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Mohamed AM, Ahmed F, Gondi KM, Salem KA, Mohammed OB, Peeran SW. Knowledge, Attitude, and Practice of Teledentistry in Periodontal Diagnosis Among Dental Interns at a College in Sebha, Libya: A Cross-Sectional Questionnaire Study. Cureus 2024; 16:e58330. [PMID: 38752082 PMCID: PMC11094666 DOI: 10.7759/cureus.58330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Background Teledentistry, a subspecialty of telemedicine dedicated to dentistry, has shown promise in improving access to dental care, particularly in rural and isolated areas. It integrates digital and telecommunication technology with dentistry, allowing for the remote distance exchange of relevant clinical information and digital dental imaging for dental consultation and treatment planning. Periodontal disease diagnosis is crucial for effective treatment and prevention of irreversible loss of periodontal structures. Early identification of periodontal disease can be pivotal in preventing periodontal tissue destruction and tooth loss and improving the overall quality of patients' lives. Sebha is a city located in the Fezzan region of southwestern Libya. It is the capital of the Sabha District and the Sabha Governorate. The city is situated in the Libyan part of the Sahara desert and is known for its strategic location as a gateway to the Sahara desert. However, there is a lack of information on the use of teledentistry in Libya in general and the use of teleperiodontics, especially in periodontal diagnosis. Hence, the aim of this questionnaire study was to evaluate knowledge, attitudes, and practice of teledentistry among dental interns at Sebha, Libya. Materials and methods A paper-based questionnaire consisting of 28 close‑ended Likert scale questions, including sections assessing the knowledge, attitude, and practice of teledentistry and teleperiodontics, was administered to dental interns at the Faculty of Dentistry, Sebha University, Sebha, Libya. Results The study surveyed 42 dental interns of the Faculty of Sebha, Libya, in total, with an 82.35% response rate among them. The majority of participants (59.5%) felt that teledentistry is reliable in arriving at periodontal diagnosis. The majority of participants (64.3%%) also had acceptable levels of trust in teledentistry equipment. However, over 45% percent of dental practitioners voiced their worries about patient privacy. Most of the participants suggested using teledentistry in some form in their future practice. Conclusion Teledentistry and its branch teleperiodontics are recent developments and its penetration among dental healthcare workers, and their knowledge, attitude, and practice remain to be thoroughly understood. The changing trends in attitudes and practice as a consequence of changes in Internet and technological awareness and the effects of the pandemic warrant closer observation and study.
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Affiliation(s)
- Adel M Mohamed
- Prosthodontics, Faculty of Dentistry, Sebha University, Sebha, LBY
| | - Fatma Ahmed
- Faculty of Dentistry, Sebha University, Sebha, LBY
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Aghili S, Rahimi H, Hakim LK, Karami S, Soufdoost RS, Oskouei AB, Alam M, Badkoobeh A, Golkar M, Abbasi K, Heboyan A, Hosseini ZS. Interactions Between Oral Microbiota and Cancers in the Aging Community: A Narrative Review. Cancer Control 2024; 31:10732748241270553. [PMID: 39092988 DOI: 10.1177/10732748241270553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
The oral microbiome potentially wields significant influence in the development of cancer. Within the human oral cavity, an impressive diversity of more than 700 bacterial species resides, making it the second most varied microbiome in the body. This finely balanced oral microbiome ecosystem is vital for sustaining oral health. However, disruptions in this equilibrium, often brought about by dietary habits and inadequate oral hygiene, can result in various oral ailments like periodontitis, cavities, gingivitis, and even oral cancer. There is compelling evidence that the oral microbiome is linked to several types of cancer, including oral, pancreatic, colorectal, lung, gastric, and head and neck cancers. This review discussed the critical connections between cancer and members of the human oral microbiota. Extensive searches were conducted across the Web of Science, Scopus, and PubMed databases to provide an up-to-date overview of our understanding of the oral microbiota's role in various human cancers. By understanding the possible microbial origins of carcinogenesis, healthcare professionals can diagnose neoplastic diseases earlier and design treatments accordingly.
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Affiliation(s)
- Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hussein Rahimi
- Student Research Committee, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | | | | | - Asal Bagherzadeh Oskouei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
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Isola G, Tartaglia GM, Santonocito S, Chaurasia A, Marya A, Lo Giudice A. Growth differentiation factor-15 and circulating biomarkers as predictors of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial. BMC Oral Health 2023; 23:582. [PMID: 37605193 PMCID: PMC10440880 DOI: 10.1186/s12903-023-03237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND During the last decades, in patients with periodontitis, periodontal treatment has been shown to reduce the potential release of local and systemic biomarkers linked to an early risk of systemic inflammatory disorders. This study evaluated the efficacy of non-surgical-periodontal treatment (NSPT) on growth differentiation factor 15 (GDF-15) and related circulating biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) in periodontal patients and explored whether subjects who had high GDF-15 levels at baseline showed increased clinical benefits following NSPT at 6-months follow-up. METHODS For this two-arm, parallel randomized clinical trial, patients with periodontitis were randomly allocated to receive quadrant scaling and root-planing (Q-SRP, n = 23, median age 51 years old) or full-mouth disinfection (FMD, n = 23, median age 50 years old) treatment. Clinical and periodontal parameters were recorded in all enrolled patients. The primary outcome was to analyse serum concentrations changes of GDF-15 and of GPx-1, hs-CRP, and SP-D at baseline and at 30, 90, and 180-days follow-up after NSPT through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques. RESULTS In comparison with FMD, patients of the Q-SRP group showed a significant improvement in clinical periodontal parameters (p < 0.05) and a reduction in the mean levels of GDF-15 (p = 0.005), hs-CRP (p < 0.001), and SP-D (p = 0.042) and an increase of GPx-1 (p = 0.025) concentrations after 6 months of treatment. At 6 months of treatment, there was a significant association between several periodontal parameters and the mean concentrations of GDF-15, GPx-1, hs-CRP, and SP-D (p < 0.05 for all parameters). Finally, the ANOVA analysis revealed that, at 6 months after treatment, the Q-SRP treatment significantly impacted the reduction of GDF-15 (p = 0.015), SP-D (p = 0.026) and the upregulation of GPx-1 (p = 0.045). CONCLUSION The results evidenced that, after 6 months of treatment, both NSPT protocols improved the periodontal parameters and analyzed biomarkers, but Q-SRP was more efficacious than the FMD approach. Moreover, patients who presented high baseline GDF-15 and SP-D levels benefited more from NSPT at 6-month follow-up. TRIAL REGISTRATION NCT05720481.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, 20100, Italy
- Ospedale Maggiore Policlinico, Fondazione IRCCS Cà Granda, Milan, 20100, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy.
| | - Akhilanand Chaurasia
- Department of Oral Medicine, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anand Marya
- Department of Orthodontics, University of Puthisastra Phnom Penh Combodia, Phnom Penh, 55180, Cambodia.
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, 600077, India.
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania, 95123, Italy
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Panayotov IV, Végh AG, Martin M, Vladimirov B, Larroque C, Gergely C, Cuisinier FJG, Estephan E. Improving dental epithelial junction on dental implants with bioengineered peptides. Front Bioeng Biotechnol 2023; 11:1165853. [PMID: 37409165 PMCID: PMC10318435 DOI: 10.3389/fbioe.2023.1165853] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction: The functionalization of titanium (Ti) and titanium alloys (Ti6Al4V) implant surfaces via material-specific peptides influence host/biomaterial interaction. The impact of using peptides as molecular linkers between cells and implant material to improve keratinocyte adhesion is reported. Results: The metal binding peptides (MBP-1, MBP-2) SVSVGMKPSPRP and WDPPTLKRPVSP were selected via phage display and combined with laminin-5 or E-cadherin epithelial cell specific peptides (CSP-1, CSP-2) to engineer four metal-cell specific peptides (MCSPs). Single-cell force spectroscopy and cell adhesion experiments were performed to select the most promising candidate. In vivo tests using the dental implant for rats showed that the selected bi functional peptide not only enabled stable cell adhesion on the trans-gingival part of the dental implant but also arrested the unwanted apical migration of epithelial cells. Conclusion: The results demonstrated the outstanding performance of the bioengineered peptide in improving epithelial adhesion to Ti based implants and pointed towards promising new opportunities for applications in clinical practice.
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Affiliation(s)
- Ivan V. Panayotov
- LBN, University Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
| | - Attila G. Végh
- Biological Research Centre, Institute of Biophysics, Eötvös Lóránd Research Network (ELKH), Szeged, Hungary
| | - Marta Martin
- L2C, University Montpellier, CNRS, Montpellier, France
| | - Boyan Vladimirov
- Department of Maxillofacial Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Christian Larroque
- Department of Nephrology, CHU Montpellier, Hôpital Lapeyronie, IRMB, University of Montpellier, INSERM U1183, Montpellier, France
| | | | | | - Elias Estephan
- LBN, University Montpellier, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Haukka A, Kaila M, Haukka J, Heikkinen AM. Adherence to individualized recall intervals for oral health examinations. Clin Exp Dent Res 2023; 9:177-185. [PMID: 36322122 PMCID: PMC9932253 DOI: 10.1002/cre2.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of this follow-up study was to investigate whether adults attend an oral health examination (OHE) based on their individual recall interval (IRI) without a reminder recall system. METHODS The study population included adults who were attending an OHE recommended by their dentists based on their IRI in public oral healthcare clinics of Helsinki City January 1, 2009-December 31, 2009. The inclusion criteria were as follows: alive until the end of IRI, length of the IRI of 12-60 months, and study participants had not been treated successfully by a dental specialist during the IRI period (n = 41,255). We used a multinomial model to identify the factors associated with the timing of OHE. The following predictors were included: oral health indices such as Decayed Teeth and the Community Periodontal Index, the length of the IRI based on an OHE in 2009, age, gender, socioeconomic status, presence of chronic diseases, and emergency appointment. Results were presented as odds ratios with 95% confidence intervals. RESULTS The OHE based on IRI occurred for 7505 individuals (18.2%) and the OHE was late for 9159 individuals (22.2%). A total of 24,591 (59.6%) adults did not undergo follow-up OHE based on the IRI period of on time or late. Those who came on time for follow-up OHE experienced less caries than those who came later. There was not much difference in periodontal health between the groups. The models indicated that having an emergency appointment was associated with a higher probability of having an OHE. A long IRI (37-60 months) was associated with a higher probability of not participating in OHE even late. CONCLUSIONS It would be beneficial for patients to take appointments based on the recall interval. The results of this study indicated that more needs to be done to increase awareness in the adult population of the benefits and availability of follow-up OHEs based on their IRI in oral healthcare.
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Affiliation(s)
- Anna Haukka
- Dental Care, Health Services, Social Services and Health CareCity of HelsinkiFinland
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Minna Kaila
- Public Health Medicine, Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Jari Haukka
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Anna M. Heikkinen
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki, Helsinki University HospitalHelsinkiFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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Pamuk F, Kantarci A. Inflammation as a link between periodontal disease and obesity. Periodontol 2000 2022; 90:186-196. [PMID: 35916870 DOI: 10.1111/prd.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.
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Affiliation(s)
- Ferda Pamuk
- Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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Abraham D, Singh A, Kurian A, Gupta A, Aneja K, Sethi S. Correlation of endodontic infection and cytokine expression in patients with systemic diseases: A systematic review of clinical studies. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Borsa L, Dubois M, Sacco G, Lupi L. Analysis the Link between Periodontal Diseases and Alzheimer's Disease: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179312. [PMID: 34501899 PMCID: PMC8430572 DOI: 10.3390/ijerph18179312] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022]
Abstract
The hypothesis of an infectious connection from the oro-pharyngeal sphere to the brain underlines the interest in analyzing the link between periodontal disease and Alzheimer’s disease. The aim of this systematic review was to examine the link between Alzheimer’s disease and periodontal disease in patients aged 65 and over. Databases (PubMed (MEDLINE), the Cochrane Library, and Embase) were analyzed for relevant references up to 21 June 2021. The authors independently selected the studies and extracted the data. The quality of included studies was checked using the National Institutes of Health’s quality assessment tools. Five studies were included. The selected studies described in their results an increase in F. nucleatum in Alzheimer’s disease patients (adjusted p = 0.02), and its incidence was linked to C. rectus and P. gingivalis (adjusted HR = 1.22 (1.04–1.43), p = 0.012) as well as A. naeslundii (crude HR = 2.0 (1.1–3.8)). The presence of periodontitis at baseline was associated with a six-fold increase in the rate of cognitive decline over a 6-month follow-up period (ADAS-Cog mean change = 2.9 ± 6.6). The current review suggests an association between periodontal disease and Alzheimer’s disease. The treatment of periodontal disease could be a way to explore Alzheimer’s disease prevention.
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Affiliation(s)
- Leslie Borsa
- Faculté de Chirurgie Dentaire-Odontologie, Université Côte d’Azur, 06300 Nice, France; (M.D.); (L.L.)
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France
- UPR7354–Laboratoire Microbiologie Orale, Immunothérapie et Santé (Micoralis), Faculté de Chirurgie Dentaire-Odontologie, Université Côte d’Azur, 06300 Nice, France
- Correspondence:
| | - Margaux Dubois
- Faculté de Chirurgie Dentaire-Odontologie, Université Côte d’Azur, 06300 Nice, France; (M.D.); (L.L.)
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France
| | - Guillaume Sacco
- Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06003 Nice, France;
- Université Côte d’Azur, CoBTeK, 06100 Nice, France
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, 49000 Angers, France
| | - Laurence Lupi
- Faculté de Chirurgie Dentaire-Odontologie, Université Côte d’Azur, 06300 Nice, France; (M.D.); (L.L.)
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France
- UPR7354–Laboratoire Microbiologie Orale, Immunothérapie et Santé (Micoralis), Faculté de Chirurgie Dentaire-Odontologie, Université Côte d’Azur, 06300 Nice, France
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Patel UK, Malik P, Kodumuri N, Patel P, Pitti V, Tyagi G, Chauhan B, Lunagariya A, Kothari R, Sen S. Chronic Periodontitis is Associated With Cerebral Atherosclerosis -A Nationwide Study. Cureus 2020; 12:e11373. [PMID: 33304705 PMCID: PMC7721345 DOI: 10.7759/cureus.11373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction Chronic periodontitis and atherosclerosis share common risk factors and produce the same inflammatory markers. Many studies found a high prevalence of chronic periodontitis in patients with atherosclerosis but there is no strong evidence to support a specific association of chronic periodontitis with cerebral atherosclerosis. We aimed to study the concurrent prevalence and association of chronic periodontitis with cerebral atherosclerosis and cerebrovascular diseases among the US population. Methods We performed a cross-sectional analysis of a Nationwide Inpatient Sample with adult hospitalizations to identify the primary diagnosis of cerebrovascular diseases [acute ischemic stroke (AIS), hemorrhagic stroke (HS), and transient ischemic attack (TIA)] with concurrent cerebral atherosclerosis and chronic periodontitis. Multivariate survey logistic regression models were fitted to evaluate the linkage of chronic periodontitis with cerebral atherosclerosis and cerebrovascular diseases. Results Of total 56,499,788 hospitalizations, 0.01% had chronic periodontitis. Prevalence of chronic periodontitis was higher in 50-64 years (36.18% vs. 23.91%), males (59.19% vs. 41.06% in females), Afro-Americans (25.93% vs. 15.21%), and 0-25th percentile median-household-income-category (38.31% vs. 30.15%) compared to non-chronic periodontitis. There was significantly higher prevalence of cerebral atherosclerosis (0.71% vs. 0.41%; p<0.0001) with weak evidence of high prevalence of cerebrovascular diseases (AIS:2.21% vs. 1.97%; p=0.1563; HS:0.57% vs. 0.46%; p=0.1560) among chronic periodontitis compared to non-chronic periodontitis. In regression analysis, odds of having cerebral atherosclerosis were 2.48-folds higher in patients with chronic periodontitis compared to that without-chronic periodontitis, and cerebral atherosclerosis patients were associated with higher odds of TIA (aOR:2.40; p<0.0001), AIS (aOR:3.35; p<0.0001), and HS (aOR:1.51; p<0.0001) compared to without-cerebral atherosclerosis. No significant relationship between chronic periodontitis and cerebrovascular diseases was observed. Conclusion Although chronic periodontitis may not directly increase the risk of cerebrovascular diseases, it increases the burden of cerebrovascular diseases by evidently increasing the risk of cerebral atherosclerosis. Early identification of chronic periodontitis and atherosclerotic risk factors may help to mitigate the risk of cerebrovascular diseases.
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Affiliation(s)
- Urvish K Patel
- Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Preeti Malik
- Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
- Neurology, Massachusetts General Hospital, Andover, USA
| | - Nishanth Kodumuri
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
| | | | - Varun Pitti
- Dentistry, Rutgers School of Dental Medicine, Newark, USA
| | - Gaurav Tyagi
- Dentistry, Rutgers School of Dental Medicine, Newark, USA
| | - Bindi Chauhan
- Public Health, Long Island University, New York, USA
| | | | - Ravish Kothari
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
| | - Souvik Sen
- Neurology, Palmetto Health-University of South Carolina School of Medicine, Columbia, USA
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Liu YCG, Lan SJ, Hirano H, Lin LM, Hori K, Lin CS, Zwetchkenbaum S, Minakuchi S, Teng AYT. Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases. J Dent Sci 2020; 16:757-773. [PMID: 33854730 PMCID: PMC8025188 DOI: 10.1016/j.jds.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.
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Affiliation(s)
- Yen Chun G. Liu
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Corresponding author. Dept. of Oral Hygiene & COBR, College of Dental Medicine, Kaohsiung Medical University; No. 100, Shih-Chun 1st Rd, Kaohsiung 807, Taiwan. Fax: +886 07 3223141.
| | - Shou-Jen Lan
- Dept. of Healthcare Administration, Asia University, Tai-Chung, Taiwan
| | - Hirohiko Hirano
- Research Team for Promoting Independence & Mental Health, and Dentistry & Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Li-min Lin
- Div. of Oral Pathology & Oral Maxillo-facial Radiology, School of Dentistry, Kaohsiung Medical University & KMU-Hospital, Kaohsiung, Taiwan
| | - Kazuhiro Hori
- Div. of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chia-shu Lin
- Dept. of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Samuel Zwetchkenbaum
- Rhode Island Dept. of Health, Rhode Island, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Shunsuke Minakuchi
- Gerodontology & Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andy Yen-Tung Teng
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Center for Osteoimmunology & Biotechnology Research (COBR) and School of Dentistry, College of Dental Medicine, Kaohsiung Medical University and KMU-Hospital, Kaohsiung, Taiwan
- Corresponding author. Center for Osteoimmunology and Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung, Taiwan.
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González-Navarro B, Segura-Egea JJ, Estrugo-Devesa A, Pintó-Sala X, Jane-Salas E, Jiménez-Sánchez MC, Cabanillas-Balsera D, López-López J. Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9103205. [PMID: 33020413 PMCID: PMC7600401 DOI: 10.3390/jcm9103205] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/23/2022] Open
Abstract
Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.
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Affiliation(s)
- Beatriz González-Navarro
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
| | - Albert Estrugo-Devesa
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Pintó-Sala
- Vascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, 08970 L’Hospitalet de Llobregat, Barcelona, Spain;
| | - Enric Jane-Salas
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mari Carmen Jiménez-Sánchez
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - José López-López
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Head of the Odontological Hospital University of Barcelona, University of Barcelona, 08970 L’Hospitalet de LLobregat, Barcelona, Spain
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
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12
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Fenning RM, Steinberg-Epstein R, Butter EM, Chan J, McKinnon-Bermingham K, Hammersmith KJ, Moffitt J, Shui AM, Parker RA, Coury DL, Wang PP, Kuhlthau KA. Access to Dental Visits and Correlates of Preventive Dental Care in Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:3739-3747. [PMID: 32112232 DOI: 10.1007/s10803-020-04420-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Dental care received by children in the Autism Speaks Autism Treatment Network (ATN) was compared to National Survey of Children's Health (NSCH) data for children without special healthcare needs and children with parent-reported ASD. Correlates of obtained preventive dental services were examined within the ATN sample. Participants included 375 families of children ages 4 to 17 enrolled in the ATN. ATN families reported levels of preventive dental care that were similar to, or exceeded, NSCH-reported care. However, disparities in obtained preventive dental services emerged within the ATN sample. Lower intellectual functioning was the most consistent correlate of reduced access to and completion of preventive dental care. Implications for developing system-wide supports and targeted interventions are discussed.
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Affiliation(s)
- Rachel M Fenning
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC-560, Fullerton, CA, 92831, USA.
- Department of Pediatrics, The Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, School of Medicine, Irvine, CA, USA.
| | - Robin Steinberg-Epstein
- Department of Pediatrics, The Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Eric M Butter
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - James Chan
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Kelly McKinnon-Bermingham
- Department of Pediatrics, The Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | | | - Jacquelyn Moffitt
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC-560, Fullerton, CA, 92831, USA
- Department of Pediatrics, The Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Amy M Shui
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A Parker
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Daniel L Coury
- Department of Developmental/Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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13
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Ambriola Oku AY, Zimeo Morais GA, Arantes Bueno AP, Fujita A, Sato JR. Potential Confounders in the Analysis of Brazilian Adolescent's Health: A Combination of Machine Learning and Graph Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010090. [PMID: 31877700 PMCID: PMC6981403 DOI: 10.3390/ijerph17010090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 12/20/2022]
Abstract
The prevalence of health problems during childhood and adolescence is high in developing countries such as Brazil. Social inequality, violence, and malnutrition have strong impact on youth health. To better understand these issues we propose to combine machine-learning methods and graph analysis to build predictive networks applied to the Brazilian National Student Health Survey (PenSE 2015) data, a large dataset that consists of questionnaires filled by the students. By using a combination of gradient boosting machines and centrality hub metric, it was possible to identify potential confounders to be considered when conducting association analyses among variables. The variables were ranked according to their hub centrality to predict the other variables from a directed weighted-graph perspective. The top five ranked confounder variables were “gender”, “oral health care”, “intended education level”, and two variables associated with nutrition habits—“eat while watching TV” and “never eat fast-food”. In conclusion, although causal effects cannot be inferred from the data, we believe that the proposed approach might be a useful tool to obtain novel insights on the association between variables and to identify general factors related to health conditions.
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Affiliation(s)
- Amanda Yumi Ambriola Oku
- Center of Mathematics, Computing and Cognition—Universidade Federal do ABC, Santo André CEP 09210-580, Brazil
| | | | - Ana Paula Arantes Bueno
- Center of Mathematics, Computing and Cognition—Universidade Federal do ABC, Santo André CEP 09210-580, Brazil
| | - André Fujita
- Institute of Mathematics and Statistics—University of São Paulo, São Paulo CEP 05508-090, Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition—Universidade Federal do ABC, Santo André CEP 09210-580, Brazil
- Correspondence:
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14
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Darnaud C, Thomas F, Danchin N, Boutouyrie P, Bouchard P. Masticatory Capacity and Mortality: The Preventive and Clinical Investigation Center (IPC) Cohort Study. J Dent Res 2019; 99:152-158. [PMID: 31765573 DOI: 10.1177/0022034519889021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor oral health (OH) has been associated with mortality, but the association between OH components and mortality remains imprecise. The present observational study aimed to investigate if there is an association between oral masticatory efficiency and cardiovascular (CV) mortality in a large French subject cohort. The study was based on a cohort of 85,830 subjects aged between 16 and 94 y at recruitment. The follow-up extended from 2001 to 2014 and the mean follow-up was 8.06 ± 2.73 y. The number of deaths totaled 1,670. Full-mouth examinations were performed. Dental plaque, dental calculus, gingival inflammation, missing teeth, and masticatory units were recorded. Masticatory units represent the number of natural or prosthetic opposing premolars and molar pairs and can be considered an accurate indicator for masticatory efficiency. Causes of death were ascertained from death certificates. Cox regression analyses were used to calculate hazard ratios (HRs). In the fully adjusted model, the number of masticatory units <5 is associated with an HR of 1.72 (95% confidence interval [CI], 1.54 to 1.91) for all-cause mortality, HR of 1.41 (95% CI, 1.01 to 1.99) for CV mortality, HR of 1.76 (95% CI, 1.44 to 2.15) for cancer mortality, and HR of 1.85 (95% CI, 1.55 to 2.20) for non-CV and noncancer mortality. Significant statistical associations with the other oral variables were also found for all-cause mortality, cancer mortality, and non-CV and noncancer mortality in the adjusted models. Our study indicates that after full adjustment, all oral parameters are associated with all-cause, cancer, and non-CV and noncancer mortality. However, the low number of masticatory units is associated with an increased risk of CV mortality. We highlight the association of masticatory units and CV mortality.
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Affiliation(s)
- C Darnaud
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7, Denis Diderot University, U.F.R. of Odontology, Paris, France.,Paris Cardiovascular Research Center, UMR-S970, Department of Epidemiology, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - N Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France.,Department of Cardiology, Georges Pompidou European Hospital, AP-HP, Paris 5, Descartes University, Medicine Faculty, Paris, France
| | - P Boutouyrie
- Paris Cardiovascular Research Center, UMR-S970, Department of Epidemiology, Paris, France.,Paris Descartes, Sorbonne Paris Cité University, Medicine Faculty, Paris, France.,Paris 5, Descartes University, AP-HP, Georges Pompidou European Hospital, INSERM U970, Pharmacology Department, Paris, France
| | - P Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7, Denis Diderot University, U.F.R. of Odontology, Paris, France.,EA 2496, Paris 5, Descartes University, U.F.R. of Odontology, Paris, France
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15
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Gustafsson N, Ahlqvist J, Näslund U, Buhlin K, Gustafsson A, Kjellström B, Klinge B, Rydén L, Levring Jäghagen E. Associations among Periodontitis, Calcified Carotid Artery Atheromas, and Risk of Myocardial Infarction. J Dent Res 2019; 99:60-68. [DOI: 10.1177/0022034519885362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular disease is a common cause of morbidity and premature mortality. Cardiovascular disease can be prevented when risk factors are identified early. Calcified carotid artery atheromas (CCAAs), detected in panoramic radiographs, and periodontitis have both been associated with increased risk of cardiovascular disease. This case-control study aimed to 1) investigate associations between periodontitis and CCAA detected in panoramic radiographs and 2) determine the risk of future myocardial infarctions due to CCAA combined with periodontitis. We evaluated 1,482 participants (738 cases and 744 controls) with periodontitis and CCAAs recruited from the PAROKRANK study (Periodontitis and Its Relation to Coronary Artery Disease). Participants were examined with panoramic radiographs, including the carotid regions. Associations between myocardial infarction and periodontitis combined with CCAA were evaluated in 696 cases and 696 age-, sex-, and residential area–matched controls. Periodontitis was evaluated radiographically (as degree of bone loss) and with a clinical periodontal disease index score (from clinical and radiographic assessments). We found associations between CCAA and clinical periodontal disease index score among cases (odds ratio [OR], 1.51; 95% CI, 1.09 to 2.10; P = 0.02) and controls (OR, 1.70; 95% CI, 1.22 to 2.38; P < 0.01), although not between CCAA and the degree of bone loss. In a multivariable model, myocardial infarction was associated with CCAA combined with periodontitis, as assessed by degree of bone loss (OR, 1.75; 95% CI, 1.11 to 2.74; P = 0.01). When the cohort was stratified by sex, only men showed a significant association between myocardial infarction and CCAA combined with periodontitis. Participants with clinically diagnosed periodontitis exhibited CCAA in panoramic radiographs more often than those without periodontitis, irrespective of the presence of a recent myocardial infarction. Participants with combined periodontitis and CCAA had a higher risk of having had myocardial infarction as compared with participants with either condition alone. These findings implied that patients in dental care might benefit from dentists assessing panoramic radiographs for CCAA—particularly, patients with periodontitis who have not received any preventive measures for cardiovascular disease.
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Affiliation(s)
- N. Gustafsson
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - J. Ahlqvist
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - U. Näslund
- Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - K. Buhlin
- Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A. Gustafsson
- Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B. Kjellström
- Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | - B. Klinge
- Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - L. Rydén
- Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | - E. Levring Jäghagen
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden
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16
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The influence of adrenergic blockade in rats with apical periodontitis under chronic stress conditions. Arch Oral Biol 2019; 110:104590. [PMID: 31743801 DOI: 10.1016/j.archoralbio.2019.104590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/11/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the influence of chronic stress and adrenergic blockade in a rat model of apical periodontitis. METHODS Thirty-two Wistar rats were submitted to an animal model of periapical lesion and randomly divided into 4 groups (n = 8): no stress (NS); stress + saline solution (SS); stress + β-adrenergic blocker (Sβ); stress + α-adrenergic blocker (Sα). The SS, Sβ and Sα groups were submitted to an animal model of chronic stress for 28 days and received daily injections of saline solution, propranolol (β adrenergic blocker) and phentolamine (α adrenergic blocker), respectively. After 28 days the animals were euthanized and the following analyses were carried out: a) serum corticosterone levels through Radioimmunoassay; b) measurement of serum levels of IL-1B, IL-6, IL-10 and IL-17 by enzyme-linked immunosorbent assay (ELISA); c) volume of periapical bone resorption by micro-computed tomography; d) histomorphometric analysis by staining with hematoxylin and eosin; e) expression of β-AR, α-AR, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) by immunohistochemistry; f) tartrate-resistant acid phosphatase (TRAP) staining; g) ex-vivo cytokine release followed by the stimulation with LPS in superfusion system, by ELISA. RESULTS SS group displayed significantly higher corticosterone levels than NS group (non-stressed). Higher IL-1β serum level was observed in the NS group (p < .05); compared to all stressed groups. Other cytokines were present in similar amounts in the serum of all groups. All groups presented similar periapical lesions. All groups presented moderate inflammatory infiltrate, without statistically significant differences between them. No differences were observed regarding β-AR, α-AR, Rank-L and OPG expression. The number of TRAP-positive cells was significantly decreased in the groups that received daily injections of adrenergic blockers. The IL-1β release followed LPS stimulation was significantly suppressed when the superfusion media contained propranolol (p < .05). Perfusion containing phentolamine induced a greater release of IL-10. TGF-β was significantly suppressed by phentolamine perfusion in the NS group (p < .05). CONCLUSIONS Chronic stress can significantly change the inflammatory cytokines release. Rank-L/OPG system and periapical lesion volume were not affected following the current method applied. The administration of adrenergic blockers was not able to modulate the inflammatory response but presented effectivity in reducing the number of osteoclasts in the periapical region.
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17
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Hung M, Voss MW, Rosales MN, Li W, Su W, Xu J, Bounsanga J, Ruiz-Negrón B, Lauren E, Licari FW. Application of machine learning for diagnostic prediction of root caries. Gerodontology 2019; 36:395-404. [PMID: 31274221 DOI: 10.1111/ger.12432] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 04/20/2019] [Accepted: 05/24/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study sought to utilise machine learning methods in artificial intelligence to select the most relevant variables in classifying the presence and absence of root caries and to evaluate the model performance. BACKGROUND Dental caries is one of the most prevalent oral health problems. Artificial intelligence can be used to develop models for identification of root caries risk and to gain valuable insights, but it has not been applied in dentistry. Accurately identifying root caries may guide treatment decisions, leading to better oral health outcomes. METHODS Data were obtained from the 2015-2016 National Health and Nutrition Examination Survey and were randomly divided into training and test sets. Several supervised machine learning methods were applied to construct a tool that was capable of classifying variables into the presence and absence of root caries. Accuracy, sensitivity, specificity and area under the receiver operating curve were computed. RESULTS Of the machine learning algorithms developed, support vector machine demonstrated the best performance with an accuracy of 97.1%, precision of 95.1%, sensitivity of 99.6% and specificity of 94.3% for identifying root caries. The area under the curve was 0.997. Age was the feature most strongly associated with root caries. CONCLUSION The machine learning algorithms developed in this study perform well and allow for clinical implementation and utilisation by dental and nondental professionals. Clinicians are encouraged to adopt the algorithms from this study for early intervention and treatment of root caries for the ageing population of the United States, and for attaining precision dental medicine.
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Affiliation(s)
- Man Hung
- Roseman University of Health Sciences College of Dental Medicine, South Jordan, Utah.,Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah.,Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah.,Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Maren W Voss
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Megan N Rosales
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Wei Li
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Weicong Su
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Julie Xu
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Jerry Bounsanga
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Bianca Ruiz-Negrón
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Evelyn Lauren
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, Utah
| | - Frank W Licari
- Roseman University of Health Sciences College of Dental Medicine, South Jordan, Utah
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18
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Karabudak S, Ari O, Durmaz B, Dal T, Basyigit T, Kalcioglu MT, Durmaz R. Analysis of the effect of smoking on the buccal microbiome using next-generation sequencing technology. J Med Microbiol 2019; 68:1148-1158. [PMID: 31199220 DOI: 10.1099/jmm.0.001003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This study aimed to investigate the effect of smoking on the buccal microbiome and to analyse the descriptive ability of each of the seven hypervariable regions in their 16S rRNA genes. METHODOLOGY Microbiome compositions of 40 buccal swab samples collected from smokers (n =20) and non-smokers (n =20) were determined using 16S rRNA sequencing. Seven different 16S rRNA hypervariable regions (V2, V3, V4, V6-7, V8 and V9) in each sample were amplified using the Ion Torrent 16S Metagenomics kit and were sequenced on the Ion S5 instrument. RESULTS Seven hypervariable regions in the 16S rRNA gene were successfully sequenced for all samples tested. The data obtained with the V2 region was found to be informative but the consensus data generated according to a number of operational taxonomic unit reads gathered from all seven hypervariable regions gave the most accurate result. At the phylum level, no statistically significant difference was found between smokers and non-smokers whereas relative abundances of Veillonella atypica, Streptococcus australis, Prevotella melaninogenica, Prevotella salivae and Rothia mucilaginosa showed significant increases in the smoker group (P-adj=0.05). Alpha diversity results did not show a significant difference between the two groups; however, beta diversity analysis indicated that samples of smoker and non-smoker groups had a tendency to be clustered within themselves. CONCLUSION The results of the current study indicate that smoking is a factor influencing buccal microbiome composition. In addition, sequencing of all seven hypervariable regions yielded more accurate results than those with any of the single variable regions.
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Affiliation(s)
- Sema Karabudak
- Ankara Yildirim Beyazit University, Central Research and Application Center, Ankara, Turkey
| | - Oguz Ari
- Ankara Yildirim Beyazit University, Central Research and Application Center, Ankara, Turkey
| | - Bengul Durmaz
- Yuksek Ihtisas University, Faculty of Medicine, Department of Clinical Microbiology, Ankara, Turkey
| | - Tuba Dal
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Clinical Microbiology, Ankara, Turkey
| | - Tugcan Basyigit
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Clinical Microbiology, Ankara, Turkey
| | - Mahmut Tayyar Kalcioglu
- Istanbul Medeniyet University, Faculty of Medicine, Department of Otolaryngology, Istanbul, Turkey
| | - Riza Durmaz
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Clinical Microbiology, Ankara, Turkey.,Ankara Yildirim Beyazit University, Central Research and Application Center, Ankara, Turkey
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19
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Münzenmayer MA, Mariño R, Hsueh A. Cost‐effectiveness of professional oral health care in Australian residential aged care facilities. Gerodontology 2018; 36:107-117. [DOI: 10.1111/ger.12386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Rodrigo Mariño
- Melbourne Dental SchoolThe University of Melbourne Melbourne Victoria Australia
| | - Arthur Hsueh
- Melbourne School of Population and Global HealthThe University of Melbourne Melbourne Victoria Australia
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20
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Gomes BPFDA, Herrera DR. Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res 2018; 32:e69. [PMID: 30365610 DOI: 10.1590/1807-3107bor-2018.vol32.0069] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 12/16/2022] Open
Abstract
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
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Affiliation(s)
| | - Daniel Rodrigo Herrera
- Universidade Estadual de Campinas -Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
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21
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Ndegwa N, Ploner A, Liu Z, Roosaar A, Axéll T, Ye W. Association between poor oral health and gastric cancer: A prospective cohort study. Int J Cancer 2018; 143:2281-2288. [PMID: 29873081 DOI: 10.1002/ijc.31614] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 04/28/2018] [Accepted: 05/09/2018] [Indexed: 01/22/2023]
Abstract
Poor oral health may be involved in the pathogenesis of gastric cancer, however, some aspects have not been explored. Further, for previously studied aspects, for example, tooth-loss, the findings are inconsistent. We conducted a prospective cohort study of 19,831 participants from Uppsala, Sweden, cancer-free at baseline in 1973-1974 and followed until 2012 through linkage to national registers. We found that individuals with fewest teeth at baseline had an increased risk of gastric cancer relative to subjects with all examined teeth present (p = 1.75e-2). Presence of denture-associated lesions was also associated with an increased risk of gastric cancer (p = 1.00e-4). However, these excess risks significantly varied with attained age; estimated hazard ratio (HR) at attained age 50 for tooth loss was 4.24 [95% confidence interval (CI) 1.83-9.80] and 5.91 (95% CI 2.76-12.63) for denture-associated lesions, decreasing at an estimated 4% and 6% per year respectively, resulting in HR of 1.54 (95% CI 0.90-2.64) for tooth loss and HR 1.29 (95% CI 0.90-1.85) for denture-associated lesions at attained age 75. No increased risk of gastric cancer was found for individuals with higher levels of dental plaque, or with Candida-related or tongue lesions. In conclusion, tooth-loss and denture-associated lesions are associated with increased risks of gastric cancer. Previous conflicting findings of tooth-loss and gastric cancer risk may partly be explained by the age-varying relative risk of gastric cancer.
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Affiliation(s)
- Nelson Ndegwa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Zhiwei Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ann Roosaar
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tony Axéll
- Maxillofacial Unit, Halmstad Hospital Halland, Halmstad, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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22
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Batty GD, Jung KJ, Mok Y, Lee SJ, Back JH, Lee S, Jee SH. Oral health and later coronary heart disease: Cohort study of one million people. Eur J Prev Cardiol 2018; 25:598-605. [PMID: 29461088 PMCID: PMC5946673 DOI: 10.1177/2047487318759112] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aims Systematic reviews report an association between poorer oral health and an increased risk of coronary heart disease. This contentious relationship may not be causal but existing studies have been insufficiently well powered comprehensively to examine the role of confounding, particularly by cigarette smoking. Accordingly, we sought to examine the role of smoking in generating the relationship between oral health and coronary heart disease in life-long non-smokers. Methods and results In the Korean Cancer Prevention Study, 975,685 individuals (349,579 women) aged 30–95 years had an oral examination when tooth loss, a widely used indicator of oral health, was ascertained. Linkage to national mortality and hospital registers over 21 years of follow-up gave rise to 64,784 coronary heart disease events (19,502 in women). In the whole cohort, after statistical adjustment for age, there was a moderate, positive association between tooth loss and coronary heart disease in both men (hazard ratio for seven or more missing teeth vs. none; 95% confidence interval 1.08; 1.02, 1.14; Ptrend across tooth loss groups <0.0001) and women (1.09; 1.01, 1.18; Ptrend 0.0016). Restricting analyses to a subgroup of 464,145 never smokers (25,765 coronary heart disease events), however, resulted in an elimination of this association in men (1.01; 0.85, 1.19); Ptrend 0.7506) but not women (1.08; 0.99, 1.18; Ptrend 0.0086). Conclusion In men in the present study, the relationship between poor oral health and coronary heart disease risk appeared to be explained by confounding by cigarette smoking so raising questions about a causal link.
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Affiliation(s)
- G David Batty
- 1 Department of Epidemiology and Public Health, University College London, UK
| | - Keum Ji Jung
- 2 Department of Epidemiology and Health Promotion, Yonsei University, South Korea.,3 Institute for Health Promotion, Yonsei University, South Korea
| | - Yejin Mok
- 4 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
| | - Sun Ju Lee
- 3 Institute for Health Promotion, Yonsei University, South Korea
| | - Joung Hwan Back
- 5 Health Insurance Policy Research Institute, Wonju, South Korea
| | - Sunmi Lee
- 5 Health Insurance Policy Research Institute, Wonju, South Korea
| | - Sun Ha Jee
- 2 Department of Epidemiology and Health Promotion, Yonsei University, South Korea.,3 Institute for Health Promotion, Yonsei University, South Korea.,4 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
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23
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Si J, Lee C, Ko G. Oral Microbiota: Microbial Biomarkers of Metabolic Syndrome Independent of Host Genetic Factors. Front Cell Infect Microbiol 2017; 7:516. [PMID: 29326886 PMCID: PMC5736563 DOI: 10.3389/fcimb.2017.00516] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/04/2017] [Indexed: 12/14/2022] Open
Abstract
The oral microbiota plays a critical role in both local and systemic inflammation. Metabolic syndrome (MetS) is characterized by low-grade inflammation, and many studies have been conducted on the gut microbiota from stool specimens. However, the etiological role of the oral microbiota in the development of MetS is unclear. In this study, we analyzed the oral and gut microbiome from 228 subgingival plaque and fecal samples from a Korean twin-family cohort with and without MetS. Significant differences in microbial diversity and composition were observed in both anatomical niches. However, a host genetic effect on the oral microbiota was not observed. A co-occurrence network analysis showed distinct microbiota clusters that were dependent on the MetS status. A comprehensive analysis of the oral microbiome identified Granulicatella and Neisseria as bacteria enriched in subjects with MetS and Peptococcus as bacteria abundant in healthy controls. Validation of the identified oral bacteria by quantitative PCR (qPCR) showed that healthy controls possessed significantly lower levels of G. adiacens (p = 0.023) and a higher ratio of Peptococcus to Granulicatella (p < 0.05) than MetS subjects. Our results support that local oral microbiota can be associated with systemic disorders. The microbial biomarkers identified in this study would aid in determination of which individuals develop chronic diseases from their MetS and contribute to strategic disease management.
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Affiliation(s)
- Jiyeon Si
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Cheonghoon Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - GwangPyo Ko
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Center for Human and Environmental Microbiome, Seoul National University, Seoul, South Korea.,N-Bio, Seoul National University, Seoul, South Korea
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24
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Interaction between diet composition and gut microbiota and its impact on gastrointestinal tract health. FOOD SCIENCE AND HUMAN WELLNESS 2017. [DOI: 10.1016/j.fshw.2017.07.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Mallapragada S, Kasana J, Agrawal P. Effect of Nonsurgical Periodontal Therapy on Serum Highly Sensitive Capsule Reactive Protein and Homocysteine Levels in Chronic Periodontitis: A Pilot Study. Contemp Clin Dent 2017; 8:279-285. [PMID: 28839416 PMCID: PMC5551335 DOI: 10.4103/ccd.ccd_140_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The aim of the present study was to assess the effect of nonsurgical periodontal therapy on circulating serum high-sensitivity capsule reactive protein (hs-CRP) and homocysteine (Hcy) levels in patients with chronic periodontitis. MATERIALS AND METHODS The study involved fifty participants. The test group included 25 systemically healthy controls (mean age 38.44 ± 3.27 years) with severe chronic periodontitis and the control group (n = 25) included age- and sex-matched systemically and periodontally healthy controls. Clinical parameters were recorded, intraoral periapical radiographs were taken, hematological tests and assessment of serum hs-CRP levels and Hcy levels were performed at baseline and 3 months after completion of nonsurgical periodontal therapy. RESULTS Mean serum hs-CRP and Hcy concentration in patients with chronic periodontitis were 3.37 ± 0.54 mg/L and 21.47 ± 7.93 μmol/L, respectively, and was significantly higher than the controls (1.68 ± 0.71 mg/L and 13.93 ± 8.30 μmol/L, respectively) (P < 0.05). Posttreatment, the mean serum hs-CRP and Hcy concentration reduced significantly in both test and control groups (P < 0.05). CONCLUSION Chronic periodontitis leads to an increase in circulating levels of hs-CRP and Hcy in plasma and nonsurgical periodontal therapy decreases periodontal inflammation, which in turn reduces systemic inflammation and consequently decreases serum levels of hs-CRP and Hcy.
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Affiliation(s)
- Siddharth Mallapragada
- Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Jyoti Kasana
- Department of Dentistry, Guru Teg Bahadur Hospital, New Delhi, India
| | - Pallavi Agrawal
- Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
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26
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Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, Inflammation, and Periodontal Disease. J Dent Res 2016; 86:400-9. [PMID: 17452558 DOI: 10.1177/154405910708600503] [Citation(s) in RCA: 249] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The prevalence of obesity has increased substantially over the past decades in most industrialized countries. Obesity is a systemic disease that predisposes to a variety of co-morbidities and complications that affect overall health. Cross-sectional studies suggest that obesity is also associated with oral diseases, particularly periodontal disease, and prospective studies suggest that periodontitis may be related to cardiovascular disease. The possible causal relationship between obesity and periodontitis and potential underlying biological mechanisms remain to be established; however, the adipose tissue actively secretes a variety of cytokines and hormones that are involved in inflammatory processes, pointing toward similar pathways involved in the pathophysiology of obesity, periodontitis, and related inflammatory diseases. We provide an overview of the definition and assessment of obesity and of related chronic diseases and complications that may be important in the periodontist’s office. Studies that have examined the association between obesity and periodontitis are reviewed, and adipose-tissue-derived hormones and cytokines that are involved in inflammatory processes and their relationship to periodontitis are discussed. Our aim is to raise the periodontist’s awareness when treating obese individuals.
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Affiliation(s)
- N Pischon
- Dept. of Periodontology, Charité University Medical Center, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
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27
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Ebersole JL, Kryscio RJ, Campbell C, Kinane DF, McDevitt J, Christodoulides N, Floriano PN, Miller CS. Salivary and serum adiponectin and C-reactive protein levels in acute myocardial infarction related to body mass index and oral health. J Periodontal Res 2016; 52:419-427. [PMID: 27549083 DOI: 10.1111/jre.12406] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Adiponectin is produced by adipose cells and is considered an anti-inflammatory molecule. In contrast, C-reactive protein (CRP) has been identified as a hallmark of systemic inflammation and used as a risk marker of cardiovascular disease (CVD). Of interest was the relationship of these two biomarkers to oral health and CVD risk. MATERIAL AND METHODS This investigation examined these two molecules in serum and unstimulated whole saliva of patients within 48 h of an acute myocardial infarction (AMI) compared to control subjects. We hypothesized a differential response in these biomolecules resulting from the heart attack that would be affected by both the body mass index and oral health characteristics of the individuals. RESULTS Significantly lower adiponectin levels were observed in the serum of patients with AMI. Serum adiponectin in both groups and salivary adiponectin in patients with AMI decreased with increasing body mass index. Oral health was significantly worse in patients with AMI, and both serum and salivary adiponectin were elevated with better oral health in control subjects. Serum CRP levels were increased in patients with AMI regardless of their oral health, and both serum and salivary CRP were significantly elevated in S-T wave elevated patients with MI. CONCLUSIONS These initial data provide evidence relating obesity and oral health to salivary and serum analyte levels that occur in association with cardiac events. Relationships have been described between CVD risk and periodontal disease. Additionally, various systemic inflammatory biomarkers appear to reflect both the CVD risk and the extent/severity of periodontitis. Our findings indicated that oral health and obesity contribute to altering levels of these salivary and serum analytes in association with cardiac events. The potential that serum and/or salivary biomarkers could aid in evaluating CVD risk requires knowledge regarding how the oral health of the individual would impact the effectiveness of these biological measures.
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Affiliation(s)
- J L Ebersole
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - R J Kryscio
- Department of Statistics, College of Arts and Sciences and Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - C Campbell
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - D F Kinane
- College of Dentistry, University of Pennsylvania, Philadelphia, PA, USA
| | - J McDevitt
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA
| | - N Christodoulides
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - P N Floriano
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - C S Miller
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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28
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Hearn L, Slack-Smith L. Engaging dental professionals in residential aged-care facilities: staff perspectives regarding access to oral care. Aust J Prim Health 2016; 22:445-451. [DOI: 10.1071/py15028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 08/17/2015] [Indexed: 11/23/2022]
Abstract
The limited access to oral care for older people living in residential aged care facilities (RACFs) has been noted repeatedly in the literature. The aim of this study was to explore RACF staff perspectives on how to engage dental professionals in the provision of oral care for RACF residents. Semi-structured interviews were conducted with 30 staff from six purposively selected RACFs located in high socioeconomic areas to gain understanding of the multidimensional issues that influenced the engagement of dental professionals from a carer perspective. Analysis revealed that staff perceived tensions regarding affordability, availability, accessibility and flexibility of dental professionals as significant barriers to better oral care for their residents. Participants raised a series of options for how to better engage dental professionals and reduce these barriers. Their ideas included: the engagement of RACF staff in collaborative discussions with representatives of public and private dental services, dental associations, corporate partners and academics; the use of hygienists/oral health therapists to educate and motivate RACF staff; the promotion of oral health information for troubleshooting and advice on how to deal with residents’ dental pain while waiting for support; the encouragement of onsite training for dental professionals; and the importance of gerodontology (geriatric dentistry). Findings highlighted the need to explore alternative approaches to delivering oral care that transcend the model of private clinical practice to focus instead on the needs of RACFs and take into account quality of end-of-life oral care.
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29
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Sasaki H, Hirai K, Martins CM, Furusho H, Battaglino R, Hashimoto K. Interrelationship Between Periapical Lesion and Systemic Metabolic Disorders. Curr Pharm Des 2016; 22:2204-15. [PMID: 26881444 PMCID: PMC4856634 DOI: 10.2174/1381612822666160216145107] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/15/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Periapical periodontitis, also known as periapical lesion, is a common dental disease, along with periodontitis (gum disease). Periapical periodontitis is a chronic inflammatory disease, caused by endodontic infection, and its development is regulated by the host immune/inflammatory response. Metabolic disorders, which are largely dependent on life style such as eating habits, have been interpreted as a "metabolically-triggered" low-grade systemic inflammation and may interact with periapical periodontitis by triggering immune modulation. The host immune system is therefore considered the common fundamental mechanism of both disease conditions. METHOD We have reviewed >200 articles to discuss the interrelationship between periapical lesions and metabolic disorders including type 2 diabetes mellitus, hypertension, and non-alcoholic fatty liver diseases (NAFLD), and their common pathological background in immunology/osteoimmunology and cytokine biology. RESULTS An elevated inflammatory state caused by metabolic disorders can impact the clinical outcome of periapical lesions and interfere with wound healing after endodontic treatment. Although additional well-designed clinical studies are needed, periapical lesions appear to affect insulin sensitivity and exacerbate non-alcoholic steatohepatitis. CONCLUSION Immune regulatory cytokines produced by various cell types, including immune cells and adipose tissue, play an important role in this interrelationship.
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Affiliation(s)
- Hajime Sasaki
- Department of Immunology & Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02494, U.S.A.
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30
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Söder B, Andersson LC, Meurman JH, Söder PÖ. Unique database study linking gingival inflammation and smoking in carcinogenesis. Philos Trans R Soc Lond B Biol Sci 2015; 370:20140041. [PMID: 25533098 DOI: 10.1098/rstb.2014.0041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
We investigated statistical association between gingival inflammation and cancer in a group of patients followed up for 26 years with the hypothesis that gingival inflammation affects carcinogenesis. Altogether, 1676 30- to 40-year-old subjects from Stockholm were clinically examined in 1985. In 2011, we compared the baseline oral examination and follow-up data with cancer diagnoses sourced from the Swedish national hospital register databases. Of 1676 individuals, 89 (55 women, 34 men) had got cancer by the year 2011. Women were found to be at higher risk for cancer than men. Smoking (expressed in pack-years) had been more prevalent in the cancer group than in those with no cancer diagnosis. Gingival index, marker of gingival inflammation, was higher in the cancer group than in subjects with no cancer. There were no significant differences between the groups regarding age, education, dental plaque and calculus index scores, or in the number of missing teeth. In multiple logistic regression analysis with cancer as the dependent variable and several independent variables, pack-years of smoking appeared to be a principal independent predictor with odds ratio (OR) 1.32 while gingival inflammation showed OR 1.29. Hence, our present findings showed that together with smoking, gingival inflammation indeed associated with the incidence of cancer in this cohort.
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Affiliation(s)
- Birgitta Söder
- Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
| | - Leif C Andersson
- Department of Pathology, Haartman Institute, University of Helsinki, 00014 Helsinki, Finland
| | - Jukka H Meurman
- Department of Oral Maxillofacial Diseases, Helsinki University Central Hospital, 00029 Helsinki, Finland
| | - Per-Östen Söder
- Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
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31
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Wu H, Tremaroli V, Bäckhed F. Linking Microbiota to Human Diseases: A Systems Biology Perspective. Trends Endocrinol Metab 2015; 26:758-770. [PMID: 26555600 DOI: 10.1016/j.tem.2015.09.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/28/2015] [Accepted: 09/28/2015] [Indexed: 12/19/2022]
Abstract
The human gut microbiota encompasses a densely populated ecosystem that provides essential functions for host development, immune maturation, and metabolism. Alterations to the gut microbiota have been observed in numerous diseases, including human metabolic diseases such as obesity, type 2 diabetes (T2D), and irritable bowel syndrome, and some animal experiments have suggested causality. However, few studies have validated causality in humans and the underlying mechanisms remain largely to be elucidated. We discuss how systems biology approaches combined with new experimental technologies may disentangle some of the mechanistic details in the complex interactions of diet, microbiota, and host metabolism and may provide testable hypotheses for advancing our current understanding of human-microbiota interaction.
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Affiliation(s)
- Hao Wu
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Valentina Tremaroli
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Fredrik Bäckhed
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, 41345 Gothenburg, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.
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32
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Hearn L, Slack-Smith L. Oral health care in residential aged care services: barriers to engaging health-care providers. Aust J Prim Health 2015; 21:148-56. [PMID: 25155109 DOI: 10.1071/py14029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 07/17/2014] [Indexed: 01/25/2023]
Abstract
The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved.
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Abstract
These days, the gut microbiota is universally recognized as an active organ that can modulate the overall host metabolism by promoting multiple functions, from digestion to the systemic maintenance of overall host physiology. Dysbiosis, the alteration of the complex ecologic system of gut microbes, is associated with and causally responsible for multiple types of pathologies. Among the latters, metabolic diseases such as type 2 diabetes and obesity are each distinguishable by a unique gut microbiota profile. Interestingly, the specific microbiota typically found in the blood of diabetic patients also has been observed at the level of atherosclerotic plaque. Here, we report evidence from the literature, as well as a few controversial reports, regarding the putative role of gut microbiota dysbiosis-induced cardiovascular diseases, such as atherosclerosis, which are common comorbidities of metabolic dysfunction.
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Borilova Linhartova P, Bartova J, Poskerova H, Machal J, Vokurka J, Fassmann A, Izakovicova Holla L. Apolipoprotein E gene polymorphisms in relation to chronic periodontitis, periodontopathic bacteria, and lipid levels. Arch Oral Biol 2015; 60:456-62. [DOI: 10.1016/j.archoralbio.2014.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/17/2014] [Accepted: 10/13/2014] [Indexed: 02/07/2023]
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35
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Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/etp.12060] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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36
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Kozarov E, Padro T, Badimon L. View of statins as antimicrobials in cardiovascular risk modification. Cardiovasc Res 2014; 102:362-74. [DOI: 10.1093/cvr/cvu058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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37
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Cardiovascular disease in autoimmune rheumatic diseases. Autoimmun Rev 2013; 12:1004-15. [PMID: 23541482 DOI: 10.1016/j.autrev.2013.03.013] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 03/07/2013] [Indexed: 12/18/2022]
Abstract
Various autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis, spondyloarthritis, vasculitis and systemic lupus erythematosus, are associated with premature atherosclerosis. However, premature atherosclerosis has not been uniformly observed in systemic sclerosis. Furthermore, although experimental models of atherosclerosis support the role of antiphospholipid antibodies in atherosclerosis, there is no clear evidence of premature atherosclerosis in antiphospholipid syndrome (APA). Ischemic events in APA are more likely to be caused by pro-thrombotic state than by enhanced atherosclerosis. Cardiovascular disease (CVD) in ARDs is caused by traditional and non-traditional risk factors. Besides other factors, inflammation and immunologic abnormalities, the quantity and quality of lipoproteins, hypertension, insulin resistance/hyperglycemia, obesity and underweight, presence of platelets bearing complement protein C4d, reduced number and function of endothelial progenitor cells, apoptosis of endothelial cells, epigenetic mechanisms, renal disease, periodontal disease, depression, hyperuricemia, hypothyroidism, sleep apnea and vitamin D deficiency may contribute to the premature CVD. Although most research has focused on systemic inflammation, vascular inflammation may play a crucial role in the premature CVD in ARDs. It may be involved in the development and destabilization of both atherosclerotic lesions and of aortic aneurysms (a known complication of ARDs). Inflammation in subintimal vascular and perivascular layers appears to frequently occur in CVD, with a higher frequency in ARD than in non-ARD patients. It is possible that this inflammation is caused by infections and/or autoimmunity, which might have consequences for treatment. Importantly, drugs targeting immunologic factors participating in the subintimal inflammation (e.g., T- and B-cells) might have a protective effect on CVD. Interestingly, vasa vasorum and cardiovascular adipose tissue may play an important role in atherogenesis. Inflammation and complement depositions in the vessel wall are likely to contribute to vascular stiffness. Based on biopsy findings, also inflammation in the myocardium and small vessels may contribute to premature CVD in ARDs (cardiac ischemia and heart failure). There is an enormous need for an improved CVD prevention in ARDs. Studies examining the effect of DMARDs/biologics on vascular inflammation and CV risk are warranted.
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Johnson VB. Evidence-based practice guideline: oral hygiene care for functionally dependent and cognitively impaired older adults. J Gerontol Nurs 2013; 38:11-9. [PMID: 23126514 DOI: 10.3928/00989134-20121003-02] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Análisis de MMPs en fluidos orales en el diagnóstico complementario de las enfermedades periodontales. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s0718-5391(12)70111-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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40
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Pulpal and periodontal diseases increase triglyceride levels in diabetic rats. Clin Oral Investig 2012; 17:1595-9. [DOI: 10.1007/s00784-012-0853-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 09/25/2012] [Indexed: 01/11/2023]
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41
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Kozarov E. Bacterial invasion of vascular cell types: vascular infectology and atherogenesis. Future Cardiol 2012; 8:123-38. [PMID: 22185451 DOI: 10.2217/fca.11.75] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
To portray the chronic inflammation in atherosclerosis, leukocytic cell types involved in the immune response to invading pathogens are often the focus. However, atherogenesis is a complex pathological deterioration of the arterial walls, where vascular cell types are participants with regards to deterioration and disease. Since other recent reviews have detailed the role of both the innate and adaptive immune response in atherosclerosis, herein we will summarize the latest developments regarding the association of bacteria with vascular cell types: infections as a risk factor for atherosclerosis; bacterial invasion of vascular cell types; the atherogenic sequelae of bacterial presence such as endothelial activation and blood clotting; and the identification of the species that are able to colonize this niche. The evidence of a polybacterial infectious component of the atheromatous lesions opens the doors for exploration of the new field of vascular infectology and for the study of atherosclerosis microbiome.
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Affiliation(s)
- Emil Kozarov
- Section of Oral & Diagnostic Sciences, Columbia University Medical Center, 630 West 168 Street, P&S Box 20, New York, NY 10032, USA.
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42
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Meisel P, Wilke P, Biffar R, Holtfreter B, Wallaschofski H, Kocher T. Total tooth loss and systemic correlates of inflammation: role of obesity. Obesity (Silver Spring) 2012; 20:644-50. [PMID: 21760638 DOI: 10.1038/oby.2011.218] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Obesity and edentulism are both associated with multiple systemic disorders with an inflammatory background including periodontal diseases. This study aimed to evaluate the different impact of obesity on inflammation in dentate and toothless subjects. The data came from the population-based, cross-sectional study SHIP (Study of Health in Pomerania). We determined anthropometric measures including BMI, waist-to-hip ratio (WHR), diagnostic periodontal parameters, and systemic metabolites. It was shown that measures of systemic markers of inflammation and lipid or glucose metabolism (P < 0.001) were increased with higher WHR. When adjusted for age, sex, smoking, diabetes, education, physical activity, and last dentist's appointment, C-reactive protein (CRP), fibrinogen, and leukocyte count were significantly related to WHR increasing from the first to the fourth WHR quartile (P < 0.001) as well as to the BMI. In both dentate and edentulous subjects higher WHR contributes significantly to increasing systemic CRP and fibrinogen with sex differences. In toothless subjects, while still dependent on increasing WHR, the inflammatory markers CRP and fibrinogen were higher than in dentate subjects, thereby revealing effect modification between sex and edentulism (P < 0.010). In conclusion, subjects with total tooth loss, although devoid of periodontal inflammation, may exhibit increased levels of systemic inflammatory mediators. Possible implications are discussed with respect to obesity and its relationship to inflammation.
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Affiliation(s)
- Peter Meisel
- Dental Clinics, Department of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany.
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43
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Bacci C, Piacentile K, Berengo M. Infezione odontogena metafocale simulante il morbo di Still: caso clinico. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2011.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Yoshino F, Yoshida A, Wada-Takahashi S, Sugiyama S, Tokutomi F, Maehata Y, Miyamoto C, Komatsu T, Takahashi SS, Kobayashi K, Lee MCI. Assessments of salivary antioxidant activity using electron spin resonance spectroscopy. Arch Oral Biol 2012; 57:654-62. [PMID: 22261034 DOI: 10.1016/j.archoralbio.2011.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 11/08/2011] [Accepted: 12/18/2011] [Indexed: 02/04/2023]
Abstract
OBJECTIVE In recent years, the function of saliva has been focused on evaluation of general status. The relationship between salivary antioxidant activity and periodontal disease progression is unclear. The aim of this study is to assess the relationship between periodontal disease and salivary antioxidant activity towards various reactive oxygen species (ROS) using electron spin resonance (ESR) technique. METHODS We demonstrated that whole saliva derived rats or human subjects scavenged ROS such as superoxide (O(2)(·-)) and hydroxyl radical (HO(·)) using ESR spectroscopy with spin trapping agent. In addition, we assessed the relationship between antioxidants activity towards ROS and periodontal index with superoxide dismutase (SOD) activity in human subject saliva. RESULTS Antioxidant activity towards O(2)(·-) was increased by Porphyromonas gingivalis (P. gingivalis) infection in rat, although antioxidant activity towards HO(·) was not changed. In human, a strong correlation (r = 0.88, p < 0.01) recognized between salivary antioxidant activity towards O(2)(·-) and probing pocket depth (PPD). In addition, the intensity of salivary antioxidant activity depended on SOD activity level. SOD activity was also correlated with PPD. CONCLUSIONS Rat salivary antioxidant activity towards O(2)(·-) was up-regulated by the inflammatory response caused by P. gingivalis infection. Similar response was recognized in human saliva with periodontal index. Additionally, a linear correlation between antioxidant activity towards O(2)(·-) and SOD activity was verified by ESR technique. Therefore, evaluation of the salivary antioxidant activity towards O(2)(·-) might be an effective parameter for the objective assessment of periodontal disease progression.
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Affiliation(s)
- Fumihiko Yoshino
- Division of Pharmacology & ESR Laboratories, Department of Clinical Care Medicine, Kanagawa Dental College, Inaoka-cho 82, Yokosuka, Kanagawa 238-8580, Japan
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45
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Abstract
Obesity is a multifaceted subject. It has increased at an alarming rate in recent years. Being overweight increases the likelihood of a patient having associated health and social problems which may affect dental services and dental management. A review of the literature on obesity and periodontal disease suggested that they both confound each other and obesity itself has been recognized as a major risk factor for periodontal disease. It has been found that adverse effects of obesity on the periodontium may be mediated through pro-inflammatory cytokines and various other bioactive substances. This article tries to focus on the possible role of obesity and obesity-related diseases like diabetes and coronary heart diseases (CHD), as a potential contributor to periodontal disease and vice versa. The meanings of these associations can be useful for various diagnostic and treatment planning purposes.
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Affiliation(s)
- Parveen Dahiya
- Department of Periodontics, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, India
| | - Reet Kamal
- Department of Oral and Maxillofacial Pathology, HP Govt. Dental College, (IGMC) Shimla, Himachal Pradesh, India
| | - Rajan Gupta
- Department of Periodontics, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, India
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46
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Iwai T, Umeda M, Inoue Y. Are There Any Objections against Our Hypothesis That Buerger Disease Is an Infectious Disease? Ann Vasc Dis 2012; 5:300-9. [PMID: 23555529 DOI: 10.3400/avd.ra.12.00032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 05/07/2012] [Indexed: 11/13/2022] Open
Abstract
In 1878, Winiwarter used a microscope and reported a case of 57 year-old man demonstrating Buerger disease. After that, 134 years passed. Leo Buerger and Edgar V. Allen strongly suggested that Buerger disease is an infectious disease without any doubt. Also, an etiologic point is the luminal infectious thrombus, which is thought to be the core of the disease. Many etiological factors were proposed and then discarded after academic scrutiny, but two big discoveries were made in 2005 and 2008. Namely, periodontal bacteria DNA was found in the occluded arteries of 93% of patients with Buerger disease, and periodontal bacteria (typical weak bacteria) were found to dwell in the platelets. Using these evidences, supported by genetic and epidemiological facts, we could almost explain the pathogenesis or clinical course of Buerger disease, which had been already studied.
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Affiliation(s)
- Takehisa Iwai
- Tsukuba Vascular Center, Buerger Disease Research Institute, Moriya, Ibaraki, Japan
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47
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Meisel P, Kohlmann T, Wallaschofski H, Kroemer HK, Kocher T. Cholesterol, C-Reactive Protein, and Periodontitis: HMG-CoA-Reductase Inhibitors (Statins) as Effect Modifiers. ISRN DENTISTRY 2011; 2011:125168. [PMID: 22203908 PMCID: PMC3235692 DOI: 10.5402/2011/125168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 09/04/2011] [Indexed: 11/23/2022]
Abstract
Common risk factors of periodontitis and cardiovascular diseases fuel the debate on interrelationships between them. The aim is to prove whether statins may influence periodontal parameters by affecting either of these factors. Out of the 4,290 subjects of SHIP (Study of Health in Pomerania), we included subjects aged >30 years (219 with statins, 2937 without) and excluded edentulous. We determined periodontal measures, cholesterol fractions, and inflammation markers. Statin use and periodontal risk factors were assessed. Gingival plaque and periodontal attachment loss were associated with systemic LDL cholesterol (P < 0.001) and C-reactive protein CRP (P = 0.019) revealing interaction with statin use. When adjusted for age, sex, smoking, diabetes, education, and dental service, statins were identified as effect modifiers abolishing the relationship between attachment loss and LDL and between gingival plaque and LDL (interactions P < 0.001). No statin-related interaction was detected with increase in CRP. The interaction supports the view of inter-relationships between periodontal and systemic inflammatory mediators.
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Affiliation(s)
- Peter Meisel
- Department of Pharmacology, University of Greifswald, 17475 Greifswald, Germany
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48
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Prevalenza della malattia parodontale in soggetti con patologie correlate all’aterosclerosi. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2011.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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49
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Abstract
Chronic spirochetal infection can cause slowly progressive dementia, cortical atrophy and amyloid deposition in the atrophic form of general paresis. There is a significant association between Alzheimer disease (AD) and various types of spirochete (including the periodontal pathogen Treponemas and Borrelia burgdorferi), and other pathogens such as Chlamydophyla pneumoniae and herpes simplex virus type-1 (HSV-1). Exposure of mammalian neuronal and glial cells and organotypic cultures to spirochetes reproduces the biological and pathological hallmarks of AD. Senile-plaque-like beta amyloid (Aβ) deposits are also observed in mice following inhalation of C. pneumoniae in vivo, and Aβ accumulation and phosphorylation of tau is induced in neurons by HSV-1 in vitro and in vivo. Specific bacterial ligands, and bacterial and viral DNA and RNA all increase the expression of proinflammatory molecules, which activates the innate and adaptive immune systems. Evasion of pathogens from destruction by the host immune reactions leads to persistent infection, chronic inflammation, neuronal destruction and Aβ deposition. Aβ has been shown to be a pore-forming antimicrobial peptide, indicating that Aβ accumulation might be a response to infection. Global attention and action is needed to support this emerging field of research because dementia might be prevented by combined antibiotic, antiviral and anti-inflammatory therapy.
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50
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Yakob M, Söder B, Meurman JH, Jogestrand T, Nowak J, Söder PÖ. Prevotella nigrescens and Porphyromonas gingivalis are associated with signs of carotid atherosclerosis in subjects with and without periodontitis. J Periodontal Res 2011; 46:749-55. [PMID: 21793826 DOI: 10.1111/j.1600-0765.2011.01398.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Oral microorganisms may be involved in the development of cardiovascular diseases, and Porphyromonas gingivalis is one of the periodontal microorganisms that has been found in carotid atheroma. The aim of this work was to study subgingival microorganisms and early carotid lesions in subjects with and without periodontitis. MATERIAL AND METHODS Eighty-eight subjects with periodontitis and 40 subjects without periodontitis underwent dental examinations in 2003. The presence of the periodontal microorganisms Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia was analyzed from subgingival plaque using PCR amplification. The common carotid artery was scanned using ultrasound and the calculated intima-media area (cIMA) was measured. The association between periodontitis, the cIMA value and the presence of periodontal microorganisms, together with several confounders, was studied in a multiple logistic regression model. RESULTS Smoking [odds ratio (OR) = 5.64; p = 0.001), level of education (OR = 5.02; p < 0.05) and the presence of P. gingivalis (OR = 6.50; p < 0.05) were associated with periodontitis. Explanatory factors for the increased cIMA were periodontitis (OR = 4.22; p < 0.05), hypertension (OR = 4.81; p < 0.05), high body mass index (OR = 5.78; p < 0.01), male gender (OR = 3.30; p < 0.05) and poor socioeconomic status (OR = 4.34; p < 0.05). P. nigrescens (OR 4.08; p < 0.05) and P. gingivalis (OR 7.63; p < 0.01) also appeared as explanatory variables associated with increased cIMA values. CONCLUSION This cross-sectional study showed that P. nigrescens and P. gingivalis were significantly associated with increased cIMA values.
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Affiliation(s)
- M Yakob
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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