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Rapone B, Scarano A, Qorri E, Pardo A, Murmura G, D'Albenzio A, Ferrara E. Salivary Oxidative-Antioxidant Profile Following Adjunctive Gaseous Ozone Administration in Non-Surgical Periodontal Treatment: A Randomized Controlled Trial. J Clin Med 2024; 13:5272. [PMID: 39274488 PMCID: PMC11396148 DOI: 10.3390/jcm13175272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/28/2024] [Accepted: 09/02/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Periodontitis is associated with increased oxidative stress, which may impair treatment outcomes. Ozone therapy has shown promise in reducing oxidative stress and improving periodontal health. This study examined the impact of adjunctive gaseous ozone administration on salivary oxidative stress markers in patients with periodontitis stages II-IV and grades A-C undergoing non-surgical periodontal treatment (NSPT). Methods: Ninety patients with periodontitis were randomly allocated to either the test group (NSPT with gaseous ozone administration) or the control group (NSPT alone) using computer-generated randomization. The OzoneDTA system was used to deliver ozone at 2100 ppm for 60 s per site once weekly for 4 weeks. Clinical periodontal parameters (probing depth [PD], clinical attachment level [CAL], plaque index [PI], gingival index [GI]) and salivary oxidative stress markers (malondialdehyde [MDA], total antioxidant capacity [TAC], superoxide dismutase [SOD]) were assessed by blinded examiners at baseline, 3, and 6 months post-treatment. Results: Mixed ANOVA revealed significant three-way interactions between time, treatment, and stage or grade for clinical and biochemical measures (p < 0.001). The test group exhibited significant improvements in TAC (mean difference: 0.45 ± 0.12 mmol/L, p = 0.002), MDA (-0.38 ± 0.09 nmol/mL, p = 0.001), and SOD (65 ± 18 U/mL, p < 0.001) compared with the control group, with more pronounced effects in stages III and IV. Large effect sizes (Cohen's d > 0.8) were observed for the test group between baseline and 6 months for all markers. Conclusions: Gaseous ozone administration as an adjunct to NSPT can effectively improve clinical periodontal parameters and salivary oxidative stress markers, particularly in stages III and IV periodontitis. The enhanced outcomes may be attributed to ozone's antimicrobial and immunomodulatory properties, which synergistically reduce oxidative stress and promote periodontal healing.
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Affiliation(s)
- Biagio Rapone
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Erda Qorri
- Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania
| | - Alessia Pardo
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Pediatrics and Gynecology (DIPSCOMI), University of Verona, 37134 Verona, Italy
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Alessandro D'Albenzio
- Complex Operative Unit of Pathological Addiction, Addiction Service, ASL2 Abruzzo, 66100 Chieti, Italy
| | - Elisabetta Ferrara
- Department of Human Sciences, Law, and Economics, Telematic University "Leonardo da Vinci", UNIDAV, Torrevecchia Teatina, 66100 Chieti, Italy
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2
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Okereke UP, Offurum C, Eze VA, Okpechukwu CP, Ifedibar WC, Akaji EA. Geriatric oral health neglect: calculus on the attached gingiva: a case report. Ann Med Surg (Lond) 2024; 86:4295-4299. [PMID: 38989208 PMCID: PMC11230770 DOI: 10.1097/ms9.0000000000002230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/19/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction and importance Aging exerts various effects on and causes changes to the oral tissues. It is often difficult to distinguish between what is caused by the physiological process of aging itself and what is caused by the individual's lifestyle or diseases. The elderly face peculiar health challenges and require special dental care. It is therefore vital that greater attention be given to the oral health needs of this rapidly population. In this article, the authors present the case of an elderly female patient with a rare case of calculus on the attached gingiva. Case presentation A 90-year-old retired teacher with a history of hypertension, presented with a small, painless, grayish-brown growth on her attached gingiva, noticed by her daughter-in-law. Examination revealed signs of gingivitis and significant dental issues including missing teeth, fractures, and calculus buildup. Diagnosis of chronic generalized marginal gingivitis and calculus deposition was made, and scaling and polishing were performed. Perforation of the attached gingiva was observed during scaling thus exposing the root, which facilitated the calculus accumulation. Post-procedure care included medication and oral hygiene instructions. Follow-up after 1 week showed satisfactory healing, but subsequent assessment at 3 months revealed plaque accumulation, with the patient declining further treatment. Clinical discussion The patient shows relative neglect in oral healthcare given the subpar oral health features she exhibited and decline of further treatment options presented to her. This is common in the population as some abnormal oral presentations and features are perceived as normal in the population, which can be attributed to poor knowledge of oral health practices, which affects the illness seeking behaviour of individual. Conclusion Calculus deposition in the oral cavity requires a hard surface for formation, and proper oral hygiene practices are essential to mitigate its adverse effects, particularly among the elderly who may require additional attention due to their unique physiological changes.
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Affiliation(s)
| | | | - Victor Anezi Eze
- Faculty of Dentistry, College of Medicine, University of Nigeria
| | | | - Wisdom Chisom Ifedibar
- Department of Preventive Dentistry, Faculty of Dentistry, University of Nigeria, Enugu Campus, Nsukka
| | - Ezi Abigail Akaji
- Department of Preventive Dentistry, Faculty of Dentistry, University of Nigeria, Enugu Campus, Nsukka
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3
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Davies K, McGowan K, Dover T, McGowan T, Tadakamadla SK. Dental referrals for patients with diabetes: survey of barriers and enablers for medical and health professionals. Aust Dent J 2023; 68:273-281. [PMID: 37676007 DOI: 10.1111/adj.12978] [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] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Oral health care improves diabetes management; however, medical and other health practitioners do not commonly refer their patients with diabetes for oral health care. This study aimed to understand barriers to and enablers of dental referrals for patients with diabetes. METHODS Quantitative data were collected from a cross-sectional survey of health care providers attending a virtual Grand Rounds on the relationship between oral health and diabetes. Attendees were invited to complete and share a Forms survey. Barriers to and enablers of dental referrals were compared for 18 health professionals working in inpatient/ward settings to 23 working in community/primary care settings using the chi-square test. RESULTS Across both work settings, only 12% of respondents often or always discussed the importance of oral health and only 8% often or always referred their patients with diabetes for dental care. Time barriers, awareness and knowledge of how/where to send dental referrals were significant barriers, while online referral pathways, more education and availability of brochures for the patient to take home were identified as key enablers for dental referrals. CONCLUSIONS Online referral pathways, targeted oral health education and resources for medical and health professionals caring for patients with diabetes may increase the number of patients being referred for dental care as part of their diabetes managements. © 2023 Australian Dental Association.
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Affiliation(s)
- K Davies
- West Moreton Oral Health, Queensland Health, Ipswich, Queensland, Australia
- Griffith University, School of Medicine and Dentistry, Gold Coast Campus, Gold Coast, Queensland, Australia
| | - K McGowan
- West Moreton Oral Health, Queensland Health, Ipswich, Queensland, Australia
| | - T Dover
- West Moreton Hospital and Health Service, Queensland Health, Ipswich, Queensland, Australia
| | - T McGowan
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia
- Central Queensland University, School of Health, Rockhampton, Queensland, Australia
| | - S K Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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4
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Khan TZ, Mobin T. Unraveling the Link Between Periodontal Disease and High Cholesterol: A Cross-Sectional Study. Cureus 2023; 15:e43463. [PMID: 37711924 PMCID: PMC10498934 DOI: 10.7759/cureus.43463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the association between high cholesterol levels and the prevalence of periodontal disease among patients in the United States, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2017 and 2020. We hypothesize that patients with high cholesterol levels will have a high prevalence of periodontal disease. METHODS The study utilized a cross-sectional design, analyzing data from NHANES 2017-March 2020 pre-pandemic survey, a nationally representative survey. The sub-sample consisted of 7,042 participants aged 30 years and older who underwent the NHANES survey questionnaire. Information on high cholesterol levels and periodontal disease was obtained through self-reported data. Statistical analyses, using SAS 9.4 (SAS Institute Inc., Cary, NC), were performed to assess the association between high cholesterol levels and periodontal disease prevalence while controlling the potential confounding variables. Descriptive statistics and multivariable logistic regression were used. Results: The study included a total of 7,042 participants. The mean age (SD) of the participants was 60.2 (13.7); 54% were females and 46% were males. Out of the total, 23% (1636) of the samples had periodontal disease and 52% (3669) of the participants had high cholesterol levels. Findings indicated a significant association between high cholesterol and periodontal disease (odds ratio, OR = 1.21, 95% confidence interval, CI = 1.06-1.40). Socioeconomic factors such as poverty and education, and other factors such as age, gender, race, smoking, physical activity, BMI, diabetes, hypertension, sugar intake, cholesterol intake, saturated fatty acids intake, and oral hygiene were identified as potential confounders. CONCLUSION This large-scale cross-sectional study investigated the association between high cholesterol and periodontal disease while comprehensively controlling for potential confounding factors. After adjusting for the relevant confounders, we found a weak positive association between high cholesterol and periodontal disease. While these findings provide valuable insights into the interplay between systemic health and oral health, the cross-sectional nature of the study limits the establishment of causality.
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Affiliation(s)
- Tooba Zahid Khan
- Dentistry, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Talha Mobin
- Dentistry, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
- Dornsife School of Public Health, Drexel University, Philadelphia, USA
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5
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Thompson LA, Chen H. Physiology of Aging of Older Adults: Systemic and Oral Health Considerations-2021 Update. Clin Geriatr Med 2023; 39:225-234. [PMID: 37045530 DOI: 10.1016/j.cger.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Most oral health care providers encounter older adults in their practices and can play a critical role in supporting independence and quality of life for this aging cohort. Physiologic and structural oral cavity changes associated with normal aging may affect the presentation and oral health care of older adults. This article reviews the normative aging of dentition and oral structures and physiologic changes associated with normal aging, including cardiovascular, metabolic, and musculoskeletal changes, and how they may affect oral health. Oral health providers should be aware of normal aging processes when they plan care or schedule procedures for older adults.
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Affiliation(s)
- Lisa A Thompson
- Geriatric Dental Fellowship, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Helen Chen
- Hebrew SeniorLife, Boston, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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6
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Mitsutake S, Ishizaki T, Edahiro A, Kitamura A, Hirata T, Saito A. The effects of dental visits on the occurrence of acute hospitalization for systemic diseases among patients aged 75 years or older: A propensity score-matched study. Arch Gerontol Geriatr 2023; 107:104876. [PMID: 36516734 DOI: 10.1016/j.archger.2022.104876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/03/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although several studies examined the association between oral status and the risk of systemic diseases, few have examined whether dental visits affect the occurrence of acute hospitalization due to systemic diseases. This study examined the effects of dental visits on preventing the occurrence of acute hospitalization due to systemic diseases in adults aged ≥ 75 years, in order to optimize the healthcare system for older adults. METHODS This propensity-score-matched retrospective cohort study was conducted using medical insurance claims data from Hokkaido, Japan. We analyzed 432,292 adult outpatients aged ≥ 75 years between September 2016 and February 2017 (baseline period). The exposure variable was visits to the dental office during the baseline period. The primary outcome variable was the occurrence of acute hospitalization due to pneumonia, urinary tract infections, cerebrovascular diseases, or coronary heart diseases between March 2017 and March 2019. RESULTS Among the 432,292 patients before propensity score matching, 149,639 (34.6%) had visited the dental office. One-to-one propensity score matching produced 149,289 matched pairs adjusted for the differences in all covariables (age, sex, copayment rate, annual health checkup, chronic diseases, and residential area). In these matched pairs, the risk ratio of the occurrence of acute hospitalization due to pneumonia, urinary tract infections, and cerebrovascular diseases was lower among patients who had visited dental office than among those who did not. CONCLUSIONS Dental visits appeared to be effective in preventing acute hospitalization due to systemic diseases, thus, dental care services would be an important component of healthcare for older adults.
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Affiliation(s)
- Seigo Mitsutake
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Atsushi Saito
- Department of Peridontology, Tokyo Dental College, Tokyo, Japan
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7
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Fogelholm N, Leskelä J, Manzoor M, Holmer J, Paju S, Hiltunen K, Roitto HM, Saarela RK, Pitkälä K, Eriksdotter M, Buhlin K, Pussinen PJ, Mäntylä P. Subgingival microbiome at different levels of cognition. J Oral Microbiol 2023; 15:2178765. [PMID: 36844899 PMCID: PMC9946326 DOI: 10.1080/20002297.2023.2178765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Oral health and declining cognition may have a bi-directional association. We characterized the subgingival microbiota composition of subjects from normal cognition to severe cognitive decline in two cohorts. Memory and Periodontitis (MINOPAR) include 202 home-living participants (50-80 years) in Sweden. Finnish Oral Health Studies in Older Adults (FINORAL) include 174 participants (≥65 years) living in long-term care in Finland. We performed oral examination and assessed the cognitive level with Mini Mental State Examination (MMSE). We sequenced the 16S-rRNA gene (V3-V4 regions) to analyse the subgingival bacterial compositions. The microbial diversities only tended to differ between the MMSE categories, and the strongest determinants were increased probing pocket depth (PPD) and presence of caries. However, abundances of 101 taxa were associated with the MMSE score. After adjusting for age, sex, medications, PPD, and caries, only eight taxa retained the significance in the meta-analyses of the two cohorts. Especially Lachnospiraceae [XIV] at the family, genus, and species level increased with decreasing MMSE. Cognitive decline is associated with obvious changes in the composition of the oral microbiota. Impaired cognition is accompanied with poor oral health status and the appearance of major taxa of the gut microbiota in the oral cavity. Good oral health-care practices require special deliberations among older adults.
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Affiliation(s)
- Nele Fogelholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jaakko Leskelä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Muhammed Manzoor
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jacob Holmer
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of Neurosciences, University of Helsinki, Helsinki, Finland.,Internal medicine and rehabilitation, Division of Geriatrics, Helsinki University Hospital Helsinki, Finland.,Population health unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Kt Saarela
- Department of Social Services and Health Care, Oral Health Care, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kåre Buhlin
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Päivi Mäntylä
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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8
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Julkunen L, Hiltunen K, Kautiainen H, Saarela RKT, Pitkälä KH, Mäntylä P. Oral disease burden of dentate older adults living in long-term care facilities: FINORAL study. BMC Oral Health 2021; 21:624. [PMID: 34876101 PMCID: PMC8650260 DOI: 10.1186/s12903-021-01984-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing number of older adults have natural teeth and are at high risk of oral diseases, which are induced by oral bacterial accumulation and proceed unnoticed and quietly. Our aim was (1) to examine the association of oral disease burden (ODB) with health and functioning among dentate long-term care residents, and (2) to find easily detectable signs for nurses to identify residents' poor oral health. METHODS In this cross-sectional observational study dentists examined 209 residents' oral status, and nurses assessed residents for their functioning and nutrition in long-term care facilities in Helsinki, Finland. ODB was defined by asymptotic dental score (ADS). Six clinical signs of residents' poor oral health were considered as potentially easy for nurses to detect: lesions on lips, teeth with increased mobility, lesions on oral mucosa, eating soft or pureed food, unclear speech, and needing assistance in eating. The association of these was tested with high ODB as outcome. RESULTS Participants were grouped according to their ADS scores: low (n = 39), moderate (n = 96) and high ODB (n = 74). ODB was linearly associated with coronary artery disease and poor cognitive and physical functioning: needing assistance in eating, poor ability to make contact, and unclear speech but not with other diseases including dementia or demographic characteristics. Furthermore, ODB was linearly associated with eating soft or pureed food. Of the six selected, easily detectable signs, having at least two positive signs gave 89% sensitivity to detecting high ODB. CONCLUSION Poor oral health was common and ODB accumulated among residents with poor functioning. Nurses may use a few easily detectable signs to screen residents' oral health when considering a resident's need for consultation with an oral health professional.
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Affiliation(s)
- Lina Julkunen
- Oral and Maxillofacial Diseases Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Riitta K T Saarela
- Department of Social Services and Health Care, Oral Health Care, City of Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Yliopistonranta 1 B, P. O. Box 1627, 70211, Kuopio, Finland.
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.
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9
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Metabolomic Evaluation of Chronic Periodontal Disease in Older Adults. Mediators Inflamm 2021; 2021:1796204. [PMID: 34840526 PMCID: PMC8617563 DOI: 10.1155/2021/1796204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/22/2021] [Accepted: 10/22/2021] [Indexed: 12/18/2022] Open
Abstract
Periodontal disease is an infectious inflammatory disease related to the destruction of supporting tissues of the teeth, leading to a functional loss of the teeth. Inflammatory molecules present in the exudate are catalyzed and form different metabolites that can be identified and quantified. Thus, we evaluated the inflammatory exudate present in crevicular fluid to identify metabolic biological markers for diagnosing chronic periodontal disease in older adults. Research participants were selected from long-term institutions in Brazil. Participants were individuals aged 65 years or older, healthy, or with chronic periodontal disease. Gas chromatography/mass spectrometry was used to evaluate potential biomarkers in 120 crevicular fluid samples. We identified 969 metabolites in the individuals. Of these, 15 metabolites showed a variable importance with projection score > 1 and were associated with periodontal disease. Further analysis showed that among the 15 metabolites, two (5-aminovaleric acid and serine, 3TMS derivative) were found at higher concentrations in the crevicular fluid, indicating their potential diagnostic power for periodontal disease in older adults. Our findings indicated that some metabolites are present at high concentrations in the crevicular fluid in older adults with periodontal disease and can be used as biomarkers of periodontal disease.
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10
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Clark D, Kotronia E, Ramsay SE. Frailty, aging, and periodontal disease: Basic biologic considerations. Periodontol 2000 2021; 87:143-156. [PMID: 34463998 PMCID: PMC8771712 DOI: 10.1111/prd.12380] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aging is associated with the development of disease. Periodontal disease is one of the many diseases and conditions that increase in prevalence with age. In addition to the traditional focus on individual age-related conditions, there is now a greater recognition that multisystem conditions such as frailty play an important role in the health of older populations. Frailty is a clinical condition in older adults that increases the risk of adverse health outcomes. Both frailty and periodontal disease are common chronic conditions in older populations and share several risk factors. There is likely a bidirectional relationship between periodontal disease and frailty. Comorbid systemic diseases, poor physical functioning, and limited ability to self-care in frail older people have been implicated as underlying the association between frailty and periodontal disease. In addition, both frailty and periodontal disease also have strong associations with inflammatory dysregulation and other age-related pathophysiologic changes that may similarly underlie their development and progression. Investigating age-related changes in immune cells that regulate inflammation may lead to a better understanding of age-related disease and could lead to therapeutic targets for the improved management of frailty and periodontal disease.
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Affiliation(s)
- Daniel Clark
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Eftychia Kotronia
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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11
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Thompson LA, Chen H. Physiology of Aging of Older Adults: Systemic and Oral Health Considerations-2021 Update. Dent Clin North Am 2021; 65:275-284. [PMID: 33641753 DOI: 10.1016/j.cden.2020.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Most oral health care providers encounter older adults in their practices and can play a critical role in supporting independence and quality of life for this aging cohort. Physiologic and structural oral cavity changes associated with normal aging may affect the presentation and oral health care of older adults. This article reviews the normative aging of dentition and oral structures and physiologic changes associated with normal aging, including cardiovascular, metabolic, and musculoskeletal changes, and how they may affect oral health. Oral health providers should be aware of normal aging processes when they plan care or schedule procedures for older adults.
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Affiliation(s)
- Lisa A Thompson
- Geriatric Dental Fellowship, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Helen Chen
- Hebrew SeniorLife, Boston, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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12
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Badewy R, Singh H, Quiñonez C, Singhal S. Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review. Health Serv Insights 2021; 14:1178632921989734. [PMID: 33597810 PMCID: PMC7841244 DOI: 10.1177/1178632921989734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.
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Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
| | | | - Carlos Quiñonez
- Faculty of Dentistry, Director of
Graduate Program in Dental Public Health, University of Toronto, Toronto, ON,
Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON,
Canada
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13
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Balasubramanian M, Keuskamp D, Amarasena N, Brennan D. Predictors for oral and general health outcomes and quality of life among older people attending general practice clinics in South Australia. Gerodontology 2021; 38:395-403. [PMID: 33475189 DOI: 10.1111/ger.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 12/15/2020] [Accepted: 01/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases. OBJECTIVE To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ years.) attending general practice (GP) clinics in South Australia. METHODS Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures. RESULTS A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β = -0.08), age (β = -0.09) and number of chronic conditions (β = -0.12) were negatively associated with EQ-5D, while living arrangement (β = 0.07) was positively associated. Further, having four or more chronic conditions (RR:1.47) was significantly associated with self-rated general health. CONCLUSION Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics.
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Affiliation(s)
- Madhan Balasubramanian
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Dominic Keuskamp
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Najith Amarasena
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - David Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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14
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Graham L, Turner W. Periodontal Disease in an Ageing Population: Key Considerations in Diagnosis and Management for the Dental Healthcare Professional. Prim Dent J 2020; 9:23-28. [PMID: 32940593 DOI: 10.1177/2050168420943407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
With patients living longer and retaining their natural teeth for longer, dental healthcare professionals are presented with new challenges. This paper outlines considerations for dental health care professionals managing periodontal disease in an ageing population. Although age itself is not considered an independent risk factor for periodontal disease, there may be complicating factors associated with ageing that impact upon the planning and delivery of care. This paper describes current evidence for the management of periodontal disease in the context of health conditions associated with ageing. It identifies aspects to consider and provides advice on how treatment planning for this patient population may be tailored.
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Affiliation(s)
- Laura Graham
- Dental Core Trainee, School of Dentistry, Belfast Health and Social Care Trust, The Royal Hospitals, Belfast UK
| | - Wendy Turner
- Centre for Dentistry, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast UK
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15
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Dang C, Comnick CL, Tabrizi M, Kaufman L, Soto A, Smith BM, Ribeiro APD, Tobey T, Capin OR, Scully A, Prince D, Xie XJ, Marchini L. Assessment of knowledge and perception about silver diamine fluoride (SDF) for treating older adults among graduating dental students. J Dent Educ 2020; 84:1210-1218. [PMID: 32592225 DOI: 10.1002/jdd.12261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE/OBJECTIVES Silver diamine fluoride (SDF) is a promising therapy for arresting and preventing caries in difficult to treat, high-risk populations, including institutionalized older adults. This study investigates the knowledge and perceptions about SDF of graduating dental students in multiple U.S. dental schools, as well as their willingness to use SDF in their practices. METHODS A survey was designed consisting of 21 total questions: 6 questions regarding students' demographic information and their SDF content exposure contextualization, 8 questions tailored to investigate 2 domains regarding students' knowledge about SDF (properties and indication), and 7 questions aiming to investigate 3 domains regarding students' perceptions about SDF (SDF usefulness, appropriateness of using SDF, and willingness to use SDF when in private practice). The survey was then distributed to graduating dental students at 7 U.S. dental schools. RESULTS A total of 386 surveys (response rate of 55%) was collected from 7 schools in the Spring of 2019. The median score resulting from the SDF content exposure questions was 3 (SD = 1.43) from a range of 0-5. The median score from knowledge about SDF properties was 4 (SD = 1.18) from a range of 0 to 6. In the multivariate analysis, a linear model found that the covariates "SDF Usefulness", "SDF Appropriateness" and "SDF Patient Willingness to Use" were significantly associated with higher student willingness to use SDF (R2 = 0.395). CONCLUSION The results indicated that the graduating students have a positive perception of SDF regarding its usefulness and appropriateness. Graduating students appear inclined to utilize SDF upon entering private practice.
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Affiliation(s)
- Connor Dang
- University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Carissa L Comnick
- Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Maryam Tabrizi
- Geriatric Dentistry, University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Laura Kaufman
- General Dentistry, Boston University Henry M Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Annetty Soto
- Restorative Dental Sciences, University of Florida, Gainesville, Florida, USA
| | - Becky M Smith
- Restorative Clinical Sciences, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | | | - Tamara Tobey
- Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Denver, Colorado, USA
| | - Oriana Reis Capin
- Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Allison Scully
- Pediatric Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - David Prince
- Restorative Dentistry, Roseman University of Health Sciences College of Dental Medicine, South Jordan, Utah, USA
| | - Xian Jin Xie
- Department of Preventive and Community Dentistry, Iowa Institute for Oral Health Research, The University of Iowa City, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
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16
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17
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18
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Abstract
As our population ages, dentists face challenges in maintaining compromised teeth in aging patients. For the most part, elderly patients (i.e., over 65 years of age) prefer to keep their natural teeth and in some cases, avoid removable dentures altogether. Ideally, patients should not be rendered edentate late in life, as they are unlikely to successfully adapt to the limitations of complete replacement dentures. However, this is not always possible and care should ideally be planned to avoid edentulism, or at least, to carefully manage the transition to the edentate state. In the course of planning care, the dentist needs to recognise the need for age appropriate care, factoring in the impact of the elderly patient's health status and social circumstances. For elderly patients with a compromised dentition, the dentist should try to provide care which is minimally invasive and with as low a burden of maintenance as possible. In this paper, principles of pragmatic care for elderly patients with a compromised dentition will be outlined using clinical cases. Three pathways will be outlined: (i) maintenance of a functional natural dentition using adhesive restorative techniques; (ii) use of overlay prostheses and complete replacement overdentures to manage toothwear and toothloss, complete replacement overdentures, and; (iii) staging a transition to the edentate state using transitional removable partial dentures.
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Affiliation(s)
- Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore
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19
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Bahammam MA. Awareness and practice about the association between periodontal diseases and diabetes mellitus: a cross-sectional study in Western Saudi Arabia among health care providers. J Multidiscip Healthc 2018; 11:511-517. [PMID: 30319268 PMCID: PMC6171752 DOI: 10.2147/jmdh.s177143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose This study aims to assess the awareness and practices of dental and medical practitioners regarding the bidirectional relationship between periodontal diseases and diabetes mellitus. Patients and methods A cross-sectional survey of randomly selected dentists and physicians practicing in Jeddah. Participants were asked several questions concerning their awareness and practices on periodontal complications, and the bidirectional link between periodontal diseases and diabetes mellitus (DM). Results A total of 560 general practitioners (284 dentists and 276 physicians) participated in the study. There were no significant differences between the two groups regarding any sociodemographic characteristics. Overall, the awareness of all participants was low in all aspects. Moreover, dentists’ awareness and practices were significantly better than physicians as majority of the questions were about the association between periodontal diseases and DM. Conclusion The awareness and practices about the link between periodontal diseases and DM should be improved among dental and medical practitioners to effectively prevent and control periodontal diseases and DM.
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Affiliation(s)
- Maha A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia,
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20
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Akaji EA, Uguru NP, Maduakor SN, Ndiokwelu EM. Using community participation to assess demand and uptake of scaling and polishing in rural and urban environments. BMC Oral Health 2018; 18:80. [PMID: 29747620 PMCID: PMC5946404 DOI: 10.1186/s12903-018-0548-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 04/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background One of the control tools for periodontal disease besides individual home care is professional oral prophylaxis that is, Scaling and Polishing (S&P).The aim of this study is to assess the effect of oral health awareness on the demand and uptake of scaling and polishing among dwellers of rural and urban environments. Methods This interventional study was conducted in Enugu, Nigeria. A questionnaire was used to obtain data on demographic details, presenting complaints and requests, and prior dental visits from consenting attendees in 4 community outreaches. The number of those demanding for scaling of teeth at point of presentation was extracted from their requests. Oral health talk was then given as the intervention for the study. Periodontal assessment was done using Community Periodontal index (CPI) and participants who received scaling thereafter were recorded. Data were analyzed with SPSS [version 20] employing Chi square to compare categorical variables and p was significant at ≤0.05. Multiple regression analysis of factors affecting oral health awareness was done and outcome of intervention was determined by percentage difference in number of participants demanding and receiving S&P. Results A total of 454 participants enlisted for the study. The outreaches served as first point of contact with dental professionals for 383 (84.4%) participants. 60 (80%) and 15 (20%) participants demanded for scaling in the urban and rural locations respectively (p = 0.00). Out of 78 with CPI 3 score, only 8 (10.3%) demanded for S&P but uptake was by 73 (93.6%) [p = 0.00]. Outcome of oral health intervention was 80.6% difference among those with periodontitis. Multiple regression analysis of factors showed that participants’ locations, that is, rural or urban, was the only factor that significantly affected oral health awareness (C.I = 0.183–0.375, p = 0.000). Conclusion Demand for scaling was sub-optimal but the uptake was satisfactory. Rural or urban location of the participants significantly influenced their oral health awareness. The keenness to take up scaling suggests benefits accruing from the oral health education. Appropriate health policies and planning could help bridge the gap between rural and urban areas and strengthen gains from this study. Electronic supplementary material The online version of this article (10.1186/s12903-018-0548-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ezi A Akaji
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, UNTH, Enugu, Nigeria.
| | - Nkolika P Uguru
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, UNTH, Enugu, Nigeria
| | - Sam N Maduakor
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, UNTH, Enugu, Nigeria
| | - Etisiobi M Ndiokwelu
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, UNTH, Enugu, Nigeria
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21
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Evaluation of Impacting Factors on Facial Bone Thickness in the Anterior Maxillary Region. J Craniofac Surg 2018; 28:700-705. [PMID: 28403135 DOI: 10.1097/scs.0000000000003643] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The goal of the current study was to measure the width of the labial alveolar bone of the overlying maxillary anterior teeth, based on cone-beam computed tomography (CBCT) images, and the distance between cementoenamel junction (CEJ) and bone crest in adult patients. METHODS A cross-sectional study was performed using a sample of 132 tomographic scans. Intact maxillary anterior with healthy periodontium and teeth was randomly selected and afterwards assessed by 2 calibrated and independent reviewers. RESULT The average bone thickness at 2 mm from the CEJ of the maxillary right central incisors was 0.63 ± 0.69 mm and over the maxillary left central incisors was 0.59 ± 0.71 mm. Moreover on the right and left lateral maxillary incisors, the crestal bone width averaged 0.64 ± 0.81 and 0.61 ± 0.7 mm, respectively. Concerning the maxillary canine region on both sides, the crestal bone thickness averaged 0.72 ± 0.9 and 0.66 ± 0.69 mm, in the maxillary right and left the canine regions, respectively. Furthermore, according to the gender and systemic disease, there were some recognizable differences in the facial bone thickness between the left and the right side. CONCLUSIONS The current study has advocated the outcome of a mostly thin buccal bone overlying the maxillary anterior teeth; hence, clinicians should always consider the thickness of the facial cortical plate of the extraction site and the positioning of the implant placement in the socket.
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22
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MacEntee MI, Donnelly LR. Oral health and the frailty syndrome. Periodontol 2000 2018; 72:135-41. [PMID: 27501496 DOI: 10.1111/prd.12134] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/27/2022]
Abstract
The frailty syndrome is an ever-growing area of study among older adults because of its association with an increased risk of falls, hospitalization, institutionalization, dependency and mortality. Frailty is neither a disease nor a disability but is better understood as a medical syndrome of multisystem dysregulation that results in a diminished ability to overcome everyday stressors. The prevalence of frailty in any given population can vary widely, in part because of the way in which it is defined and measured, but in general it is higher among women and in those with advanced age and declining health. Whilst it is largely understood that older adults will differ biologically, psychologically and socially, and that each of these domains can impact oral health, we are only beginning to investigate how the mouth is affected in frailty. Given that both hard and soft structures contribute to oral health and disease status among older adults with varying degrees of impairment and disability, frailty adds yet another dimension to be considered. This paper will discuss how frailty can influence and be influenced by oral disorders, as well as the potential relationship to oral neglect and the resultant consequences among this vulnerable population.
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23
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Delwel S, Binnekade TT, Perez RSGM, Hertogh CMPM, Scherder EJA, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clin Oral Investig 2018; 22:93-108. [PMID: 29143189 PMCID: PMC5748411 DOI: 10.1007/s00784-017-2264-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/24/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND The number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published. OBJECTIVE To provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues. METHODS A literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list. RESULTS The searches yielded 549 unique articles, of which 36 were included for critical appraisal and data extraction. The included studies suggest that older people with dementia had high scores for gingival bleeding, periodontitis, plaque, and assistance for oral care. In addition, candidiasis, stomatitis, and reduced salivary flow were frequently present in older people with dementia. CONCLUSIONS The studies included in the current systematic review suggest that older people with dementia have high levels of plaque and many oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, stomatitis, mucosal lesions, and reduced salivary flow. SCIENTIFIC RATIONALE FOR STUDY With the aging of the population, a higher prevalence of dementia and an increase in oral health problems can be expected. It is of interest to have an overview of the prevalence of oral problems in people with dementia. PRINCIPAL FINDINGS Older people with dementia have multiple oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, mucosal lesions, and reduced salivary flow. PRACTICAL IMPLICATIONS The oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular professional dental care to people with dementia.
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Affiliation(s)
- Suzanne Delwel
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands.
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Faculty of Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahler Laan 3004, 1081, LA, Amsterdam, The Netherlands.
| | - Tarik T Binnekade
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Roberto S G M Perez
- Department of Anesthesiology and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Faculty of Medicine, Department of Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Erik J A Scherder
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Faculty of Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahler Laan 3004, 1081, LA, Amsterdam, The Netherlands
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24
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Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 PMCID: PMC5339276 DOI: 10.3389/fimmu.2017.00241] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to “inflammaging” that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
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Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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25
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Heron SE, Elahi S. HIV Infection and Compromised Mucosal Immunity: Oral Manifestations and Systemic Inflammation. Front Immunol 2017; 8:241. [PMID: 28326084 DOI: 10.3389/fimmu.2017.00241doi|] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 05/25/2023] Open
Abstract
Mucosal surfaces account for the vast majority of HIV transmission. In adults, HIV transmission occurs mainly by vaginal and rectal routes but rarely via oral route. By contrast, pediatric HIV infections could be as the result of oral route by breastfeeding. As such mucosal surfaces play a crucial role in HIV acquisition, and spread of the virus depends on its ability to cross a mucosal barrier. HIV selectively infects, depletes, and/or dysregulates multiple arms of the human immune system particularly at the mucosal sites and causes substantial irreversible damage to the mucosal barriers. This leads to microbial products translocation and subsequently hyper-immune activation. Although introduction of antiretroviral therapy (ART) has led to significant reduction in morbidity and mortality of HIV-infected patients, viral replication persists. As a result, antigen presence and immune activation are linked to "inflammaging" that attributes to a pro-inflammatory environment and the accelerated aging process in HIV patients. HIV infection is also associated with the prevalence of oral mucosal infections and dysregulation of oral microbiota, both of which may compromise the oral mucosal immunity of HIV-infected individuals. In addition, impaired oral immunity in HIV infection may predispose the patients to periodontal diseases that are associated with systemic inflammation and increased risk of cardiovascular diseases. The purpose of this review is to examine existing evidence regarding the role of innate and cellular components of the oral cavity in HIV infection and how HIV infection may drive systemic hyper-immune activation in these patients. We will also discuss current knowledge on HIV oral transmission, HIV immunosenescence in relation to the oral mucosal alterations during the course of HIV infection and periodontal disease. Finally, we discuss oral manifestations associated with HIV infection and how HIV infection and ART influence the oral microbiome. Therefore, unraveling how HIV compromises the integrity of the oral mucosal tissues and innate immune components of the oral cavity and its association with induction of chronic inflammation are critical for the development of effective preventive interventions and therapeutic strategies.
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Affiliation(s)
- Samantha E Heron
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta , Edmonton, AB , Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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26
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Rodrigues WF, Miguel CB, Mendes NS, Freire Oliveira CJ, Ueira-Vieira C. Association between pro-inflammatory cytokine interleukin-33 and periodontal disease in the elderly: A retrospective study. J Indian Soc Periodontol 2017; 21:4-9. [PMID: 29386793 PMCID: PMC5767989 DOI: 10.4103/jisp.jisp_178_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Senescence is a multifactorial process that in humans may be accompanied by inflammation and immune dysfunction in the oral cavity. Notably, periodontal disease, considered one of the most common inflammatory disorders in the oral cavity, has also been linked to the onset of other chronic inflammatory diseases common in the elderly. Thus, investigating immunity and inflammation during senescence may not only illuminate the pathophysiology of periodontal disease, but also identify new therapeutic targets. Materials and Methods: To this end, we retrospectively and systematically reviewed studies of immune molecules associated with periodontal disease. These studies were identified in PubMed from three independent searches based on distinct sets of search terms. Results: The data highlight the need to further investigate inflammatory molecules involved in chronic periodontal disease in the elderly, but strongly suggest that interleukin (IL)-33 is involved. Indeed, various genetic and environmental factors appear to contribute to pathogenesis via IL-33. Conclusion: The IL-33 axis may be promising therapeutic target in elderly patients.
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Affiliation(s)
- Wellington Francisco Rodrigues
- Postgraduate Course in Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil.,Institute of Genetics and Biochemistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
| | - Camila Botelho Miguel
- Postgraduate Course in Health Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil.,Morphofunctional Laboratory, University Center of Mineiros - UNIFIMES, Mineiros, GO, Brazil
| | - Niege Silva Mendes
- Department of Genetics, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Carlo José Freire Oliveira
- Institute of Biological and Natural Sciences, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
| | - Carlos Ueira-Vieira
- Institute of Genetics and Biochemistry, Federal University of Uberlandia, Uberlandia, MG, Brazil
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27
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Renvert S, Persson GR. Treatment of periodontal disease in older adults. Periodontol 2000 2016; 72:108-19. [DOI: 10.1111/prd.12130] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 12/20/2022]
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28
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Restricted diversity of dental calculus methanogens over five centuries, France. Sci Rep 2016; 6:25775. [PMID: 27166431 PMCID: PMC4863154 DOI: 10.1038/srep25775] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/05/2016] [Indexed: 11/08/2022] Open
Abstract
Methanogens are acknowledged archaeal members of modern dental calculus microbiota and dental pathogen complexes. Their repertoire in ancient dental calculus is poorly known. We therefore investigated archaea in one hundred dental calculus specimens collected from individuals recovered from six archaeological sites in France dated from the 14(th) to 19(th) centuries AD. Dental calculus was demonstrated by macroscopic and cone-beam observations. In 56 calculus specimens free of PCR inhibition, PCR sequencing identified Candidatus Methanobrevibacter sp. N13 in 44.6%, Methanobrevibacter oralis in 19.6%, a new Methanomassiliicoccus luminyensis-like methanogen in 12.5%, a Candidatus Nitrososphaera evergladensis-like in one and Methanoculleus bourgensis in one specimen, respectively. One Candidatus Methanobrevibacter sp. N13 dental calculus was further documented by fluorescent in situ hybridization. The prevalence of dental calculus M. oralis was significantly lower in past populations than in modern populations (P = 0.03, Chi-square test). This investigation revealed a previously unknown repertoire of archaea found in the oral cavity of past French populations as reflected in preserved dental calculus.
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29
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Wu B, Luo H, Flint E, Qin L. Dental care utilization among caregivers who care for older adults. Res Aging 2015; 37:388-412. [PMID: 25651576 DOI: 10.1177/0164027514537082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of this study was to investigate individual and contextual factors associated with dental care utilization by U.S. informal caregivers. The sample included all 2010 Behavioral Risk Factor Surveillance System respondents who completed the caregiver module and reported providing care for 1 year or more to an individual aged ≥ 50 years or older (n = 1,196). Multiple logistic regressions were used to examine associations of caregiver and care characteristics and county-level contextual characteristics (from Area Resource File data) with two outcomes: dental visits and dental cleaning during previous year. Caregivers with health insurance coverage and higher education were more likely to use dental care; those who had lost more teeth and who were spouse caregivers were less likely to do so. Community characteristics were not correlated with caregivers' use of dental care. Our findings suggest that better access to dental care could improve dental care utilization by caregivers.
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Affiliation(s)
- Bei Wu
- School of Nursing, Duke University, Durham, NC, USA
| | - Huabin Luo
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | | | - Lu Qin
- School of Nursing, Duke University, Durham, NC, USA
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Abstract
PURPOSE This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information. METHODS Diabetic patients (n=454) who were receiving care at the diabetes clinic in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2013 to May 2014, completed a six-part questionnaire assessing their sociodemographic characteristics, general and oral health awareness and practices, and sources of diabetes-related information. Descriptive statistics were used to report the results. RESULTS The responses indicated inadequate health-related practices in the surveyed group: 22.2% brushed their teeth twice daily, 73.6% never flossed their teeth, and while 80.2% visited a physician in the past year, only 12.6% visited a dentist during the same year. Of the respondents, 94.8% reported that they had never received advice on oral hygiene tasks in relation to diabetes from a health professional. Awareness about the diabetes and periodontal disease association was limited: 46.7% knew that diabetics have gum problems more often if their blood sugar stays very high, and only 21.8% knew that gum disease makes it harder to control blood sugar in diabetic patients. A significant association (P<0.05) was found between a higher level of education and greater general and oral awareness, as well as a significant association (P<0.05) between longer duration of disease, regular exercise, and regular visits to the physician and awareness about diabetes mellitus. Additionally, a significant association (P<0.05) was found between regular dental visits and both periodontal disease and diabetes awareness. Family and friends were the main source of diabetes-related information, and the Internet was the least likely source. CONCLUSION Customized educational programs should be planned for diabetic patients according to community needs.
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Affiliation(s)
- Maha A Bahammam
- Department of Periodontology, King Abdulaziz University Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia
- Correspondence: Maha A Bahammam, Department of Periodontology, King Abdulaziz University Faculty of Dentistry, PO Box 80209, Jeddah 21589, Kingdom of Saudi Arabia, Tel +966 5 0530 3227, Fax +966 1 2640 3316, Email
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Abrams AP, Thompson LA. Physiology of aging of older adults: systemic and oral health considerations. Dent Clin North Am 2014; 58:729-738. [PMID: 25201538 DOI: 10.1016/j.cden.2014.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article reviews the concepts of physiologic reserve, the principles of the normative aging process as exemplified by the cardiovascular, neurologic, and musculoskeletal systems. How these principles apply to oral health, and age-related changes in the oral cavity itself, is reviewed and suggests how they may affect disease management by oral health care providers. It does not focus on diseases related to aging, but rather aims to explore the normal physiologic changes associated with aging dentition and systemic changes related to age, thus enabling clinicians to obtain a better understanding of the presentation of older adults and how it may change their approach to diagnosis and treatment.
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Affiliation(s)
- Alan P Abrams
- Geriatric Medical Fellowship Program, Division of Gerontology, Beth Israel Deaconess Medical Center, 110 Francis Street, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
| | - Lisa A Thompson
- Fellowship in Geriatric Dentistry, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
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Moosani A, Sigal MJ, Glogauer M, Lawrence HP, Goldberg M, Tenenbaum HC. Evaluation of periodontal disease and oral inflammatory load in adults with special needs using oral neutrophil quantification. SPECIAL CARE IN DENTISTRY 2014; 34:303-12. [DOI: 10.1111/scd.12077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Anita Moosani
- Staff Pediatric Dentist; Department of Dentistry; Holland Bloorview Kids Rehabilitation Hospital, Toronto; MSc Pediatric Dentistry Graduate; Faculty of Dentistry; University of Toronto; Former Dental Resident; Department of Dentistry; Mount Sinai Hospital; Toronto Ontario Canada
| | - Michael J. Sigal
- Dentist-in-Chief; Department of Dentistry; Mount Sinai Hospital, Toronto; Professor and Head Pediatric Dentistry and Director of Pediatric Dentistry Graduate Program; Faculty of Dentistry; University of Toronto; Toronto Ontario Canada
| | - Michael Glogauer
- Canadian Institutes of Health Research Group in Matrix Dynamics; Associate Professor of Periodontology; Faculty of Dentistry; University of Toronto; Cross appointed to Faculty of Medicine; University of Toronto, Staff; Division of Research; Department of Dentistry; Mount Sinai Hospital; Toronto Ontario Canada
| | - Herenia P. Lawrence
- Associate Professor; Department of Biological and Diagnostic Sciences; Dental Public Health; Faculty of Dentistry; University of Toronto; Toronto Ontario Canada
| | - Michael Goldberg
- Assistant Professor of Periodontology; Faculty of Dentistry; University of Toronto; Head, Division of Periodontology; Department of Dentistry; Mount Sinai Hospital, Staff; Wasser and Orofacial Pain Clinics; Mount Sinai Hospital; Toronto Ontario Canada
| | - Howard C. Tenenbaum
- Professor of Periodontology; Faculty of Dentistry; University of Toronto; Professor, Laboratory Medicine and Pathobiology; Faculty of Medicine; University of Toronto, Head; Division of Research; Department of Dentistry; Mount Sinai Hospital; Toronto Ontario Canada
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León S, Bravo-Cavicchioli D, Giacaman RA, Correa-Beltrán G, Albala C. Validation of the Spanish version of the oral health impact profile to assess an association between quality of life and oral health of elderly Chileans. Gerodontology 2014; 33:97-105. [DOI: 10.1111/ger.12124] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Soraya León
- Department of Oral Rehabilitation; University of Talca; Talca Chile
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
| | - Daniel Bravo-Cavicchioli
- Department of Oral Rehabilitation; University of Talca; Talca Chile
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
| | - Rodrigo A. Giacaman
- Department of Oral Rehabilitation; University of Talca; Talca Chile
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
| | | | - Cecilia Albala
- Institute of Nutrition and Food Technology; University of Chile; Santiago Chile
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Mayor-Subirana G, Yagüe-García J, Valmaseda-Castellón E, Arnabat-Domínguez J, Berini-Aytés L, Gay-Escoda C. Anesthetic efficacy of Oraqix® versus Hurricaine® and placebo for pain control during non-surgical periodontal treatment. Med Oral Patol Oral Cir Bucal 2014; 19:e192-201. [PMID: 24316699 PMCID: PMC4015044 DOI: 10.4317/medoral.19202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/15/2013] [Indexed: 11/24/2022] Open
Abstract
Objectives: To evaluate the efficacy of Oraqix® during scaling and root planing (SRP) in comparison with 20% benzocaine and placebo.
Study Design: 15 patients requiring 4 sessions of SRP were enrolled. For each patient, Oraqix®, Hurricaine®, vaseline or no anesthetic product were randomly assigned each to a quadrant. Treatment pain was evaluated on a 100 mm Visual Analog Scale (VAS) and on a Verbal Rating Scale (VRS). The amount of product administered, the need to re-anesthetise, patient and operator satisfaction and the onset of side-effects were also recorded.
Results: Oraqix® was significantly better than nothing, with a reduction of VAS score to 13.3 units, but without significant differences with Vaseline or Hurricaine®. Oraqix® was better in VRS reduction than not using any anesthetic (p=0.001) or using vaseline (p=0.024), but similar to Hurricaine® (p=0.232).
Conclusions: Oraqix® effectively controls pain in SRP procedures, with few side-effects and a good acceptance on the part of patients and clinicians.
Key words:Controlled clinical trial, topical anesthetic, scaling and root planing.
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Affiliation(s)
- G Mayor-Subirana
- Facultat d'Odontologia (UB), Campus de Bellvitge, Pavelló de Govern, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat,
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Franco EJ, Pogue RE, Sakamoto LHT, Cavalcante LLM, Carvalho DRD, de Andrade RV. Increased expression of genes after periodontal treatment with photodynamic therapy. Photodiagnosis Photodyn Ther 2014; 11:41-7. [DOI: 10.1016/j.pdpdt.2013.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 02/08/2023]
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van der Putten GJ, De Visschere L, van der Maarel-Wierink C, Vanobbergen J, Schols J. The importance of oral health in (frail) elderly people – a review. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Associations of depressive and anxiety disorders with periodontal disease prevalence in young adults: analysis of 1999-2004 National Health and Nutrition Examination Survey (NHANES) data. Ann Behav Med 2013; 45:393-7. [PMID: 23389686 DOI: 10.1007/s12160-013-9471-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Depression and anxiety have been linked to periodontal disease, an emerging risk factor for chronic diseases. However, this literature is mixed, and few studies have concurrently evaluated depression and anxiety. PURPOSE We simultaneously examined the associations of depressive and anxiety disorders with periodontal disease prevalence and explored tobacco use as a mediator. METHODS Participants were 1,979 young adults from the National Health and Nutrition Examination Survey 1999-2004 who underwent a diagnostic interview and a dental examination. RESULTS Adults with panic disorder had a threefold higher odds of having periodontal disease than those without this disorder (OR = 3.07, 95 % CI 1.17-8.02). This relationship was partially mediated by tobacco use and remained after adjustment for major depressive disorder and generalized anxiety disorder, which were not related to periodontal disease. CONCLUSIONS Young adults with panic disorder may have greater odds of having periodontal disease, in part, due to increased tobacco use.
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Bonwell PB, Parsons PL, Best AM, Hise S. An interprofessional educational approach to oral health care in the geriatric population. GERONTOLOGY & GERIATRICS EDUCATION 2013; 35:182-199. [PMID: 24131421 DOI: 10.1080/02701960.2013.827572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
An interprofessional educational approach was used to provide five in-service training sessions for all direct health care providers in a long-term care facility, and one half-day seminar/live webinar for community-licensed health care professionals. Content included presentations by five disciplines: (a) periodontist: oral-systemic relationship, (b) oral pathologist: oral pathology, (c) pharmacist: oral health-pharmacological link, (d) dietitian: oral health-dietary link, and (e) occupational therapist: providing and practicing proper oral hygiene. Significant improvement in posttest scores for the five in-service training sessions and the half-day seminar/live webinar was revealed in t-test results, representing an increase in knowledge gained. Approximately 80% of the 145 participants indicated that they would make a change in patient care. Findings indicate that the in-service training sessions and half-day seminar/live webinar supported development of the geriatric work force by utilizing an interprofessional educational approach which will assist in meeting the oral health care needs of the geriatric population.
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Affiliation(s)
- Patricia Brown Bonwell
- a Dental Hygiene Program, Department of Oral Health Promotion and Community Outreach, School of Dentistry , Virginia Commonwealth University , Richmond , Virginia , USA
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Shet UK, Oh HK, Kim HJ, Chung HJ, Kim YJ, Kim OS, Choi HR, Kim OJ, Lim HJ, Lee SW. Quantitative analysis of periodontal pathogens present in the saliva of geriatric subjects. J Periodontal Implant Sci 2013; 43:183-90. [PMID: 24040571 PMCID: PMC3769597 DOI: 10.5051/jpis.2013.43.4.183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 08/07/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition. METHODS Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured. RESULTS It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples. CONCLUSIONS Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.
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Affiliation(s)
- Uttom K Shet
- Department of Oral & Maxillofacial Surgery, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea
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Komulainen K, Ylöstalo P, Syrjälä AM, Ruoppi P, Knuuttila M, Sulkava R, Hartikainen S. Oral health intervention among community-dwelling older people: a randomised 2-year intervention study. Gerodontology 2013; 32:62-72. [DOI: 10.1111/ger.12067] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Kaija Komulainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
- Social and Health Centre of Kuopio; Kuopio Finland
| | - Pekka Ylöstalo
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
- Unit of Dentistry; School of Medicine; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Anna-Maija Syrjälä
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
- Oulu Health Centre; Oulu Finland
| | - Piia Ruoppi
- Social and Health Centre of Kuopio; Kuopio Finland
| | - Matti Knuuttila
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Raimo Sulkava
- Division of Geriatrics; Institute of Public Health and Clinical Nutrition; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Sirpa Hartikainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
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Deves C, de Assunção TM, Ducati RG, Campos MM, Basso LA, Santos DS, Batista EL. The transition state analog inhibitor of Purine Nucleoside Phosphorylase (PNP) Immucillin-H arrests bone loss in rat periodontal disease models. Bone 2013; 52:167-75. [PMID: 23026564 DOI: 10.1016/j.bone.2012.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 08/14/2012] [Accepted: 09/21/2012] [Indexed: 12/19/2022]
Abstract
Purine nucleoside phosphorylase (PNP) is a purine-metabolizing enzyme that catalyzes the reversible phosphorolysis of 6-oxypurine (deoxy)nucleosides to their respective bases and (deoxy)ribose-1-phosphate. It is a key enzyme in the purine salvage pathway of mammalian cells. The present investigation sought to determine whether the PNP transition state analog inhibitor (Immucillin-H) arrests bone loss in two models of induced periodontal disease in rats. Periodontal disease was induced in rats using ligature or LPS injection followed by administration of Immucillin-H for direct analysis of bone loss, histology and TRAP staining. In vitro osteoclast differentiation and activation of T CD4+ cells in the presence of Immucillin-H were carried out for assessment of RANKL expression, PNP and Cathepsin K activity. Immucillin-H inhibited bone loss induced by ligatures and LPS, leading to a reduced number of infiltrating osteoclasts and inflammatory cells. In vitro assays revealed that Immucillin-H could not directly abrogate differentiation of osteoclast precursor cells, but affected lymphocyte-mediated osteoclastogenesis. On the other hand, incubation of pre-activated T CD4+ with Immucillin-H decreased RANKL secretion with no compromise of cell viability. The PNP transition state analog Immucillin-H arrests bone loss mediated by T CD4+ cells with no direct effect on osteoclasts. PNP inhibitor may have an impact in the treatment of diseases characterized by the presence of pathogens and imbalances of bone metabolism.
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Affiliation(s)
- Candida Deves
- Graduate Program in Cellular and Molecular Biology, Centro de Pesquisas/ Biologia Molecular e Funcional (CP-BMF), Pontifícia Universidade Católica do Rio Grande do Sul-PUCRS, RS, Brazil
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McNally ME, Matthews DC, Clovis JB, Brillant M, Filiaggi MJ. The oral health of ageing baby boomers: a comparison of adults aged 45-64 and those 65 years and older. Gerodontology 2012; 31:123-35. [DOI: 10.1111/ger.12022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2012] [Indexed: 01/08/2023]
Affiliation(s)
- Mary E. McNally
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
| | - Debora C. Matthews
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
| | - Joanne B. Clovis
- School of Dental Hygiene; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
| | - Martha Brillant
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
| | - Mark J. Filiaggi
- Department of Applied Oral Sciences; Faculty of Dentistry; Dalhousie University; Halifax NS Canada
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Ueno M, Izumi Y, Kawaguchi Y, Ikeda A, Iso H, Inoue M, Tsugane S. Prediagnostic plasma antibody levels to periodontopathic bacteria and risk of coronary heart disease. Int Heart J 2012; 53:209-14. [PMID: 22878796 DOI: 10.1536/ihj.53.209] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many epidemiological studies have indicated that periodontitis is an important risk factor for coronary heart disease (CHD). We examined whether plasma antibody levels to 3 major periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia predicted the risk of CHD events. A nested case-control research design (case: n = 191, control: n = 382), by matching gender, age, study area, date of blood collection, and time since last meal at blood collection, was employed in a large cohort of Japanese community residents.Antibody levels of periodontopathic bacteria were associated with risk of CHD after adjusting for BMI, smoking status, alcohol intake, history of hypertension, history of diabetes mellitus, exercise during leisure time, and perceived mental stress. The association was different by age subgroup. For subjects aged 40-55 years, the medium (31.7-184.9 U/mL) or high tertile plasma antibody level (> 184.9 U/mL) of A. actinomycetemcomitans showed higher risk of CHD (medium: OR = 3.72; 95% CI = 1.20-11.56, high: OR = 4.64; 95% CI = 1.52-14.18) than the low tertile level (< 31.7 U/mL). The ORs of CHD incidence became higher with an increase in IgG level of A. actinomycetemcomitans (P for trend = 0.007). For subjects aged 56-69 years, the high tertile level (> 414.1 U/mL) of P. intermedia was associated with higher risk of CHD (OR = 2.65; 95% CI = 1.18-5.94) in a dose-response fashion (P for trend = 0.007). The possible role of periodontopathic bacteria as a risk factor for CHD incidence was suggested by the results of this study by the elevated antibody level to these bacteria with the increased risk of CHD.
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Affiliation(s)
- Masayuki Ueno
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Renvert S, Persson RE, Persson GR. Tooth loss and periodontitis in older individuals: results from the Swedish National Study on Aging and Care. J Periodontol 2012; 84:1134-44. [PMID: 23088532 DOI: 10.1902/jop.2012.120378] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Due to the increasing number of older people, there is a need for studies focused on this population. The aims of the present study are to assess oral and systemic conditions in individuals aged 60 to 95 years with access to dental insurance. METHODS Probing depths (PDs), tooth loss, alveolar bone levels, and systemic health were studied among a representative cohort of older individuals. RESULTS A total of 1,147 individuals in young-old (aged 60 or 67 years), old (aged 72 or 78 years), and old-old (aged ≥81 years) age groups were enrolled, including 200 individuals who were edentulous, in this study. Annual dental care was received by 82% of dentate individuals. Systemic diseases were common (diabetes: 5.8%; cardiovascular diseases: 20.7%; obesity: 71.2%; elevated C-reactive protein [CRP]: 98.4%). Serum CRP values were unrelated to periodontal conditions. Rates of periodontitis, defined as ≥30% of sites with a distance from cemento-enamel junction to bone of ≥5 mm, were 11.2% in women in the young-old age group and 44.9% in men in the old-old age group. Individuals in older age groups had a higher likelihood of periodontitis defined by bone loss and cutoff levels of PD ≥5 mm (odds ratio: 1.8; 95% confidence interval: 1.2 to 2.5; P <0.01). A total of 7% of individuals in the old-old age group had ≥20 teeth and no periodontitis. Systemic diseases, dental use, or smoking were not explanatory, whereas age and sex were explanatory for periodontitis. CONCLUSIONS The prevalence of periodontitis increased with age. Sex seems to be the dominant explanatory factor for periodontitis in older individuals. Despite frequent dental visits, overall oral health in the oldest age cohort was poor.
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Affiliation(s)
- Stefan Renvert
- Oral Health Sciences, University of Kristianstad, Kristianstad, Sweden
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46
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Moedano DE, Irigoyen ME, Borges-Yáñez A, Flores-Sánchez I, Rotter RC. Osteoporosis, the risk of vertebral fracture, and periodontal disease in an elderly group in Mexico City. Gerodontology 2011; 28:19-27. [PMID: 19863666 DOI: 10.1111/j.1741-2358.2009.00342.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aims of this study were to identify the possible association of osteoporosis, fracture risk and periodontitis, and consider the role of pharmacological treatment of osteoporosis and the periodontal condition. METHODS Patients aged 60 and older from the Mexican National Medical Science and Nutrition Institute Salvador Zubirán participated in the study. DXA was used to assess osteoporosis and risk of vertebral fracture. A modified version of the extent and severity index (ESI) was applied to evaluate periodontitis (cut-off point for attachment loss ≥ 4 mm) and all teeth were examined. RESULTS One hundred and sixty-six patients were examined, 88.6% were females, 47.0% had osteoporosis and 38.6% showed a high risk of fracture. The modified ESI was 5.13 mm (SD 1.4), 57.8% (SD 29.7). The model for periodontitis severity showed an association with oral hygiene (OR = 1.85) and use of osteoporosis medication (OR = 0.43). The model for the extent of periodontitis identified an association with smoking (OR = 2.37), osteoporosis (OR = 1.82) and osteoporosis medication (OR = 0.36). The model for tooth loss detected an association with fracture risk (OR = 3.02) and osteoporosis medication (OR = 0.33). CONCLUSION Periodontitis extent was associated with osteoporosis, and tooth loss with fracture risk.
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Affiliation(s)
- Diana E Moedano
- National Autonomous University of Mexico - School of Dentistry, Mexico city, Mexico
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Ghassemian M, Nowzari H, Lajolo C, Verdugo F, Pirronti T, D'Addona A. The thickness of facial alveolar bone overlying healthy maxillary anterior teeth. J Periodontol 2011; 83:187-97. [PMID: 21692627 DOI: 10.1902/jop.2011.110172] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A facial bone (<2 mm) overlying maxillary anterior teeth may be prone to resorptive processes after extraction and immediate implant placement. A thin bone contributes to risk of bone fenestration, dehiscence, and soft-tissue recession. This study measures the distance between the cemento-enamel junction (CEJ) and alveolar bone crest and the thickness of facial alveolar bone at points 1 to 5 mm from the bone crest for the six maxillary anterior teeth. METHODS Sixty-six tomographic scans (31 males and 35 females; aged 17 to 69 years; mean age: 39.9 years) of intact anterior maxilla were randomly selected and evaluated by two calibrated and independent examiners (MG and TP). RESULTS A high variation of CEJ-bone crest (0.8 to 7.2 mm) was detected. A significantly larger CEJ-bone crest was measured in smokers (P <0.05) and patients who were ≥50 years old (P <0.05). The average bone thickness at 3 mm from the CEJ for the maxillary right central incisor was 1.41 mm and for the maxillary left central incisor was 1.45 mm. For the maxillary right and left lateral incisors, the crestal bone thickness averaged 1.73 and 1.59 mm, respectively. For the maxillary right and left canines, the crestal bone thickness averaged 1.47 and 1.60 mm, respectively. CONCLUSIONS The present study supports the finding of a predominantly thin facial bone overlying the six maxillary anterior teeth. Therefore, it is essential to make informed treatment decisions based on thorough site evaluation before immediate implant placement.
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Affiliation(s)
- Marjan Ghassemian
- Unit of Oral Surgery and Implant-Prosthetic Rehabilitation, Catholic University of the Sacred Heart, Rome, Italy.
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Newton KM, Chaudhari M, Barlow WE, Inge RE, Theis MK, Spangler LA, Hujoel PP, Reid RJ. A population-based study of periodontal care among those with and without diabetes. J Periodontol 2011; 82:1650-6. [PMID: 21609255 DOI: 10.1902/jop.2011.100609] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Our objectives were to describe the prevalence of periodontal care (a marker of periodontitis) among persons with and without diabetes and to examine the association between periodontal care and diabetes. METHODS We conducted a cross-sectional analysis, using 5 years of electronic data from a population-based cohort (N = 46,132), aged 40 to 70 years, with dental and medical insurance, and ≥ 1 dental and ≥ 1 medical visit. Periodontal care (yes/no) was defined by dental claims codes for procedures used to manage periodontitis. The association between periodontal care and diabetes was determined using logistic regression adjusted for and stratified by age, sex, insurance type, smoking status, body mass index (BMI) (in kilograms per square meter), and resource utilization band (RUB) (a measure of expected health care utilization attributable to comorbidity). RESULTS Overall, 11.2% (5,153 of 46,132) met diabetes criteria. The age-adjusted prevalence of periodontal care among those with and without diabetes was 39.1% and 32.5%, respectively (P <0.0001). The association between diabetes and periodontal care decreased with increasing age (interaction, P <0.0001), adjusting for BMI and RUB. The aged-stratified, adjusted odds ratio (OR) for periodontal care associated with diabetes was highest among those aged 40 to 44 years [OR, 1.6; confidence interval (CI), 1.30 to 1.97] and lowest among those aged 60 to 64 years (OR, 0.97; CI, 0.81 to 1.15) and was significant only among those aged 40 to 54 years. CONCLUSION We found that the prevalence of periodontal care was significantly higher among those with diabetes compared to those without diabetes and that the magnitude of this association decreased with increasing age.
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Contardo M, Díaz N, Lobos O, Padilla C, Giacaman R. Oral colonization by Streptococcus mutans and its association with the severity of periodontal disease in adults. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s0718-5391(11)70058-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Suzuki JI, Aoyama N, Ogawa M, Hirata Y, Izumi Y, Nagai R, Isobe M. Periodontitis and cardiovascular diseases. Expert Opin Ther Targets 2010; 14:1023-7. [DOI: 10.1517/14728222.2010.511616] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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