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Reytor-González C, Parise-Vasco JM, González N, Simancas-Racines A, Zambrano-Villacres R, Zambrano AK, Simancas-Racines D. Obesity and periodontitis: a comprehensive review of their interconnected pathophysiology and clinical implications. Front Nutr 2024; 11:1440216. [PMID: 39171112 PMCID: PMC11335523 DOI: 10.3389/fnut.2024.1440216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Obesity and periodontitis are significant health problems with a complex bidirectional relationship. Excess body fat is linked to systemic diseases and can lead to persistent inflammation, potentially harming periodontal health. Periodontitis, a chronic inflammatory condition affecting the supporting structures of teeth, poses substantial health risks. Both conditions share pathological processes such as inflammation and oxidative stress, which aggravate health status and make treatment more challenging. Understanding this interaction is crucial for developing effective management strategies for both diseases. This study explores the multifaceted aspects of obesity and periodontitis and their reciprocal relationship.
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Affiliation(s)
- Claudia Reytor-González
- Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador
| | - Juan Marcos Parise-Vasco
- Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador
| | - Natali González
- Facultad de Odontología, Universidad UTE, Santo Domingo, Ecuador
| | - Alison Simancas-Racines
- Carrera de Medicina Veterinaria, Facultad de Ciencias Agropecuarias y Recursos Naturales, Universidad Técnica de Cotopaxi, Latacunga, Ecuador
| | | | - Ana Karina Zambrano
- Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación Genética y Genómica, Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador
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2
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Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Luján-Urviola E, Farje-Gallardo CA. Association between Periodontal Disease and Obesity: Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:621. [PMID: 38674267 PMCID: PMC11051919 DOI: 10.3390/medicina60040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Faculty of Dentistry, Dentistry School, San Martin de Porres University, Chiclayo 14012, Peru;
- Faculty of Human Medicine, Human Medicine School, San Martín de Porres University, Chiclayo 14012, Peru
| | - Fredy Hugo Cruzado-Oliva
- Faculty of Stomatology, Stomatology School, Nacional University of Trujillo, Trujillo 13001, Peru;
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Catholic University of Santa Maria, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Catholic University of Santa Maria, Arequipa 04013, Peru
| | - Eduardo Luján-Urviola
- Faculty of Dentistry, Néstor Cáceres Velásquez Andean University, Juliaca 21104, Peru;
| | - Carlos Alberto Farje-Gallardo
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru; (F.T.C.-Z.); (C.A.F.-G.)
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Kaye E, McDonough R, Singhal A, Garcia RI, Jurasic M. Effect of Overweight and Obesity on Periodontal Treatment Intensity. JDR Clin Trans Res 2023; 8:158-167. [PMID: 35148660 PMCID: PMC10029136 DOI: 10.1177/23800844221074354] [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] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Obesity is associated with greater utilization of medical resources, but it is unclear if a similar relationship exists for dental care. OBJECTIVES This retrospective cohort study compared periodontal disease treatment among obese, overweight, and normal-weight patients attending an urban US dental school clinic. METHODS Periodontal, demographic, and medical history data for 3,443 adult patients examined between July 1, 2010, and July 31, 2019, were extracted from electronic health records. Body mass index (BMI) was computed from self-reported height and weight and categorized as obese (≥30 kg/m2), overweight (25-29.9 kg/m2), or normal (18-24.9 kg/m2). Periodontal disease was categorized using clinical probing measures. Procedure codes defined treatment type (surgical, nonsurgical, local chemotherapeutics, or none). Logistic regression models controlling for initial periodontal disease severity, age, gender, tobacco use, history of diabetes, dental insurance type, and follow-up (log of days) estimated odds ratios (ORs) and 95% confidence intervals (CIs) of any treatment among obese and overweight relative to normal-weight patients. The association between BMI and a periodontal treatment intensity score, based on treatment type, number of teeth treated, and number of visits, was evaluated with multivariable negative binomial regression. RESULTS Mean age at baseline was 44 ± 15 y, and severe periodontal disease was present in 32% of obese, 31% of overweight, and 21% of normal-weight patients. Average follow-up was 3.9 ± 1.6 y. Obese and overweight patients were more likely to have nonsurgical scaling and root planing or surgical procedures than normal-weight patients. Adjusted odds of any treatment were higher among obese (OR = 1.34; 95% CI, 1.14-1.72) and overweight (OR = 1.18; 95% CI, 0.97-1.42) relative to normal weight. Obese and overweight patients had 40% and 24% higher treatment intensity scores, respectively, than normal-weight patients. CONCLUSION These results indicate obese and overweight individuals require more intensive periodontal treatment compared to normal-weight individuals, independent of initial disease severity. KNOWLEDGE OF TRANSFER STATEMENT The results of this study can be used by dental providers and policymakers to better understand patient characteristics that influence the variability in frequency and length of periodontal treatment. Knowledge of a patient's body mass index may be useful in identifying patients who possibly will have a poorer periodontal prognosis.
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Affiliation(s)
- E Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - R McDonough
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - A Singhal
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - R I Garcia
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - M Jurasic
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
- Department of General Dentistry, Director of the Center for Clinical Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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Toy VE, Ataoglu T, Eltas A, Otlu HG, Karabulut AB. Obesity as a modifying factor of periodontal therapy outcomes: local and systemic adipocytokines and oxidative stress markers. Clin Oral Investig 2023:10.1007/s00784-022-04854-7. [PMID: 36604342 DOI: 10.1007/s00784-022-04854-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Adipocytokines and oxidative stress (OS) are involved in the pathogenesis of both obesity and periodontitis. The aim of this study was to evaluate periodontal therapy outcomes in terms of serum and gingival crevicular fluid (GCF) levels of adipocytokines and OS markers in obese patients with periodontitis, in order to have an insight into the association between obesity and periodontitis. MATERIALS AND METHODS A total of 39 patients (20 obese, 19 non-obese) with periodontitis were included in this study. Clinical periodontal parameters were assessed; serum and GCF levels of adipocytokines and OS markers were evaluated by ELISA at baseline and 3 months after non-surgical periodontal therapy. RESULTS Significant improvements in clinical periodontal parameters were observed in both groups at 3 months (p < 0.01). While serum levels of TNF-α, leptin, and total oxidant status (TOS) in the obese group were higher at baseline (p < 0.01), leptin levels remained higher at 3 months despite a significant decrease (p < 0.01). Although NSPT improved GCF levels of total antioxidant status (TAS) and TOS in both groups, they were significantly different between the groups after therapy (p < 0.05). CONCLUSIONS It seems that leptin, TNF-α, and TOS contribute to systemic inflammatory and oxidative state in patients with obesity. Despite improvements in clinical periodontal parameters, obesity might be a modulating factor in the development and progression of periodontal disease in terms of some adipocytokines and OS markers. CLINICAL RELEVANCE Since the global burden of both obesity and periodontitis is continuously increasing, the management of these inflammatory diseases has become more important. The current study contributes to our understanding of the role of OS and adipocytokines on the relationship between obesity and periodontitis by response to periodontal treatment.
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Affiliation(s)
- Vesile Elif Toy
- Department of Periodontology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Tamer Ataoglu
- Department of Periodontology, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Abubekir Eltas
- Department of Periodontology, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - Husniye Gul Otlu
- Medical Laboratory Techniques Program, Vocational School of Health Services, Turgut Ozal University, Malatya, Turkey
| | - Aysun Bay Karabulut
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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Pamuk F, Kantarci A. Inflammation as a link between periodontal disease and obesity. Periodontol 2000 2022; 90:186-196. [PMID: 35916870 DOI: 10.1111/prd.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.
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Affiliation(s)
- Ferda Pamuk
- Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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6
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Mulhall H, DiChiara JM, Huck O, Amar S. Pasteurized Akkermansia muciniphila reduces periodontal and systemic inflammation induced by Porphyromonas gingivalis in lean and obese mice. J Clin Periodontol 2022; 49:717-729. [PMID: 35415929 DOI: 10.1111/jcpe.13629] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/24/2022] [Accepted: 03/19/2022] [Indexed: 02/06/2023]
Abstract
AIM The aim of this study was to evaluate the effect of the administration of pasteurized Akkermansia muciniphila and Amuc_1100 on periodontal destruction in lean and obese mice and to determine the impact of the mode of administration. MATERIALS AND METHODS Porphyromonas gingivalis-associated experimental periodontitis was induced in lean and obese mice. After 3 weeks, live, pasteurized A. muciniphila or Amuc_1100 was administered by oral or gastric gavage for three additional weeks. Moreover, an evaluation of the interaction between A. muciniphila and P. gingivalis was performed by RNA-sequencing, and cytokines secretion was measured in exposed macrophages. RESULTS Oral administration of live, pasteurized A. muciniphila or Amuc_1100 significantly decreased P. gingivalis-induced periodontal destruction and inflammatory infiltrate in lean and obese mice and contributed to the reduction of the plasma level of TNF-α and to the increase of IL-10. The co-culture of A. muciniphila and P. gingivalis induced an increased expression of genes linked to the synthesis of monobactam-related antibiotics in A. muciniphila, while a decrease of the gingipains and type IX secretion system was observed in P. gingivalis. In P. gingivalis-infected macrophages, pasteurized A. muciniphila decreased TNF-α and increased IL-10 levels. CONCLUSIONS Pasteurized A. muciniphila can counteract P. gingivalis-associated periodontal destruction.
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Affiliation(s)
- Hannah Mulhall
- Department of Microbiology and Immunology, New York Medical College, Valhalla, New York, USA
| | - Jeanne M DiChiara
- Department of Pharmacology, New York Medical College, Valhalla, New York, USA
| | - Olivier Huck
- Faculté de Chirurgie-Dentaire, Université de Strasbourg, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Salomon Amar
- Department of Microbiology and Immunology, New York Medical College, Valhalla, New York, USA.,Department of Pharmacology, New York Medical College, Valhalla, New York, USA
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Zhao P, Xu A, Leung WK. Obesity, Bone Loss, and Periodontitis: The Interlink. Biomolecules 2022; 12:biom12070865. [PMID: 35883424 PMCID: PMC9313439 DOI: 10.3390/biom12070865] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity and periodontitis are both common health concerns that have given rise to considerable economic and societal burden worldwide. There are established negative relationships between bone metabolism and obesity, obesity and diabetes mellitus (DM), and DM and periodontitis, to name a few, with osteoporosis being considered a long-term complication of obesity. In the oral cavity, bone metabolic disorders primarily display as increased risks for periodontitis and alveolar bone loss. Obesity-driven alveolar bone loss and mandibular osteoporosis have been observed in animal models without inoculation of periodontopathogens. Clinical reports have also indicated a possible association between obesity and periodontitis. This review systematically summarizes the clinical periodontium changes, including alveolar bone loss in obese individuals. Relevant laboratory-based reports focusing on biological interlinks in obesity-associated bone remodeling via processes like hyperinflammation, immune dysregulation, and microbial dysbiosis, were reviewed. We also discuss the potential mechanism underlying obesity-enhanced alveolar bone loss from both the systemic and periodontal perspectives, focusing on delineating the practical considerations for managing periodontal disease in obese patients.
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Affiliation(s)
- Pengfei Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Aimin Xu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
- Correspondence: ; Tel.: +852-2859-0417
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8
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Association between clinical measures of gingival inflammation and obesity in adults: systematic review and meta-analyses. Clin Oral Investig 2021; 25:4281-4298. [PMID: 33904994 DOI: 10.1007/s00784-021-03961-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/20/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to systematically review the literature about the association between clinical measures of gingival inflammation and obesity in adults. MATERIAL AND METHODS Searches for studies were performed in five databases (Medline-PubMed, Scopus, Web of Science, Cochrane Library, and Embase) to compile studies of any design that evaluated the association between clinical measures of gingival inflammation and obesity in adults. Selection of studies, data extraction and risk of bias analysis were performed independently by two reviewers, and a third researcher was involved to resolve disagreements. Meta-analyses were performed for measures of gingival inflammation as compared to body mass index (BMI). Independent analyses were performed for studies involving periodontitis, gingivitis, and population-based/studies that did not provide a periodontal diagnosis. Standard mean deviation (SMD) and its 95% confidence interval (95%CI) were estimated. RESULTS Ninety studies were included (cross-sectional/clinical trials [n=82], case-control [n=3], cohorts [n=5]). Most of the studies demonstrated no significant difference in the measures of gingival inflammation regardless of the comparison performed. However, meta-analysis showed that among individuals with periodontitis, significantly higher levels of gingival inflammation are observed in those with obesity (n of individuals=240) when compared to those who were not obese (n of individuals=574) (SMD:0.26; 95%CI:0.07-0.44). When considering population-based/those studies that did not provide periodontal diagnosis, significantly higher measures of gingival inflammation were observed in the groups with higher BMI. CONCLUSIONS Within the limitations of the present study, it was concluded that higher measures of gingival inflammation may be expected for those with higher BMI. CLINICAL RELEVANCE Clinicians must be aware that higher measures of gingival inflammation may be expected for individuals with higher BMI. However, there is a necessity for further longitudinal studies regarding the association between obesity and gingival inflammation.
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Sczepanik FSC, Grossi ML, Casati M, Goldberg M, Glogauer M, Fine N, Tenenbaum HC. Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way. Periodontol 2000 2020; 84:45-68. [PMID: 32844417 DOI: 10.1111/prd.12342] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis is a highly prevalent disease. As it progresses, it causes serious morbidity in the form of periodontal abscesses and tooth loss and, in the latter stages, pain. It is also now known that periodontitis is strongly associated with several nonoral diseases. Thus, patients with periodontitis are at greater risk for the development and/or exacerbation of diabetes, chronic obstructive pulmonary disease, and cardiovascular diseases, among other conditions. Although it is without question that specific groups of oral bacteria which populate dental plaque play a causative role in the development of periodontitis, it is now thought that once this disease has been triggered, other factors play an equal, and possibly more important, role in its progression, particularly in severe cases or in cases that prove difficult to treat. In this regard, we allude to the host response, specifically the notion that the host, once infected with oral periodontal pathogenic bacteria, will mount a defense response mediated largely through the innate immune system. The most abundant cell type of the innate immune system - polymorphonuclear neutrophils - can, when protecting the host from microbial invasion, mount a response that includes upregulation of proinflammatory cytokines, matrix metalloproteinases, and reactive oxygen species, all of which then contribute to the tissue damage and loss of teeth commonly associated with periodontitis. Of the mechanisms referred to here, we suggest that upregulation of reactive oxygen species might play one of the most important roles in the establishment and progression of periodontitis (as well as in other diseases of inflammation) through the development of oxidative stress. In this overview, we discuss both innate and epigenetic factors (eg, diabetes, smoking) that lead to the development of oxidative stress. This oxidative stress then provides an environment conducive to the destructive processes observed in periodontitis. Therefore, we shall describe some of the fundamental characteristics of oxidative stress and its effects on the periodontium, discuss the diseases and other factors that cause oxidative stress, and, finally, review potentially novel therapeutic approaches for the management (and possibly even the reversal) of periodontitis, which rely on the use of therapies, such as resveratrol and other antioxidants, that provide increased antioxidant activity in the host.
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Affiliation(s)
| | - Márcio Lima Grossi
- School of Health Sciences, Dentistry, Post-Graduate Program in Dentistry, Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Márcio Casati
- Dental Research Division, School of Dentistry, Paulista University (UNIP), Sao Paulo, Brazil.,Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Michael Goldberg
- Discipline of Periodontology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, University of Toronto, Toronto, ON, Canada.,Division of Periodontology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Howard C Tenenbaum
- Department of Dentistry, Mount Sinai Hospital, Thodupuzha, India.,Faculty of Dentistry, Centre for Advanced Dental Research and Care, University of Toronto, Toronto, ON, Canada
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10
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Petit C, Anadon-Rosinach V, Rettig L, Schmidt-Mutter C, Tuzin N, Davideau JL, Huck O. Influence of psychological stress on non-surgical periodontal treatment outcomes in patients with severe chronic periodontitis. J Periodontol 2020; 92:186-195. [PMID: 32716522 DOI: 10.1002/jper.20-0105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/21/2020] [Accepted: 06/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the influence of psychological stress on non-surgical periodontal treatment (SRP) outcomes in patients with severe chronic periodontitis (stage 3/4 generalized periodontitis) at 6 months in the French population. METHODS Patients diagnosed with severe generalized chronic periodontitis (periodontitis stage 3/4) were included in this study. At baseline, psychological status was evaluated by self-administered questionnaire (Depression Anxiety Stress Scale 42 [DASS-42] and Toulouse coping scale [TCS]). Plasma levels of cortisol and chromogranin-A were determined. Patients were then managed by oral hygiene instructions, scaling and root planing of sites with PD >3 mm and followed at 3 and 6 months. Quantitative and qualitative variables were described and interactions were determined by linear and logistic regressions. RESULTS Seventy-one patients were included in this study and 54 were followed up to 6 months. An average probing depth (PD) reduction of 0.73 ± 0.11 mm and decrease of diseased sites (PD >3 mm) were measured at 6 months illustrating SRP efficacy. Multivariable analysis showed that increased DASS-stress score was associated to worsened SRP outcomes in terms of bleeding on probing (BOP) (OR = 1.02, P <0.05) and mean PD (P <0.05) reduction. An increase of DASS-depression score negatively influenced PD >5 mm (OR = 1.06, P <0.05), PD >7 mm (OR = 1.17, P <0.01), CAL >5 mm (OR = 1.03, P <0.05), and CAL >7 mm (OR = 1.07, P <0.05) reduction. Negative coping strategies were also associated with worsened SRP outcomes. CONCLUSIONS Patients with increased stress, anxiety, and depression scores as well as those exhibiting negative coping strategies demonstrate worsened SRP outcomes. DASS-42 and TCS were useful to determine psychological status and their use could be incorporated to assess treatment prognosis.
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Affiliation(s)
- Catherine Petit
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France.,UMR 1260 Regenerative Nanomedicine, INSERM (French National Institute of Health and Medical Research), Strasbourg, France
| | - Victor Anadon-Rosinach
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Laurence Rettig
- Clinical Investigation Center, INSERM U1434, University Hospital of Strasbourg, Strasbourg, France
| | - Catherine Schmidt-Mutter
- Clinical Investigation Center, INSERM U1434, University Hospital of Strasbourg, Strasbourg, France
| | - Nicolas Tuzin
- Methodology and Biostatistics Group, Public Health Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Jean-Luc Davideau
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France
| | - Olivier Huck
- Periodontology, University of Strasbourg, Dental Faculty, Strasbourg, France.,University Hospital of Strasbourg, Strasbourg, France.,UMR 1260 Regenerative Nanomedicine, INSERM (French National Institute of Health and Medical Research), Strasbourg, France
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11
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Impact of Molar Furcations on Photodynamic Therapy Outcomes: A 6-Month Split-Mouth Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114162. [PMID: 32545223 PMCID: PMC7312923 DOI: 10.3390/ijerph17114162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022]
Abstract
The effectiveness of adjunctive photodynamic treatment (PDT) to non-surgical periodontal therapy has been shown to depend on initial periodontal status. As molar furcation involvement impairs healing response to non-surgical periodontal therapy, the aim of this study was to evaluate the impact of furcation involvement on PDT outcomes. Thirty-six patients suffering from severe chronic periodontitis were included in a 6-month split-mouth randomized clinical trial. PDT applications used the toluidine blue O and a light-emitting diode (LED) with a red spectrum. Repeated PDT applications were performed in addition to non-surgical periodontal treatment at baseline and at 3-months. Pocket probing depth (PPD), plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, and again at 3- and 6-months. Furcation sites of molars were compared to other sites of molars and non-molars. Multilevel analysis showed no PDT effect in molar furcation sites while an additional significant reduction (odds ratio = 0.67) of pockets with PPD > 5 mm in other sites at 3-months was measured. PPD reduction appeared delayed in molar furcation sites treated with PDT. There is no additional apparent benefit to use PDT in molar furcation sites for the reduction of pockets with PPD > 5 mm contrary to other sites.
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12
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Suvan J, Harrington Z, Petrie A, Patel K, Darbar U, Donos N, D'Aiuto F. Obesity as predictive factor of periodontal therapy clinical outcomes: A cohort study. J Clin Periodontol 2020; 47:594-601. [DOI: 10.1111/jcpe.13261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 01/04/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Jean Suvan
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | | | - Aviva Petrie
- Unit of Biostatistics UCL Eastman Dental Institute London UK
| | - Kalpesh Patel
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Ulpee Darbar
- Unit of Periodontology UCL Eastman Dental Institute London UK
| | - Nikos Donos
- Centre for Oral Clinical Research Barts and The London School of Medicine and Dentistry QMUL London UK
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13
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Huck O, Mulhall H, Rubin G, Kizelnik Z, Iyer R, Perpich JD, Haque N, Cani PD, de Vos WM, Amar S. Akkermansia muciniphila reduces Porphyromonas gingivalis-induced inflammation and periodontal bone destruction. J Clin Periodontol 2020; 47:202-212. [PMID: 31674689 DOI: 10.1111/jcpe.13214] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/17/2019] [Accepted: 10/20/2019] [Indexed: 12/11/2022]
Abstract
AIM Akkermansia muciniphila is a beneficial gut commensal, whose anti-inflammatory properties have recently been demonstrated. This study aimed to evaluate the effect of A. muciniphila on Porphyromonas gingivalis elicited inflammation. MATERIAL AND METHODS In lean and obese mice, A. muciniphila was administered in P. gingivalis-induced calvarial abscess and in experimental periodontitis model (EIP). Bone destruction and inflammation were evaluated by histomorphometric analysis. In vitro, A. muciniphila was co-cultured with P. gingivalis, growth and virulence factor expression was evaluated. Bone marrow macrophages (BMMϕ) and gingival epithelial cells (TIGK) were exposed to both bacterial strains, and the expression of inflammatory mediators, as well as tight junction markers, was analysed. RESULTS In a model of calvarial infection, A. muciniphila decreased inflammatory cell infiltration and bone destruction. In EIP, treatment with A. muciniphila resulted in a decreased alveolar bone loss. In vitro, the addition of A. muciniphila to P. gingivalis-infected BMMϕ increased anti-inflammatory IL-10 and decreased IL-12. Additionally, A. muciniphila exposure increases the expression of junctional integrity markers such as integrin-β1, E-cadherin and ZO-1 in TIGK cells. A. muciniphila co-culture with P. gingivalis reduced gingipains mRNA expression. DISCUSSION This study demonstrated the protective effects of A. muciniphila administration and may open consideration to its use as an adjunctive therapeutic agent to periodontal treatment.
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Affiliation(s)
- Olivier Huck
- UMR 1260, Fédération de Médecine Translationnelle de Strasbourg (FMTS), INSERM (French National Institute of Health and Medical Research), Regenerative Nanomedicine, Strasbourg, France
- Faculté de Chirurgie-Dentaire, Université de Strasbourg, Strasbourg, France
| | - Hannah Mulhall
- Department of Pharmacology, New York Medical College, Valhalla, NY, USA
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - George Rubin
- Touro College of Dental Medicine, Valhalla, NY, USA
| | - Zev Kizelnik
- Touro College of Dental Medicine, Valhalla, NY, USA
| | - Radha Iyer
- Department of Pharmacology, New York Medical College, Valhalla, NY, USA
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - John D Perpich
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Nasreen Haque
- Department of Pathology, New York Medical College, Valhalla, NY, USA
| | - Patrice D Cani
- WELBIO (Walloon Excellence in Life sciences and BIOtechnology), Metabolism and Nutrition research group, UCLouvain, Université Catholique de Louvain, Louvain Drug Research Institute, Brussels, Belgium
| | - Willem M de Vos
- Department of Bacteriology and Immunology, RPU Human Microbiome, University of Helsinki, Helsinki, Finland
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Salomon Amar
- Department of Pharmacology, New York Medical College, Valhalla, NY, USA
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
- Touro College of Dental Medicine, Valhalla, NY, USA
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14
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Impact of tooth-related factors on photodynamic therapy effectiveness during active periodontal therapy: A 6-months split-mouth randomized clinical trial. Photodiagnosis Photodyn Ther 2019; 27:167-172. [DOI: 10.1016/j.pdpdt.2019.05.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
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15
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Martinez‐Herrera M, López‐Domènech S, Silvestre FJ, Silvestre‐Rangil J, Bañuls C, Hernández‐Mijares A, Rocha M. Dietary therapy and non‐surgical periodontal treatment in obese patients with chronic periodontitis. J Clin Periodontol 2018; 45:1448-1457. [DOI: 10.1111/jcpe.13030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 10/19/2018] [Accepted: 10/21/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Mayte Martinez‐Herrera
- Service of StomatologyUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
- Department of StomatologyUniversity of Valencia Valencia Spain
| | - Sandra López‐Domènech
- Service of Endocrinology and NutritionUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
| | - Francisco Javier Silvestre
- Service of StomatologyUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
- Department of StomatologyUniversity of Valencia Valencia Spain
| | | | - Celia Bañuls
- Service of Endocrinology and NutritionUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
| | - Antonio Hernández‐Mijares
- Service of Endocrinology and NutritionUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
- Department of MedicineUniversity of Valencia Valencia Spain
| | - Milagros Rocha
- Service of Endocrinology and NutritionUniversity Hospital Doctor Peset‐FISABIO Valencia Spain
- CIBER CB06/04/0071 Research GroupCIBER Hepatic and Digestive DiseasesUniversity of Valencia Valencia Spain
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16
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Singh SP, Huck O, Abraham NG, Amar S. Kavain Reduces Porphyromonas gingivalis-Induced Adipocyte Inflammation: Role of PGC-1α Signaling. THE JOURNAL OF IMMUNOLOGY 2018; 201:1491-1499. [PMID: 30037847 DOI: 10.4049/jimmunol.1800321] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
A link between obesity and periodontitis has been suggested because of compromised immune response and chronic inflammation in obese patients. In this study, we evaluated the anti-inflammatory properties of Kavain, an extract from Piper methysticum, on Porphyromonas gingivalis-induced inflammation in adipocytes with special focus on peroxisome proliferation-activated receptor γ coactivator α (PGC-1α) and related pathways. The 3T3-L1 mouse preadipocytes and primary adipocytes harvested from mouse adipose tissue were infected with P. gingivalis, and inflammation (TNF-α; adiponectin/adipokines), oxidative stress, and adipogenic marker (FAS, CEBPα, and PPAR-γ) expression were measured. Furthermore, effect of PGC-1α knockdown on Kavain action was evaluated. Results showed that P. gingivalis worsens adipocyte dysfunction through increase of TNF-α, IL-6, and iNOS and decrease of PGC-1α and adiponectin. Interestingly, although Kavain obliterated P. gingivalis-induced proinflammatory effects in wild-type cells, Kavain did not affect PGC-1α-deficient cells, strongly advocating for Kavain effects being mediated by PGC-1α. In vivo adipocytes challenged with i.p. injection of P. gingivalis alone or P. gingivalis and Kavain displayed the same phenotype as in vitro adipocytes. Altogether, our findings established anti-inflammatory and antioxidant effects of Kavain on adipocytes and emphasized protective action against P. gingivalis-induced adipogenesis. The use of compounds such as Kavain offer a portal to potential therapeutic approaches to counter chronic inflammation in obesity-related diseases.
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Affiliation(s)
- Shailendra P Singh
- Department of Pharmacology, New York Medical College, Valhalla, NY 10595
| | - Olivier Huck
- INSERM, UMR 1260, Regenerative Nanomedicine (Fédération de Médicine Translationalle de Strasbourg), 67000 Strasbourg, France; and.,Periodontology, Dental Faculty, University of Strasbourg, 67000 Strasbourg, France
| | - Nader G Abraham
- Department of Pharmacology, New York Medical College, Valhalla, NY 10595
| | - Salomon Amar
- Department of Pharmacology, New York Medical College, Valhalla, NY 10595;
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17
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Martinez-Herrera M, Silvestre-Rangil J, Silvestre FJ. Association between obesity and periodontal disease. A systematic review of epidemiological studies and controlled clinical trials. Med Oral Patol Oral Cir Bucal 2017; 22:e708-e715. [PMID: 29053651 PMCID: PMC5813989 DOI: 10.4317/medoral.21786] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/15/2017] [Indexed: 12/11/2022] Open
Abstract
Background Obesity is a very prevalent chronic disease worldwide and has been suggested to increase susceptibility of periodontitis. The aim of this paper was to provide a systematic review of the association between obesity and periodontal disease, and to determine the possible mechanisms underlying in this relationship. Material and Methods A literature search was carried out in the databases PubMed-Medline and Embase. Controlled clinical trials and observational studies identifying periodontal and body composition parameters were selected. Each article was subjected to data extraction and quality assessment. Results A total of 284 articles were identified, of which 64 were preselected and 28 were finally included in the review. All the studies described an association between obesity and periodontal disease, except two articles that reported no such association. Obesity is characterized by a chronic subclinical inflammation that could exacerbate other chronic inflammatory disorders like as periodontitis. Conclusions The association between obesity and periodontitis was consistent with a compelling pattern of increased risk of periodontitis in overweight or obese individuals. Although the underlying pathophysiological mechanism remains unclear, it has been pointed out that the development of insulin resistance as a consequence of a chronic inflammatory state and oxidative stress could be implicated in the association between obesity and periodontitis. Further prospective longitudinal studies are needed to define the magnitude of this association and to elucidate the causal biological mechanisms. Key words:Periodontal disease, periodontitis, periodontal infection, obesity, abdominal obesity.
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Affiliation(s)
- M Martinez-Herrera
- Clínica Odontológica Universitaria, Unidad de Odontología en Pacientes Especiales, Gascó Oliag 1, 46021 -Valencia, Spain,
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18
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Wilkins LM, Kaye EK, Wang HY, Rogus J, Doucette-Stamm L, Kornman K, Garcia RI. Influence of Obesity on Periodontitis Progression Is Conditional on Interleukin-1 Inflammatory Genetic Variation. J Periodontol 2017; 88:59-68. [DOI: 10.1902/jop.2016.160408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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19
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Akram Z, Baharuddin NA, Vaithilingam RD, Rahim ZHA, Chinna K, Krishna VG, Saub R, Safii SH. Effect of nonsurgical periodontal treatment on clinical periodontal variables and salivary resistin levels in obese Asians. J Oral Sci 2017; 59:93-102. [DOI: 10.2334/josnusd.16-0127] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Zohaib Akram
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
- Department of Periodontology, Faculty of Dentistry, Ziauddin University
| | - Nor A. Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
| | | | - Zubaidah H. A. Rahim
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, University of Malaya
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya
| | - Vignes G. Krishna
- Department of Development Studies, Faculty of Economics and Administration, University of Malaya
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya
| | - Syarida H. Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
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20
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Gerber FA, Sahrmann P, Schmidlin OA, Heumann C, Beer JH, Schmidlin PR. Influence of obesity on the outcome of non-surgical periodontal therapy - a systematic review. BMC Oral Health 2016; 16:90. [PMID: 27590050 PMCID: PMC5010690 DOI: 10.1186/s12903-016-0272-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity and periodontitis are important chronic health problems. Obesity is associated with an increased prevalence of periodontitis. Whether obesity also affects the outcome of non-surgical periodontal therapy is to date still unclear. METHODS A systematic review of studies referenced in SCOPUS, MEDLINE, PubMed, Cochrane, CINAHL, Biosis and Web of Science was performed. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. Probing pocket depth reduction was analyzed as primary surrogate parameter for therapeutic success after non-surgical periodontal therapy. RESULTS One-hundred-and-fifty-nine potentially qualifying studies were screened. Eight studies fulfilled the inclusion criteria and were analyzed. Three of eight studies failed to show an influence of obesity on pocket depth reduction after non-surgical therapy. The remaining five studies documented a clear negative effect on the outcome of non-surgical periodontal therapy. The finally included studies did not correspond to the highest level of quality (RCTs). Due to the heterogeneity of the data a meta-analysis was not possible. CONCLUSION The literature on the effect of obesity on the treatment outcome of non-surgical periodontal therapy remains controversial. The data, however, support that obesity is not only a factor associated with poorer periodontal health but might also result in inferior response to non-surgical treatment of periodontitis.
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Affiliation(s)
- Fabienne A. Gerber
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Oliver A. Schmidlin
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürg Hans Beer
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
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