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Liu X, Zhang J, Wang X, Zhang Z. Transcriptomic analysis identifies diagnostic genes in polycystic ovary syndrome and periodontitis. Eur J Med Res 2024; 29:3. [PMID: 38167332 PMCID: PMC10762819 DOI: 10.1186/s40001-023-01499-4] [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: 08/25/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE To investigate underlying co-mechanisms of PCOS and periodontitis through transcriptomic approach. METHODS PCOS and periodontitis gene expression data were downloaded from the GEO database to identify differentially expressed genes. GO and KEGG pathway enrichment analysis and random forest algorithm were used to screen hub genes. GSEA analyzed the functions of hub genes. Correlations between hub genes and immune infiltration in two diseases were examined, constructing a TF-ceRNA regulatory network. Clinical samples were gathered from PCOS and periodontitis patients and RT-qPCR was performed to verify the connection. RESULTS There were 1661 DEGs in PCOS and 701 DEGs in periodontitis. 66 intersected genes were involved and were enriched in immune and inflammation-related biological pathways. 40 common genes were selected from the PPI network. RF algorithm demonstrated that ACSL5, NLRP12, CCRL2, and CEACAM3 were hub genes, and GSEA results revealed their close relationship with antigen processing and presentation, and chemokine signaling pathway. RT-qPCR results confirmed the upregulated gene expression in both PCOS and periodontitis. CONCLUSION The 4 hub genes ACSL5, NLRP12, CCRL2, and CEACAM3 may be diagnostic genes for PCOS and periodontitis. The created ceRNA network could provide a molecular basis for future studies on the association between PCOS and periodontitis.
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Affiliation(s)
- Xiaodan Liu
- Department of Stomatology, Peking University Third Hospital, Beijing, China.
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| | - Jingran Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xiao Wang
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Zhihui Zhang
- Department of Stomatology, Peking University Third Hospital, Beijing, China.
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Joseph P, Prabhakar P, Holtfreter B, Pink C, Suvan J, Kocher T, Pitchika V. Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions. Clin Oral Investig 2023; 28:21. [PMID: 38147183 PMCID: PMC10751251 DOI: 10.1007/s00784-023-05392-6] [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: 08/22/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up. MATERIALS AND METHODS A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities. RESULTS The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group. CONCLUSION Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions. TRIAL REGISTRATION This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
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Affiliation(s)
- Prabhakar Joseph
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany
| | - Priya Prabhakar
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany
- Department of Orthodontics, University Medicine Greifswald, Greifswald, Germany
| | - Jeanie Suvan
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany.
| | - Vinay Pitchika
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Luthra S, Orlandi M, Hussain SB, Leira Y, Botelho J, Machado V, Mendes JJ, Marletta D, Harden S, D'Aiuto F. Treatment of periodontitis and C-reactive protein: A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2023; 50:45-60. [PMID: 35946825 PMCID: PMC10087558 DOI: 10.1111/jcpe.13709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/25/2022] [Accepted: 07/23/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation. PURPOSE To comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum C-reactive protein (CRP) levels. DATA SOURCES Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only. STUDY SELECTION Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment. DATA EXTRACTION Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models. RISK OF BIAS Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed. DATA SYNTHESIS Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to -0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline. LIMITATIONS High level of heterogeneity. CONCLUSIONS Treatment of periodontitis reduces serum CRP levels (up to 6 months follow-up) to a degree equivalent to that observed after traditional lifestyle or drug interventions. This evidence supports a causal association between periodontitis and systemic inflammation.
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Affiliation(s)
- Shailly Luthra
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | | | - Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | - José João Mendes
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | | | - Simon Harden
- Department of Statistical Science, UCL Eastman Dental Institute, London, UK
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Dou Y, Xin J, Zhou P, Tang J, Xie H, Fan W, Zhang Z, Wu D. Bidirectional association between polycystic ovary syndrome and periodontal diseases. Front Endocrinol (Lausanne) 2023; 14:1008675. [PMID: 36755917 PMCID: PMC9899846 DOI: 10.3389/fendo.2023.1008675] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) and periodontal disease (PDD) share common risk factors. The bidirectional interaction between PCOS and PDD has been reported, but until now, the underlying molecular mechanisms remain unclear. Endocrine disorders including hyperandrogenism (HA) and insulin resistance (IR) in PCOS disturb the oral microbial composition and increase the abundance of periodontal pathogens. Additionally, PCOS has a detrimental effect on the periodontal supportive tissues, including gingiva, periodontal ligament, and alveolar bone. Systemic low-grade inflammation status, especially obesity, persistent immune imbalance, and oxidative stress induced by PCOS exacerbate the progression of PDD. Simultaneously, PDD might increase the risk of PCOS through disturbing the gut microbiota composition and inducing low-grade inflammation and oxidative stress. In addition, genetic or epigenetic predisposition and lower socioeconomic status are the common risk factors for both diseases. In this review, we will present the latest evidence of the bidirectional association between PCOS and PDD from epidemiological, mechanistic, and interventional studies. A deep understanding on their bidirectional association will be beneficial to provide novel strategies for the treatment of PCOS and PDD.
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Affiliation(s)
- Yang Dou
- Department of Stomatology, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Jinglei Xin
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Peng Zhou
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Jianming Tang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Hongliang Xie
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Wanting Fan
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Zheng Zhang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Donglei Wu
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Donglei Wu,
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Zia A, Hakim S, Khan AU, Bey A, Ateeq H, Parveen S, Khalid S, Yusufi F. Bone markers and bone mineral density associates with periodontitis in females with poly-cystic ovarian syndrome. J Bone Miner Metab 2022; 40:487-497. [PMID: 35072780 DOI: 10.1007/s00774-021-01302-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/10/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Studies suggest an association between poly-cystic ovarian syndrome (PCOS) and chronic periodontitis (CP), both being inflammatory conditions. However, insufficient evidence assesses the impact of this inflammation on bone metabolism and bone turnover markers (BTMs). The present study aimed to determine the association between BTMs, bone mineral density (BMD), and clinical periodontal parameters in PCOS women with CP. MATERIALS AND METHODS Three groups, each with 40 newly diagnosed (1) PCOS+CP, (2) PCOS alone, (3) CP alone, and fourth group (n = 20) systemically and periodontally healthy females aged 18-30 years were included in the study. Full mouth clinical periodontal parameters, C-terminal telopeptides of type I collagen (CTX), bone alkaline phosphatase (ALP), BMD and 25-hydroxyvitamin D (VD) were recorded for all. RESULTS Low BMD (0.89 ± 0.11 g/cm2), increased CTX levels (2.76 ± 4.64 ng/ml), decreased bone ALP levels (11.09 ± 6.86 ng/ml), higher VD levels (289.02 ± 168.28 nmol/l) and poor clinical periodontal status were observed in PCOS + CP females. BMD-spine showed weak positive correlation with CTX, bone ALP, VD (r = 0.02, r = 0.07, r = 0.15, respectively) in PCOS + CP group. ANCOVA depicted covariates had no confounding effect. Multiple regression model explained 21.0% for BMD-spine and 12.7% for BMD-femur of total variability signifying association with all measured parameters among all groups. CONCLUSION Enhanced inflammatory thrust by periodontitis increases CTX levels and decreases bone ALP and BMD levels in women with PCOS. Screening PCOS women for periodontal disease and vice versa may have a direct bearing on overall bone health.
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Affiliation(s)
- Afaf Zia
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmed Dental College (DRZADC), Aligarh Muslim University (AMU), Aligarh, 202002, Uttar Pradesh, India.
| | - S Hakim
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and Hospital (JNMCH), AMU, Aligarh, Uttar Pradesh, India
| | - A U Khan
- Interdisciplinary Biotechnology Unit, AMU, Aligarh, Uttar Pradesh, India
| | - A Bey
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmed Dental College (DRZADC), Aligarh Muslim University (AMU), Aligarh, 202002, Uttar Pradesh, India
| | - H Ateeq
- Department of Biochemistry, AMU, Aligarh, Uttar Pradesh, India
| | - S Parveen
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and Hospital (JNMCH), AMU, Aligarh, Uttar Pradesh, India
| | - S Khalid
- Interdisciplinary Biotechnology Unit, AMU, Aligarh, Uttar Pradesh, India
| | - Fnk Yusufi
- Department of Statistics and Operations, AMU, Aligarh, Uttar Pradesh, India
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Orlandi M, Muñoz Aguilera E, Marletta D, Petrie A, Suvan J, D'Aiuto F. Impact of the treatment of periodontitis on systemic health and quality of life: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:314-327. [PMID: 34791686 DOI: 10.1111/jcpe.13554] [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: 08/05/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022]
Abstract
AIM To investigate the effect of treatment of periodontitis on systemic health outcomes, pregnancy complications, and associated quality of life. MATERIALS AND METHODS Systematic electronic searches were conducted to identify randomized controlled trials with minimum 6-month follow-up and reporting on the outcomes of interest. Qualitative and quantitative analyses were performed as deemed suitable. RESULTS Meta-analyses confirmed reductions of high-sensitivity C-reactive protein (hs-CRP) [0.56 mg/L, 95% confidence interval (CI) (-0.88, -0.25), p < .001]; interleukin (IL)-6 [0.48 pg/ml, 95% CI (-0.88, -0.08), p = .020], and plasma glucose [1.33 mmol/l, 95% CI (-2.41, -0.24), p = .016], and increase of flow-mediated dilation (FMD) [0.31%, 95% CI (0.07, 0.55), p = .012] and diastolic blood pressure [0.29 mmHg, 95% CI (0.10, 0.49), p = .003] 6 months after the treatment of periodontitis. A significant effect on preterm deliveries (<37 weeks) was observed [0.77 risk ratio, 95% CI (0.60, 0.98), p = .036]. Limited evidence was reported on quality-of-life (QoL) outcomes in the included studies. CONCLUSIONS Treatment of periodontitis results in systemic health improvements including improvement in cardiometabolic risk, reduction in systemic inflammation and the occurrence of preterm deliveries. Further research is however warranted to confirm whether these changes are sustained over time. Further, appropriate QoL outcomes should be included in the study designs of future clinical trials.
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Affiliation(s)
- Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | | | | | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - Jean Suvan
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
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Association between metabolic and hormonal profile, proinflammatory cytokines in saliva and gingival health in adolescent females with polycystic ovary syndrome. BMC Oral Health 2021; 21:193. [PMID: 33849511 PMCID: PMC8045362 DOI: 10.1186/s12903-021-01553-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
Background Research studies indicate that polycystic ovary syndrome (PCOS) may increase susceptibility to periodontal disease. The mechanisms that link both conditions are not entirely understood. Thus, the study aimed to investigate the impact of hormonal and metabolic disturbances on the gingival health and salivary levels of tumor necrosis factor (TNF-α), interleukin 1β (IL1-β), and interleukin 6 (IL-6) in adolescent girls with PCOS. Methods Thirty-one patients with PCOS and twenty-eight healthy age-mates (as the control group) were enrolled in the study. Individuals with PCOS underwent blood tests for the determination of hormonal and metabolic parameters. Saliva samples were collected to measure salivary testosterone and proinflammatory cytokines in both studied groups. Calibrated dentist assessed oral hygiene and gingival health of all subjects. Results Salivary testosterone was significantly higher in the study group (p = 0.0007). The groups did not differ significantly concerning periodontal parameters. Patients with PCOS revealed higher levels of salivary cytokines (p < 0.0001). Gingival index (GI) and the percentage of sites bleeding upon probing (BOP%) were positively correlated with the plaque index (PI) in both groups (rs ≥ 0.60, p < 0.001), and negatively correlated with salivary testosterone level in the PCOS group (rs = − 0.44, p = 0.0138 and rs = − 0.37, p = 0.0424, respectively). BOP% was also positively correlated with body mass index (BMI) in the control group (rs = 0.40, p = 0.0368) and index of insulin resistance (HOMA-IR) in the study group (rs = 0.48, p = 0.0068). Salivary testosterone was positively correlated with TNF-α in the control group (rs = 0.41, p = 0.0321), while in the study group, total testosterone (TT) was positively correlated with IL-6 (rs = 0.37, p = 0.0400) and free androgen index (FAI) with TNF-α (rs = 0.36, p = 0.0491). Conclusions Gingival health of the examined population was associated primarily with oral hygiene and, to a lesser extent, with the hormonal and metabolic profile. Despite similar periodontal parameters in the both studied groups, patients with PCOS revealed significantly higher levels of proinflammatory cytokines in saliva, which might be the manifestation of the systemic low-grade inflammation associated with PCOS.
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Machado V, Botelho J, Proença L, Mendes JJ. Comparisons of Periodontal Status between Females Referenced for Fertility Treatment and Fertile Counterparts: A Pilot Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5281. [PMID: 32707937 PMCID: PMC7432159 DOI: 10.3390/ijerph17155281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/20/2022]
Abstract
Studies investigating the periodontal status of women seeking fertility treatment have never been conducted. The purpose of this pilot study was to compare the periodontal status among females referenced to a Fertility Clinic (FC) when compared to matched females from a representative regional epidemiological sample. Our secondary aims were to investigate if periodontal clinical measures differ between these two groups of females and how they impact on oral health-related quality of life (OHRQoL). We enrolled 18 women from an FC and 18 age, race and body mass index matched controls from the epidemiological survey Study of Periodontal Health in Almada-Seixal (SoPHiAS). In each subject, we performed a circumferential periodontal inspection to infer the periodontal status and applied a questionnaire measuring OHRQoL. FC females presented higher levels of periodontal disease, with higher periodontal epithelial surface area, periodontal probing depth and clinical attachment loss. However, periodontal diseases did not impact OHRQoL in this particular group of women seeking fertility care, suggesting unawareness about periodontal diseases. Within the limitations of this study, females referenced for fertility treatment presented worse periodontal measures than females from a representative control sample. These preliminary results may support future prospective studies to further explore the periodontal status and possible consequences in women seeking fertility care.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal;
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - José João Mendes
- Clinical Research Unit (CRU), CiiEM, IUEM, 2829-511 Almada, Portugal;
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Machado V, Escalda C, Proença L, Mendes JJ, Botelho J. Is There a Bidirectional Association between Polycystic Ovarian Syndrome and Periodontitis? A Systematic Review and Meta-analysis. J Clin Med 2020; 9:jcm9061961. [PMID: 32585861 PMCID: PMC7355910 DOI: 10.3390/jcm9061961] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) has reproductive and metabolic properties that may be linked to periodontitis (PD). This study aimed to update and render a robust critical assessment on all evidence linking PCOS and PD, and appraising a hypothetical bidirectional association. Five databases (PubMed, Scholar, EMBASE, Web of Science and CENTRAL) were searched up to May 2020. Case-control and cohort studies on the association of PCOS and PD were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses of standardized mean difference (SMD) and risk ratio (RR) were performed. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Twelve case-controls fulfilled the inclusion criteria (876 with PCOS and 48170 healthy controls), all scored as having a low risk of bias. Meta-analysis revealed that PCOS females have 28% more risk towards PD, and PD females have 46% more risk to have PCOS. PCOS females with PD had higher gum bleeding, periodontal pocket depth and clinical attachment loss than non-PCOS females with PD. Populations with undefined periodontal status contribute to underestimated results. On the basis of the available evidence, it is possible to assume a bidirectional link between PCOS and PD. That is, PCOS increases by 28% the risk of having PD and in the same fashion, PD increases by 46% the risk of having PCOS. Furthermore, women with PCOS were associated with worsening clinical characteristics and inflammation of PD. These findings suggest that PCOS and PD may be linked. Hence, further prospective and clinical trial studies with nonsurgical periodontal therapy are necessary to clarify the existence of an increased risk of PCOS in women with PD and vice-versa.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
- Correspondence:
| | - Cláudia Escalda
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (C.E.); (J.J.M.); (J.B.)
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10
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Association between Periodontal Diseases and Polycystic Ovary Syndrome: A Systematic Review. J Clin Med 2020; 9:jcm9051586. [PMID: 32456146 PMCID: PMC7290429 DOI: 10.3390/jcm9051586] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023] Open
Abstract
Background: A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Therefore, the aim of this study was to evaluate the association between periodontal disease—gingivitis and CP—and PCOS. Materials and Methods: The PICO (Participants, Intervention, Control, and Outcomes) question was as follows: “Is there an association between PCOS and CP?” A systematic review of three databases—PubMed, Embase and Scopus—was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Original studies in human cohorts carried out in the last 10 years and including a control group were eligible for inclusion. Letters to the editor, case reports, and reviews were not considered. Results: Ten articles met all the selection criteria and provided a positive answer to the PICO question. Our review of these articles revealed an association between CP and PCOS, since periodontal parameters were altered more frequently in patients with these conditions than in healthy young women. This altered periodontal response in PCOS was associated with a proinflammatory status that seemed to increase susceptibility to periodontal disease. Conclusion: Patients with PCOS appear to be more susceptible to developing periodontal diseases than women without the pathology.
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Sanz M, Marco del Castillo A, Jepsen S, Gonzalez‐Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel J, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol 2020; 47:268-288. [PMID: 32011025 PMCID: PMC7027895 DOI: 10.1111/jcpe.13189] [Citation(s) in RCA: 612] [Impact Index Per Article: 153.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. MATERIAL AND METHODS There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of BonnBonnGermany
| | - Jose R. Gonzalez‐Juanatey
- Cardiology DepartmentUniversity HospitalIDISCIBERCVUniverity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Francesco D’Aiuto
- Department of PeriodontologyEastman Dental Institute and HospitalUniversity College LondonLondonUK
| | - Philippe Bouchard
- U.F.R. d'odontologieUniversité Paris DiderotHôpital Rothschild AP‐HPParisFrance
| | - Iain Chapple
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Thomas Dietrich
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Israel Gotsman
- Heart InstituteHadassah University HospitalJerusalemIsrael
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
| | - David Herrera
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Phoebus Madianos
- Department of PeriodontologySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Jean‐Baptiste Michel
- Inserm Unit 1148Laboratory for Translational CV ScienceX. Bichat HospitalParisFrance
| | - Pablo Perel
- World Heart FederationGenevaSwitzerland
- Centre for Global Chronic ConditionsLondon School of Hygiene & Tropical MedicineLondonUK
| | - Burkert Pieske
- Department of Internal Medicin & CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- DZHK (German Center for Cardiovascular Research) Partnersite BerlinGerman Heart Institut BerlinBerlinGermany
| | - Lior Shapira
- Department of PeriodontologyHebrew University – Hadassah Faculty of Dental MedicineJerusalemIsrael
| | - Michael Shechter
- Leviev Heart CenterChaim Sheba Medical Centertel Hashomer and the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv‐YafoIsrael
| | - Maurizio Tonetti
- Department of PeriodontologyPrince Philip Dental HospitalThe University of Hong KongHong KongHong Kong
| | | | - Gernot Wimmer
- Department of Prosthetic DentistrySchool of Dental MedicineKarl‐Franzens University GrazGrazAustria
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12
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Cagetti MG, Wolf TG, Tennert C, Camoni N, Lingström P, Campus G. The Role of Vitamins in Oral Health. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030938. [PMID: 32028631 PMCID: PMC7037089 DOI: 10.3390/ijerph17030938] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 12/31/2022]
Abstract
The association between vitamins and oral health have recently been discussed, yielding increased attention from medical and dental perspectives. The present review aimed to systematically evaluate and appraise the most recently scientific papers investigating the role of vitamins in the prevention and treatment of the main oral diseases as hard dental pathological processes and gum/periodontal disease. Randomized controlled trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, reporting associations between vitamins and oral diseases or the use of vitamins to prevent or treat oral diseases in patients of any age were included. PubMed, Embase and Scopus were searched to November 2019 using an ad hoc prepared search string. All the papers meeting the inclusion criteria were subjected to a quality assessment. The search identified 1597 papers; 741 were selected after removing duplicates. A total of 334 articles were excluded after title and abstract evaluation; 407 were assessed and 73 papers were full-text assessed; other 14 papers were discharged after full text evaluation, leaving finally 58 papers included. In general, there is weak evidence supporting the association between vitamins and both gingival/periodontal disease and hard dental pathological processes.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Science, University of Milan, IT-20142 Milan, Italy; (M.G.C.); (N.C.)
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Paediatric Dentistry, University of Bern, CH-3010 Bern, Switzerland; (C.T.); (G.C.)
- Correspondence: ; Tel.: +41-(0)31-664098
| | - Christian Tennert
- Department of Restorative, Preventive and Paediatric Dentistry, University of Bern, CH-3010 Bern, Switzerland; (C.T.); (G.C.)
| | - Nicole Camoni
- Department of Biomedical, Surgical and Dental Science, University of Milan, IT-20142 Milan, Italy; (M.G.C.); (N.C.)
| | - Peter Lingström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-41390 Gothenburg, Sweden;
| | - Guglielmo Campus
- Department of Restorative, Preventive and Paediatric Dentistry, University of Bern, CH-3010 Bern, Switzerland; (C.T.); (G.C.)
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, IT-07100 Sassari, Italy
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13
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Sanz M, del Castillo AM, Jepsen S, Gonzalez-Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and Cardiovascular Diseases. Consensus Report. Glob Heart 2020; 15:1. [PMID: 32489774 PMCID: PMC7218770 DOI: 10.5334/gh.400] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. Material and Methods There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations. Results and Conclusions The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- M. Sanz
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | | | - S. Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, DE
| | - J. R. Gonzalez-Juanatey
- Cardiology Department, University Hospital, University of Santiago de Compostela, IDIS, CIBERCV, ES
| | - F. D’Aiuto
- Department of Periodontology, Eastman Dental Institute and Hospital, University College London, London, UK
| | - P. Bouchard
- U.F.R. d’odontologie, Université Paris Diderot, Hôpital Rothschild AP-HP, Paris, FR
| | - I. Chapple
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - T. Dietrich
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
| | - I. Gotsman
- Heart Institute, Hadassah University Hospital, Jerusalem, IL
| | - F. Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, IT
| | - D. Herrera
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, Madrid, ES
| | - B. Loos
- ACTA University, Amsterdam, NL
| | - P. Madianos
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, GR
| | - J. B. Michel
- Inserm Unit 1148, laboratory for translational CV science, X. Bichat hospital, Paris, FR
| | - P. Perel
- World Heart Federation, Geneva, CH
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, UK
| | - B. Pieske
- Charité Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Berlin, DE
- DZHK (German Center for Cardiovascular Research) Partnersite Berlin, German Heart Institut Berlin, DE
| | - L. Shapira
- Department of Periodontology, Hebrew University – Hadassah Faculty of Dental Medicine, Jerusalem, IL
| | - M. Shechter
- Leviev Heart Center, Chaim Sheba Medical Center, tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, IL
| | - M. Tonetti
- Department of Periodontology, The University of Hong Kong, Prince Philip Dental Hospital, HK
| | - C. Vlachopoulos
- Department of Cardiology, National and Kapodistrian University of Athens, GR
| | - G. Wimmer
- Department of Prosthetic Dentistry, School of Dental Medicine, Karl-Franzens University Graz, AT
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Tong C, Wang YH, Yu HC, Chang YC. Increased Risk of Polycystic Ovary Syndrome in Taiwanese Women with Chronic Periodontitis: A Nationwide Population-Based Retrospective Cohort Study. J Womens Health (Larchmt) 2019; 28:1436-1441. [PMID: 31145020 DOI: 10.1089/jwh.2018.7648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Both hormonal and inflammatory influences are assumed to affect periodontal tissues. Previous studies have shown that PCOS patients could have higher prevalence of gingival inflammation. However, the relationship between PCOS and chronic periodontitis (CP) is not clear. Materials and Methods: In this study, we evaluated the risk of PCOS from CP exposure in a nationwide population-based retrospective cohort study in Taiwan. We studied the claims data of Taiwanese population from 2001 to 2012. The 24,410 female patients with CP were identified from the National Health Insurance Database. The 24,410 controls were selected with randomly frequency matched by age, sex, and index year from the general population. The risk of PCOS was analyzed by Cox proportional hazards regression models, including sex, age, and comorbidities. Results: In this study, 24,410 female patients with CP (mean age: 35.14 ± 8.81 years) and 24,410 controls (mean age: 35.14 ± 8.8 years) were observed for 8.89 and 8.85 years, respectively. A total of 441 cases of PCOS were identified in CP cohort and 304 cases in non-CP cohort. Multivariate Cox regression analysis indicated that the incidence rate of PCOS was significantly higher in CP cohort than those in non-CP cohort (adjusted hazard ratio: 1.44, 95% confidence interval: 1.24-1.67). Conclusions: Taken together, this nationwide retrospective cohort study demonstrated that the risk of PCOS was significantly higher in female patients with CP than those without CP in Taiwan.
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Affiliation(s)
- Ching Tong
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Division of Endodontics and Periodontology, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
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15
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Influence of polycystic ovary syndrome on the periodontal health of Indian women visiting a secondary health care centre. Clin Oral Investig 2018; 23:3249-3255. [PMID: 30430337 DOI: 10.1007/s00784-018-2741-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Periodontal disease and polycystic ovary syndrome (PCOS) share risk factors like obesity, insulin resistance, and dyslipidemia, along with evidence of chronic inflammation in the two conditions. Evaluating the influence of PCOS on periodontal health would, therefore, identify a possible association. MATERIALS AND METHODS Sixty women, divided into equal groups of PCOS and healthy patients, were clinically examined for periodontal parameters like probing depth (PD), plaque index (PI), modified gingival index (mGI), and bleeding on probing (BOP). Fasting blood sugar (FBS), insulin (FI), triglycerides (TG), and free testosterone along with serum and gingival crevicular fluid (GCF) levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were the biochemical parameters evaluated. RESULTS Women with PCOS had statistically significant differences in mGI, PI, testosterone, FBS, and TG when compared with healthy women (p < 0.05). MDA levels in serum and GCF between women with PCOS and controls were also significantly different. BOP and mGI showed a moderate positive correlation (r = 0.45 and 0.44) with serum levels of MDA. Relatively greater gingival inflammation was observed in patients with PCOS compared to healthy controls, independent of the risk factors present. CONCLUSION PCOS seemed to have an impact on gingival inflammation, in addition to the effect of dental plaque and other local factors in the oral cavity, in PCOS patients when compared with healthy individuals. CLINICAL RELEVANCE Women diagnosed with PCOS may have probabaility of co-existing gingival inflammation. Therefore, emphasis on medical treatment for PCOS and periodic screening for periodontal disease may be warranted.
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