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Mishra S, M. P. G, Rahman W. Clinical and diagnostic significance of blood leukocyte ratios in young patients with stage III grade C periodontitis. Acta Odontol Scand 2022; 80:161-168. [PMID: 34436974 DOI: 10.1080/00016357.2021.1969035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Blood leukocyte ratios have been recently proposed as simple, rapid, cheap and easily accessible biomarkers of systemic inflammation. However, little is known about the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with periodontitis, which might not only serve as the potential biomarkers of systemic inflammation but also aid in diagnosis/screening of severe periodontitis. Hence, the purpose of this study was to evaluate the differences in the serum levels of these leukocyte ratios in healthy subjects and patients with generalized stage III Grade C periodontitis, and their applicability in identifying patients with the risk of developing severe periodontitis. MATERIAL AND METHODS The subjects were categorized into case and control group. Clinical parameters including Plaque index (PI), modified Gingival Index (mGI), Mean ratio of bleeding sites, Probing Pocket depth (PPD) and the clinical attachment loss (CAL) were assessed in both the groups. Venous blood samples were collected from subjects from both groups for the biochemical analysis and blood leukocyte ratios- NLR, PLR and LMR were calculated. The values were then subjected to statistical analysis. RESULTS The results showed significantly higher NLR and lower LMR values in patients with generalized stage III grade C periodontitis. Both the blood leukocyte ratios were moderately associated with increasing clinical parameters of periodontal disease. However, the values of PLR, although found to be higher in the periodontitis group, did not make a significant difference when compared with periodontally healthy subjects. The cut-off value of >2.15 for NLR and <7.16 for LMR fairly predicted the risk of severe periodontitis in young adults. CONCLUSIONS NLR and LMR can provide a new insight into the relationship between periodontitis and systemic diseases and can be of potential diagnostic value in identifying patients with severe periodontitis of younger age group.
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Affiliation(s)
- Supriya Mishra
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Gazala M. P.
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
| | - Waheda Rahman
- Department of Periodontics, Government Dental College and Hospital, Raipur, India
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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郜 洪, 徐 菁, 孟 焕, 和 璐, 侯 建. [Effect of initial periodontal therapy on blood parameters related to erythrocyte and platelet in patients with type 2 diabetes mellitus and chronic periodontitis]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:750-754. [PMID: 32773814 PMCID: PMC7433617 DOI: 10.19723/j.issn.1671-167x.2020.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare the blood parameters related to erythrocyte and platelet between baseline and 3 months after initial periodontal therapy in patients with both type 2 diabetes mellitus and chronic periodontitis (DM-P). METHODS According to the International Symposium on Classification of Periodontal Diseases and Conditions in 1999 and the diagnostic criteria of type 2 diabetes mellitus proposed by the World Health Organization in 1999, 35 patients with DM-P were recruited. All the participants received initial periodontal therapy, including oral hygiene instruction, scaling, and root planning provided by one senior periodontist. Original diet, exercise, and medication for blood glucose control were unchanged for all the participants. At baseline and 3 months after initial periodontal therapy, the clinical periodontal parameters, including probing depth (PD), bleeding index (BI) and clinical attachment loss (CAL); erythrocyte-related indexes, including red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC volume distribution width (RDW); platelet-related indexes, including platelet (PLT) count, mean platelet volume (MPV), platelet distribution width (PDW), plateletocrit (PCT) were measured and compared. RESULTS Compared with baseline, the periodontal parameters, including PD [(3.370±0.601) mm vs. (2.729±0.431) mm], BI [2.160 (1.550~3.410) vs. 1.420 (1.000~2.970)] and CAL [(3.307±1.577) mm vs. (2.990±1.587) mm], were significantly reduced (P < 0.001) three months after the initial periodontal therapy; the erythrocyte-related indexes, including RBC count [(4.727±0.392)×1012/L vs. (4.825±0.394)×1012/L, P=0.010], HGB [(145.886±11.792) g/L vs. (149.200±12.979) g/L, P=0.007] and HCT [43.40% (37.50%~48.50%) vs. 43.80% (38.50%~53.20%), P=0.003], were significantly increased three months after the initial periodontal therapy; PLT count [(216.714±61.900)×109/L vs. (205.886±62.051)×109/L, P=0.016] was significantly reduced 3 months after the initial periodontal therapy. CONCLUSIONS The initial periodontal therapy can significantly improve blood parameters related to RBC and PLT, which might decrease the risk of vascular complications in DM-P patients.
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Affiliation(s)
- 洪宇 郜
- 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 天津医科大学口腔医院牙周科,天津 300070Department of Periodontology, School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - 菁玲 徐
- 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学第三医院口腔科,北京 100191Department of Stomatology, Peking University Third Hospital, Beijing 100191, China
| | - 焕新 孟
- 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 璐 和
- 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 建霞 侯
- 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Pérez-Losada FDL, Estrugo-Devesa A, Castellanos-Cosano L, Segura-Egea JJ, López-López J, Velasco-Ortega E. Apical Periodontitis and Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9020540. [PMID: 32079175 PMCID: PMC7074097 DOI: 10.3390/jcm9020540] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/06/2020] [Accepted: 02/12/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: Investigate if there is an association between apical periodontitis and diabetes mellitus. Material and methods: A bibliographic search was performed on Medline/PubMed, Scopus and Cochrane databases using the keywords apical periodontitis and diabetes mellitus. Published papers written in English and performed on animals or humans were included. Meta-analysis was performed using the OpenMeta (analyst) tool for the statistical analysis. The variables analyzed were the prevalence of Apical Periodontitis (AP) among teeth and patients with Diabetes Mellitus (DM). Results: Of the total studies found, only 21 met the inclusion criteria. Ten clinical studies on animals, ten studies on humans and a systematic review were included. Meta-analysis shows that the prevalence of teeth with apical periodontitis among patients with diabetes mellitus has an odds ratio of 1.166 corresponding to 507 teeth with AP + DM and 534 teeth with AP without DM. The prevalence of patients with AP and DM shows an odds ratio of 1.552 where 91 patients had AP + DM and 582 patients AP without DM. Conclusion: Scientific evidence suggests that there could be a common physiopathological factor between apical periodontitis and diabetes mellitus but more prospective studies are needed to investigate the association between these two diseases.
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Affiliation(s)
- Flor de Liz Pérez-Losada
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.d.L.P.-L.); (A.E.-D.)
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.d.L.P.-L.); (A.E.-D.)
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Lissett Castellanos-Cosano
- Department of Stomatology, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (L.C.-C.); (J.J.S.-E.); (E.V.-O.)
| | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (L.C.-C.); (J.J.S.-E.); (E.V.-O.)
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.d.L.P.-L.); (A.E.-D.)
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-606-457-362
| | - Eugenio Velasco-Ortega
- Department of Stomatology, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (L.C.-C.); (J.J.S.-E.); (E.V.-O.)
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Th1/Th2/Th17/Treg Balance in Apical Periodontitis of Normoglycemic and Diabetic Rats. J Endod 2019; 45:1009-1015. [DOI: 10.1016/j.joen.2019.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
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Romandini M, Laforí A, Romandini P, Baima G, Cordaro M. Periodontitis and platelet count: A new potential link with cardiovascular and other systemic inflammatory diseases. J Clin Periodontol 2018; 45:1299-1310. [DOI: 10.1111/jcpe.13004] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/27/2018] [Accepted: 08/19/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Mario Romandini
- Institute of Dentistry and Maxillofacial Surgery; Fondazione Policlinico Universitario A. Gemelli IRCCS; Catholic University of the Sacred Heart; Rome Italy
- Currently undertaking the EFP Program in Periodontology at Complutense University; Madrid Spain
| | - Andreina Laforí
- Department of Periodontology and Prosthodontics; Policlinico “Umberto I” - “G. Eastman” Section; Rome Italy
| | - Pierluigi Romandini
- Department of Oral and Maxillo-Facial Sciences; “Sapienza” University of Rome; Rome Italy
| | - Giacomo Baima
- Department of Surgical Sciences; University of Turin; Turin Italy
| | - Massimo Cordaro
- Institute of Dentistry and Maxillofacial Surgery; Fondazione Policlinico Universitario A. Gemelli IRCCS; Catholic University of the Sacred Heart; Rome Italy
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Cintra LTA, Estrela C, Azuma MM, Queiroz ÍODA, Kawai T, Gomes-Filho JE. Endodontic medicine: interrelationships among apical periodontitis, systemic disorders, and tissue responses of dental materials. Braz Oral Res 2018; 32:e68. [DOI: 10.1590/1807-3107bor-2018.vol32.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
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