10.1111/prd.12326] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontitis is a multifactorial chronic inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. Globally, it is estimated that 740 million people are affected by its severe form. Periodontitis has been suggested to be linked to obesity and metabolic syndrome. Obesity, defined as excessive fat accumulation, is a complex multifactorial chronic inflammatory disease, with a high and increasing prevalence. Metabolic syndrome is defined as a cluster of obesity, dyslipidemia, hypertension, and dysglycemia. Obesity, metabolic syndrome and periodontitis are among the most common non-communicable diseases and a large body of evidence from epidemiologic studies supports the association between these conditions. Extensive research has established plausible mechanisms to explain how these conditions can negatively impact each other, pointing to a bidirectional adverse relationship. At present there is only limited evidence available from a few intervention studies. Nevertheless, the global burden of periodontitis combined with the obesity epidemic has important clinical and public health implications for the dental team. In accordance with the common risk factor approach for tackling non-communicable diseases, it has been proposed that oral healthcare professionals have an important role in the promotion of periodontal health and general well-being through facilitation of healthy lifestyle behaviours.
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Affiliation(s)
- Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Jean Suvan
- Department of Periodontology, UCL Eastman Dental Institute, London, UK
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany
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20
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Suvan J, Harrington Z, Petrie A, Patel K, Darbar U, Donos N, D'Aiuto F. Obesity as predictive factor of periodontal therapy clinical outcomes: A cohort study. J Clin Periodontol 2020; 47:594-601. [DOI: 10.1111/jcpe.13261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 01/04/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Jean Suvan
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | | | - Aviva Petrie
- Unit of Biostatistics UCL Eastman Dental Institute London UK
| | - Kalpesh Patel
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Ulpee Darbar
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Nikos Donos
- Centre for Oral Clinical Research Barts and The London School of Medicine and Dentistry QMUL London UK
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Gulati NN, Masamatti SS, Chopra P. Association between obesity and its determinants with chronic periodontitis: A cross-sectional study. J Indian Soc Periodontol 2020; 24:167-172. [PMID: 32189846 PMCID: PMC7069116 DOI: 10.4103/jisp.jisp_157_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/25/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022] Open
Abstract
Background Various systemic disorders such as cardiovascular, diabetes, and osteoporosis are linked to periodontitis. Obesity is one such epidemic, and although many studies have addressed its relationship with periodontitis, the mechanism still remains unclear. Aim This study aims to assess the association between obesity and its determinants with clinical periodontal parameters in adult patients visiting a dental college in Haryana. Materials and Methods This cross-sectional study was performed in 317 patients visiting a dental college in Gurugram. Obesity parameters such as body mass index (BMI), body fat percentage (BF%), waist circumference (WC), and waist-hip ratio (WHR) were assessed using body fat analyzer (Omron HBF 701). Depending on their BMI, individuals were stratified as overweight (OW), Class 1, Class 2, and Class 3 obese. Periodontal status was assessed by plaque index, gingival index, probing pocket depth (PPD), and clinical attachment level. These periodontal parameters were correlated with BMI, BF%, WC, and WHR. Statistical analysis was done, and P ≤ 0.05 was considered as statistically significant. Results The prevalence of periodontitis in OW, Class 1, Class 2, and Class 3 obese was 16.4%, 79.2%, 2.8%, and 1.6%, respectively. PPD was significantly associated with obesity determinants, especially among Class 2 and Class 3 obese individuals. Similarly, BF% was associated with all the periodontal parameters. Conclusion Within the restrictions of the study, it can be concluded that obesity and chronic periodontitis are interlinked.
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Affiliation(s)
- Neha Nasa Gulati
- Department of Periodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | | | - Priyanka Chopra
- Department of Periodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
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Di Spirito F, Sbordone L, Pilone V, D’Ambrosio F. Obesity and Periodontal Disease: A Narrative Review on Current Evidence and Putative Molecular Links. Open Dent J 2019. [DOI: 10.2174/1874210601913010526] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background:
Obesity represents one of the main health problems worldwide and is considered a risk factor for several diseases, including periodontitis, which is a microbially-associated inflammatory disease affecting the tooth-supporting structures.
Objective:
The aim of this review was to report the current direct and indirect evidence concerning the possible association between obesity and periodontitis and their putative molecular links.
Methods:
A literature search was conducted between January 1999 and September 2019, in PubMed/MEDLINE and Science Direct databases, using pertinent keyword combined by Boolean operators. Through a multi-step screening process (literature search; articles title and abstract evaluation and full-text reading), studies fitting inclusion/exclusion criteria were considered for the review.
Results:
35 studies were included in the present review (17 observational studies; 7 systematic reviews; 11 systematic reviews with meta-analysis), focusing on the direct and indirect evidence of the possible association between obesity and periodontitis and their potential etiopathogenic molecular links
Conclusion:
Although the majority of the studies reported a positive association between obesity and periodontitis, the heterogeneity of the classification criteria and of the clinical parameters employed in the studies for both obesity and periodontitis evaluation, complicated the comparison of the results, thus considered inconclusive. Although several putative molecular pathogenic links between obesity and periodontitis have been highlighted, further studies, with longer follow-ups and with homogeneous clinical criteria, are needed to better understand the putative relation between obesity and periodontal disease.
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Kalsi AS, Bomfim DI, Hussain Z. Factors affecting decision making at reassessment of periodontitis. Part 2: interpretation of clinical findings - systemic factors. Br Dent J 2019; 227:797-801. [PMID: 31705095 DOI: 10.1038/s41415-019-0893-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper is the second in a four-part series outlining treatment planning at periodontal reassessment. The first article focussed on the information that should be gathered at the reassessment appointment. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option. Residual periodontal probing depths can be associated with both systemic and local factors. This article (part 2) outlines systemic factors that need to be assessed when faced with residual periodontal probing depths.
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Affiliation(s)
- Amardip S Kalsi
- Speciality Trainee Registrar in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - Deborah I Bomfim
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
| | - Zahra Hussain
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
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Arboleda S, Vargas M, Losada S, Pinto A. Review of obesity and periodontitis: an epidemiological view. Br Dent J 2019; 227:235-239. [PMID: 31399683 DOI: 10.1038/s41415-019-0611-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obesity and periodontitis are among the most common non-communicable diseases, and epidemiological studies report the influence of obesity in the onset and progression of periodontitis. Data indicate that increased body mass index, waist circumference, percentage of subcutaneous body fat, and serum lipid levels are associated with increased risk to develop periodontitis. The underlying biological mechanisms of this association involve adipose tissue-derived cytokines, such as tumour necrosis factor-α and interleukin-6, which affect whole-body metabolism and contribute to the development of a low-grade systemic inflammation. Multiple studies report a positive association between these two diseases across diverse populations. Obesity does not appear to impair the success of periodontal therapy. However, currently available evidence is variable and therefore inconclusive. Despite the limited evidence about recommendations on treatment planning, oral healthcare professionals need to be aware of the complexity of obesity to counsel their patients about the importance of maintaining healthy body weight and performing good oral hygiene procedures.
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Affiliation(s)
- Silie Arboleda
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia.
| | - Miguel Vargas
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - Sergio Losada
- Unit of Clinical Oral Epidemiology (UNIECLO) Investigations, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - Andres Pinto
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University, School of Dental Medicine and University Hospitals Cleveland Medical Centre, Cleveland, Ohio, USA
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Abstract
The purpose of this paper was to identify and summarize current evidence describing periodontal complications associated with obesity. Electronic searches supplemented with manual searches were carried out to identify relevant systematic reviews. Identification, screening, eligibility, and inclusion of studies were performed independently by two reviewers. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess the quality and risk of bias of the included reviews. From 430 titles and abstracts screened, 14 systematic reviews were considered as eligible for inclusion in this meta-review. Eight reviews reported on cross-sectional studies investigating the association of obesity and periodontal diseases, 4 included longitudinal studies, 5 addressed response to periodontal therapy, 5 reported on studies investigating biomarkers, and only 2 were related to pediatric population samples. Systematic review summaries in the various study design domains (cross-sectional, longitudinal and experimental) report that obese individuals are more likely to have periodontal diseases, with more severe periodontal conditions, than nonobese individuals, with cross-sectional evidence congruent with longitudinal studies showing that obesity or weight gain increases the risk of periodontitis onset and progression. Published research on the effect of obesity on responses to periodontal therapy, or systemic or local biomarkers of inflammation, is variable and therefore inconclusive based on the evidence currently available, which suggests that overweight/obesity contributes to periodontal complications independently of other risk factors, such as age, gender, smoking, or ethnicity. This evidence supports the need for risk assessments for individual patients to facilitate personalized approaches in order to prevent and treat periodontal diseases.
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Affiliation(s)
- Jean E Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Nicholas Finer
- National Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science, London, UK
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Graziani F, Karapetsa D, Alonso B, Herrera D. Nonsurgical and surgical treatment of periodontitis: how many options for one disease? Periodontol 2000 2018; 75:152-188. [PMID: 28758300 DOI: 10.1111/prd.12201] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.
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