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Bagde H, Sharma AK, Chaubey PP, Benjamin N, Ghosh D, Kaushal L. Effect of Scaling and Root Planing in Conjunction with Antimicrobial Therapy on Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S956-S959. [PMID: 37694051 PMCID: PMC10485511 DOI: 10.4103/jpbs.jpbs_268_23] [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: 03/15/2023] [Revised: 03/20/2023] [Accepted: 03/26/2023] [Indexed: 09/12/2023] Open
Abstract
Background Scaling and root planing with systemic doxycycline had an effect on blood glucose levels in type 2 diabetes patients, according to the results of a glycosylated hemoglobin assay. The trial was conducted to determine whether periodontal therapy affected blood sugar regulation as a result of this finding. Methods A total of 60 people with type 2 diabetes (diabetes mellitus not caused by insulin deficiency) were split into three groups. Group I (control group) consists of patients who are only taking an oral anti-diabetic medication. Patients on an oral anti-diabetic drug plus scaling and root planing make up group II. Patients on an oral anti-diabetic drug, scaling, root planing, and doxycycline constitute Group III. The patients were re-evaluated for glycated hemoglobin levels and periodontal status using the clinical parameters of gingival index by Loe and Silness and clinical attachment level at baseline, 30th, 60th, and 90th day. Results Compared with group II, the findings showed a statistically significant decrease in glycated hemoglobin values (p =0.001) and improvements in clinical attachment level (p =0.022, 0.05) and gingival index (p = 0.009.,01) in group III. In the control group (group I), no such finding was made. The average gingival index, however, increased statistically significantly (p = 0.032, 0.05). Conclusion Various studies have been showing the benefits of non-surgical periodontal therapy as a benefit for improving the overall glycemic status of the patient. Non-surgical mechanical periodontal therapy combined with systemic administration of antimicrobials such as doxycycline enhances the metabolic status of type 2 diabetes mellitus patients better than non-surgical mechanical periodontal therapy alone.
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Affiliation(s)
- Hiroj Bagde
- Department of Periodontology, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Ashish K. Sharma
- Assistant Professor, Adesh Medical College and Hospital, Haryana, India
| | - Priyanka P. Chaubey
- Department of Microbiology, Datta Meghe Medical College (Datta Meghe Institute of Higher Education and Research - Deemed to be University), Nagpur, Maharashtra, India
| | - Niharika Benjamin
- Assistant Professor, Department of Public Health Dentistry, Hitkarini Dental College and Hospital, Jabalpur, India
| | - Debasmita Ghosh
- Department of Conservative Dentistry and Endodontics, Post Graduate Student, Rama Dental College, Hospital and Research Centre, Jabalpur, India
| | - Laxmi Kaushal
- Department of Periodontology Maitri College of Dentistry and Research Centre, Durg, Chhattisgarh, India
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Wang Z, Chen H, Peng L, He Y, Wei J, Zhang X. DNER and GNL2 are differentially m6A methylated in periodontitis in comparison with periodontal health revealed by m6A microarray of human gingival tissue and transcriptomic analysis. J Periodontal Res 2023; 58:529-543. [PMID: 36941720 DOI: 10.1111/jre.13117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/01/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aims to investigate the differences in the epigenomic patterns of N6-methyladenosine (m6A) methylation in gingival tissues between patients with periodontitis (PD) and healthy controls, identifying potential biomarkers. BACKGROUND As a multifactorial disease, PD involves multiple genetic and environmental effects. The m6A modification is the most prevalent internal mRNA modification and linked to various inflammatory diseases. However, the m6A modification pattern and m6A-related signatures in PD remain unclear. MATERIALS AND METHODS An m6A microarray of human gingival tissues was conducted in eight subjects: four diagnosed with PD and four healthy controls. Microarray analysis was performed to identify the differentially m6A methylated mRNAs (DMGs) and the differentially expressed mRNAs (DEGs). The differentially methylated and expressed mRNAs (DMEGs) were subjected to functional enrichment analysis by Metascape. The weighted gene co-expression network analysis (WGCNA) algorithm, the least absolute shrinkage and selection operator (LASSO) regression, and univariate logistic regression were performed to identify potential biomarkers. The cell type localization of the target genes was determined using single-cell RNA-seq (scRNA-seq) analysis. The m6A methylation level and gene expression of hub genes were subsequently verified by m6A methylated RNA immunoprecipitation (MeRIP) and quantitative real-time PCR (qRT-PCR). RESULTS In total, 458 DMGs, 750 DEGs, and 279 DMEGs were identified based on our microarray. Pathway analyses conducted for the DMEGs revealed that biological functions were mainly involved in the regulation of stem cell differentiation, ossification, circadian rhythm, and insulin secretion pathways. Besides, the genes involved in crucial biological processes were mainly expressed in fibroblast and epithelial cells. Furthermore, the m6A methylation and expression levels of two hub biomarkers (DNER and GNL2) were validated. CONCLUSION The current study exhibited a distinct m6A epitranscriptome, identified and verified two PD-related biomarkers (DNER and GNL2), which may provide novel insights into revealing the new molecular mechanisms and latent targets of PD.
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Affiliation(s)
- Zhenxiang Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Hang Chen
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Limin Peng
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yujuan He
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Jingjing Wei
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Xiaonan Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
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Upadhyaya JD, Mutalik VS. Oral Lesions Associated with Systemic Disease. Oral Maxillofac Surg Clin North Am 2023; 35:227-236. [PMID: 36805901 DOI: 10.1016/j.coms.2022.10.002] [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: 02/17/2023]
Abstract
Oral manifestations may be the first sign of a systemic disease, or represent lesions associated with an established or recurrent disease. Oral health care providers are often the first to recognize these signs. Some lesions have characteristic features that allow for early detection and intervention. On the contrary, clinical manifestations may be diverse and require a comprehensive evaluation to establish a definitive diagnosis. This article reviews the oral manifestations of select systemic diseases to help clinicians develop a differential diagnosis that leads to early diagnosis and timely intervention.
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Affiliation(s)
- Jasbir D Upadhyaya
- Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, 2800 College Avenue, Building 285, Alton, IL 62002, USA.
| | - Vimi Sunil Mutalik
- Department of Dental Diagnostic and Surgical Sciences, University of Manitoba Dr. Gerald Niznick College of Dentistry, 780 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W2, Canada
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Wang Y, Yang C. Enhanced VEGF-A expression and mediated angiogenic differentiation in human gingival fibroblasts by stimulating with TNF-α in vitro. J Dent Sci 2022; 17:876-881. [PMID: 35756776 PMCID: PMC9201534 DOI: 10.1016/j.jds.2021.09.022] [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: 08/31/2021] [Revised: 09/13/2021] [Indexed: 11/24/2022] Open
Abstract
Backgroud/purpose The effects of inflammatory cytokines were reported to involve in the process of periodontal disease and inflamed tissue enhanced the expression of inflammatory mediators which in turn may promote angiogenesis. Human gingival fibroblasts (HGFs) exert the basic function in periodontal tissue repair and regeneration. However, studies specially focused on the effects of inflammation-related HGFs on angiogenic and osteogenic differentiation are limited. This study was aimed to test whether HGFs enhance vascular endothelial growth factor (VEGF)-A expression mediating angiogenic and osteogenic differentiation by stimulating with tumor necrosis factor-α (TNF-α), to further identify the possible mechanism which may be responsible for this activity. Materials and methods In this study, HGFs are treated by TNF-α in order to detect the effects of angiogenic and osteogenic differentiation under inflammation-related condition. Results TNF-α enhances VEGF-A expression and results in increasing cell migration and angiogenic differentiation and inhibiting osteogenic differentiation in HGFs. Besides, TNF-α stimulated VEGF-A-mediated angiogenic differentiation is dependent on the activation of mitogen-activated protein kinase (MAPK) pathway, Extracellular signal-regulated kinase (ERK) 1/2 phosphorylation may contribute to regulate the function of VEGF-A in inflammation-related HGFs. Conclusion This study demonstrated that enhanced VEGF-A-mediated angiogenic differentiation in HGFs is dependent on the activation of MAPK pathway by stimulating with TNF-α in vitro. Therefore, this study could provide better understand for the progression of inflammation-related periodontal diseases.
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Duseja A, Chahal GS, Jain A, Mehta M, Ranjan A, Grover V. Association between nonalcoholic fatty liver disease and inflammatory periodontal disease: A case‑control study. J Indian Soc Periodontol 2021; 25:47-54. [PMID: 33642741 PMCID: PMC7904021 DOI: 10.4103/jisp.jisp_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background: Recent evidence suggests an interconnection between chronic periodontal disease and systemic diseases. Aim: The aim of this study is to evaluate the possible association between nonalcoholic fatty liver disease (NAFLD) and inflammatory periodontal disease among north Indian population. Settings and Design: Tertiary health care center, cross-sectional case-control observational study. Materials and Methods: A total of 40 cases, i.e., patients with NAFLD and 40 healthy volunteers were included over a period of 8 months and their periodontal status was compared. The status of their hepatic health was ascertained by anthropometric, imaging, and biochemical evaluation including ultrasound examination of abdomen and transient elastography. Statistical Data Analysis: Paired t-test, multivariate logistic regression analysis using IBM SPSS STATISTICS (version 22.0, Armonk, NY: IBM Corp). Results: The study revealed that only 11.9% and 20% of participants had periodontitis, in healthy controls and hepatic disease patients, respectively. A statistically significant difference was observed in clinical parameters of periodontal status, except for malocclusion. Comparative analysis of tumor necrosis factor-α (TNF-α), interleukin-6, C-reactive protein, and cytokeratin-18 revealed differences in mean scores, though statistically nonsignificant. Only aspartate transaminase, number of missing teeth, and bleeding on probing (BOP) were observed with higher odds ratios for hepatic disease patients. Spearman correlation analysis revealed significant positive correlations between TNF-α and BOP, for cases. Conclusion: Patients with hepatic disease showed a higher prevalence of periodontal disease, worse oral hygiene and periodontal health status compared to healthy individuals.
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Affiliation(s)
- Ajay Duseja
- Department of Hepatology, PGIMER, Panjab University, Chandigarh, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Manu Mehta
- Department of Hepatology, PGIMER, Panjab University, Chandigarh, India
| | - Aditya Ranjan
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Vishakha Grover
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
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Study on the Effects of Melatonin on Glycemic Control and Periodontal Parameters in Patients with Type II Diabetes Mellitus and Periodontal Disease. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57020140. [PMID: 33562452 PMCID: PMC7915328 DOI: 10.3390/medicina57020140] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/03/2022]
Abstract
Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth—PD; clinical attachment loss—CAL; bleeding on probing—BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.
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Machado V, Escalda C, Proença L, Mendes JJ, Botelho J. Is There a Bidirectional Association between Polycystic Ovarian Syndrome and Periodontitis? A Systematic Review and Meta-analysis. J Clin Med 2020; 9:jcm9061961. [PMID: 32585861 PMCID: PMC7355910 DOI: 10.3390/jcm9061961] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) has reproductive and metabolic properties that may be linked to periodontitis (PD). This study aimed to update and render a robust critical assessment on all evidence linking PCOS and PD, and appraising a hypothetical bidirectional association. Five databases (PubMed, Scholar, EMBASE, Web of Science and CENTRAL) were searched up to May 2020. Case-control and cohort studies on the association of PCOS and PD were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses of standardized mean difference (SMD) and risk ratio (RR) were performed. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Twelve case-controls fulfilled the inclusion criteria (876 with PCOS and 48170 healthy controls), all scored as having a low risk of bias. Meta-analysis revealed that PCOS females have 28% more risk towards PD, and PD females have 46% more risk to have PCOS. PCOS females with PD had higher gum bleeding, periodontal pocket depth and clinical attachment loss than non-PCOS females with PD. Populations with undefined periodontal status contribute to underestimated results. On the basis of the available evidence, it is possible to assume a bidirectional link between PCOS and PD. That is, PCOS increases by 28% the risk of having PD and in the same fashion, PD increases by 46% the risk of having PCOS. Furthermore, women with PCOS were associated with worsening clinical characteristics and inflammation of PD. These findings suggest that PCOS and PD may be linked. Hence, further prospective and clinical trial studies with nonsurgical periodontal therapy are necessary to clarify the existence of an increased risk of PCOS in women with PD and vice-versa.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
- Correspondence:
| | - Cláudia Escalda
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
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杜 芹, 马 歆. [Research progress of correlation between periodontal pathogens and systemic diseases]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:759-764. [PMID: 32897213 PMCID: PMC7277321 DOI: 10.12122/j.issn.1673-4254.2020.05.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 11/24/2022]
Abstract
Periodontal pathogens are the main pathogenic factor of periodontitis. Periodontal pathogens have a large variety of virulence factors such as lipopolysaccharide, fimbriae and proteases, which enables the pathogens to infect periodontal tissues and stimulate the secretion of inflammatory cytokines, causing chronic systemic inflammation. Periodontal pathogens may invade multiple systems such as the circulatory system, immune system, respiratory system and digestive system to cause systematic diseases. Recent studies have shown that periodontal pathogens may have close relations with systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and cancer. Among the periodontal pathogens, Porphyromonas gingivalis can be found in atherosclerotic plaques to impairing the function of the vascular endothelium; Porphyromonas gingivalis may also increase the level of inflammatory factors such as TNF-α to promote insulin resistance and diabetes. Many of the periodontal pathogens such as Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia can be detected in the synovial fluid of rheumatoid arthritis patients, suggesting their involvement in the pathogenesis of rheumatoid arthritis. Fusobacterium nucleatum may cause alterations in the intestinal microbiome in mice and promote the occurrence of intestinal tumors. Herein we review the recent progresses in the relationship between periodontal pathogens and systemic diseases.
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Affiliation(s)
- 芹 杜
- 四川省医学科学院//四川省人民医院口腔科,四川 成都 610072Department of Stomatlogy, Sichuan Academy of Medical Science & Sichuan People's Hospital, Chengdu 610072, China
- 电子科技大学附属医学院,四川 成都 610054School of Medicine, University of Electronic Science and Technology, Chengdu 610054, China
- 中国科学院成都生物研究所,四川 成都 610041Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, China
| | - 歆茹 马
- 四川省医学科学院//四川省人民医院口腔科,四川 成都 610072Department of Stomatlogy, Sichuan Academy of Medical Science & Sichuan People's Hospital, Chengdu 610072, China
- 遵义医科大学口腔医学院,贵州 遵义 563000School of Stomatology, Zunyi Medicial University, Zunyi 563000, China
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Minty M, Canceil T, Serino M, Burcelin R, Tercé F, Blasco-Baque V. Oral microbiota-induced periodontitis: a new risk factor of metabolic diseases. Rev Endocr Metab Disord 2019; 20:449-459. [PMID: 31741266 DOI: 10.1007/s11154-019-09526-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It has recently become evident that the periodontium (gingiva, desmodontal ligament, cementum and alveolar bone) and the associated microbiota play a pivotal role in regulating human health and diseases. The oral cavity is the second largest microbiota in the body with around 500 different bacterial species identified today. When disruption of oral cavity and dysbiosis occur, the proportion of strict anaerobic Gram-negative bacteria is then increased. Patients with periodontitis present 27 to 53% more risk to develop diabetes than the control population suggesting that periodontitis is an aggravating factor in the incidence of diabetes. Moreover, dysbiosis of oral microbiota is involved in both periodontal and metabolic disorders (cardiovascular diseases, dyslipidaemia …). The oral diabetic dysbiosis is characterized by a specific bacteria Porphyromonas, which is highly expressed in periodontal diseases and could exacerbate insulin resistance. In this review, we will address the nature of the oral microbiota and how it affects systemic pathologies with a bidirectional interaction. We also propose that using prebiotics like Akkermansia muciniphila may influence oral microbiota as novel therapeutic strategies. The discovery of the implication of oral microbiota for the control of metabolic diseases could be a new way for personalized medicine.
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Affiliation(s)
- Matthieu Minty
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Thibault Canceil
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Matteo Serino
- INSERM, INRA, ENVT, UPS, IRSD, Université de Toulouse, 31024, Toulouse, France
| | - Remy Burcelin
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - François Tercé
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Vincent Blasco-Baque
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France.
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France.
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France.
- INSERM UMR1048-I2MC Team 2 « Intestinal Risk Factors, Diabetes and Dyslipidemia » Building L4, 1st floor, Hospital of Rangueil 1, Avenue Jean Poulhès, 84225 31432, Toulouse Cedex 4 Lab, BP, France.
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Periodontal Treatment Experience Associated with Oral Health-Related Quality of Life in Patients with Poor Glycemic Control in Type 2 Diabetes: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204011. [PMID: 31635118 PMCID: PMC6843950 DOI: 10.3390/ijerph16204011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023]
Abstract
Severe periodontitis is a risk factor for poor glycemic control. The appropriate medical treatment and plaque control of periodontitis positively affects blood-sugar control in diabetes patients. We aimed to identify the factors associated with glycemic control and examine the periodontal treatment (PT) experience and oral health-related quality of life (OHQoL) for patients with poor glycemic control in type 2 diabetes mellitus (T2DM). This multicenter case–control study recruited 242 patients with poor glycemic control and 198 patients with good glycemic control. We collected patients’ information through face-to-face interviews using a structured questionnaire. The Oral Health Impact Profile-14 (OHIP-14) was used to measure OHQoL. Based on PT status, the patients were classified into three groups: a non-periodontal disease group, a PT group, and a non-PT (NPT) group. Regression models were used to analyze the data. No interdental cleaning (adjusted odds ratio (aOR) = 1.78) and positive attitudes toward periodontal health (aOR = 1.11) were significantly more likely to be associated with poor glycemic control in patients with T2DM. The PT group had a significantly lower OHIP-14 score than the NPT group (6.05 vs. 9.02, p < 0.001), indicating a better OHQoL among patients with poorly controlled T2DM. However, the OHQoL did not differ significantly in patients with well-controlled T2DM between the PT and NPT groups. This suggested that diabetic patients with poor glycemic control must improve periodontal care practices and receive proper PT, if necessary, to improve their OHQoL.
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Ninomiya M, Hashimoto M, Yamanouchi K, Fukumura Y, Nagata T, Naruishi K. Relationship of oral conditions to the incidence of infective endocarditis in periodontitis patients with valvular heart disease: a cross-sectional study. Clin Oral Investig 2019; 24:833-840. [PMID: 31197658 DOI: 10.1007/s00784-019-02973-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 06/06/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Infective endocarditis (IE) is a life-threatening infectious disease, but the pathogenesis of the disease remains uncertain. The objective of this study was to examine whether oral infectious conditions are associated with the occurrence of IE in valvular heart disease (VHD) patients. MATERIALS AND METHODS A total of 119 periodontitis (P) patients with or without VHD were enrolled, and cross-sectional analyses were performed. Patients were classified as follows: (1) mild-to-moderate P without VHD, (2) mild-to-moderate P with VHD, (3) severe P without VHD, or (4) severe P with VHD. A total of 78 VHD patients were classified as (1) VHD without IE or (2) VHD with IE. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI). RESULTS No significant differences were observed between patients with or without VHD in oral conditions. A significant increase in the percentage of alveolar bone loss in VHD patients with IE was observed compared with that of patients without IE. The ratio of both Porphyromonas gingivalis (Pg) IgG titer > 1.68 and Pg fimA type II genotype in patients with IE was significantly higher than in patients without IE. There was a significant correlation between the occurrence of IE and clinical oral findings (number of remaining teeth: OR, 0.17; rate of alveolar bone loss > 40%: OR, 11.8). CONCLUSIONS VHD patients with IE might have severe periodontitis compared with patients without IE, although further investigation will be needed because this is based on only 7 VHD patients with IE. CLINICAL RELEVANCE The patients with IE had fewer remaining teeth, more advanced bone resorption compared with those of patients without IE. These findings suggest a possible association between the occurrence of IE and periodontal infection.
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Affiliation(s)
- Masami Ninomiya
- Department of Periodontology and Endodontology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Mari Hashimoto
- Department of Periodontology and Endodontology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | | | - Yoshiaki Fukumura
- Department of Cardiovascular Surgery, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Toshihiko Nagata
- Department of Periodontology and Endodontology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Koji Naruishi
- Department of Periodontology and Endodontology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan.
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Choubaya C, Chahine R, Zalloua P, Salameh Z. Periodontitis and diabetes interrelationships in rats: biochemical and histopathological variables. J Diabetes Metab Disord 2019; 18:163-172. [PMID: 31275887 PMCID: PMC6581989 DOI: 10.1007/s40200-019-00403-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 04/12/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND A two-way relationship between diabetes and periodontitis is now clinically established. Both conditions share common mechanisms of pathogenesis that are related to altered immune-inflammatory responses at local and/or systemic levels. The aim of this study is to investigate whether periodontitis is associated with the development and progression of diabetes and to evaluate the health impact of coexistence of both diseases. MATERIAL AND METHODS Male Sprague Dawley rats (10 weeks old) were randomized into seven groups (n = 12): Group 1) Control; Groups 2 and 6) Periodontitis induced at two or six weeks; Groups 3 and 5) Diabetes induced at two or six weeks; Groups 4 and 7) Periodontitis followed by diabetes, and diabetes followed by periodontitis at two or six weeks. For diabetes induction, animals received a one-time intravenous injection of streptozotocin (50 mg/kg). Periodontitis was induced by Lipoppolysaccharide injection (20 μg/rat) through the palatal gingival and by placing a ligature of 0/0 braided silk around the cervix of the upper right second molar. Body weight, glycaemia as well as urine were collected weekly. Rats were sacrificed at the end of week 10, gingival tissue was removed, fixed in formaldehyde and processed for histopathological study. RESULTS Body weight was significantly decreased (25%) following diabetes induction (p < 0.01). 40% weight loss was observed when diabetes was induced first compared to 30% when periodontitis was first induced in the animals (p < 0.01). Rats treated with streptozotocin showed a three-fold increase in diabetes compared to the control group (p < 0.01). In rats where periodontitis was induced after diabetes, glucose levels increased significantly (450 mg/dL) compared to glucose levels (410 mg/dL) where periodontitis was induced first (p < 0.01). Histopathological studies showed greater alveolar bone loss when both diabetes and periodontitis were present. CONCLUSION When periodontitis occurs after diabetes it aggravates the symptoms of the two pathologies. When diabetes is induced after periodontitis, no symptoms aggravation is observed for diabetes, although periodontitis gets worse.
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Affiliation(s)
- Charbel Choubaya
- Department of Surgery, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
| | - Ramez Chahine
- Oxidative Stress and Antioxidant Research Team, Lebanese University and Faculty of Public Health La Sagesse University, Beirut, Lebanon
| | - Pierre Zalloua
- Faculty of Medicine, Lebanese American University, Byblos, Lebanon
| | - Ziad Salameh
- Department of Prosthodontics and Department of Research, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
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13
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Naruishi K, Nagata T. Biological effects of interleukin‐6 on Gingival Fibroblasts: Cytokine regulation in periodontitis. J Cell Physiol 2018; 233:6393-6400. [DOI: 10.1002/jcp.26521] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Koji Naruishi
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolKuramotoTokushimaJapan
| | - Toshihiko Nagata
- Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolKuramotoTokushimaJapan
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Basil YAA, Rakan SAD. Oral hygiene practice of adult diabetic patients and their awareness about oral health problems related to diabetes. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/jdoh2017.0219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Faramarzi M, Shirmohammadi A, Chitsazi M, Shamami MS, Ghanitab S. The clinical and metabolic effects of subgingival application of xanthan-based chlorhexidine gel in Type 2 diabetic patients with chronic periodontitis. Dent Res J (Isfahan) 2017; 14:299-305. [PMID: 29109743 PMCID: PMC5654223 DOI: 10.4103/1735-3327.215961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: There is a two-way relationship between periodontal disease and diabetes. The purpose of this study was to evaluate the clinical and metabolic effects of a xanthan-based chlorhexidine (CHX) gel used as an adjunct to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. Materials and Methods: Sixty-eight diabetic patients with moderate to advanced periodontitis and glycated hemoglobin (HbA1c) ≥6% were selected. The test group (n = 34) received scaling and root planning (SRP) plus xanthan-based CHX gel. The control group (n = 34) received single SRP. Fasting blood sugar (FBS) and HbA1c tests were done at the baseline and after 3 and 6 months. Data from the study were analyzed using descriptive statistics (mean ± standard deviation and frequency), ANOVA test by SPSS.15 software (SPSS Inc. Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Patients in test group exhibited a decrease in FBS from the baseline (227 ± 64.97) to the 3 and 6 months follow-up (208 ± 61.95 and 201 ± 61.33; P < 0.001). HbA1cb levels decreased from 7.72 ± 0.99 to 6.20 ± 0.97 and 6.06 ± 1.04 after 3 and 6 months follow-up (P < 0.001), respectively. Reduction of FBS and HbA1c was statistically significant after 3 and 6 months in the control group (P < 0.001). Conclusion: Considering the limitations of this study, the application of CHX gel might improve the effects of nonsurgical periodontal treatment in diabetic patients with periodontitis.
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Affiliation(s)
- Masoumeh Faramarzi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohammadi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadtaghi Chitsazi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoosh Sadighi Shamami
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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16
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Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, Koga T. The Severity of Periodontal Disease is Associated with the Development of Glucose Intolerance in Non-diabetics: The Hisayama Study. J Dent Res 2016; 83:485-90. [PMID: 15153457 DOI: 10.1177/154405910408300610] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammation is hypothesized to play a significant role in the development of type 2 diabetes; however, reports on clinical inflammatory conditions are limited. Studies have suggested that periodontitis affects glucose control in diabetics. This community-based study examined the relationship between periodontitis and glucose tolerance status, including changes in status. The relationship between periodontal condition and the results of a 75-g oral glucose tolerance test was examined in 961 adults in 1998. Deep pockets (mean pocket depth > 2.0 mm) were significantly associated with impaired glucose tolerance and with diabetes as compared with shallow pockets (< 1.3 mm). In the subgroup with normal glucose tolerance 10 years previously, subjects who subsequently developed impaired glucose tolerance were significantly more likely to have deep pockets. Deep pockets were closely related to current glucose tolerance status and the development of glucose intolerance.
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Affiliation(s)
- T Saito
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
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17
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Chiu HC, Fu MMJ, Yang TS, Fu E, Chiang CY, Tu HP, Chin YT, Lin FG, Shih KC. Effect of high glucose,Porphyromonas gingivalislipopolysaccharide and advanced glycation end-products on production of interleukin-6/-8 by gingival fibroblasts. J Periodontal Res 2016; 52:268-276. [DOI: 10.1111/jre.12391] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 01/10/2023]
Affiliation(s)
- H-C. Chiu
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
- Institute of Dental Sciences; National Defense Medical Center; Taipei Taiwan
| | - M. M-J. Fu
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
| | - T-S. Yang
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
- Institute of Dental Sciences; National Defense Medical Center; Taipei Taiwan
| | - E. Fu
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
- Institute of Dental Sciences; National Defense Medical Center; Taipei Taiwan
| | - C-Y. Chiang
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
- Institute of Dental Sciences; National Defense Medical Center; Taipei Taiwan
| | - H-P. Tu
- Department of Periodontology; School of Dentistry; National Defense Medical Center and Tri-Service General Hospital; Taipei Taiwan
| | - Y-T. Chin
- Institutes for Cancer Biology and Drug Discovery; Taipei Medical University; Taipei Taiwan
| | - F-G. Lin
- School of Public Health; National Defense Medical Center; Taipei Taiwan
| | - K-C. Shih
- Division of Endocrinology & Metabolism; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
- Division of Endocrinology & Metabolism; Taipei-Veteran General Hospital; Taipei Taiwan
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18
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Al Amri MD, Kellesarian SV, Al-Kheraif AA, Malmstrom H, Javed F, Romanos GE. Effect of oral hygiene maintenance on HbA1c levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients: 2 years follow-up. Clin Oral Implants Res 2016; 27:1439-1443. [PMID: 26756309 DOI: 10.1111/clr.12758] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the present 2-year follow-up study was to assess the effect of oral hygiene maintenance on hemoglobin Alc (HbA1c) levels and peri-implant parameters around immediately-loaded dental implants placed in type-2 diabetic patients with varying glycemic levels. MATERIAL AND METHODS Ninety-one individuals were divided into three groups. In group 1, 30 systemically healthy individuals were included (HbA1c < 6%). Patients in group 2 and 3, comprised of 30 patients with T2DM (HbA1c 6.1-8%); and 31 patients with T2DM (HbA1c 8.1-10%) respectively. In all groups, patients received immediately loaded bone level implants. All participants were enrolled in a 6 monthly periodontal/peri-implant maintenance program. Peri-implant bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL) were measured at 6, 12, and 24 months of follow-up. RESULTS Mean preoperative HbA1c levels in patients in groups 1, 2, and 3 were 4.5%, 6.8%, and 8.7% respectively. In group-1, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in groups 2 and 3, there was a significant decrease in HbA1c levels at 24-months follow-up than 6-months follow-up. At 6 months follow-up, BOP, PD, and MBL were significantly higher among patients in group-3 than group-1. At 12 and 24 months follow-up, there was no significant difference in BOP, PD, and MBL in all groups. CONCLUSIONS Oral hygiene maintenance reduces hyperglycemia and peri-implant inflammatory parameters around immediately loaded dental implants placed in type 2 diabetic patients.
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Affiliation(s)
- Mohammad D Al Amri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hans Malmstrom
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, New York, NY, USA. .,Department of Oral Surgery and Implant Dentistry, Dental School Frankfurt, Frankfurt, Germany.
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19
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Abstract
The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health.
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20
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Suvan J, Needleman I, Moles DR, Tonetti M. Local delivery antimicrobials for chronic periodontitis. Hippokratia 2015. [DOI: 10.1002/14651858.cd004939.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jean Suvan
- UCL Eastman Dental Institute; Periodontology Unit, Division of Restorative Dental Services; 256 Gray's Inn Road London UK WC1X 8LD
| | - Ian Needleman
- UCL Eastman Dental Institute; Unit of Periodontology and International Centre for Evidence-Based Oral Healthcare; 256 Gray's Inn Road London UK WC1X 8LD
| | - David R Moles
- Peninsula Dental School; Oral Health Services Research; The John Bull Building, Tamar Science Park, Research Way Plymouth UK PL6 8BU
| | - Maurizio Tonetti
- European Research Group on Periodontology (ERGOPERIO); Berne Switzerland
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21
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The potential oral health impact of cost barriers to dental care: findings from a Canadian population-based study. BMC Oral Health 2014; 14:78. [PMID: 24962622 PMCID: PMC4079168 DOI: 10.1186/1472-6831-14-78] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 06/11/2014] [Indexed: 12/22/2022] Open
Abstract
Background Prior to the 2007/09 Canadian Health Measures Survey, there was no nationally representative clinical data on the oral health of Canadians experiencing cost barriers to dental care. The aim of this study was to determine the oral health status and dental treatment needs of Canadians reporting cost barriers to dental care. Methods A secondary data analysis of the 2007/09 Canadian Health Measures Survey was undertaken using a sample of 5,586 Canadians aged 6 to 79. Chi square tests were conducted to test the association between reporting cost barriers to care and oral health outcomes. Logistic regressions were conducted to identify predictors of reporting cost barriers. Results Individuals who reported cost barriers to dental care had poorer oral health and more treatment needs compared to their counterparts. Conclusions Avoiding dental care and/or foregoing recommended treatment because of cost may contribute to poor oral health. This study substantiates the potential likelihood of progressive dental problems caused by an inability to treat existing conditions due to financial barriers.
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Abstract
UNLABELLED Periodontal debridement (PD) remains a gold standard for the treatment of inflammatory periodontitis. BACKGROUND/PURPOSE The evidence base regarding the causal relationship between oral biofilm and the host inflammatory response to the etiology of periodontal disease has substantially increased over the years. What has not changed significantly during that time is the conservative manner in which the disease can be treated with periodontal debridement (PD). Since dental hygienists, in particular, specialize in providing these procedures it is important to evaluate the evidence that supports periodontal debridement as a primary and fundamental treatment modality. METHOD An extensive narrative literature review that included systematic reviews, examined traditional PD, the use of adjuncts to enhance PD and newer PD procedures to determine what are the best practices for achieving optimal clinical outcomes. CONCLUSION Compared to surgical therapy, PD results in maintenance of attachment levels over time, but is not as effective in the initial reduction of probing depths in deep pockets. Sustained release local drug delivery agents have some modest adjunctive effects when used with PD, as do systemic antibiotics in aggressive periodontitis cases. Reported analyses of the long term effects of chemotherapeutic agents usually do not extend beyond a few months to a year. While laser therapy is still under investigation it remains as a potential PD therapy. New instruments being refined to better visualize the root surface either non-surgically or with mini papilla reflection flaps, hold promise for the future when they become more affordable and accessible. Despite the development of new technology, it still appears that periodontal debridement (PD) remains the gold standard for the treatment of inflammatory periodontitis.
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Affiliation(s)
- Connie L Drisko
- GRU & GRHS Leadership Academy (GLA), Georgia Regents University, Augusta, GA 30912, USA.
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23
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Effect of nonsurgical periodontal therapy (with or without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes: a short-term longitudinal randomized case-control study. Clin Oral Investig 2014; 18:1963-8. [PMID: 24449228 DOI: 10.1007/s00784-014-1185-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/06/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of the present short-term longitudinal randomized case-control study was to assess the effect of nonsurgical periodontal therapy (NSPT) (with and without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes. MATERIAL AND METHODS Sixty-six patients with prediabetes and periodontal disease were included. Characteristics of the study cohort (age, gender, socioeconomic status [SES] education status, duration of prediabetes, and type of treatment adopted for prediabetes management) were recorded. Patients were randomly divided into two groups (33 patients/group). In group 1, scaling and root planing (SRP) was performed, and in group-2, patients underwent SRP and oral doxycycline (100 mg) administration once daily for 15 days. In each group, the following parameters were investigated at baseline and after 3 months: (a) fasting blood glucose level (FBGL), (b) hemoglobin A1c (HbA1c), and (c) periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment loss [AL]). Statistical analysis was performed using Student's t test. RESULTS There was no significant difference in age, gender, SES, education status, and duration and treatment of prediabetes among individuals in groups 1 and 2. Three months post-NSPT, FBGL and HbA1c were significantly reduced among patients in group 1 (P < 0.05) and group 2 (P < 0.05) compared to baseline. Three months post-NSPT, PI (P < 0.05), BOP (P < 0.05), and PD (P < 0.05) were significantly reduced among patients in group 1 (P < 0.05) and group 2 (P < 0.05) compared to baseline. There was no difference in clinical AL between the groups after 3 months of NSPT. CONCLUSION NSPT (with and without oral doxycycline delivery) reduces hyperglycemia and periodontal inflammation in patients with prediabetes.
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Patel SP, Raju PA. Resistin in serum and gingival crevicular fluid as a marker of periodontal inflammation and its correlation with single-nucleotide polymorphism in human resistin gene at -420. Contemp Clin Dent 2013; 4:192-7. [PMID: 24015008 PMCID: PMC3757881 DOI: 10.4103/0976-237x.114878] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIMS Resistin is an adipocytokine, which have been studied for its role in insulin resistance and recently in inflammation. The aim of the present study is to assess the concentration of resistin in serum and gingival crevicular fluid (GCF) and to compare the levels between subjects with and without periodontitis and type 2 diabetes mellitus (T2DM) and to further correlate the resistin levels with the single-nucleotide polymorphism (SNP) at -420. SETTING AND DESIGNS A total of 96 subjects (48 males and 48 females) were divided on the basis of gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL) and hemoglobin A1c levels into healthy (group 1, n = 24), uncontrolled-diabetes related periodontitis (group 2, n = 24), controlled-diabetes related periodontitis (group 3, n = 24) and chronic periodontitis without T2DM (group 4, n = 24). MATERIALS AND METHODS The GCF and serum levels of resistin were quantified using the enzyme-linked immunosorbent assay and compared among the study groups. Further, the association of the resistin levels with periodontal inflammation and SNP at -420 was studied. RESULTS AND CONCLUSION The resistin levels in GCF and serum from patients with periodontitis or diabetes mellitus related periodontitis (controlled or uncontrolled) were higher than that of healthy subjects and correlated positively with GI. Further, subjects with GG genotype at -420 showed significantly higher GI, PD, CAL as compared with genotype group CC. Resistin was detected in all serum and GCF samples and was significantly higher in periodontitis. Further, GG genotype at -420 was associated significantly with periodontal inflammation and resistin levels.
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Affiliation(s)
- Swati Pradeep Patel
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
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25
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Promsudthi A, Poomsawat S, Limsricharoen W. The role of Toll-like receptor 2 and 4 in gingival tissues of chronic periodontitis subjects with type 2 diabetes. J Periodontal Res 2013; 49:346-54. [PMID: 23844856 DOI: 10.1111/jre.12112] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Diabetes is one important risk factor of chronic periodontitis. However, the roles of toll-like receptor (TLR) 2 and TLR4, which are implicated in the inflammatory process in both chronic periodontitis and diabetes, have not been studied. This study aimed to determine whether TLR2 and TLR4 might be involved in the relationship between chronic periodontitis and diabetes by examining TLR2 and TLR4 expression in gingival tissues from subjects with chronic periodontitis without diabetes (CP) and with diabetes (CP+DM) and from periodontally healthy subjects without diabetes (PH) and with diabetes (PH+DM). MATERIAL AND METHODS Gingival tissues were collected from 23 CP subjects, 21 CP+DM subjects, 22 PH subjects and 20 PH+DM subjects. The expression of TLR2 and TLR4 in gingival tissues was determined using an immunohistochemical method. In gingival epithelium, staining patterns and intensity levels of TLR2 and TLR4 expression were studied. In connective tissues, the percentages of TLR2- and TLR4-positive cells were calculated. The intensity levels and the percentages of positive cells were statistically analyzed. RESULTS Chronic periodontitis or diabetes showed no significant effect on TLR2 expression in the oral epithelium. However, diabetes increased the expression of TLR2 in sulcular epithelium and changed the pattern of TLR2 expression in gingival epithelium. Chronic periodontitis decreased the expression of TLR4 in gingival epithelium. In connective tissue under sulcular epithelium, CP+DM subjects showed statistically significant higher percentages of TLR2- and TLR4-positive cells compared with PH and PH+DM subjects. CONCLUSION Our results suggest that hyperglycemia and chronic periodontitis had effects on TLR2 and TLR4 expression in gingival tissue. The differences in TLR2 and TLR4 expression could contribute to a greater inflammatory response, leading to periodontal disease initiation and progression.
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Affiliation(s)
- A Promsudthi
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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26
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Shetty D, Dua M, Kumar K, Dhanapal R, Astekar M, Shetty DC. Oral hygiene status of individuals with cardiovascular diseases and associated risk factors. Clin Pract 2012; 2:e86. [PMID: 24765485 PMCID: PMC3981199 DOI: 10.4081/cp.2012.e86] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 07/30/2012] [Accepted: 08/30/2012] [Indexed: 12/21/2022] Open
Abstract
Dentist and oral health screening may be the latest weapon in identifying persons at risk of cardiovascular disease. Oral infections, specifically periodontitis, may confer independent risks for different systemic conditions. The risk factors associated with cardiovascular diseases also suggest that the relationship between periodontal disease and diabetes works in both ways. The aim of this study was to support and strengthen the association and relationship between oral hygiene status of individuals with cardiovascular diseases and its associated risk factors. A simple random sampling was carried out in 200 inhabitants of Western Utter Pradesh, India. An oral health visit and examination was made for an equal number of males and females of different age groups with cardiovascular diseases. Evaluation of the oral status was made by means of an oral hygiene index, community periodontal index of treatment needs and loss of attachment. Evaluation of oral status in patients with cardiovascular diseases and in the control group has shown a statistically significant low level of oral health in patients with cardiovascular diseases as compared to control. Prevalence of systemic diseases in different age groups significantly correlated with the prevalence of severe periodontal diseases. Treating gum disease may reduce the risk of heart disease and improve health outcomes for patients with periodontal disease and vascular heart problems.
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Affiliation(s)
- Divya Shetty
- Department of Orthodontics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad (U.P)
| | - Mahima Dua
- Oral and Maxillofacial Pathology and Microbiology, Inderprastha Dental College, Sahibabad, Ghaziabad (U.P)
| | - Kiran Kumar
- Oral and Maxillofacial Pathology and Microbiology, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad (U.P)
| | - Raghu Dhanapal
- Oral and Maxillofacial Pathology and Microbiology, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad (U.P)
| | - Madhusudan Astekar
- Oral and Maxillofacial Pathology and Microbiology, Pacific Dental College and Hospital, Debari, Udaipur, Rajasthan, India
| | - Devi Charan Shetty
- Oral and Maxillofacial Pathology and Microbiology, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad (U.P)
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Özdemir SP, Kurtiş B, Tüter G, Bozkurt Ş, Gültekin SE, Sengüven B, Watanabe K, Aydın S. Effects of Low-Dose Doxycycline and Bisphosphonate Clodronate on Alveolar Bone Loss and Gingival Levels of Matrix Metalloproteinase-9 and Interleukin-1β in Rats With Diabetes: A Histomorphometric and Immunohistochemical Study. J Periodontol 2012; 83:1172-82. [DOI: 10.1902/jop.2012.110459] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Marlow NM, Slate EH, Fernandes JK, Leite RS. Associations between health insurance and generalized periodontal disease in a study population of Gullah African Americans with type-2 diabetes. Community Dent Oral Epidemiol 2012; 41:40-7. [PMID: 22882563 DOI: 10.1111/j.1600-0528.2012.00737.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 06/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore the relationship between health insurance status (Medicare, Medicaid, private, and uninsured) and generalized periodontal disease (GPD) among a study population (N = 245) of adult Gullah African Americans with type-2 diabetes mellitus (T2DM) ages <65 years. METHODS We used multivariable logistic regression to assess GPD [using three different and increasingly severe clinical assessments: 3, 4, and 5 mm clinical attachment level (CAL) at 30% of sites] according to health insurance status. RESULTS Prevalence of GPD was 33.06% for 3, 18.78% for 4, and 9.80% for 5 mm CAL. Age ranged 26-64 years (mean = 52.11, SD = 8.53, median = 53). Private insurance was most prevalent (39.59%), followed by uninsured (30.61%), Medicaid (16.33%), and Medicare (13.47%). Results showed increased odds (versus private insurance) for GPD at 3 mm among Medicaid (OR = 1.82, P = 0.2404), Medicare (OR = 3.34, P = 0.0103), and uninsured (OR = 1.96, P = 0.0956) groups; GPD at 4 mm among Medicaid (OR = 1.97, P = 0.3303), Medicare (OR = 5.02, P = 0.0121), and uninsured (OR = 3.38, P = 0.0319) groups; and GPD at 5 mm among Medicaid (OR = 1.21, P = 0.8507), Medicare (OR = 12.62, P = 0.0038), and uninsured (OR = 4.00, P = 0.0763) groups. CONCLUSIONS We observed substantial disparities for GPD severity among those without private health insurance even after adjusting for glycemic control, income, dental health behaviors, and other covariates. Improved insurance benefits as well as individualized oral health educational interventions may decrease GPD severity for this study population of younger (ages <65 years) Gullah African Americans with T2DM, particularly those with Medicare insurance.
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Moeintaghavi A, Arab HR, Bozorgnia Y, Kianoush K, Alizadeh M. Non-surgical periodontal therapy affects metabolic control in diabetics: a randomized controlled clinical trial. Aust Dent J 2012; 57:31-7. [PMID: 22369555 DOI: 10.1111/j.1834-7819.2011.01652.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Periodontal diseases and diabetes are two common diseases with high prevalence. Many clinicians have accepted the relationship between these two diseases. Some investigators have reported that periodontal treatment may enhance the metabolic control of diabetes. The effects of non-surgical periodontal treatment on metabolic control in people with type 2 diabetes mellitus (DM2) were examined. METHODS Forty patients with DM2 and chronic periodontitis [mean age = 50.29 years; mean glycated haemoglobin (HbA1c) = 8.72] were randomly assigned to two groups. The treatment group (n = 22) received full-mouth scaling and root planing, whereas the control group (n = 18) received no periodontal treatment. Gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), fasting plasma glucose (FPG), HbA1c, total cholesterol (TC), triglyceride (TG) and cholesterol levels were recorded at baseline and compared to data collected three months later. RESULTS The groups did not differ in gender ratio, age or clinical parameters [PPD (p = 0.107), CAL (p = 0.888), PI (p = 0.180)] and biochemical markers at baseline [FPG (p = 0.429), HbA1c (p = 0.304), TG (p = 0.486), TC (p = 0.942), LDL (p = 0.856) and HDL (p = 0.881)]. FPG, HbA1c and clinical parameters differed between the treatment and control groups (p = 0.006, 0.003 and 0, respectively). From baseline to follow-up (after three months), HbA1c levels decreased in the treated group (p = 0.003). In the same time period, FPG, GI, PPD and CAL increased in the control group (p = 0.016, 0.0, 0.0 and 0.004, respectively) but HbA1c did not change significantly. CONCLUSIONS Non-surgical periodontal therapy could improve metabolic control in diabetic patients.
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Affiliation(s)
- A Moeintaghavi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Jawed M, Khan RN, Shahid SM, Azhar A. Protective effects of salivary factors in dental caries in diabetic patients of Pakistan. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:947304. [PMID: 22778718 PMCID: PMC3388590 DOI: 10.1155/2012/947304] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 05/06/2012] [Indexed: 01/22/2023]
Abstract
Salivary factors have been studied for their effects on the process of dental caries in patients of diabetes mellitus type 2. In this study, protective role of salivary pH, salivary flow rate, and salivary calcium is assessed in the patients of diabetes mellitus type 2 with dental caries. The samples of saliva were collected from 400 patients of diabetes mellitus type 2 and 300 age- and sex- matched controls after getting informed consent. All the subjects were classified into four groups according to age. The severity of dental caries was counted by decayed, missed, and filled teeth (DMFT) score. The salivary pH, flow rate, and calcium levels were found to be low in patients as compared to controls. The levels of fasting blood sugar, HbA1c, and DMFT score were found to be significantly high in patients than controls. The glycemic factors were significantly correlated with salivary factors indicating their influence on progression of caries in diabetes. On the basis of findings, it is concluded that the suitable salivary pH and flow rate may be regarded as main protective factors against dental caries in diabetes. Optimum level of salivary calcium may be responsible for continuous supply of calcium to arrest the demineralization and help reduce the occurrence of dental caries.
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Affiliation(s)
- Muhammad Jawed
- Department of Biochemistry, Liaquat College of Medicine and Dentistry, Karachi 75290, Pakistan
| | - Rashid N. Khan
- Department of Medicine, Liaquat College of Medicine and Dentistry, Karachi 75290, Pakistan
| | - Syed M. Shahid
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
| | - Abid Azhar
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
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Chan HH, Rahim ZHA, Jessie K, Hashim OH, Taiyeb-Ali TB. Salivary proteins associated with periodontitis in patients with Type 2 diabetes mellitus. Int J Mol Sci 2012; 13:4642-4654. [PMID: 22606001 PMCID: PMC3344237 DOI: 10.3390/ijms13044642] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 03/23/2012] [Accepted: 03/31/2012] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to investigate the salivary proteins that are associated with periodontitis in patients with Type 2 diabetes mellitus (T2DM). Volunteers for the study were patients from the Diabetic Unit, University of Malaya Medical Centre, whose periodontal status was determined. The diabetic volunteers were divided into two groups, i.e., patients with periodontitis and those who were periodontally healthy. Saliva samples were collected and treated with 10% TCA/acetone/20 mM DTT to precipitate the proteins, which were then separated using two-dimensional polyacrylamide gel electrophoresis. Gel images were scanned using the GS-800TM Calibrated Densitometer. The protein spots were analyzed and expressed in percentage volumes. The percentage volume of each protein spot was subjected to Mann-Whitney statistical analysis using SPSS software and false discovery rate correction. When the expression of the salivary proteins was compared between the T2DM patients with periodontitis with those who were periodontally healthy, seven proteins, including polymeric immunoglobulin receptor, plastin-2, actin related protein 3, leukocyte elastase inhibitor, carbonic anhydrases 6, immunoglobulin J and interleukin-1 receptor antagonist, were found to be differentially expressed (p < 0.01304). This implies that the proteins may have the potential to be used as biomarkers for the prediction of T2DM patients who may be prone to periodontitis.
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Affiliation(s)
- Hang Haw Chan
- Department of Oral Biology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; E-Mails: (H.H.C.); (K.J.)
| | - Zubaidah H. A. Rahim
- Department of Oral Biology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; E-Mails: (H.H.C.); (K.J.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +603-79674851; Fax: +603-79674536
| | - Kala Jessie
- Department of Oral Biology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; E-Mails: (H.H.C.); (K.J.)
| | - Onn H. Hashim
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; E-Mail:
- University of Malaya Centre for Proteomics Research, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Tara B. Taiyeb-Ali
- Department of Oral Pathology and Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; E-Mail:
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Grubbs V, Plantinga LC, Tuot DS, Powe NR. Chronic kidney disease and use of dental services in a United States public healthcare system: a retrospective cohort study. BMC Nephrol 2012; 13:16. [PMID: 22471751 PMCID: PMC3368751 DOI: 10.1186/1471-2369-13-16] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 04/02/2012] [Indexed: 11/10/2022] Open
Abstract
Background As several studies have shown an association between periodontal disease and chronic kidney disease (CKD), regular dental care may be an important strategy for reducing the burden of CKD. Access to dental care may be limited in the US public health system. Methods In this retrospective cohort study of 6,498 adult patients with (n = 2,235) and without (n = 4,263) CKD and at least 12 months of follow-up within the San Francisco Department of Public Health Community Health Network clinical databases, we examined the likelihood of having a dental visit within the observation period (2005-2010) using Cox proportional hazards models. To determine whether dental visits reflected a uniform approach to preventive service use in this setting, we similarly examined the likelihood of having an eye visit among those with diabetes, for whom regular retinopathy screening is recommended. We defined CKD status by average estimated glomerular filtration rate based on two or more creatinine measurements ≥ 3 months apart (no CKD, ≥ 60 ml/min/1.73 m2; CKD, < 60 ml/min/1.73 m2). Results Only 11.0% and 17.4% of patients with and without CKD, respectively, had at least one dental visit. Those with CKD had a 25% lower likelihood of having a dental visit [HR = 0.75, 95% CI (0.64-0.88)] than those without CKD after adjustment for confounders. Among the subgroup of patients with diabetes, 11.8% vs. 17.2% of those with and without CKD had a dental visit, while 58.8% vs. 57.8% had an eye visit. Conclusions Dental visits, but not eye visits, in a US public healthcare setting are extremely low, particularly among patients with CKD. Given the emerging association between oral health and CKD, addressing factors that impede dental access may be important for reducing the disparate burden of CKD in this population.
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Affiliation(s)
- Vanessa Grubbs
- San Francisco General Hospital, Division of Nephrology, University of California, San Francisco, USA.
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López R, Baelum V. Contesting conventional periodontal wisdom: implications for periodontal classifications. Community Dent Oral Epidemiol 2012; 40:385-95. [DOI: 10.1111/j.1600-0528.2012.00677.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 01/18/2012] [Indexed: 01/06/2023]
Affiliation(s)
- Rodrigo López
- Department of Periodontology; Faculty of Health Sciences; Aarhus University; Aarhus; Denmark
| | - Vibeke Baelum
- Department of Epidemiology; School of Dentistry; Faculty of Health Sciences; Aarhus University; Aarhus; Denmark
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Burcelin R, Serino M, Chabo C, Blasco-Baque V, Amar J. Gut microbiota and diabetes: from pathogenesis to therapeutic perspective. Acta Diabetol 2011; 48:257-273. [PMID: 21964884 PMCID: PMC3224226 DOI: 10.1007/s00592-011-0333-6] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 09/01/2011] [Indexed: 12/13/2022]
Abstract
More than several hundreds of millions of people will be diabetic and obese over the next decades in front of which the actual therapeutic approaches aim at treating the consequences rather than causes of the impaired metabolism. This strategy is not efficient and new paradigms should be found. The wide analysis of the genome cannot predict or explain more than 10-20% of the disease, whereas changes in feeding and social behavior have certainly a major impact. However, the molecular mechanisms linking environmental factors and genetic susceptibility were so far not envisioned until the recent discovery of a hidden source of genomic diversity, i.e., the metagenome. More than 3 million genes from several hundreds of species constitute our intestinal microbiome. First key experiments have demonstrated that this biome can by itself transfer metabolic disease. The mechanisms are unknown but could be involved in the modulation of energy harvesting capacity by the host as well as the low-grade inflammation and the corresponding immune response on adipose tissue plasticity, hepatic steatosis, insulin resistance and even the secondary cardiovascular events. Secreted bacterial factors reach the circulating blood, and even full bacteria from intestinal microbiota can reach tissues where inflammation is triggered. The last 5 years have demonstrated that intestinal microbiota, at its molecular level, is a causal factor early in the development of the diseases. Nonetheless, much more need to be uncovered in order to identify first, new predictive biomarkers so that preventive strategies based on pre- and probiotics, and second, new therapeutic strategies against the cause rather than the consequence of hyperglycemia and body weight gain.
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Affiliation(s)
- Rémy Burcelin
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1048, Toulouse, France.
- Université de Toulouse, UPS, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 31432, Toulouse cedex 4, France.
| | - Matteo Serino
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1048, Toulouse, France
- Université de Toulouse, UPS, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 31432, Toulouse cedex 4, France
| | - Chantal Chabo
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1048, Toulouse, France
- Université de Toulouse, UPS, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 31432, Toulouse cedex 4, France
| | - Vincent Blasco-Baque
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1048, Toulouse, France
- Université de Toulouse, UPS, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 31432, Toulouse cedex 4, France
| | - Jacques Amar
- Department of Therapeutics, Rangueil Hospital, Toulouse, France
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Oral health awareness in adult patients with diabetes: a questionnaire study. Br Dent J 2011; 211:E12. [PMID: 21941301 DOI: 10.1038/sj.bdj.2011.769] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2011] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate oral health awareness, oral hygiene and attitudes towards general dental practitioners' (GDP) involvement in diabetes screening in adults with diabetes. DESIGN Self-completion questionnaire. SETTING General medical practices in Warwickshire. SUBJECTS AND METHODS Adults with diabetes attending clinics run by practice or diabetes nurses in general medical practices. RESULTS Two hundred and twenty-nine of 615 (37.2%) questionnaires were completed in 14 general medical practices. The majority of respondents (79.8%, 178/223) visited a dentist once or twice a year, but oral care varied; 67.2% (133/198) reported brushing at least twice a day, whereas only 15.3% (29/190) flossed daily. Awareness of oral health risks was limited: 69.1% (150/217) had never received any oral health advice related to their diabetes. Over half of respondents supported the idea of dentists offering screening for diabetes (121/226, 53.5%). CONCLUSIONS Many adults with diabetes have poor awareness of oral care and health complications associated with diabetes, and are receiving limited advice from healthcare professionals. Training and advice for both healthcare professionals and patients concerning the importance of good oral health in patients with diabetes is needed. The role of dentists in diabetes screening and support requires further investigation.
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Zhang P, Liu J, Xu Q, Harber G, Feng X, Michalek SM, Katz J. TLR2-dependent modulation of osteoclastogenesis by Porphyromonas gingivalis through differential induction of NFATc1 and NF-kappaB. J Biol Chem 2011; 286:24159-69. [PMID: 21566133 DOI: 10.1074/jbc.m110.198085] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Osteolytic diseases, including rheumatoid arthritis, osteomyelitis, and periodontitis, are usually associated with bacterial infections. However, the precise mechanisms by which bacteria induce bone loss still remain unclear. Evidence exists that Toll-like receptor (TLR) signaling regulates both inflammation and bone metabolism and that the receptor activator of NF-κB ligand (RANKL) and its receptor RANK are the key regulators for bone remodeling and for the activation of osteoclasts. Here, we investigate the direct effects of the periodontal pathogen Porphyromonas gingivalis on osteoclast differentiation and show that P. gingivalis differentially modulates RANKL-induced osteoclast formation contingent on the state of differentiation of osteoclast precursors. In addition, although an optimal induction of cytokines by P. gingivalis is dependent on TLR2 and TLR4, as well as myeloid differentiation factor 88 and Toll/IL-1R domain-containing adaptor-inducing IFN-β, P. gingivalis utilizes TLR2/ myeloid differentiation factor 88 in modulating osteoclast differentiation. P. gingivalis modulates RANKL-induced osteoclast formation by differential induction of NFATc1 and c-Fos. More importantly, RANKL-mediated lineage commitment also has an impact on P. gingivalis-induced cytokine production. RANKL inhibits P. gingivalis-induced cytokine production by down-regulation of TLR/NF-κB and up-regulation of NFATc1. Our findings reveal novel aspects of the interactions between TLR and RANK signaling and provide a new model for understanding the mechanism underlying the pathogenesis of bacteria-mediated bone loss.
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Affiliation(s)
- Ping Zhang
- Department of Pediatric Dentistry, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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Jawed M, Shahid SM, Qader SA, Azhar A. Dental caries in diabetes mellitus: role of salivary flow rate and minerals. J Diabetes Complications 2011; 25:183-6. [PMID: 20801061 DOI: 10.1016/j.jdiacomp.2010.07.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 07/13/2010] [Indexed: 01/08/2023]
Abstract
This study was designed to evaluate the possible protective role of salivary factors like salivary flow rate and adequate level of calcium, phosphate, and fluoride in diabetes mellitus type 2 patients with dental caries. A total of 398 diabetes mellitus type 2 patients with dental caries and 395 age- and sex-matched non-diabetic subjects with dental caries were included as controls, all of whom gave informed consent. All subjects were divided into four groups according to their age. Decayed, missed, and filled teeth (DMFT) were scored to indicate the severity of dental caries. Saliva was collected, flow rate was noted, and calcium, phosphate, and fluoride were analyzed. The blood glucose, HbA1c, and DMFT indices were found to be significantly high in diabetic patients as compared to controls. The salivary flow rate, calcium, phosphate, and fluoride were found to be significantly low whereas no significant difference was found in salivary magnesium in patients as compared to controls. Optimum salivary flow rate is responsible for establishing protective environment against dental caries. Adequate level of salivary calcium, phosphate, and fluoride is also involved in significant deposition of these minerals in plaque, which greatly reduces the development of caries in the adjacent enamel of teeth.
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Affiliation(s)
- Muhammad Jawed
- Department of Biochemistry, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
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Marlow NM, Slate EH, Bandyopadhyay D, Fernandes JK, Leite RS. Health insurance status is associated with periodontal disease progression among Gullah African-Americans with type 2 diabetes mellitus. J Public Health Dent 2011; 71:143-51. [PMID: 21774138 PMCID: PMC4234040 DOI: 10.1111/j.1752-7325.2011.00243.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2023]
Abstract
OBJECTIVES Assess periodontal disease progression among GullahAfrican Americans with type 2 diabetes mellitus (T2DM) according to health insurance coverage. METHODS From an ongoing clinical trial among T2DM Gullah, we extracted a cohort that was previously enrolled in a cross-sectional study (N=93). Comparing prior exam to trial initiation, total tooth sites/person with periodontal disease progression events [evaluated separately: 2+ mm of clinical attachment loss (CAL), 2+ mm increased periodontal probing depths (PPD), bleeding on probing (BOP) emergence] were evaluated according to health insurance coverage using regression techniques appropriate for data with different counts of potential events per subject (varying tooth sites available). We used negative binomial regression techniques to account for overdispersion and fit multivariable models that also included baseline glycemic control (poor: glycated hemoglobin > OR =7 percent, well: glycated hemoglobin <7 percent), history of established periodontitis, age, gender, body mass index, annual income, and oral hygiene behaviors. Final models included health insurance status, other significant predictors, and any observed confounders. RESULTS Privately insured were most prevalent (41.94 percent), followed by uninsured (23.66 percent), Medicare (19.35 percent), and Medicaid (15.05 percent). Those with poor glycemic control (65.59 percent) were more prevalent than well-controlled (34.41 percent). CAL events ranged from 0 to 58.8 percent tooth sites/ person (11.83 +/- 12.44 percent), while PPD events ranged from 0 to 44.2 percent (8.66 +/- 10.97 percent) and BOP events ranged from 0 to 95.8 percent (23.65 +/- 17.21 percent). Rates of CAL events were increased among those who were uninsured [rate ratio (RR) = 1.75, P = 0.02], Medicare-insured (RR = 1.90, P = 0.03), and Medicaid-insured (RR = 1.89, P = 0.06). CONCLUSIONS Increased access to health care, including dental services, may achieve reduction in chronic periodontal disease progression (as determined by CAL) for this study population. These results are very timely given the March 2010 passing of the US healthcare reform bills.
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Affiliation(s)
- Nicole M Marlow
- Division of Biostatistics and Epidemiology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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Stashenko P, Van Dyke T, Tully P, Kent R, Sonis S, Tanner ACR. Inflammation and genetic risk indicators for early periodontitis in adults. J Periodontol 2010; 82:588-96. [PMID: 21054222 DOI: 10.1902/jop.2010.100443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND This report is a further analysis of a study designed to determine clinical and microbial risk indicators for progressing periodontitis. METHODS One hundred ninety subjects who were periodontally healthy or had early signs of periodontitis (age range: 20 to 40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. At each visit, gingival crevicular fluid (GCF) and blood were collected for determination of interleukin (IL)-1β content (in GCF) and IL-1 genotype (in blood). Interproximal sites with a >1.5-mm increase in clinical attachment over 18 months were considered disease active. Characteristics were compared between active and inactive subjects. RESULTS IL-1β levels in GCF increased with the severity of disease and correlated well with clinical signs of incipient disease. However, the IL-1 genotype did not show any significant associations with disease or the extent of disease. CONCLUSION Indicators of inflammation may be important clinical determinants of future periodontal disease progression, but the IL-1 genotype was not a risk indictor for early (slight) periodontitis as defined in this subject population.
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Affiliation(s)
- Philip Stashenko
- Department of Cytokine Biology, The Forsyth Institute, Boston, MA, USA
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Effects of gender on serum biomarkers of systemic inflammation coincident to experimentally-induced periapical lesions. Arch Oral Biol 2010; 56:168-76. [PMID: 20943210 DOI: 10.1016/j.archoralbio.2010.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 08/18/2010] [Accepted: 09/13/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The literature suggests that females have less adverse effects to infection than males, due to the protective effects of oestrogen. The purpose of our study is to compare the systemic effects of induced periapical lesions between groups of animals with various serum concentrations of oestrogen. METHODS To induce periapical inflammation, two molar tooth pulps were exposed in ovariectomized (OVX) and normal female (F) and castrated (Cast-M) and normal male (M) Sprague-Dawley rats (Experimental group, E). Sham-operated control animals from each group were also studied (Control group, C). Twenty-eight days later, serum and maxillas were collected. Serum 17β-oestradiol, testosterone, MMP-9, IL-18, IL-6, TNF-α, and IL-1β concentrations were measured by ELISA. Maxillas were cleaned of residual tissue and digital radiographs were made to verify the presence of periapical lesions. Data were compared by factorial ANOVA, post hoc Tukey, and Pearson correlation tests. Groups were considered to be significantly different when p<0.05. RESULTS The serum concentration of IL-18, TNF-α, IL-1-β, IL-6 and MMP-9 was greatest in OVX-E animals, compared to all other groups (p<0.001). F-E rats had significantly higher serum concentrations of these cytokines, compared to F-C. The fold difference in serum concentration of the biomarkers (between E and C groups) was significantly greater in females than males, even though males had higher baseline concentrations of all these biomarkers. CONCLUSION When females are oestrogen-deficient, their systemic response to periapical lesions is significantly greater than males, suggesting that oestrogen is essential in protecting females from the effects of this type of inflammation.
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Susanto H, Nesse W, Dijkstra PU, Agustina D, Vissink A, Abbas F. Periodontitis prevalence and severity in Indonesians with type 2 diabetes. J Periodontol 2010; 82:550-7. [PMID: 20932156 DOI: 10.1902/jop.2010.100285] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of diabetes mellitus type 2 (DM2) in Indonesia is high and still rising. Periodontitis is associated with DM2. No study has investigated this association in Indonesia, nor has any study investigated this association using a variety of methods to operationalize periodontitis. The present study compares prevalence and severity of periodontitis in patients with DM2 to healthy controls, using different methods to operationalize periodontitis. METHODS A total of 78 subjects with DM2 and 65 healthy control subjects underwent a full-mouth periodontal screening assessing probing depth, gingival recession, plaque index, and bleeding on probing. Using these measurements, the prevalence and severity of periodontitis was operationalized in various ways. Differences in the prevalence and severity of periodontitis between subjects with DM2 and healthy subjects were analyzed using univariate analyses. In regression analyses, the prevalence and severity of periodontitis were predicted on the basis of DM2 presence, controlling for confounders and effect modification. RESULTS Prevalence of periodontitis was significantly higher in subjects with DM2 compared to healthy subjects, showing odds ratios of 5.0 and 6.1. Likewise, periodontitis severity was significantly higher in subjects with DM2. CONCLUSION Indonesian subjects with DM2 had more prevalent and more severe periodontitis than healthy Indonesian subjects, independent of confounding factors or the methods used to operationalize periodontitis.
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Affiliation(s)
- Hendri Susanto
- Department of Oral Medicine, Faculty of Dentistry, Gadjah Mada University, Yogjakarta, Indonesia
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Faraj M, Lavoie MÈ, Messier L, Bastard JP, Prud’homme D. Reduction in serum apoB is associated with reduced inflammation and insulin resistance in post-menopausal women: A MONET study. Atherosclerosis 2010; 211:682-8. [DOI: 10.1016/j.atherosclerosis.2010.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 04/10/2010] [Accepted: 04/12/2010] [Indexed: 11/29/2022]
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43
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Bandyopadhyay D, Marlow NM, Fernandes JK, Leite RS. Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetes. J Clin Periodontol 2010; 37:501-9. [PMID: 20507373 PMCID: PMC2891073 DOI: 10.1111/j.1600-051x.2010.01564.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIM To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). MATERIALS AND METHODS From an ongoing clinical trial among T2DM Gullah, we extracted a cohort previously in a cross-sectional study (N=88). Time from baseline (previous study) to follow-up (trial enrollment, before treatment interventions) ranged 1.93-4.08 years [mean=2.99, standard deviation (SD)=0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of > or =2 mm, periodontal probing depth (PPD) increases of > or =2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled=HbA(1c)<7%, poorly-controlled=HbA(1c)> or =7%) using multivariable generalized estimating equations logistic regression, nesting tooth sites/person. RESULTS Poorly-controlled T2DM (68.18%) was more prevalent than well-controlled T2DM (31.82%). Proportions of tooth sites/person with CAL progression between baseline and follow-up ranged 0.00-0.59 (mean=0.12, SD=0.12), while PPD and BOP progression ranged 0.00-0.44 (mean=0.09, SD=0.11) and 0.00-0.96 (mean=0.24, SD=0.18), respectively. Site-level PPD at baseline was a significant effect modifier of associations between poorly-controlled T2DM and site-level CAL and PPD progression [adjusted odds ratios (OR) according to poorly-controlled T2DM among PPD at baseline=3, 5 and 7 mm, respectively: CAL progression=1.93, 2.64, and 3.62, PPD progression=1.98, 2.76, and 3.84; p<0.05 for all]. Odds of site-level BOP progression were increased (OR=1.24) for poorly-controlled T2DM, yet the results were not significant (p=0.32). CONCLUSIONS These findings from a distinct, homogenous population further support the clinical relevance of identifying patients with poor glycaemic control and periodontitis, particularly among those with disparities for both diseases.
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Affiliation(s)
- Dipankar Bandyopadhyay
- Division of Biostatistics and Epidemiology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Nicole M. Marlow
- Division of Biostatistics and Epidemiology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Jyotika K. Fernandes
- Division of Endocrinology, Diabetes, and Medical Genetics, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Renata S. Leite
- Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
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44
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Inaba H, Amano A. Roles of oral bacteria in cardiovascular diseases--from molecular mechanisms to clinical cases: Implication of periodontal diseases in development of systemic diseases. J Pharmacol Sci 2010; 113:103-9. [PMID: 20501966 DOI: 10.1254/jphs.09r23fm] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Periodontal diseases, some of the most common infectious diseases seen in humans, are characterized by gingival inflammation, as well as loss of connective tissue and bone from around the roots of the teeth, which leads to eventual tooth exfoliation. In the past decade, the association of periodontal diseases with the development of systemic diseases has received increasing attention. Although a number of studies have presented evidence of close relationships between periodontal and systemic diseases, the majority of findings are limited to epidemiological studies, while the etiological details remain unclear. Nevertheless, a variety of recent hypothesis driven investigations have compiled various results showing that periodontal infection and subsequent direct oral-hematogenous spread of bacteria are implicated in the development of various systemic diseases. Herein, we present current understanding in regard to the relationship between periodontal and systemic diseases, including cardiovascular diseases, preterm delivery of low birth weight, diabetes mellitus, respiratory diseases, and osteoporosis.
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Affiliation(s)
- Hiroaki Inaba
- Department of Oral Frontier Biology, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan
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45
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Demmer RT, Desvarieux M, Holtfreter B, Jacobs DR, Wallaschofski H, Nauck M, Völzke H, Kocher T. Periodontal status and A1C change: longitudinal results from the study of health in Pomerania (SHIP). Diabetes Care 2010; 33:1037-43. [PMID: 20185742 PMCID: PMC2858171 DOI: 10.2337/dc09-1778] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Infection may be a type 2 diabetes risk factor. Periodontal disease is a chronic infection. We hypothesized that periodontal disease was related to A1C progression in diabetes-free participants. RESEARCH DESIGN AND METHODS The Study of Health in Pomerania (SHIP) is a population-based cohort in Germany including 2,973 diabetes-free participants (53% women; aged 20-81 years). Participants were categorized into four groups according to increasing baseline periodontal disease levels (percentage of sites per mouth with attachment loss >or=5 mm, determined a priori); sample sizes for each respective category were 1,122, 488, 463, and 479 (241 participants were edentulous). Mean absolute changes (year 5 minus baseline) in A1C (DeltaA1C) were regressed across periodontal categories while adjusting for confounders (e.g., age, sex, smoking, obesity, physical activity, and family history). RESULTS Across baseline periodontal disease categories, DeltaA1C +/- SEM values were 0.023 +/- 0.02, 0.023 +/- 0.02, 0.065 +/- 0.03, and 0.106 +/- 0.03 (P(trend) = 0.02), yielding an approximate fivefold increase in the absolute difference in DeltaA1C when dentate participants in the highest versus lowest periodontal disease category were compared; these results were markedly stronger among participants with high-sensitivity C-reactive protein >or=1.0 mg/l (P(interaction) = 0.01). When individuals who had neither baseline periodontal disease nor deterioration in periodontal status at 5 years were compared with individuals with both poor baseline periodontal health and longitudinal periodontal deterioration, mean DeltaA1C values were 0.005 vs. 0.143% (P = 0.003). CONCLUSIONS Periodontal disease was associated with 5-year A1C progression, which was similar to that observed for a 2-SD increase in either waist-to-hip ratio or age in this population.
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Affiliation(s)
- Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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46
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Pan Z, Guzeldemir E, Toygar HU, Bal N, Bulut S. Nitric oxide synthase in gingival tissues of patients with chronic periodontitis and with and without diabetes. J Periodontol 2010; 81:109-20. [PMID: 20059423 DOI: 10.1902/jop.2009.090454] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the expression of inducible nitric oxide synthase (iNOS) in the gingival tissues of periodontitis patients with and without type 2 diabetes to assess whether NO plays a role in the severity of periodontitis in patients with diabetes. Patients with diabetes and healthy patients were used as controls. METHODS A total of 80 patients were evaluated in four groups (with 20 subjects each): patients with chronic periodontitis and diabetes (12 males and eight females; mean age, 52.1 +/- 6.9 years), patients with chronic periodontitis who were otherwise healthy (12 males and eight females; mean age, 43.1 +/- 8.9 years), periodontally healthy patients with diabetes (12 males and eight females; mean age 50.9 +/- 6.3 years), and systemically and periodontally healthy control subjects (12 males and eight females; mean age 29.8 +/- 9.2 years). Periodontal parameters were recorded. Immunohistochemistry was used to detect inflammation and iNOS expression in gingival tissues. RESULTS Although periodontal parameters were slightly higher in periodontitis compared to diabetic periodontitis, immunohistochemical parameters were higher in diabetic periodontitis compared to periodontitis. All periodontal parameters were higher in patients with periodontitis and with/without diabetes compared to controls and patients with diabetes. All immunohistochemical parameters were higher in patients with diabetes and periodontitis compared to patients with only diabetes or periodontitis, but there was no difference between the latter two groups. There was a correlation between the expression of iNOS and inflammatory cells in controls, patients with diabetes, and patients with periodontitis but not in patients with diabetes and periodontitis. CONCLUSIONS Inflammation and iNOS expression were more prominent in the gingiva of the patients with both diabetes and periodontitis. However, iNOS expression did not seem to have an additional detrimental effect on the course of periodontitis in patients with diabetes compared to those with periodontitis alone.
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Affiliation(s)
- Zeynep Pan
- Department of Periodontology, Baskent University, 06490 Ankara, Turkey
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47
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Vascular endothelial growth factor expression levels of gingiva in gingivitis and periodontitis patients with/without diabetes mellitus. Inflamm Res 2010; 59:543-9. [DOI: 10.1007/s00011-010-0158-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 12/01/2009] [Accepted: 01/11/2010] [Indexed: 10/19/2022] Open
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48
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Ren L, Fu Y, Deng Y, Qi L, Jin L. Advanced glycation end products inhibit the expression of collagens type I and III by human gingival fibroblasts. J Periodontol 2009; 80:1166-73. [PMID: 19563298 DOI: 10.1902/jop.2009.080669] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND It is evident that diabetes and periodontal disease are closely interrelated. Accumulation of advanced glycation end products (AGEs), coupled with exaggerated host responses to bacterial infection, may account for the increased periodontal destruction observed in patients with uncontrolled diabetes. The present study investigated the effects of AGEs on the viability of human gingival fibroblasts (HGFs) and the expression of types I and III collagen in HGFs. METHODS The cell viability of HGFs was examined by methylthiazolet-etrazolium assay, whereas the expression of types I and III collagen message and protein was detected by real-time quantitative reverse transcription-polymerase chain reaction and sandwich enzyme-linked immunosorbent assay, respectively. RESULTS AGEs significantly suppressed the cell viability of HGFs from 24 to 72 hours (P <0.01). A high concentration of glucose (25 mmol/l) in the culture media exaggerated the inhibition of the survival rate of HGFs (P <0.01). The expression of collagen types I and III messages and proteins was significantly downregulated at 72 hours by AGEs in a concentration-dependent manner (P <0.05). Moreover, the synthesis of intracellular types I and III collagen protein was markedly inhibited by AGEs (P <0.05). CONCLUSIONS AGEs may suppress the cell viability of HGFs and downregulate the expression of types I and III collagen by the cells. Further investigations are warranted to clarify the molecular mechanisms of AGEs in the regulation of cell function and collagen metabolism in patients with diabetes and periodontitis.
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Affiliation(s)
- Lei Ren
- Department of Periodontology, Institute of Stomatological Research, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
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Kesić L, Petrović D, Obradović R, Gasić J, Todorović K. [Diabetes mellitus and periodontal disease]. MEDICINSKI PREGLED 2009; 62:534-538. [PMID: 20491379 DOI: 10.2298/mpns0912534k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION This review highlights the relations between diabetes mellitus and periodontal disease, as well as the pathogenic mechanisms which are still the subject of investigations. The possible pathogenic mechanisms important for developing periodontal disease in the diabetics are: vascular gingival changes, the disorders in the metabolism of the collagen, disorders in the function of the polimorphonuclear leukocytes and specific microbial flora in the parodontal pockets. CONCLUSION It is clear that adequate early recognition and good treatment are very important and significant for treatment of diabetic periodontal disease.
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Affiliation(s)
- Ljiljana Kesić
- Odeljenje za oralnu medicinu i parodontologiju, Medicinski fakultet, Klinika za stomatologiju, Nis
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50
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Yamaoka M, Ono Y, Ishizuka M, Yasuda K, Uematsu T, Furusawa K. Radiolucency below the crown of mandibular horizontal incompletely impacted third molars and acute inflammation in men with diabetes. Clin Cosmet Investig Dent 2009; 1:27-34. [PMID: 23674902 PMCID: PMC3652348 DOI: 10.2147/ccide.s4632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Although mandibular third molar has a high risk of infection extending any complications, the influence of diabetes on radiolucency and acute inflammation in pericoronitis remains unclear. The present study was to evaluate whether radiolucency below the crown is related to acute inflammation in mandibular horizontal incompletely impacted third molars and to review the records of 140 men more than 45 years with and without diabetes. The odds ratio of exhibiting acute inflammation was 3.38 (95% CI: 1.13-10.16, p < 0.05) and that of exhibiting severe acute inflammation was 15.38 (95% CI: 3.56-66.49, p < 0.0001), indicating an association of acute pericoronitis in diabetes. The frequency of radiolucency below the crown and below the root in diabetics was similar to that in nondiabetics. However, the odds ratio of exhibiting both radiolucency below the crown and acute inflammation under the diabetic condition was 4.85 (95% CI: 1.60-14.73, p < 0.01), whereas that of diabetics showing both radiolucency below the root and acute inflammation was 0.46 (95% CI: 0.06-3.74, p = 0.74). Radiolucency below the crown and acute inflammation were associated with diabetes, but that below root and acute inflammation were not associated with diabetes, indicating that the region below the crown carries susceptibility to acute pericoronitis, whereas the periodontium shows a protective effect against acute pericoronitis.
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Affiliation(s)
- Minoru Yamaoka
- Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Nagano 399-0781, Japan
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