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Son JY, Kim EJ. Interdental cleaning and periodontal status among older Koreans: Findings from KNHANES VII. Gerodontology 2024; 41:295-304. [PMID: 37927103 DOI: 10.1111/ger.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea. BACKGROUND In order to maintain oral health in older people, it is very important to use interdental cleaning devices. However, there is a lack of research on periodontal status and interdental cleaning device use in older people. METHODS This study used data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018). A total of 3426 older people adults aged 65 years or older were selected from 16 489 participants. Data on sociodemographic status (sex, age, level of education, income, residential area), personal health practice (subjective health status, smoking, physical activity, hypertension, and diabetes mellitus), oral health practice (subjective oral health status, tooth brushing frequency, dental visits, and chewing problem), the number of teeth and periodontitis were collected. Periodontitis was defined as having a World Health Organisation community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as a CPI code 4. Participants having a CPI code of 3 or 4 were considered to have periodontal disease in this study. Logistic regression analysis investigated the association between interdental cleaning devices usage and periodontitis controlling the confounding factors. RESULTS Those who do not use dental floss had a higher rate of periodontal disease (AOR = 1.47, 95% confidence interval [CI]: 1.05 to 2.1). However, there were no significant differences by interdental brush use. In those with 20 or more teeth, non-users of dental floss had a higher risk of periodontitis in all models. Conversely, in those with fewer than 20 teeth, no significant differences were observed. CONCLUSIONS Older people with mostly intact dentitions have better periodontal health if they clean between their teeth.
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Affiliation(s)
- Ji-Young Son
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Eun-Jeong Kim
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
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Dai T, Dai Q. Effect of blood lead levels on periodontitis in American adults: a cross-sectional analysis from the national health and nutrition examination survey. BMC Oral Health 2024; 24:364. [PMID: 38515151 PMCID: PMC10956260 DOI: 10.1186/s12903-024-04068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The primary objective of this study was to assess the impact of blood lead levels on the development and progression of periodontitis. METHODS This study included 8600 participants from the National Nutrition and Health Examination Survey conducted the United States between 2009 and 2014. The exposure variable was the blood lead level, while the outcome variable was periodontitis. To evaluate the relationship between the blood lead level and periodontitis, a multivariate logistic regression model was used. RESULTS A positive association was observed between blood lead levels and the risk of periodontitis in Model 1 (OR = 7.04, 95% CI = 5.95-8.31). After adjusting for age (continuous), sex, ethnicity, and BMI (continuous) in Model 2, the significant association between blood lead levels and periodontitis risk remained evident (OR = 3.06, 95% CI: 2.54-3.70). Consequently, even after comprehensive adjustment for potential confounding factors in Model 3, the robust association between blood lead levels and periodontitis risk persisted (OR = 2.08, 95% CI = 1.67-2.60). When considering the serum lead concentration as a categorical variable and after adjusting for potential confounders in Model 3, we observed that the odds ratios (ORs) of periodontitis in the T2 (0.94 µg/dL-1.60 µg/dL) and T3 (lead ≥ 1.60 µg/dL) groups increased from 1.27 (OR = 1.27, 95% CI: 1.11-1.44) to 1.57 (OR = 1.57, 95% CI: 1.36-1.81) compared to T1 group. Subgroup analysis revealed no effect modifiers. CONCLUSIONS Our main findings suggest that there is no safe range of blood lead levels regarding periodontitis risk and that increasing blood lead levels can significantly increase the prevalence of periodontitis.
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Affiliation(s)
- Tangye Dai
- Nanchang University Affiliated Stomatological Hospital, Jiangxi Province, China.
- Hangzhou stomatological hospital, Hangzhou, Zhejiang, China.
| | - Qun Dai
- Nanchang University Affiliated Stomatological Hospital, Jiangxi Province, China.
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Maynalovska H, Mlachkova A, Voyslavov T, Kotsilkov K. Occurrence and distribution of lost molars and furcation defects in a Bulgarian population: A retrospective three-dimensional study. Clin Exp Dent Res 2024; 10:e2835. [PMID: 38345499 PMCID: PMC10838140 DOI: 10.1002/cre2.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To identify the ocuurrence, distribution, and factors associated with lost molars and furcation defects in a sample of the Bulgarian population. MATERIAL AND METHODS The full mouth cone-beam computed tomography of 56 male and 57 female patients, aged between 19 and 84 years, were examined. A comprehensive evaluation was performed on a total of 675 molars-339 in maxilla and 336 in mandible. Associations with variables such as age, gender, and periodontal disease were analyzed. RESULTS With aging the number of missing teeth and interradicular lesions increased. No significant links between gender and molar loss (p = .64) or gender and furcation involvement (p = .25) was found. Periodontitis was strongly associated with both studied dental problems (p < .001). The occurrence of furcation defects was more frequently observed in the maxilla than in the mandible. CONCLUSION The occurrence and distribution of lost molars and furcation defects is substantial within the studied sample. Further investigation with a larger patient cohort is needed. Pertinent healthcare strategies to address the observed dental health issues also have to be developed.
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Affiliation(s)
- Hristina Maynalovska
- Department of Periodontology, Faculty of Dental MedicineMedical University of SofiaSofiaBulgaria
| | - Antoaneta Mlachkova
- Department of Periodontology, Faculty of Dental MedicineMedical University of SofiaSofiaBulgaria
| | - Tsvetomil Voyslavov
- Department of Analytical Chemistry, Faculty of Chemistry and PharmacySofia University St. Kliment OhridskiSofiaBulgaria
| | - Kamen Kotsilkov
- Department of Periodontology, Faculty of Dental MedicineMedical University of SofiaSofiaBulgaria
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Albandar JM. Disparities and social determinants of periodontal diseases. Periodontol 2000 2024. [PMID: 38217495 DOI: 10.1111/prd.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/15/2024]
Abstract
Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.
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Affiliation(s)
- Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
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Nam SH. Antimicrobial Activity of Crataegi fructus Extract Used for Potential Application in the Prevention and Treatment of Oral Diseases. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:13. [PMID: 38276047 PMCID: PMC10817675 DOI: 10.3390/medicina60010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Background and Objectives: This study evaluated the antimicrobial effect and cytotoxic potential of the natural Crataegi fructus extract against Streptococcus mutans (S. mutans), the causative agent of dental caries, which is a typical oral disease, and Candida albicans (C. albicans), which causes oral candidiasis. Materials and Methods: Crataegi fructus was shaken in 70% ethanol for 12 h to obtain samples through enrichment and lyophilization. Then, 1, 5, 10, 20, 30, and 40 mg/mL of the Crataegi fructus extract were applied to S. mutans and C. albicans to demonstrate its antimicrobial effect after 24 h. The stability of Crataegi fructus extract on the survival rate of human keratinocytes (HaCaT) was confirmed using water-soluble tetrazolium salt (WST-1) analysis. A one-way ANOVA determined the difference between each group. A Tukey HSD test was performed as a post-hoc analysis at the 0.05 significance level. Results: Crataegi fructus extract showed antimicrobial effects against S. mutans and C. albicans that increased in a concentration-dependent manner. However, high concentrations affected cell growth and lowered cell survival. The half maximal inhibitory concentration (IC50 value) of Crataegi fructus extract showed a survival rate of 53.04% at a concentration of 30 mg/mL, which was found to be applicable. Conclusions: Thus, Crataegi fructus extract may be used as a natural material for the prevention and treatment of oral diseases. Crataegi fructus demonstrates optimal antimicrobial effects without affecting cell proliferation and growth at 30 mg/mL concentration.
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Affiliation(s)
- Seoul-Hee Nam
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok 25945, Gangwon-do, Republic of Korea
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Saquib Abullais S, Wykole Y, Abdul Khader M, Mohamed Shamsudeen S, Alanazi S, Ullah Khateeb S, Saleem Bhat MY, Shamsuddin S. Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study. PeerJ 2023; 11:e16495. [PMID: 38077410 PMCID: PMC10702329 DOI: 10.7717/peerj.16495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases. Aim To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively. Materials and methods The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel's index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment. Results The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell's index. Conclusion As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.
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Affiliation(s)
- Shahabe Saquib Abullais
- Department of Periodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - Mohasin Abdul Khader
- Department of Periodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Shaik Mohamed Shamsudeen
- Department of Diagnostic Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Sultan Alanazi
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | - Shafait Ullah Khateeb
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - Shaheen Shamsuddin
- Department of Orthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Williams KM, Challa PK, Lopes EW, Burke KE, Ananthakrishnan AN, Richter JM, Chan AT, Khalili H. Periodontal disease is not associated with risk of inflammatory bowel disease: Results from two prospective cohort studies in the US. Aliment Pharmacol Ther 2023; 58:1052-1061. [PMID: 37781885 DOI: 10.1111/apt.17732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/19/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
AIM To examine the relationship between periodontal disease and tooth loss and risk of inflammatory bowel disease (IBD). METHODS We conducted a prospective cohort study of 86,602 women from the Nurses' Health Study (1992-2016) and 50,349 men from the Health Professionals Follow-up Study (1986-2016) with available data on periodontal disease and tooth loss. Cases of IBD were initially reported by participants and then confirmed by medical record review. We used Cox proportional hazards modelling to estimate multivariable-adjusted hazard ratios (aHRs) and 95% CIs. RESULTS Through the end of follow-up, we documented 175 cases of Crohn's disease (CD) and 209 cases of ulcerative colitis (UC). After adjustment for potential risk factors, there was no association between periodontal disease and risk of CD (pooled aHR: 0.99, 95% CI: 0.65-1.52, p = 0.970) or UC (aHR: 0.99, 95% CI: 0.68-1.45, p = 0.971). Similarly, we did not observe an association between tooth loss and risk of CD (aHR: 0.72, 95% CI: 0.43-1.21, p = 0.218) or UC (aHR: 0.89, 95% CI: 0.58-1.36, p = 0.581) in the pooled analysis. The associations were not modified by sex, age, body mass index (BMI), smoking status or NSAID use (all pinteraction > 0.87). CONCLUSION In two large prospective cohort studies, we did not observe an association between periodontal disease and tooth loss and risk of CD or UC.
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Affiliation(s)
- Katherine M Williams
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Prasanna K Challa
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily W Lopes
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kristin E Burke
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James M Richter
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andrew T Chan
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Channing Laboratory, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Hamed Khalili
- Division of Gastroenterology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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Karimi N, Samiee N, Moradi Y. The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta-analysis of analytical observational studies. Health Sci Rep 2023; 6:e1630. [PMID: 37867783 PMCID: PMC10587389 DOI: 10.1002/hsr2.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
Background and Aim The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE), premature rupture of the amniotic sac, gestational diabetes (GDM), or low birth weight (LBW) in pregnant women, which should be investigated in a systematic meta-analysis. Methods Studies that reported the association between PD and pregnancy or neonatal outcomes and were published from January 1990 to December 2022, were identified by an extensive search in PubMed (Medline), Scopus, Web of Sciences, and Medline (Elsevier). After retrieving the studies, the screening stage was performed based on their titles, abstracts, and full texts, and after selecting the final articles, their information was extracted and their quality was assessed using the Newcastle Ottawa Scale checklist. Results Pregnant women with PD had a 1.39 higher chance of developing GDM than those who did not have the infection (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.21-1.61; I square: 49.67%; p: 0.03). Additionally, the pooled RR of LBW was 2.19, which indicates that pregnant women with PD had a 2.19-fold higher risk of LBW than pregnant women who do not have the infection (RR: 2.19; 95% CI: 1.82-2.64; I square: 0.00%; p: 0.65). The relationship between the risk of PE and the existence of PD was examined in 33 cohort and case-control studies for this meta-analysis. These results were combined, and the pooled RR was 1.43. This indicates that pregnant women with PD are 1.43 times more likely to experience PE than pregnant women without PD (RR: 1.43; 95% CI: 1.32-1.54; I square: 82.64%; p: 0.00). Conclusion According to the findings of the current meta-analysis, PD may contribute to a higher risk of poor maternal and newborn outcomes in pregnant women.
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Affiliation(s)
- Newsha Karimi
- Student Research Committee, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Negin Samiee
- Oral and Maxillofacial Medicine Department, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Social Determinant of the Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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Yu F, Wang H, Wang Q, Zhao B, Zhao Z, Bian W. Evaluation of bi-directional causal association between periodontal disease and erectile dysfunction: a two-sample Mendelian randomization study. Clin Oral Investig 2023; 27:5895-5903. [PMID: 37581767 DOI: 10.1007/s00784-023-05201-0] [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: 01/13/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The association between periodontal disease (PD) and erectile dysfunction (ED) has been well-documented in observational studies. However, observational studies are vulnerable to reverse causality and confounding factors, making the inference of causal-effect relationships challenging. Contrary to the current belief, Mendelian randomization (MR) can be applied to comprehensively assess the bi-directional causal effects between PD and ED. METHODS A two-sample MR analysis was performed using pooled statistics from genome-wide association studies involving European populations with PD (12,289 patients with PD and 22,326 controls) and ED (6,175 patients with clinically diagnosed ED and 217,630 controls). In this MR analysis, three methods--the inverse-variance weighted (IVW) average, weighted median, and MR-Egger regression methods--were used to evaluate the causal relationships between PD and ED. RESULTS According to the IVW analysis results, genetically predicted PD did not have a causal effect on ED (odds ratio 1.07, 95% confidence interval 0.96-1.20, p = 0.22). Furthermore, there was no clear indication of a significant causal effect of ED on PD in the reverse MR analysis (odds ratio 0.98, 95% confidence interval 0.90-1.08, p = 0.74). The results of the MR-Egger regression and weighted median methods were consistent with those of the IVW method. Based on the sensitivity analysis results, a major bias from genetic pleiotropy was unlikely to distort the causal estimates. CONCLUSION The present study does not support a causal effect between PD and ED. CLINICAL RELEVANCE From the perspective of genetics, PD does not appear to be a risk factor for the development of ED.
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Affiliation(s)
- Feiyan Yu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - He Wang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Qianqian Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Baoling Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Zhenni Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Wei Bian
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, No. 63, New South Road, Yingze District, Taiyuan, Shanxi, 030001, People's Republic of China.
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Shanxi Medical University, Taiyuan, China.
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Xing X, Qin H, Sun J, Li K. Asymmetric Extraction Treatment in a Middle-Aged Patient with Dental Crowding and Protrusion using Clear Aligners. Case Rep Dent 2023; 2023:8836409. [PMID: 37680957 PMCID: PMC10482525 DOI: 10.1155/2023/8836409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/31/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
Frequently, orthodontic treatment involves symmetrically extracting premolars to correct severe crowding or protrusion. Nevertheless, in some cases, a more reasonable alternative may be to remove teeth with poor prognoses to improve protrusion and relieve crowding. A middle-aged woman sought treatment for dental protrusion and crowding. Her mandibular right first molar had been treated with root canal therapy due to pulpitis, but she still felt uncomfortable. In addition, her maxillary left second premolar had become carious. Extractions of the maxillary right first premolar and left second premolar, as well as mandibular right first molar and left first premolar were chosen to resolve the occlusion problems. The patient opted for clear aligners on the demands of esthetics as well as comfort. Following orthodontic treatment, the patient attained properly aligned teeth, a pleasing smile, and a facial profile that exhibited greater harmony. This case report demonstrates that, under proper planning, clear aligners are capable of handling challenging cases, including those involving middle-aged individuals and molar extractions.
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Affiliation(s)
- Xiujin Xing
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Hanglin Qin
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Jing Sun
- Wolong Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Kun Li
- Fushan Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
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Tabaa M, Adatowovor R, Shabila A, Morford L, Dawson D, Harrison P, Aukhil I, Huang H, Stromberg A, Goncalves J, Shaddox LM. Pattern of grade C molar-incisor pattern periodontitis in families. J Periodontol 2023; 94:811-822. [PMID: 36370032 DOI: 10.1002/jper.22-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to determine the clinical and inflammatory response patterns for individual siblings diagnosed with grade C molar-incisor pattern periodontitis (C-MIP) and between the related siblings within families. METHODS Sixty-nine siblings within 28 families with moderate-to-severe C-MIP were included. Clinical parameters were evaluated for symmetry regarding the affected type of teeth, side and/or arch, and bone loss pattern. The protein concentrations from in vitro whole blood cultures for 14 different lipopolysaccharide-stimulated inflammatory markers were correlated with the extent and severity of disease, within an individual sibling and among siblings within a family. RESULTS A similar disease pattern was observed among all siblings and within families. The most common teeth affected were first molars and incisors or first molars only within the permanent dentition and only molars within the primary dentition (p < 0.001). Symmetry involving molars was higher than in incisors in siblings, regardless of arch or side affected (p = 0.020). Arc-shape/vertical bone defects were the most common (p = 0.006) and higher symmetry was found for these defects in the permanent dentition (p = 0.005). Positive correlations were found between age, clinical attachment loss, and percent affected sites with several inflammatory markers. The inflammatory responses for several inflammatory markers were correlated within and among families (p < 0.050). Specifically, the intraclass correlation coefficient within families was highest (>0.5) for interleukin (IL)-8, IL-6, and IL-10. CONCLUSIONS Families with C-MIP presented similar patterns of disease. The level of an inflammatory response to bacteria seemed to play a role in the extent and severity of this disease, exemplified by the high degree of correlation in these families.
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Affiliation(s)
- Mostafa Tabaa
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Reuben Adatowovor
- Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Avesta Shabila
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Lorri Morford
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Dolph Dawson
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Peter Harrison
- Department of Periodontology, Dublin School of Dentistry, Dublin, Ireland
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Hong Huang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Arnold Stromberg
- Statistics, College of Arts and Science, University of Kentucky, Lexington, Kentucky, USA
| | - Jussara Goncalves
- Division of Periodontology and Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Luciana M Shaddox
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
- Division of Periodontology and Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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Bertolini M, Clark D. Periodontal disease as a model to study chronic inflammation in aging. GeroScience 2023:10.1007/s11357-023-00835-0. [PMID: 37285008 DOI: 10.1007/s11357-023-00835-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/20/2023] [Indexed: 06/08/2023] Open
Abstract
Periodontal disease is a chronic inflammatory condition that results in the destruction of the teeth supporting tissues, eventually leading to the loss of teeth and reduced quality of life. In severe cases, periodontal disease can limit proper nutritional intake, cause acute pain and infection, and cause a withdrawal from social situations due to esthetic and phonetic concerns. Similar to other chronic inflammatory conditions, periodontal disease increases in prevalence with age. Research into what drives periodontal disease pathogenesis in older adults is contributing to our general understanding of age-related chronic inflammation. This review will present periodontal disease as an age-related chronic inflammatory disease and as an effective geroscience model to study mechanisms of age-related inflammatory dysregulation. The current understanding of the cellular and molecular mechanisms that drive inflammatory dysregulation as a function of age will be discussed with a focus on the major pathogenic immune cells in periodontal disease, which include neutrophils, macrophages, and T cells. Research in the aging biology field has shown that the age-related changes in these immune cells result in the cells becoming less effective in the clearance of microbial pathogens, expansion of pathogenic subpopulations, or an increase in pro-inflammatory cytokine secretions. Such changes can be pathogenic and contribute to inflammatory dysregulation that is associated with a myriad of age-related disease including periodontal disease. An improved understanding is needed to develop better interventions that target the molecules or pathways that are perturbed with age in order to improve treatment of chronic inflammatory conditions, including periodontal disease, in older adult populations.
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Affiliation(s)
- Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - Daniel Clark
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
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13
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Andriankaja OM, Pérez CM, Modi A, Suaréz EL, Gower BA, Rodríguez E, Joshipura K. Systemic Inflammation, Endothelial Function, and Risk of Periodontitis in Overweight/Obese Adults. Biomedicines 2023; 11:1507. [PMID: 37371602 PMCID: PMC10294979 DOI: 10.3390/biomedicines11061507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
The network interaction between systemic inflammatory mediators, endothelial cell adhesion function, and adiponectin as mediators of the association between metabolic diseases and periodontitis has not been evaluated. The objective of this study is to assess whether the interaction of baseline serum levels of TNF-α, hs-CRP, ICAM-1, VCAM-1, and adiponectin leads to periodontitis. Five hundred and ninety-seven overweight/obese (overweight: BMI 25 to <30 kg/m2; obese: >30 kg/m2) adults, aged 40-65 years, with complete 3-year follow-up data were included. Generalized structural equation models with negative binomial regression were used to estimate the regression coefficient (β) for the outcome number of teeth with probing pocket depth (PPD) ≥ 4 mm and bleeding on probing (BOP) at 3-year follow-up for a 1 standard deviation unit increase (Δ = +1SD) in each biomarker. After adjusting for multiple covariates, baseline ICAM-1 and VCAM-1 had significant direct effects on increased log-transformed number of teeth with PPD ≥ 4 mm and BOP (β: 0.16; 95% CI: 0.02-0.30; β: 0.15; 95% CI: 0.02-0.30, respectively). Baseline hs-CRP showed a significant indirect effect via ICAM-1 on the log-transformed number of teeth with PPD ≥ 4 mm and BOP (β: 4.84; 95% CI: 0.27-9.42). Thus, elevated serum ICAM-1 and VCAM-1 have a significant direct effect and increased hs-CRP has a significant indirect effect on the predicted level of periodontitis at the 3-year follow-up among overweight/obese Hispanic adults.
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Affiliation(s)
- Oelisoa M. Andriankaja
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (C.M.P.); (E.L.S.)
| | - Ashwin Modi
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
| | - Erick L. Suaréz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (C.M.P.); (E.L.S.)
| | - Barbara A. Gower
- Department of Nutrition Sciences, Division of Physiology & Metabolism, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Elaine Rodríguez
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
| | - Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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14
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Devi OM, Gupta J, Chahal GS, Jain A. Is periodontal infection a risk factor for thromboembolic disease? A systematic review. J Indian Soc Periodontol 2023; 27:238-250. [PMID: 37346852 PMCID: PMC10281308 DOI: 10.4103/jisp.jisp_576_21] [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: 09/20/2021] [Revised: 06/11/2022] [Accepted: 07/10/2022] [Indexed: 06/23/2023] Open
Abstract
Background Venous thromboembolism (VTE) is a rising major health problem comprising pulmonary embolism (PE) and deep vein thrombosis. It is of concern due to premature mortality, increased morbidity, and associated healthcare costs and hospitalization. Periodontitis can increase the risk of VTE by way of systemic inflammation induced by infection that can contribute to hypercoagulability and platelet aggregation. This systematic review aims to synthesize all the evidence concerning periodontal infection as a risk factor for thromboembolic disease. Materials and Methods A search for articles published from 1967 till December 2020 was conducted in the PubMed (MEDLINE), Scopus, and EMBASE data bases. Results Five hundred and five articles were retrieved after running search strategies in PubMed, Scopus, and EMBASE search databases. Based on the inclusion criteria, three clinical studies, two case series, and ten case reports were included for qualitative analysis. The presence of periodontal disease was reported to influence the occurrence of venous thromboembolic disease with a statistical significance of <0.010. Case series and case reports of septic PE due to periodontal disease showed complete resolution of lung lesions and subsiding of symptoms after dental treatment and antimicrobial therapy. Conclusions The results of this systematic review suggested for an association between periodontal disease and the incidence of thromboembolic disease. As most of the included/available studies are case series and case reports, the strength of evidence is weak. Evidence generated from well-designed longitudinal controlled clinical trials may be helpful to further assess the strength of the association.
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Affiliation(s)
- Oinam Monica Devi
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Jyoti Gupta
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, 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
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15
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Gupta S, Rangappa KKG, Rani S, Ganesh R, Kukreja P, Kukreja BJ. Periodontal and Dentition Status among Psychiatric Patients in Indore: A Descriptive Cross-sectional Study. J Contemp Dent Pract 2022; 23:1260-1266. [PMID: 37125525 DOI: 10.5005/jp-journals-10024-3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM To assess and record periodontal and dentition status among psychiatric patients using modified WHO Oral Health Assessment form 1997. MATERIALS AND METHODS A descriptive cross-sectional study was conducted at Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore, among the inpatients and outpatients. Ethical approval for the study was obtained from Institutional Review Board of Sri Aurobindo College of Dentistry. Statistical analysis was done using SPSS, IBM version 20.0. Descriptive statistics was used to find the frequencies, mean, and standard deviation of variables considered in the study. RESULTS Among all the disorders, schizophrenia subjects had shallow pockets 28 (25.2%) and deep pockets 55 (49.5%). Only 2 (2.6%) study subjects who had major depressive disorder had more than 12 mm loss of attachment (LOA). The highest mean DMFT score was recorded for schizophrenia patients (13.0 ± 7.09). CONCLUSION The results reveal an unmet need of projecting effective planning and implementation strategies toward the improvement of periodontal and dentition status health of the psychiatric patients. CLINICAL SIGNIFICANCE The study highlights the importance of incorporating dental health education to psychiatric rehabilitation programs.
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Affiliation(s)
- Sonali Gupta
- Department of Public Health Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India, Phone: +91 9993043736 e-mail:
| | | | - Shikha Rani
- Department of Orthodontics and Dentofacial Orthopedics, Dr BR Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Rajendran Ganesh
- Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Pankaj Kukreja
- Department of Biomedical and Dental Sciences, Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Bhavna Jha Kukreja
- Department of Preventive Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
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16
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Association between Periodontitis and Chronic Rhinosinusitis Involving Maxillary Sinus Measured by Lund Mackay Staging System. Healthcare (Basel) 2022; 10:healthcare10101961. [PMID: 36292408 PMCID: PMC9602182 DOI: 10.3390/healthcare10101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/04/2022] Open
Abstract
This study aimed to evaluate the association between periodontitis and chronic rhinosinusitis (CRS) via cone-beam-computed tomography (CBCT) using the Lund–Mackay staging system. CBCT images from different departments of the school of dentistry, at Prince Sattam University were evaluated for the presence of rhinosinusitis. All the CBCT scans were exposed for multiple indications, and no patients had a scan exposed solely for this study. The Lund–Mackay staging system was used to measure the CRS in the CBCT. Descriptive statistics for the frequencies and percentages were used to summarize the data. Logistic regression was used to examine the associations between periodontitis and CRS. Each variable was assessed individually by using multivariable analysis. Collinearity issues among the variables were solved to select a limited set of factors using a stepwise variable selection procedure. A total of 399 CBCT images were included in the current research. Logistic regression showed that only gender was significantly associated (p = 0.0001) with the presence of CRS. However, a stepwise variable selection procedure included gender and bone loss as significantly associated with CRS. No significant difference was observed between unilateral vs. bilateral CRS in gender, bone loss, medical status, and periodontitis. However, only gender showed a significant difference in both bilateral vs. no CRS and unilateral vs. no CRS. Periodontitis is not associated with CRS. However, gender has a significant influence on CRS.
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A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness. Psychosom Med 2022; 84:836-847. [PMID: 35797566 DOI: 10.1097/psy.0000000000001102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Periodontal disease represents a global public health concern, with a disproportionate burden being borne by vulnerable populations. One such group is people with severe mental illness (SMI), and this study examined whether periodontal health is poorer in people with SMI than the general population. METHODS We conducted a systematic search for studies published before March 2021 on the periodontal health of people with SMI using the following databases: PubMed, PsycINFO, EMBASE, China National Knowledge Infrastructure, and Chongqing VIP. Outcomes were periodontitis, periodontal disease, and shallow and deep periodontal pockets. Results were compared with the general population. RESULTS Seventeen studies had sufficient data for a random-effects meta-analysis, consisting of 4404 psychiatric patients and 95,411 controls. SMI was associated with an increased prevalence of periodontitis (odds ratio = 1.97, 95% confidence interval [CI] = 1.15-3.35) compared with the general population. People with SMI had 4.28 the odds of having periodontal disease compared with controls (95% CI = 2.54-7.21). They also had 3.65 the odds of shallow pockets (95% CI = 1.80-7.42) and 2.76 the odds of deep pockets (95% CI = 1.10-6.93). CONCLUSIONS Our findings highlight the increased prevalence and severity of periodontal disease in people with SMI. Oral health is often considered the gateway to overall health and should be a public health priority for this population.
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18
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Shimizu M, Miyawaki S, Kuroda T, Umeta M, Kawabe M, Watanabe K. Erythritol inhibits the growth of periodontal-disease-associated bacteria isolated from canine oral cavity. Heliyon 2022; 8:e10224. [PMID: 36051266 PMCID: PMC9424944 DOI: 10.1016/j.heliyon.2022.e10224] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 08/04/2022] [Indexed: 12/02/2022] Open
Abstract
Periodontal disease (PD) is the most common oral disease that is caused by infection with periodontal-disease-associated bacteria (PDAB) such as Porphyromonas gulae and Porphyromonas macacae in dogs as well as in humans. Unlike humans, most dogs do not follow daily oral hygiene routine, and this results in many dogs being affected by PD. Thus, to prevent PD, it is important to control PDAB. Xylitol is a sugar alcohol that inhibits the growth of oral bacteria in humans. However, xylitol is poisonous to dogs and can lead to hypoglycemia and hepatic failure. Herein, we show the inhibitory effect of erythritol, a sugar alcohol that can be used safely in dogs, on the growth of PDAB isolated from dogs with PD. Oral bacteria were isolated from the oral cavities of dogs with PD, and the distribution of PDAB was evaluated. Interestingly, Porphyromonas gingivalis, a bacterium typically responsible for PD in humans, was not isolated from dog samples. The bacteriostatic effect of erythritol supplementation was investigated on isolated PDAB in vitro. Our results show that erythritol exert bacteriostatic effects on PDAB comparable to xylitol. Thus, application of erythritol can be suggested to control PDAB in dogs in the future.
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Affiliation(s)
- Mamu Shimizu
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Shingo Miyawaki
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Taishin Kuroda
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Miyu Umeta
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Mifumi Kawabe
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Kazuhiro Watanabe
- Laboratory of Veterinary Surgery, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
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19
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Evaluation of periodontitis-related tooth loss according to the new 2018 classification of periodontitis. Sci Rep 2022; 12:11893. [PMID: 35831375 PMCID: PMC9279363 DOI: 10.1038/s41598-022-15462-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
The new 2018 classification of periodontal diseases is reported to be related to tooth loss due to periodontal disease (TLPD) during supportive periodontal therapy (SPT). However, few reports have evaluated this relationship for Asians or have analyzed the association of the new classification and TLPD by distinguishing between active periodontal therapy (APT) and SPT. In this study, we retrospectively applied the new classification to 607 Japanese periodontitis patients and examined the relationship between the new classification and annual TLPD rates per patient during the respective periods. TLPD rates were higher in patients in stage IV and/or grade C during both APT and SPT. TLPD during SPT was not associated with the presence or absence of TLPD during APT. Multivariate analysis revealed that stage IV and grade C as independent variables were significantly associated with the number of instances of TLPD not only during the total treatment period, but also during APT or SPT. Our results suggest that the new classification has a significantly strong association with TLPD during both APT and SPT, and that patients diagnosed with stage IV and/or grade C periodontitis had a higher risk of TLPD during both periods.
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20
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Nicholson JS, Landry KS. Oral Dysbiosis and Neurodegenerative Diseases: Correlations and Potential Causations. Microorganisms 2022; 10:microorganisms10071326. [PMID: 35889043 PMCID: PMC9317272 DOI: 10.3390/microorganisms10071326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023] Open
Abstract
Biofilms are a heterogenous complex community of vegetative cells and extracellular polymeric substances that can adhere to various surfaces and are responsible for a variety of chronic and acute diseases. The impact of bacterial biofilms on oral and intestinal health is well studied, but the correlation and causations of biofilms and neurodegenerative diseases are still in their infancy. However, the correlations between biofilms and diseases such as Alzheimer’s Disease, Multiple Sclerosis, and even Parkinson’s Disease are starting to demonstrate the role bacterial biofilms have in promoting and exasperating various illnesses. The review article provides insight into the role bacterial biofilms may have on the development and progression of various neurodegenerative diseases and hopefully shine a light on this very important area of research.
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Affiliation(s)
- Justine S. Nicholson
- Delavie Sciences, Worcester, MA 01605, USA;
- Department of Neurobiology, Columbia University, New York, NY 10027, USA
| | - Kyle S. Landry
- Delavie Sciences, Worcester, MA 01605, USA;
- Department of Health Sciences, Boston University, Boston, MA 02215, USA
- Correspondence: or
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21
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Kissa J, El Houari B, Amine K, Chemlali S, Khlil N, Mikou S, Gharibi A, El Ouadnassi I, Rifki C, Albandar JM. Prevalence of periodontal disease in young moroccans. A national survey. J Periodontol 2022; 93:1867-1877. [PMID: 35708520 DOI: 10.1002/jper.22-0103] [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: 02/10/2022] [Revised: 05/19/2022] [Accepted: 05/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND There are few large surveys of periodontal disease in young age cohorts, and national surveys in Africa do not existent. This study assessed the prevalence and severity of periodontal disease in a national survey of adolescents and young adults in Morocco. METHODS A multi-stage probability sampling design was used to draw a sample of 14,667 students 12-25 years old attending 87 schools. The sample was representative of approximately 3 million Moroccan students in this age group. RESULTS 27.9%, 11.9%, and 7.7% of the subjects had ≥1 teeth with ≥4 mm, ≥5 mm, and ≥6 mm probing depth, and the population estimates were approximately 822, 350, and 226 thousand affected subjects, respectively. For attachment loss the prevalences were: 11.6%, 9.5%, and 6.9% (or ≈ 342, 281, and 204 thousand affected subjects) for ≥4 mm, ≥5 mm, and ≥6 mm, respectively. The rates of probing depth and attachment loss increased significantly with the increase in age (p<0.01, p<0.001). Gender and urban status did not show significant effects on the prevalence of periodontal disease (p>0.05). Similarly, the relationship between the occupation status and periodontal status was modest and not statistically significant (p>0.05). CONCLUSIONS Children and young adults attending public schools in Morocco have a high prevalence and severity of periodontal disease compared to other populations of similar age. The rate of periodontal disease reported here may be used as baseline population estimates in the surveillance of disease status in this population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jamila Kissa
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Bouchra El Houari
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Khadija Amine
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Sihame Chemlali
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Nadia Khlil
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Salwa Mikou
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Amina Gharibi
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Imane El Ouadnassi
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Chouaib Rifki
- Department of Oral Surgery, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, USA
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22
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Nouri S, Holcroft J, Caruso LL, Vuong TV, Simmons CA, Master ER, Ganss B. An SCPPPQ1/LAM332 protein complex enhances the adhesion and migration of oral epithelial cells: Implications for dentogingival regeneration. Acta Biomater 2022; 147:209-220. [PMID: 35643199 DOI: 10.1016/j.actbio.2022.05.035] [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: 01/18/2022] [Revised: 04/16/2022] [Accepted: 05/19/2022] [Indexed: 12/11/2022]
Abstract
Common periodontal disease treatment procedures often fail to restore the structural integrity of the junctional epithelium (JE), the epithelial attachment of the gum to the tooth, leaving the tooth-gum interface prone to bacterial colonization. To address this issue, we introduced a novel bio-inspired protein complex comprised of a proline-rich enamel protein, SCPPPQ1, and laminin 332 (LAM332) to enhance the JE attachment. Using quartz crystal microbalance with dissipation monitoring (QCM-D), we showed that SCPPPQ1 and LAM332 interacted and assembled into a protein complex with high-affinity adsorption of 5.9e-8 [M] for hydroxyapatite (HA), the main component of the mineralized tooth surfaces. We then designed a unique shear device to study the adhesion strength of the oral epithelial cells to HA. The SCPPPQ1/LAM332 complex resulted in a twofold enhancement in adhesion strength of the cells to HA compared to LAM332 (from 31 dyn/cm2 to 63 dyn/cm2). In addition, using a modified wound-healing assay, we showed that gingival epithelial cells demonstrated a significantly high migration rate of 2.7 ± 0.24 µm/min over SCPPPQ1/LAM332-coated surfaces. Our collective data show that this protein complex has the potential to be further developed in designing a bioadhesive to enhance the JE attachment and protect the underlying connective tissue from bacterial invasion. However, its efficacy for wound healing requires further testing in vivo. STATEMENT OF SIGNIFICANCE: This work is the first functional study towards understanding the combined role of the enamel protein SCPPPQ1 and laminin 332 (LAM332) in the epithelial attachment of the gum, the junctional epithelium (JE), to the tooth hydroxyapatite surfaces. Such studies are essential for developing therapeutic approaches to restore the integrity of the JE in the destructive form of gum infection. We have developed a model system that provided the first evidence of the strong interaction between SCPPPQ1 and LAM332 on hydroxyapatite surfaces that favored protein adsorption and subsequently oral epithelial cell attachment and migration. Our collective data strongly suggested using the SCPPPQ1/LAM332 complex to accelerate the reestablishment of the JE after surgical gum removal to facilitate gum regeneration.
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23
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Yan Y, Mao M, Li YQ, Chen YJ, Yu HD, Xie WZ, Huang Q, Leng WD, Xiong J. Periodontitis Is Associated With Heart Failure: A Population-Based Study (NHANES III). Front Physiol 2022; 13:854606. [PMID: 35514329 PMCID: PMC9065405 DOI: 10.3389/fphys.2022.854606] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: The aim of this study was to investigate the relationship between periodontitis and heart failure using the Third National Health and Nutrition Examination Survey (NHANES III). Methods: Participants who had received a periodontal examination were included and investigated for the occurrence of heart failure. The included participants were divided into no/mild periodontitis and moderate/severe periodontitis groups according to their periodontal status. Weighted prevalence of heart failure was calculated, and weighted logistic regressions models were used to explore the association between periodontitis and heart failure. Possible influencing factors were then explored through subgroup analysis. Results: Compared with that of the no/mild periodontitis group, the incidence of heart failure in participants with moderate/severe periodontitis was 5.72 times higher (95% CI: 3.76-8.72, p < 0.001). After adjusting for gender, age, race, body mass index, poverty income ratio, education, marital status, smoking status, drinking status, hypertension, diabetes, stroke, and asthma, the results showed that the incidence of heart failure in the moderate/severe group was 3.03 times higher (95% CI: 1.29-7.13, p = 0.012). Subgroup analysis showed that criteria, namely, male, 40-60 years old, non-Hispanic white, body mass index >30, poverty income ratio ≥1, not more than 12 years of education, currently drinking, stroke but no diabetes, or asthma supported moderate/severe periodontitis as a risk factor for heart failure (p < 0.05). Conclusion: According to data from this nationally representative sample from the United States, periodontitis is associated with an increased risk of heart failure.
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Affiliation(s)
- Yan Yan
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Min Mao
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yan-Qin Li
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yong-Ji Chen
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - He-Dong Yu
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wen-Zhong Xie
- Department of Stomatology, Kaifeng University Health Science Center, Kaifeng, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jie Xiong
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
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24
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Alshihayb TS, Sharma P, Dietrich T, Heaton B. Exploring periodontitis misclassification mechanisms under partial-mouth protocols. J Clin Periodontol 2022; 49:448-457. [PMID: 35246856 DOI: 10.1111/jcpe.13611] [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: 11/11/2021] [Revised: 01/25/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
AIM To investigate the sources of periodontitis misclassification under partial-mouth protocols (PMPs) and to explore possible approaches to enhancing protocol validity. MATERIALS AND METHODS Using data from 10,680 adults with 244,999 teeth from the National Health and Nutrition Examination Survey, we compared tooth-, site-, and quadrant-specific periodontal parameters and case identification under full-mouth protocols and PMPs. Separately, we utilized population measures of tooth-specific periodontal severity to generate PMPs with tooth selection based on the population ranking of clinical severity and assessed the sensitivity of case identification. RESULTS Symmetry of clinical severity was generally confirmed, with the exception of lingual inter-proximal sites, which yielded greater sensitivity in identifying periodontitis compared to buccal sites due to more severe pocketing and attachment loss on average. Misclassification of severe periodontitis occurred more frequently under commonly implemented PMPs compared to ranking-based selection of teeth, which yielded sensitivity estimates of 70.1%-79.4% with the selection of 8 teeth and reached 90% with the selection of only 14 teeth. CONCLUSIONS Clinical symmetry and sources of periodontitis misclassification were confirmed. The proposed selection of teeth based on population rankings of clinical severity yielded optimal sensitivity estimates for the detection of severe periodontitis and may present a favourable alternative to current options.
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Affiliation(s)
- Talal S Alshihayb
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Praveen Sharma
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Periodontal Research Group, University of Birmingham, Birmingham, UK
| | - Thomas Dietrich
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - Brenda Heaton
- Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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Kissa J, Albandar JM, El Houari B, Khlil N, Amine K, Chemlali S, Mikou S, Gharibi A, El Ouadnassi I, Tricha L, Himmiche M, Rifki C. National survey of periodontal diseases in adolescents and young adults in Morocco. J Clin Periodontol 2022; 49:439-447. [PMID: 35246871 DOI: 10.1111/jcpe.13613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
AIM National surveys of periodontal diseases in children are rare. This study describes the first national survey of oral health of adolescents attending public schools in Morocco. We report the prevalence and demographic determinants of periodontal diseases, and generate population estimates for this young population. MATERIALS AND METHODS This study used a multi-stage probability sample comprising 14,667 students in 87 schools and 520 classrooms, representative of students attending grades 6-12 (age 12-18 years) in Morocco. The students were interviewed and then examined clinically to assess their periodontal status, which was classified according to the 2017 World Workshop. In addition, the diagnosis of aggressive periodontitis (AgP) was assessed. RESULTS Of approximately 3 million students in this age cohort, 12.3% (or approximately 360,894 subjects) had periodontitis and 46.9% (1.4 million) had gingivitis. They comprised 10.8%, 2.9%, and 6.1% subjects with periodontitis stage I, II, and III/IV, respectively; 5.0%, or 148,336 subjects, had AgP. The prevalence rates were not significantly different by gender or urban status. However, the prevalence of AgP was particularly high in certain regions of Morocco. CONCLUSIONS The prevalence of staged periodontitis and AgP in this young population is among the highest reported in national surveys worldwide.
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Affiliation(s)
- Jamila Kissa
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
| | - Bouchra El Houari
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Nadia Khlil
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Khadija Amine
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Sihame Chemlali
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Salwa Mikou
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Amina Gharibi
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Imane El Ouadnassi
- Department of Periodontology, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | - Latifa Tricha
- Department of Pedodontics, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
| | | | - Chouaib Rifki
- Department of Oral Surgery, Faculty of Dental Medicine, University of Hassan II, Casablanca, Morocco
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26
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Rad MR, Atarbasi-Moghadam F, Khodayari P, Sijanivandi S. Periodontal ligament stem cell isolation protocol: A systematic review. Curr Stem Cell Res Ther 2022; 17:537-563. [PMID: 35088677 DOI: 10.2174/1574888x17666220128114825] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/08/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022]
Abstract
Despite the plethora of literature regarding isolation and characterization of periodontal ligament stem cells (PDLSCs), due to the existence of controversies in the results, in this comprehensive review, we aimed to summarize and compare the effect of isolation methods on PDLSC properties, including clonogenicity, viability/proliferation, markers expression, cell morphology, differentiation, and regeneration. Moreover, the outcomes of included studies, considering various parameters such as teeth developmental stages, donor age, periodontal ligament health status, and part of the teeth root from which PDLSCs were derived, have been systematically discussed. It has been shown that from included studies PDLSCs can be isolated from teeth from any developmental stages, any health status condition, and any donor age. Also, a non-enzymatic digestion method, named as an explant or outgrowth technique, is a suitable protocol for of PDLSCs isolation.
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Affiliation(s)
- Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fazele Atarbasi-Moghadam
- Department of Periodontics, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pouya Khodayari
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soran Sijanivandi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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27
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Isolation and identification of the oral bacteria and their characterization for bacteriocin production in the oral cavity. Saudi J Biol Sci 2022; 29:318-323. [PMID: 35002424 PMCID: PMC8716906 DOI: 10.1016/j.sjbs.2021.08.096] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/23/2022] Open
Abstract
Oral cavity is a diverse ecosystem which harbors immense diversity of microorganisms like fungi, virus and bacteria. Some of these microorganisms are involved in causing multiple infections. Oral flora is continuously changing due to connection with the external environment and produce bacteriocin against each other to compete for nutrient in this mini ecosystem. Current study was aimed to explore and compare the bacterial fauna of both healthy and non-healthy dental samples, by isolation and identification with biochemical tests to characterize the bacteriocin production. During study 120 swabs were taken from both healthy and unhealthy subjects. Samples were collected from the dental clinics of Makkah City, in sterile eppendorfs containing 1 ml nutrient broth, and were incubated overnight using shaking incubator. Bacteria were isolated following identification through Gram staining, microscopy and biochemical test. Total 15 strains of bacteria were isolated during the study amongst which 8 strains were gram positive and 7 strains were gram negative. The most dominant species of the gram positive strains was Streptococcus pneumoniae (n = 26). On the other hand, Escherichia coli (n = 26) was the prominent specie amongst the gram negative strains. Overall, the dominated family was Enterobacteriaceae (19.36%) followed by Streptococcaceae with 13.83% abundance. One of the most cariogenic strain Klebsiella pneumoniae (n = 14) was also isolated. The bacterial strain diversity between these two type of ecosystem was approximately the same, with slight variation in Shannon (HS:2.627187, NHS:2.653594) and Simpson diversity (HS:0.923461, NHS: 0.92684) index. The current research revealed that bacteriocin production in the Enterobacter species was prominent against Escherichia coli and Klebsiella pneumoniae. Apart from this other strains like Klebsiella pneumoniae and Exiguobacterium spp were also able to produce bacteriocin against Enterobacter species and Bacillus cereus respectively.
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28
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Alawaji YN, Alshammari A, Mostafa N, Carvalho RM, Aleksejuniene J. Periodontal disease prevalence, extent, and risk associations in untreated individuals. Clin Exp Dent Res 2022; 8:380-394. [PMID: 35015383 PMCID: PMC8874091 DOI: 10.1002/cre2.526] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives to examine the prevalence, extent, and risk associations of untreated periodontitis. Materials and Methods A purposive sample of subjects who were never treated for periodontal conditions was clinically examined after collecting information about their sociodemographic characteristics, medical conditions, oral health behaviors, perceived stress, and perceived social support. Results A total of 431 subjects were recruited (response rate, 97.0%), and their mean age (SD) was 35.4 (13.3) years. Overall, high plaque levels were observed in all untreated individuals. The prevalence of periodontitis and severe (stage III/IV) periodontitis using the American Academy of Periodontology and European Federation of Periodontology (AAP/EFP) classification were 85.4% and 48.5%, respectively. The prevalence of moderate‐severe and severe periodontitis using the definitions of the Centers for Disease Control and Prevention (CDC) and AAP were 78.4% and 31.1%, respectively. The extent of periodontitis expressed as mean% of clinical attachment loss (CAL) ≥ 3 mm and CAL ≥ 5 mm were 34.9% and 14.4%, respectively, while the mean% of a periodontal probing depth (PPD) ≥4 mm and PPD ≥6 mm were 22.0% and 9.2%, respectively. Risk determinants associated with AAP/EFP periodontitis after the adjustment for other variables were age ≥35 years (odds ratio [OR] = 11.5) and lower income (OR = 2.5). Adjusted risk associations with stage II/IV periodontitis included age ≥35 years (OR = 8.2), males (OR = 2.5), lower income (OR = 2.3), and lower perceived stress (OR = 2.0). Adjusted risk associations with CDC/AAP moderate‐severe periodontitis included age ≥35 years (OR = 12.0), lower income (OR = 2.1), and current cigarette smoking (OR = 4.2). Adjusted risk associations with CDC/AAP severe periodontitis included age ≥35 years (OR = 4.5), males (OR = 1.9), lower education (OR = 2.0), lower income (OR = 1.7), uncontrolled diabetes mellitus (OR = 2.0), and current cigarette smoking (OR = 2.3). Conclusions The prevalence and extent of periodontitis were high in untreated subjects. Risk associations with untreated periodontitis included age ≥35 years, males, lower income, lower education, current cigarette smoking, uncontrolled diabetes mellitus, and lower perceived stress.
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Affiliation(s)
- Yasmine N Alawaji
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia.,Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Abdulsalam Alshammari
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nesrine Mostafa
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ricardo M Carvalho
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jolanta Aleksejuniene
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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29
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Faramarzi M, Shirmohammadi A, Khorramdel A, Sadighi M, Bargahi E. Effect of non-surgical periodontal therapy on serum ferritin levels in postmenopausal women with chronic periodontitis. J Dent Res Dent Clin Dent Prospects 2021; 15:178-182. [PMID: 34712408 PMCID: PMC8538142 DOI: 10.34172/joddd.2021.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background. Ferritin is a positive acute phase protein (APP) in inflammation and chronic infections, including chronic periodontitis. Two key factors that can regulate ferritin expression are iron and pro-inflammatory cytokines. Serum ferritin levels increase after menopause, affecting women’s health. This study aimed to evaluate serum ferritin levels in postmenopausal women upon undertaking non-surgical periodontal treatment.
Methods. In this cross-sectional study, blood samples of 38 postmenopausal women with chronic periodontitis were collected before any treatment. The serum ferritin levels and periodontal parameters, probing depth (PD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and three months after non-surgical periodontal therapy. Wilcoxon test was used to compare serum ferritin levels before and after treatment. T-test was used for comparison of periodontal parameters, with a P value of ≤0.05 considered significant.
Results. A decrease was observed in the serum ferritin level (from 108.55 mcg/L to 98.28 mcg/L) after treatment compared to baseline (P < 0.001). Also, significant improvements in periodontal parameters were observed compared to the baseline (P < 0.001).
Conclusion. Based on the results, it can be concluded that non-surgical periodontal treatment significantly reduces serum ferritin levels in postmenopausal women with chronic periodontitis.
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Affiliation(s)
- Masoumeh Faramarzi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Adileh Shirmohammadi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Azin Khorramdel
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Mehrnoosh Sadighi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
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30
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Stöhr J, Barbaresko J, Neuenschwander M, Schlesinger S. Bidirectional association between periodontal disease and diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sci Rep 2021; 11:13686. [PMID: 34211029 PMCID: PMC8249442 DOI: 10.1038/s41598-021-93062-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/17/2021] [Indexed: 12/24/2022] Open
Abstract
Periodontal disease has been reported to be associated with diabetes mellitus. However, the direction of the association and the influence of bias are not clear. Thus, the aim of this systematic review and meta-analysis was to summarize the existing evidence on the bidirectional prospective association between periodontal disease and diabetes mellitus by accounting for the risk of bias of the original studies. The literature search was conducted on the electronic data sources PubMed and Web of Science up to February 9th, 2021. We included observational studies, which investigated the prospective association between diabetes mellitus and periodontal disease or vice versa. The risk of bias of the primary studies was evaluated by applying the Quality in Prognosis Studies (QUIPS) tool. Random effects models were used to calculate summary relative risk (SRR) with 95% CI. Subgroup analyses were applied to investigate heterogeneity and the robustness of the finding. In total, 15 studies were included . The SRR for incident diabetes mellitus was 1.26 (95% CI 1.12, 1.41; I2: 71%, n = 10; participants = 427,620; identified cases = 114,361), when comparing individuals with periodontitis to individuals without periodontitis. The SRR for incident periodontitis was 1.24 (95% CI 1.13, 1.37; I2: 92%, n = 7; participants = 295,804; identified cases: > 22,500), comparing individuals with diabetes to individuals without diabetes. There were no significant differences between subgroups after stratification for risk of bias. The findings show a positive bidirectional association between periodontal disease and diabetes mellitus, and thus, underline the need for screening of patients with periodontitis regarding diabetes mellitus and vice versa. The main limitation of the study is the high unexplained heterogeneity between the studies including the different assessment methods of the disease diagnosis.
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Affiliation(s)
- Julia Stöhr
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany. .,German Center for Diabetes Research, München-Neuherberg, Germany.
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31
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Tuominen H, Taina M, Puranen M, Onatsu J, Huumonen S, Vanninen R. Serum High-Sensitive C-reactive Protein May Reflect Periodontitis in Patients With Stroke. In Vivo 2021; 34:2829-2835. [PMID: 32871821 DOI: 10.21873/invivo.12109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM Chronic infectious diseases are believed to increase the risk of stroke. We aimed to evaluate the prevalence of periodontal disease and its association with systemic inflammatory processes in patients suffering an acute stroke/transient ischemic attack (TIA). PATIENTS AND METHODS Altogether 36 acute stroke/TIA patients underwent clinical, laboratory and radiological examinations. The level of systemic inflammation was analyzed both with routine measurements of plasma C-reactive protein (p-CRP) and serum high-sensitivity CRP (s-hsCRP) to analyze their associations with periodontitis. The diagnostic criteria for periodontitis included increased probing depth (>4 mm) measured from four different sites, bleeding on probing, and horizontal (>1 mm), vertical (>1 mm) or apical bone loss observed on orthopantomography. RESULTS Twenty-six (72.2%) patients were diagnosed with periodontitis. Only five of the patients with periodontitis (19.2%) had elevated p-CRP values whereas the majority, (17/26; 65.4%) had elevated s-hsCRP values (p<0.01). Absolute s-hsCRP values in patients with periodontitis (8.9±12.5 mg/l) were significantly higher than in patients without periodontitis (2.3±3.0 mg/l; p<0.05). Absolute p-CRP concentrations did not differ (2.3±5.8 vs. 2.4±5.1 mg/l; p=not significant). The total number of periodontitis findings was significantly associated with s-hsCRP values (r=1.83) but not with p-CRP values. Conversely, seventeen of the nineteen patients with elevated s-hsCRP (89.5%) indicative of systemic inflammation had periodontitis. CONCLUSION Periodontitis is a common finding among patients with acute stroke/TIA as over 80% of patients with cryptogenic stroke/TIA had periodontitis. S-hsCRP is a useful tool for detecting subclinical systemic inflammation.
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Affiliation(s)
- Hanna Tuominen
- The Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Mikko Taina
- Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Mirja Puranen
- Department of Pathology, Kuopio University Hospital, Kuopio, Finland.,Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland
| | - Juha Onatsu
- NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Sisko Huumonen
- The Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Ritva Vanninen
- Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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Dommisch H, Walter C, Dannewitz B, Eickholz P. Resective surgery for the treatment of furcation involvement: A systematic review. J Clin Periodontol 2021; 47 Suppl 22:375-391. [PMID: 31912534 DOI: 10.1111/jcpe.13241] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the benefit of resective surgical periodontal therapy (root amputation or resection, root separation, tunnelling) in periodontitis patients exhibiting class II and III furcation involvement (FI) compared with non-surgical treatment (SRP) or open flap debridement (OFD). MATERIAL Outcomes were tooth survival (primary), vertical probing attachment gain, and reduction in probing pocket depth (secondary) evidenced by randomized clinical trials, prospective and retrospective cohort studies and case series with ≥ 12 months of follow-up. Search was performed on 3 electronic databases from January 1998 to December 2018. RESULTS From a total of 683 articles, 66 studies were identified for full-text analysis and 7 studies finally included. Six hundred sixty-seven patients contributed 2,021 teeth with class II or III FI. Data were very heterogeneous regarding follow-up and distribution of FI. A total of 1,515 teeth survived 4 to 30.8 years after therapy. Survival ranged from 38%-94.4% (root amputation or resection, root separation), 62%-67% (tunnelling), 63%-85% (OFD) and 68%-80% (SRP). Overall, treatment provided better results for class II FI than class III. CONCLUSION Within their limits, the data indicate that in class II and III FI, SRP and OFD may result in similar survival rates as root amputation/resection, root separation or tunnelling.
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Affiliation(s)
- Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
| | - Bettina Dannewitz
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
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33
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Adel-Khattab D, Montero E, Herrera D, Zhao D, Jin L, Al-Shaikh Z, Renvert S, Meyle J. Evaluation of the FDI Chairside Guide for Assessment of Periodontal Conditions: A Multicentre Observational Study. Int Dent J 2021; 71:390-398. [PMID: 33531146 PMCID: PMC9275347 DOI: 10.1016/j.identj.2020.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective There is a need to develop easy-to-use tools to screen for periodontal conditions in daily practice. This study aimed to evaluate the FDI World Dental Federation “Chairside Guide” (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening. Methods Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis. Results Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001). Conclusion The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice.
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Affiliation(s)
- Doaa Adel-Khattab
- Faculty of Dentistry, Department of Oral Medicine, Periodontology and Diagnosis, Ain Shams University, Cairo, Egypt; Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
| | - Eduardo Montero
- Etiology and Research of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense of Madrid, Madrid, Spain.
| | - David Herrera
- Etiology and Research of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Dan Zhao
- Faculty of Dentistry, Division of Periodontology & Implant Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Faculty of Dentistry, Division of Periodontology & Implant Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Zahra Al-Shaikh
- Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden; Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Joerg Meyle
- Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
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Sirin DA, Ozcelik F. The relationship between COVID-19 and the dental damage stage determined by radiological examination. Oral Radiol 2021; 37:600-609. [PMID: 33389600 PMCID: PMC7778567 DOI: 10.1007/s11282-020-00497-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE COVID-19 causes severe complications particularly in respiratory system especially in the elderly and those with poor general health. General and oral health are closely related to the course of such viral diseases. This study aims to reveal the relationship between the Dental Damage Stage (DD Stg) and the severity of COVID-19 disease. MATERIALS AND METHODS The study included 137 patients (20-65 years) based on oral examination records and panoramic X-rays of 1516 COVID-19 patients diagnosed through real time PCR tests. DD Stg were determined according to data of Apical Periodontitis Grading Scale, Radiologic Alveolar Bone Loss and Pathophysiological Process of Dental Caries obtained from dental radiological images. DD Stg were determined according to the severity of dental pathology and compared in terms of age, gender, numbers of dental caries (NDC), dental implants (NDI), root canal treatment (NRCT), tooth fillings (NTF), missing teeth (NMT) and hospitalization due to COVID-19 (NHC), presence of chronic disease (CD), and symptom associated with COVID-19 (SAC) RESULTS: Patients in DD Stg 3 had significantly higher age and mortality. CD, NDC and NHC values were higher in DD Stg 2 and 3 than in DD Stg 0 and 1. NHCs were higher in DD Stg 3 than in DD Stg 2. NMTs were higher in DD Stg 3 than other stages. SACs were significantly lower in DD Stg 0 than in DD Stg 1, 2 and 3. NDC, NHC, SAC and CD were effective on DD staging; they were moderately positively related. CONCLUSIONS The relationship detected between DD stage and the severity and prognosis of viral disease such as COVID-19 was found to be remerkable for extensive studies.
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Affiliation(s)
- Dursun Ali Sirin
- University of Health Sciences, Hamidiye Faculty of Dentistry, Department of Endodontics and Sultan 2. Abdulhamid Han Training Hospital, Saglik Bilimleri Universitesi, 34668, Istanbul, Turkey.
| | - Fatih Ozcelik
- University of Health Sciences, Sultan Abdülhamid Han Training Hospital, Biochemistry Specialist Department of Medical Biochemistry, Sağlık Bilimleri Üniversitesi, İstanbul, Turkey
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Boyapati R, Cherukuri S, Bodduru R, Kiranmaye A. Influence of female sex hormones in different stages of women on periodontium. J Midlife Health 2021; 12:263-266. [PMID: 35264831 PMCID: PMC8849144 DOI: 10.4103/jmh.jmh_142_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/16/2021] [Accepted: 12/05/2021] [Indexed: 11/23/2022] Open
Abstract
The primary etiologic factor for periodontal diseases is “Dental plaque.” Although pathogenic bacteria in dental plaque are required for the incidence of periodontal disease, a susceptible host is also very important. The susceptibility of the host can be modified by many systemic factors with hormones level being one. The periodontium shows an exaggerated inflammatory response to plaque modified by female sex hormones during puberty, pregnancy, in women taking oral contraceptives, and at the postmenopausal stage. This review provides an in detail analysis of how periodontium is influenced by the fluctuation in sex steroid hormones of females during different phases of their lifetime and to discuss how much the same hormone at different ages and stages shows an exaggerated gingival response to plaque.
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Dicembrini I, Serni L, Monami M, Caliri M, Barbato L, Cairo F, Mannucci E. Type 1 diabetes and periodontitis: prevalence and periodontal destruction-a systematic review. Acta Diabetol 2020; 57:1405-1412. [PMID: 32318875 DOI: 10.1007/s00592-020-01531-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
AIMS Data about the association between periodontal disease or periodontitis (PD), diabetes and hyperglycemia have been reported mostly in patients with type 2 diabetes. Conversely, information about PD in type 1 diabetes (T1DM) is relatively scarce. The aim of this meta-analysis is therefore: (1) to assess the prevalence and severity of PD in patients affected by T1DM in comparison with the general population and (2) to verify the association between severity of PD and glycemic control in type 1 diabetics. METHODS An electronic search was performed on MEDLINE, Cochrane Central Register of Trials and EMBASE, up to October 31, 2019. Estimates of prevalence of PD in T1DM were calculated together with Mantel-Haenszel odds ratios (MH-OR) of the risk of PD associated with T1DM; weighed mean difference in CAL between T1DM and control and weighed mean difference in CAL in patients with T1DM and unsatisfactory glycemic control as compared with those in good glycemic control were also evaluated.. RESULTS The prevalence of PD in type 1 diabetes was 18.5 [8.0; 37.1] %; the MH-OR for PD is 2.51 (1.32;4.76) in T1DM patients versus general population (p = 0.005). The weighed mean difference in CAL depth between T1DM patients and controls is 0.506 [0.181; 0.832] mm (p < 0.005), and in T1DM patients with good glycemic control CAL depth is - 0.71 [- 1.00; - 0.42] mm less deep than in subjects with HbA1c > 7%. CONCLUSIONS The present data confirm that T1DM is a relevant risk factor for the development of PD. The proportion of patients affected by PD is more than doubled in subjects with T1DM in comparison with non-diabetic individual, and among patients with T1DM, PD seems to be more severe and the differences appear very wide between subjects in optimal and suboptimal glycemic control.
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Affiliation(s)
- Ilaria Dicembrini
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Lapo Serni
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Matteo Monami
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Mariasmeralda Caliri
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Edoardo Mannucci
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy.
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Ferreira CL, de Fátima Pedroso J, da Silva Lima VC, de Souza Ramos TC, Melo Filho AB, Neves Jardini MA. Treatment of Grade III furcation involvement in upper molars: Case Series with 2-16-year follow-up. J Indian Soc Periodontol 2020; 24:387-391. [PMID: 32831515 PMCID: PMC7418549 DOI: 10.4103/jisp.jisp_251_19] [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: 04/23/2019] [Revised: 08/16/2019] [Accepted: 09/01/2019] [Indexed: 12/03/2022] Open
Abstract
Frequently, the clinicians are addressed to decide between the preservation of Grade III furcation molar and the implant replacement, due to the increased access among the population to this therapy over the years and high success rate of the osseointegrated implants. This case series presents clinical and radiographic data collected from 10 patients who underwent 13 root amputations for the treatment of degree Grade III furcation in maxillary molars with follow-up until 16 years. The results showed improvements in probing depth, bleeding on probing, and radiographic aspects. The follow-up time indicates that root amputation is an effective long-term treatment solution, especially when the patient's local, systemic, or financial conditions make it difficult or impossible to implant placement.
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Affiliation(s)
- Camila Lopes Ferreira
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Juliana de Fátima Pedroso
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Victória Clara da Silva Lima
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Tatiane Caroline de Souza Ramos
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Antonio Braulino Melo Filho
- Department of Social and Pediatric Dentistry, Division of Integrated Clinic, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
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Assiri H, Dawasaz AA, Alahmari A, Asiri Z. Cone beam computed tomography (CBCT) in periodontal diseases: a Systematic review based on the efficacy model. BMC Oral Health 2020; 20:191. [PMID: 32641102 PMCID: PMC7341656 DOI: 10.1186/s12903-020-01106-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Periodontal diseases are prevalent among adult populations. Its diagnosis depends mainly on clinical findings supported by radiographic examinations. In previous decades, cone beam computed tomography has been introduced to the dental field. The aim of this study was to address the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. Methods A systematic search of electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted in February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on diagnostic imaging modality. Four examiners performed the eligibility and quality assessment of relevant studies and consensus was reached in cases where disagreement occurred. Results The search resulted in 64 studies. Of these, 34 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy of the included studies showed a low or moderate risk of bias and applicability concerns in the use of CBCT. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of outcomes after the treatment of periodontal defects. Conclusion CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
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Affiliation(s)
- Hassan Assiri
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia.
| | - Ali Azhar Dawasaz
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ahmad Alahmari
- Department of Periodontology, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Zuhair Asiri
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Kida M, Ono T, Kokubo Y, Yoshimuta Y, Kosaka T, Kikui M, Yamamoto MA, Ikebe K, Maeda Y, Nokubi T, Nishimura K, Watanabe M, Higashiyama A, Miyamoto Y. Decreased masticatory performance is related to increased intima-media thickness in a general urban Japanese population: The Suita study. J Prosthodont Res 2020; 64:346-353. [DOI: 10.1016/j.jpor.2019.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/27/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
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Cesur Aydin K, Tekin A. Impact of Body Mass Index on dental health status. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.19.04092-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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KANMAZ B, NİZAM N, KAÇMAZ BAŞOĞLU Ö, TAŞBAKAN MS, BUDUNELİ N. Effect of CPAP Therapy on Clinical Periodontal Status of Patients with Obstructive Sleep Apnea Syndrome: 6-year Follow-up. ACTA ODONTOLOGICA TURCICA 2020. [DOI: 10.17214/gaziaot.630740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Increased Risk of Chronic Periodontitis in Chronic Rhinosinusitis Patients: A Longitudinal Follow-Up Study Using a National Health-Screening Cohort. J Clin Med 2020; 9:jcm9041170. [PMID: 32325855 PMCID: PMC7231281 DOI: 10.3390/jcm9041170] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 12/18/2022] Open
Abstract
This study compared the risk of chronic periodontitis (CP) between chronic rhinosinusitis (CRS) and non-chronic rhinosinusitis (control) patients using a national cohort dataset from the Korean Health Insurance Review and Assessment Service. CRS (n = 5951) and control participants (n = 23,804) were selected after 1:4 ratio matching for age, sex, income, region of residence, and preoperative CP visits. Postoperative CP visits were measured between 2002 and 2015. The margin of equivalence of the difference between the CRS and control groups was set between -0.5 and 0.5. Statistical significance was noted in the post-index date (ID) of the third, fourth, and fifth year periods. In subgroup analyses according to age and sex, statistical significance was observed in 40-59-year-old males in post-ID third, fourth, and fifth year periods, ≥60-year-old males in post-ID third and fourth year periods, and ≥60-year-old females in post-ID fifth year period (p < 0.05, each). In another subgroup analysis based on the number of pre-ID CP visits, statistical significance was observed for pre-ID CP (0 time) in the third, fourth, and fifth year periods (p < 0.05, each). This study revealed that CRS participants were likely to receive CP diagnosis and treatment.
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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AlGhamdi A, Almarghlani A, Alyafi R, Ibraheem W, Assaggaf M, Howait M, Alsofi L, Banjar A, Al-Zahrani M, Kayal R. Prevalence of periodontitis in high school children in Saudi Arabia: a national study. Ann Saudi Med 2020; 40:7-14. [PMID: 32026714 PMCID: PMC7012028 DOI: 10.5144/0256-4947.2020.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The occurrence of periodontitis is rather infrequent in children and adolescence and increases with age. We conducted this study because there have been few epidemiological studies on prevalence of periodontitis in children in Saudi Arabia. OBJECTIVE Determine the prevalence of periodontitis in high school children in Saudi Arabia. DESIGN Cross-sectional, using cluster and multistage sampling. SETTING High school children in Saudi Arabia. PARTICIPANTS AND METHODS Periodontal examinations were conducted on a randomized sample of high school children between the ages 15 to 19 in Saudi Arabia. The study spanned from September 2012 to January 2016. Clinical examinations included measurements of the probing depth (PD) percentage of PD ≥4 mm per patient. MAIN OUTCOME MEASURES The prevalence of periodontitis (PD ≥4 mm and CAL ≥1 mm), the mean percentage PD ≥4 mm, the mean percentage CAL ≥1 mm, plaque index (PI) and gingival index (GI). SAMPLE SIZE 2435 high school students. RESULTS Of 2435 high school children in the sample, 209 students (8.6%) had periodontitis. The mean (standard deviation) for the PD was 0.59 (0.17) mm. Differences in percentage PD ≥4 mm and CAL ≥1 mm were greater in students with periodontitis ( P<.001). The prevalence of periodontitis was higher among non-Saudis, students who did not brush their teeth and did not visit their dentist regularly. In the bivariate analysis, periodontitis was positively associated with GI, PI, number of teeth extracted, mean percentage PD ≥4 mm, and mean PD. However, in the multivariate analysis, tooth brushing was the main factor protective against periodontitis (odds ratio: 0.62, 95% CI 0.42-0.92, P=.017). CONCLUSION Periodontitis prevalence was high compared with Western countries in a nationally representative sample of high school students in Saudi Arabia. LIMITATIONS Partial mouth study design, which may underestimate the disease prevalence. CONFLICT OF INTEREST None.
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Affiliation(s)
- Ali AlGhamdi
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ammar Almarghlani
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rusha Alyafi
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wael Ibraheem
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Assaggaf
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Howait
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Loai Alsofi
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa Banjar
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Al-Zahrani
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rayyan Kayal
- From the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Isik Andrikopoulos G, Farsalinos K, Poulas K. Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health. TOXICS 2019; 7:toxics7040061. [PMID: 31817732 PMCID: PMC6958319 DOI: 10.3390/toxics7040061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/27/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
The number and popularity of electronic nicotine delivery systems (ENDS) and especially e-cigarettes (e-cigs) have been increasing in the last decade. Although ENDS owe their popularity to excluding the harmful chemicals that are present in tobacco smoke, there is a debate whether they are safe, regulated, and as harmless as they are assumed to be and have potential unknown long-term effects. Involvement of cigarette smoking to the progression of periodontal diseases, other adverse oral health outcomes, and its detrimental effects to oral health are well-described. ENDS producer companies claim that these products can improve oral health by providing alternatives to smoking. However, the effect of e-cigs on oral health is not fully understood and is still debated among many scientists and clinicians. The number of studies addressing the potential toxic effect of ENDS or e-cig aerosol on oral cells is limited along with the clinical studies which are still preliminary, and their sample size is limited. The long-term effects of inhaled aerosols and the potential synergistic effect of the e-cigs components are not known. It is essential and of utmost importance to determine whether exposure to ENDS aerosol contributes to the progression of periodontal diseases and how it affects periodontal ligament and gingival cells which are believed to be its first targets. This review briefly summarizes the available evidence about the effects of e-cigs on periodontal health including several pathophysiological events, such as oxidative stress, DNA damage, inflammation, cellular senescence, dysregulated repair, and periodontal diseases.
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Affiliation(s)
| | - Konstantinos Farsalinos
- Department of Pharmacy, University of Patras, Rio, 26500 Patras, Greece; (G.I.A.); (K.F.)
- Department of Cardiology, Onassis Cardiac Surgery Center, 17674 Kallithea, Greece
- National School of Public Health, Leof. Alexandras 196, 111521 Athens, Greece
| | - Konstantinos Poulas
- Department of Pharmacy, University of Patras, Rio, 26500 Patras, Greece; (G.I.A.); (K.F.)
- Institute of Research and Innovation NONSMOKE TEAM, Patras Science Park, Stadiou, Platani, Rio, 26504 Patras, Greece
- Correspondence: ; Tel.: +30-2610-962353
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Gomes-Filho IS, Cruz SSD, Trindade SC, Passos-Soares JDS, Carvalho-Filho PC, Figueiredo ACMG, Lyrio AO, Hintz AM, Pereira MG, Scannapieco F. Periodontitis and respiratory diseases: A systematic review with meta-analysis. Oral Dis 2019; 26:439-446. [PMID: 31715080 DOI: 10.1111/odi.13228] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/08/2019] [Accepted: 10/27/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to evaluate the recent scientific literature addressing the association between periodontitis and asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. MATERIALS AND METHODS The search for studies was carried out using MEDLINE/PubMed, EMBASE, Lilacs, Web of Science, Scopus, and SciELO databases, including the gray literature (ProQuest). Reference lists of selected articles were also searched. Studies having varying epidemiological designs assessing the association between periodontitis and respiratory diseases in human subjects were eligible for inclusion. Three independent reviewers performed the selection of articles and data extraction. Fixed and random effects meta-analysis were performed for the calculation of the association measurements (Odds Ratio-OR) and 95% confidence intervals (95% CI). RESULTS A total of 3,234 records were identified in the database search, with only 13 studies meeting the eligibility criteria and 10 studies contributed data for meta-analysis. Using a random effects models periodontitis was associated with asthma: ORadjusted: 3.54 (95% CI: 2.47-5.07), I2 = 0%; with COPD: OR adjusted: 1.78 (95% CI: 1.04-3.05), I2 = 37.9%; and with pneumonia: OR adjusted: 3.21 (95% CI: 1.997-5.17), I2 = 0%. CONCLUSIONS The main findings of this systematic review validated an association between periodontitis and asthma, COPD and pneumonia.
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Affiliation(s)
| | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Bahia, Brazil.,Department of Epidemiology, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | | | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Bahia, Brazil.,Department of Preventive Dentistry, Federal University of Bahia, Salvador, Brazil
| | | | | | - Amanda Oliveira Lyrio
- Faculty of Health Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
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Botelho J, Machado V, Proença L, Alves R, Cavacas MA, Amaro L, Mendes JJ. Study of Periodontal Health in Almada-Seixal (SoPHiAS): a cross-sectional study in the Lisbon Metropolitan Area. Sci Rep 2019; 9:15538. [PMID: 31664143 PMCID: PMC6820786 DOI: 10.1038/s41598-019-52116-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022] Open
Abstract
This study aimed to describe the prevalence and extent of periodontal diseases among adults in the southern region of the Lisbon Metropolitan Area. This population-based cross-sectional study included 1,064 randomized participants (aged 18 to 95 years, 617 females/447 males). Sociodemographic, behaviours and medical information were recorded. Periodontal conditions were assessed with a full-mouth circumferential periodontal examination. It was used the American Association of Periodontology/European Federation of Periodontology 2017 case definitions. A logistic regression analysis was applied to ascertain hypothetical risk factors towards periodontitis. The prevalence of periodontitis was 59.9%, with 24.0% and 22.2% of the participants exhibiting severe and moderate periodontitis, respectively. The risk of periodontitis significantly increased with age (OR = 1.05, 95% CI: 1.04-1.06), for active and former smokers (OR = 3.76 and OR = 2.11, respectively), with lower education levels (OR = 2.08, OR = 1.86, for middle and elementary education, respectively) and with diabetes mellitus (OR = 1.53). This study confirms a high burden of periodontitis in the target (Portuguese) sub-population. The findings provide a comprehensive understanding that will empower appropriate national public oral health programmes and population-based preventive actions.
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Affiliation(s)
- João Botelho
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal.
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal.
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), CiiEM, Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Ricardo Alves
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Maria Alzira Cavacas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
| | - Luís Amaro
- Health Centers grouping (HCG) Almada-Seixal, Regional Health Administration of Lisbon and Tagus Valley (RHALTV), Lisbon, Portugal
- Hospital Garcia de Orta, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, Monte de Caparica, Portugal
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48
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Gomes‐Filho IS, Batista JET, Trindade SC, Passos‐Soares JDS, Cerqueira EDMM, Costa TSD, Figueiredo ACMG, Costa MDCN, Adan LFF, Orrico GS, Porto ECL, Pimenta RMC, Scannapieco FA, Loomer PM, Cruz SSD. Obesity and periodontitis are not associated in pregnant women. J Periodontal Res 2019; 55:77-84. [DOI: 10.1111/jre.12690] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/27/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Isaac S. Gomes‐Filho
- Department of Health Feira de Santana State University Feira de Santana Bahia Brazil
| | | | | | - Johelle de Santana Passos‐Soares
- Department of Health Feira de Santana State University Feira de Santana Bahia Brazil
- Department of Preventive Dentistry Federal University of Bahia Salvador Bahia Brazil
| | | | | | | | | | | | | | | | | | - Frank A. Scannapieco
- Department of Oral Biology, School of Dental Medicine University at Buffalo, The State University of New York Buffalo NY USA
| | - Peter Michael Loomer
- School of Dentistry University of Texas Health Science Center at San Antonio San Antonio TX USA
| | - Simone Seixas da Cruz
- Department of Health Feira de Santana State University Feira de Santana Bahia Brazil
- Department of Epidemiolog yFederal University of Recôncavo da BahiaSanto Antônio de Jesus Bahia Brazil Bahia Brazil
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49
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Dixon DR, London RM. Restorative design and associated risks for peri‐implant diseases. Periodontol 2000 2019; 81:167-178. [DOI: 10.1111/prd.12290] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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50
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Pei X, Ouyang X, Luan Q, Suda R, Cao C. Natural 4‐year periodontal progression of mandibular first molars in Chinese villagers based on radiographic records. J Periodontol 2019; 90:1390-1398. [PMID: 31257589 DOI: 10.1002/jper.18-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 01/14/2019] [Accepted: 03/01/2019] [Indexed: 01/22/2023]
Affiliation(s)
- Xiyan Pei
- Department of PeriodontologyPeking University School and Hospital of Stomatology Beijing P. R. China
- First Clinic DivisionPeking University School and Hospital of Stomatology Beijing P. R. China
| | - Xiangying Ouyang
- Department of PeriodontologyPeking University School and Hospital of Stomatology Beijing P. R. China
| | - Qingxian Luan
- Department of PeriodontologyPeking University School and Hospital of Stomatology Beijing P. R. China
| | - Reiko Suda
- Departments of PeriodonticsShowa University School of Dentistry Tokyo Japan
| | - Caifang Cao
- Department of PeriodontologyPeking University School and Hospital of Stomatology Beijing P. R. China
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