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Yamazaki Y, Morita T, Nakai K, Konishi Y, Goto A, Yamamoto T, Seto M, Ozaki M, Tanaka H, Maeno M, Kawato T. Impact of dental health intervention on cardiovascular metabolic risk: a pilot study of Japanese adults. J Hum Hypertens 2024; 38:500-509. [PMID: 34006984 DOI: 10.1038/s41371-021-00551-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/23/2021] [Accepted: 05/05/2021] [Indexed: 11/09/2022]
Abstract
This study aimed to determine whether a dental health education program would reduce cardiometabolic risk (obesity, hypertension, dyslipidemia, and hyperglycemia) in people with periodontitis. We used annual check-up data provided by the Japanese company's health insurance union. Of 182 male employees with cardiometabolic risk and periodontal pockets at baseline, 21 participants of the dental health education program and 21 non-participants matched for age, the presence of obesity, and periodontal pocket at baseline were allocated to the intervention (mean age, 53.3 ± 7.0) and the non-intervention groups (mean age, 52.9 ± 7.0), respectively. The program focused on self-removal of dental plaque with a toothbrush and interdental brush and comprised five sessions over 12 months. In the intervention group, waist circumference (cm) and diastolic blood pressure (mmHg) decreased from 88.4 ± 6.3 to 86.8 ± 6.3 and from 85.7 ± 8.2 to 82.6 ± 8.3, respectively (P < 0.05). Intergroup comparison showed significant improvement of systolic blood pressure (mmHg) in the intervention group (-3.7 ± 12.5) compared with the non-intervention group (4.0 ± 15.9) (P < 0.05) with no significant differences in the other parameters. The intervention group had a decrease in plaque accumulation and periodontitis symptoms, such as the depth of periodontal pocket and the presence of periodontal pocket and bleeding on probing, but an increase in the frequency of interdental brushing and duration of tooth brushing. Our findings show that dental self-care may improve blood pressure in people with cardiometabolic risk factors and periodontitis.
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Affiliation(s)
| | - Toyoko Morita
- The Lion Foundation for Dental Health, Tokyo, Japan
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Kumiko Nakai
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Yumi Konishi
- The Lion Foundation for Dental Health, Tokyo, Japan
| | - Ayae Goto
- The Lion Foundation for Dental Health, Tokyo, Japan
| | | | - Misae Seto
- Lion Corporation, Health Care Center, Tokyo, Japan
| | - Manami Ozaki
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Hideki Tanaka
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takayuki Kawato
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.
- Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan.
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Lu L, Zhao D, Li C, Sun Y, Geng F, Zhang S, Li W, Wang S, Pan Y. The role of periodontitis in the development of atherosclerotic cardiovascular disease in participants with the components of metabolic syndrome: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:339. [PMID: 38801482 DOI: 10.1007/s00784-024-05731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Prevention of atherosclerotic cardiovascular disease (ASCVD) is important in individuals with metabolic syndrome components (MetS), and periodontitis may play an important role in this process. This study aims to evaluate the association between periodontitis and ASCVD in participants with the components of MetS, including obesity, dysglycemia, hypertension, and dyslipidemia. MATERIALS AND METHODS This study conducted followed the MOOSE reporting guidelines and the PRISMA 2020 guidelines. EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed and OpenGrey were searched for observational studies about the linkage of periodontitis to ASCVD in people with MetS components up to April 9, 2023. Cohort, case-control and cross-sectional studies were included after study selection. Quality evaluation was carried out using the original and modified Newcastle-Ottawa Scale as appropriate. Random-effects model was employed for meta-analysis. RESULTS Nineteen studies were finally included in the quality analysis, and all of them were assessed as moderate to high quality. Meta-analyses among fifteen studies revealed that the participants with periodontitis were more likely to develop ASCVD in those who have dysglycemia (RR = 1.25, 95% CI = 1.13-1.37; p < 0.05), obesity (RR = 1.13, 95% CI = 1.02-1.24; p < 0.05), dyslipidemia (RR = 1.36, 95% CI = 1.13-1.65; p < 0.05), or hypertension (1.20, 95% CI = 1.05-1.36; p < 0.05). CONCLUSIONS Periodontitis promotes the development of ASCVD in participants with one MetS component (obesity, dysglycemia, hypertension or dyslipidemia). CLINICAL RELEVANCE In people with MetS components, periodontitis may contribute to the ASCVD incidence.
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Affiliation(s)
- Lijie Lu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Dan Zhao
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Chen Li
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yangyang Sun
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Shuwei Zhang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Weiqi Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Songlin Wang
- Salivary Gland Disease Center, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
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Boitor O, Stoica F, Mihăilă R, Stoica LF, Stef L. Automated Machine Learning to Develop Predictive Models of Metabolic Syndrome in Patients with Periodontal Disease. Diagnostics (Basel) 2023; 13:3631. [PMID: 38132215 PMCID: PMC10743072 DOI: 10.3390/diagnostics13243631] [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: 10/23/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Metabolic syndrome is experiencing a concerning and escalating rise in prevalence today. The link between metabolic syndrome and periodontal disease is a highly relevant area of research. Some studies have suggested a bidirectional relationship between metabolic syndrome and periodontal disease, where one condition may exacerbate the other. Furthermore, the existence of periodontal disease among these individuals significantly impacts overall health management. This research focuses on the relationship between periodontal disease and metabolic syndrome, while also incorporating data on general health status and overall well-being. We aimed to develop advanced machine learning models that efficiently identify key predictors of metabolic syndrome, a significant emphasis being placed on thoroughly explaining the predictions generated by the models. We studied a group of 296 patients, hospitalized in SCJU Sibiu, aged between 45-79 years, of which 57% had metabolic syndrome. The patients underwent dental consultations and subsequently responded to a dedicated questionnaire, along with a standard EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) questionnaire. The following data were recorded: DMFT (Decayed, Missing due to caries, and Filled Teeth), CPI (Community Periodontal Index), periodontal pockets depth, loss of epithelial insertion, bleeding after probing, frequency of tooth brushing, regular dental control, cardiovascular risk, carotid atherosclerosis, and EQ-5D-5L score. We used Automated Machine Learning (AutoML) frameworks to build predictive models in order to determine which of these risk factors exhibits the most robust association with metabolic syndrome. To gain confidence in the results provided by the machine learning models provided by the AutoML pipelines, we used SHapley Additive exPlanations (SHAP) values for the interpretability of these models, from a global and local perspective. The obtained results confirm that the severity of periodontal disease, high cardiovascular risk, and low EQ-5D-5L score have the greatest impact in the occurrence of metabolic syndrome.
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Affiliation(s)
- Ovidiu Boitor
- Dental Medicine Research Center, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Florin Stoica
- Department of Mathematics and Informatics, Research Center in Informatics and Information Technology, Faculty of Sciences, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Romeo Mihăilă
- Department of Internal Medicine, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Laura Florentina Stoica
- Department of Mathematics and Informatics, Research Center in Informatics and Information Technology, Faculty of Sciences, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Laura Stef
- Department of Oral Health, Dental Medicine Research Center, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
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Pietropaoli D, Altamura S, Ortu E, Guerrini L, Pizarro TT, Ferri C, Del Pinto R. Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study. J Transl Med 2023; 21:252. [PMID: 37038173 PMCID: PMC10088168 DOI: 10.1186/s12967-023-04072-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/21/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of atherosclerotic risk factors that increases cardiovascular risk. MetS has been associated with periodontitis, but the contribution of single MetS components and any possible sexual dimorphism in this relation remain undetermined. METHODS Using the third National Health and Nutrition Examination Survey (NHANES III), we performed a nested cross-sectional study to test whether individuals aged > 30 years undergoing periodontal evaluation (population) exposed to ≥ 1 MetS component (exposure) were at increased risk of bleeding/non-bleeding periodontal diseases (outcome) compared to nonexposed individuals, propensity score matched for sex, age, race/ethnicity, and income (controls). The association between MetS components combinations and periodontal diseases was explored overall and across subgroups by sex and smoking. Periodontal health status prediction based on MetS components was assessed. RESULTS In total, 2258 individuals (n. 1129/group) with nested clinical-demographic features were analyzed. Exposure was associated with gingival bleeding (+ 18% risk for every unitary increase in MetS components, and triple risk when all five were combined), but not with stable periodontitis; the association was specific for women, but not for men, irrespective of smoking. The only MetS feature with significant association in men was high BP with periodontitis. CRP levels significantly increased from health to disease only among exposed women. MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease. CONCLUSION The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. Further research is needed to validate and expand these findings.
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Affiliation(s)
- Davide Pietropaoli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Serena Altamura
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
| | - Eleonora Ortu
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | - Luca Guerrini
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | - Theresa T Pizarro
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Claudio Ferri
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
| | - Rita Del Pinto
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy.
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy.
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The etiological consideration of oxidized low-density lipoprotein in periodontitis. J Oral Biosci 2023; 65:19-23. [PMID: 36206991 DOI: 10.1016/j.job.2022.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Epidemiologically, correlations between periodontal disease activity and CVD/serum lipid-related condition have been reported. Known mediators of these links include triglycerides, oxidized LDL (oxLDL) and inflammatory cytokines such as TNF-α supplied by adipocytes as well as oxidative degeneration products of these lipids. In this review, we focused on oxidized LDL and considered the relationship between periodontal disease and systemic conditions. HIGHLIGHT The degree of oxidation in the periodontal pocket can be evaluated by analyzing the Gingival Cervicular Fluid (GCF), which can be easily collected with paperpoint. The oxLDL/LDL ratio in GCF has been shown to be 17 times as high as that in blood, and IL-8 and IL-1β were also abundantly found in GCF. Periodontal treatment significantly lowers oxLDL levels in not only GCF but also plasma. In addition, there has been growing body of evidence that periodontal infections by periodontopathic bacteria affect arteriosclerosis. On the other hands, neutrophil extracellular traps (NETs), a form of innate immune responses, reportedly play a role as a defense mechanism in the periodontal pockets. However, the regulatory mechanism of NETs in periodontal pocket is still unknown. Recently, NETs induced by oxidized cholesterol have been reported to be involved in inflammatory damage to vascular endothelial cells. CONCLUSION Further understanding of the newly discovered roles of oxLDL in the defense and destruction of periodontal tissues are anticipated.
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Modifiable risk factors for the development and progression of periodontal tissue diseases. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.5-2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In this review, an analysis of modifiable risk factors for the development and progression of periodontal tissue diseases was carried out. The review highlights the data on the relationship of periodontal infection, tobacco smoking, diabetes mellitus, cardiovascular disease, drug-induced periodontal tissue damage, stress, and obesity with the risk of developing and progression of periodontal tissue diseases. A rather detailed analysis of the mechanisms of pathogenic influence of the microflora of the oral cavity, including in the subgingival plaque, was carried out. The mechanisms of the pathological effect of smoking on the state of periodontal tissues are described. Data on the effect of periodontal treatment on glycemic control in patients with diabetes mellitus are presented. The article emphasizes the importance of the presence of periodontal diseases as a risk factor for cardiovascular and cerebrovascular diseases, describes the mechanisms of the mutual influence of cardiovascular pathology and the inflammatory process in the periodontium. In addition, the article presents the possibilities of the iatrogenic effect of systemic drugs on the state of periodontal tissues. The data on the influence of stress loads on the development of dental diseases are presented. The review article describes in detail the mechanisms of influence of overweight and obesity on the risks of development and progression of periodontal tissue diseases. Based on the results of the scientific research publications presented in the article, it can be stated that not only the dentist, but also doctors of other specialties need to work to change the modifiable risk factors for the development and progression of periodontal diseases.
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Jeong J, Kim HS, Lee D, Kim K, Kim YH. Association between Four Dietary Patterns and the Risk of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14204362. [PMID: 36297045 PMCID: PMC9611912 DOI: 10.3390/nu14204362] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Several dietary patterns are reported as risk factors for several chronic diseases including oral diseases. However, thus far, there has been no comprehensive quantitative analysis of nutrition and periodontal diseases. Methods: This systematic review was conducted according to the PRISMA guidelines. Cohort, case–control, and cross-sectional studies were eligible for inclusion in this study. The Newcastle–Ottawa scale was used to qualitatively assess the risk of bias in the included studies. The number of samples was used for odds ratio calculation, followed by the unadjusted value and 95% confidence interval. Results: Nine papers were included for the systematic review and meta-analysis. The results of screening for database search records showed that four diet patterns (western diet, dairy product intake, sugar intake, and vitamin C intake) have enough data for meta-analysis. The risk of periodontal disease in the western-diet group and the lowest dairy product intake group was 1.05 (0.51–2.13) and 1.28 (0.89–1.84), respectively. The risk of periodontal disease in the highest sugar intake group and the lowest vitamin C intake group was 1.52 (0.79–2.91) and 1.15 (1.08–1.23), respectively. Conclusions: With aging of the population globally, the prevalence of periodontal disease increases, and the associated cost also increases. Though this study, we found foods related to the risk of periodontal disease, and we are confident that it will contribute to lowering the incidence of the disease.
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Affiliation(s)
- Jaehun Jeong
- School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Hyung-Sik Kim
- Department of Oral Biochemistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Dongjun Lee
- Department of Convergence Medicine, School of Medicine, Pusan National University, Yangsan 50612, Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan 49267, Korea
- Correspondence: (K.K.); (Y.-H.K.); Tel.: +82-51-510-6368 (K.K.); +82-51-510-8091 (Y.-H.K.); Fax: +82-51-510-6694 (K.K.); +82-51-510-8049 (Y.-H.K.)
| | - Yun-Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan 50612, Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan 50612, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
- Correspondence: (K.K.); (Y.-H.K.); Tel.: +82-51-510-6368 (K.K.); +82-51-510-8091 (Y.-H.K.); Fax: +82-51-510-6694 (K.K.); +82-51-510-8049 (Y.-H.K.)
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8
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts
- Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts
- Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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Kayal RA, Almutadares M, Algarni A, Alfaifi K, Bahammam MA, Alhazzazi TY. The Effect of Self-Reported Diabetes on Alveolar Bone Loss and Number of Missing Teeth. Open Dent J 2021. [DOI: 10.2174/1874210602115010526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Diabetes mellitus, a major public health problem worldwide, is a known risk factor for periodontitis.
Objective:
This study aimed to investigate the effect of diabetes on periodontal health in a Saudi population by assessing alveolar bone level, and the number of missing teeth.
Methods:
In this retrospective study, the dental records of 203 patients (30–70 years old) patients (diabetic group = 102; control = 101) who visited King Abdulaziz University, Faculty of Dentistry, were examined through panoramic radiography. Bone loss measurements were carried out using the Ramfjord teeth index, and the number of missing teeth was counted for both groups. Independent t-test was used for comparing the total average represented by two group means, while Chi-square test was utilized to establish relationships between categorical variables.
Results:
The diabetic group had a significant 1.35-fold higher mean total bone loss (3.59 ± 1.37) compared to the control (2.66 ± 1.05). This was statistically significant in both genders (p = 001) and in >45 years old age group (p <0.05). The number of missing teeth was significantly higher in diabetic patients compared to control patients, specifically when missing >10 teeth and belonging to >55 years old age group (p <0.05).
Conclusion:
Our findings have shown a positive association between periodontal disease and diabetic patients, emphasizing the importance of early screening and diagnosis of diabetes and periodontitis in Saudi Arabia, which would help patients to avoid alveolar bone and tooth loss at early stages.
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Mikami R, Mizutani K, Matsuyama Y, Matsuura T, Kido D, Takeda K, Takemura S, Nakagawa K, Mukaiyama Y, Suda T, Yasuda T, Ohta S, Takaya N, Fujiwara T, Izumi Y, Iwata T. Association between periodontal inflammation and serum lipid profile in a healthy population: A cross-sectional study. J Periodontal Res 2021; 56:1037-1045. [PMID: 34273107 DOI: 10.1111/jre.12917] [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: 03/28/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 01/01/2023]
Abstract
AIMS The impact of periodontal inflammation on lipid metabolism is controversial. This study aimed to investigate the association between full-mouth periodontal inflammation and serum lipid levels. MATERIALS AND METHODS In this cross-sectional study, we performed periodontal and bacteriological examinations during medical checkup on 131 subjects. The association between the periodontal inflamed surface area (PISA) and the lipid markers was analyzed by multiple linear regression, adjusting for age, sex, smoking, and body mass index. RESULTS Overall, 118 medically healthy participants were analyzed. The proportions of none, mild, moderate, and severe periodontitis were 37.3%, 32.2%, 25.4%, and 5.1%, respectively. Multivariate analysis showed that high-density lipoprotein cholesterol was significantly higher in participants with the lowest tertile of PISA values (PISA low, coefficient: 7.94; 95% confidence interval [CI]: 1.63, 14.26, p = .01) compared to those in other tertiles (PISA high). Low-density/high-density lipoprotein cholesterol and total/high-density lipoprotein cholesterol ratios were significantly lower in the PISA-low group than the PISA-high group (coefficient: -0.26 and -0.30; 95% CI: -0.50, -0.02, and -0.59, -0.0002; p = .04 and .0498). Serum high-sensitivity C-reactive protein level, but not serum Porphyromonas gingivalis antibody titer, partly explained the association between PISA and high-density lipoprotein cholesterol. A significant interaction between female sex and PISA values toward high-density lipoprotein cholesterol level was detected. CONCLUSION Periodontal inflammation was inversely associated with higher high-density lipoprotein cholesterol, especially in females. Elevated serum C-reactive protein partly explained this association.
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Affiliation(s)
- Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Daisuke Kido
- Department of General Dentistry, Tokyo Medical and Dental University Dental Hospital, Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shu Takemura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keita Nakagawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuto Mukaiyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | | | | | | | - Takeo Fujiwara
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Oral Care Perio Center, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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11
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Moreira ARO, Batista RFL, Ladeira LLC, Thomaz EBAF, Alves CMC, Saraiva MC, Silva AAM, Brondani MA, Ribeiro CCC. Higher sugar intake is associated with periodontal disease in adolescents. Clin Oral Investig 2020; 25:983-991. [PMID: 32519237 DOI: 10.1007/s00784-020-03387-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18-19 years old). MATERIALS AND METHODS This was a cross-sectional study nested to RPS Cohorts Consortium, São Luís, Brazil (n = 2515). The exposure was percentage of daily calories from added sugar (≥ 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth ≥ 4 mm, and clinical attachment level ≥ 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent's educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and ≥ 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson. RESULTS High sugar intake was associated with ≥ 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03-1.94; p = 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03-1.29; p = 0.011). CONCLUSION High level of added sugar intake was associated with greater extent of periodontal disease in adolescents. CLINICAL RELEVANCE High sugar intake was associated with periodontal disease in adolescents, supporting the integrated hypothesis of dental caries and periodontal disease and giving impetus to future clinical investigation on the effect of restriction of added sugar consumption in periodontal parameters, which potentially may change traditional treatment protocols of periodontal disease.
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Affiliation(s)
- Ana R O Moreira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Rosangela F L Batista
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Lorena L C Ladeira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Erika B A F Thomaz
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Claudia M C Alves
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Maria C Saraiva
- Department of Pediatric Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio A M Silva
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Mario A Brondani
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Cecilia C C Ribeiro
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil.
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil.
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12
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Helmi M, Goodson JM, Hasturk H, Natto ZS. Annual alveolar bone loss in subjects with cardiovascular disease adjusting for associated systemic diseases and risk factors: a retrospective study. BMC Oral Health 2020; 20:28. [PMID: 32000769 PMCID: PMC6993352 DOI: 10.1186/s12903-020-1015-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/20/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To detect annual alveolar bone loss in subjects with cardiovascular disease (CVD) adjusting for associated systemic diseases and risk factors. METHODS A total number of 132 subjects that reported having CVD from 2008 to 2015 (N = 132). For longitudinal data analysis, 58 subjects eligible for inclusion with at least two exposures of complete mouth set or repeated BW radiographs with at least one-year interval compared with a control group. Alveolar bone level on mesial and distal sites of posterior teeth was measured on bitewing (BW) radiographs available in the electronic health records of each subject. RESULTS Subjects who reported having cardiovascular diseases experienced higher annual mean alveolar bone loss (0.062 mm per year) compared to Subjects with no cardiovascular diseases (0.022 mm per year). CONCLUSION Subjects who have reported CVD had higher rate of annual bone loss compared to subjects who did not have any CVD. This observation indicates that targeting high-risk individuals for risk assessment is fundamental to provide the best healthcare possible to those who are the most in need. Periodic examination and assessment of periodontal health is an essential key factor for better oral health, however, it has to be more emphasized and prioritized for individuals that are more prone to the disease.
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Affiliation(s)
- Mohammad Helmi
- Periodontics and Community Dentistry Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - J Max Goodson
- Department of Oral Medicine, Infection, and Immunity, School of Dental Medicine, Harvard University, Boston, MA, USA
- Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Hatice Hasturk
- Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, P.O.BOX 40311, Jeddah, 21499, Saudi Arabia.
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13
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Morita T, Yamazaki Y, Seto M, Yamamoto T, Nakai K, Tanaka H, Ozaki M, Koshi R, Maeno M, Kawato T. Effect of Periodontitis and Toothbrushing Frequency on Obesity Onset: A Cohort Study. Med Sci Monit 2019; 25:9712-9720. [PMID: 31852008 PMCID: PMC6930697 DOI: 10.12659/msm.917356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The interplay between obesity and periodontitis has been widely examined. While obesity was reported as a risk factor for periodontitis, the inverse relationship is still little explored. Therefore, we aimed to determine whether periodontitis and toothbrushing frequency affect the onset of obesity. Material/Methods This cohort study included 1619 employees of a business enterprise headquartered in Tokyo, who in 2002 and 2006 underwent in prescribed annual health checks, both general and dental-specific, and who were not obese in 2002 (body mass index <25). The response variable was obesity (or absence) at 4 years, while the explanatory variables were presence/absence of periodontal pockets and toothbrushing frequency in 2002; their relationships were examined by multiple logistic regression analysis. Results Subjects with periodontal pockets ≥4 mm showed a significantly higher odds ratio (OR) for onset of obesity at 4 years than those without periodontal pockets [OR: 1.59, 95% CI (confidence interval): 1.08–2.35, p<0.05]. Similarly, subjects who brushed their teeth ≥3 times/day had a significantly lower obesity OR than those who brushed ≤1 time/day (OR: 0.49, 95% CI: 0.28–0.85, p<0.01). Conclusions The presence of periodontal pockets and toothbrushing frequency are significantly associated with the onset of obesity. Periodontal pockets ≥4 mm are associated with increased risk of obesity, while frequent toothbrushing (≥3 times/day) appears to reduce the risk of obesity.
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Affiliation(s)
- Toyoko Morita
- The Lion Foundation for Dental Health, Tokyo, Japan.,Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | | | | | | | - Kumiko Nakai
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Hideki Tanaka
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Manami Ozaki
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Ryosuke Koshi
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takayuki Kawato
- Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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14
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Anbarcioglu E, Kirtiloglu T, Öztürk A, Kolbakir F, Acıkgöz G, Colak R. Vitamin D deficiency in patients with aggressive periodontitis. Oral Dis 2018; 25:242-249. [PMID: 30169905 DOI: 10.1111/odi.12968] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/07/2018] [Accepted: 08/26/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Vitamin D deficiency is a frequent health problem worldwide, especially as fewer people spend much time in the sun. Vitamin D deficiency is linked to several infectious and inflammatory conditions, including periodontal disease. However, its role in aggressive periodontitis (AgP) has not been well studied. We evaluated the association between vitamin D concentration and periodontal disease, both AgP and chronic (CP) periodontitis. METHOD AND MATERIALS Forty-seven AgP 55 CP and 27 control subjects participated. All patients were tested for serum vitamin D concentration (25(OH)D), parathyroid hormone, and serum bone-related biomarkers (alkaline phosphatases, calcium, and phosphorus) regulated by vitamin D. RESULTS The patients with AgP had lower serum 25(OH)D concentration (11.22 ± 4.8 ng/ml) than controls (16.9 ± 6.4 ng/ml) and patients with CP (16.13 ± 8.3 ng/ml; overall p value 0.0002). These associations remained significant after adjustment for age and gender (p = 0.002). No significant differences were observed in any bone-related biomarker among the three groups, and no association was observed with periodontal disease indices. CONCLUSIONS Our results suggest that vitamin D deficiency may be a potential risk factor for AgP. Given the high prevalence of vitamin D deficiency in AgP patients, routine screening for vitamin D status may be advisable in these subjects.
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Affiliation(s)
- Emrah Anbarcioglu
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Tugrul Kirtiloglu
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayla Öztürk
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Filiz Kolbakir
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Gökhan Acıkgöz
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ramis Colak
- Department of Endocrinology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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15
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Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, Koga T. The Severity of Periodontal Disease is Associated with the Development of Glucose Intolerance in Non-diabetics: The Hisayama Study. J Dent Res 2016; 83:485-90. [PMID: 15153457 DOI: 10.1177/154405910408300610] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammation is hypothesized to play a significant role in the development of type 2 diabetes; however, reports on clinical inflammatory conditions are limited. Studies have suggested that periodontitis affects glucose control in diabetics. This community-based study examined the relationship between periodontitis and glucose tolerance status, including changes in status. The relationship between periodontal condition and the results of a 75-g oral glucose tolerance test was examined in 961 adults in 1998. Deep pockets (mean pocket depth > 2.0 mm) were significantly associated with impaired glucose tolerance and with diabetes as compared with shallow pockets (< 1.3 mm). In the subgroup with normal glucose tolerance 10 years previously, subjects who subsequently developed impaired glucose tolerance were significantly more likely to have deep pockets. Deep pockets were closely related to current glucose tolerance status and the development of glucose intolerance.
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Affiliation(s)
- T Saito
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
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16
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Morita T, Yamazaki Y, Fujiharu C, Ishii T, Seto M, Nishinoue N, Sasaki Y, Nakai K, Tanaka H, Kawato T, Maeno M. Association Between the Duration of Periodontitis and Increased Cardiometabolic Risk Factors: A 9-Year Cohort Study. Metab Syndr Relat Disord 2016; 14:475-482. [PMID: 27740886 DOI: 10.1089/met.2016.0018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Epidemiological studies have reported that periodontitis and cardiometabolic disease such as cardiovascular disease and type 2 diabetes are associated; however, there have been very few prospective cohort studies on this topic. Therefore, we conducted a 9-year follow-up study to examine the relationship between the duration of periodontitis and cardiometabolic risk factors, including hypertension, hyperglycemia, dyslipidemia, and obesity. METHODS The study participants comprised 572 adult industrial workers (417 men and 155 women; mean age, 37.4 years) who had undergone annual medical and dental health examinations from 2003 to 2012; the evaluation of the four cardiometabolic risk factors in 2003 revealed normal values in all the participants. We investigated the relationship between the cumulative duration of the presence of periodontal pockets, which is a major symptom of periodontitis, and the presence of cardiometabolic risk factors after 9 years using multiple logistic regression analysis. RESULTS The odds ratio (OR) for the presence of ≥1 cardiometabolic risk factor in participants with a cumulative duration of periodontal pockets for ≥6 years was significantly higher than that in participants without pockets. The ORs for the onset of obesity, hypertension, dyslipidemia, and hyperglycemia were higher in participants with a cumulative duration of periodontal pockets for ≥6 years than those in participants without pockets or in participants with a cumulative duration of periodontal pockets for ≤5 years, and all the differences, except dyslipidemia, were significant. CONCLUSIONS Chronic periodontitis was significantly associated with having cardiometabolic risk factors during the 9-year observation period, suggesting that the risk of cardiometabolic disease might increase in people who have untreated periodontitis.
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Affiliation(s)
- Toyoko Morita
- 1 The Lion Foundation for Dental Health , Tokyo, Japan .,2 Department of Oral Health Sciences, Nihon University School of Dentistry , Tokyo, Japan
| | - Yoji Yamazaki
- 1 The Lion Foundation for Dental Health , Tokyo, Japan
| | | | | | - Misae Seto
- 3 Lion Corporation, Health Care Center , Tokyo, Japan
| | | | - Yoshiyuki Sasaki
- 4 Research and Industry-University Alliance Organization, Tokyo Medical and Dental University , Tokyo, Japan
| | - Kumiko Nakai
- 2 Department of Oral Health Sciences, Nihon University School of Dentistry , Tokyo, Japan .,5 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
| | - Hideki Tanaka
- 2 Department of Oral Health Sciences, Nihon University School of Dentistry , Tokyo, Japan .,5 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
| | - Takayuki Kawato
- 2 Department of Oral Health Sciences, Nihon University School of Dentistry , Tokyo, Japan .,5 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
| | - Masao Maeno
- 2 Department of Oral Health Sciences, Nihon University School of Dentistry , Tokyo, Japan .,5 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry , Tokyo, Japan
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17
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Ren C, McGrath C, Yang Y. Edentulism and associated factors among community-dwelling middle-aged and elderly adults in China. Gerodontology 2016; 34:195-207. [PMID: 27709661 DOI: 10.1111/ger.12249] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the prevalence of self-reported edentulism and its associated risk factors among community-dwelling adults aged 45 years and older in China. MATERIALS AND METHODS Data from the national baseline survey (2011-2012) of the China Health and Retirement Longitudinal Study (CHARLS) were used for this study (N = 17 167). Bivariate and multivariate logistic regressions were conducted to assess the predictors of edentulism. Models 1 and 2 were based on the whole sample. Models 3 and 4 were based on the subsample (N = 9933) from whom anthropometric and blood biomarker data were available. RESULTS The prevalence of edentulism was 8.64% among Chinese adults aged 45 and above. As shown by Model 1, older age was a robust predictor for edentulism (odds ratio [OR] = 3.81 for people aged 55-64; OR = 11.22 for people aged 65-74; OR = 24.05 for people aged 75 and above). Other factors positively associated with edentulism included being female (OR = 1.25), rural residence (OR = 1.30), asthma (OR = 1.48), depression (OR = 1.20), reduced physical function (OR = 1.37) and current smoking status (OR = 1.36). People with higher educational levels (OR = 0.75 for people who can read and write; OR = 0.64 for people who obtained a junior high school education or above) and better-off economic status (OR = 0.80) were less likely to be edentate. The association between edentulism and age, educational level, economic status and physical function remained significant in Model 3, and in addition, being underweight appeared as another strong predictor (OR = 1.93). CONCLUSIONS The estimated prevalence of edentulism and the identified associated factors will provide epidemiologic evidence for future research and interventions in the target population in China.
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Affiliation(s)
- Chong Ren
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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18
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Kikui M, Kokubo Y, Ono T, Kida M, Kosaka T, Yamamoto M, Watanabe M, Maeda Y, Miyamoto Y. Relationship between Metabolic Syndrome Components and Periodontal Disease in a Japanese General Population: the Suita Study. J Atheroscler Thromb 2016; 24:495-507. [PMID: 27725400 PMCID: PMC5429165 DOI: 10.5551/jat.33761] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Aim: A positive association between metabolic syndrome (MetS) and periodontal status has recently been noted. However, no study has evaluated the relationship by sex and in a general urban population using the uniform definition proposed in the 2009 Joint Interim Statement. The aim of this study was to clarify the relationship between MetS and periodontal status using the uniform definition in a general urban Japanese population. Methods: A total of 1,856 Japanese men and women (mean age: 66.4 years) were studied using data from the Suita study. Periodontal status was evaluated by the Community Periodontal Index (CPI). MetS was defined using the 2009 Joint Interim Statement. The associations of the MetS and its components with periodontal disease were investigated using multiple logistic regression analysis adjusting for age, drinking, and smoking. Results: Among the components of the MetS, low HDL cholesterol level was significantly associated with periodontal disease in men and women [odds ratios (OR) = 2.39 and 1.53; 95% confidence intervals = 1.36–4.19 and 1.06–2.19]. Furthermore, the risk of periodontal disease showed 1.43-, 1.42-, and 1.89-fold increases in those with 2, 3, and ≥ 4 components, respectively, compared with those having no components (Ptrend < 0.001). For the analysis by sex, the risk of periodontal disease was increased 2.27- and 1.76-fold in those with ≥ 4 components in men and women, respectively (both Ptrend = 0.001). Conclusion: These findings suggest that MetS and lower HDL cholesterol are associated with periodontal disease. Subjects with two or more MetS components had a significantly higher prevalence of periodontal disease.
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Affiliation(s)
- Miki Kikui
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry.,Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences
| | - Momoyo Kida
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Takayuki Kosaka
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Masaaki Yamamoto
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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19
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Kumar N, Bhardwaj A, Negi PC, Jhingta PK, Sharma D, Bhardwaj VK. Association of chronic periodontitis with metabolic syndrome: A cross-sectional study. J Indian Soc Periodontol 2016; 20:324-9. [PMID: 27563208 PMCID: PMC4976555 DOI: 10.4103/0972-124x.183096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Prevalence of metabolic syndrome (MeS) is high among Asians, including Indians and is rising, particularly with the adoption of modernized lifestyle. Various studies have reported a significant relationship between periodontal status and MeS. The objective of this study is to investigate the association between periodontitis and MeS. Materials and Methods: The study included 259 subjects (130 cases with chronic periodontitis, 129 controls without chronic periodontitis) who underwent medical and periodontal checkup. Five components (obesity, high blood pressure, low- and high-density lipoproteins, cholesterol, hypertriglyceridemia, and high plasma glucose) of MeS were evaluated, and individuals with ≥3 positive components were defined as having MeS. The periodontal parameter was clinical attachment level (CAL) on the basis of which cases were selected with moderate (CAL loss 3–4 mm) and severe (CAL loss ≥5 mm) generalized chronic periodontitis. The association between chronic periodontitis and MeS components was investigated using odds ratios (ORs) and 95% confidence intervals (CIs). Results: The association of MeS and chronic periodontitis was strong and significant with OR: 2.64, 95% CI: 1.36–5.18, and P < 0.003. Comparison of mean values of components of MeS between cases and controls reveals that the mean waist circumference (mean difference: −4.8 [95% CI: 7.75–−1.84], P < 0.002) and mean triglycerides level (mean difference: −25.75 [95% CI: −49.22–−2.28], P < 0.032) were significantly higher in cases than in control groups. Although mean systolic blood pressure, diastolic blood pressure, and fasting blood sugar level were higher in cases (125.77, 82.99 and 86.38, respectively) compared with control (122.81, 81.3 and 83.68, respectively), it was statistically insignificant. Conclusion: The results of this study suggest that there is a strong association between chronic periodontitis and MeS. The association was independent of the various potential confounding risk factors affecting the chronic periodontitis such as age, sex, residential background, and tobacco consumption.
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Affiliation(s)
- Naresh Kumar
- Department of Periodontology, Maharaj Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
| | - Ashu Bhardwaj
- Department of Periodontology, Dental Faculty, Jamia Millia Islamia, New Delhi, India
| | - Prakash Chand Negi
- Department of Cardiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India
| | - Pravesh Kumar Jhingta
- Department of Periodontology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Deepak Sharma
- Department of Periodontology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Vinay Kumar Bhardwaj
- Department of Public Health Dentistry, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
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20
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Meisel P, Pink C, Nauck M, Jablonowski L, Voelzke H, Kocher T. Magnesium/Calcium Ratio in Serum Predicts Periodontitis and Tooth Loss in a 5-Year Follow-up. JDR Clin Trans Res 2016; 1:266-274. [PMID: 30931742 DOI: 10.1177/2380084416663458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In the cross-sectional Study of Health in Pomerania (SHIP-0), subjects with an adequate magnesium supply had a lower risk of periodontal disease and more teeth than those with low magnesium levels. The authors analyzed 5-y follow-up data (SHIP-1) to determine whether the baseline magnesium levels had a long-term effect on attachment level and number of teeth lost. Of the participants examined dentally in the baseline study, 3,300 (75%) were examined for progression or recession of periodontal attachment level after 5 y. For 2,432 subjects, the authors related the outcome variables of periodontal attachment level and tooth loss to baseline characteristics, especially serum magnesium and calcium concentrations, as well as systemic markers of inflammation. The progression of periodontitis was associated with the magnesium/calcium (Mg/Ca) ratio at baseline in a dose-dependent manner. Progression of mean attachment loss was prevented in the upper quartile of the Mg/Ca ratio ( P < 0.001) with antagonistic effects of magnesium and calcium irrespective of inflammatory state. With respect to tooth loss, Mg/Ca exerted dimorphic effects. In inflammatory states as indicated by high C-reactive protein (>3 mg/L), tooth loss was prevented in subjects with high Mg/Ca ratio (incidence rate ratio = 0.60, 95% confidence interval: 0.45 to 0.80, P = 0.001), but the contrary was observed in subjects with low C-reactive protein levels (incidence rate ratio = 1.14, 95% confidence interval: 0.97 to 1.34, NS). Similar results were observed with stratifying the regression on tooth loss by interleukin 6 or fibrinogen threshold. An adequate magnesium serum level and Mg/Ca balance may prevent progression of attachment level and tooth loss, especially in inflammatory states. Knowledge Transfer Statement: The results of this study present evidence that an adequate magnesium supply may be important in the prevention of periodontal diseases and future tooth loss. A diet high in magnesium could improve periodontal health, notwithstanding its beneficial effects on systemic disease. In populations with a high prevalence of hypomagnesemia, additional intake of supplements is advisable.
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Affiliation(s)
- P Meisel
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - C Pink
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - M Nauck
- 2 Department of Clinical Chemistry and Laboratory Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - L Jablonowski
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - H Voelzke
- 3 Department of Community Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - T Kocher
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
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21
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Pradeep AR, Manjunath RGS, Kathariya R. Progressive periodontal disease has a simultaneous incremental elevation of gingival crevicular fluid and serum CRP levels. ACTA ACUST UNITED AC 2015; 1:133-8. [PMID: 25427270 DOI: 10.1111/j.2041-1626.2010.00022.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Increased C-reactive protein levels have been found in all active inflammations, including periodontitis. This study aims to assess the C-reactive protein levels in periodontal disease progression. METHODS Forty-five patients were divided into the following three groups (n=15) based on gingival index, probing pocket depth, and clinical attachment level: healthy (group I), gingivitis (group II), and chronic periodontitis (group III). Gingival crevicular fluid and serum samples were quantified for C-reactive protein using enzyme-linked immunosorbent assay. RESULTS The mean C-reactive protein concentration in gingival crevicular fluid and serum was found to be highest in group III (1233.33ng/mL for gingival crevicular fluid, 5483.33ng/mL for serum), and least in group I (60 ng/mL and 413 ng/mL for gingival crevicular fluid and serum, respectively) The mean C-reactive protein concentration in group II (453.33ng/mL for gingival crevicular fluid and 3565.33 ng/mL for serum) was found to be intermediate. CONCLUSIONS C-reactive protein levels in gingival crevicular fluid and serum increased proportionately with the severity of periodontal disease. They correlated positively with clinical parameters, including gingival index, probing pocket depth, and clinical attachment level. Thus, it can be considered as a periodontal inflammatory biomarker and deserves further consideration.
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Affiliation(s)
- A R Pradeep
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, India.
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Oluwagbemigun K, Bergmann M, Pischon N, Dietrich T, Boeing H. Cross-Sectional Association Between Number of Teeth and High-Sensitivity C-Reactive Protein Among Middle-Aged Germans. J Periodontol 2015; 87:228-37. [PMID: 26513265 DOI: 10.1902/jop.2015.150384] [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: 01/09/2023]
Abstract
BACKGROUND The association between number of teeth and low-grade systemic inflammation deserves consideration within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam since the association between number of teeth and myocardial infarction has been established. METHODS Two subsamples (n = 2,439 and 728) were randomly selected from EPIC-Potsdam. Participants provided information on number of natural teeth, anthropometry, lifestyle factors, and illness-related factors. High-sensitivity C-reactive protein (hsCRP) was measured from serum. Adjusted means of hsCRP across five categories of numbers of teeth in each subsample and in the combined sample were determined, and linear trends were checked. Non-linear associations were investigated with restricted cubic spline (RCS) regression. RESULTS In the first subsample, the full multivariable-adjusted model showed that participants with 28 to 32, 24 to 27, 18 to 23, 1 to 17, and 0 teeth had mean hsCRP values of 1.32, 1.39, 1.54, 1.38, and 1.48 mg/L, respectively; in the second subsample, mean hsCRP values were 1.64, 1.67, 1.73, 1.47, and 1.87 mg/L; combined hsCRP values were 1.49, 1.53, 1.64, 1.44, and 1.65 mg/L. No linear trend was observed in these models, and RCS regression showed no non-linear association. CONCLUSION This study shows that number of teeth has a weak association with hsCRP, if any, thereby excluding this marker of low-grade systemic inflammation as a possible explanation for the association between number of teeth and myocardial infarction.
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Affiliation(s)
- Kolade Oluwagbemigun
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Nuthetal, Germany
| | - Manuela Bergmann
- Department of Periodontology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nicole Pischon
- Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - Thomas Dietrich
- Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Nuthetal, Germany
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Park HS, Nam HS, Seo HS, Hwang SJ. Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: a pilot study. BMC Oral Health 2015; 15:109. [PMID: 26385382 PMCID: PMC4575481 DOI: 10.1186/s12903-015-0094-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 09/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. Exercise training in high fat mice or rats can inhibit gingival inflammation effectively. The objective of this human intervention study was to investigate whether short-term weight control could affect periodontal indexes and serum and gingival crevicular fluid (GCF) biomarkers in young Koreans. METHODS Forty-one obese volunteers (body mass index (BMI) > 25.0) and 12 normal weight subjects (18.5 ≤ BMI ≤ 23.0) participated in a four-week weight control program to analyze the changes in anthropometric criteria, the concentrations of C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides in serum, gingival index, bleeding on probing, periodontal biomarkers in GCF, and dental plaque index at the first and the 27th days. RESULTS The means of obesity measures decreased significantly more in the obese group (BMI 2.53 ± 0.96, waist-to-hip ratio (WHR) 4.88 ± 1.58 %, LDL 35.85 ± 21.74 mgdL(-1)) than in the normal weight group (BMI 0.78 ± 0.72, WHR 2.00 ± 0.95 %, LDL 15.58 ± 18.07 mgdL(-1)). While the obese group showed significant decreases in the biomarkers in GCF (IL-1β 58.38 ± 65.55 pgmL(-1), MMP-8 4.19 ± 5.61 ngmL(-1), MMP-9 3.36 ± 6.30 ngmL(-1)), the mean changes for the normal weight group (IL-1β 10.07 ± 21.08 pgmL(-1), MMP-8 1.49 ± 4.61 ngmL(-1), MMP-9 -1.52 ± 9.71 ngmL(-1)) were not statistically significant. Anthropometric measures and the amounts of GCF biomarkers had weak positive correlations (0.242 ≤ r ≤ 0.340), and LDL in serum correlated with MMP-8 (r = 0.332) and IL-1β (r = 0.342) in the obese group. Stepwise multiple linear regression analysis in the obese group showed that the relationship between the amount of IL-1β in GCF and predictor variables including LDL and BMI was highly significant and accounted for 19.1 % of the variance in IL-1β in GCF. CONCLUSIONS In periodontally healthy subjects, weight control could reduce the amounts of MMP-8, MMP-9, and IL-1β in GCF of the obese subjects. Further studies with periodontally unhealthy and obese people are needed to identify the mechanism of decreases in inflammation biomarkers in GCF through weight control. TRIAL REGISTRATION ISRCTN86753073 (2015.08.14).
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Affiliation(s)
- Hoo-Seob Park
- Department of Preventive Medicine and Public Health, School of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Hae-Sung Nam
- Department of Preventive Medicine and Public Health, School of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Hyung-Seok Seo
- Department of Sports Medicine, College of Culture, Science & Technology, Konyang University, Nonsan, Chungcheongnamdo, South Korea.
| | - Soo-Jeong Hwang
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea. .,Department of Dental Hygiene, College of Medical Science, Konyang University, Daejeon, South Korea.
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Azizi A, Sarlati F, Bidi M, Mansouri L, Azaminejad SMM, Rakhshan V. Effects of smoking severity and moderate and severe periodontitis on serum C-reactive protein levels: an age- and gender-matched retrospective cohort study. Biomarkers 2015; 20:306-12. [DOI: 10.3109/1354750x.2015.1068864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Caúla AL, Lira-Junior R, Tinoco EMB, Fischer RG. Serum creatinine and alkaline phosphatase levels are associated with severe chronic periodontitis. J Periodontal Res 2015; 50:793-7. [PMID: 25753255 DOI: 10.1111/jre.12266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis may alter systemic homeostasis and influence creatinine and alkaline phosphatase levels. Therefore, the aim of this study was to evaluate the relationship between severe chronic periodontitis and serum creatinine and alkaline phosphatase levels. MATERIAL AND METHODS One hundred patients were evaluated, 66 with severe chronic periodontitis (test group) and 34 periodontally healthy controls (control group). Medical, demographic and periodontal parameters were registered. Blood sample was collected after an overnight fast and serum creatinine and alkaline phosphatase levels were determined. RESULTS There were significant differences between test and control groups in ethnicity, gender and educational level (p < 0.05). Patients with periodontitis showed a lower mean creatinine level (p < 0.05) and higher mean alkaline phosphatase level (p < 0.001) than the control group. There were significant correlations between periodontal parameters and serum creatinine and alkaline phosphatase levels. CONCLUSION Severe chronic periodontitis was associated to lower creatinine and higher alkaline phosphatase levels.
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Affiliation(s)
- A L Caúla
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R Lira-Junior
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - E M B Tinoco
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R G Fischer
- Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Bansal T, Dhruvakumar D, Pandey A. Comparative evaluation of C-reactive protein in peripheral blood of patients with healthy gingiva, gingivitis and chronic periodontitis: A clinical and particle-enhanced turbidimetric immuno-analysis. J Indian Soc Periodontol 2015; 18:739-43. [PMID: 25624631 PMCID: PMC4296459 DOI: 10.4103/0972-124x.147410] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 05/02/2014] [Indexed: 11/28/2022] Open
Abstract
Background: C-reactive protein (CRP), an acute-phase protein monitored as a marker of inflammatory status, has been identified as a major risk factor for various systemic diseases. It is a reliable marker to infectious burdens and/or inflammation. The aim of this study was to compare and evaluate the systemic levels of CRP in the serum sample of the patients with healthy gingiva, gingivitis, and chronic periodontitis. Materials and Methods: A total of 60 systemically healthy patients were selected and divided into three groups: Patients with healthy gingiva (Group A), patients with generalized gingivitis (Group B) and patients with chronic periodontitis (Group C). Peripheral blood was collected and high-sensitive (hs)-CRP levels were estimated in the serum samples by using the particle-enhanced turbidimetric immuno-assay technique using a commercially available kit. Results: The mean hs-CRP level in Group A recorded was 0.437 ± 0.216, Group B was 0.771 ± 0.384 and Group C was 2.285 ± 0.381. A significantly elevated hs-CRP level was found in Group C as compared with Group B and A (P < 0.05). However, a moderate, but statistically significant increase in the hs-CRP levels was observed in Group B as compared with Group A (P < 0.05). The percentage of patients with elevated levels of hs-CRP >2 mg/l was significantly higher in Group C. Conclusion: The patients with chronic periodontitis demonstrated a mean hs-CRP levels higher than the patients with gingivitis and with healthy gingiva. Furthermore, with the increasing inflammation, the hs-CRP levels increased proportionately.
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Affiliation(s)
- Tushika Bansal
- Department of Periodontology, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand, India
| | - Deepa Dhruvakumar
- Department of Periodontology, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Anita Pandey
- Department of Microbiology, Subharti Medical College, Meerut, Uttar Pradesh, India
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Morita T, Yamazaki Y, Fujiharu C, Ishii T, Seto M, Nishinoue N, Sasaki Y, Kawato T, Motohashi M, Maeno M. Serum γ-glutamyltransferase level is associated with periodontal disease independent of drinking habits in Japanese adults. Med Sci Monit 2014; 20:2109-16. [PMID: 25360830 PMCID: PMC4226313 DOI: 10.12659/msm.891204] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Non-alcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome. Periodontal disease is a mild chronic inflammatory disease with systemic effects, and many studies have indicated an association between metabolic syndrome and periodontitis. In the present study, we investigated the relationship between periodontitis and liver biochemical parameters according to alcohol drinking habits through a cross-sectional study based on data from Japanese people in occupational settings. Material and Methods The subjects were 1510 employees (1218 males, 292 females, mean age 50.4 years) who underwent dental and medical checkups in 2012. Associations between the presence of periodontal pockets and serum levels of liver biochemical parameters were assessed. Results Alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) levels were higher in subjects with than without periodontal pockets. Multiple logistic regression analysis (adjusting for age, gender, cigarette smoking, and alcohol drinking habits, and components of metabolic syndrome) with GGT or ALT as the dependent variable revealed that there was a significant association between periodontal pockets and GGT (odds ratio, OR=1.48), but not ALT. Similar associations were observed when an analysis was performed according to the presence or absence of alcohol drinking habits; the OR was higher in subjects without (OR=1.84) than with drinking habits (OR=1.41). Conclusions The presence of periodontal pockets was associated with serum levels of GGT, a liver biochemical parameter, in Japanese adults with no drinking habit, suggesting that periodontal disease is associated with liver function, independent of alcohol ingestion.
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Affiliation(s)
| | | | | | | | - Misae Seto
- Health Care Center, Lion Corporation, Tokyo, Japan
| | | | - Yoshiyuki Sasaki
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Kawato
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Masafumi Motohashi
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Masao Maeno
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan
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Bansal T, Pandey A, D D, Asthana AK. C-Reactive Protein (CRP) and its Association with Periodontal Disease: A Brief Review. J Clin Diagn Res 2014; 8:ZE21-4. [PMID: 25177663 DOI: 10.7860/jcdr/2014/8355.4646] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 06/04/2014] [Indexed: 11/24/2022]
Abstract
Periodontal disease is a chronic infection of the gums characterised by a loss of attachment between the tooth and bone, and bone loss. C-reactive protein (CRP) elevation is a part of the acute phase response to acute and chronic inflammation. Many epidemiological studies have shown that serum CRP levels were elevated in patients with chronic periodontitis. CRP levels increase to hundreds of μg/ml within hours following infection. It out-performs erythrocyte sedimentation rate (ESR) in terms of responsiveness and specificity for inflammation. While CRP elevation is suggestive of inflammation or infection in the appropriate clinical context, it can also occur with obesity and renal dysfunction. Conversely, a lack of CRP elevation in inflammation may be seen with hepatic failure, as well as during flares of conditions such as systemic lupus erythematosus.
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Affiliation(s)
- Tushika Bansal
- Senior Lecturer, Department of Periodontics, Subharti Dental College, Swami Vivekanand Subharti University , Meerut, U.P., India
| | - Anita Pandey
- Professor, Department of Microbiology, Subharti Medical College, Swami Vivekanand Subharti University , Meerut, U.P., India
| | - Deepa D
- Professor, Department of Periodontics, Subharti Dental College, Swami Vivekanand Subharti University , Meerut, U.P., India
| | - Ashish K Asthana
- Assistant Professor, Department of Microbiology, Subharti Medical College, Swami Vivekanand Subharti University , Meerut, U.P., India
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Kumar KRV, Ranganath V, Naik R, Banu S, Nichani AS. Assessment of high-sensitivity C-reactive protein and lipid levels in healthy adults and patients with coronary artery disease, with and without periodontitis - a cross-sectional study. J Periodontal Res 2014; 49:836-44. [DOI: 10.1111/jre.12172] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 12/13/2022]
Affiliation(s)
- K. R. V. Kumar
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - V. Ranganath
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - R. Naik
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - S. Banu
- Department of Biochemistry; Sri Jayadeva Institute of Cardiovascular Sciences and Research; Bangalore India
| | - A. S. Nichani
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
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Öztekin G, Baser U, Kucukcoskun M, Tanrikulu-Kucuk S, Ademoglu E, Isik G, Ozkan G, Yalcin F, Kiyan E. The Association between Periodontal Disease and Chronic Obstructive Pulmonary Disease: A Case Control Study. COPD 2013; 11:424-30. [DOI: 10.3109/15412555.2013.858316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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do Nascimento CM, Cassol T, da Silva FS, Bonfleur ML, Nassar CA, Nassar PO. Radiographic evaluation of the effect of obesity on alveolar bone in rats with ligature-induced periodontal disease. Diabetes Metab Syndr Obes 2013; 6:365-70. [PMID: 24124386 PMCID: PMC3794961 DOI: 10.2147/dmso.s50105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
There is evidence that the lack of metabolic control of obese patients may accelerate periodontitis. The aim of this study was to evaluate radiographically the effect of cafeteria-diet-induced obesity on alveolar bone loss in rats subjected to periodontal disease. Twenty male Wistar rats were randomly divided into four groups: 1) control group, 2) control and ligature group; 3) cafeteria group; and 4) cafeteria and ligature group. The animals were evaluated for obesity and euthanized, and the mandible of each rat was removed to perform a radiographic evaluation of alveolar bone loss and its effect on diet-induced obesity. The results showed greater alveolar bone loss in the mice in Group 4 (P<0.01). Thus, we concluded that obese mice, on average, showed greater radiographic evidence of alveolar bone loss than mice undergoing induction of obesity.
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Affiliation(s)
| | - Tiago Cassol
- State University of West Paraná (UNIOESTE), Cascavel, Paraná, Brazil
| | | | - Maria Lucia Bonfleur
- Fisiology, Dental School, State University of West Paraná (UNIOESTE), Cascavel, Paraná, Brazil
| | - Carlos Augusto Nassar
- Periodontology, Dental School, State University of West Paraná (UNIOESTE), Cascavel, Paraná, Brazil
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Penumarthy S, Penmetsa GS, Mannem S. Assessment of serum levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in periodontitis patients. J Indian Soc Periodontol 2013; 17:30-5. [PMID: 23633769 PMCID: PMC3636940 DOI: 10.4103/0972-124x.107471] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 11/02/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Periodontal disease is a destructive inflammatory disease inducing profound changes in the plasma concentrations of cytokines leading to a catabolic state characterized by altered lipid metabolism and hypertriglyceridemia. The main objective of the present study was to evaluate the effect of periodontal infection on serum levels of triglycerides (TGL), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol. MATERIALS AND METHODS A sample of 90 subjects; 30 periodontally healthy individuals, 30 chronic gingivitis cases (n=30), and 30 chronic periodontitis cases (n=30) with an age range of 25 to 65 years were included in the study. Periodontal parameters including Plaque Index, Gingival Index, Probing Depth, and Clinical Attachment Level were recorded. Venous blood samples were obtained after 12 hours fasting period from antecubital vein and serum levels of TGL, TC, HDL, and LDL cholesterol were measured. RESULTS The levels of TGL, TC, and LDL cholesterol were significantly higher for periodontitis group (P<0.05) as compared to gingivitis and periodontally healthy groups. HDL cholesterol levels were significantly lower in periodontitis group (P<0.05) as compared to periodontally healthy and gingivitis groups. CONCLUSION The results of the present study indicate that periodontal infection has a definite role in altering lipid metabolism leading to hyperlipidemia. However, further studies are required to clarify the relationship between periodontitis and serum lipid levels and to determine whether oral healthcare has the potential to reduce serum lipid levels in otherwise systemically healthy individuals.
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Affiliation(s)
- Swati Penumarthy
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Gautami S. Penmetsa
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Satheesh Mannem
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Fukui N, Shimazaki Y, Shinagawa T, Yamashita Y. Periodontal Status and Metabolic Syndrome in Middle-Aged Japanese. J Periodontol 2012; 83:1363-71. [DOI: 10.1902/jop.2012.110605] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chopra R, Patil SR, Kalburgi NB, Mathur S. Association between alveolar bone loss and serum C-reactive protein levels in aggressive and chronic periodontitis patients. J Indian Soc Periodontol 2012; 16:28-31. [PMID: 22628959 PMCID: PMC3357029 DOI: 10.4103/0972-124x.94600] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 11/09/2011] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND C-reactive protein (CRP) is an acute phase reactant that is produced in response to diverse inflammatory stimuli, and is known predictor of cardiovascular disease risk. Aggressive and chronic periodontitis are two main forms of periodontal disease, which differ mainly in the method of disease progression. This study aims at determining and comparing the relative levels of serum CRP and alveolar bone loss in aggressive and chronic periodontitis patients. MATERIALS AND METHODS A total of 45 subjects, which were divided into 3 groups diagnosed as having generalized aggressive periodontitis (GAP), chronic generalized periodontitis (CGP) and non-periodontitis controls (NP), were selected for the study. Venous blood samples were collected for quantitative CRP analysis using Turbidimetric immunoassay. Alveolar bone loss (ABL) was measured at proximal sites of posterior teeth on a panoramic radiograph. The relationship between the mean ratio of ABL to root length and serum CRP levels was statistically analyzed using Student unpaired t-test, analysis of variance (ANOVA) and Pearson's correlation coefficient. RESULTS Mean CRP levels were significantly greater in both GAP (7.49±2.31 mg/l) and CGP (4.88±1.80 mg/l) groups as compared to NP (0.68±0.23 mg/l) with P value <0.0001. The mean value of ABL (%) was 31.58 in CGP group and 36.77 in the GAP group, the difference being statistically significant (P=0.0079). Correlation coefficient between CRP and ABL is 0.9310 in CGP, and 0.9252 in GAP, which indicates a positive correlation between both variables. CONCLUSION Both forms of periodontitis are associated with increased systemic inflammatory response with aggressiveness of disease progression determining the degree of response.
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Affiliation(s)
- Rahul Chopra
- Department of Periodontics, Government Dental College, Rohtak, Haryana, India
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Brandelero S, Bonfleur ML, Ribeiro RA, Vanzela EC, Nassar CA, Nassar PO, Balbo SL. Decreased TNF-α gene expression in periodontal ligature in MSG-obese rats: A possible protective effect of hypothalamic obesity against periodontal disease? Arch Oral Biol 2012; 57:300-6. [DOI: 10.1016/j.archoralbio.2011.08.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 07/27/2011] [Accepted: 08/29/2011] [Indexed: 11/16/2022]
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36
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Sezer U, Erciyas K, Pehlivan Y, Ustün K, Tarakçioğlu M, Senyurt SZ, Onat AM. Serum cytokine levels and periodontal parameters in ankylosing spondylitis. J Periodontal Res 2011; 47:396-401. [PMID: 22126620 DOI: 10.1111/j.1600-0765.2011.01448.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Multiple studies support the role of periodontal disease in contributing to the chronic systemic inflammatory burden in a variety of diseases, including ankylosing spondylitis (AS), in the progression which the inflammatory process plays an important role. We assume that patients with AS are more likely to have periodontal disease than healthy individuals. The aim of this study was to determine the possible relationship between inflammatory periodontal diseases and AS by evaluating clinical periodontal parameters and serum cytokine levels. MATERIAL AND METHODS Forty-eight adults with AS (35 women and 13 men; age range 18-56 years; mean age 34.27 years) and 48 age- and sex-matched systemically healthy control subjects participated in the study. The clinical periodontal parameters, venous blood and Bath Ankylosing Spondylitis Disease Activity Score were obtained, and serum C-reactive protein, tumour necrosis factor-α and interleukin-6 (IL-6) levels were evaluated. RESULTS There was statistically no significant difference in the frequency of periodontitis between AS patients and the control group. Furthermore, there was no significant difference in probing depth, clinical attachment level and plaque index, and the only significant clinical difference between groups was in levels of bleeding on probing (p < 0.001). Serum concentrations of IL-6, tumour necrosis factor-α and C-reactive protein in the AS group were significantly higher than those in the control group (p < 0.001). In the AS group, there was a correlation between serum IL-6 levels and clinical attachment level (p < 0.001). CONCLUSION The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL-6 levels.
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Affiliation(s)
- U Sezer
- Department of Periodontology, Faculty of Dentistry, Gaziantep University, Gaziantep,Turkey.
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Nagarale G, Ravindra S, Thakur S, Setty S. Efficacy of a chairside diagnostic test kit for estimation of C-reactive protein levels in periodontal disease. J Indian Soc Periodontol 2011; 14:213-6. [PMID: 21731244 PMCID: PMC3118069 DOI: 10.4103/0972-124x.76919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Accepted: 07/27/2010] [Indexed: 01/18/2023] Open
Abstract
Background: C-reactive protein [CRP] levels increase to hundreds of mg/mL within hours following infection. Studies have shown that serum CRP levels were elevated in periodontal disease. However, in all the previous studies, CRP levels were measured by using high-sensitivity CRP assay kits with minimal detection limits of 0.1 to 3 mg/L, which was much below the normal value of 10 mg/L. These high-sensitivity CRP assays need a proper laboratory setup, and these methods cannot be used as a routine chair-side test in the dental office. Aim: The purpose of this study was to investigate the serum CRP levels in subjects with periodontal disease by using a rapid chair-side diagnostic test kit with a lower detection limit of 6 mg/L and to compare the CRP levels before and after periodontal therapy. Materials and Methods: A total of 45 systemically healthy subjects were selected for the study. Subjects were divided into three groups: group A: healthy controls, group B: gingivitis, group C: periodontitis. Serum levels of CRP were determined by using a latex slide agglutination method with commercially available kit with lower detection limit of 6 mg/L. Results: CRP was negative in all the 15 subjects in groups A and B at baseline, 7th and 30th day. CRP was positive only in 2 subjects in Group C at baseline and 7th day. Conclusion: Estimation of serum CRP by using a rapid chair-side diagnostic test kit is not of any significance in subjects with periodontitis.
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Affiliation(s)
- Girish Nagarale
- Department of Periodontics, S.D.M. College of Dental Sciences and Hospital, Dharwad, Karnataka, India
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Javed F, Al-Askar M, Al-Hezaimi K. Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: a literature review. J Periodontol 2011; 83:156-61. [PMID: 21692634 DOI: 10.1902/jop.2011.110207] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontitis may occur in patients with and without type 2 diabetes (T2D). It may be hypothesized that the gingival crevicular fluid (GCF) cytokine profile in patients with periodontitis with poorly controlled T2D may differ from the GCF cytokine profile in medically healthy individuals with periodontitis. The aim was to review the cytokine profiles in the GCF of patients with periodontitis with and without T2D. METHODS Databases were searched from 1988 to August 2011 using different combinations of various keywords. Titles and abstracts of articles that satisfied the eligibility criteria were screened by the authors and checked for agreement. Only articles published in English were included. RESULTS Ten studies were included. Two studies reported GCF concentrations of interleukin (IL)-6 to be higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. Two studies showed GCF IL-6 levels to be higher in periodontitis with T2D compared to medically healthy subjects without periodontitis. In one study GCF levels of IL-17, IL-23, and interferon-γ were higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. In one study, GCF concentrations of IL-8 were significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. Three studies reported GCF levels of IL-1α to be significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. CONCLUSION The GCF cytokine profile in patients with and without T2D seems to be governed by the intensity of periodontal inflammation and the role of T2D in this regard is rather secondary.
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Affiliation(s)
- Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Meng S, Zhang L, Zhao L, Fang YR, Fujimoto T, Hirano SI, Inoue H, Uchihashi K, Nishikawa Y, Wu YF. Effects of C-reactive protein on CC chemokine receptor 2-mediated chemotaxis of monocytes. DNA Cell Biol 2011; 31:30-5. [PMID: 21682549 DOI: 10.1089/dna.2010.1178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Periodontal infections can increase patients' serum C-reactive protein (CRP) level, which is a predictive marker of future cardiovascular events. Serum CRP may be a key mediator associating periodontitis with cardiovascular disease. It is not yet clarified whether the chemotactic activity of monocytes changes with increased serum CRP. This study investigated the influence of CRP on monocyte chemotaxis and the effects of CRP on CC chemokine receptor 2 (CCR2) expression by monocytes in vitro. Monocyte cell line THP-1 was cultured with human recombinant CRP of different final concentrations, which were 2, 4, 6, 8, and 10 mg/L, respectively. After 24 h incubation, Transwell chambers were applied to analyze the chemotactic activity of pretreated monocytes. Flow cytometry analysis and real-time reverse transcription-polymerase chain reaction (RT-PCR) were applied to detect the CCR2 protein and gene expression levels. In Transwell chambers, more cells were attracted in CRP-pretreated groups than that of blank control with no CRP (p<0.05). The chemotaxis activity was stronger in higher CRP concentration groups than lower ones (p<0.05). The CCR2 protein and mRNA expression was increased in a CRP concentration-dependent manner (p<0.05). CRP stimulation may induce CCR2 overexpression on monocytes and then promote the chemotaxis ability of monocytes. This result suggests that increased serum CRP concentration of periodontitis patients may be associated with high risk of cardiovascular disease.
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Affiliation(s)
- Shu Meng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
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Pradeep A, Kathariya R, Raghavendra N, Sharma A. Levels of Pentraxin-3 in Gingival Crevicular Fluid and Plasma in Periodontal Health and Disease. J Periodontol 2011; 82:734-41. [DOI: 10.1902/jop.2010.100526] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aspriello SD, Zizzi A, Tirabassi G, Buldreghini E, Biscotti T, Faloia E, Stramazzotti D, Boscaro M, Piemontese M. Diabetes mellitus-associated periodontitis: differences between type 1 and type 2 diabetes mellitus. J Periodontal Res 2010; 46:164-9. [PMID: 21108647 DOI: 10.1111/j.1600-0765.2010.01324.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Although many studies have appeared about diabetes mellitus-associated periodontitis, few have compared periodontitis inflammatory markers between type 1 (T1DM) and type 2 diabetes mellitus (T2DM), and information regarding this issue is scarce and contradictory. We evaluated the levels of plasma C-reactive protein and of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in gingival crevicular fluid in two groups of subjects affected by T1DM and T2DM, in order to identify possible differences between the two classes in the inflammatory mechanisms of diabetes mellitus-associated periodontitis. MATERIAL AND METHODS Plasma C-reactive protein and gingival crevicular fluid IL-1β, IL-6 and TNF-α were measured in periodontitis patients affected by type 1 (P-T1DM, n = 24) and type 2 diabetes mellitus (P-T2DM, n = 24). RESULTS Gingival crevicular fluid levels of IL-1β and TNF-α in P-T1DM subjects were significantly higher than in P-T2DM subjects. In P-T1DM subjects, we found significant negative correlations between the duration of diabetes mellitus and IL-1β and between the duration of diabetes mellitus and TNF-α. CONCLUSION This study shows that IL-1β and TNF-α levels in periodontitis patients with T1DM are affected by the duration of diabetes mellitus.
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Affiliation(s)
- S D Aspriello
- Division of Periodontology, Department of Clinical and Dental Sciences, Polytechnic University of Marche, Torrette, Ancona, Italy
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Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol 2010; 81:1708-24. [PMID: 20722533 DOI: 10.1902/jop.2010.100321] [Citation(s) in RCA: 311] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Obesity is increasing in prevalence and is a major contributor to worldwide morbidity. One consequence of obesity might be an increased risk for periodontal disease, although periodontal inflammation might, in turn, exacerbate the metabolic syndrome, of which obesity is one component. This review aims to systematically compile the evidence of an obesity-periodontal disease relationship from epidemiologic studies and to derive a quantitative summary of the association between these disease states. METHODS Systematic searches of the MEDLINE, SCOPUS, BIOSIS, LILACS, Cochrane Library, and Brazilian Bibliography of Dentistry databases were conducted with the results and characteristics of relevant studies abstracted to standardized forms. A meta-analysis was performed to obtain a summary measure of association. RESULTS The electronic search identified 554 unique citations, and 70 studies met a priori inclusion criteria, representing 57 independent populations. Nearly all studies matching inclusion criteria were cross-sectional in design with the results of 41 studies suggesting a positive association. The fixed-effects summary odds ratio was 1.35 (Shore-corrected 95% confidence interval: 1.23 to 1.47), with some evidence of a stronger association found among younger adults, women, and non-smokers. Additional summary estimates suggested a greater mean clinical attachment loss among obese individuals, a higher mean body mass index (BMI) among periodontal patients, and a trend of increasing odds of prevalent periodontal disease with increasing BMI. Although these results are highly unlikely to be chance findings, unmeasured confounding had a credible but unknown influence on these estimates. CONCLUSIONS This positive association was consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease. However, with few quality longitudinal studies, there is an inability to distinguish the temporal ordering of events, thus limiting the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain. In clinical practice, a higher prevalence of periodontal disease should be expected among obese adults.
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Affiliation(s)
- Benjamin W Chaffee
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA 94720-7358, USA.
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Griffiths R, Barbour S. Lipoproteins and lipoprotein metabolism in periodontal disease. CLINICAL LIPIDOLOGY 2010; 5:397-411. [PMID: 20835400 PMCID: PMC2933935 DOI: 10.2217/clp.10.27] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that the incidence of atherosclerosis is increased in subjects with periodontitis - a chronic infection of the oral cavity. This article summarizes the evidence that suggests periodontitis shifts the lipoprotein profile to be more proatherogenic. LDL-C is elevated in periodontitis and most studies indicate that triglyceride levels are also increased. By contrast, antiatherogenic HDL tends to be low in periodontitis. Periodontal therapy tends to shift lipoprotein levels to a healthier profile and also reduces subclinical indices of atherosclerosis. In summary, periodontal disease alters lipoprotein metabolism in ways that could promote atherosclerosis and cardiovascular disease.
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Affiliation(s)
- Rachel Griffiths
- Department of Biochemistry & Molecular Biology, Virginia Commonwealth University School of Medicine, Box 980614, Richmond, VA 23298-0614, USA
| | - Suzanne Barbour
- Department of Biochemistry & Molecular Biology, Virginia Commonwealth University School of Medicine, Box 980614, Richmond, VA 23298-0614, USA
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Chen L, Wei B, Li J, Liu F, Xuan D, Xie B, Zhang J. Association of periodontal parameters with metabolic level and systemic inflammatory markers in patients with type 2 diabetes. J Periodontol 2010; 81:364-71. [PMID: 20192862 DOI: 10.1902/jop.2009.090544] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUNDS Although worldwide evidence tends to prove that diabetes adversely affects periodontal health, there are insufficient clues indicating whether periodontitis may aggravate metabolic control and systemic inflammation. This study, as a preliminary part of an ongoing research project, aims to clarify the relationship of periodontal parameters with metabolic levels and systemic inflammatory markers in patients with diabetes. METHODS A total of 140 qualified, adult patients with type 2 diabetes and periodontitis were recruited into this study. Periodontal examinations, including a full-mouth assessment of probing depths (PDs), bleeding on probing, gingival recession, and clinical attachment level, were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting glucose, high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-alpha), and lipid profiles. Subjects were divided into three groups according to tertiles of the mean PD and compared. RESULTS Upon an analysis of covariance, subjects with an increased mean PD had significantly higher levels of HbA1c and hsCRP (P <0.05). No significant difference was found among different groups in the levels of serum TNF-alpha, fasting glucose, and lipid profiles (P >0.05). After controlling for age, gender, body mass index, duration of diabetes mellitus, smoking, regular physical exercise, and alcohol consumption, positive correlations were found between mean PD and HbA1c (r = 0.2272; P = 0.009) and between mean PD and hsCRP (r = 0.2336; P = 0.007). After adjustment for possible confounders, the mean PD emerged as a significant predictor variable for elevated levels of HbA1c and hsCRP (P <0.05). CONCLUSION Chronic periodontitis was associated with glycemic metabolic and serum hsCRP levels in patients with type 2 diabetes.
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Affiliation(s)
- Lei Chen
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, Guangdong, China
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Morita T, Yamazaki Y, Mita A, Takada K, Seto M, Nishinoue N, Sasaki Y, Motohashi M, Maeno M. A Cohort Study on the Association Between Periodontal Disease and the Development of Metabolic Syndrome. J Periodontol 2010; 81:512-9. [DOI: 10.1902/jop.2010.090594] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yoshii S, Tsuboi S, Morita I, Takami Y, Adachi K, Inukai J, Inagaki K, Mizuno K, Nakagaki H. Temporal association of elevated C-reactive protein and periodontal disease in men. J Periodontol 2009; 80:734-9. [PMID: 19405826 DOI: 10.1902/jop.2009.080537] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Most studies on the relationship between serum C-reactive protein (CRP) and periodontal disease have been cross-sectional. In this study, we investigated the temporal association between CRP and periodontal disease by following a large number of subjects for 1 year. METHODS We studied 11,162 men in Nagoya, Japan, who had an initial dental examination as part of a complete physical examination and then underwent the same examination 1 year later. For the 4,997 men without periodontal disease at baseline, logistic regression analysis was performed to examine the relationship between baseline CRP and periodontal disease 1 year later, adjusting for age, body mass index, glycosylated hemoglobin A1c level, and smoking status. Similarly, logistic regression analysis was performed to examine the relationship between periodontal disease at baseline and CRP 1 year later for the 10,376 men with normal baseline CRP, adjusting for the same confounding factors. RESULTS Among men without high CRP at baseline, periodontal disease at baseline correlated to CRP 1 year later. The odds ratio was 1.336 (95% confidence interval [CI]: 1.115 to 1.674). However, in the men without periodontal disease, no significant correlations were seen with baseline CRP or periodontal disease 1 year later. The odds ratio was 1.163 (95% CI: 0.894 to 1.513). CONCLUSION Periodontal disease increased the risk for high serum CRP levels in men after 1 year of follow-up.
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Affiliation(s)
- Saori Yoshii
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
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Bullon P, Morillo JM, Ramirez-Tortosa MC, Quiles JL, Newman HN, Battino M. Metabolic syndrome and periodontitis: is oxidative stress a common link? J Dent Res 2009; 88:503-18. [PMID: 19587154 DOI: 10.1177/0022034509337479] [Citation(s) in RCA: 158] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A review of pathological mechanisms that can explain the relationship between periodontitis and cardiovascular disease (CVD) is necessary to improve the management of both conditions. Metabolic syndrome is a combination of obesity, hypertension, impaired glucose tolerance or diabetes, hyperinsulinemia, and dyslipidemia. All these have been examined in recent years in terms of their relationship to periodontitis. Reviewed data indicate an association between some of them (body mass index, high-density lipoprotein-cholesterol [HDL-C], triglycerides, high blood pressure, among others) and periodontitis. Oxidative stress may act as a potential common link to explain relationships between each component of metabolic syndrome and periodontitis. Both conditions show increased serum levels of products derived from oxidative damage, with a pro-inflammatory state likely influencing each other bidirectionally. Adipocytokines might modulate the oxidant/anti-oxidant balance in this relationship.
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Affiliation(s)
- P Bullon
- Deptartment of Periodontology, Dental School, University of Sevilla, Spain
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Morillo JM, Bullon P, Ramirez-Tortosa MDC, Quiles JL, Newman HN, Bertoli E, Battino M. Nutrition-linked chronic disease and periodontitis: are they the two faces of the same coin? MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2009. [DOI: 10.1007/s12349-009-0055-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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