1
|
Chen Z, Song J, Tang L. Investigation on the association between serum lipid levels and periodontitis: a bidirectional Mendelian randomization analysis. BMC Oral Health 2023; 23:827. [PMID: 37919698 PMCID: PMC10623747 DOI: 10.1186/s12903-023-03575-x] [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: 06/08/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE Several research has considered the potential correlation between periodontitis and serum lipids. However, serum lipid profiles correlation with periodontitis remains largely unknown. The investigation objective was to examine periodontitis correlation with serum lipid levels using a bidirectional Mendelian randomization (MR) analysis. METHODS The study employed a bidirectional MR analysis with two samples, utilizing a freely accessible genome-wide association study (GWAS). Furthermore, the primary analysis employed the inverse variance weighted (IVW) method. To determine whether the lipid profiles were associated with periodontitis, a variety of sensitivity analyses (including MR-Egger regression, MR-PRESSO, and weighted median), as well as multivariable MR, were employed. RESULTS MR analysis performed by IVW did not reveal any relationship between periodontitis and low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), or total cholesterol (TC). It was also found that LDL, HDL, TG, and TC were not associated to periodontitis. Furthermore, the MR estimations exhibited consistency with other MR sensitivity and multivariate MR (MVMR) analyses. These results show that the correlation between serum lipid levels and periodontitis could not be established. CONCLUSION The finding indicates a negligible link between periodontitis and serum lipid levels were identified, despite previous observational studies reporting a link between periodontitis and serum lipid levels.
Collapse
Affiliation(s)
- Zhihong Chen
- Stomatology Department, Guizhou Provinicial People's Hospital, Guiyang, China
- Department of Oral and Maxillofacial Surgery, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, Guizhou Medical Univerisity, Guiyang, China.
| | - Liszen Tang
- Department of Oral and Maxillofacial Surgery, Universiti Sains Malaysia, Kota Bharu, Malaysia.
| |
Collapse
|
2
|
Soubiya, Madaiah H, Tarannum F, Faizuddin M. Association of adipocyte fatty acid-binding protein and tumor necrosis factor alpha with periodontal health and disease: A cross-sectional investigation. Dent Res J (Isfahan) 2021; 18:79. [PMID: 34760070 PMCID: PMC8543096 DOI: 10.4103/1735-3327.326652] [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: 07/23/2020] [Revised: 01/30/2021] [Accepted: 03/17/2021] [Indexed: 11/04/2022] Open
Abstract
Background Adipocyte fatty acid binding protein (A-FABP) is a novel biomarker of inflammation for various chronic systemic diseases. Since periodontitis is a chronic inflammatory disease, this study explores the association of A-FABP with periodontal disease parameters and tumor necrosis factor-alpha (TNF-α) levels in gingival crevicular fluid in periodontal health and disease. Materials and Methods This original research article describes a cross-sectional study conducted at the Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bangalore, India. This cross-sectional investigation was conducted on sixty subjects which were divided into three groups of twenty subjects each - healthy, gingivitis, and chronic periodontitis. Clinical parameters - plaque index, bleeding index, probing depth, and clinical attachment loss were recorded. Gingival crevicular fluid samples were analyzed for A-FABP and TNF-α levels using ELISA. One-way analysis of variance was used to find the significance of study parameters on a continuous scale between three groups. Pearson's correlation has been used to find the relationship between Gingival crevicular fluid concentration of markers and periodontal parameters. Multiple linear regression analysis was applied to the study. The statistical significance was considered at P < 0.05. Results Mean concentration of A-FABP (6.43 ± 2.51) and TNF-α (3454.82 ± 1566.44) was highest in the periodontitis group, and the difference among the groups was statistically significant (P < 0.05). A positive correlation was observed between clinical attachment loss and the two markers among all groups. The correlation between A-FABP and TNF-α in periodontitis groups was positive and statistically significant (P < 0.05). Multiple linear regression model was statistically significant (P < 0.05) indicating that there is a significant relationship between the set of predictors and the clinical attachment loss. Conclusion A-FABP and TNF-α levels in GCF were significantly elevated in the presence of inflammation. A-FABP has a probable stimulatory effect on TNF-α; however, its role needs to be explored. A-FABP could serve as a novel inflammatory biomarker of periodontitis and the scope of using A-FABP inhibition as a treatment modality could be investigated with interventional studies.
Collapse
Affiliation(s)
- Soubiya
- Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Hemalata Madaiah
- Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Fouzia Tarannum
- Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Mohamed Faizuddin
- Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
3
|
Eke PI, Borgnakke WS, Genco RJ. Recent epidemiologic trends in periodontitis in the USA. Periodontol 2000 2020; 82:257-267. [PMID: 31850640 DOI: 10.1111/prd.12323] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The most important development in the epidemiology of periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of periodontitis in US adults. This initiative first suggested new periodontitis case definitions for surveillance in 2007 and revised them slightly in 2012. This classification is now regarded as the global standard for periodontitis surveillance and is used worldwide. First, application of such a standard in reporting finally enables results from different researchers in different countries to be meaningfully compared. Second, this initiative tackled the concern that prior national surveys, which used partial-mouth periodontal examination protocols, grossly underestimated the prevalence of periodontitis of potentially more than 50%. Consequently, because previous national surveys significantly underestimated the true prevalence of periodontitis, it is not possible to extrapolate any trend in periodontitis prevalence in the USA over time. Any difference calculated may not represent any actual change in periodontitis prevalence, but rather is a consequence of using different periodontal examination protocols. Finally, the initiative addressed the gap in the need for state and local data on periodontitis prevalence. Through the direct efforts of the Centers for Disease Control and Prevention and the American Academy of Periodontology initiative, full-mouth periodontal probing at six sites around all nonthird molar teeth was included in the 6 years of National Health and Nutrition Examination Surveys from 2009-2014, yielding complete data for 10 683 dentate community-dwelling US adults aged 30 to 79 years. Applying the 2012 periodontitis case definitions to the 2009-2014 National Health and Nutrition Examination Surveys data, the periodontitis prevalence turned out to be much greater than previously estimated, namely affecting 42.2% of the population with 7.8% of people experiencing severe periodontitis. It was also discovered that only the moderate type of periodontitis is driving the increase in periodontitis prevalence with age, not the mild or the severe types whose prevalence do not increase consistently with age, but remain ~ 10%-15% in all age groups of 40 years and older. The greatest risk for having periodontitis of any type was seen in older people, in males, in minority race/ethnic groups, in poorer and less educated groups, and especially in cigarette smokers. The Centers for Disease Control and Prevention and the American Academy of Periodontology initiative reported, for the first time, the periodontitis prevalence estimated at both local and state levels, in addition to the national level. Also, this initiative developed and validated in field studies a set of eight items for self-reported periodontitis for use in direct survey estimates of periodontitis prevalence in existing state-based surveys. These items were also included in the 2009-2014 National Health and Nutrition Examination Surveys for validation against clinically determined cases of periodontitis. Another novel result of this initiative is that, for the first time, the geographic distribution of practicing periodontists in relation to the geographic distribution of people with severe periodontitis is illustrated. In summary, the precise periodontitis prevalence and distribution among subgroups in the dentate US noninstitutionalized population aged 30-79 years is better understood because of application of valid periodontitis case definitions to full-mouth periodontal examination, in combination with reliable information on demographic and health-related measures. We now can monitor the trend of periodontitis prevalence over time as well as guide public health preventive and intervention initiatives for the betterment of the health of the adult US population.
Collapse
Affiliation(s)
- Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Robert J Genco
- (Formerly) Distinguished Professor of Oral Biology and Microbiology; Director, UB Center for Microbiome Research, State University of New York (SUNY), University at Buffalo, Amherst, New York, USA
| |
Collapse
|
4
|
Amaroli A, Barbieri R, Signore A, Marchese A, Parker S, De Angelis N, Benedicenti S. Simultaneous photoablative and photodynamic 810-nm diode laser therapy as an adjunct to non-surgical periodontal treatment: an in-vitro study. ACTA ACUST UNITED AC 2020; 69:1-7. [PMID: 32214064 DOI: 10.23736/s0026-4970.19.04233-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The use of lasers at different wavelengths has been proposed in combination with conventional non-surgical periodontal treatment in order to improve the clinical outcome of periodontal disease. However, the clinical use of laser photonic energy is still the subject of research and debate because the antibacterial activity of the laser is dependent upon method, laser parameters, quantity of bacteria, species selected and photosensitizers used. METHODS We evaluated the in-vitro bactericidal activity of 810 nm diode-laser irradiation in simultaneous photoablative and photodynamic mode against the major pathogenic bacterial organisms associated with periodontal inflammation and disease. We used indocyanine green as photosensitizer and the high-energy density of 161.7 J/cm2 or 215.0 J/cm2 for the photoablative-photodynamic irradiation. RESULTS The bacteria were drastically affected by the 215.0 J/cm2 irradiation in the presence of indocyanine green. In fact, the number of Porphyromonas gingivalis and Prevotella intermedia was reduced by 99.9% (P<0.001), while the number of Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Actinomyces viscosus decremented by 83.3% (P<0.01), 86.8% (P<0.05), 75% (P<0.01) and 78.7% (P<0.001), respectively. P. gingivalis and P. intermedia were the only bacteria that were sensitive to the treatment with indocyanine green dye and 161.7 J/cm2 of laser irradiation (P<0.001). CONCLUSIONS Our preliminary in-vitro data suggest that simultaneous photoablative-photodynamic irradiation could be a promising therapy against a wide range of bacteria involved in periodontal disease. We believe that further additional in-vivo investigation is necessary, to enable a more complete picture of effectiveness within a clinical setting to be established. In addition, the use of a simultaneous photoablative-photodynamic therapy is suggested to reduce treatment time, without compromising the efficacy against the periodontal pathogens.
Collapse
Affiliation(s)
- Andrea Amaroli
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy - .,Department of Orthopedic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia -
| | - Ramona Barbieri
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - Antonio Signore
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy.,Faculty of Therapeutic Stomatology, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anna Marchese
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - Steven Parker
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - Nicola De Angelis
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| |
Collapse
|
5
|
Al-Isa M, Alotibi M, Alhashemi H, Althobiani F, Atia A, Baz S. Effect of non-surgical periodontal therapy on the fibrinogen levels in chronic periodontitis patients. Saudi Dent J 2018; 31:188-193. [PMID: 30983828 PMCID: PMC6445522 DOI: 10.1016/j.sdentj.2018.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/28/2018] [Accepted: 12/02/2018] [Indexed: 01/22/2023] Open
Abstract
Objective This study aimed to evaluate the effect of non-surgical periodontal therapy on the fibrinogen levels in chronic periodontitis patients when compared to the levels seen in healthy subjects. Materials and methods A total of 30 subjects, with an average age of 38 ± 25 years, were enrolled in the present study. They were divided into two groups, namely Group 1 (15 periodontally healthy subjects) and Group 2 (15 moderate to severe chronic periodontitis patients). The periodontal condition of each periodontitis patient was assessed by recording the probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI) both before and after periodontal therapy had been administered for one month. Additionally, blood samples were collected from the healthy subjects and the periodontitis patients before and after the periodontal treatment in order to assay the plasma fibrinogen levels. Results The clinical parameters were found to be improved after one month of periodontal therapy, with the statistical difference in the mean values of the BI and PD being highly significant (P < 0.01), while the statistical differences concerning the PI and CAL were significant (P < 0.05). The fibrinogen levels (mg/dL) for the periodontitis patients before and after treatment were 342.26 ± 69.00 and 352.93 ± 64.3 mg/dL, respectively. The level was 269.85 ± 43.68 mg/dL for the healthy subjects. In terms of the between-group comparison, the fibrinogen levels of the healthy subjects were observed to be highly significantly lower than the levels of the periodontitis patients before and after the treatment (P < 0.01), in contrast the statistical analysis showed a non-significant difference in the fibrinogen levels (P > 0.05) before and after the periodontal treatment. In addition, the statistical analysis revealed non-significant correlation between the fibrinogen levels and all the periodontal parameters (P > 0.05). Conclusion The non-surgical periodontal therapy proved to be effective in improving the clinical periodontal condition of the periodontitis patients, while the plasma fibrinogen levels were not found to be influenced by the periodontal therapy. Further studies are needed to evaluate the fibrinogen levels over a longer duration after periodontal treatment in patients following a periodontal maintenance program.
Collapse
Affiliation(s)
- Mohammad Al-Isa
- Faculty of Dentistry Umm Al-Qura University, Saudi Arabia
- Corresponding author at: College of Dentistry, Umm Al-Qura University, P.O. Box 8117, Makkah 24238, Saudi Arabia.
| | | | | | | | - Alaa Atia
- Faculty of Dentistry Umm Al-Qura University, Saudi Arabia
- Faculty of Dentistry, Al-Azhar University (Assuit Division), Egypt
| | - Sameh Baz
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Saudi Arabia
| |
Collapse
|
6
|
Nepomuceno R, Pigossi SC, Finoti LS, Orrico SRP, Cirelli JA, Barros SP, Offenbacher S, Scarel-Caminaga RM. Serum lipid levels in patients with periodontal disease: A meta-analysis and meta-regression. J Clin Periodontol 2017; 44:1192-1207. [DOI: 10.1111/jcpe.12792] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Rafael Nepomuceno
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Suzane C. Pigossi
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Livia S. Finoti
- Department of Periodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA USA
| | - Silvana R. P. Orrico
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Joni A. Cirelli
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Silvana P. Barros
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Steven Offenbacher
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Raquel M. Scarel-Caminaga
- Department of Morphology; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| |
Collapse
|
7
|
Assessment of periodontal bone level revisited: a controlled study on the diagnostic accuracy of clinical evaluation methods and intra-oral radiography. Clin Oral Investig 2017; 22:425-431. [PMID: 28550521 DOI: 10.1007/s00784-017-2129-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/15/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The accuracy of analogue and especially digital intra-oral radiography in assessing interdental bone level needs further documentation. The aim of this study was to compare clinical and radiographic bone level assessment to intra-surgical bone level registration (1) and to identify the clinical variables rendering interdental bone level assessment inaccurate (2). MATERIALS AND METHODS The study sample included 49 interdental sites in 17 periodontitis patients. Evaluation methods included vertical relative probing attachment level (RAL-V), analogue and digital intra-oral radiography and bone sounding without and with flap elevation. The latter was considered the true bone level. Five examiners evaluated all radiographs. RESULTS Significant underestimation of the true bone level was observed for all evaluation methods pointing to 2.7 mm on average for analogue radiography, 2.5 mm for digital radiography, 1.8 mm for RAL-V and 0.6 mm for bone sounding without flap elevation (p < 0.001). Radiographic underestimation of the true bone level was higher in the (pre)molar region (p ≤ 0.047) and increased with defect depth (p < 0.001). Variation between clinicians was huge (range analogue radiography 2.2-3.2 mm; range digital radiography 2.1-3.0 mm). CONCLUSION All evaluation methods significantly underestimated the true bone level. Bone sounding was most accurate, whereas intra-oral radiographs were least accurate. Deep periodontal defects in the (pre)molar region were most underrated by intra-oral radiography. CLINICAL RELEVANCE Bone sounding had the highest accuracy in assessing interdental bone level.
Collapse
|
8
|
Lombardo L, Carlucci A, Palone M, Mollica F, Siciliani G. Stiffness comparison of mushroom and straight SS and TMA lingual archwires. Prog Orthod 2016; 17:27. [PMID: 27593408 PMCID: PMC5018471 DOI: 10.1186/s40510-016-0140-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/17/2016] [Indexed: 11/11/2022] Open
Abstract
Background The aim of this study is to investigate the relative stiffness of straight and mushroom lingual archwires of different diameters, cross sections and alloys, plotting their load/deflection graphs and using a modified three-point bending test. Methods Fujita’s mushroom archwires and straight lingual archwires of different diameters, cross sections and alloys were derived by a virtual set-up of an equal malocclusion and were cut at their straight distal portion. These distal portions were tested using a modified three-point bending test by an Instron 4467 dynamometer and the forces, were exerted at 1-mm deflection and were compared on each resulting load/deflection curve by means of ANOVA (p < 0.05). Results All upper lingual mushroom wires exerted significantly lower forces than the straight wire. Lower mushroom archwires were stiffer than their upper counterparts, which were longer and featured inset bends. In the lower arch, similar levels of forces were recorded for the two types of wire. Load-deflection curves were higher for the straight wires, and stiffness increased proportionally with their diameter. Conclusions The stiffness of an archwire is a function of its diameter, length and the alloy it is made from. In lower lingual wires, there is little difference in stiffness between mushroom and straight wires, but in upper wires, the straight version is considerably stiffer. The greater bearing effect exhibited by the straight wire in the working and finishing phases makes it less susceptible to bowing effect and therefore preferable for sliding mechanics during en masse retraction, particularly in the upper arch.
Collapse
Affiliation(s)
- Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Montebello 31, 44100, Ferrara, Italy
| | - Antonella Carlucci
- Postgraduate School of Orthodontics, University of Ferrara, Via Montebello 31, 44100, Ferrara, Italy
| | - Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Montebello 31, 44100, Ferrara, Italy.
| | - Francesco Mollica
- Department of Engineering, University of Ferrara, Via Montebello 31, 44100, Ferrara, Italy
| | - Giuseppe Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Via Montebello 31, 44100, Ferrara, Italy
| |
Collapse
|
9
|
Bandyopadhyay D, Canale A. Nonparametric spatial models for clustered ordered periodontal data. J R Stat Soc Ser C Appl Stat 2016; 65:619-640. [PMID: 27524839 DOI: 10.1111/rssc.12150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Clinical attachment level (CAL) is regarded as the most popular measure to assess periodontal disease (PD). These probed tooth-site level measures are usually rounded and recorded as whole numbers (in mm) producing clustered (site measures within a mouth) error-prone ordinal responses representing some ordering of the underlying PD progression. In addition, it is hypothesized that PD progression can be spatially-referenced, i.e., proximal tooth-sites share similar PD status in comparison to sites that are distantly located. In this paper, we develop a Bayesian multivariate probit framework for these ordinal responses where the cut-point parameters linking the observed ordinal CAL levels to the latent underlying disease process can be fixed in advance. The latent spatial association characterizing conditional independence under Gaussian graphs is introduced via a nonparametric Bayesian approach motivated by the probit stick-breaking process, where the components of the stick-breaking weights follows a multivariate Gaussian density with the precision matrix distributed as G-Wishart. This yields a computationally simple, yet robust and flexible framework to capture the latent disease status leading to a natural clustering of tooth-sites and subjects with similar PD status (beyond spatial clustering), and improved parameter estimation through sharing of information. Both simulation studies and application to a motivating PD dataset reveal the advantages of considering this flexible nonparametric ordinal framework over other alternatives.
Collapse
Affiliation(s)
| | - Antonio Canale
- Department of Economics and Statistics, University of Turin and Collegio Carlo Alberto, Turin, Italy
| |
Collapse
|
10
|
Peter KP, Mute BR, Pitale UM, Shetty S, Hc S, Satpute PS. Prevalence of periodontal disease and characterization of its extent and severity in an adult population - an observational study. J Clin Diagn Res 2014; 8:ZC04-7. [PMID: 25654019 DOI: 10.7860/jcdr/2014/8684.5231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 09/17/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Present study was undertaken to determine the prevalence of periodontal disease in an adult population and to further characterize the extent and severity of the disease. MATERIALS AND METHODS The study population consisted of 700 randomly selected individuals reporting to out patient department of dental college and hospital. Demographic details and lifestyle characteristics of the all the subjects were recorded and a thorough oral examination was performed. In order to evaluate the periodontal status of subjects, five indices (CAL, PD, OHI, PI and GI) were assessed and subjects having at least one site with clinical attachment loss (CAL) ≥3mm were diagnosed as having periodontitis. Further, to analyse the extent of disease, subjects having periodontitis were divided into two groups as having at least one site with CAL ≥5mm and having at least three sites with CAL ≥5mm. RESULTS RESULTS showed that there was a high prevalence of periodontitis amongst population with almost 72% of the individuals having at least one site with CAL ≥3mm. A trend was noted in which periodontal status worsened as the age increased. Analysing the extent and severity of disease amongst the population, results revealed that almost 41% of population had at least one site with CAL ≥5mm whereas almost 21% of individuals had at least three sites with CAL ≥5mm. CONCLUSION Present study provides with evidence of high prevalence of periodontal disease amongst the population. Importantly, this study also unveils the lack of awareness for dental health amidst the population.
Collapse
Affiliation(s)
- Kalpak Prafulla Peter
- Assistant Professor, Department of Periodontology, Government Dental College and Hospital , Nagpur, India
| | - Bhumika Ramchandra Mute
- Assistant Professor, Department of Orthodontics, R.K.D.F Dental College and Research Centre , Bhopal, India
| | - Unnati Mahesh Pitale
- Professor, Department of Periodontics, R.K.D.F Dental College and Research Centre , Bhopal, India
| | - Sujan Shetty
- Reader, Department of Periodontology, R.K.D.F Dental College and Research Centre , Bhopal, India
| | - Shashikiran Hc
- Reader, Department of Periodontology, R.K.D.F Dental College and Research Centre , Bhopal, India
| | - Pranali Shirish Satpute
- Assistant Professor, Department of Oral Pathology, Government Dental College and Hospital , Nagpur, India
| |
Collapse
|
11
|
Relvas M, Tomás I, Salazar F, Velazco C, Blanco J, Diz P. Reliability of partial-mouth recording systems to determine periodontal status: a pilot study in an adult Portuguese population. J Periodontol 2013; 85:e188-97. [PMID: 24224960 DOI: 10.1902/jop.2013.130389] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The efficacy of various partial-mouth recording (PMR) systems is analyzed in the evaluation of periodontal status, using index teeth and different combinations of quadrants. METHODS The study group was formed of 108 adults aged 25 to 65 years old. A full-mouth examination (FME) was performed in all participants to determine the periodontal probing depth (PD) and clinical attachment level (CAL) at six sites per tooth. The results of PMR using the Ramfjord teeth, the Community Periodontal Index of Treatment Needs teeth, and the four quadrants individually and combined in pairs were compared to the results obtained with FME. RESULTS Concordance with FME in terms of the prevalence of patients with PD ≥4 mm, CAL ≥2 mm, and CAL ≥4 mm was lowest with examination of single quadrants and highest with combinations that included one superior and one inferior quadrant. CONCLUSIONS PMR systems, particularly with combinations of a superior plus an inferior quadrant, could be useful to evaluate periodontal status based on PD and CAL. This tool could be useful for epidemiologic surveys on periodontal status.
Collapse
Affiliation(s)
- Marta Relvas
- School of Dentistry, Northern Higher Institute of Health Sciencies, Porto, Portugal
| | | | | | | | | | | |
Collapse
|
12
|
Arowojolu MO, Fawole OI, Dosumu EB, Opeodu OI. A comparative study of the oral hygiene status of smokers and non-smokers in Ibadan, Oyo state. Niger Med J 2013; 54:240-3. [PMID: 24249949 PMCID: PMC3821224 DOI: 10.4103/0300-1652.119627] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIMS The aim of this study was to assess the effect of tobacco smoking on gingival health and the oral hygiene status of respondents. MATERIALS AND METHODS A cross-sectional survey of 213 adults from three communities in the Ibadan North local government was carried out. Respondents were divided into two groups comprising of 117 smokers (cases) and 96 non-smokers (control). Intra oral examination was done using the Simplified Oral Hygiene Index (OHI-S) and Gingival index (GI). RESULTS The mean age of the smokers was 31.2 ± 12.6 years and that of the non-smokers 32.8 ± 9.5 years. The mean Simplified Oral Hygiene Index (OHI-S) was 1.15 ± 0.51 for the non-smokers and 2.19 ± 0.62 for the smokers (P < 0.05). The mean GI was 1.06 ± 0.55 for the non-smokers and 1.62 ± 0.58 for the smokers (P < 0.05). CONCLUSION The study shows that smoking is associated with increased severity of gingival disease. It is, therefore, recommended that smokers should be encouraged to visit a dentist for preventive procedure more regularly than the non-smokers and better still, smokers should be encouraged to quit smoking as gingival disease is not without consequences if allowed to persist.
Collapse
Affiliation(s)
- Modupe O. Arowojolu
- Department of Periodontology & Community Dentistry, University of Ibadan, Ibadan, Nigeria
| | - Olufunmilayo I. Fawole
- Department of Epidemiology, Medical Statistics & Environmental Health, University of Ibadan, Ibadan, Nigeria
| | - Elizabeth B. Dosumu
- Department of Periodontology & Community Dentistry, University of Ibadan, Ibadan, Nigeria
| | - O. I. Opeodu
- Department of Periodontology & Community Dentistry, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
13
|
Martin JA, Grill AC, Matthews AG, Vena D, Thompson VP, Craig RG, Curro FA. Periodontal diagnosis affected by variation in terminology. J Periodontol 2013; 84:606-13. [PMID: 22702518 PMCID: PMC4392916 DOI: 10.1902/jop.2012.110743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The randomized case presentation (RCP) study is designed to assess the degree of diagnostic accuracy for described periodontal cases. This is to lay the basis for practitioner calibration in the Practitioners Engaged in Applied Research and Learning (PEARL) Network for future clinical studies. METHODS The RCP consisted of 10 case scenarios ranging from periodontal health to gingivitis and mild, moderate, and severe periodontitis. Respondents were asked to diagnose the described cases. Survey diagnoses were compared to two existing classifications of periodontal disease status. The RCP was administered via a proprietary electronic data capture system maintained by the PEARL Data Coordinating Center. Standard analytic techniques, including frequency counts and cross-tabulations, were used for categorical data with mean and standard deviation and median values reported for continuous data elements. RESULTS Demonstrable variations in periodontal assessment for health, gingivitis, and mild, moderate, and severe periodontitis were found among the 130 PEARL general practitioners who participated in the RCP survey. The highest agreement for diagnosis among dentists was for severe periodontitis (88%) and the lowest for gingivitis (55%). The highest percentage of variation was found in cases with health and gingivitis. CONCLUSIONS There was variation among PEARL practitioners in periodontal diagnosis that may affect treatment outcomes. Our findings add clinical support to recent publications suggesting a need for standardization of terminology in periodontitis diagnosis.
Collapse
Affiliation(s)
- John A. Martin
- Practitioners Engaged in Applied Research and Learning (PEARL) Network, private practice, State College, PA
- PreViser, Mt. Vernon, WA
| | - Ashley C. Grill
- Department of Dental Hygiene, New York City College of Technology, City University of New York, Brooklyn, NY
- PEARL Network, College of Dentistry, New York University, New York, NY
| | | | - Don Vena
- PEARL Network, EMMES Corporation, Rockville, MD
| | - Van P. Thompson
- Currently, PEARL Network, King’s College London Dental Institute, London, UK; previously, PEARL Network, Department of Biomaterials and Biomimetics, College of Dentistry, New York University
| | - Ronald G. Craig
- PEARL Network, Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University
| | - Frederick A. Curro
- PEARL Network, Department of Oral Pathology, Medicine and Radiology, College of Dentistry, New York University
| |
Collapse
|
14
|
Palle AR, Reddy CMSK, Shankar BS, Gelli V, Sudhakar J, Reddy KKM. Association between obesity and chronic periodontitis: a cross-sectional study. J Contemp Dent Pract 2013; 14:168-73. [PMID: 23811640 DOI: 10.5005/jp-journals-10024-1294] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIM Chronic periodontitis is multifactorial and numerous risk factors have been identified to contribute in the disease progression. Current study aimed to conduct a cross-sectional study in a population of patients with cardiovascular diseases in order to correlate the association between obesity [body mass index (BMI) and waist circumference (WC)] and periodontal disease parameters. MATERIALS AND METHODS The study was of a cross-sectional design and a total of 201 patients were examined after obtaining their informed consent. Subjects who had a history of cardiovascular diseases and under treatment were included in the study. Two indicators of obesity were used: BMI and WC. The following periodontal parameters were assessed: Probing depth, clinical attachment level. The oral hygiene status of the subjects was assessed by the oral hygiene index (OHI, simplified) given by John C Greene and Jack R Vermillion. The influence of the BMI and other confounding variables on periodontitis severity was assessed by multivariate logistic regression analysis. Data were analyzed using SPSS. RESULTS Significant association was seen with low density lipoproteins (LDL) and severity of periodontitis (p < 0.005), triglyceride levels (TGL) and severity of periodontitis (p < 0.005), cholesterol and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Significant association was seen with smoking and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), WC and severity of periodontitis (p < 0.001), cholesterol and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). CONCLUSION Obesity has been implicated as a risk factor for several conditions including cardiovascular disease, diabetes, etc. In our study the relation between measures of overall and abdominal obesity (BMI and WC) and periodontal disease showed significant association in the multivariate logistic regression analysis independent of other confounding factors. CLINICAL SIGNIFICANCE Obesity can act as a significant risk factor in progression of periodontitis.
Collapse
Affiliation(s)
- Ajay Reddy Palle
- Department of Periodontology, Army College of Dental Sciences, Hyderabad, Andhra Pradesh, India
| | | | | | | | | | | |
Collapse
|
15
|
Seo WH, Cho ER, Thomas RJ, An SY, Ryu JJ, Kim H, Shin C. The association between periodontitis and obstructive sleep apnea: a preliminary study. J Periodontal Res 2012. [PMID: 23199371 DOI: 10.1111/jre.12032] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis is becoming a highly prevalent disease worldwide. Obstructive sleep apnea (OSA) is a common disorder that is characterized by repeated disruptions in breathing during sleep, and mouth breathing is a common characteristic among patients with OSA. We aimed to assess the hypothesis that OSA is associated with the onset and progression of periodontal disease. MATERIAL AND METHODS This is a cross-sectional study of a total of 687 participants (460 men and 227 women), 47-77 years of age, who were examined between August 2009 and September 2010 as part of the Korean Genome and Epidemiology Study. The participants underwent standard polysomnography, clinical periodontal examination and health-screening examinations. Periodontitis was defined as clinical attachment level (CAL) ≥ 6 mm and probing pocket depth ≥ 4 mm. OSA was determined using the apnea-hypopnea index (AHI), and an AHI score of ≥ 5 was the cut-off used to indicate the presence of OSA. RESULTS The results showed that 17.5% of the participants had periodontitis, 46.6% had OSA and 60.0% who were diagnosed with periodontitis had OSA. In our study, old age, male gender, current smoking status, mouth breathing during sleep and high AHI were identified as risk factors for periodontitis. OSA was positively associated with periodontitis [odds ratio (OR) = 1.84, 95% confidence interval (CI) = 1.18-2.87], probing pocket depth (OR = 2.22, 95% CI = 1.30-3.77) and CAL (OR = 1.86, 95% CI = 1.07-3.21) in a dose-response manner. Additionally, OSA was positively associated with periodontitis (OR = 2.51, 95% CI = 1.37-4.62) in subjects ≥ 55 years of age, but not in subjects < 55 years of age. CONCLUSION There is a significant association between OSA and periodontal disease. Further research is needed to clarify the causal relationship between the two conditions.
Collapse
Affiliation(s)
- W H Seo
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | | | | | | | | | | | | |
Collapse
|
16
|
Laine ML, Crielaard W. Functional foods/ingredients and periodontal diseases. Eur J Nutr 2012; 51 Suppl 2:S27-30. [PMID: 22535144 DOI: 10.1007/s00394-012-0325-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marja L Laine
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | |
Collapse
|
17
|
Ozturk Ortan Y, Yurdakuloglu Arslan T, Aydemir B. A comparative in vitro study of frictional resistance between lingual brackets and stainless steel archwires. Eur J Orthod 2011; 34:119-25. [PMID: 21239394 DOI: 10.1093/ejo/cjq180] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yildiz Ozturk Ortan
- Department of Orthodontics, Faculty of Dentistry, Istanbul University, Capa, Istanbul.
| | | | | |
Collapse
|
18
|
Teeuw WJ, Gerdes VEA, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care 2010; 33:421-7. [PMID: 20103557 PMCID: PMC2809296 DOI: 10.2337/dc09-1378] [Citation(s) in RCA: 294] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There is growing evidence that periodontitis may affect general health. This study was assigned to explore the robustness of observations that periodontal therapy leads to the improvement of glycemic control in diabetic patients. RESEARCH DESIGN AND METHODS A literature search (until March 2009) was carried out using two databases (MEDLINE and the Cochrane Library) with language restriction to English. Selection of publications was based on 1) original investigations, 2) controlled periodontal intervention studies where the diabetic control group received no periodontal treatment, and 3) study duration of > or =3 months. RESULTS Screening of the initial 639 identified studies and reference checking resulted in five suitable articles. A total of 371 patients were included in this analysis with periodontitis as predictor and the actual absolute change in A1C (DeltaA1C) as the outcome. The duration of follow-up was 3-9 months. All studies described a research population of type 2 diabetic patients in whom glycemic control improved after periodontal therapy compared with the control group (range DeltaA1C: Delta-1.17 up to Delta-0.05%). The studies in a meta-analysis demonstrated a weighted mean difference of DeltaA1C before and after therapy of -0.40% (95% CI -0.77 to -0.04%, P = 0.03) favoring periodontal intervention in type 2 diabetic patients. Nevertheless, this improvement in %A1C must be interpreted with care due to limited robustness as evidenced by heterogeneity among studies (59.5%, P = 0.04). CONCLUSIONS The present meta-analysis suggests that periodontal treatment leads to an improvement of glycemic control in type 2 diabetic patients for at least 3 months.
Collapse
Affiliation(s)
- Wijnand J Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands.
| | | | | |
Collapse
|
19
|
Furuta M, Ekuni D, Yamamoto T, Irie K, Koyama R, Sanbe T, Yamanaka R, Morita M, Kuroki K, Tobe K. Relationship between periodontitis and hepatic abnormalities in young adults. Acta Odontol Scand 2010; 68:27-33. [PMID: 19878045 DOI: 10.3109/00016350903291913] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Obesity has been implicated as a risk factor for periodontitis and non-alcoholic fatty liver disease (NAFLD). In NAFLD, elevated alanine aminotransferase (ALT) is associated with obesity. Although a possible interrelationship between liver function and periodontitis has been reported among the middle-aged population, the correlation in young adults is little known. This study was designed to investigate the relationship between ALT and the presence of periodontitis in university students in Japan. MATERIAL AND METHODS Medical and oral health data were collected in a cross-sectional examination conducted by the Health Service Center of Okayama University. Systemically healthy, non-smoking students aged 18 and 19 years old (n = 2225) were included. The protocol of the United States National Health and Nutrition Examination Survey was applied. Subjects with probing pocket depth >or= 4 mm were defined as having periodontitis. Logistic regression analysis was used to estimate the association between ALT, body mass index and periodontitis. RESULTS The number of subjects with periodontitis was 104 (4.7%). In males, having periodontitis was significantly associated with an increased level of ALT (>or= 41 IU/l) in logistic regression analysis (adjusted odds ratio 2.3; 95% confidence interval 1.0-5.2; p < 0.05). However, there was no significant association between periodontitis and ALT in female students. CONCLUSIONS Elevated ALT could be a potential risk indicator for periodontitis among young males. Monitoring hepatic abnormalities to prevent periodontitis must be better understood, even in the young adult population.
Collapse
Affiliation(s)
- Michiko Furuta
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Fernandes JK, Wiegand RE, Salinas CF, Grossi SG, Sanders JJ, Lopes-Virella MF, Slate EH. Periodontal disease status in gullah african americans with type 2 diabetes living in South Carolina. J Periodontol 2009; 80:1062-8. [PMID: 19563285 DOI: 10.1902/jop.2009.080486] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND African Americans have a disproportionate burden of diabetes. Gullah African Americans are the most genetically homogeneous population of African descent in the United States, with an estimated European admixture of only 3.5%. This study assessed the previously unknown prevalence of periodontal disease among a sample of Gullah African Americans with diabetes and investigated the association between diabetes control and the presence of periodontal disease. METHODS Two hundred thirty-five Gullah African Americans with type 2 diabetes were included. Diabetes control was assessed by percentage of glycosylated hemoglobin (HbA1c) and divided into three categories: well controlled, <7%; moderately controlled, 7% to 8.5%; and poorly controlled, >8.5%. Participants were categorized as healthy (no clinical attachment loss [AL] or bleeding on probing) or as having early periodontitis (clinical AL > or =1 mm in at least two teeth), moderate periodontitis (three sites with clinical AL > or =4 mm and at least two sites with probing depth [PD] > or =3 mm), or severe periodontitis (clinical AL > or =6 mm in at least two teeth and PD > or =5 mm in at least one site). Observed prevalences of periodontitis were compared to rates reported for the National Health and Nutrition Examination Survey (NHANES) studies. RESULTS All subjects had evidence of periodontal disease: 70.6% had moderate periodontitis and 28.5% had severe disease. Diabetes control was not associated with periodontal disease. The periodontal disease proportions were significantly higher than the reported national prevalence of 10.6% among African Americans without diabetes. CONCLUSION Our sample of Gullah African Americans with type 2 diabetes exhibited a higher prevalence of periodontal disease compared to African Americans, with and without diabetes, as reported in NHANES III and NHANES 1999-2000.
Collapse
Affiliation(s)
- Jyotika K Fernandes
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | | | | | | | | | | | | |
Collapse
|
21
|
Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J Clin Periodontol 2009; 36:458-67. [PMID: 19508246 DOI: 10.1111/j.1600-051x.2009.01408.x] [Citation(s) in RCA: 299] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To perform a systematic review and critical analysis of the definitions of periodontitis and the methods which have been used to identify and measure this disease. MATERIAL AND METHODS Relevant publications were identified after searching MEDLINE, EMBASE, SCISEARCH and LILACS electronic databases. Screening of titles and abstracts and data extraction was conducted independently by two reviewers. To be included in the review, studies were required to define periodontitis and to indicate how it was measured. Studies that related purely to gingivitis, and/or intervention studies, and/or studies where prevalence or severity of periodontitis was not a principal outcome were excluded. RESULTS From a total of 34,72 titles and abstracts, 104 potentially relevant full text papers were identified. Of these, 15 met the criteria for inclusion in the final stage of the review. The survey revealed heterogeneity between the studies in the measurement tools used, particularly the types of probes and the sites and areas of the mouth that were assessed. There was also heterogeneity in the use of clinical attachment loss (CAL) and pocket probing depth (PPD) as criteria for periodontitis. In the 15 studies, the threshold for a diagnosis of periodontitis when CAL was the criterion ranged from 2 to > or =6 mm and when PPD was used, from 3 to > or =6 mm. CONCLUSIONS This review has confirmed previous work which has suggested that epidemiological studies of periodontal diseases are complicated by the diversity of methodologies and definitions used. The studies that were reviewed utilized a minimum diagnostic threshold defining periodontitis, at a given site in terms of CAL of 2 mm and PPD of 3 mm.
Collapse
Affiliation(s)
- Amir Savage
- UCL Eastman Dental Institute, London WC1X 8WD, UK
| | | | | | | |
Collapse
|
22
|
Abstract
Periodontal disease is a common infectious disease in women of reproductive age. The disease is often not diagnosed and in studies of over 10 000 women has been associated with preterm birth, small for gestational age newborns, and preeclampsia. It has been shown in a smaller number of women that treatment of periodontal disease may reduce the rate of preterm birth. The pregnancy complications of periodontal disease may be due to lipopolysaccharide from the periodontal pockets inciting prostaglandin pathways controlling parturition. Three large randomized controlled trials of treatment of periodontal disease are underway and may provide confirmation of the importance of periodontal disease in causing complications of pregnancy.
Collapse
Affiliation(s)
- Alexis Shub
- School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia.
| | | | | |
Collapse
|
23
|
Cobb CM, Williams KB, Gerkovitch MM. Is the prevalence of periodontitis in the USA in decline? Periodontol 2000 2009; 50:13-24. [DOI: 10.1111/j.1600-0757.2008.00284.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Karlsson MR, Diogo Löfgren CI, Jansson HM. The effect of laser therapy as an adjunct to non-surgical periodontal treatment in subjects with chronic periodontitis: a systematic review. J Periodontol 2009; 79:2021-8. [PMID: 18980508 DOI: 10.1902/jop.2008.080197] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The objective of this study was to systematically review the evidence on the effectiveness of laser therapy as an adjunct to non-surgical periodontal treatment in adults with chronic periodontitis. METHODS A search was conducted for randomized controlled trials comparing the outcome of periodontitis with laser as an adjunct to scaling and root planing in the treatment of chronic periodontal disease. The electronic databases, PubMed and Cochrane Central Register of Controlled Trials, were used as data sources. Screening, data abstraction, and quality assessment were conducted independently by three reviewers (MK, HJ, and CDL). The primary outcome measures evaluated were changes in clinical attachment level, probing depth, and bleeding on probing. RESULTS The search resulted in 25 abstracts; four randomized controlled clinical trials were included. Four different laser methods were used; consequently, it was impossible to conduct a quantitative data synthesis leading to a meta-analysis. All studies included a limited number of subjects. CONCLUSIONS No consistent evidence supports the efficacy of laser treatment as an adjunct to non-surgical periodontal treatment in adults with chronic periodontitis. More randomized controlled clinical trials are needed.
Collapse
Affiliation(s)
- Marcus R Karlsson
- Department of Periodontology, Center for Oral Health Sciences, Malmö University, Malmö, Sweden
| | | | | |
Collapse
|
25
|
Teeuw WJ, Coelho L, Silva A, van der Palen CJNM, Lessmann FGJM, van der Velden U, Loos BG. Validation of a dental image analyzer tool to measure alveolar bone loss in periodontitis patients. J Periodontal Res 2009; 44:94-102. [DOI: 10.1111/j.1600-0765.2008.01111.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
26
|
|
27
|
Williams RC. Understanding and Managing Periodontal Diseases: A Notable Past, a Promising Future. J Periodontol 2008; 79:1552-9. [DOI: 10.1902/jop.2008.080182] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
28
|
|
29
|
Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008; 35:277-90. [PMID: 18294231 DOI: 10.1111/j.1600-051x.2007.01173.x] [Citation(s) in RCA: 479] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIM Elevated plasma C-reactive protein (CRP) is regarded as a risk predictor for cardiovascular diseases. This systematic review explored the robustness of observations that CRP is elevated in periodontitis. Similarly, the effect of periodontal therapy on CRP levels was investigated. MATERIAL AND METHODS Selection of publications was based on: (1) cross-sectional (case-control) studies; (2) longitudinal (treatment) studies; (3) high-sensitivity CRP measurement; (4) median and/or mean (+/-SD) values presented; and (5) subjects with no systemic disorders. RESULTS Screening of the initially 448 identified studies and reference checking resulted in 18 suitable papers. The majority of the studies showed that CRP levels are higher in patients than in controls. Often, studies showed that patients had CRP levels >2.1 mg/l. A meta-analysis of 10 cross-sectional studies showed that the weighted mean difference (WMD) of CRP between patients and controls was 1.56 mg/l (p<0.00001). Evidence from available treatment studies (n=6) showed lower levels of CRP after periodontal therapy. Eligible treatment studies in a meta-analysis demonstrated a WMD of reductions of CRP after therapy of 0.50 mg/L (95% CI 0.08-0.93) (p=0.02). CONCLUSIONS There is strong evidence from cross-sectional studies that plasma CRP in periodontitis is elevated compared with controls. There is modest evidence on the effect of periodontal therapy in lowering the levels of CRP.
Collapse
Affiliation(s)
- Spiros Paraskevas
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands.
| | | | | |
Collapse
|
30
|
Sugawara Y, Kuroda S, Tamamura N, Takano-Yamamoto T. Adult patient with mandibular protrusion and unstable occlusion treated with titanium screw anchorage. Am J Orthod Dentofacial Orthop 2008; 133:102-11. [DOI: 10.1016/j.ajodo.2006.06.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Revised: 06/30/2006] [Accepted: 06/30/2006] [Indexed: 10/22/2022]
|
31
|
Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007; 78:1387-99. [PMID: 17608611 DOI: 10.1902/jop.2007.060264] [Citation(s) in RCA: 1027] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many definitions of periodontitis have been used in the literature for population-based studies, but there is no accepted standard. In early epidemiologic studies, the two major periodontal diseases, gingivitis and periodontitis, were combined and considered to be a continuum. National United States surveys were conducted in 1960 to 1962, 1971 to 1974, 1981, 1985 to 1986, 1988 to 1994, and 1999 to 2000. The case definitions and protocols used in the six national surveys reflect a continuing evolution and improvement over time. Generally, the clinical diagnosis of periodontitis is based on measures of probing depth (PD), clinical attachment level (CAL), the radiographic pattern and extent of alveolar bone loss, gingival inflammation measured as bleeding on probing, or a combination of these measures. Several other patient characteristics are considered, and several factors, such as age, can affect measurements of PD and CAL. Accuracy and reproducibility of measurements of PD and CAL are important because case definitions for periodontitis are based largely on either or both measurements, and relatively small changes in these values can result in large changes in disease prevalence. The classification currently accepted by the American Academy of Periodontology (AAP) was devised by the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions. However, in 2003 the Centers for Disease Control and Prevention and the AAP appointed a working group to develop further standardized clinical case definitions for population-based studies of periodontitis. This classification defines severe periodontitis and moderate periodontitis in terms of PD and CAL to enhance case definitions and further demonstrates the importance of thresholds of PD and CAL and the number of affected sites when determining prevalence.
Collapse
Affiliation(s)
- Roy C Page
- Regional Clinical Dental Research Center, Schools of Dentistry and Medicine, University of Washington, Seattle, WA 98195, USA
| | | |
Collapse
|
32
|
Almeida ALPFD, Madeira LC, Freitas KCD, Greghi SLA, Pegoraro LF. Cross-Sectional Evaluation of the Presence of Gingival Recession in Individuals With Cleft Lip and Palate. J Periodontol 2007; 78:29-36. [PMID: 17199536 DOI: 10.1902/jop.2007.050303] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In dentistry, investigations in the field of periodontics in individuals with cleft lip and palate are scarce, with few studies on the prevalence, incidence, extension, and severity of periodontal alterations and their treatment in adults. METHODS This study analyzed the prevalence, extension, and severity of recessions and the relationship with some etiologic factors in 200 individuals with cleft lip and palate aged 13 to 56 years. Examination comprised measurements of gingival recession, amount of keratinized mucosa, frenum insertions, and tooth positioning in the dental arch. RESULTS Analysis of the results revealed that the prevalence of recession was high, because 75% of individuals in the sample had at least one tooth with gingival recession; 100% of individuals aged >43 years presented at least one recession, and most recessions were Miller Class I. The multiple linear regression demonstrated that recession is directly proportional to age (i.e., it increases with age); concerning the amount of keratinized mucosa, the proportion is inverse (i.e., the larger the recession, the smaller the amount of mucosa); and gingival inflammation also presented a positive correlation. CONCLUSIONS Gingival recessions are caused by many etiologic factors, which usually act in combination. Thus, all factors causing recession should be analyzed so that planning and treatment of this clinical condition may be established, for achievement of optimal outcomes.
Collapse
|
33
|
Dockter KM, Williams KB, Bray KS, Cobb CM. Relationship Between Prereferral Periodontal Care and Periodontal Status at Time of Referral. J Periodontol 2006; 77:1708-16. [PMID: 17032114 DOI: 10.1902/jop.2006.060063] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND According to a recent study, the severity of periodontal disease of individuals referred for periodontal care is greater now than in 1980. Variability in the standard of periodontal care in general dental practices may result in less than desirable outcomes and consequences of poorer periodontal health. METHODS A sample of 100 newly referred dental patients from three separate periodontal practices in the greater Kansas City, Missouri area participated in this study. Data were collected from three sources: 1) a clinical chart audit, 2) current periodontal disease status as determined by clinical examination, and 3) a patient response questionnaire on past professional care and personal oral care habits. Bivariate analyses were performed using a statistical package. RESULTS Of the 100 subjects, 74 were diagnosed as periodontal case type IV at the point of referral, of which 29.8% were treatment planned by the periodontist for two or more extractions. Teeth treatment planned for extraction were significant as a function of disease severity (P = 0.0001). Periodontal treatment provided in general dental practices did not vary because of disease severity. The incidence of deep cleanings (scaling and root planing) was reported slightly higher (32.4%) for case type IV than for case type III (26.9%), but this difference was not statistically significant. The average number of cleanings received in the general dental office was less than the standard of care according to the severity of the disease. CONCLUSION If one assumes that the data obtained in the Kansas City practices are representative of a larger geographic area, it indicates that dentistry may be failing to address issues of the timely diagnosis of periodontal disease, appropriate treatment, and/or timely referral for treatment.
Collapse
Affiliation(s)
- Kathryn M Dockter
- Department of Dental Public Health and Behavioral Sciences, School of Dentistry, University of Missouri, Kansas City, MO, USA.
| | | | | | | |
Collapse
|
34
|
Thomson WM, Broadbent JM, Poulton R, Beck JD. Changes in periodontal disease experience from 26 to 32 years of age in a birth cohort. J Periodontol 2006; 77:947-54. [PMID: 16734567 PMCID: PMC2257476 DOI: 10.1902/jop.2006.050319] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Information is lacking on the natural history of periodontitis through the third and fourth decades of life. METHODS Periodontal examinations were conducted at 26 and 32 years of age in a longstanding prospective study of a birth cohort born in Dunedin, New Zealand, in 1972 and 1973. At each age, gingival recession (GR) and probing depth (PD) were recorded at three sites per tooth using a diagonal half-mouth design (measurements were made in all four quadrants at 32 years of age, but longitudinal comparisons were made using only the half-mouth data). RESULTS A total of 882 individuals were examined at both ages. The mean number of measured sites fell between 26 and 32 years of age. The overall prevalence of one or more sites with >or=4 mm combined attachment loss (CAL) rose from 18.6% to 21.8%, whereas there were greater increases in the proportion with two or more sites with >or=4 mm CAL (from 8.0% to 12.6%) and one or more sites with >or=5 mm CAL (from 3.6% to 8.0%). The extent and severity of CAL also increased. A total of 403 individuals (45.7%) had an increase in CAL >or=2 mm at one or more sites, whereas 110 (12.5%) had a CAL increase >or=3 mm at one or more sites. Seen in approximately 4% of sites, negative GR (i.e., gingival enlargement) had a substantial effect on PD-based estimates. An increase in PD >or=2 mm at one or more sites was experienced by 345 individuals (39.1%), whereas 88 people (10.0%) had an increase in PD >or=3 mm at one or more sites. The greatest mean attachment loss was experienced at disto-lingual sites on molars, and most manifested as PD increases. Notable increases in GR were seen with lower incisors and canines. CONCLUSIONS Periodontal loss of attachment continues among a sizable proportion of people from the third to the fourth decade of life; however, contrary to patterns in older adults, changes in the PD component are greater than the changes in the recession component. Incident attachment loss is most frequently observed at proximal sites on posterior teeth.
Collapse
Affiliation(s)
- W Murray Thomson
- Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand.
| | | | | | | |
Collapse
|
35
|
Jansson H, Lindholm E, Lindh C, Groop L, Bratthall G. Type 2 diabetes and risk for periodontal disease: a role for dental health awareness. J Clin Periodontol 2006; 33:408-14. [PMID: 16677329 DOI: 10.1111/j.1600-051x.2006.00929.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Several studies have found correlations between diabetes and an increased prevalence of periodontitis. OBJECTIVE To analyse, in a group of subjects with type 2 diabetes (T2D), (i) the association between medical characteristics and severe periodontal disease and (ii) dental care habits and knowledge of oral health. METHODS One hundred and ninety-one subjects with T2D were examined. Based on assessment of marginal bone height in panoramic radiographs, two periodontal subgroups were identified: one periodontally diseased (PD+) and one periodontally healthy (PD-) group. All subjects completed a questionnaire about their medical and oral health. RESULTS Twenty per cent of the subjects were classified as PD+. This was verified by clinical parameters. PD+ individuals had higher haemoglobin A1c (HbA1c) levels (p=0.033) and higher prevalences of cardiovascular complications (p=0.012). They were also less likely to be of Scandinavian origin (p=0.028) and more likely to smoke (p<0.001) than the PD- group. The PD+ group rated their oral health as poor (p<0.0001) and believed that T2D had an influence on their oral status (p<0.0001). CONCLUSION The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D.
Collapse
Affiliation(s)
- H Jansson
- Department of Periodontology, Centre for Oral Health Sciences, Malmö University, Malmö, Sweden.
| | | | | | | | | |
Collapse
|
36
|
Beck JD, Caplan DJ, Preisser JS, Moss K. Reducing the bias of probing depth and attachment level estimates using random partial-mouth recording. Community Dent Oral Epidemiol 2006; 34:1-10. [PMID: 16423025 DOI: 10.1111/j.1600-0528.2006.00252.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the bias and precision of probing depth (PD) and clinical attachment level (CAL) estimates of random and fixed partial examination methods compared with full-mouth examinations. METHODS PD and CAL were calculated on six sites for up to 28 teeth (considered to be the gold standard with no bias) and three fixed-site selection methods (FSSMs) that resulted in a partial examination of sites: the Ramfjord method, and the NIDCR methods used in NHANES I, and NHANES 2000. Finally, seven random-site selection methods (RSSMs) were created by sampling the following number of sites: 84, 42, 36, 28, 20, 15, 10 and 6. To compare bias and precision of the methods we calculated percent relative bias and relative error. RESULTS Estimates of means, standard deviations (SD), relative bias and relative error for RSSMs were almost identical to the full-mouth examination, but SDs increase slightly when fewer than 28 sites were sampled and relative bias and error increase for methods sampling fewer than 20 sites. The FSSMs had very low relative error, but much higher relative bias indicating underestimation. The FSSM with the smallest bias and error was the Ramfjord method, but the Random 36 method had less bias and less relative error. The NHANES 2000 method was the FSSM with the lowest bias and relative error for estimates of Extent Scores (percent of sites > or =3, 4, 5, or 5 mm PD or CAL) but random methods sampling fewer sites performed just as well. Both FSSMs and RSSMs underestimated prevalence, especially prevalence of less frequently occurring conditions, but most RSSMs were less likely to underestimate prevalence than the FSSMs. CONCLUSION The promise of reducing bias and increasing precision of the estimates support the continued development and examination of RSSMs.
Collapse
Affiliation(s)
- James D Beck
- Department of Dental Ecology, University of North Carolina at Chapel Hill, 27516, USA.
| | | | | | | |
Collapse
|
37
|
Suzuki S, Mitani A, Koyasu K, Oda SI, Yoshinari N, Fukuda M, Hanamura H, Nakagaki H, Noguchi T. A Model of Spontaneous Periodontitis in the Miniature Goat. J Periodontol 2006; 77:847-55. [PMID: 16671878 DOI: 10.1902/jop.2006.050203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The pathogenesis and progression of periodontal disease have been extensively studied through the use of animal models. However, no animal model has yet been established that is precisely similar to periodontitis in humans. In the present study, we examined the use of Shiba goats as a model for spontaneous periodontitis. METHODS Thirty-four Shiba goats (seven males and 27 females, aged 10 to 98 months) were used. We examined periodontitis in Shiba goats clinically, histopathologically, and microbiologically. RESULTS The mean probing depth (PD) of the 68 teeth examined was 2.7 +/- 0.8 mm. The incidences of PD > or =3 and 4 mm were 46.4% and 22.1%, respectively. The incidence of bleeding on probing in 68 sites and in 34 animals was 60.7% and 73.5%, respectively. The formation of vertical alveolar bone defects and downgrowth of gingival epithelial cells were found in the areas of periodontitis. The prevalence of Tannerella forsythensis, Campylobacter rectus, Fusobacterium necrophorum, Fusobacterium nucleatum, and Actinobacillus actinomycetemcomitans in subgingival plaque by polymerase chain reaction was 46.4%, 28.5%, 28.5%, 17.8%, and 3.5%, respectively. These percentages were increased in subgingival plaque from PD > or =3 mm. CONCLUSIONS The clinical, histopathological, and microbiological features of spontaneous periodontitis in Shiba goats were somewhat similar to those in human periodontitis. Moreover, there are some advantages of using the Shiba goat; the size of the oral cavity is suitable for periodontal treatment, and handling and housing are relatively easy. Therefore, these results suggest that the Shiba goat is a useful animal model for human periodontitis.
Collapse
Affiliation(s)
- Sachiyo Suzuki
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Aichi, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
There is an increasing amount of evidence suggesting a systemic link between periodontal disease in the pregnant mother and pre-term low birth weight (PLBW). Severe periodontitis affects at least 10% of the general population. The aetiology of periodontitis is essentially a bacterially induced inflammatory reaction within the attachment surrounding the teeth. Maternal infection has been linked with pre-term delivery. Normal pregnancy itself is associated with inflammatory changes very similar to those found in sepsis. Because the infected periodontal tissues can act as a reservoir for both bacterial products and inflammatory cytokines, it may be possible that periodontal infection and the resultant inflammation could be linked with PLBW. Current understanding suggests that prostaglandins and proinflammatory cytokines play a pivotal role in the initiation process because of the close relationship of inflammation and infection. High levels of maternally or fetally derived cytokines such as tumour necrosis factor alpha (TNFalpha) may enhance amniochorionic and decidual interleukin six (IL-6) expression. Prostaglandin E2 (PGE2) has also been associated with periodontitis and PLBW. Periodontitis is a possible risk factor for PLBW with an odds ratio of 2.30. For the majority of individuals affected with periodontitis, the condition is symptom-free until the disease is more advanced. Therefore there is the need for medical carers of pregnant patients to increase the awareness among pregnant women themselves. Although there is plenty of evidence associating periodontitis with PLBW, interventional studies for the treatment of periodontitis measuring the impact on PLBW are few in number. Therefore more good quality clinical trials are required to address this issue.
Collapse
Affiliation(s)
- Richard Tucker
- Eastman Dental Institute for Oral Health Care Sciences, University College London, 256 Gray's Inn Road, London WC1X 8LD, England.
| |
Collapse
|
39
|
Abstract
This literature review summarizes current knowledge on the systemic levels of selected markers of inflammation in periodontitis. From samples of peripheral blood the following cellular factors are discussed: total number of white blood cells, red blood cells, and thrombocytes. Further, plasma levels of acute-phase proteins, cytokines, and coagulation factors are reviewed. From the available literature it appears that the total numbers of leukocytes and plasma levels of C-reactive protein are consistently higher in periodontitis patients compared to healthy controls. Numbers of red blood cells and levels of hemoglobin are lower in periodontitis and there is a trend towards anemia of chronic disease. Most systemic markers of inflammation discussed in this review are also regarded as predictive markers for cardiovascular diseases. Therefore, changes in these markers in periodontitis may be part of the explanation why periodontitis is associated with cardiovascular diseases and/or cerebrovascular events in epidemiological studies. It is hypothesized that possibly daily episodes of a bacteremia originating from periodontal lesions are the cause for the changes in systemic markers in periodontitis; the cumulative size of all periodontal lesions in the untreated severe patient may amount to 15 to 20 cm2.
Collapse
Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands.
| |
Collapse
|
40
|
Troil-Lindén B, Torkko H, Alaluusua S, Wolf J, Jousimies-Somer H, Asikainen S. Periodontal findings in spouses. J Clin Periodontol 2005. [DOI: 10.1111/j.1600-051x.1995.tb00119.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Maffei G, Brouwer N, Dolman KM, van der Velden U, Roos D, Loos BG. Plasma Levels of Mannan-Binding Lectin in Relation to Periodontitis and Smoking. J Periodontol 2005; 76:1881-9. [PMID: 16274307 DOI: 10.1902/jop.2005.76.11.1881] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Mannan-binding lectin (MBL) is an important molecule of innate immunity; it acts as an opsonin and stimulates the classical complement pathway. Moreover, it has been suggested that MBL acts as a weak acute phase protein. We investigated whether MBL levels are increased in periodontitis, and we tested whether individuals deficient for MBL are more susceptible to periodontitis. METHODS A total of 219 subjects participated in the study. Plasma samples from 115 periodontitis patients and 104 healthy controls were taken, and the MBL levels were measured by enzyme-linked immunosorbent assay (ELISA). MBL levels were analyzed in relation to periodontitis, taking into consideration age, gender, ethnic and educational background, and smoking status. In some analyses, subjects with MBL plasma levels <0.8 microg/ml were considered MBL deficient. RESULTS MBL plasma concentrations were not significantly different in moderate and severe periodontitis compared to controls (1.6, 1.4, and 1.6 microg/ml, respectively). Also, the prevalence of MBL deficiency was not found to be different between controls and moderate and severe periodontitis (45%, 37%, and 36%). However, among all subjects and among the non-deficient subjects, MBL levels were markedly increased in heavy smokers (>10 cigarettes per day), irrespective of periodontal disease status, in comparison to non-smokers and light smokers. MBL plasma levels did not show a correlation with plasma C-reactive protein (CRP) and were also not related to the prevalence of specific periodontal pathogens. CONCLUSIONS MBL levels were not elevated in periodontitis, and MBL deficiency was not related to susceptibility for periodontitis. The fact that MBL levels were higher among heavy smokers is the subject of further investigation.
Collapse
Affiliation(s)
- Gaia Maffei
- Department of Periodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije University, Amsterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
42
|
|
43
|
Pelosini I, Scarpignato C. Rifaximin, a Peculiar Rifamycin Derivative: Established and Potential Clinical Use Outside the Gastrointestinal Tract. Chemotherapy 2005; 51 Suppl 1:122-30. [PMID: 15855757 DOI: 10.1159/000081999] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Rifaximin is a poorly absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. The availability of a topical formulation (a cream containing 5% of the drug) and the lack of transcutaneous absorption pointed out in both animal and human studies has allowed its topical use in skin infections. Furthermore, since the spectrum of antibacterial action of rifaximin includes many organisms (e.g. Bacteroides bivius-disiens, Gardnerella vaginalis, Haemophilus ducreyi) causing genital infections, including Trichomonas vaginalis and Chlamydia trachomatis, its local application in the treatment of bacterial vaginosis (BV) has been attempted. Finally, since periodontal disease, caused by plaque (an aggregate of various bacteria), can be considered a 'local' infection, intrapocket rifaximin was tried in the treatment of periodontal infections. While the efficacy in pyogenic infections of the skin has been confirmed by several investigations, which showed an improvement of both subjective and objective parameters significantly better than that of the reference drug (i.e. chlortetracycline or oxytetracycline), the usefulness of rifaximin in BV and periodontal disease needs to be further studied in well-designed clinical trials.
Collapse
Affiliation(s)
- Iva Pelosini
- Laboratory of Clinical Pharmacology, Department of Human Anatomy, Pharmacology and Forensic Sciences, School of Medicine and Dentistry, University of Parma, Parma, Italy
| | | |
Collapse
|
44
|
Endean C, Roberts-Thomson K, Wooley S. Anangu oral health: The status of the Indigenous population of the Anangu Pitjantjatjara lands. Aust J Rural Health 2004; 12:99-103. [PMID: 15200519 DOI: 10.1111/j.1440-1854.2004.00566.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe oral health in the Anangu Pitjantjatjaraku lands in South Australia and to compare with earlier surveys and national data. DESIGN Descriptive. SETTING Data were collected at the time of dental care service provision, according to World Health Organization protocols, at the request of the Nganampa Health Council on optical mark reader forms. PARTICIPANTS There were 356 Anangu adults and 317 children surveyed. RESULTS The mean number of teeth affected by dental caries in the deciduous dentition in young children, aged 5-6 years, was double (mean 3.20) that of the overall Australian child population aged 5-6 years (mean 1.44). In contrast to the decline in deciduous caries in Australian children generally, Anangu children aged 5-9 years had a 42% increase in the mean number of teeth affected since 1987. Adults experienced low levels of dental caries, but severe periodontal disease was more prevalent among diabetics (79%) compared with-non-diabetics (13.8%). Tooth loss was found more frequently among adults with diabetes (mean 5.51) than non-diabetics (mean 1.53). CONCLUSIONS Oral health promotion strategies, in association with general health strategies, need to be developed to improve oral health in this remote Aboriginal population.
Collapse
Affiliation(s)
- Colin Endean
- Nganampa Health Council, The University of Adelaide, South Australia
| | | | | |
Collapse
|
45
|
Borges-Yáñez SA, Maupomé G, Jiménez-García G. Validity and reliability of partial examination to assess severe periodontitis. J Clin Periodontol 2004; 31:112-8. [PMID: 15016036 DOI: 10.1111/j.0303-6979.2004.00456.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the extent and severity index (ESI) with a gold standard represented by actual readings of loss of attachment on six sites around all teeth present (excluding third molars). METHODS Five standardized dentists (kappa=0.6) examined 712 subjects > or =20 years of age at a dental school (1993-1995). Sensitivity, specificity, positive and negative predictive values, and true and apparent prevalence were established. RESULTS True severe periodontitis prevalence was 95.8%. ESI underestimated the severity (0.1 mm), extent (4%), and prevalence (16%) of periodontitis. The severity, as established by ESI, coincided 23.4% with the gold standard. ESI failed to identify 16.7% of subjects with severe periodontal disease, but specificity and positive predictive value were very high. CONCLUSIONS The underestimation of severe periodontitis through ESI may lead to inadequate recommendations for further treatment. Accurately identifying subjects with severe periodontitis requires a full-mouth examination. Because the ESI relies on measurements taken on only 28 periodontal sites to estimate the periodontitis status of the entire mouth, the validity and reliability of ESI may be modified by the prevalence of severe periodontal disease and the distribution of disease according to age and operational definitions.
Collapse
Affiliation(s)
- S Aída Borges-Yáñez
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autoónoma de México, México DF, Mexico.
| | | | | |
Collapse
|
46
|
Do GL, Spencer AJ, Roberts-Thomson K, Ha HD. Smoking as a risk indicator for periodontal disease in the middle-aged Vietnamese population. Community Dent Oral Epidemiol 2004; 31:437-46. [PMID: 14986911 DOI: 10.1046/j.1600-0528.2003.00009.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Studies from developed countries have found smoking a significant risk indicator for periodontitis. However, few such studies have been conducted in developing populations, where the natural history of the disease is rarely confounded by treatment and smoking is highly prevalent. AIM The present study aimed to confirm the consistency, strength and dose-response of the association of smoking with periodontitis measured by loss of attachment (LOA) in a representative middle-aged adult sample from a developing country. METHODS A cross-sectional study with a multistage stratified random sample was conducted in two provinces of Vietnam. RESULTS A total of 575 (response: 84.6%) 35-44-year-old subjects were interviewed and periodontally examined. Data were re-weighted to represent the population of the provinces. 28.9% were current smokers (CS), 8.6% former smokers (FS) and 62.5% never-smokers (NS). Number of cigarette pack-years was calculated to divide CS into light smokers, LS < or = 5 pack-years, and heavy smokers, HS 5+ pack-years. The US NIDR protocol was employed for LOA measurement at two sites per tooth for every tooth. HS presented with the highest prevalence of LOA exceeding various thresholds followed by LS (chi2, P < 0.001). The extent of sites with LOA > or = 4 mm and LOA > or = 6 mm was significantly higher among HS and LS compared to NS (ANOVA; P < 0.001). The severity scores of LOA for NS, FS, LS and HS were 2.42, 2.50, 2.64 and 3.05 mm respectively (ANOVA; P < 0.001). Disease cases were defined as having 2+ sites with LOA > or = 5 mm and 1+ site with PD > or = 4 mm. Compared to NS, the odds ratio for periodontitis among heavy smokers was 7.17 (CI: 2.87-17.92, P < 0.001). CONCLUSION Smoking is a risk indicator for periodontitis among the middle-aged Vietnamese population. To pursue a population prevention approach for periodontitis, dentistry in Vietnam needs to be part of antismoking and smoking cessation programs.
Collapse
Affiliation(s)
- G Loc Do
- Australian Research Centre for Population Oral Health, The University of Adelaide, Australia
| | | | | | | |
Collapse
|
47
|
Sayegh A, Hilow H, Bedi R. Pattern of tooth loss in recipients of free dental treatment at the University Hospital of Amman, Jordan. J Oral Rehabil 2004; 31:124-30. [PMID: 15009595 DOI: 10.1046/j.0305-182x.2003.01229.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients <or=40 years of age whereas periodontal extractions were predominant for the above 40-year-old group. In addition, the most frequently extracted teeth, due to caries, were lower first and second molars while lower incisors were most commonly extracted for periodontal disease. Premolars were extracted for orthodontic reasons, upper incisors for trauma, third molars for eruption problems and canines for pre-prosthetic reasons. In conclusion, dental caries was the main reason for removal of teeth in adults attending the University of Jordan free dental casualty clinic. Therefore, in order to reduce the rate of dental extractions in this sector of the Jordanian population, efforts should focus on prevention and treatment of caries. Efforts should also be made to change the values and beliefs of this sector towards the importance of natural dentition.
Collapse
Affiliation(s)
- A Sayegh
- Department of Oral Surgery, Oral Medicine and Periodontology, Faculty of Dentistry/University of Jordan, Amman, Jordan
| | | | | |
Collapse
|
48
|
Schätzle M, Löe H, Bürgin W, Anerud A, Boysen H, Lang NP. Clinical course of chronic periodontitis. J Clin Periodontol 2003; 30:887-901. [PMID: 14710769 DOI: 10.1034/j.1600-051x.2003.00414.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the influence of long-standing gingival inflammation on periodontal attachment loss. On the basis of repeated examinations, the present report describes the influence of gingival inflammation on the initiation of periodontitis from 16 to 59 years of age. MATERIAL AND METHODS The data originated from a 26-year longitudinal study of Norwegian males, who practiced daily oral home care and received state-of-the-art dental care. The initial examination included 565 individuals. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. All tooth sites were divided into four categories according to their history of gingival inflammation over the entire observation period: sites always scoring GI = 0, GI = 1 and GI = 2 sites (GI = gingival index). Sites disclosing various GI scores at different observation periods were not considered. RESULTS The mean cumulative attachment loss for non-inflamed (GI = 0) sites in individuals approaching 60 years of age was 1.94 mm. Sites always scoring GI = 1 yielded 2.42 mm, and sites that always scored GI = 2 exhibited 3.31 mm of periodontal attachment loss. At interproximal sites of all three groups where gingival trauma was assumed to be minimal or non-existent, only very few sites expressed attachment loss due to gingival recession (2-4%). At interproximal sites always scoring GI = 0, 20% loss of attachment was in the form of pocket formation by 59 years of age. The GI = 1 and the GI = 2 cohorts exhibited attachment loss with pocket formation in 28% and 54%, respectively. CONCLUSION This study has shown that, as men approach 60 years of age, gingival sites that throughout the 26 years of observation bled on probing had approximately 70% more attachment loss than sites that were consistently non-inflamed (GI = 0). Before 40 years of age, there was a slight increase in periodontal attachment loss due to pocket formation, but after this, the frequency increased significantly. Loss of attachment due to gingival recession was very small in all three groups. The fact that sites with non-inflamed gingiva also exhibited some loss of attachment and pocket formation may be explained by fluctuation in the variations of tissue status during long observation intervals combined with the presence of subclinical inflammation.
Collapse
Affiliation(s)
- Marc Schätzle
- Department of Periodontology and Fixed Prosthodontics, University of Berne, School of Dental Medicine, Switzerland.
| | | | | | | | | | | |
Collapse
|
49
|
Donaldson D, Gelskey SC, Landry RG, Matthews DC, Sandhu HS. A placebo-controlled multi-centred evaluation of an anaesthetic gel (Oraqix) for periodontal therapy. J Clin Periodontol 2003; 30:171-5. [PMID: 12631173 DOI: 10.1034/j.1600-051x.2003.00017.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Six Canadian dental schools investigated the ability of a thermosetting gel containing 25 mg/g prilocaine and 25 mg/g lidocaine as active agents to produce analgesia in periodontal pockets utilizing a randomized, double-blind, placebo-controlled study. MATERIALS AND METHODS The study consisted of 130 patients, each of whom received the active or placebo gel in periodontal pockets in one quadrant of the mouth for 30 s prior to periodontal debridement (scaling and root planing). Pain was measured using both a 100-mm Visual Analogue Scale (VAS) and a Verbal Rating Scale (VRS). RESULTS The median VAS pain score for the patients treated with the anaesthetic gel was 5 mm (range 0-85 mm) as opposed to 13 mm (range 0-79 mm) in the placebo-treated patients (P=0.015). There was no significant difference in the percentage of patients reporting no or mild pain (78% and 76% for the anaesthetic gel and placebo, respectively). No significant differences were seen in patient demographics, or mandible versus maxilla. CONCLUSIONS The VAS pain scores showed that the anaesthetic gel 5% was statistically more effective than the placebo in reducing pain during periodontal debridement.
Collapse
Affiliation(s)
- D Donaldson
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada.
| | | | | | | | | |
Collapse
|
50
|
Craig RG, Yip JK, Mijares DQ, Boylan RJ, Haffajee AD, Socransky SS. Destructive periodontal diseases in minority populations. Dent Clin North Am 2003; 47:103-14, x. [PMID: 12519008 DOI: 10.1016/s0011-8532(02)00052-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Disparities in the prevalence and severity of destructive periodontal diseases have been reported for American minority populations and have raised the following questions. Are differences in destructive periodontal disease prevalence and severity due to genetic or other confounding variables associated with ethnicity race? Do risk factors for destructive periodontal diseases differ among American minority populations or differ from the population at large? Answers to these questions will have profound impact on the direction of future research and the allocation of resources to address disparities in destructive periodontal diseases in American minority populations. Risk assessment studies that examined a set of clinical, demographic, immunologic, and microbiologic parameters of Asian Americans, African Americans, and Hispanic Americans resident in the greater New York City region suggest that occupational status, monitored as a surrogate variable for socioeconomic status, may be a more robust risk factor than ethnicity/race for destructive periodontal diseases in these populations.
Collapse
Affiliation(s)
- Ronald G Craig
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA.
| | | | | | | | | | | |
Collapse
|