1
|
Ashford JR. Impaired oral health: a required companion of bacterial aspiration pneumonia. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1337920. [PMID: 38894716 PMCID: PMC11183832 DOI: 10.3389/fresc.2024.1337920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
Laryngotracheal aspiration has a widely-held reputation as a primary cause of lower respiratory infections, such as pneumonia, and is a major concern of care providers of the seriously ill orelderly frail patient. Laryngeal mechanical inefficiency resulting in aspiration into the lower respiratory tract, by itself, is not the cause of pneumonia. It is but one of several factors that must be present simultaneously for pneumonia to develop. Aspiration of oral and gastric contentsoccurs often in healthy people of all ages and without significant pulmonary consequences. Inthe seriously ill or elderly frail patient, higher concentrations of pathogens in the contents of theaspirate are the primary catalyst for pulmonary infection development if in an immunocompromised lower respiratory system. The oral cavity is a complex and ever changing eco-environment striving to maintain homogeneity among the numerous microbial communities inhabiting its surfaces. Poor maintenance of these surfaces to prevent infection can result inpathogenic changes to these microbial communities and, with subsequent proliferation, can altermicrobial communities in the tracheal and bronchial passages. Higher bacterial pathogen concentrations mixing with oral secretions, or with foods, when aspirated into an immunecompromised lower respiratory complex, may result in bacterial aspiration pneumonia development, or other respiratory or systemic diseases. A large volume of clinical evidence makes it clear that oral cleaning regimens, when used in caring for ill or frail patients in hospitals and long-term care facilities, drastically reduce the incidence of respiratory infection and death. The purpose of this narrative review is to examine oral health as a required causative companionin bacterial aspiration pneumonia development, and the effectiveness of oral infection control inthe prevention of this disease.
Collapse
|
2
|
Ozcelik F, Ersahan S, Sirin DA, Ozçelik IK, Hepsenoglu YE, Karip B. The importance of mechanosensitive cell mediated prostaglandin and nitric oxide synthesis in the pathogenesis of apical periodontitis: comparative with chronic periodontitis. Clin Oral Investig 2024; 28:337. [PMID: 38795217 PMCID: PMC11127815 DOI: 10.1007/s00784-024-05721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/12/2024] [Indexed: 05/27/2024]
Abstract
OBJECTIVES Mechano-sensitive odontoblast cells, which sense mechanical loading and various stresses in the tooth structure, synthesize early signaling molecules such as prostaglandin E2 (PGE2) and nitric oxide (NO) as an adaptive response. It is thought that these synthesized molecules can be used for the diagnosis and treatment of periodontal and periapical diseases. The aim of this study was to investigate the relationship between the severity of apical periodontitis (AP) and chronic periodontitis (CP) and serum (s) TNF-α, IL-10, PGE2 and NO levels, as well as PGE2 and NO levels in gingival crevicular fluid (GCF) samples. MATERIALS & METHODS A total of 185 subjects were divided into three categories: AP group (n = 85), CP group (n = 50) and healthy control group (n = 50). The AP group was divided into 3 subgroups according to abscess scoring (AS-PAI 1, 2 and 3) based on the periapical index. The CP group was divided into 4 subgroups according to the periodontitis staging system (PSS1, 2,3 and 4). After recording the demographic and clinical characteristics of all participants, serum (s) and gingival crevicular fluid (GCF) samples were taken. TNF-α, IL-10, PGE2 and NO levels were measured in these samples. RESULTS Unlike serum measurements (sTNF-α, sIL-10, sNO and sPGE2), GCF-NO and GCF-PGE levels of the AP group were significantly higher than the control group in relation to abscess formation (54.4 ± 56.3 vs. 22.5 ± 12.6 µmol/mL, p < 0.001 and 100 ± 98 vs. 41 ± 28 ng/L, p < 0.001, respectively). Confirming this, the GCF-NO and GCF-PGE levels of the AS-PAI 1 group, in which abscesses have not yet formed, were found to be lower than those in AS-PAI 2 and 3, which are characterized by abscess formation [(16.7(3.7-117.8), 32.9(11.8-212.8) and 36.9(4.3-251.6) µmol/mL, p = 0,0131; 46.0(31.4-120.0), 69.6(40.3-424.2) and 74.4(32.1-471.0) ng/L, p = 0,0020, respectively]. Consistent with the increase in PSS, the levels of sTNF [29.8 (8.2-105.5) vs. 16.7(6.3-37.9) pg/mL, p < 0.001], sIL-10 [542(106-1326) vs. 190(69-411) pg/mL, p < 0.001], sNO [182.1(36.3-437) vs. 57.0(15.9-196) µmol/mL, p < 0.001], sPGE2 [344(82-1298) vs. 100(35-1178) ng/L, p < 0.001], GCF-NO [58.9 ± 33.6 vs. 22.5 ± 12.6 ng/L, p < 0.001] and GCF-PGE2 [ 99(37-365) vs. 30(13-119), p < 0.001] in the CP group were higher than the control group. Comparison ROC analysis revealed that the GCF-PGE2 test had the best diagnostic value for both AP and CP (sensitivity: 94.1 and 88.0; specificity: 64.0 and 78.0, respectively; p < 0.001). CONCLUSIONS GCF-PE2 and GCF-NO have high diagnostic value in the determination of AP and CP, and can be selected as targets to guide treatment. In addition, the measurements of PGE2 and NO in GCF can be used as an important predictor of pulpal necrosis leading to abscess in patients with AP. CLINICAL RELEVANCE In this article, it is reported that syntheses of early signaling molecules such as PGE2 and NO can be used for the diagnosis and treatment target of periapical and periodontal infections.
Collapse
Affiliation(s)
- Fatih Ozcelik
- Department of Medical Biochemistry, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkiye, Istanbul, Türkiye.
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye
| | - Dursun Ali Sirin
- Department of Endodontics, Faculty of Dentistry, University of Health Sciences, Istanbul, Türkiye
| | | | - Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye
| | - Burak Karip
- Department of Anatomy (Dentist), Hamidiye Faculty of Medicine, University of Health Sciences Turkiye, Istanbul, Türkiye
| |
Collapse
|
3
|
AlHazmi B, Natto ZS, AlQarni M. Is There a Correlation Between Periodontal Disease Symptoms and the COVID-19 Vaccination? Cureus 2024; 16:e58892. [PMID: 38800223 PMCID: PMC11117175 DOI: 10.7759/cureus.58892] [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] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This study aimed to investigate and compare potential associations between different COVID-19 vaccines and periodontal diseases, mainly gingival bleeding and oral malodor (bad breath). MATERIALS AND METHODS This cross-sectional study used an online questionnaire consisting of 15 questions regarding demographic information, medical history, type of COVID-19 vaccine received, history of COVID-19, and general and periodontal symptoms after vaccination. The survey was voluntary and privately accessed online using SurveyMonkey®. A total of 2000 participants from three regions of Saudi Arabia participated in the study from October 11, 2021, to October 11, 2022. RESULTS Of the participants, 95.8% received at least one dose of the available COVID-19 vaccine. Oxford-AstraZeneca was the most administered (41.7%). Patients who suffered from chronic diseases or had a history of COVID-19 infection were less likely to be vaccinated (OR= 0.62, 95% CI 0.40-0.97; OR=0.62, 95% CI 0.39-0.99) compared with people with no chronic diseases or who had a history of COVID-19. The odds ratios for gingival bleeding, oral malodor, mobility, and tooth loss indicated no significant differences regarding vaccination status. CONCLUSION COVID-19 vaccines might not affect periodontal tissue conditions. People should not avoid vaccination due to concerns with oral or general health, as the benefits of vaccination outweigh the potential side effects.
Collapse
Affiliation(s)
- Bann AlHazmi
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
| | - Zuhair S Natto
- Dental Public Health and Periodontology, King Abdulaziz University, Jeddah, SAU
| | - Mayson AlQarni
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
| |
Collapse
|
4
|
Fatani F, El-Metwally A, Alkadi L, Al Kadri HM, Binhowaimel N, Almuflih A, Al Khateeb BF, Alshahrani A, Alsaif A, Aldubikhi A. Predictors influencing dental clinic utilization in primary health care: A retrospective analysis of 233,069 patient records in Riyadh, Saudi Arabia. Saudi Dent J 2024; 36:456-460. [PMID: 38525184 PMCID: PMC10960147 DOI: 10.1016/j.sdentj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 03/26/2024] Open
Abstract
Aim This study aims to identify and address the predictors that promote or prevent the utilization of dental services in primary health care (PHC) centers located in Riyadh, Saudi Arabia, with an ultimate goal to increase the uptake of oral health care (OHC) services. Methodology Registration data from 99 PHC centers was used. For each patient visiting a PHC center, information on the number of dental visits was captured. Continuous data was summarized as means, medians, and ranges, and categorical data as frequencies (%). The strength of association was reported as an incidence rate ratio (IRR) with 95% confidence interval (CI) and a p-value. Further analysis was conducted to illustrate the association between dental care visits and factors found independently significant in the final multivariate model using Karl Pearson correlation coefficient and t-test. All tests were two-sided and a p-value of p < 0.05 was considered significant. Results The comorbidity profile of patients shows that 11,751(5%) were diabetic, while hypertension amounted to 10,712(4.6%). A statistically significant inverse correlation was observed between dental care visits and both age (r = -0.025, p < 0.001) and BMI (r = -0.013, p < 0.001). Mean dental care visits were significantly higher in patients without hypertension compared with those with hypertension (p < 0.001). Moreover, there was an approximate 4% increase in dental care visits among females compared to males, although this difference was not statistically significant. Conclusion The study identified three predictors contributing to the low utilization of dental services in PHC centers in Riyadh. These include an inverse association between both age and body mass index (BMI) and the utilization of OHC. Additionally, the mean dental care visits were significantly higher for patients without hypertension in comparison to hypertensive patients.
Collapse
Affiliation(s)
- Faris Fatani
- Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Lubna Alkadi
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hanan M Al Kadri
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | | | | | - Badr F Al Khateeb
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Awad Alshahrani
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Medicine, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- College Of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
5
|
Zhang Y, Tang P, Yang Q, Li C, Li L, Han M. Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial. Clin Oral Investig 2024; 28:143. [PMID: 38349450 DOI: 10.1007/s00784-024-05510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE The study aims to determine the effects of Nd:YAG laser-assisted with subgingival scaling and root planing (SRP) treatment on glucose control and the dynamic changes of subgingival microbiome in periodontitis with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Twenty-two patients were split into Nd:YAG group (n = 11) and SRP group (n = 11). Patients in the Nd:YAG group received SRP and auxiliary Nd:YAG laser treatment; patients in the SRP group received SRP treatment only. Periodontal tissue inflammation and glycemic control were assessed and analyzed during the treatment period and the changes of subgingival microbiome were analyzed by full-length 16S rRNA sequencing. RESULTS After 3 months of treatment, PD and CAL values improved significantly in the Nd:YAG group compared to the SRP group. BOP in both groups improved significantly after treatment. FPG levels in the Nd:YAG group were significantly reduced after treatment. Porphyromonas and Porphyromonadaceae were enriched in the Nd:YAG group at baseline, and Fusobacteriota, Fusobacteriia, Fusobacteriales, Leptotrichiaceae, and Leptotrichia were enriched after treatment. CONCLUSION Nd:YAG laser-assisted SRP therapy has additional benefits in improving periodontal tissue inflammation and blood glucose control in periodontitis patients with T2DM compared with SRP therapy alone and there was a trend towards a decrease in disease-associated taxa and an increase in health-associated taxa following auxiliary Nd:YAG laser treatment. CLINICAL RELEVANCE The effects of Nd:YAG laser-assisted SRP treatment on inflammation, glucose control, and subgingival microbiome in periodontitis patients with T2DM were elucidated, and new ideas for the treatment of T2DM periodontitis were provided.
Collapse
Affiliation(s)
- Yifei Zhang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chen Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China.
| |
Collapse
|
6
|
Lalli AK, Dhingra S, Lalli AS, Kaur G, Gupta H, Goyal S. Clinical Evaluation of Diode Laser as an Adjunct to Scaling and Root Planing in Patients With Chronic Periodontitis and Type II Diabetes Mellitus: A Split-Mouth Study. Cureus 2024; 16:e54178. [PMID: 38496103 PMCID: PMC10941804 DOI: 10.7759/cureus.54178] [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] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The primary goal of periodontal therapy is to arrest the inflammatory disease process which is done by non-surgical and surgical therapies in order to reduce the microorganisms. The outcome of periodontal therapy may not reveal the desired results owing to inaccessible areas for instrumentation, pathogenicity, resistance of the microorganisms, or even due to compromised host response to the treatment. Thus, adjunctive laser therapy has been proposed as a novel treatment modality in the treatment of periodontal disease. Aim: The aim of this study was to clinically evaluate the effect of a 980 nm diode laser (DEN10B; Wuhan Gigaa Optronics Technology Co., Ltd., Wuhan, China) therapy as an adjunct to scaling and root planing in patients with chronic periodontitis and type II diabetes. METHODS Twenty patients were divided into two groups in a split-mouth study design. Group I (Control) comprised mechanical debridement alone and Group II (test) comprised mechanical debridement followed by adjunctive laser therapy. The clinical parameters were recorded at baseline, six weeks, and three months, and the results were analyzed. RESULTS There was a significant improvement in gingival and plaque index in the test group. Though there was no significant improvement in probing pocket depth and clinical attachment, the results in the test group were superior relative to the control group. CONCLUSION Non-surgical periodontal therapy with adjunctive use of diode laser is effective in the management of generalized chronic periodontitis in patients with type II diabetes which led to a significant reduction in plaque score, gingival index score, probing pocket depth, and gain in clinical attachment level.
Collapse
Affiliation(s)
- Agamjot K Lalli
- Periodontology, Sri Guru Ram Das Institute of Dental Sciences & Research, Amritsar, IND
| | - Sachin Dhingra
- Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | | | - Gurleen Kaur
- Emergency Medicine, District Hospital, Mohali, IND
| | - Harinder Gupta
- Periodontology, Government Dental College and Hospital, Patiala, Patiala, IND
| | - Sanjay Goyal
- Medicine, Government Medical College, Patiala, Patiala, IND
| |
Collapse
|
7
|
Delbari A, Ghavidel F, Rashedi V, Bidkhori M, Saatchi M, Hooshmand E. Evaluation of oral health status in the population above 50: evidence from the ardakan cohort study on aging (ACSA). BMC Oral Health 2024; 24:154. [PMID: 38297233 PMCID: PMC10832343 DOI: 10.1186/s12903-024-03916-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The global population is undergoing rapid aging, and older individuals are more susceptible to various health issues, including oral health problems. Despite the increasing attention given to healthy aging, oral health has often been overlooked in discussions related to health problems. This study aims to assess the oral health status of middle-aged and older adults in Iran. METHODS This cross-sectional study analyzed data from 4970 men and women aged 50 years and above, who participated in the Ardakan Cohort Study on Aging (ACSA) between 2020 and 2022. Trained personnel administered a questionnaire and conducted oral health examinations to determine the oral health status and oral hygiene behaviors of the participants. RESULTS The mean value (SD) of the total Decayed, Missing, and Filled Teeth (DMFT) index was 21.3 (10.7). Approximately 46% of all participants were completely edentulous (without natural teeth). Moreover, 58.5% of the total sample wore dentures, and the mean age (SD) when they started using dentures was 48.5 (20.7) years. About 71% of participants with natural teeth reported brushing their teeth at least once a day, while about 63% of denture wearers cleaned their dentures daily. In the sample, 28% of individuals had visited a dentist in the last year. The prevalence of difficulty in biting and chewing food among the participants was 48.2% and 44.6%, respectively. Additionally, nearly 68% of all samples reported experiencing at least one difficulty in daily functioning due to oral/dental conditions. The study identified cutoff points of seven (sensitivity = 56.8 and specificity = 77.5) and 10 (sensitivity = 72.1 and specificity = 71.1) missing teeth, indicating the presence of at least one problem in daily functioning due to oral/dental conditions in middle-aged and older adults, respectively. CONCLUSION The study reveals a high prevalence of edentulism and denture use among participants aged 50 years and above. The majority of samples reported difficulties in daily functioning due to oral and dental conditions, especially in biting and chewing food. These findings highlight the importance of proactive measures to address oral health issues in middle-aged and older adults, thereby enhancing their overall health and well-being.
Collapse
Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Fatemeh Ghavidel
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Vahid Rashedi
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran.
| |
Collapse
|
8
|
Ansari Moghadam S, Abbaszade H, Sartipi M, Ansari Moghadam A. Evaluating the association between gingival crevicular blood glucose levels and finger capillary blood glucose levels according to periodontal status. Eur J Med Res 2024; 29:86. [PMID: 38291508 PMCID: PMC10826020 DOI: 10.1186/s40001-023-01611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/21/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association between gingival crevicular blood glucose levels (GCBG) and finger capillary blood glucose levels (FCBG) according to the periodontal status of patients. MATERIALS AND METHODS In this case-control study, 80 patients were divided into 4 groups according to their periodontal status. In these patients, an area of the maxillary gingiva with the highest probing depth was selected for blood sampling. Blood glucose obtained from this area and the right fingertip was measured with a glucometer. Data were analyzed using ANOVA and Pearson correlation coefficient with a significance threshold of 0.05. RESULTS The groups studied were matched in regard to their sex and age (P > 0.05). The average FCBG and GCBG were not significantly different according to periodontal status (P > 0.05). The correlation between the FCBG and the GCBG showed a significant positive correlation in the total number of participants (P < 0.05, r = 0.531). CONCLUSION The study observed a positive association between GCBG and FCBG. However, the relationship with periodontal status appeared to be relatively weak. Further research may be needed to determine the potential efficacy of GCBG in diabetes screening during periodontal examinations. CLINICAL RELEVANCE Most patients with diabetes do not have proper periodontal health, so it may be helpful to screen for diabetes during periodontal examinations.
Collapse
Affiliation(s)
- Somaye Ansari Moghadam
- Department of Periodontology, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hanie Abbaszade
- Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohadeseh Sartipi
- Sri Rajiv Gandhi College of Dental Science & Hospital, Rajiv Gandhi University of Health Sciences, Bangalore, India.
| | - Alireza Ansari Moghadam
- Department of Health, Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
9
|
Gül SNS, Eminoğlu DÖ, Laloğlu E, Aydın T, Dilsiz A. Salivary and serum asprosin hormone levels in the 2018 EFP/AAP classification of periodontitis stages and body mass index status: a case-control study. Clin Oral Investig 2024; 28:91. [PMID: 38217801 PMCID: PMC10787907 DOI: 10.1007/s00784-024-05494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/06/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVES A newly discovered adipokine known asprosin in serum and saliva in patients with periodontitis has not been explored. The aim of this study was to determine the relationship between serum and saliva asprosin levels and periodontitis by grouping it according to body mass index (BMI). MATERIALS AND METHODS The study was conducted on 65 systemically healthy patients (35 patients with periodontitis (periodontitis group), 30 periodontally healthy patients (control group)). In each patient, age, BMI, and clinical periodontal parameters (plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL)) were evaluated. Statistical analyses were conducted utilizing the Student t-test, ANOVA, and Pearson correlation analysis. For the significance level of the tests, p<0.05 were accepted. RESULTS The serum and saliva were collected to assess asprosin levels. Both the serum and saliva asprosin levels were statistically significantly higher in the periodontitis group than in the control group (p<0.001). Saliva and serum asprosin levels were directly proportional to the severity of the periodontal disease (p<0.05). Asprosin levels were higher in patients with a higher BMI (p<0.05). CONCLUSION Asprosin levels were increased in periodontitis, and even a high BMI status apparently affected the levels of this hormone. It is thought that asprosin may be a useful biomarker in evaluating the relationship between periodontal status and BMI. CLINICAL RELEVANCE Asprosin may be a useful parameter as a biomarker of periodontal disease progression. However, BMI status should be considered when evaluating asprosin levels in patients with periodontitis.
Collapse
Affiliation(s)
- Sema Nur Sevinç Gül
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
| | - Didem Özkal Eminoğlu
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Esra Laloğlu
- Department of Medical Biochemistry, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Tuğba Aydın
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| |
Collapse
|
10
|
Chien WC, Fu E, Chung CH, Cheng CM, Tu HP, Lee WC, Chen WL, Shih KC. Type 2 Diabetes Mellitus and Periodontitis: Bidirectional Association in Population-based 15-year Retrospective Cohorts. J Clin Endocrinol Metab 2023; 108:e1289-e1297. [PMID: 37224522 DOI: 10.1210/clinem/dgad287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/18/2023] [Accepted: 05/23/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE A two-way relationship between periodontitis and diabetes has been proposed. However, bidirectional epidemiological observation is limited and inconsistent. OBJECTIVE Using the National Health Insurance Research Database of Taiwan (covering over 99% of the entire population), we aimed to estimate the development of diabetes in periodontitis patients or that of periodontitis in patients with type 2 diabetes mellitus (T2DM), respectively. METHODS A total of 11 011 patients with severe periodontitis were recruited from 2000 to 2015. After matching by age, sex, and index date, 11 011 patients with mild periodontitis and 11 011 non-periodontitis controls were registered. Additionally, 157 798 patients with T2DM and 157 798 non-T2DM controls were enrolled, in whom the development of periodontitis was traced. Cox proportional hazards model was performed. RESULTS Periodontitis patients tended to have a statistically high risk for T2DM. The adjusted hazard ratio was 1.94 (95% CI, 1.49-2.63, P < .01) and 1.72 (95% CI, 1.24-2.52, P < .01) for severe and mild periodontitis groups, respectively. The patients with severe periodontitis had a higher risk of having T2DM relative to those with mild periodontitis (1.17 [95% CI, 1.04-1.26, P < .001]). Conversely, the risk of periodontitis increased significantly in patients with T2DM (1.99 [95% CI, 1.42-2.48, P < .01]). However, high risk was observed for the outcome of severe periodontitis (2.08 [95% CI, 1.50-2.66, P < .001]), but not for mild periodontitis (0.97 [95% CI, 0.38-1.57, P = .462]). CONCLUSION We suggest that the bidirectional association is between T2DM and severe but not mild periodontitis.
Collapse
Affiliation(s)
- Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan, ROC
| | - Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Xindian, New Taipei City 23142, Taiwan, ROC
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan, ROC
| | - Chia-Mao Cheng
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Xindian, New Taipei City 23142, Taiwan, ROC
| | - Hsiao-Pei Tu
- Department of Oral Hygiene, Hsin-Sheng Junior College of Medical Care and Management, Taoyuan City 32544, Taiwan, ROC
| | - Wei-Cheng Lee
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
| | - Wei-Liang Chen
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan, ROC
| | - Kuang-Chung Shih
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan, ROC
- Division of Endocrinology & Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan, ROC
- Division of Endocrinology & Metabolism, Cheng Hsin General Hospital, Taipei 11220, Taiwan, ROC
| |
Collapse
|
11
|
Brinar S, Skvarča A, Gašpirc B, Schara R. The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus. Clin Oral Investig 2023; 27:6235-6244. [PMID: 37672083 PMCID: PMC10560165 DOI: 10.1007/s00784-023-05239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES This study is aimed at determining the effect of concomitant antimicrobial photodynamic therapy (aPTD) on periodontal disease and glycaemic control in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Twenty-four patients with T2DM were enrolled in the study. Periodontal clinical parameters were assessed by measuring probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), full-mouth bleeding score (FMBS), full-mouth plaque score (FMPS), and full-mouth sulcus bleeding score (FMSBS). Glycated haemoglobin A1c (HbA1c) was measured. To determine the presence of the following periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, subgingival plaque samples were taken from two periodontal pockets per jaw with the greatest PPD using paper tips. Patients were randomly divided into the test and control group. In the test group, full-mouth disinfection was performed in combination with aPTD. In the control group, only full-mouth disinfection was performed. RESULTS The results showed an improvement in periodontal clinical parameters in both groups. The difference between the groups in favour of the test group was statistically significant for BOP. The HbA1c level decreased in both groups. The difference was not statistically significant. The results of the microbiological analysis suggest that the presence of periodontal pathogenic bacteria is lower with additional antimicrobial photodynamic therapy with statistically significant difference for T. forsythia. CONCLUSIONS Additional aPDT causes a significant reduction in BoP in the proportion of positive sites for periodontal pathogens. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05816941. CLINICAL RELEVANCE aPTD is a noninvasive adjunctive therapy that can positively influence the periodontal treatment outcome.
Collapse
Affiliation(s)
- Sara Brinar
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Community Health Centre Murska Sobota, Murska Sobota, Slovenia
| | - Aleš Skvarča
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Boris Gašpirc
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rok Schara
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia.
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| |
Collapse
|
12
|
Zhao D, Sun Y, Li X, Wang X, Lu L, Li C, Pan Y, Wang S. Association between Periodontitis and HbA1c Levels in Non-Diabetic Patients: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2649. [PMID: 37830686 PMCID: PMC10572398 DOI: 10.3390/healthcare11192649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND A high detection rate of diabetes among dental visitors has been reported recently. This systematic review aimed to evaluate the association between periodontitis and glycated hemoglobin (HbA1c) levels among non-diabetic individuals. METHODS The EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed, and Open GREY databases were searched, and observational studies published until 1st June 2023 were identified. A methodological quality assessment was conducted based on the original and modified versions of the Newcastle-Ottawa scale. Cohort, case-control, and cross-sectional studies that performed clinical periodontal examinations and measured HbA1c levels in non-diabetic adults were included. A meta-analysis was conducted to estimate the weighted mean difference (WMD) between individuals with and without periodontitis. RESULTS In total, 29 case-control and 5 cross-sectional studies were selected from 2583 potentially eligible articles. Among them, sixteen case-control and three cross-sectional studies with moderate to high quality were selected for the meta-analyses. The HbA1c levels in periodontitis patients were significantly higher than those in individuals with healthy periodontal conditions (WMD = 0.16; p < 0.001) among the non-diabetic populations. CONCLUSIONS This study reveals a significant association between periodontitis and HbA1c levels in non-diabetic populations. Thus, HbA1c screening may be recommended to detect potential hyperglycemia in non-diabetic periodontitis patients.
Collapse
Affiliation(s)
- Dan Zhao
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China;
| | - Yangyang Sun
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Xin Li
- School of Public Health, National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China;
| | - Xiaoxiao Wang
- Department of Oral Implantology and Prosthodontics, Shenzhen Stomatology Hospital Affiliated to Shenzhen University, Shenzhen 518001, China;
| | - Lijie Lu
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Chen Li
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Yaping Pan
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Songlin Wang
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| |
Collapse
|
13
|
Chen HF, Lee HE, Chen IT, Huang YT, Ho PS, Karim SA. Rural-urban disparities in the incidence and treatment intensity of periodontal disease among patients with diabetes. Front Public Health 2023; 11:1241150. [PMID: 37736085 PMCID: PMC10509757 DOI: 10.3389/fpubh.2023.1241150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
Background Diabetes threatens population health, especially in rural areas. Diabetes and periodontal diseases have a bidirectional relationship. A persistence of rural-urban disparities in diabetes may indicate a rural-urban difference in periodontal disease among patients with diabetes; however, the evidence is lacking. This retrospective study aimed to investigate rural-urban discrepancies in the incidence and treatment intensity of periodontal disease among patients who were newly diagnosed with type 2 diabetes in the year 2010. Methods The present study was a retrospective cohort design, with two study samples: patients with type 2 diabetes and those who were further diagnosed with periodontal disease. The data sources included the 2010 Diabetes Mellitus Health Database at the patient level, the National Geographic Information Standardization Platform and the Department of Statistics, Ministry of Health and Welfare in Taiwan at the township level. Two dependent variables were a time-to-event outcome for periodontal disease among patients with type 2 diabetes and the treatment intensity measured for patients who were further diagnosed with periodontal disease. The key independent variables are two dummy variables, representing rural and suburban areas, with urban areas as the reference group. The Cox and Poisson regression models were applied for analyses. Results Of 68,365 qualified patients, 49% of them had periodontal disease within 10 years after patients were diagnosed with diabetes. Compared to urban patients with diabetes, rural (HR = 0.83, 95% CI: 0.75-0.91) and suburban patients (HR = 0.86, 95% CI: 0.83-0.89) had a lower incidence of periodontal disease. Among 33,612 patients with periodontal disease, rural patients received less treatment intensity of dental care (Rural: RR = 0.87, 95% CI: 0.83, 0.92; suburban: RR = 0.93, 95% CI: 0.92, 0.95) than urban patients. Conclusion Given the underutilization of dental care among rural patients with diabetes, a low incidence of periodontal disease indicates potentially undiagnosed periodontal disease, and low treatment intensity signals potentially unmet dental needs. Our findings provide a potential explanation for the persistence of rural-urban disparities in poor diabetes outcomes. Policy interventions to enhance the likelihood of identifying periodontal disease at the early stage for proper treatment would ease the burden of diabetes care and narrow rural-urban discrepancies in diabetes outcomes.
Collapse
Affiliation(s)
- Hsueh-Fen Chen
- Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huey-Er Lee
- Department of Dentistry, Yuan's General Hospital, Kaohsiung, Taiwan
| | - I-Te Chen
- Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ting Huang
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Saleema A. Karim
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmomd, VA, United States
| |
Collapse
|
14
|
Persson GR, Widén C, Wohlfart B, Sjöberg K, Steen S, Coleman MD, Holmer H. Impact of an Okinawa/Nordic based diet on endocrinological and periodontal conditions in individuals with type 2 diabetes. A randomized case-control study. BMC Oral Health 2023; 23:544. [PMID: 37553617 PMCID: PMC10410947 DOI: 10.1186/s12903-023-03272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES To assess if the results following intake of a diet using an Okinawan-based Nordic diet (OBND) over one month differs in endocrinological, periodontal clinical outcome, and serum cytokine levels compared to a standard hospital care diet in individuals with diabetes type 2 (T2D) (control group). BACKGROUND Scientific evidence suggests that the use of diet for individuals with T2D may be beneficial. METHODS Participating individuals with T2D were randomly assigned to a test (OBND) (n = 14), or control group (n = 16). Anthropometric data, blood glucose levels, HbA1c levels, lipids, serum inflammation markers (CRP, and a routine panel of 24 cytokines), blood pressure, gingival bleeding on probing (BOP), probing pocket depths (PPD), and clinical attachment levels (CAL) were studied. RESULTS Statistical analyses of baseline study data failed to demonstrate study group differences. The mean weight reduction was greater in the OBND group (4.1 kg) versus the control group (1.3 kg) (p < 0.01). The reduction in BMI was 1.4 kg/m2 in OBND (p < 0.001) and 0.5 kg/m2 in the control group, respectively (p < 0.01). Diastolic and systolic blood pressure reductions were greater in the OBND group than in the control group (p < 0.01). Periodontal study parameters (BOP % scores) and (PPD values) decreased (p < 0.001) overall with no between group differences. The OBND resulted in reduction of serum levels of IFNγ, Eotaxin IL-9, IP10,IL17a, MCP-1,m and PDFBB compared to the control diet. CONCLUSIONS A strict T2D- diet provides an association between reduction in serum HbA1c and BOP scores. Serum levels decreases in IFNγ, Eotaxin IL-9, IP-10, IL17a. MCP-1, and PDFBB were only found in the test group.
Collapse
Affiliation(s)
- G Rutger Persson
- Departments of Periodontics, and Oral Medicine, School of Dentistry, University of Washington, HSB Box 357444, Seattle, WA, 98195, USA.
| | - Cecilia Widén
- Faculty of Health, Kristianstad University, SE-29188, Kristianstad, Sweden
| | - Björn Wohlfart
- Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, SE-22100, Lund, Sweden
| | - Klas Sjöberg
- Department of Gastroenterology, Lund University, Lund, Sweden
| | - Stig Steen
- Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, SE-22100, Lund, Sweden
- Department of Cardiothoracic Surgery, Clinical Sciences Lund, Lund University, SE-22100, Lund, Sweden
| | - Michael D Coleman
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Helene Holmer
- Kristianstad Central Hospital, SE-29185, Kristianstad, Sweden
| |
Collapse
|
15
|
De Angelis P, Rella E, Manicone PF, De Rosa G, Gallottini S, Liguori MG, Papi P, Desantis V, Passarelli PC, D'Addona A. The Effect of Diabetes and Hyperglycemia on Horizontal Guided Bone Regeneration: A Clinical Prospective Analysis. Healthcare (Basel) 2023; 11:1801. [PMID: 37372917 DOI: 10.3390/healthcare11121801] [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: 04/04/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Guided bone regeneration (GBR) is a reconstructive procedure for treating atrophic alveolar ridges. This study aims to assess the correlation between different glycemic control levels and clinical findings in patients undergoing horizontal GBR before implant placement. The study population consisted of all patients requiring horizontal GBR. Patients were divided into three groups based on HbA1c levels: non-diabetic normoglycemic patients (HbA1c < 5.7%), non-diabetic hyperglycaemic patients (HbA1c < 6.5%), and patients with controlled diabetes (HbA1c < 7%). The primary outcomes were the horizontal (mm) and vertical (mm) dimensional changes of the alveolar ridge 6 months after the procedure. The study sample consisted of 54 patients. Sixty-eight implants (95.8%) were classified as "successful," meaning the possibility of inserting a standard-sized implant following the GBR (diameter ≥ 4 mm). There was a statistically significant difference between the three groups in terms of horizontal gain at 6 months: in particular, there was a statistically significant difference between group 1 and group 2 (p = 0.026) and between group 1 and group 3 (p = 0.030). The present investigation showed that patients with HbA1c levels below 7% could undergo GBR and obtain a statistically significant horizontal bone gain.
Collapse
Affiliation(s)
- Paolo De Angelis
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Edoardo Rella
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Francesco Manicone
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe De Rosa
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sofia Gallottini
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Margherita Giorgia Liguori
- Department of Life, Health and Environmental Sciences, Università degli Studi dell'Aquila, 67100 L'Aquila, Italy
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00168 Rome, Italy
| | - Viviana Desantis
- Department of Oral Surgery, University of Milan, 20122 Milan, Italy
| | - Pier Carmine Passarelli
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| |
Collapse
|
16
|
Li Y, Lu Z, Kirkwood CL, Kirkwood KL, Wank SA, Li AJ, Lopes-Virella MF, Huang Y. GPR40 deficiency worsens metabolic syndrome-associated periodontitis in mice. J Periodontal Res 2023; 58:575-587. [PMID: 36807310 PMCID: PMC10182248 DOI: 10.1111/jre.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND AND OBJECTIVE G protein-coupled receptor 40 (GPR40) is a receptor for medium- and long-chain free fatty acids (FFAs). GPR40 activation improves type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), and the complications of T2DM and MetS. Periodontitis, a common oral inflammatory disease initiated by periodontal pathogens, is another complication of T2DM and MetS. Since FFAs play a key role in the pathogenesis of MetS which exacerbates periodontal inflammation and GPR40 is a FFA receptor with anti-inflammatory properties, it is important to define the role of GPR40 in MetS-associated periodontitis. MATERIALS AND METHODS We induced MetS and periodontitis by high-fat diet and periodontal injection of lipopolysaccharide (LPS), respectively, in wild-type and GPR40-deficient mice and determined alveolar bone loss and periodontal inflammation using micro-computed tomography, histology, and osteoclast staining. We also performed in vitro study to determine the role of GPR40 in the expression of proinflammatory genes. RESULTS The primary outcome of the study is that GPR40 deficiency increased alveolar bone loss and enhanced osteoclastogenesis in control mice and the mice with both MetS and periodontitis. GPR40 deficiency also augmented periodontal inflammation in control mice and the mice with both MetS and periodontitis. Furthermore, GPR40 deficiency led to increased plasma lipids and insulin resistance in control mice but had no effect on the metabolic parameters in mice with MetS alone. For mice with both MetS and periodontitis, GPR40 deficiency increased insulin resistance. Finally, in vitro studies with macrophages showed that deficiency or inhibition of GPR40 upregulated proinflammatory genes while activation of GPR40 downregulated proinflammatory gene expression stimulated synergistically by LPS and palmitic acid. CONCLUSION GPR40 deficiency worsens alveolar bone loss and periodontal inflammation in mice with both periodontitis and MetS, suggesting that GPR40 plays a favorable role in MetS-associated periodontitis. Furthermore, GPR40 deficiency or inhibition in macrophages further upregulated proinflammatory and pro-osteoclastogenic genes induced by LPS and palmitic acid, suggesting that GPR40 has anti-inflammatory and anti-osteoclastogenic properties.
Collapse
Affiliation(s)
- Yanchun Li
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Cameron L. Kirkwood
- Departments of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Keith L. Kirkwood
- Departments of Oral Biology, School of Dental Medicine, University at Buffalo
- Department of Head & Neck/Plastic & Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Stephen A. Wank
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Ai-Jun Li
- Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington
| | - Maria F. Lopes-Virella
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Yan Huang
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| |
Collapse
|
17
|
Jung Y, Kim JH, Shin AR, Song KB, Amano A, Choi YH. Association of Adiposity with Periodontitis and Metabolic Syndrome: From the Third National Health and Nutrition Examination Survey of United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032533. [PMID: 36767897 PMCID: PMC9916149 DOI: 10.3390/ijerph20032533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 05/31/2023]
Abstract
This study explored the epidemiological role of central adiposity and body mass index (BMI) in terms of clinical attachment loss (CAL)/pocket depth (PD) and metabolic syndrome components. This study included data from the National Health and Nutrition Examination Survey III of America on 12,254 adults aged 20 years of age or older with a blood sample, anthropometric measurements, and a periodontal examination. Clinical periodontitis measurements, including CAL and PD, were classified into quintiles or quartiles and compared. CAL was positively associated with central adiposity, hypertension, and hyperglycemia; the relationship between CAL and diabetes was stronger when central adiposity was absent (odds ratio [OR] and 95% confidence interval: 6.33, 2.14-18.72 vs. 3.14, 1.78-5.56). The relationship between CAL and impaired fasting glucose (IFG) differed slightly with BMI. The IFG ORs for normal, overweight, and obese patients were 1.63 (1.08-2.45), 1.76 (1.05-2.97), and 1.43 (0.88-2.30), respectively. CAL was positively correlated with all metabolic syndrome components except hypertriglyceridemia. Associations between CAL, diabetes, and IFG significantly varied with BMI. Periodontitis in individuals without central obesity or with normal bodyweight may independently indicate diabetes and IFG. Therefore, preventive measures against periodontitis without obesity are necessary to improve general and oral health.
Collapse
Affiliation(s)
- YunSook Jung
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju 37224, Republic of Korea
| | - Ji-Hye Kim
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Ah-Ra Shin
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Craniofacial Nerve-Bone Network Research Center, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| |
Collapse
|
18
|
Patil S, Yadalam PK, Hosmani J, Khan ZA, Shankar VG, Shaukat L, Khan SS, Awan KH. Modulation of oral cancer and periodontitis using chemotherapeutic agents - A narrative review. Dis Mon 2023; 69:101348. [PMID: 35341589 DOI: 10.1016/j.disamonth.2022.101348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontitis, an inflammatory condition, is linked to a higher risk of developing oral cancer. Periodontitis may be a precipitating factor for tumorigenesis and the aggressiveness of specific cancer variants. Although genetics is considered the primary etiologic factor for the development of most cancers, many factors have come to be recognized in the initiation and progression of oral cancer. Consecutively, it is suggestive that periodontitis and oral cancer are distinct disease entities but share common pathogenic mechanisms. Oxidative stress and epigenetic mechanisms are among the most researched mechanisms responsible for initiating apoptotic mechanisms implicated in periodontitis and oral cancer. Current research aims to formulate therapeutic agents to intercede in these mechanisms via host modulation therapy and epigenetic therapy. These advances can revolutionize the treatment of periodontitis and oral cancer. This review aims to shed light on the common pathogenic mechanisms of these diseases and the various host modulation agents that could be beneficial in their treatment.
Collapse
Affiliation(s)
- Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Pradeep Kumar Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai 600 077, India
| | - Jagadish Hosmani
- Oral Pathology Division, Department of Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Zafar Ali Khan
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | | | - Lubna Shaukat
- Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Samar Saeed Khan
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States.
| |
Collapse
|
19
|
The relationship between glycated hemoglobin level and the stage of periodontitis in individuals without diabetes. PLoS One 2023; 18:e0279755. [PMID: 36608039 PMCID: PMC9821507 DOI: 10.1371/journal.pone.0279755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Glycemic control appears to have a significant impact on the relationship between periodontitis and diabetes. The current study aimed to investigate the association between the stage of periodontitis and hemoglobin A1c (HbA1c) levels in patients considered to be normoglycemic. A total of 135 patients (100 females and 35 males) with no history of diabetes were included in the study. The mean age of the participants was 38.4 years old. All patients underwent a full-mouth periodontal examination. Periodontal diagnosis was determined according to the 2017 World Workshop on the Classification of Periodontal Disease. The glycemic state of the patients was assessed using a chair-side HbA1c analyzer. Ninety patients were diagnosed with periodontitis. Higher average HbA1c levels were associated with the different stages of periodontitis (p<0.01). Most of the non-periodontitis patients were in the non-diabetes group (67%), while most of the periodontitis patients were in the undiagnosed pre-diabetes group (47% of the stages I and II group, and 44% of the stages III and IV groups) (p<0.001). Periodontitis was found to be significantly associated with elevated glycated hemoglobin levels in patients not previously diagnosed with diabetes, and the elevation in HbA1c levels was more evident in patients with stage III and IV periodontitis.
Collapse
|
20
|
A Multimodal Deep Learning Approach to Predicting Systemic Diseases from Oral Conditions. Diagnostics (Basel) 2022; 12:diagnostics12123192. [PMID: 36553200 PMCID: PMC9777898 DOI: 10.3390/diagnostics12123192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Background: It is known that oral diseases such as periodontal (gum) disease are closely linked to various systemic diseases and disorders. Deep learning advances have the potential to make major contributions to healthcare, particularly in the domains that rely on medical imaging. Incorporating non-imaging information based on clinical and laboratory data may allow clinicians to make more comprehensive and accurate decisions. Methods: Here, we developed a multimodal deep learning method to predict systemic diseases and disorders from oral health conditions. A dual-loss autoencoder was used in the first phase to extract periodontal disease-related features from 1188 panoramic radiographs. Then, in the second phase, we fused the image features with the demographic data and clinical information taken from electronic health records (EHR) to predict systemic diseases. We used receiver operation characteristics (ROC) and accuracy to evaluate our model. The model was further validated by an unseen test dataset. Findings: According to our findings, the top three most accurately predicted chapters, in order, are the Chapters III, VI and IX. The results indicated that the proposed model could predict systemic diseases belonging to Chapters III, VI and IX, with AUC values of 0.92 (95% CI, 0.90-94), 0.87 (95% CI, 0.84-89) and 0.78 (95% CI, 0.75-81), respectively. To assess the robustness of the models, we performed the evaluation on the unseen test dataset for these chapters and the results showed an accuracy of 0.88, 0.82 and 0.72 for Chapters III, VI and IX, respectively. Interpretation: The present study shows that the combination of panoramic radiograph and clinical oral features could be considered to train a fusion deep learning model for predicting systemic diseases and disorders.
Collapse
|
21
|
Modifiable risk factors for the development and progression of periodontal tissue diseases. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.5-2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In this review, an analysis of modifiable risk factors for the development and progression of periodontal tissue diseases was carried out. The review highlights the data on the relationship of periodontal infection, tobacco smoking, diabetes mellitus, cardiovascular disease, drug-induced periodontal tissue damage, stress, and obesity with the risk of developing and progression of periodontal tissue diseases. A rather detailed analysis of the mechanisms of pathogenic influence of the microflora of the oral cavity, including in the subgingival plaque, was carried out. The mechanisms of the pathological effect of smoking on the state of periodontal tissues are described. Data on the effect of periodontal treatment on glycemic control in patients with diabetes mellitus are presented. The article emphasizes the importance of the presence of periodontal diseases as a risk factor for cardiovascular and cerebrovascular diseases, describes the mechanisms of the mutual influence of cardiovascular pathology and the inflammatory process in the periodontium. In addition, the article presents the possibilities of the iatrogenic effect of systemic drugs on the state of periodontal tissues. The data on the influence of stress loads on the development of dental diseases are presented. The review article describes in detail the mechanisms of influence of overweight and obesity on the risks of development and progression of periodontal tissue diseases. Based on the results of the scientific research publications presented in the article, it can be stated that not only the dentist, but also doctors of other specialties need to work to change the modifiable risk factors for the development and progression of periodontal diseases.
Collapse
|
22
|
Gupta S, Rangappa KKG, Rani S, Ganesh R, Kukreja P, Kukreja BJ. Periodontal and Dentition Status among Psychiatric Patients in Indore: A Descriptive Cross-sectional Study. J Contemp Dent Pract 2022; 23:1260-1266. [PMID: 37125525 DOI: 10.5005/jp-journals-10024-3451] [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: 05/02/2023]
Abstract
AIM To assess and record periodontal and dentition status among psychiatric patients using modified WHO Oral Health Assessment form 1997. MATERIALS AND METHODS A descriptive cross-sectional study was conducted at Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore, among the inpatients and outpatients. Ethical approval for the study was obtained from Institutional Review Board of Sri Aurobindo College of Dentistry. Statistical analysis was done using SPSS, IBM version 20.0. Descriptive statistics was used to find the frequencies, mean, and standard deviation of variables considered in the study. RESULTS Among all the disorders, schizophrenia subjects had shallow pockets 28 (25.2%) and deep pockets 55 (49.5%). Only 2 (2.6%) study subjects who had major depressive disorder had more than 12 mm loss of attachment (LOA). The highest mean DMFT score was recorded for schizophrenia patients (13.0 ± 7.09). CONCLUSION The results reveal an unmet need of projecting effective planning and implementation strategies toward the improvement of periodontal and dentition status health of the psychiatric patients. CLINICAL SIGNIFICANCE The study highlights the importance of incorporating dental health education to psychiatric rehabilitation programs.
Collapse
Affiliation(s)
- Sonali Gupta
- Department of Public Health Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India, Phone: +91 9993043736 e-mail:
| | | | - Shikha Rani
- Department of Orthodontics and Dentofacial Orthopedics, Dr BR Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Rajendran Ganesh
- Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Pankaj Kukreja
- Department of Biomedical and Dental Sciences, Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Bhavna Jha Kukreja
- Department of Preventive Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| |
Collapse
|
23
|
Diabetes mellitus and periodontal disease: the profession's choices. Br Dent J 2022; 233:537-538. [PMID: 36241800 DOI: 10.1038/s41415-022-5029-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/07/2022] [Indexed: 11/08/2022]
Abstract
This paper reviews why doctors rarely refer their diabetic patients for a dental opinion and suggests strategies to teach them the importance of controlling periodontal disease as part of a system of joint care. A pro forma to share results and define diabetic risks for doctors, dentists and patients has been developed. Periodontal risks could be better defined if the community periodontal index of treatment needs score of 2 for calculus is divided into 2 for supra-gingival and 2* for sub-gingival types.
Collapse
|
24
|
Impact of Periodontitis on Glycemic Control and Metabolic Status in Diabetes Patients: Current Knowledge on Early Disease Markers and Therapeutic Perspectives. Mediators Inflamm 2022; 2022:4955277. [PMID: 35996409 PMCID: PMC9392618 DOI: 10.1155/2022/4955277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
Diabetes mellitus and periodontitis are two of the most common chronic diseases affecting the world's population, and they are intimately linked. For several years, in fact, it has been known that there is an interdependent relationship between the two diseases: Diabetes promotes the destruction of periodontal tissues, and periodontal disease negatively affects glycemic control. In relation to the control of dental plaque and oral dysbiosis responsible for periodontal disease, both nonsurgical and surgical therapy associated with proper home hygiene procedures have emerged as essential for good glycemic control. Moreover, several evidences suggest the essential role played by the control of periodontal disease in preventing the onset of the most common complications of diabetes: cardiovascular diseases, retinopathies, and other systemic diseases. The aim of this study is to update the current knowledge on the bi-univocal relationship between diabetes and periodontitis and the impact of therapy in the optimal management of these two disorders. From the information found in the literature, it has emerged that the correct treatment of periodontal disease in diabetic patients represents one of the main mechanisms and means currently established and valid to control periodontal disease and glucose metabolism and prevent the onset or development of diabetic complications.
Collapse
|
25
|
Pamuk F, Kantarci A. Inflammation as a link between periodontal disease and obesity. Periodontol 2000 2022; 90:186-196. [PMID: 35916870 DOI: 10.1111/prd.12457] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.
Collapse
Affiliation(s)
- Ferda Pamuk
- Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | | |
Collapse
|
26
|
Mariño R, Priede A, King M, Adams GG, Sicari M, Morgan M. Oral health professionals screening for undiagnosed type-2 diabetes and prediabetes: the iDENTify study. BMC Endocr Disord 2022; 22:183. [PMID: 35850674 PMCID: PMC9294826 DOI: 10.1186/s12902-022-01100-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As part of an evaluation of an oral healthcare practice-based model that identifies patients with prediabetes or type-2 diabetes, this study reports on the proportion of patients identified with clinically confirmed type-2 diabetes (T2D)/prediabetes and barriers of implementation of the model. METHODOLOGY Urban and rural oral healthcare practices were invited to participate. Participating practices invited eligible patients to participate in the screening program using the Australian Type-2 Diabetes Risk Assessment Tool (AUSDRISK). Participants were categorised as low, intermediate, or high-risk for prediabetes/T2D. Patients in the intermediate or high-risk category were referred to their General Medical Practitioner (GP) for further investigation. RESULTS Fifty-one oral healthcare practices and 76 Oral Health Professionals (OHP) participated (60 Dentists, 8 Dental Hygienists, 8 Oral Health Therapists). 797 patients were screened; 102 were low-risk; 331 intermediate-risk; and 364 high-risk for T2D. Of the 695 participants in the intermediate or high-risk groups, 386 (55.5%) were referred to their GP for T2D assessment. Of them, 96 (25.0%) results were returned to OHPs. Of the returned results, six were (6.3%) diagnosed with pre-T2D. CONCLUSION Patients found to have undiagnosed T2D/prediabetes (6.3%) were within the expected range reported in the literature. Findings indicate that identifying individuals at an elevated risk of having or developing T2D is effective, feasible and could be incorporated into oral healthcare settings. However, this integration may require additional OHPs training and education to ensure that patients at elevated risk of T2D are referred for further assessment.
Collapse
Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Andre Priede
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Michelle King
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Geoffrey G. Adams
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Maria Sicari
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | | |
Collapse
|
27
|
Zhao D, Wu MZ, Yu SY, Pelekos G, Yiu KH, Jin L. Periodontitis links to concurrent systemic comorbidities among 'self-perceived health' individuals. J Periodontal Res 2022; 57:632-643. [PMID: 35438191 DOI: 10.1111/jre.12992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/03/2022] [Accepted: 04/03/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Our recent work shows that periodontitis experience reflects host susceptibility to the onset of multiple systemic diseases and conditions. This cross-sectional study further investigated whether and to what extent the existing periodontitis could reflect the concurrent presence of inflammatory comorbidities among 'self-perceived health' individuals. MATERIALS AND METHODS There were 115 'self-perceived health' adults who completed a questionnaire on demographic characteristics and lifestyles. Twenty medical diagnostic tests were then performed to detect eight common systemic diseases and conditions. Meanwhile, full-mouth periodontal examination was undertaken, and the subjects were classified as two subgroups with or without Generalized Severe Periodontitis (Stages III/IV, generalized). The interlink of periodontal status and concurrent systemic comorbidities was assessed. RESULTS 98.3% (113/115) of the subjects exhibited at least one undiagnosed systemic disease/disorder. Of them, 52.2% (59/113) and 47.8% (54/113) concurrently presented with 1-5 or ≥6 abnormal test results, respectively. Overall, 96.5% (111/115) had periodontitis. Generalized Severe Periodontitis was present in 43.2% (48/111) of the periodontitis patients, and it was significantly associated with the profiles of abnormal test results after adjusting potential confounders (abnormal test results 1-5 vs ≥6; OR: 3.23, p = .012). CONCLUSIONS The present study shows that existing severe periodontitis could well reflect the concurrent presence of multiple inflammatory comorbidities. Oral and medical professionals can play proactive roles in enhancing health awareness and healthcare, through strong collaboration and teamwork.
Collapse
Affiliation(s)
- Dan Zhao
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Mei-Zhen Wu
- Division of Cardiology, Department of Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Shuk Yin Yu
- Division of Cardiology, Department of Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - George Pelekos
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Kai Hang Yiu
- Division of Cardiology, Department of Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Lijian Jin
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
28
|
Čolak D, Cmok Kučič A, Pintar T, Gašpirc B, Gašperšič R. Periodontal and systemic health of morbidly obese patients eligible for bariatric surgery: a cross-sectional study. BMC Oral Health 2022; 22:174. [PMID: 35562737 PMCID: PMC9107195 DOI: 10.1186/s12903-022-02207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background In obese patients, periodontitis might be associated with deprived systemic health. Edmonton obesity staging system (EOSS) is a new tool for classification of obesity that considers the metabolic, physical, and psychological health. The cross-sectional study aimed to evaluate the periodontal status of morbidly obese patients eligible for bariatric surgery and the association between periodontitis, obesity-related comorbidities, and EOSS. Methods Morbidly obese patients eligible for bariatric surgery underwent detailed periodontal examination and were divided into the periodontitis group (PG) and the non-periodontitis group (NPG). The medical and demographic data were obtained from medical files, while behavioural data were obtained by the interview. Descriptive statistics and simple statistical tests were used to summarise the characteristics of the sample and the differences between PG and NPG. The logistic regression models were used to calculate the association (odds ratio (OR)) between periodontitis and obesity-related diseases and EOSS. Results The study included 79 patients, with an average BMI of 44.6 kg/m2 (SD = 7.2). The prevalence of periodontitis was 65% (CI 95% 53%-75%). PG patients (n = 51) were older, more often smokers and were more often hypertensive than NPG patients (n = 28) (p < 0.05). Hypertension was positively associated with periodontitis with adjusted OR 3.98 (95% CI 1.23–12.8; p = 0.021)) and age with adjusted OR 1.06, (95% CI 1.01–1.13; p = 0.038)), while other tested conditions (diabetes, dyslipidaemia, and smoking habits) did not show significant association with periodontitis. Periodontitis did not correlate with EOSS or other obesity-related comorbidities (p > 0.05). Conclusion The morbidly obese patients eligible for bariatric surgery show a high prevalence of periodontitis and, therefore, are advised to be examined by a dentist before undergoing surgery. They have higher odds of hypertension but not of other obesity-related diseases or higher stages of EOSS. The medical personnel should raise awareness among obese patients on the potential association of poor periodontal health with hypertension. Trial registration NCT04653714. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02207-0.
Collapse
Affiliation(s)
- Dejana Čolak
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia. .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Alja Cmok Kučič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Boris Gašpirc
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rok Gašperšič
- Department of Oral Diseases and Periodontology, Dental Clinic, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
29
|
Simpson TC, Clarkson JE, Worthington HV, MacDonald L, Weldon JC, Needleman I, Iheozor-Ejiofor Z, Wild SH, Qureshi A, Walker A, Patel VA, Boyers D, Twigg J. Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev 2022; 4:CD004714. [PMID: 35420698 PMCID: PMC9009294 DOI: 10.1002/14651858.cd004714.pub4] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Glycaemic control is a key component in diabetes mellitus (diabetes) management. Periodontitis is the inflammation and destruction of the underlying supporting tissues of the teeth. Some studies have suggested a bidirectional relationship between glycaemic control and periodontitis. Treatment for periodontitis involves subgingival instrumentation, which is the professional removal of plaque, calculus, and debris from below the gumline using hand or ultrasonic instruments. This is known variously as scaling and root planing, mechanical debridement, or non-surgical periodontal treatment. Subgingival instrumentation is sometimes accompanied by local or systemic antimicrobials, and occasionally by surgical intervention to cut away gum tissue when periodontitis is severe. This review is part one of an update of a review published in 2010 and first updated in 2015, and evaluates periodontal treatment versus no intervention or usual care. OBJECTIVES: To investigate the effects of periodontal treatment on glycaemic control in people with diabetes mellitus and periodontitis. SEARCH METHODS An information specialist searched six bibliographic databases up to 7 September 2021 and additional search methods were used to identify published, unpublished, and ongoing studies. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs) of people with type 1 or type 2 diabetes mellitus and a diagnosis of periodontitis that compared subgingival instrumentation (sometimes with surgical treatment or adjunctive antimicrobial therapy or both) to no active intervention or 'usual care' (oral hygiene instruction, education or support interventions, and/or supragingival scaling (also known as PMPR, professional mechanical plaque removal)). To be included, the RCTs had to have lasted at least 3 months and have measured HbA1c (glycated haemoglobin). DATA COLLECTION AND ANALYSIS At least two review authors independently examined the titles and abstracts retrieved by the search, selected the included trials, extracted data from included trials, and assessed included trials for risk of bias. Where necessary and possible, we attempted to contact study authors. Our primary outcome was blood glucose levels measured as glycated (glycosylated) haemoglobin assay (HbA1c), which can be reported as a percentage of total haemoglobin or as millimoles per mole (mmol/mol). Our secondary outcomes included adverse effects, periodontal indices (bleeding on probing, clinical attachment level, gingival index, plaque index, and probing pocket depth), quality of life, cost implications, and diabetic complications. MAIN RESULTS We included 35 studies, which randomised 3249 participants to periodontal treatment or control. All studies used a parallel-RCT design and followed up participants for between 3 and 12 months. The studies focused on people with type 2 diabetes, other than one study that included participants with type 1 or type 2 diabetes. Most studies were mixed in terms of whether metabolic control of participants at baseline was good, fair, or poor. Most studies were carried out in secondary care. We assessed two studies as being at low risk of bias, 14 studies at high risk of bias, and the risk of bias in 19 studies was unclear. We undertook a sensitivity analysis for our primary outcome based on studies at low risk of bias and this supported the main findings. Moderate-certainty evidence from 30 studies (2443 analysed participants) showed an absolute reduction in HbA1c of 0.43% (4.7 mmol/mol) 3 to 4 months after treatment of periodontitis (95% confidence interval (CI) -0.59% to -0.28%; -6.4 mmol/mol to -3.0 mmol/mol). Similarly, after 6 months, we found an absolute reduction in HbA1c of 0.30% (3.3 mmol/mol) (95% CI -0.52% to -0.08%; -5.7 mmol/mol to -0.9 mmol/mol; 12 studies, 1457 participants), and after 12 months, an absolute reduction of 0.50% (5.4 mmol/mol) (95% CI -0.55% to -0.45%; -6.0 mmol/mol to -4.9 mmol/mol; 1 study, 264 participants). Studies that measured adverse effects generally reported that no or only mild harms occurred, and any serious adverse events were similar in intervention and control arms. However, adverse effects of periodontal treatments were not evaluated in most studies. AUTHORS' CONCLUSIONS Our 2022 update of this review has doubled the number of included studies and participants, which has led to a change in our conclusions about the primary outcome of glycaemic control and in our level of certainty in this conclusion. We now have moderate-certainty evidence that periodontal treatment using subgingival instrumentation improves glycaemic control in people with both periodontitis and diabetes by a clinically significant amount when compared to no treatment or usual care. Further trials evaluating periodontal treatment versus no treatment/usual care are unlikely to change the overall conclusion reached in this review.
Collapse
Affiliation(s)
- Terry C Simpson
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Janet E Clarkson
- School of Dentistry, University of Dundee, Dundee, UK
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Laura MacDonald
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Jo C Weldon
- Faculty of Health and Care, University of Central Lancashire, Preston, UK
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | | | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ambrina Qureshi
- Department of Community Dentistry, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Veena A Patel
- Orthodontic Department, Leeds Dental Institute, Leeds, UK
| | | | - Joshua Twigg
- School of Dentistry, University of Leeds, Leeds, UK
| |
Collapse
|
30
|
Efficacy of Antioxidant Supplementation to Non-Surgical Periodontal Therapy on Metabolic Control in Type 2 Diabetes Patients: A Network Meta-Analysis. Antioxidants (Basel) 2022; 11:antiox11040621. [PMID: 35453306 PMCID: PMC9031448 DOI: 10.3390/antiox11040621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023] Open
Abstract
This network meta-analysis (NMA) investigated the effectiveness of antioxidants as adjuncts to non-surgical periodontal therapy (NSPT) in the glycated hemoglobin (HbA1c) control of type 2 diabetes (T2D) patients with periodontitis. PubMed, Cochrane, LILACS, Web of Science, Scopus, Embase, LIVIVO, and grey literature were searched. Risk of bias was assessed with the RoB v2.0 tool. A frequentist NMA assessed HbA1c improvement, through standardized mean difference under a random-effects model. Certainty of evidence was addressed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) partially contextualized framework. Ten randomized controlled clinical trials were included, with 234 patients receiving alpha lipoic acid (ALA), cranberry juice, cranberry juice enriched with omega-3, fenugreek, ginger, grape seed, lycopene, melatonin, omega-3, propolis or vitamin C supplementation to NSPT, and 220 patients receiving NSPT alone or with placebo. Nine studies were meta-analyzed. HbA1c improved when NSPT was combined with propolis, ALA and melatonin supplementation (moderate-to-low certainty), compared to NSPT alone or with placebo. Risk of bias issues were found in eight studies. In conclusion, the use of propolis supplementation to NSPT probably results in HbA1c improvement in T2D patients with periodontitis (large effect with moderate certainty), while ALA and melatonin supplementation may contribute to reduce the HbA1c in T2D patients with periodontitis (large effects with low certainty).
Collapse
|
31
|
A Tale of Two Fimbriae: How Invasion of Dendritic Cells by Porphyromonas gingivalis Disrupts DC Maturation and Depolarizes the T-Cell-Mediated Immune Response. Pathogens 2022; 11:pathogens11030328. [PMID: 35335652 PMCID: PMC8954744 DOI: 10.3390/pathogens11030328] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 12/29/2022] Open
Abstract
Porphyromonas gingivalis (P. gingivalis) is a unique pathogen implicated in severe forms of periodontitis (PD), a disease that affects around 50% of the US population. P. gingivalis is equipped with a plethora of virulence factors that it uses to exploit its environment and survive. These include distinct fimbrial adhesins that enable it to bind to other microbes, colonize inflamed tissues, acquire nutrients, and invade cells of the stroma and immune system. Most notable for this review is its ability to invade dendritic cells (DCs), which bridge the innate and adaptive immune systems. This invasion process is tightly linked to the bridging functions of resultant DCs, in that it can disable (or stimulate) the maturation function of DCs and cytokines that are secreted. Maturation molecules (e.g., MHCII, CD80/CD86, CD40) and inflammatory cytokines (e.g., IL-1b, TNFa, IL-6) are essential signals for antigen presentation and for proliferation of effector T-cells such as Th17 cells. In this regard, the ability of P. gingivalis to coordinately regulate its expression of major (fimA) and minor (mfa-1) fimbriae under different environmental influences becomes highly relevant. This review will, therefore, focus on the immunoregulatory role of P. gingivalis fimbriae in the invasion of DCs, intracellular signaling, and functional outcomes such as alveolar bone loss and immune senescence.
Collapse
|
32
|
Park MS, Jeon J, Song TJ, Kim J. Association of periodontitis with microvascular complications of diabetes mellitus: A nationwide cohort study. J Diabetes Complications 2022; 36:108107. [PMID: 35063344 DOI: 10.1016/j.jdiacomp.2021.108107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Periodontitis is a common chronic inflammatory disease and one of oral complications in diabetes. Diabetes-related microvascular complications and periodontitis are also closely related to systemic inflammation. We hypothesized that periodontitis and oral hygiene markers might increase the risk of microvascular complications in diabetes mellitus. METHODS We enrolled 11,353 diabetes participants without prior microvascular complications who received complete oral health checkups in the National Health Insurance Service-National Health Screening Cohort in 2003-2004. The primary outcome was the first development of diabetes-related microvascular complications, including nephropathy, neuropathy, and retinopathy. RESULTS The age of all participants was 55.27 ± 9.46 years, and 7833 (68.99%) participants were male. Periodontitis was noted in 8.37%. During the 7.03 ± 4.30 year of the mean follow-up period, 7227 patients experienced diabetes-related microvascular complications (2645 with nephropathy, 2513 with neuropathy, 2069 with retinopathy). Multivariable Cox regression analyses revealed that periodontitis was an independent risk factor for diabetes-related microvascular complications (adjusted hazard ratio (HR):1.13; 95% confidence interval (CI):1.04-1.23; p = 0.004). In the secondary analysis for individual microvascular complications, periodontitis was an independent risk factor for retinopathy (adjusted HR: 1.21; 95% CI: 1.04-1.40; p = 0.013). CONCLUSIONS The presence of periodontitis was associated with an increased risk of microvascular complications in diabetes patients.
Collapse
Affiliation(s)
- Moo-Seok Park
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jimin Jeon
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
33
|
ArefNezhad R, Motedayyen H, Roghani-Shahraki H. Do cytokines associate periodontitis with metabolic disorders? An overview of current documents. Endocr Metab Immune Disord Drug Targets 2022; 22:778-786. [PMID: 35043774 DOI: 10.2174/1871530322666220119112026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/28/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
Periodontitis is an oral chronic inflammatory condition affecting the adult population worldwide. Many microorganisms act as an initiator for induction of inflammatory immune responses, which participate in the destruction of connective tissue surrounding the teeth and thereby result in tooth loss. Cytokines may have indispensable roles in its pathogenesis through enhancing inflammatory and immune responses. Cytokines can affect functions of some cells of different tissues, such as the cells of the pancreas, liver, and adipose tissues. There is evidence that periodontitis is associated with metabolic disorders, like liver cirrhosis, obesity, and diabetes mellitus. Hence, this review was focused on determining how cytokines can participate in the correlation of periodontitis with metabolic disorders.
Collapse
Affiliation(s)
- Reza ArefNezhad
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | |
Collapse
|
34
|
Expanded substrate specificity supported by P1' and P2' residues enables bacterial dipeptidyl-peptidase 7 to degrade bioactive peptides. J Biol Chem 2022; 298:101585. [PMID: 35032549 PMCID: PMC8851246 DOI: 10.1016/j.jbc.2022.101585] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 01/06/2023] Open
Abstract
Dipeptide production from extracellular proteins is crucial for Porphyromonas gingivalis, a pathogen related to chronic periodontitis, because its energy production is entirely dependent on the metabolism of amino acids predominantly incorporated as dipeptides. These dipeptides are produced by periplasmic dipeptidyl-peptidase (DPP)4, DPP5, DPP7, and DPP11. Although the substrate specificities of these four DPPs cover most amino acids at the penultimate position from the N terminus (P1), no DPP is known to cleave penultimate Gly, Ser, Thr, or His. Here, we report an expanded substrate preference of bacterial DPP7 that covers those residues. MALDI-TOF mass spectrometry analysis demonstrated that DPP7 efficiently degraded incretins and other gastrointestinal peptides, which were successively cleaved at every second residue, including Ala, Gly, Ser, and Gln, as well as authentic hydrophobic residues. Intravenous injection of DPP7 into mice orally administered glucose caused declines in plasma glucagon-like peptide-1 and insulin, accompanied by increased blood glucose levels. A newly developed coupled enzyme reaction system that uses synthetic fluorogenic peptides revealed that the P1′ and P2′ residues of substrates significantly elevated kcat values, providing an expanded substrate preference. This activity enhancement was most effective toward the substrates with nonfavorable but nonrepulsive P1 residues in DPP7. Enhancement of kcat by prime-side residues was also observed in DPP11 but not DPP4 and DPP5. Based on this expanded substrate specificity, we demonstrate that a combination of DPPs enables proteolytic liberation of all types of N-terminal dipeptides and ensures P. gingivalis growth and pathogenicity.
Collapse
|
35
|
Jenifer Cynthia RA, Srinivasan S, Vijay VK, Saravanan D, Balaji S, Navarasu M. Estimation of Serum Procalcitonin (ProCT/PCT) Levels in Periodontally Healthy Individuals and Chronic Periodontitis Patients with Type II Diabetes Mellitus – An Original Research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S955-S958. [PMID: 36110712 PMCID: PMC9469443 DOI: 10.4103/jpbs.jpbs_746_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/14/2021] [Indexed: 11/22/2022] Open
Abstract
Aim: The present study aimed to estimate the serum procalcitonin (PCT) levels in periodontally healthy individuals and chronic periodontitis patients with Type II diabetes mellitus (DM). Materials and Methods: Forty-five male subjects aged 25–60 years were enrolled in the study and grouped as Group I (healthy), Group II (chronic periodontitis), and Group III (chronic periodontitis with Type II DM). Clinical parameters (dental plaque scores, bleeding scores, probing pocket depth, and loss of attachment) and glycemic parameters (random blood sugar and glycated hemoglobin levels) were recorded. Serum procalcitonin levels were analyzed using Raybio® Human Procalcitonin Enzyme-Linked Immunosorbent Assay kit using the sandwich technique. All the data obtained were tabulated and analyzed using SYSTAT 12 statistical software. Kruskal–Wallis test was applied to compare the mean scores between the three study groups, and Spearman's ρ correlation coefficient was used to find out the association. Results: Serum procalcitonin levels were markedly increased in periodontitis group when compared to the healthy group. The mean serum levels of procalcitonin in Group I, Group II, and Group III were 22.52 pg/ml, 64.23 pg/ml, and 185.86 pg/ml, respectively. The variation in the procalcitonin levels was statistically significant at P < 0.001. Conclusion: The expression of procalcitonin in serum was increased to eightfold in the periodontitis group with diabetes in comparison to the healthy group, which shows that periodontal disease can cause the release of procalcitonin.
Collapse
|
36
|
Patel E, Parikh H, Shah R, Mandaliya D, Vishwkarama S, Nayak S. Evaluation of periodontal status amongst the diabetic patients visiting private dental clinic in ahmedabad using CPITN. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_141_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
37
|
Singh J, Kaur I, Singh G, Saini RG, Gupta H, Singh R. Influence of nonsurgical periodontal therapy on serum hemoglobin levels among patients with type 2 diabetes mellitus: A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_117_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
38
|
Lee MY, Kim MH, Lee WI, Kang SY. Septic shock caused by Slackia exigua in a patient with diabetes. Anaerobe 2021; 73:102498. [PMID: 34875369 DOI: 10.1016/j.anaerobe.2021.102498] [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: 10/15/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/01/2022]
Abstract
We report a case of septic shock caused by Slackia exigua, an obligatory anaerobic gram-positive rod, in an 82-year-old woman with diabetes. Dental assessment revealed a palatal lesion and untreated periodontitis. Although a resident species in the oral cavity and associated with localized disorders, S. exigua can cause extra-oral diseases, which can be fatal in individuals with risk factors, such as diabetes. Thus, control of oral lesions caused by S. exigua is important to prevent systemic infection.
Collapse
Affiliation(s)
- Min Young Lee
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Myeong Hee Kim
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
| | - Woo In Lee
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - So Young Kang
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| |
Collapse
|
39
|
Alwan AM, Mousa HA, Talib HJ, Jassim TK. Impact of Air and Manual Scaling on Dental Anxiety and Blood Glucose Level among Diabetic Patients. J Int Soc Prev Community Dent 2021; 11:510-515. [PMID: 34760794 PMCID: PMC8533038 DOI: 10.4103/jispcd.jispcd_411_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/14/2021] [Accepted: 04/06/2021] [Indexed: 11/05/2022] Open
Abstract
Aims: The current study aimed at describing the short-term effect of nonsurgical periodontal treatment on dental anxiety and blood glucose level change among diabetic patients. Materials and Methods: One hundred and fifty patients with diabetes participated in a cross-sectional study design. All of them were divided into two groups, with 75 patients in each group. The first group was treated with air scaling, whereas the second group was treated with manual scaling. The determination of treatment needs and the evaluation of periodontal health status were achieved by using Community Periodontal Index for Treatment Need (CPITN). The level of dental anxiety was assessed by using Visual Analogue Scale (VAS). The glucose change was calculated by subtracting the glucose level before treatment from the glucose level straight after treatment. Results: No significant difference in glucose level was observed between manual scaling and air scaling after treatment (P = 0.076), and the level of glucose was significantly lower after scaling treatment within the treatment groups (P = 0.000). The level of glucose change between the groups was significantly lower for the manual scaling treatment group (P = 0.013), and it was significantly correlated with VAS (P = 0.000). Multiple regression analysis showed a significant association between the treatment groups (P = 0.007). Conclusions: Scaling reduced blood glucose and dental anxiety levels in patients with diabetes. Manual scaling was associated with reduced glucose level change less than air scaling after treatment.
Collapse
Affiliation(s)
- Alyamama M Alwan
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Hussein A Mousa
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Haider J Talib
- Department of Periodontal Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| | - Tameem K Jassim
- Department of Prosthetic Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
| |
Collapse
|
40
|
Bendek MJ, Canedo-Marroquín G, Realini O, Retamal IN, Hernández M, Hoare A, Busso D, Monteiro LJ, Illanes SE, Chaparro A. Periodontitis and Gestational Diabetes Mellitus: A Potential Inflammatory Vicious Cycle. Int J Mol Sci 2021; 22:ijms222111831. [PMID: 34769262 PMCID: PMC8584134 DOI: 10.3390/ijms222111831] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is a chronic inflammatory immune disease associated with a dysbiotic state, influenced by keystone bacterial species responsible for disrupting the periodontal tissue homeostasis. Furthermore, the severity of periodontitis is determined by the interaction between the immune cell response in front of periodontitis-associated species, which leads to the destruction of supporting periodontal tissues and tooth loss in a susceptible host. The persistent bacterial challenge induces modifications in the permeability and ulceration of the sulcular epithelium, which facilitates the systemic translocation of periodontitis-associated bacteria into distant tissues and organs. This stimulates the secretion of pro-inflammatory molecules and a chronic activation of immune cells, contributing to a systemic pro-inflammatory status that has been linked with a higher risk of several systemic diseases, such as type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM). Although periodontitis and GDM share the common feature of systemic inflammation, the molecular mechanistic link of this association has not been completely clarified. This review aims to examine the potential biological mechanisms involved in the association between periodontitis and GDM, highlighting the contribution of both diseases to systemic inflammation and the role of new molecular participants, such as extracellular vesicles and non-coding RNAs, which could act as novel molecular intercellular linkers between periodontal and placental tissues.
Collapse
Affiliation(s)
- María José Bendek
- Department of Periodontology, Centre for Biomedical Research, Faculty of Dentistry, Universidad de los Andes, Av. Plaza 2501, Las Condes, Santiago 7620157, Chile; (M.J.B.); (G.C.-M.); (O.R.); (I.N.R.)
| | - Gisela Canedo-Marroquín
- Department of Periodontology, Centre for Biomedical Research, Faculty of Dentistry, Universidad de los Andes, Av. Plaza 2501, Las Condes, Santiago 7620157, Chile; (M.J.B.); (G.C.-M.); (O.R.); (I.N.R.)
| | - Ornella Realini
- Department of Periodontology, Centre for Biomedical Research, Faculty of Dentistry, Universidad de los Andes, Av. Plaza 2501, Las Condes, Santiago 7620157, Chile; (M.J.B.); (G.C.-M.); (O.R.); (I.N.R.)
| | - Ignacio N. Retamal
- Department of Periodontology, Centre for Biomedical Research, Faculty of Dentistry, Universidad de los Andes, Av. Plaza 2501, Las Condes, Santiago 7620157, Chile; (M.J.B.); (G.C.-M.); (O.R.); (I.N.R.)
| | - Marcela Hernández
- Laboratory of Periodontal Biology and Department of Pathology and Oral Medicine, Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380544, Chile;
| | - Anilei Hoare
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Olivos 943, Independencia, Santiago 8380544, Chile;
| | - Dolores Busso
- Program in Biology of Reproduction, Centre for Biomedical Research and Innovation (CIIB), Universidad de los Andes, Santiago 8380544, Chile; (D.B.); (L.J.M.); (S.E.I.)
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago 8380544, Chile
| | - Lara J. Monteiro
- Program in Biology of Reproduction, Centre for Biomedical Research and Innovation (CIIB), Universidad de los Andes, Santiago 8380544, Chile; (D.B.); (L.J.M.); (S.E.I.)
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago 8380544, Chile
| | - Sebastián E. Illanes
- Program in Biology of Reproduction, Centre for Biomedical Research and Innovation (CIIB), Universidad de los Andes, Santiago 8380544, Chile; (D.B.); (L.J.M.); (S.E.I.)
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago 8380544, Chile
| | - Alejandra Chaparro
- Department of Periodontology, Centre for Biomedical Research, Faculty of Dentistry, Universidad de los Andes, Av. Plaza 2501, Las Condes, Santiago 7620157, Chile; (M.J.B.); (G.C.-M.); (O.R.); (I.N.R.)
- Correspondence: ; Tel.: +56-998376593
| |
Collapse
|
41
|
Curtis DA, Lin GH, Rajendran Y, Gessese T, Suryadevara J, Kapila YL. Treatment planning considerations in the older adult with periodontal disease. Periodontol 2000 2021; 87:157-165. [PMID: 34463978 DOI: 10.1111/prd.12383] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Periodontal health in the elderly is influenced by numerous factors, including systemic conditions, patient compliance, age-associated changes, and restorative procedures. The numerous comorbidities seen in the elderly necessitate individualized approaches for treatment planning. In this paper, we review how age, comorbidities, oral hygiene, and restorative dental procedures collectively influence the treatment and management of the periodontium in the elderly. The elderly population is predicted to double in 30 years, which will have an economic impact the dental profession needs to plan for. Preventative and noninvasive treatment, supportive periodontal therapy, and patient-specific maintenance plans are imperative to maintaining oral health in the older population. Multiple coexisting changes, including xerostomia, altered wound healing, altered bone physiology, altered microbiome, and diminished plaque control, can add complexity to periodontal management. Considerations of the patient's general health, the selected periodontal treatment plan, and the selected completed restorative procedures need to be considered. The influence of caries, fixed prosthodontics, partial dentures, shortened dental arch, and implant therapy can have unintended impacts on periodontal health in the elderly. Adverse periodontal outcomes in the elderly can be minimized by carefully assessing the patient's medical history, impact of medications, functional needs, properly finishing and contouring restorations to avoid plaque accumulation, and designing restorations to allow access for hygiene. Partial dentures can be a source of plaque accumulation leading to periodontal disease, caries, and recession around abutment teeth. A shortened dental arch should be considered as a functional and cost-effective alternative to partial dentures. With dental implants, the patient's tissue phenotype, keratinized tissue quantity, risk of peri-implantitis, and patient access for maintaining adequate oral hygiene are all important to consider. Implant risk-assessment tools show promise by providing a systematic approach for early diagnosis to avoid future complications.
Collapse
Affiliation(s)
- Donald A Curtis
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yogalakshmi Rajendran
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Tsegazeab Gessese
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Jyotirmaie Suryadevara
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA.,Navy Dental Corps, Naval Medical Leader and Professional Development Command, Bethesda, Maryland, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, Division of Periodontology, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
42
|
Adhenkavil Radhakrishnan R, Joseph Vadakkekuttical R, Radhakrishnan C. Proportion and severity of periodontitis and correlation of periodontal inflamed surface area with glycemic status in patients with type 2 diabetic neuropathy with and without diabetic foot. J Periodontol 2021; 93:687-696. [PMID: 34460108 DOI: 10.1002/jper.21-0174] [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: 04/01/2021] [Revised: 07/30/2021] [Accepted: 08/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The association between diabetic neuropathy with and without diabetic foot and periodontitis remains unaddressed in the literature. The present study was conducted to evaluate the frequency of patients with periodontitis and its severity, and to correlate clinical attachment loss (AL) and periodontal inflamed surface area (PISA) with HbA1c in Type 2 Diabetic Neuropathy (T2DN) patients with and without diabetic foot. METHODS In this cross-sectional study 310 patients with type 2 diabetic neuropathy (T2DN) were randomly selected, and the study comprised of 120 patients with T2DN with diabetic foot and 155 patients with T2DN without diabetic foot. All patients were assessed for periodontal parameters (bleeding on probing, probing depth, clinical AL, oral hygiene index-simplified), plaque index, and PISA) and systemic parameters (HbA1c, fasting blood glucose, post prandial blood glucose, urinary albumin creatine ratio, erythrocyte sedimentation rate, and high-sensitivity C-reactive protein).Unpaired t-test and Chi-Square test were used to analyze quantitative data and qualitative data, respectively. RESULTS The frequency of patients with periodontitis in patients with T2DN with and without diabetic foot was 91.7% and 88.4%, respectively. The severity of periodontitis, PISA, and clinical AL were higher in the diabetic foot group. Clinical AL and PISA were significantly related with HbA1c in patients with T2DN with and without diabetic foot. CONCLUSIONS Percentage of patients with periodontitis and the severity of periodontal destruction were high in type 2 diabetic neuropathy with diabetic foot. A significant correlation of PISA, clinical AL with glycemic status was found in patients with T2DN with and without diabetic foot.
Collapse
|
43
|
Sinha S, Sonoo PR, Siddhartha R, Singh SK, Singh A. Effect of Conventional Periodontal Treatment (Scaling and Root Planing) on Type-2 Diabetic Patient with Moderate Generalized Chronic Periodontitis: A Clinical Study. J Pharm Bioallied Sci 2021; 13:S706-S710. [PMID: 34447186 PMCID: PMC8375805 DOI: 10.4103/jpbs.jpbs_692_20] [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: 10/21/2020] [Revised: 11/02/2020] [Accepted: 11/24/2020] [Indexed: 11/07/2022] Open
Abstract
Background: The aim is to assess the effect of periodontal therapy and scaling and root planing (SRP) on the metabolic control in Type 2 diabetes mellitus (DM) patients with chronic periodontitis based on the estimation of glycated hemoglobin (HbA1c). Materials and Methods: A prospective, comparative, clinical study was performed on 50 patients suffering from Type 2 DM with moderate, generalized chronic periodontitis. Type 2 moderately controlled diabetic patients with HbA1c values within the range of 6%–8% were selected. The parameters recorded were gingival index, plaque index, sulcus bleeding index, probing pocket depth, clinical attachment level, and HbA1c. The recordings were done at baseline and 6 months after SRP procedures. Results: Reductions in all the clinical parameters were observed and were found to be statistically significant (P < 0.05). Conclusion: SRP resulted in a statistically significant reduction in the clinical parameters and HbA1c. Hence, periodontal treatment should be included in the management of diabetic patients.
Collapse
Affiliation(s)
- Sachin Sinha
- Department of Periodontics, PHC, Patna, Bihar, India
| | - Priyanshu Ranjan Sonoo
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Rohit Siddhartha
- Department of Conservative Dentistry, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Sanjay Kumar Singh
- Department of Dentistry, Patna Medical College and Hospital, Patna, Bihar, India
| | - Anjali Singh
- Department of Periodontics, Private Practitioner, Patna, Bihar, India
| |
Collapse
|
44
|
Allicin May Promote Reversal of T-Cell Dysfunction in Periodontitis via the PD-1 Pathway. Int J Mol Sci 2021; 22:ijms22179162. [PMID: 34502071 PMCID: PMC8431528 DOI: 10.3390/ijms22179162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 12/14/2022] Open
Abstract
We evaluated the role of allicin in periodontitis using an in silico and in vitro design. An in silico docking analysis was performed to assess the plausible interactions between allicin and PD-L1. The cytokine profile of gingival crevicular fluid (GCF) samples obtained from periodontitis patients was estimated by cytometric bead array. CD3+ lymphocytes isolated from the peripheral blood were sorted and characterized using immunomagnetic techniques. Cultured and expanded lymphocytes were treated with the GCF samples to induce T-cell exhaustion. Optimum concentrations of allicin were added to exhausted lymphocytes to compare the expression of TIM-3 and LAG-3 gene expression at baseline and post-treatment. Allicin was found to bind to the PD-L1 molecule as revealed by the in-silico experiment, which is possibly an inhibitory interaction although not proven. GCF from periodontitis patients had significantly higher concentrations of TNF-α, CCL2, IL-6, IFN-γ, and CXCL8 than controls. GCF treatment of CD3+ lymphocytes from the periodontitis patients significantly increased expression of T-cell exhaustion markers TIM-3 and LAG-3. Allicin administration with GCF treatment resulted in significant lowering of the expression of exhaustion markers. Allicin may exert an immunostimulatory role and reverse immune-destructive mechanisms such as T-cell exhaustion.
Collapse
|
45
|
Clinical Outcomes and Oral Health-Related Quality of Life after Periodontal Treatment with Community Health Worker Strategy in Patients with Type 2 Diabetes: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168371. [PMID: 34444121 PMCID: PMC8394731 DOI: 10.3390/ijerph18168371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/20/2021] [Accepted: 08/05/2021] [Indexed: 01/18/2023]
Abstract
Interventions engaging community health workers (CHW) for diabetes management aim to improve diabetes care and self-management behaviors among patients. We evaluated the effects of nonsurgical periodontal treatment (NSPT) with the CHW strategy on oral self-care behaviors, periodontal status and oral health-related quality of life (OHQoL) in patients with type 2 diabetes mellitus (T2DM). The participants were randomly assigned to experimental (EG; n = 35) and control (CG; n = 33) groups. All participants received NSPT, whereas the patients in the EG also received one-on-one 30 min lessons from a CHW over 4 weeks. The EG exhibited greater improvement in the probing pocket depth (β = −0.2, effect size [ES] = 0.61) and clinical attachment level (β = −0.2, ES = 0.59) at 1-month follow-up than the CG did. The ES increased over the 1-, 3- and 6-month follow-ups, indicating an increase in OHQoL (ES = 0.19, 0.60, and 0.62, respectively) in the EG. The patients in the EG were more likely to change their oral self-care behaviors than patients in the CG were. The NSPT with CHW strategy had a positive effect on 1-month periodontal treatment outcomes, long-term OHQoL and oral self-care behaviors in patients with T2DM.
Collapse
|
46
|
Mariño R, Priede A, King M, Adams GG, Lopez D. Attitudes and opinions of Oral healthcare professionals on screening for Type-2 diabetes. BMC Health Serv Res 2021; 21:743. [PMID: 34315460 PMCID: PMC8314562 DOI: 10.1186/s12913-021-06756-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals’ (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs’ concerns and perceived barriers to screening for T2D. Methods Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients’ awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP). Conclusions The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues.
Collapse
Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, University of Melbourne, Melbourne, Australia.
| | - Andre Priede
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Michelle King
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Geoffrey G Adams
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Diego Lopez
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| |
Collapse
|
47
|
Tandon A, Kamath YS, Gopalkrishna P, Saokar A, Prakash S, Sarpangala SB, Bhandary SV. The association between diabetic retinopathy and periodontal disease. Saudi J Ophthalmol 2021; 34:167-170. [PMID: 34085007 PMCID: PMC8081093 DOI: 10.4103/1319-4534.310412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 10/19/2020] [Accepted: 11/08/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE: The purpose of the study was to study the association between diabetic retinopathy (DR) and periodontal disease (PD) in a South Indian cohort. METHODS: This was a cross-sectional, observational, interdisciplinary hospital-based study wherein patients with diabetes mellitus visiting the ophthalmology department of a university teaching hospital in coastal Karnataka, south India, during the study period, were screened independently for retinopathy by an ophthalmologist and PD by a periodontal surgeon. All the patients were above 18 years of age and did not have juvenile or gestational diabetes. A total of 213 patients consented to participate in the study. The data were analyzed for association using the Chi-square test. RESULTS: There was a statistically significant association between the presence of DR and PD (P = 0.02). The increasing severity of DR was associated with an increase in the components of PD including plaque index (P < 0.001) and gingival index (P < 0.001). CONCLUSION: There is a significant association between DR and PD. The awareness of this association can aid in the screening of potentially sight-threatening retinopathy in diabetics presenting to the dental clinic with PD.
Collapse
Affiliation(s)
- Akash Tandon
- Department of Ophthalmology, Kasturba Medical College-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Yogish S Kamath
- Department of Ophthalmology, Kasturba Medical College-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pratibha Gopalkrishna
- Department of Periodontics, Manipal College of Dental Sciences-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Asmita Saokar
- Department of Periodontics, Manipal College of Dental Sciences-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sugandha Prakash
- Department of Periodontics, Manipal College of Dental Sciences-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shailaja B Sarpangala
- Department of Ophthalmology, Kasturba Medical College-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sulatha V Bhandary
- Department of Ophthalmology, Kasturba Medical College-Manipal; Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
48
|
Lima MLDS, de Medeiros CACX, Guerra GCB, Santos R, Bader M, Pirih FQ, de Araújo Júnior RF, Chan AB, Cruz LJ, Brito GADC, Leitão RFDC, da Silveira EJD, Garcia VB, Martins AA, de Araújo AA. AT1 and AT2 Receptor Knockout Changed Osteonectin and Bone Density in Mice in Periodontal Inflammation Experimental Model. Int J Mol Sci 2021; 22:5217. [PMID: 34069164 PMCID: PMC8157150 DOI: 10.3390/ijms22105217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the role of AT1 and AT2 receptors in a periodontal inflammation experimental model. METHODS Periodontal inflammation was induced by LPS/Porphyromonas gingivalis. Maxillae, femur, and vertebra were scanned using Micro-CT. Maxillae were analyzed histopathologically, immunohistochemically, and by RT-PCR. RESULTS The vertebra showed decreased BMD in AT1 H compared with WT H (p < 0.05). The femur showed increased Tb.Sp for AT1 H and AT2 H, p < 0.01 and p < 0.05, respectively. The Tb.N was decreased in the vertebra (WT H-AT1 H: p < 0.05; WT H-AT2 H: p < 0.05) and in the femur (WT H-AT1 H: p < 0.01; WT H-AT2 H: p < 0.05). AT1 PD increased linear bone loss (p < 0.05) and decreased osteoblast cells (p < 0.05). RANKL immunostaining was intense for AT1 PD and WT PD (p < 0.001). OPG was intense in the WT H, WT PD, and AT2 PD when compared to AT1 PD (p < 0.001). AT1 PD showed weak immunostaining for osteocalcin compared with WT H, WT PD, and AT2 PD (p < 0.001). AT1 H showed significantly stronger immunostaining for osteonectin in fibroblasts compared to AT2 H (p < 0.01). CONCLUSION AT1 receptor knockout changed bone density, the quality and number of bone trabeculae, decreased the number of osteoblast cells, and increased osteonectin in fibroblasts.
Collapse
Affiliation(s)
- Maria Laura de Souza Lima
- Postgraduate Program in Dentistry Sciences, Department of Biophysical and Pharmacology, Federal University of Rio Grande Norte, Natal, RN 59078-900, Brazil; (M.L.d.S.L.); (E.J.D.d.S.)
| | - Caroline Addison Carvalho Xavier de Medeiros
- Postgraduate Program in Biological Science, Postgraduate Program in RENORBIO, Department of Biophysical and Pharmacology, Federal University of Rio Grande Norte, Natal, RN 59078-970, Brazil;
| | - Gerlane Coelho Bernardo Guerra
- Postgraduate Program in Biological Science, Postgraduate Program in Pharmaceutical Science, Department of Biophysical and Pharmacology, Federal University of Rio Grande Norte, Natal, RN 59078-970, Brazil;
| | - Robson Santos
- Department of Physiology, Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil;
| | - Michael Bader
- Max Delbrück Center of Molecular Medicine, 13125 Berlin, Germany;
| | - Flavia Q. Pirih
- School of Dentistry, Universidad California-Los Angeles (UCLA), Los Angeles, CA 90095, USA;
| | - Raimundo Fernandes de Araújo Júnior
- Post Graduate Program Functional and Structural Biology, Post Graduate Program Health Science, Department of Morphology, Federal University of Rio Grande do Norte, 3000 Senador Salgado Filho Ave, Lagoa Nova, Natal, RN 59078-970, Brazil;
| | - Alan B. Chan
- Percuros B.V, 2333 CL Leiden, The Netherlands;
- Translational Nanobiomaterials and Imaging, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Luis J. Cruz
- Translational Nanobiomaterials and Imaging, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Gerly Anne de Castro Brito
- Postgraduate Program in Pharmacology, Postgraduate Program in Morphology, Department of Morphology, Fortaleza, CE 60430-170, Brazil;
| | | | - Ericka Janine Dantas da Silveira
- Postgraduate Program in Dentistry Sciences, Department of Biophysical and Pharmacology, Federal University of Rio Grande Norte, Natal, RN 59078-900, Brazil; (M.L.d.S.L.); (E.J.D.d.S.)
| | - Vinicius Barreto Garcia
- Postgraduate Program in Health Sciences, Cancer and Inflammation Research laboratory, Department of Morphology, Federal University of Rio Grande Norte, Natal, RN 59078-970, Brazil;
| | - Agnes Andrade Martins
- Department of Dentistry, Federal University of Rio Grande Norte, Natal, RN 59078-970, Brazil;
| | - Aurigena Antunes de Araújo
- Postgraduate Program in Dentistry Sciences, Department of Biophysical and Pharmacology, Federal University of Rio Grande Norte, Natal, RN 59078-900, Brazil; (M.L.d.S.L.); (E.J.D.d.S.)
- AV. Senador Salgado Filho, S/N, Campus Universitário, Centro de Bio-ciências, Departamento de Biofísica e Farmacologia, UFRN, Natal, RN 59078-900, Brazil
| |
Collapse
|
49
|
Hsiao T, Ho Y, Chen M, Lee S, Sun C. Disease activation maps for subgingival dental calculus identification based on intelligent dental optical coherence tomography. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Tien‐Yu Hsiao
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Yi‐Ching Ho
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
| | - Mei‐Ru Chen
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Shyh‐Yuan Lee
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
- Department of Dentistry Yangming Branch of Taipei City Hospital Taipei Taiwan, ROC
| | - Chia‐Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| |
Collapse
|
50
|
Zainal Abidin Z, Zainuren ZA, Noor E, Mohd Nor NS, Mohd Saffian S, Abdul Halim R. Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta-analysis. Aust Dent J 2021; 66 Suppl 1:S15-S26. [PMID: 33864280 DOI: 10.1111/adj.12845] [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: 09/25/2020] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 01/02/2023]
Abstract
Diabetes mellitus (DM) is a complex metabolic disease characterized by hyperglycaemia resulted from defects in insulin secretion or action, or both. Various studies have reported on the bidirectional relationship between DM and periodontal disease. A systematic search of the literature was performed in several databases, EBSCO Medline Complete, PubMed, Science Direct and a manual search for articles from 2000 until 2019. Literature that fulfilled the inclusion criteria were identified, and data measuring plaque index (PI), gingival index (GI), clinical attachment loss (CAL) and periodontal probing depth (PPD) were extracted and subjected to Random-effects meta-analysis. From 947 titles and abstracts screened, 11 articles were included for meta-analysis. It was found that PI, GI, CAL and PPD were significantly higher in DM children than in non-DM children according to the Standardized Mean different (SMD) and 95% confidence intervals (CI) (SMD 0.54, 95% CI 0.20-0.87, P = 0.002; SMD 0.63, 95% CI 0.39-0.87, P < 0.001; SMD 0.79, 95% CI 0.52-1.05, P < 0.001, SMD 0.67, 95% CI 0.23-1.11, P = 0.003, respectively). The meta-analysis showed significant differences in PI, GI, PD and CAL between the two groups, favouring non-DM children. Therefore, early detection of DM children with periodontal disease is crucial to prevent periodontal disease.
Collapse
Affiliation(s)
- Z Zainal Abidin
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - Z A Zainuren
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - E Noor
- Centre of Periodontology Studies, Faculty of Dentistry, Universiti Teknologi Mara (UiTM), Sungai Buloh, Malaysia
| | - N S Mohd Nor
- Paediatric Department, Faculty of Medicine and Institute for Pathology, Laboratory and Forensic Medicine (IPPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - S Mohd Saffian
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Abdul Halim
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, UniversitiTeknologi Mara (UiTM), Sungai Buloh, Malaysia
| |
Collapse
|