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Özer E, Yilmaz HE, Narin F, Sağlam M. The evaluation of salivary leucine-rich alpha-2 glycoprotein (LRG) and C-reactive protein (CRP) in humans with periodontal health or periodontal disease. J Periodontal Res 2024; 59:387-394. [PMID: 38126217 DOI: 10.1111/jre.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The purpose of the present research is to evaluate the salivary levels of leucine-rich alpha-2 glycoprotein (LRG) and C-reactive protein (CRP) in periodontal health and disease (gingivitis and stage III periodontitis) and also to compare the discriminative efficiencies of both biomarkers in periodontal disease. BACKGROUND LRG is a new acute-phase protein whose functions are still being investigated. LRG and CRP are both biomarkers that are increased by inflammation. No clinical study has yet investigated the comparison of the level of LRG and CRP in periodontal health, gingivitis and periodontitis in saliva samples. METHODS A total of 60 individuals, including 20 periodontally healthy (control group/group C), 20 with gingivitis (group G), and 20 with Stage III periodontitis (group P), who were systemically healthy and non-smokers, participated in this study. Periodontal charts were used for recording clinical periodontal parameters and saliva LRG and CRP levels were measured by ELISA. Analyzing the area under the curve (AUC) was performed by the receiver-operating characteristics curve. RESULTS Salivary levels of LRG and CRP were significantly higher in disease groups than in group C (p < .05). Positive statistically significant correlations were observed between both biomarkers and clinical parameters (p < .05). There was also a strong positive correlation between two biomarkers (p < .05). In distinguishing periodontal disease from periodontal health, LRG (AUC = 0.833) and CRP (AUC = 0.826) were found to have similar accuracy (p = .923). CONCLUSION LRG and CRP may be useful and similarly effective biomarkers in the diagnosis of periodontal diseases based on the findings of this study.
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Affiliation(s)
- Ece Özer
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Huriye Erbak Yilmaz
- Department of Medical Biochemistry, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey
- Izmir Biomedicine Genome Center, Dokuz Eylul University, Izmir, Turkey
| | - Figen Narin
- Department of Medical Biochemistry, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Mehmet Sağlam
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Kashefimehr A, Babaloo A, Afrashteh A. Evaluation of clinical and serological responses after full-mouth implantation in single-visit versus multiple-session surgery. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:15-21. [PMID: 39027205 PMCID: PMC11252158 DOI: 10.34172/japid.2024.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/09/2024] [Indexed: 07/20/2024]
Abstract
Background This research aimed to evaluate the clinical characteristics of pain and wound healing and serological inflammatory markers after full-mouth implantation in one session compared to several sessions. Methods A single-masked clinical trial was conducted on 20 patients (n=10) receiving full-mouth implants. Patients were randomly divided into two groups. The first group was operated under general anesthesia in one session and the second group in multi-sessions. Inflammation level was evaluated through white blood cell (WBC) and serum C-reactive protein (CRP) before and after surgery by a blood test. Pain and early wound healing (EHS) assessment was conducted after surgery with VAS and EHS indicators, respectively. Serological and clinical parameters were compared by repeated-measures ANOVA and Sidak and Man-Whitney U tests, respectively, using SPSS 20. Results The CRP level 48 hours postoperatively was not different in the two groups; however, seven days after treatment, it was higher in the multi-session group than in the single-session approach. The WBC was not different between the two groups at evaluated intervals. Serum levels of WBC and CRP increased 48 hours postoperatively and decreased seven days later. EHS showed no difference between the two groups at the three investigated intervals. The amount of VAS 24 and 48 hours and 7 days postoperatively was higher in multi-session surgery than in the one-session approach. In both groups, VAS was not different at 24 and 48 hours postoperatively and decreased over seven days. Conclusion Full-mouth implant surgery under general anesthesia in one session caused less inflammation and pain postoperatively while presenting the same wound-healing process as the multi-session surgery.
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Affiliation(s)
| | | | - Ahmad Afrashteh
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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3
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Li L, Jia L, Hou S, Zhang T, Zhou M, Chen T, Song J. Temporal and spatial effects on C-reactive protein's regulation of inducible nitric oxide synthase production in periodontal disease. J Periodontol 2024; 95:268-280. [PMID: 37515488 DOI: 10.1002/jper.22-0529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 05/14/2023] [Accepted: 07/22/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Inducible nitric oxide synthase (iNOS) is associated with inflammation and osteoclastic differentiation in periodontal disease. This study was conducted to compare the time-dependent variation in iNOS production between the gingiva and other periodontal tissues and to explore the potential association with C-reactive protein (CRP) in early periodontal disease. METHODS Ligature-induced periodontal disease models (0-14 days) were established in wild-type and CRP knockout rats. Changes in CRP, iNOS, and autophagy levels were examined in the gingiva and other periodontal tissues. Macrophages were treated with lipopolysaccharide and chloroquine to explore the role of autophagy in iNOS production. iNOS, CRP, and autophagy-related proteins were analyzed using Western blotting, immunostaining, and enzyme-linked immunosorbent assays. mRNA expression was detected by quantitative real-time polymerase chain reaction. Hematoxylin and eosin staining was used for histological analysis. Cathepsin K immunostaining and microcomputed tomography of the maxillae were performed to compare alveolar bone resorption. RESULTS iNOS and CRP levels increased rapidly in periodontal tissues, as observed on Day 2 of ligature, then decreased more rapidly in the gingiva than in other periodontal tissues. CRP deficiency did not prevent iNOS generation, but effectively accelerated iNOS reduction and delayed alveolar bone loss. The CRP effect on iNOS was accompanied by a change in autophagy, which was reduced by CRP knockout. CONCLUSIONS The regulation of iNOS by CRP shows temporospatial variation in early periodontal disease and is potentially associated with autophagy. These findings may contribute to the early detection and targeted treatment of periodontal disease.
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Affiliation(s)
- Lingjie Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Lurong Jia
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory for Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Siyu Hou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Tingwei Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Mengjiao Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory for Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinlin Song
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
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Cichońska D, Mazuś M, Kusiak A. Recent Aspects of Periodontitis and Alzheimer's Disease-A Narrative Review. Int J Mol Sci 2024; 25:2612. [PMID: 38473858 DOI: 10.3390/ijms25052612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Periodontitis is an inflammatory condition affecting the supporting structures of the teeth. Periodontal conditions may increase the susceptibility of individuals to various systemic illnesses, including Alzheimer's disease. Alzheimer's disease is a neurodegenerative condition characterized by a gradual onset and progressive deterioration, making it the primary cause of dementia, although the exact cause of the disease remains elusive. Both Alzheimer's disease and periodontitis share risk factors and clinical studies comparing the associations and occurrence of periodontitis among individuals with Alzheimer's disease have suggested a potential correlation between these conditions. Brains of individuals with Alzheimer's disease have substantiated the existence of microorganisms related to periodontitis, especially Porphyromonas gingivalis, which produces neurotoxic gingipains and may present the capability to breach the blood-brain barrier. Treponema denticola may induce tau hyperphosphorylation and lead to neuronal apoptosis. Lipopolysaccharides-components of bacterial cell membranes and mediators of inflammation-also have an impact on brain function. Further research could unveil therapeutic approaches targeting periodontal pathogens to potentially alleviate AD progression.
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Affiliation(s)
- Dominika Cichońska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Magda Mazuś
- Student Research Group of the Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdańsk, Orzeszkowej 18 St. 18, 80-208 Gdańsk, Poland
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Estarreja J, Pimenta AC, Botelho J, Vilares AM, Mendes JJ, Rocha J, Pinto R, Mateus V, Machado V. Blood count, endocrine, immunologic, renal, and hepatic markers in a case-control animal study of induced periodontitis in female rodents. Front Physiol 2024; 15:1327399. [PMID: 38444766 PMCID: PMC10912185 DOI: 10.3389/fphys.2024.1327399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction: Periodontitis is a non-communicable chronic inflammatory disease with a systemic burden. Animal models of induced periodontitis help elucidate the mechanisms by which periodontal inflammation drives systemic effects. Studying this systemic involvement over longer follow-up periods may provide a strong foundation for future research on the association between diseases and periodontitis, particularly in female rats. Therefore, we aimed to compare blood, endocrine, immunologic, renal, and hepatic markers in a rat model of induced periodontitis in females with their control counterparts. Methods: Experimental periodontitis was induced in 20 female Wistar rats by the application and maintenance of silk ligatures on the upper molars. The rats were then assessed for macroscopical analysis, complete blood count, and biochemical, endocrine, and immunologic markers at 21, 28, 42, and 56 days. Results: Chronic periodontal inflammation was observed after 42 days of exposure to the ligatures. Additionally, it was also possible to notice significant systemic manifestations, such as the reduction of triiodothyronine and thyroxine levels, along with an increase in the expression of alkaline phosphatase, gamma-glutamyl transpeptidase, and lactate dehydrogenase. Discussion: The study's findings imply that certain changes can be underscored to highlight a reduced risk of conception. Notably, previous investigations have indicated that subfertile women exhibit lower levels of thyroid hormones and elevated lactate dehydrogenase expression. Despite the absence of preclinical data delineating a possible association between periodontitis and female infertility, the results of this study may prove to be a crucial contribution to both the scientific and medical fields.
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Affiliation(s)
- João Estarreja
- H&TRC—Health and Technology Research Center, ESTeSL—Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Ana Clara Pimenta
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - Arminda Maria Vilares
- Laboratório de Fisiologia e Bioquímica do Exercício, Universidade de Lisboa Faculdade de Motricidade Humana, Lisboa, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - João Rocha
- iMed.ULisboa, Faculdade de Farmácia, Universidade de Lisboa, Lisbon, Portugal
| | - Rui Pinto
- iMed.ULisboa, Faculdade de Farmácia, Universidade de Lisboa, Lisbon, Portugal
- Joaquim Chaves Saúde, Joaquim Chaves Laboratório de Análises Clínicas, Miraflores, Portugal
| | - Vanessa Mateus
- H&TRC—Health and Technology Research Center, ESTeSL—Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
- iMed.ULisboa, Faculdade de Farmácia, Universidade de Lisboa, Lisbon, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
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Huang Q, Wu X, Zhou X, Sun Z, Shen J, Kong M, Chen N, Qiu JG, Jiang BH, Yuan C, Zheng Y. Association of cigarette smoking with oral bacterial microbiota and cardiometabolic health in Chinese adults. BMC Microbiol 2023; 23:346. [PMID: 37978427 PMCID: PMC10655299 DOI: 10.1186/s12866-023-03061-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/12/2023] [Indexed: 11/19/2023] Open
Abstract
The interplay among cigarette smoking status, oral microbiota, and cardiometabolic health is poorly understood. We aimed to examine the association of cigarette smoking status with oral microbiota and to assess the association of the identified microbial features with cardiometabolic risk factors in a Chinese population. This study included 587 participants within the Central China Cohort, including 111 smokers and 476 non-smokers, and their oral microbiota was profiled by 16S rRNA sequencing. Both oral microbial alpha- and beta-diversity were distinct between smokers and non-smokers (p < 0.05). With adjustment for sociodemographics, alcohol and tea drinking, tooth brushing frequency, and body mass index, the relative abundance of nine genera and 26 pathways, including the genus Megasphaera and two pathways involved in inositol degradation which have potentially adverse effects on cardiometabolic health, was significantly different between two groups (FDR q < 0.20). Multiple microbial features related to cigarette smoking were found to partly mediate the associations of cigarette smoking with serum triglycerides and C-reactive protein levels (p-mediation < 0.05). In conclusion, cigarette smoking status may have impacts on the oral microbial features, which may partially mediate the associations of cigarette smoking and cardiometabolic health.
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Affiliation(s)
- Qiumin Huang
- School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200433, China
| | - Xuemei Wu
- School of Public Health, Fudan University, Shanghai, 200032, China
| | - Xiaofeng Zhou
- School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200433, China
| | - Zhonghan Sun
- School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200433, China
| | - Jie Shen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mengmeng Kong
- School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200433, China
| | - Nannan Chen
- School of Medicine, Nantong University, Jiangsu, 226019, China
| | - Jian-Ge Qiu
- The Academy of Medical Science, Zhengzhou University, Zhengzhou, 450000, China
| | - Bing-Hua Jiang
- The Academy of Medical Science, Zhengzhou University, Zhengzhou, 450000, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Yan Zheng
- School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, 200433, China.
- Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Clemente LM, Ribeiro AB, Fortes CV, Ribeiro AB, Oliveira VDC, Macedo AP, Salgado HC, da Silva CHL. Risk factors and immunological biomarkers in denture stomatitis: An observational cross-sectional study. Arch Oral Biol 2023; 155:105799. [PMID: 37672969 DOI: 10.1016/j.archoralbio.2023.105799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Assess risk factors, local and systemic immunological biomarkers in healthy individuals and with Denture Stomatitis (DS). DESIGN For this observational transversal study, 27 participants without DS (Group 0), 24 with moderate DS (Group 1), and 25 with severe DS (Group 2) were assessed for sociodemographic, behavioral, and clinical parameters, microbial load of Candida spp., Staphylococcus spp., Streptococcus mutans, Pseudomonas spp., and enterobacteria, and cytokine and C-reactive protein levels. ANOVA, Fisher's exact, Kruskal-Wallis, Mann-Whitney, Wilcoxon and Pearson's chi-square tests were used for data analysis (α = 0.05). RESULTS Group 1 had a significantly higher mean age compared to the other groups (P = 0.018), but no correlation was identified between age and DS (P = 0.830; r = 0.025). No significant differences were found among the groups for other sociodemographic and behavioral characteristics. Group 1 had significantly older upper and lower dentures; however, no correlation was identified between age of upper (P = 0.522; r = 0.075) and lower (P = 0.143; r = 0.195) dentures and DS. The microbial load of Candida albicans on the dentures (P = 0.035) and Candida spp. on the palate (P = 0.008) of the groups 1 and 2 was higher than group 0. Group 1 and 2 had higher Candida spp. counts on denture (P = 0.003) than group 0. There was no difference among groups for bacterial analyzed. Group 1 showed higher and Group 2 intermediate salivary levels of IL-6 compared to Group 0. There was no difference in the C-reactive protein levels among groups. CONCLUSIONS Microbial load of Candida spp. is the factor with the strongest relationship with DS, with capacity for local signaling through IL-6.
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Affiliation(s)
- Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirao Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Caroline Vieira Fortes
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirao Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | | | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Hélio César Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
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Lieske B, Moszka N, Borof K, Petersen EL, Jagemann B, Ebinghaus M, Beikler T, Heydecke G, Aarabi G, Zyriax BC. Association between an Anti-Inflammatory Dietary Score and Periodontitis-Evidence from the Population-Based Hamburg City Health Study. Nutrients 2023; 15:3235. [PMID: 37513653 PMCID: PMC10386141 DOI: 10.3390/nu15143235] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), we developed an anti-inflammatory dietary score using a data-driven approach based on the relationship of relevant selected food groups with inflammatory biomarkers (hsCRP and IL-6). The aim of this cross-sectional study was to evaluate the association between the anti-inflammatory dietary score and the incidence of periodontitis in Hamburg, Germany. A total of n = 5642 participants fit the required inclusion criteria and were selected for analysis. Periodontal disease was assessed using probing depth, gingival recession, and bleeding on probing. Dietary intake was measured using a food frequency questionnaire (FFQ). A self-developed anti-inflammatory dietary score served as the key explanatory variable. Higher scores reflected lower inflammatory processes (measured through the biomarkers hsCRP and IL-6). Several covariates were included in the regression analysis. Regressions revealed that a higher anti-inflammatory dietary score was significantly associated with lower odds to be affected by periodontal disease in an unadjusted model (OR 0.86, 95% CI 0.82-0.89, p < 0.001) and in an adjusted model (age, sex, smoking, diabetes, hypertension, and physical activity) (OR 0.93, 95% CI 0.89-0.98, p = 0.003). Our study demonstrated a significant inverse association between an anti-inflammatory dietary score and periodontitis. Individuals with higher intake of proinflammatory nutrition should be specifically addressed to avoid periodontitis.
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Affiliation(s)
- Berit Lieske
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Nina Moszka
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Elina Larissa Petersen
- Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Bettina Jagemann
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Merle Ebinghaus
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Mayer C, Walther C, Borof K, Nägele FL, Petersen M, Schell M, Gerloff C, Kühn S, Heydecke G, Beikler T, Cheng B, Thomalla G, Aarabi G. Association between periodontal disease and microstructural brain alterations in the Hamburg City Health Study. J Clin Periodontol 2023. [PMID: 37263624 DOI: 10.1111/jcpe.13828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/24/2023] [Accepted: 05/07/2023] [Indexed: 06/03/2023]
Abstract
AIM The aim of the PAROBRAIN study was to examine the association of periodontal health with microstructural white matter integrity and cerebral small vessel disease (CSVD) in the Hamburg City Health Study, a large population-based cohort with dental examination and brain magnetic resonance imaging (MRI). MATERIALS AND METHODS Periodontal health was determined by measuring clinical attachment loss (CAL) and plaque index. Additionally, the decayed/missing/filled teeth (DMFT) index was quantified. 3D-FLAIR and 3D-T1-weighted images were used for white matter hyperintensity (WMH) segmentation. Diffusion-weighted MRI was used to quantify peak width of skeletonized mean diffusivity (PSMD). RESULTS Data from 2030 participants were included in the analysis. Median age was 65 years, with 43% female participants. After adjusting for age and sex, an increase in WMH load was significantly associated with more CAL, higher plaque index and higher DMFT index. PSMD was significantly associated with the plaque index and DMFT. Additional adjustment for education and cardiovascular risk factors revealed a significant association of PSMD with plaque index (p < .001) and DMFT (p < .01), whereas effects of WMH load were attenuated (p > .05). CONCLUSIONS These findings suggest an adverse effect of periodontal health on CSVD and white matter integrity. Further research is necessary to examine whether early treatment of periodontal disease can prevent microstructural brain damage.
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Affiliation(s)
- Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Felix L Nägele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schell
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Said-Sadier N, Sayegh B, Farah R, Abbas LA, Dweik R, Tang N, Ojcius DM. Association between Periodontal Disease and Cognitive Impairment in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4707. [PMID: 36981618 PMCID: PMC10049038 DOI: 10.3390/ijerph20064707] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/12/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Periodontitis is a severe oral infection that can contribute to systemic inflammation. A large body of evidence suggests a role for systemic inflammation in the initiation of neurodegenerative disease. This systematic review synthesized data from observational studies to investigate the association between periodontitis and neuroinflammation in adults. METHODS AND MATERIALS A systematic literature search of PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for studies published from the date of inception up to September 2021. Search terms for the exposure "oral disease" and outcome "dementia", "neuroinflammation" and "cognitive decline" were used. Study selection and data extraction were independently undertaken by two reviewers. The final eligible articles were included only if the exposure is periodontitis and the outcome is cognitive impairment or dementia or a topic related to this condition, and if the study was conducted in an adult population. The quality and risk of bias were assessed by Newcastle Ottawa Scale (NOS). Qualitative synthesis was used to narratively synthesize the results. Six cohort studies, three cross-sectional studies, and two case-control studies met the inclusion criteria. These eleven studies were only narratively synthesized. Meta-analysis was not performed due to the methodological heterogeneity of the studies. RESULTS The results of included studies show that chronic periodontitis patients with at least eight years of exposure are at higher risk of developing cognitive decline and dementia. Oral health measures such as gingival inflammation, attachment loss, probing depth, bleeding on probing, and alveolar bone loss are associated with cognitive impairment. The reduction of epidermal growth factor (EGF), interleukin 8 (IL-8), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) in addition to over expression of interleukin 1-β (IL-1β) are significant in patients suffering from cognitive decline with pre-existing severe periodontitis. CONCLUSIONS All the included studies show evidence of an association between periodontitis and cognitive impairment or dementia and Alzheimer's disease pathology. Nonetheless, the mechanisms responsible for the association between periodontitis and dementia are still unclear and warrant further investigation.
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Affiliation(s)
- Najwane Said-Sadier
- College of Health Sciences, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates
| | - Batoul Sayegh
- Neuroscience Research Center (NRC), Lebanese University, Beirut 1533, Lebanon
| | - Raymond Farah
- Neuroscience Research Center (NRC), Lebanese University, Beirut 1533, Lebanon
| | - Linda Abou Abbas
- Neuroscience Research Center (NRC), Lebanese University, Beirut 1533, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon
| | - Rania Dweik
- College of Health Sciences, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates
| | - Norina Tang
- Department of Periodontics, University of the Pacific, San Francisco, CA 94103, USA
- Department of Laboratory Medicine, Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Arthur Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94103, USA
| | - David M. Ojcius
- Arthur Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94103, USA
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Remnant Cholesterol as an Independent Predictor of Periodontitis: A Population-Based Study. DISEASE MARKERS 2023; 2023:3413356. [PMID: 36824233 PMCID: PMC9943602 DOI: 10.1155/2023/3413356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/16/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
Objective Numerus studies present that remnant cholesterol (RC) as a risk factor participates in the progression of multiple diseases. The aim of this study was to assess the relationship between cholesterol and periodontitis in the US population to find a reliable lipid predictor for periodontitis. Materials and Methods Clinical data was retrieved from the National Health and Nutrition Examination Survey (NHANES) database between 2009 and 2014. The logistic regression was conducted to examine the corelationship between RC and various clinical features. Meanwhile, the dose-response relationship was measured through restricted cubic spline analysis. And the propensity score matching (PSM) was established to further investigate the potential relationship between RC and periodontitis. Results A number of 4,829 eligible participants were included in this study. It was found that the increased RC is associated with the higher risk of periodontitis after adjusting the potential confounding factors with the adjusted odds ratios (aOR) of 1.403 (95% confidence intervals (CI): 1.171-1.681, P < 0.001, univariate analysis) and 1.341 (95% CI: 1.105-1.629, P = 0.003, multivariate analysis) in the highest grade. There were significant differences in the relationship between RC and various clinical features including age, gender, body mass index (BMI), race, hypertension, and diabetes mellitus (all P < 0.001). Besides, the calculated thresholds for predicting periodontitis were 19.99 (before propensity score matching (PSM)) and 20.91 (after PSM) mg/dL. Conclusions In this study, RC was identified to be positively associated with the occurrence of periodontitis, which suggests that RC can be considered as a predictor for periodontitis.
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12
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Ozgur E, Topcu DI, Bayraktar N, Alptekin NO. Peri-implant crevicular fluid and serum levels of soluble ST2 in peri-implant diseases: A pilot study. J Periodontal Res 2023; 58:204-211. [PMID: 36504319 DOI: 10.1111/jre.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/30/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Soluble ST2 (sST2) is a current biomarker of cardiovascular disease. It is used to predict susceptibility to cardiovascular diseases and to analyze their prognosis. Serum sST2 level increases in inflammatory diseases such as periodontitis. However, the level of sST2 in peri-implant diseases and crevicular fluid has not been investigated yet. Thus, the aim of this cross-sectional study is to analyze the level of sST2 in peri-implant health and diseases. METHODS Sixty-nine participants were divided into 3 groups as peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (P-I). Peri-implant crevicular fluid (PICF) and serum samples were collected from each participant. The levels of sST2 and IL-6 in PICF and sST2, IL-6, and CRP in serum were compared between the groups. Pocket depth (PD), modified bleeding index (mBI), modified plaque index (mPI), keratinized mucosa index (KTW), and gingival/mucosal recession (REC) were recorded as clinical parameters. Biomarkers in the serum and PICF were analyzed by ELISA kit. RESULTS Sixty-nine patients were included in the study. The differences in the following parameters were statistically significant between groups: age (p = .009), implant function time (p = .027), PD (p < .001), mBI (p < .001), mPI (p < .001), and KTW (p = .043). The PICF volume of P-I and PM groups were statistically higher than PH (p < .001). The amount of sST2 in P-I and PM groups were higher than PH (p = .043). Serum CRP was higher in the P-I group than in other groups (p = .034). There were no significant differences in serum sST2 (p = .247) and IL-6 (p = .110) levels between groups. CONCLUSION The PICF levels of sST2 were significantly higher in PM and P-I groups compared to the healthy group. However, no significant difference was observed between the groups in terms of serum sST2 level.
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Affiliation(s)
- Engin Ozgur
- Department of Periodontology, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Deniz Ilhan Topcu
- Department of Medical Biochemistry, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Nilufer Bayraktar
- Department of Medical Biochemistry, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Nilgun Ozlem Alptekin
- Department of Periodontology, Faculty of Dentistry, Başkent University, Ankara, Turkey
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Shevchuk M, Shkrebnyuk R, Dyryk V, Mrochko O. STUDY OF IMMUNE-INFLAMMATORY RESPONSE CHANGES IN ORAL FLUID IN PATIENTS WITH DISEASES OF PERIODONTAL TISSUES IN COMBINATION WITH GENERAL SOMATIC PATHOLOGY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1554-1561. [PMID: 37622497 DOI: 10.36740/wlek202307107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim: To determine the concentration of markers of the immune-inflammatory response (IL-1β, IL-10, IL-1β / IL-10, hsCRP) in oral fluid in patients with diseases of periodontal tissues in combination with general somatic pathology. PATIENTS AND METHODS Materials and methods: The study was conducted at Danylo Halytsky Lviv National Medical University, Department of therapeutic dentistry FPGE, Lviv, Ukraine. The patients were divided into two groups: the main group - 144 patients (with periodontal tissue diseases on the background of general somatic pathology) and the control group - 30 somatically and dentally healthy persons, in whose oral fluid was determined the concentration of IL-1β, IL-10, hsCRP by the enzyme immunoassay method. RESULTS Results: As a result of our research, it was found that in people with periodontal tissue diseases, against the background of general somatic pathology, there is an activation of the immune-inflammatory response, which aggravates the course of general somatic and dental diseases in this contingent of patients. CONCLUSION Conclusions: Therefore, in patients with periodontal tissue diseases on the background of somatic diseases, a significant increase in the level of the pro-in-flammatory cytokine IL-1β and hsCRP was determined against the background of a decrease in the anti-inflammatory cytokine IL-10 in the oral fluid compared to the values in the control group.
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Affiliation(s)
| | | | | | - Oleg Mrochko
- DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE
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14
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Milanesi FC, Greggianin BF, Dos Santos GO, Toniazzo MP, Weidlich P, Gerchman F, Oppermann RV. Effect of periodontal treatment on glycated haemoglobin and metabolic syndrome parameters: A randomized clinical trial. J Clin Periodontol 2023; 50:11-21. [PMID: 36053828 DOI: 10.1111/jcpe.13717] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Abstract
AIM To assess the effect of periodontal treatment on HbA1c and diagnostic parameters of patients with metabolic syndrome (MetS). MATERIALS AND METHODS One hundred and fifty-eight patients with MetS and moderate and severe periodontitis were included. They were randomized into a test group (n = 79), which received non-surgical periodontal treatment, and a control group (n = 79), which received no treatment. Medical treatment was delivered to both groups. Clinical periodontal, anthropometric and serological parameters were assessed at baseline, 3 and 6 months. The main outcome was glycated haemoglobin (HbA1c) levels, and the secondary outcomes were changes in the MetS parameters, C-reactive protein (CRP) and HOMA indexes. RESULTS Significant reductions in all periodontal parameters were observed in the test group, compared with the control group, at 3 and 6 months (p < .001). HbA1c levels, MetS parameters, CRP and HOMA indexes showed no significant differences between the test group and the control group at 3 and 6 months. CONCLUSIONS Periodontal treatment led to a substantial reduction in periodontal inflammation, although there was no significant effect on the parameters used for MetS diagnosis in patients with early diagnosed and well-controlled MetS.
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Affiliation(s)
- Fernanda C Milanesi
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna F Greggianin
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela O Dos Santos
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mirian P Toniazzo
- Post-graduate Program in Dentistry: Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Weidlich
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rui V Oppermann
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Wang L, Liang D, Huang Y, Chen Y, Yang X, Huang Z, Jiang Y, Su H, Wang L, Pathak JL, Ge L. SAP deficiency aggravates periodontitis possibly via C5a-C5aR signaling-mediated defective macrophage phagocytosis of Porphyromonas gingivalis. J Adv Res 2022:S2090-1232(22)00218-1. [PMID: 36243399 PMCID: PMC10403661 DOI: 10.1016/j.jare.2022.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Serum amyloid P component (SAP) regulates the innate immune system and microbial diseases. Periodontitis is an inflammatory oral disease developed by the host immune system's interaction with the dysbiotic oral microbiome, thereby SAP could play a role in periodontitis pathogenicity. OBJECTIVES To investigate the role of SAP in oral microbiome modulation and peridontitis pathogenicity. METHODS In this study, wildtype and SAP-knockout (KO) mice were used. Ligature-based periodontitis was developed in mice. Oral microbiome diversity was analyzed by 16 s rRNA sequencing. Macrophages and Porphyromonas gingivalis (P. gingivalis) co-culture system analyzed the effect of SAP in macrophage phagocytosis of P. gingivalis. RESULTS The level of SAP was upregulated in the periodontitis-affected periodontium of humans and mice but not in the liver and blood circulation. Periodontal macrophages were the key source of upregulated SAP in periodontitis. SAP-KO aggravated periodontal inflammation, periodontitis, and a higher number of M1-type inflammatory macrophage infiltration in the periodontium. The oral microbiome of SAP-KO periodontitis mice was altered with a higher abundance of Porphyromonas at the genus level. SAP-KO macrophages showed compromised phagocytosis of P. gingivalis in the co-culture system. Co-culture of SAP-KO macrophages and P. gingivalis induced the C5a expression and exogenous SAP treatment nullified this effect. Exogenous recombinant SAP treatment did not affect P. gingivalis growth and opsonization. PMX205, an antagonist of C5a, treatment robustly enhanced P. gingivalis phagocytosis by SAP-KO macrophages, indicating the involvement of the C5a-C5aR signaling in the compromised P. gingivalis phagocytosis by SAP-KO macrophages. CONCLUSION SAP deficiency aggravates periodontitis possibly via C5a-C5aR signaling-mediated defective macrophage phagocytosis of P. gingivalis. A higher abundance of P. gingivalis during SAP deficiency could promote M1 macrophage polarization and periodontitis. This finding suggests the possible protecting role of elevated levels of periodontal SAP against periodontitis progression.
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Association between periodontal inflamed surface area and serum acute phase biomarkers in patients with sickle cell anemia. Arch Oral Biol 2022; 143:105543. [PMID: 36155345 DOI: 10.1016/j.archoralbio.2022.105543] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of the present cross-sectional study was to investigate the association between periodontal inflamed surface area (PISA) and serum inflammatory biomarkers in patients with sickle cell anemia. DESIGN Patients with sickle cell anemia (n = 80) and systemically healthy individuals (n = 80) were enrolled in the study. Crisis episodes were recorded and blood samples were collected from patients with sickle cell anemia. Clinical periodontal parameters and PISA values were calculated from all patients. Ferritin and high sensitivity C-reactive protein (hs-CRP) levels were analyzed biochemically. RESULTS In sickle cell anemia group, presence of periodontitis (p < 0.001) was more frequent than periodontal health (p < 0.001). All clinical periodontal recordings and PISA values were higher in the sickle cell anemia group compared to controls (p < 0.001). Patients with PISA > 776 mm² had 6.06-fold greater chances of having hs-CRP levels above 10 mg/L (OR = 6.06; 95 % CI: 1.9-19.26) and had 31.41-fold greater chances of having ferritin levels above 1000 ng/L (OR = 31.41; 95 % CI: 6.62-149.16). Also, they had 3.27-fold greater risk of having crisis frequency above three times per year (OR = 3.27; 95 % CI: 1.05-10.23) after adjusting for confounders. CONCLUSION In patients with sickle cell anemia, positive association was evident between PISA values and serum acute phase biomarkers levels as well as the frequency of acute painful crisis. Patients with increased inflammatory burden may have a higher likelihood of developing periodontitis in the presence of sickle cell anemia. PISA value could be a candidate disease activity indicator in patients with an underlying hematological condition.
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Lu H, Wu H, Yang Y, Feng X, Ma X, Xie Y, Xie D, Wang W, Lo ECM, Ye W. Relationship between chronic periodontitis and inflammatory cytokines in patients undergoing maintenance hemodialysis. Clin Oral Investig 2022; 26:6699-6709. [PMID: 35861756 DOI: 10.1007/s00784-022-04629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the correlation between serum and gingival crevicular fluid (GCF) levels of inflammatory cytokines and the association with periodontal parameters in patients with maintenance hemodialysis (MHD) and healthy control. MATERIALS AND METHODS Patients who were undergoing MHD were enrolled as the MHD group. Healthy individuals who underwent oral examination were selected as the control group after matching for the MHD group. All participants underwent a full-mouth periodontal evaluation, and the levels of eight inflammatory cytokines, including IL-1β, IL-17, IL-6, IL-8, and tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-8 (MMP-8), and C-reactive protein (CRP), in the GCF and serum were measured. RESULTS A total of 63 MHD patients and 75 healthy persons were included. The prevalence of moderate/severe periodontitis was significantly higher in the MHD group than in the control group (88.9 vs. 66.7%, P < 0.05). The GCF levels of CRP, TNF-α, MCP-1, and MMP-8 were higher in patients in the MHD group with moderate/severe periodontitis than in the control group (P < 0.05). Serum CRP, MCP-1, TNF-α, and MMP-8 levels were positively correlated with the GCF CRP levels (P < 0.05). The GCF and serum CRP levels were positively correlated with the periodontal clinical parameters (P < 0.05). CONCLUSIONS Serum CRP, MCP-1, TNF-α, and MMP-8 may relate with the GCF CRP levels. The GCF and serum CRP levels correlated positively with the periodontal clinical parameters, including the VPI, PPD, and CAL, indicating that CRP may play an important role between periodontitis and ESRD. CLINICAL RELEVANCE The present study indicated that GCF and serum CRP levels correlated positively with the periodontal clinical parameters, and the CRP levels may be selected as an indicator to evaluate the severity of inflammation and the effectiveness, prognosis of periodontal treatment in ESRD patients.
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Affiliation(s)
- Haixia Lu
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Hongyu Wu
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, 356 Beijingdong Road, Shanghai, China
| | - Yuanmeng Yang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Xiaoxin Ma
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China
| | - Yingxin Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Danshu Xie
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Wenji Wang
- Department of Nephrology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, University of Hong Kong, 34 Hospital Road, Hong Kong, China
| | - Wei Ye
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, 639 Zhizaoju Road, Shanghai, China.
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Assessment of Cardiovascular Risk in Women with Periodontal Diseases According to C-reactive Protein Levels. Biomolecules 2021; 11:biom11081238. [PMID: 34439905 PMCID: PMC8394419 DOI: 10.3390/biom11081238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 12/25/2022] Open
Abstract
Cardiovascular diseases (CVD) are highly prevalent non-communicable diseases worldwide. Periodontitis may act as a non-traditional cardiovascular risk (CVR) factor, linked by a low-grade systemic inflammation mediated by C-reactive protein (CRP). Patients with periodontitis reported higher serum CRP levels; however, a CRP systemic and periodontal correlation in gingival crevicular fluid (GCF) and its CVR impact have been barely studied. We aimed to assess the association between periodontal diseases and CVR in a group of adult women, based on serum high-sensitivity CRP (hs-CRP) levels; and secondly, to determine the association between serum and GCF CRP levels. Gingival crevicular fluid and blood samples were obtained from women with periodontitis, gingivitis, and healthy controls. Serum and GCF CRP were determined by turbidimetric method and Luminex technology, respectively. Data were analyzed and adjusted by CVR factors. All women presented moderate CVR, without an evident association between serum hs-CRP levels and periodontal diseases. While serum hs-CRP concentrations did not significantly differ between groups, patients with gingivitis and periodontitis showed higher CRP levels in GCF, which positively correlated to CRP detection in serum.
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A Study on the Correlation between C-Reactive Protein Concentration and Teeth with a ≥5 mm Periodontal Pocket in Chronic Periodontitis Patients. Int J Dent 2021; 2020:8832186. [PMID: 33424972 PMCID: PMC7773474 DOI: 10.1155/2020/8832186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To evaluate the relationship between CRP levels and teeth with ≥5 mm PD in chronic periodontitis patients. Materials and Methods We evaluated 49 patients with chronic periodontitis who visited the Department of Periodontology at Wonkwang University Dental Hospital. At the first visit, high-sensitive CRP testing of venous blood samples was performed, and correlations were statistically evaluated. Results The mean hs-CRP level of patients diagnosed with severe periodontitis was 2.0 mg/L (0.13–13.95 mg/L). Statistically, patients with a high rate of teeth diagnosed with severe periodontitis are more likely to have higher hs-CRP level. Conclusion Within the limits of this study, the number and proportion of teeth showing ≥5 mm PD was positively correlated with CRP concentration.
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Keles Yucel ZP, Balli U. Leucine-rich alpha-2 glycoprotein (LRG): A novel acute phase protein expressed in Stage 3 Grade C periodontitis before and after periodontal therapy. J Periodontol 2020; 92:104-112. [PMID: 33128400 DOI: 10.1002/jper.20-0358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Leucine-rich alpha-2 glycoprotein (LRG) is a novel acute phase protein involved in inflammation-associated diseases and that considered to be induced by multiple proinflammatory cytokines. This study aimed to investigate gingival crevicular fluid (GCF) and serum levels of LRG, interleukin (IL)-6 and tumor necrosis factor (TNF)-α in patients with Stage 3 periodontitis before and after non-surgical periodontal treatment. METHODS Twenty-five Stage 3 periodontitis and twenty-five periodontally healthy individuals were enrolled in the study. Clinical periodontal measurements were recorded; periodontitis patients received non-surgical periodontal treatment, and GCF and serum samples were obtained at baseline and at 6 weeks after treatment. LRG, IL-6 and TNF-α were determined by ELISA. RESULTS GCF and serum LRG, IL-6 and TNF-α were significantly higher in periodontitis group than healthy controls (P < .001). A significant decrease in GCF and serum LRG, IL-6 and TNF-α was detected after periodontal treatment compared with baseline values of periodontitis patients (P < .001). CONCLUSION Our findings revealed that LRG expression was increased in Stage 3 periodontitis both locally and systemically, and non-surgical periodontal therapy was effective in reducing LRG levels in GCF and serum of these patients.
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Affiliation(s)
| | - Umut Balli
- Department of Periodontology, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
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Zhang Y, Leveille SG, Edward J. Wisdom teeth, periodontal disease, and C-reactive protein in US adults. Public Health 2020; 187:97-102. [PMID: 32942171 DOI: 10.1016/j.puhe.2020.07.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The study aim was to evaluate the associations among the presence of wisdom teeth (third molars, M3), periodontal disease, and serum C-reactive protein (CRP) in the US adult population, thus to generate population-based evidence to inform heart disease prevention and dental care. STUDY DESIGN We performed secondary data analysis of the 2009-2010 National Health and Nutrition Examination Survey (NHANES), and included 3752 people aged 30 years and older who participated in the periodontal examination. METHODS Descriptive analyses were performed to determine the prevalence of M3 presence, periodontal disease, and elevated CRP. Multivariate logistic regression modeling was used to determine the association between M3 presence, periodontal disease, and elevated CRP. RESULTS The prevalence of M3 presence, periodontal disease (probing periodontal pockets depth (PPD)≥ 4 mm), and elevated serum C-reactive protein level (≥5 mg/L) was 39%, 41%, and 19% respectively. M3 presence was highest among men, younger adults, Blacks and Hispanics compared to Non-Hispanic Whites, those who did not attend college, and people with low incomes (P < 0.001). M3 presence, adjusted for sociodemographic and health characteristics, was independently associated with periodontal disease (adjusted [Adj.] odds ratio [OR] 1.61, 95% confidence interval [CI] 1.31, 1.97), and periodontal disease was independently associated with elevated serum CRP (Adj. OR 1.35, 95% CI 1.06, 1.73), but we did not find M3 presence associated with elevated serum CRP (Adj. OR 1.02, 95% CI 0.79, 1.31). CONCLUSIONS We observed expected associations between M3 presence and periodontal disease, and periodontal disease and elevated CRP. However, M3 presence alone is not associated with elevated CRP. Further research into cardiovascular health hazards related to the retention of wisdom teeth is needed, including examining possible relationships with other inflammatory factors.
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Affiliation(s)
- Y Zhang
- College of Nursing and Health Science, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - S G Leveille
- College of Nursing and Health Science, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - J Edward
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY, 40536, USA
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22
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Esteves-Lima RP, Reis CS, Santirocchi-Júnior F, Abreu LG, Costa FO. Association between periodontitis and serum c-reactive protein levels. J Clin Exp Dent 2020; 12:e838-e843. [PMID: 32994872 PMCID: PMC7511054 DOI: 10.4317/jced.57041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/14/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Periodontal disease may be associated with more bacteria and consequent induction of a systemic inflammatory process, with changes in the levels of C-reactive protein (CRP). The purpose of this cross-sectional study was to evaluate the association between periodontitis and serum levels of C-reactive protein. MATERIAL AND METHODS The sample comprised 100 individuals distributed into two groups according to serum levels of C-reactive protein: normal or altered. Social, biological and behavioral data were collected by means of a structured questionnaire. Additionally, a blood test was requested to measure C-reactive protein levels. CRP values less than 3 mg/l were considered normal. Periodontal clinical examination was conducted in each participant for analysis of probing depth, bleeding on probing and clinical attachment level. Descriptive statistics, univariate analysis and logistic regression were performed. Results were provided in odds ratio, confidence intervals and p values. RESULTS Individuals with altered C-reactive protein levels showed a higher prevalence of periodontitis than individuals with normal C-reactive protein levels (p=0.008). In the final logistic regression model, individuals with periodontitis were more likely to present altered C-reactive protein than individuals without periodontitis (OR=3.27, CI=1.42-7.52, p=0.005). CONCLUSIONS The alteration of the C-reactive protein levels among individuals with a higher prevalence of periodontitis corroborates clinical evidence that periodontal infection has a systemic impact. Key words:C-reactive protein, cytokines, periodontal diseases, periodontitis.
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Affiliation(s)
- Rafael-Paschoal Esteves-Lima
- PhD in Periodontics. Faculty of Dentistry of Federal University of Minas Gerais, Av, Antônio Carlos, 6627, Belo Horizonte (MG), 31270-901, Brazil
| | - Christian-Santiago Reis
- Graduate in Dentistry. Faculty of Dentistry of Federal University of Minas Gerais, Av, Antônio Carlos, 6627, Belo Horizonte (MG), 31270-901, Brazil
| | - Francisco Santirocchi-Júnior
- Graduate in Dentistry. Faculty of Dentistry of Federal University of Minas Gerais, Av, Antônio Carlos, 6627, Belo Horizonte (MG), 31270-901, Brazil
| | - Lucas-Guimarães Abreu
- PhD in Pediatric Dentistry. Faculty of Dentistry of Federal University of Minas Gerais, Av, Antônio Carlos, 6627, Belo Horizonte (MG), 31270-901, Brazil
| | - Fernando-Oliveira Costa
- PhD in Epidemiology. Faculty of Dentistry of Federal University of Minas Gerais, Av, Antônio Carlos, 6627, Belo Horizonte (MG), 31270-901, Brazil
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23
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Chang YQ, Fang FF, Qin SS, Dong YC, Chen B. [Effect of scaling and root planing on serum C-reactive protein levels in patients with moderate to severe chronic periodontitis: a systematic review and Meta-analysis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:385-392. [PMID: 32865356 PMCID: PMC7426693 DOI: 10.7518/hxkq.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/18/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the effect of scaling and root planing (SRP) on serum C-reactive protein (CRP) levels in patients with moderate to severe chronic periodontitis. METHODS We searched the PubMed, Web of Science, EMBASE, Cochrane, CNKI, Wanfang, and VIP databases from the inception to July 8th, 2019. Two reviewers independently screened literature, extracted data, and evaluated the bias risk of included studies. Then, a meta-analysis was performed using RevMan 5.3 software. RESULTS A total of 13 randomized controlled clinical trials and 12 prospective clinical trials were included. Meta-analysis showed that serum CRP levels decreased at 2 and 3 months after SRP (P<0.05), and no significant difference in serum CRP levels was found at 6 months (P=0.49). CONCLUSIONS SRP can reduce serum CRP levels in systematically healthy patients with moderate to severe chronic periodontitis at 2 and 3 months after SRP.
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Affiliation(s)
- Ya-Qin Chang
- Dept. of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Fang-Fang Fang
- Dept. of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Sha-Sha Qin
- Dept. of Non-Communicable Diseases Prevention and Control, Xi'an Center for Disease Control and Prevention, Xi'an 710054, China
| | - Ying-Chun Dong
- Dept. of Anesthesiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - Bin Chen
- Dept. of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
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24
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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25
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Stănescu I, Bulboacă AE, Micu IC, Bolboacă SD, Feștilă DG, Bulboacă AC, Bodizs G, Dogaru G, Boarescu PM, Popa-Wagner A, Roman A. Gender Differences in the Levels of Periodontal Destruction, Behavioral Risk Factors and Systemic Oxidative Stress in Ischemic Stroke Patients: A Cohort Pilot Study. J Clin Med 2020; 9:jcm9061744. [PMID: 32512870 PMCID: PMC7356570 DOI: 10.3390/jcm9061744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to determine if gender differences exist regarding periodontal status and several plasma biomarkers in patients with a recent large artery atherosclerosis ischemic stroke (IS). Material and methods: Patients with their first IS within less than six weeks who were able to undergo periodontal examinations were evaluated. Demographic data, periodontal status, oxidative stress parameters/plasma antioxidant capacity, and C-reactive protein in patients who suffered a recent large artery atherosclerosis ischemic stroke were reccorded. Results: 93 patients were included in the study. More men were smokers (12/57 vs. 3/36) and consumed alcohol (17/57 vs. 3/36), and more women had higher glycemic values (p = 0.023), total cholesterol (p < 0.001), LDL (low-density lipoprotein)-cholesterol (p = 0.010), and HDL (high-density lipoprotein)-cholesterol (p = 0.005) levels. Significantly more men than women had moderate plus severe periodontal disease (p = 0.018), significantly higher levels of nitric oxide (p = 0.034), and significantly lower levels of total antioxidant capacity (p = 0.028). Conclusions: In this pilot study, men seem to be more prone to oxidative stress and to develop more severe forms of periodontitis among patients with stroke, but the results need validation on a larger sample.
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Affiliation(s)
- Ioana Stănescu
- Department of Neurology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (I.S.); (A.C.B.)
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, IuliuHaţieganu University of Medicine and Pharmacy, Victor Babeş Str., no. 15, 400012 Cluj-Napoca, Romania; (I.C.M.); (A.R.)
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, IuliuHațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Dana Gabriela Feștilă
- Department of Orthodontics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Angelo C. Bulboacă
- Department of Neurology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (I.S.); (A.C.B.)
| | - Gyorgy Bodizs
- Clinical Rehabilitation Hospital, Viilor Str., no. 46-50, 400347 Cluj-Napoca, Romania;
| | - Gabriela Dogaru
- Department of Physical Medicine and Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Paul Mihai Boarescu
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Aurel Popa-Wagner
- Department of Patho-Biochemistry, University of Medicine and Pharmacy Craiova, Petru Rareș Str., No. 2-4, 200349 Craiova, Romania
- Vascular Neurology and Dementia, University of Medicine, Essen, HufelandStr., no. 55, 45122 Essen, Germany
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, IuliuHaţieganu University of Medicine and Pharmacy, Victor Babeş Str., no. 15, 400012 Cluj-Napoca, Romania; (I.C.M.); (A.R.)
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26
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Mulawarmanti D, Parisihni K, Widyastuti W. The Impact of Hyperbaric Oxygen Therapy on Serum C-Reactive Protein Levels, Osteoprotegerin Expression, and Osteoclast Numbers in Induced-Periodontitis Diabetic Rats. Eur J Dent 2020; 14:404-409. [PMID: 32447751 PMCID: PMC7440948 DOI: 10.1055/s-0040-1712072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives
This study aimed to examine the impact of hyperbaric oxygen therapy (HBOT) on serum C-reactive protein (CRP) levels, osteoclast numbers, and osteoprotegerin (OPG) expression in periodontitis-induced diabetic rats
Materials and Methods
This study constituted an
in vivo
laboratory-based experiment incorporating a posttest only control group design. Thirty male Wistar rats were divided into three groups of research subjects: a healthy group (K0), periodontitis-induced diabetic group (K1), and periodontitis-induced diabetic group treated with HBOT for 7 days (K2). After treatment, the subjects were sacrificed to determine the level of serum CRP by the ELISA method. Immunohistochemical analysis was conducted to check the level of OPG expression, while a histological analysis was undertaken to quantify the number of osteoclasts.
Statistical Analysis
The data was analyzed using a one-way ANOVA and Least Significant Difference (LSD) test on which a result of
p
< 0.05 was considered statistically significant.
Results
HBOT appreciably decreased serum CRP levels, significantly enhancing OPG expression in periodontitis-induced diabetic (
p
< 0.05) and decreasing the number of osteoclasts in -periodontitis-induced diabetic (
p
> 0.05).
Conclusion
HBOT reduced the serum CRP level, increased OPG expression, and decreased osteoclast numbers in periodontitis-induced diabetic rats.
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Affiliation(s)
- Dian Mulawarmanti
- Department of Oral Biology, Faculty of Dentistry, Universitas Hang Tuah, Indonesia
| | - Kristanti Parisihni
- Department of Oral Biology, Faculty of Dentistry, Universitas Hang Tuah, Indonesia
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27
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Gupta S, Suri P, Patil PB, Rajguru JP, Gupta P, Patel N. Comparative evaluation of role of hs C -reactive protein as a diagnostic marker in chronic periodontitis patients. J Family Med Prim Care 2020; 9:1340-1347. [PMID: 32509613 PMCID: PMC7266256 DOI: 10.4103/jfmpc.jfmpc_1063_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/08/2020] [Accepted: 02/12/2020] [Indexed: 01/19/2023] Open
Abstract
Background and Aim C-reactive protein (CRP) is a type I acute phase protein, which can increase up to 1000 fold after the onset of a stimulus. It is a phylogenetically highly conserved plasma protein with homolog in vertebrates and many invertebrates that participate in systemic response to inflammation. Serum C-reactive protein levels are raised in patients with myocardial infarction and periodontitis, providing a potential mechanism to link destructive periodontal disease with an increased risk for other atherosclerotic complications. The purpose of the present study was to estimate and compare the levels of hs- C Reactive protein in chronic periodontitis patients before and after non-surgical periodontal therapy. Methods The study sample consisted of 45 individuals of age group 30-60 years that was divided into two groups Group I (control) and Group II (patients with chronic generalized periodontitis). The clinical parameters such as plaque index, calculus index, gingival index, probing pocket depth, clinical attachment level, and serum hs-CRP levels were recorded for these individuals. Results The patients with healthy gingiva possessed a mean hs-CRP level of 0.252 ± 0.0393 which was lower as compared to the patients with chronic periodontitis. In periodontitis patients mean levels of hs-CRP was 0.106 ± 0.029 which reduced to 0.044 ± 0.027 after periodontal therapy. A significantly elevated CRP level was found in subjects with periodontitis compared to the controls. Conclusion The serum levels of C-reactive protein were elevated in patients with periodontitis and this might be a diagnostic marker for cardiovascular diseases.
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Affiliation(s)
- Shivangi Gupta
- Department of Periodontology and Implantology, MMCDSR, Deemed to be University, Mullana, Ambala, Haryana, India
| | - Prerna Suri
- Private Practitioner and Consultant Orthodontist, Mumbai, India
| | - Pankaj Bajirao Patil
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed to be University, Karad, Maharashtra, India
| | - Jagadish Prasad Rajguru
- Department of Oral and Maxillofacial Pathology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Palak Gupta
- Private Practitioner Gurgaon, Haryana, India
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28
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Caribé PMV, Villar CC, Romito GA, Pacanaro AP, Strunz CMC, Takada JY, Cesar LAM, Mansur ADP. Influence of the treatment of periodontal disease in serum concentration of sirtuin 1 and mannose-binding lectin. J Periodontol 2020; 91:900-905. [PMID: 31749165 DOI: 10.1002/jper.19-0236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/02/2019] [Accepted: 09/05/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Increased levels of periodontal pathogens disrupt the homeostasis between the host and its microbiota and increase susceptibility to periodontal diseases. Periodontitis increases the serum concentration of mannose-binding lectin (MBL), which exacerbates local inflammatory processes. In animal studies, sirtuin 1 (SIRT1) was associated with protection against inflammation. This study analyzed the influence of non-surgical periodontal treatment on serum levels of MBL and SIRT1. METHODS Forty patients with periodontitis and 38 periodontally healthy individuals (aged 45 to 79 years) were included. Periodontitis patients received scaling and root planing using machine driven and hand instruments. Clinical parameters, inflammatory biomarkers, MBL, and SIRT1 levels were measured at baseline and at post-treatment. RESULTS For all patients, an inverse correlation was observed between serum concentrations of MBL and SIRT1 (r = -0.30; P = 0.006). Periodontal treatment reduced serum concentrations of MBL (1,099.35 ± 916.59 to 861.42 ± 724.82 ng/mL; P < 0.001) and C-reactive protein (6.05 ± 8.99 to 2.49 ± 2.89 mg/L; P = 0.009). By contrast, SIRT1 serum levels increased (1.06 ± 1.03 to 1.66 ± 1.64 ng/mL; P < 0.001) following periodontal treatment. CONCLUSIONS Periodontal treatment was associated with decreased serum concentrations of MBL and CRP and increased serum levels of SIRT1. Prospective studies are needed to assess the impact of these biomarkers on pathophysiology of periodontitis.
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Affiliation(s)
- Pérola Michelle Vasconcelos Caribé
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil.,Division of Periodontology, Stomatology Department, Dental School, University of Sao Paulo, Sao Paulo, Brazil PhD thesis of the Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
| | - Cristina Cunha Villar
- Division of Periodontology, Stomatology Department, Dental School, University of Sao Paulo, Sao Paulo, Brazil PhD thesis of the Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
| | - Giuseppe Alexandre Romito
- Division of Periodontology, Stomatology Department, Dental School, University of Sao Paulo, Sao Paulo, Brazil PhD thesis of the Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
| | - Ana Paula Pacanaro
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
| | | | - Júlio Yoshio Takada
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
| | | | - Antonio de Padua Mansur
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil
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29
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Abstract
Sleep disordered breathing (SDB) may be associated with sleep bruxism and periodontal diseases. Through a review of the current literature, this article aims to describe the characteristics of sleep bruxism and its relationship with SDB as well as the current evidence supporting an association between periodontal diseases and SDB. Sleep bruxism is characterized by muscle clenching and tooth grinding during sleep, typically during N2 sleep stage and in association with micro-arousals. The probability of observing sleep bruxism is almost 4 times higher in the presence of SDB, with a close temporal relationship between the episode of upper airway obstruction or oxygen desaturation and the episode of bruxism, which most often occurs in the 0-10 seconds following the obstruction. These findings support the hypothesis that sleep bruxism is triggered by SDB and may have a "protective" role being a muscular activity that helps restore the permeability of the upper airways. On the other hand, SDB have been linked to periodontal diseases. Periodontal diseases are inflammatory and dysbiotic disorders that can have a negative impact on oral health (leading to the destruction of the periodontium and tooth loss) and on general health. Recently, it has been observed that SDB patients have a 1.6 to 4-fold higher risk of having or developing severe periodontitis, suggesting that SDB may be a new risk factor for periodontal diseases. Dentists, who are part of the team of sleep medicine specialists, have a key role in the detection, prevention and treatment of SDB and their relationship with sleep bruxism and periodontal diseases.
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Affiliation(s)
- Maria Clotilde Carra
- Département de Parodontologie, Hôpital Rothschild, AP-HP, 5 rue Santerre, 75012 Paris, France UFR d'Odontologie, Université de Paris, 5 rue Garancière, 75005 Paris, France
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30
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Hatta K, Gondo Y, Kamide K, Masui Y, Inagaki H, Nakagawa T, Matsuda KI, Inomata C, Takeshita H, Mihara Y, Fukutake M, Kitamura M, Murakami S, Kabayama M, Ishizaki T, Arai Y, Sugimoto K, Rakugi H, Maeda Y, Ikebe K. Occlusal force predicted cognitive decline among 70- and 80-year-old Japanese: A 3-year prospective cohort study. J Prosthodont Res 2019; 64:175-181. [PMID: 31685341 DOI: 10.1016/j.jpor.2019.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Dementia is a growing health problem for countries with aging populations, but few effective dementia treatments are available. However, there is increasing interest in oral health as a modifiable risk factor in interventions to prevent cognitive decline. This study aimed to investigate the impact of oral health on the decline of cognitive function over 3 years among Japanese people aged 70 and 80 years. METHODS Participants (n = 860) were community-dwelling older adults who participated in baseline and follow-up surveys (at baseline: 69-71 years n = 423; 79-81 years, n = 437). Registered dentists examined the number of teeth, number of functional teeth, number of periodontal teeth, and occlusal force. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. We also evaluated socioeconomic factors, medical history, drinking and smoking habits, physical performance, genetic factors, and C-reactive protein concentration in blood. A generalized estimating equation (GEE) was used to examine how oral health at baseline influenced cognitive decline over 3 years. RESULTS The GEE showed that the number of teeth (non-standardized coefficient: B = 0.031, p = 0.022) and occlusal force (B = 0.103, p = 0.004) at baseline were associated with cognitive function at follow-up, even after adjusting for other risk factors. Furthermore, maintaining more teeth (B = 0.009, p = 0.004) and a stronger occlusal force (B = 0.020, p = 0.040) buffered cognitive decline. CONCLUSIONS Number of teeth and occlusal force predict cognitive decline over 3 subsequent years in Japanese older adults aged 70 and 80 years.
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Affiliation(s)
- Kodai Hatta
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yasuyuki Gondo
- Osaka University Graduate School of Human Sciences, Department of Clinical Thanatology and Geriatric Behavioral Science, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kei Kamide
- Osaka University Graduate School of Allied Health Sciences, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Takeshi Nakagawa
- National Center for Geriatrics and Gerontology, 7-430 Moriokamachi, Obu, Aichi 474-8511, Japan
| | - Ken-Ichi Matsuda
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Chisato Inomata
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hajime Takeshita
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yusuke Mihara
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Motoyoshi Fukutake
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masahiro Kitamura
- Osaka University Graduate School of Dentistry, Department of Periodontics, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shinya Murakami
- Osaka University Graduate School of Dentistry, Department of Periodontics, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Mai Kabayama
- Osaka University Graduate School of Allied Health Sciences, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Sinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ken Sugimoto
- Osaka University Graduate School of Medicine, Department of Geriatric and General Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiromi Rakugi
- Osaka University Graduate School of Medicine, Department of Geriatric and General Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshinobu Maeda
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazunori Ikebe
- Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology and Oral Rehabilitation, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
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Schmalz G, Hübscher AE, Angermann H, Schmidt J, Schmickler J, Legler TJ, Ziebolz D. High prevalence of periodontitis in blood donors and the possibility of questionnaire-based screening - results of a cross-sectional study. Transfus Med 2019; 29:394-400. [PMID: 31608531 DOI: 10.1111/tme.12633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/24/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Periodontitis is an inflammatory disease of high prevalence and, thus, of potential relevance to the management of blood donation. OBJECTIVES The aim of this cross-sectional study was to assess periodontal health and its associations to common blood parameters, as well as questionnaire-based periodontitis screening in blood donors. METHODS Generally healthy blood donors were recruited and underwent oral examination. Thereby, the decayed-, missing- and filled-teeth index (DMF-T) and periodontal status, including periodontal probing depth and clinical attachment loss, were assessed. Based on periodontal status, periodontitis severity was classified into no/mild, moderate or severe. Six yes/no questions regarding periodontal complaints and history were asked. Furthermore, common blood parameters were analysed. RESULTS A total of 148 participants (mean age 53·33 years) were included. The DMF-T was 15·28 ± 6·44. Nearly three quarters of participants suffered from a periodontitis (moderate 59·5% and severe 14·8%, total periodontitis 74·3%). Periodontitis severity was associated with the history of dental visits caused by periodontal complaints (P < 0·01) and previous periodontal therapy (P < 0·01). Only procalcitonin was initially found to be associated with blood periodontitis severity (P = 0·02). This observation was not confirmed by post-hoc testing between subgroups (Pi > 0·2). No further association between periodontitis severity and blood parameters was found (Pi > 0·05). CONCLUSION The prevalence of periodontitis in German blood donors is high. However, further studies with sensitive testing of bacteria in peripheral blood are required in order to determine the relevance of this result for the safety of blood components.
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Affiliation(s)
- G Schmalz
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - A E Hübscher
- Department. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Goettingen, Germany
| | - H Angermann
- Department. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Goettingen, Germany
| | - J Schmidt
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - J Schmickler
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - T J Legler
- Department of Transfusion Medicine, University Medical Centre Goettingen, Goettingen, Germany
| | - D Ziebolz
- Departmet of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Systemic inflammation linking chronic periodontitis to cognitive decline. Brain Behav Immun 2019; 81:63-73. [PMID: 31279681 DOI: 10.1016/j.bbi.2019.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022] Open
Abstract
Persistent inflammation in the systemic immune system can impose detrimental effects on the central nervous system (CNS). Neuroinflammation might be a result of this to accelerate the progressive deterioration of neuronal functions during aging. In this regard, controlling inflammation through delaying and/or preventing chronic inflammatory diseases may be a potential strategy to prevent or modify the progression of Alzheimer's Disease (AD). Periodontitis is a chronic inflammatory disease of the oral cavity that is common among the elderly, especially for those who have decline in cognitive functions. While epidemiological findings support the association of chronic periodontitis and cognitive decline, whether they have causal relationship remains unclear. Nonetheless, the possibility that periodontopathogens, systemic immune cells and inflammatory cytokines could reach the CNS should not be overlooked. The impacts of periodontitis on CNS homeostasis and inflammation as a pathophysiological factor concerning the association between periodontitis and AD will be discussed in this review. Future work should elucidate the pathological pathways involved in periodontitis-induced cerebral infections and inflammation, and define the role of the latter in AD progression.
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Leite SADM, Casanovas RC, Rodrigues VP, Pereira ADFV, Ferreira TCA, Nascimento FRFD, Nascimento JRD, Gomes-Filho IS, Bastos MG, Pereira ALA. The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels. Braz Oral Res 2019; 33:e055. [PMID: 31531562 DOI: 10.1590/1807-3107bor-2019.vol33.0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 04/08/2019] [Indexed: 11/22/2022] Open
Abstract
Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.
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Affiliation(s)
| | - Rosana Costa Casanovas
- Universidade Federal do Maranhão - UFMA, Graduate Program in Dentistry, São Luís, MA, Brazil
| | | | | | | | | | | | - Isaac Suzart Gomes-Filho
- Universidade Estadual de Feira de Santana - UEFS, Department of Health, Feira de Santana, BA, Brazil
| | - Marcus Gomes Bastos
- Universidade Federal de Juiz de Fora - UFJF, Department of Nephrology, Juiz de Fora, MG, Brazil
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Singh N, Uppoor A, Rajendran V, Naik DG. Periodontal disease and hemolysis in glucose-6-phosphate dehydrogenase deficiency: Is there a nexus? J Oral Biosci 2019; 61:129-133. [PMID: 31235029 DOI: 10.1016/j.job.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an erythrocyte enzyme defect that amplifies the susceptibility of erythrocytes to oxidative stress due to excessive levels of reactive oxygen species. Consequently, erythrocyte destruction and hemolysis occur. HIGHLIGHT The possible mechanism of oxidative stress-mediated destruction of erythrocytes in G6PD deficient individuals induced by periodontal infection is highlighted. CONCLUSION Periodontal diseases feature systemic loading of reactive oxygen species, and they may increase the risk of hemolysis in individuals with G6PD deficiency.
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Affiliation(s)
- Neelesh Singh
- Department of Periodontology, Maharana Pratap Dental College & Hospital, Kanpur, India.
| | - Ashita Uppoor
- Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
| | - Valliammai Rajendran
- Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
| | - Dilip G Naik
- Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
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Schmalz G, Hübscher AE, Angermann H, Schmidt J, Schmickler J, Legler TJ, Ziebolz D. Associations of chairside salivary aMMP-8 findings with periodontal parameters, potentially periodontal pathogenic bacteria and selected blood parameters in systemically healthy adults. Diagn Microbiol Infect Dis 2019; 95:179-184. [PMID: 31174997 DOI: 10.1016/j.diagmicrobio.2019.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 12/19/2022]
Abstract
The aim of this cross-sectional study was to investigate associations between salivary active matrix-metalloproteinase 8 (aMMP-8) and periodontitis severity, potentially periodontal pathogenic bacteria as well as blood parameters in generally healthy participants. Therefore, 188 participants with a mean age of 48.9 ± 8 years were examined. The periodontitis severity was assessed based on periodontal probing depth and clinical attachment loss. Both, aMMP-8 and microbiological analysis were performed using a validated, commercially available test system. Blood values were utilized from regular differential blood count. The aMMP-8 findings were associated with the periodontitis severity (P < 0.01), as well as with the prevalence of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Parvimonas micra, Camphylobacter rectus and Eubacterium nodatum (Pi < 0.05). No associations between aMMP-8 and the examined blood parameters were found (Pi > 0.05). In conclusion, salivary aMMP-8 findings seem to reflect periodontal disease severity as a result of an immunoreaction, especially against bacteria with high periodontal pathogenic potential.
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Affiliation(s)
- Gerhard Schmalz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Anna Elisabeth Hübscher
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Helena Angermann
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Jana Schmidt
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Jan Schmickler
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Tobias J Legler
- Department of Transfusion Medicine, University Medical Centre Goettingen, Germany
| | - Dirk Ziebolz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci 2019; 20:ijms20061414. [PMID: 30897827 PMCID: PMC6470716 DOI: 10.3390/ijms20061414] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, initiated by the presence of a bacterial biofilm, called dental plaque, which affects both the periodontal ligaments and bone surrounding teeth. In the last decades, several lines of evidence have supported the existence of a relationship between periodontitis and systemic health. For instance, as periodontitis acts within the same chronic inflammatory model seen in cardiovascular disease (CVD), or other disorders, such as diabetes, several studies have suggested the existence of a bi-directional link between periodontal health and these pathologies. For instance, people with diabetes are more susceptible to infections and are more likely to suffer from periodontitis than people without this syndrome. Analogously, it is now evident that cardiac disorders are worsened by periodontitis, both experimentally and in humans. For all these reasons, it is very plausible that preventing periodontitis has an impact on the onset or progression of CVD and diabetes. On these grounds, in this review, we have provided an updated account on the current knowledge concerning periodontal disease and the adverse effects exerted on the cardiovascular system health and diabetes, informing readers on the most recent preclinical studies and epidemiological evidence.
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Affiliation(s)
- Daniela Liccardo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy.
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
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Sirin DA, Ozcelik F, Uzun C, Ersahan S, Yesilbas S. Association between C-reactive protein, neutrophil to lymphocyte ratio and the burden of apical periodontitis: a case-control study. Acta Odontol Scand 2019; 77:142-149. [PMID: 30394169 DOI: 10.1080/00016357.2018.1522447] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Endodontic originated chronic apical periodontitis (AP) is an inflammatory disease of periapical tissue. High-sensitivity C-reactive protein (hsCRP) as an inflammatory marker and hemogram indexes provide valuable information to clinicians for diagnosis, screening and follow-up of various diseases. The aim of this study was to investigate AP in terms of its association with hemogram indices and hsCRP levels. MATERIAL AND METHODS Study includes 104 patients with AP and 40 participants as the control group. 160 teeth were diagnosed as AP through digital radiographic images and scored with respect to Periapical Index (PAI) scoring. Afterwards, patients were categorized into 3 grades in accordance with both the number and the severity of AP. AP grade 0 was considered for the control group with regard to a new scoring system. Patients with only one tooth involved with AP with a PAI score of 3 or 4 were categorized as an AP Grade 1, when a patient had more than one tooth with a PAI score of 3 or 4 he was classified as an AP Grade 2 and a patient with at least one tooth scored as a PAI 5 was rated as an AP Grade 3. Hemograms and hsCRP levels were measured for each individual to establish a correlation with inflammatory markers. RESULTS The neutrophil/lymphocyte ratio (NLR) levels of patients with AP Grade 3 were significantly higher than all other AP grades (p < .05). hsCRP levels in patients with an AP Grade 2 and 3 were higher than both AP Grade 0 and 1 (p < .05). CONCLUSIONS hsCRP levels of patients were reliable predictive indicators for AP severity in correlation with the new proposed scoring system for AP.
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Affiliation(s)
- DA Sirin
- Department of Endodontics, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - F Ozcelik
- Medical Biochemistry Department, Sultan Abdülhamid Han Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - C Uzun
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - S Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - S Yesilbas
- Medical Biochemistry Department, Sultan Abdülhamid Han Training Hospital, University of Health Sciences, Istanbul, Turkey
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Dengizek Eltas S, Gursel M, Eltas A, Alptekin NO, Ataoglu T. Evaluation of long‐term effects of diode laser application in periodontal treatment of poorly controlled type 2 diabetic patients with chronic periodontitis. Int J Dent Hyg 2019; 17:292-299. [DOI: 10.1111/idh.12384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 01/22/2023]
Affiliation(s)
| | - Mihtikar Gursel
- Department of Periodontology, Faculty of Dentistry Selcuk University Konya Turkey
| | - Abubekir Eltas
- Department of Periodontology, Faculty of Dentistry University of Health Science Istanbul Turkey
| | | | - Tamer Ataoglu
- Department of Periodontology, Faculty of Dentistry Selcuk University Konya Turkey
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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40
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Gomes-Filho IS, Trindade SC, Passos-Soares JDS, Figueiredo ACMG, Vianna MIP, Hintz AM, Batista OET, Orrico GS, Conceição SDS, Coelho JMF, Santos ENP, Nascimento MT, Miranda SS, Xavier Ramos M, Lima Porto EC, alencar Cruz C, Carvalho SS, Seixas da Cruz S. Critical appraisal of systematic and narrative reviews of literature in the field of orthodontics. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/jdhodt.2018.09.00408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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41
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Aarabi G, Schnabel RB, Heydecke G, Seedorf U. Potential Impact of Oral Inflammations on Cardiac Functions and Atrial Fibrillation. Biomolecules 2018; 8:biom8030066. [PMID: 30071583 PMCID: PMC6164509 DOI: 10.3390/biom8030066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/14/2018] [Accepted: 07/26/2018] [Indexed: 02/07/2023] Open
Abstract
Inflammation may be a risk factor for atrial fibrillation (AF). Oral infections frequently lead to chronic inflammation, such as gingivitis, periodontitis, and endodontic lesions. In this narrative review, we consider five basic pathogenic mechanisms that involve oral infections and inflammations in the pathogenesis of AF: (1) low level bacteremia by which oral bacteria enter the blood stream at inflamed sites of the oral cavity and invade the heart; (2) Systemic inflammation induced by inflammatory mediators, which are released from the sites of oral inflammation into the blood stream, affecting cardiac remodeling; (3) autoimmunity against molecular structures expressed in the heart caused by the host immune response to specific components of oral pathogens; (4) potentially arrhythmic effects mediated by activation of the autonomous nervous system triggered by oral inflammations; and (5) arrhythmic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. A number of studies support the involvement of all five mechanisms, suggesting a potentially complex contribution of oral inflammations to the pathogenesis of AF.
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Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany.
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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Roles of Oral Infections in the Pathomechanism of Atherosclerosis. Int J Mol Sci 2018; 19:ijms19071978. [PMID: 29986441 PMCID: PMC6073301 DOI: 10.3390/ijms19071978] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 12/14/2022] Open
Abstract
Oral infections occur frequently in humans and often lead to chronic inflammations affecting the teeth (i.e., caries), the gingival tissues surrounding the teeth (i.e., gingivitis and endodontic lesions), and the tooth-supporting structures (i.e., periodontitis). At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. In this narrative review, we summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis.
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Gopinath D, Menon RK. C-reactive protein as an individual prognostic marker in oral cancer: Practical considerations. Clin Otolaryngol 2018; 43:1184. [PMID: 29877050 DOI: 10.1111/coa.13157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 11/27/2022]
Affiliation(s)
- D Gopinath
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - R K Menon
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Carrizales-Sepúlveda EF, Ordaz-Farías A, Vera-Pineda R, Flores-Ramírez R. Periodontal Disease, Systemic Inflammation and the Risk of Cardiovascular Disease. Heart Lung Circ 2018; 27:1327-1334. [PMID: 29903685 DOI: 10.1016/j.hlc.2018.05.102] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 05/11/2018] [Indexed: 01/08/2023]
Abstract
Periodontal and cardiovascular disease are both major health issues. Poor oral health has long been associated with the development of systemic diseases, with the typical example being the risk of endocarditis posterior to dental procedures. Through the years, the association of periodontal disease with other non-infectious systemic diseases has been brought to attention. One of the most interesting associations is the one that exists with the development of cardiovascular disease. Many studies, including systematic reviews and meta-analyses, suggest an important association between periodontal disease and ischaemic heart disease, cerebrovascular disease, heart failure, atrial fibrillation and peripheral artery disease. Among the proposed mechanisms of this relationship, systemic inflammation appears to play a major role. Evidence suggests that periodontal inflammation triggers a systemic inflammatory state that, added to the damage mediated by antibodies that cross react between periodontal pathogens and components of the intimal wall, and the direct lesion of the intima by bacteria entering the circulation, promotes atheroma plaque development and progression. There are other studies that show a clear relationship between periodontal disease severity, elevations of inflammatory markers, and the presence of atherosclerosis. Here, we give a review of the available evidence supporting this association, and the possible mechanisms involved.
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Affiliation(s)
| | - Alejandro Ordaz-Farías
- Echocardiography Laboratory, Cardiology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Raymundo Vera-Pineda
- Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Ramiro Flores-Ramírez
- Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México; Echocardiography Laboratory, Cardiology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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Martín A, Bravo M, Arrabal M, Magán-Fernández A, Mesa F. Chronic periodontitis is associated with erectile dysfunction. A case-control study in european population. J Clin Periodontol 2018; 45:791-798. [DOI: 10.1111/jcpe.12909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/13/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Amada Martín
- Department of Periodontics; School of Dentistry; University of Granada; Granada Spain
| | - Manuel Bravo
- Department of Preventive and Community Dentistry; School of Dentistry; University of Granada; Granada Spain
| | - Miguel Arrabal
- Urology Unit; Granada University Hospital Complex; Granada Spain
| | | | - Francisco Mesa
- Department of Periodontics; School of Dentistry; University of Granada; Granada Spain
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Oral Healthcare and Cardiovascular Disease: A Scoping Review of Current Strategies and Implications for Nurses. J Cardiovasc Nurs 2018; 32:E10-E20. [PMID: 28145980 DOI: 10.1097/jcn.0000000000000388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND There is epidemiological evidence showing an association between periodontal disease and cardiovascular disease (CVD). Despite this evidence* no comprehensive review has been undertaken to identify strategies to improve the oral health of people with CVD. OBJECTIVES The aim of this review is to identify current evidence relating to the oral healthcare and management of patients with CVD. METHODS A scoping review was undertaken focusing on 4 key areas, namely, the impact of periodontal treatment on CVD, current recommendations regarding oral health and CVD, the role of nurses in promoting oral health, and available resources to support them. Databases were searched using a combination of keywords and search terms and 34 articles were selected. RESULTS Systematic reviews suggest that periodontal treatment may improve CVD outcomes by reducing systemic inflammation and improving endothelial function. However, there is insufficient evidence to confirm or refute these findings. International guidelines recognize the link between periodontal disease and CVD and recommend preventative strategies in this area. Non-oral health professionals, including nurses, can promote oral health and have been undertaking this role in areas like aged care and pregnancy. However, this aspect of nursing care has not been explored in the cardiac setting and no relevant training and assessment tools are available. CONCLUSIONS Maintaining oral health among cardiovascular patients is important, yet it appears to be neglected during cardiac care. Cardiac nurses are in an excellent position to promote oral health but further research is required to define their role and develop supporting resources.
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Prestes AP, Machado WM, Oliveira JG, Olchanheski LR, Santos FA, Alves GF, Prudente AS, Otuki MF, Paludo KS, Sordi R, Fernandes D. Experimental periodontitis in rats potentiates inflammation at a distant site: Role of B 1 kinin receptor. Life Sci 2018; 194:40-48. [DOI: 10.1016/j.lfs.2017.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 12/02/2017] [Accepted: 12/06/2017] [Indexed: 01/05/2023]
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Mysak J, Podzimek S, Vasakova J, Mazanek J, Vinsu A, Duskova J. C-reactive protein in patients with aggressive periodontitis. J Dent Sci 2017; 12:368-374. [PMID: 30895077 PMCID: PMC6395364 DOI: 10.1016/j.jds.2017.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 04/06/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP) in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. MATERIALS AND METHODS All patients (N = 45) were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23) and group LAgP (Localised form of aggressive periodontitis, N = 22). Control group (CON) included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. RESULTS CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP) in a similar way as bleeding on probing (BOP) and probing pocket depth (PPD) indices. CONCLUSION Our study results showed that CRP levels, as well as bleeding on probing (BOP) and probing pocket depth (PPD), indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis.
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Affiliation(s)
- Jaroslav Mysak
- Department of Periodontology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Stepan Podzimek
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Vasakova
- Department of Paediatric Dentistry, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jiri Mazanek
- Department of Maxillofacial Surgery, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Alex Vinsu
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
| | - Jana Duskova
- Department of Oral Biology, Institute of Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32 and Katerinska 32, 121 11 Prague, Czech Republic
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Teixeira FB, Saito MT, Matheus FC, Prediger RD, Yamada ES, Maia CSF, Lima RR. Periodontitis and Alzheimer's Disease: A Possible Comorbidity between Oral Chronic Inflammatory Condition and Neuroinflammation. Front Aging Neurosci 2017; 9:327. [PMID: 29085294 PMCID: PMC5649154 DOI: 10.3389/fnagi.2017.00327] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 12/31/2022] Open
Abstract
Periodontitis is an oral chronic infection/inflammatory condition, identified as a source of mediators of inflammation into the blood circulation, which may contribute to exacerbate several diseases. There is increasing evidence that inflammation plays a key role in the pathophysiology of Alzheimer’s disease (AD). Although inflammation is present in both diseases, the exact mechanisms and crosslinks between periodontitis and AD are poorly understood. Therefore, this article aims to review possible comorbidity between periodontitis and AD. Here, the authors discuss the inflammatory aspects of periodontitis, how this oral condition produces a systemic inflammation and, finally, the contribution of this systemic inflammation for worsening neuroinflammation in the progression of AD.
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Affiliation(s)
- Francisco B Teixeira
- Institute of Biological Science, Federal University of Pará, Belém, Brazil.,College of Medicine, Federal University of Pará, Altamira, Brazil
| | - Miki T Saito
- Dental School, Brazil-Amazon Integrated Faculty, Belém, Brazil
| | - Filipe C Matheus
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rui D Prediger
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Elizabeth S Yamada
- Institute of Biological Science, Federal University of Pará, Belém, Brazil
| | | | - Rafael R Lima
- Institute of Biological Science, Federal University of Pará, Belém, Brazil
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50
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Sanchez P, Everett B, Salamonson Y, Ajwani S, Bhole S, Bishop J, Lintern K, Nolan S, Rajaratnam R, Redfern J, Sheehan M, Skarligos F, Spencer L, Srinivas R, George A. Oral health and cardiovascular care: Perceptions of people with cardiovascular disease. PLoS One 2017; 12:e0181189. [PMID: 28727751 PMCID: PMC5519046 DOI: 10.1371/journal.pone.0181189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/26/2017] [Indexed: 01/01/2023] Open
Abstract
MAIN OBJECTIVE The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis. RESULTS Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants. RELEVANCE TO CLINICAL PRACTICE The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in their practice. Affordable and accessible dental care services for people with cardiovascular disease should be considered and offered by health services in Australia.
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Affiliation(s)
- Paula Sanchez
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Centre for Applied Nursing Research, Liverpool, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Centre for Applied Nursing Research, Liverpool, Australia
| | - Shilpi Ajwani
- Sydney Local Health District, Sydney, Australia.,Oral Health Services, Sydney Dental Hospital, Sydney, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
| | - Sameer Bhole
- Sydney Local Health District, Sydney, Australia.,Oral Health Services, Sydney Dental Hospital, Sydney, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
| | | | - Karen Lintern
- South Western Sydney Local Health District, Sydney, Australia
| | | | - Rohan Rajaratnam
- South Western Sydney Local Health District, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,University of New South Wales, Sydney, Australia
| | - Julie Redfern
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Maria Sheehan
- South Western Sydney Local Health District, Sydney, Australia
| | | | | | - Ravi Srinivas
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
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