Associations of periodontal damage and tooth loss with atherogenic factors among patients with type 2 diabetes mellitus

Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index

To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as 'GLUCAR = (Fasting Glucose × CRP/Albumin Ratio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR ˂ 1.8 (N = 78) and GLUCAR ≥ 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR ≥ 31.8 (84.4% vs. 47.4% for GLUCAR ˂ 31.8; odds ratio (OR):1.82; p < 0.001). In the univariate analysis, the mean mandibular dose ≥ 38.5 Gy group (76.5% vs. 54.9% for <38.5 Gy; OR: 1.45; p = 0.008), mandibular V55.2 Gy group ≥ 40.5% (80.3 vs. 63.5 for <40.5%, p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis (p < 0.05 for each). Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment.

Association between type 2 diabetes (T2D) and tooth loss: a systematic review and meta-analysis

BACKGROUND

Several studies have assessed the relationship between type 2 diabetes (T2D) and tooth loss; however, results have been inconsistent. Therefore, the present systematic review and meta-analysis of observational studies was designed to examine the association between T2D and tooth loss.

METHODS

This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. We searched all the relevant studies in international databases of Scopus, PubMed, ProQuest, Web of Science, Cochrane Library, and Google scholar search engine until February 2022. The heterogeneity of the studies was calculated using the I2 index. Measure of effect and 95% confidence interval (CI) were extracted from each study. The results of the study were analyzed using the random effects model.

RESULTS

In the present study, 22 eligible studies were included. Meta-analysis of unadjusted and adjusted results showed that T2D significantly increased the risk of tooth loss, and Odds Ratio (OR) unadjusted was 1.87 (95% CI: 1.62-2.13, p < 0.001), and OR adjusted was 1.20 (95% CI: 1.10-1.30, p < 0.001), respectively. Subgroup analysis based on study design for adjusted OR indicated that in the cohort study (OR: 1.29, 95% CI: 1.07-1.51), in the cross-sectional study (OR: 1.15, 95% CI: 1.06-1.23), and in the case-control study (OR: 5.10, 95% CI: 1.01-9.18) there was a significant association between T2D and tooth loss. Other subgroups analyses showed consistent results and no publication bias existed.

CONCLUSIONS

The findings suggest that T2D is associated with increased risk of tooth loss. This conclusion may provide useful evidence for correlated clinical researches.

Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review

OBJECTIVE

This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults.

BACKGROUND

Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status.

MATERIAL AND METHODS

Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements.

RESULTS

Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.

CONCLUSIONS/PRACTICAL IMPLICATIONS

This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.

SUMO1 modification of IGF-1R combining with SNAI2 inhibited osteogenic differentiation of PDLSCs stimulated by high glucose

Background

Periodontal disease, an oral disease characterized by loss of alveolar bone and progressive teeth loss, is the sixth major complication of diabetes. It is spreading worldwide as it is difficult to be cured. The insulin-like growth factor 1 receptor (IGF-1R) plays an important role in regulating functional impairment associated with diabetes. However, it is unclear whether IGF-1R expression in periodontal tissue is related to alveolar bone destruction in diabetic patients. SUMO modification has been reported in various diseases and is associated with an increasing number of biological processes, but previous studies have not focused on diabetic periodontitis. This study aimed to explore the role of IGF-1R in osteogenic differentiation of periodontal ligament stem cells (PDLSCs) in high glucose and control the multiple downstream damage signal factors.

Methods

PDLSCs were isolated and cultured after extraction of impacted teeth from healthy donors or subtractive orthodontic extraction in adolescents. PDLSCs were cultured in the osteogenic medium with different glucose concentrations prepared by medical 5% sterile glucose solution. The effects of different glucose concentrations on the osteogenic differentiation ability of PDLSCs were studied at the genetic and cellular levels by staining assay, Western Blot, RT-PCR, Co-IP and cytofluorescence.

Results

We found that SNAI2, RUNX2 expression decreased in PDLSCs cultured in high glucose osteogenic medium compared with that in normal glucose osteogenic medium, which were osteogenesis-related marker. In addition, the IGF-1R expression, sumoylation of IGF-1R and osteogenic differentiation in PDLSCs cultured in high glucose osteogenic medium were not consistent with those cultured in normal glucose osteogenic medium. However, osteogenic differentiation of PDLCSs enhanced after adding IGF-1R inhibitors to high glucose osteogenic medium.

Conclusion

Our data demonstrated that SUMO1 modification of IGF-1R inhibited osteogenic differentiation of PDLSCs by binding to SNAI2 in high glucose environment, a key factor leading to alveolar bone loss in diabetic patients. Thus we could maximize the control of multiple downstream damage signaling factors and bring new hope for alveolar bone regeneration in diabetic patients.

Predictors of periodontal disease among rural Indian type 2 diabetic population

BACKGROUND

Periodontal Disease (PD) is associated with complications of diabetes. Control of the PD reduces glycated hemoglobin (HbA1c) level. This study aimed to evaluate the relationship of PD with duration, severity of diabetes and eGFR.

MATERIAL AND METHOD

A Prospective observational study conducted at Sidhi Vinayaka Hospitals (SVH) Sangareddy during the period of January 2014 to December 2019. Total 1436 patients with a definite diagnosis of type 2 diabetes (T2DM), between the ages of 45-60 years were included. They were classified according to CPITN score for PD and compared against the variables.

RESULTS

A total of 1436 consecutive outpatients attending to SVH were included. Among them 662 (46.1%) were males and 774(53.9%) were females. The mean age of the patients was 48.3(SD ± 10.62) and mean duration of diabetes was 2.9(SD ± 4.18). The mean fasting blood glucose was 198.5(SD ± 85), mean post prandial blood glucose was 277.2 (SD ± 107.7) and mean HBA1c was 9.98% (SD ± 2.6). Among the study group 1198 (83.4%) had none/mild (Grade I) PD, 192(13.4%) had moderate/severe (Grade II) PD and 46(3.2%) were completely edentulous (Grade III).

CONCLUSION

There is a linear correlation between PD and age of patient, duration of diabetes, eGFR and level of glycemic status among rural population with T2DM.

Association between Oral Health Status and Diabetic Nephropathy-Related Indices in Japanese Middle-Aged Men

Oral health status is known to be associated with lifestyle-related diseases such as diabetes and chronic kidney disease. In Japan, around 40% of hemodialysis cases are patients with diabetic nephropathy. The aim of this study was to clarify the association between oral health status and diabetic nephropathy-related indices in Japanese middle-aged men. Sixty-six men (age range: 55-64 years) with ≥20 remaining teeth and who received public medical checkups and oral examinations were enrolled. We examined correlations of age, body mass index, HbA1c, HDL-C, LDL-C, neutral fat, serum creatinine, and the estimated glomerular filtration rate (eGFR) with the number of remaining teeth or the community periodontal index (CPI) score (periodontal pocket < 4 mm: 0, 4-6 mm: 1, ≥6 mm: 2). A positive correlation between the CPI score and serum creatinine and a negative correlation between CPI score and eGFR (Spearman's rank correlation coefficient, r = 0.459, p < 0.01, and r = -0.460, p < 0.01, respectively) were observed. The mean eGFR in the CPI score 0 group was significantly higher than that in the CPI score 1/2 group (82.6 vs. 70.7, Student's t-test, p < 0.01). Logistic regression analysis using eGFR as a dependent variable and age, CPI score, body mass index, HbA1c, and neutral fat as independent variables suggested that low eGFR (<60) could be attributed to CPI score (OR = 3.169, 95% CI: 1.031-9.742, p = 0.044). These results suggest a possible association between periodontal status and renal function in Japanese middle-aged men. Periodontal condition is controlled by oral prophylaxis, and periodontal disease and chronic kidney disease have some common risk factors. Thus, periodontal management can contribute to the prevention of severe chronic kidney disease.

A comparison of the periodontal status in patients with type 2 diabetes based on glycated haemoglobin levels and other risk factors

PURPOSE

The aim of this study was to compare the periodontal status in patients with type 2 diabetes based on glycated haemoglobin levels and other risk factors.

MATERIAL/METHODS

75 patients with DM2 were grouped according to glycemic control: 40 subjects with HbA1c<7.0% and 35 subjects with HbA1c≥7.0%. We performed measurements of HbA1c, C-reactive protein (CRP), Approximal Plaque Index (API), Gingival Severity Index (GSI), tooth mobility (TM) as well as periodontal parameters such as probing depth (PD) and clinical attachment level (CAL). Age, gender and duration of the disease were analyzed too.

RESULTS

No significant differences in PD, CAL, API, GSI and TM were found between the analyzed groups. HbA1c positively correlated with CRP (p=0.046) and the duration of DM2 (p=0.012) but not with the periodontal parameters. Patients' age was positively correlated with both the duration of DM2 (p=0.002) and CAL (p=0.034). Regardless of HbA1c, men had significantly worse periodontal parameters compared to women (respectively: PD 2.73mm vs. 2.18mm, p=0.01; CAL 3.84mm vs. 2.54mm, p=0.005; proportion of deep pockets 9.06% vs. 2.97%, p=0.01; proportion of teeth with grade 2 mobility 9.14% vs. 2.8%, p=0.02).

CONCLUSIONS

The selected group of patients attending the Diabetes Outpatient Clinic showed a similar periodontal status with regard to glycated haemoglobin levels and other risk factors except gender. Male gender turned out to be a significant risk factor for periodontal disease in patients with type 2 diabetes mellitus.

Associations between the number of natural teeth and metabolic syndrome in adults

AIM

To explore associations between the number of natural teeth and metabolic syndrome in adults.

MATERIAL AND METHODS

Cross-sectional data from the National Health and Nutrition Examination Survey 2005-2008 were used. Eligible adults (n = 5511) were classified into four groups by their number of natural teeth (excluding third molars): full dentition, 21-27 teeth, 1-20 teeth, or edentulous. Metabolic syndrome was defined by diagnostic guidelines from the American Heart Association and National Heart, Lung, and Blood Institute. Associations were analysed by survey logistic regression. Biometric and metabolic parameters in different dentition groups were compared.

RESULTS

Adjusting for age, gender, race/ethnicity, ratio of family income to poverty, physical activity, smoking, and energy intake, tooth loss was significantly associated with metabolic syndrome (p = 0.002). Compared to participants with full dentition, the odds were 32% higher in those with 21-27 teeth, 55% higher in those with 1-20 teeth and 79% higher in edentulous participants. The number of natural teeth was inversely associated with body mass index, waist circumference, blood pressure, fasting plasma glucose and insulin concentrations (p < 0.01 for all); it was positively associated with serum HDL cholesterol concentration (p = 0.003).

CONCLUSIONS

The number of natural teeth is inversely associated with the presence of metabolic syndrome in adults.

Relationship between Type 2 Diabetic Retinopathy and Periodontal Disease in Iranian Adults

Background:

Periodontal disease in diabetic patients can compromise a patient's ability to maintain a proper metabolic control and may be associated with diabetic complication.

Aims:

This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR).

Materials and Methods:

A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR.

Results:

In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P < 0.001) and more severe periodontal disease (P < 0.001) than no retinopathy. Also, our results indicated a relationship between type 2 DM and periodontal disease.

Conclusions:

The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility.

Association between type 1 diabetes and periodontal health

PURPOSE

We assessed periodontal status in patients with type 1 diabetes and healthy individuals in relation to their glycemic control, smoking and inflammatory biomarkers.

MATERIAL/METHODS

Periodontal status was examined in 107 patients with diabetes and 40 controls, using Oral Hygiene Index (OHI), Community Periodontal Index (CPI) and tooth number. CPI values of 0-2 and 3-4 were classified as non-periodontitis and periodontitis, respectively. Blood samples were analyzed for glucose, HbA1c, CRP, fibrinogen, interleukin-1 and tumor necrosis factor-alpha (TNF-α).

RESULTS

Periodontitis was found in 15.0% of the controls and 57.9% of diabetic patients, including 40.0% of these with good metabolic control (GMC) and 59.5% of those with poor metabolic control (PMC). Severe periodontitis was more frequent in the PMC than in the GMC group and in the controls (26.0% vs. 20.0% vs. 5.0%). The PMC patients had lower number of sextants with CPI 0 and higher number of sextants with CPI 3 and CPI 4 as well as lower tooth number in comparison with the controls. The patients with periodontitis had higher TNF-α (p<0.001) and OHI (p<0.001) than the patients without periodontitis. The number of sextants with CPI 0 correlated negatively with fibrinogen and TNF-α levels, whereas the number of sextants with CPI 3 correlated positively with TNF-α and fasting glucose level.

CONCLUSIONS

There is good evidence that type 1 diabetes increases the risk of periodontal disease. Our results suggest that poor metabolic control of diabetes together with smoking and inadequate oral hygiene increase the risk of severe periodontal destruction in patients with type 1 diabetes.

Epidemiology and risk factors of tooth loss among Iranian adults: findings from a large community-based study

Objectives. To investigate the prevalence of tooth loss and different prosthetic rehabilitations among Iranian adults, as well as the potential determinants of tooth loss. Methods. In a cross-sectional community-based study conducted among 8094 Iranian adults living in Isfahan province, a self-administered questionnaire was used to assess epidemiologic features of tooth loss. Results. Thirty-two percent of subjects had all their teeth, 58.6% had lost less than 6, and 7.2% of participants had lost more than 6 teeth. One hundred and sixty-nine individuals (2.2%) were edentulous. Among participants, 2.3% had single jaw removable partial denture, 3.6% had complete removable denture in both jaws, and 4.6% had fixed prosthesis. Others reported no prosthetic rehabilitation (89.5%). In the age subgroup analysis (≤35 and >35 years old) tooth loss was more prevalent among men than women (OR = 2.8 and 1.9, resp., P < 0.01). Also, in both age groups, current and former smokers had higher levels of tooth loss than nonsmokers (P < 0.001 and P < 0.05, resp.). In addition, tooth loss was positively related to metabolic abnormality for age group >35 years (adjusted OR = 1.29, P < 0.01). Conclusions. Tooth loss is highly prevalent in Iranian adult population. Community programs promoting oral health for prevention of tooth loss should be considered taking into account its major determinants including lower educational level, male gender, smoking, and metabolic abnormality.

Sociodemographic and health-related risk factors associated with tooth loss among adults in Rhode Island

Introduction

Oral health is an integral component of overall health and well-being. Very little Rhode Island state-level information exists on the determinants of tooth loss. The objective of this study was to systematically identify sociodemographic characteristics, health behaviors, health conditions and disabilities, and dental insurance coverage associated with tooth loss among noninstitutionalized adults in Rhode Island.

Methods

We analyzed Rhode Island’s 2008 and 2010 Behavioral Risk Factor Surveillance System survey data in 2011. The survey had 4 response categories for tooth loss: none, 1 to 5, 6 or more but not all, and all. We used multinomial logistic regression models to assess the relationship between 4 risk factor domains and tooth loss.

Results

An estimated 57.6% of Rhode Island adults had all their teeth, 28.9% had 1 to 5 missing teeth, 8.9% had 6 to 31 missing teeth, and 4.6% were edentulous. Respondents who had low income, low education, unhealthy behaviors (ie, were former or current smokers and did not engage in physical activity), chronic conditions (ie, diabetes and obesity) or disabilities, and no dental insurance coverage were more likely to have fewer teeth compared with their referent groups. However, the association of these variables with tooth loss was not uniform by age group.

Conclusion

Adults who report risky health behaviors or impaired health may be considered target subpopulations for prevention of tooth loss and promotion of good oral health.

Association between self-reported oral health, tooth loss and atherosclerotic burden

Previous studies have suggested that oral diseases may influence the development of atherosclerosis. The aim of this study was to test the hypothesis that poor self-reported oral health (SROH) and tooth loss are positively associated with coronary atherosclerotic burden (CAB). 382 consecutive subjects undergoing coronary angiography were included. Socio-demographic characteristics, cardiovascular risk factors and oral health status were collected using a standardized questionnaire, including data on SROH and use of dental prosthesis. Number of teeth and anthropometric measures were collected through clinical examinations. CAB at coronary angiography was quantified using the Friesinger score (FS). Prevalence ratios (PR) were calculated with Poisson regression analyses. Mean age was 60.3 ± 10.8 years, with 63.2% males. In the bivariate analysis, there was a significant association (p < 0.05) between CAB and age (> 60y) (PR = 1.01, 95%CI = 1.02-1.16), male gender (PR = 1.11, 95%CI = 1.03-1.19), smoking (PR = 1.08, 95%CI = 1.01- 1.16), hypertension (PR = 1.12, 95%CI = 1.03-1.22), diabetes (PR = 1.17, 95%CI = 1.05-1.21), poor SROH (PR = 1.22, 95%CI = 1.02-1.46) and tooth loss (< 20 teeth present) (PR = 1.10, 95%CI = 1.02-1.19). The use of dental prosthesis was not associated with CAB. The multivariate models, adjusted for age, gender, smoking, hypertension, diabetes and dyslipidemia showed that poor SROH (p = 0.03) and tooth loss (p = 0.02) were independently associated with CAB, confirming the study hypothesis.

No more fighting and biting during mouth care: applying the theoretical constructs of threat perception to clinical practice

The purpose of this article is to describe how the neurobiological principles of threat perception and fear response can support clinical approaches to prevent and reduce care-resistant behaviors during mouth care. Nursing home residents who exhibit care-resistant behavior are at risk for poor oral health because daily oral hygiene may not be consistently provided. Poor oral health predisposes these older people to systemic problems such as pneumonia, cerebral vascular accidents, and hyperglycemia. Care-resistant behavior is a fear-evoked response to nurses' unintentionally threatening behavior during mouth care. Nurses can safely and effectively provide mouth care to persons with dementia who resist care by using personalized combinations of 15 threat reduction strategies.

Periodontitis prevalence and severity in Indonesians with type 2 diabetes

BACKGROUND

The prevalence of diabetes mellitus type 2 (DM2) in Indonesia is high and still rising. Periodontitis is associated with DM2. No study has investigated this association in Indonesia, nor has any study investigated this association using a variety of methods to operationalize periodontitis. The present study compares prevalence and severity of periodontitis in patients with DM2 to healthy controls, using different methods to operationalize periodontitis.

METHODS

A total of 78 subjects with DM2 and 65 healthy control subjects underwent a full-mouth periodontal screening assessing probing depth, gingival recession, plaque index, and bleeding on probing. Using these measurements, the prevalence and severity of periodontitis was operationalized in various ways. Differences in the prevalence and severity of periodontitis between subjects with DM2 and healthy subjects were analyzed using univariate analyses. In regression analyses, the prevalence and severity of periodontitis were predicted on the basis of DM2 presence, controlling for confounders and effect modification.

RESULTS

Prevalence of periodontitis was significantly higher in subjects with DM2 compared to healthy subjects, showing odds ratios of 5.0 and 6.1. Likewise, periodontitis severity was significantly higher in subjects with DM2.

CONCLUSION

Indonesian subjects with DM2 had more prevalent and more severe periodontitis than healthy Indonesian subjects, independent of confounding factors or the methods used to operationalize periodontitis.

Association between chronic periodontal disease and obesity: a systematic review and meta-analysis

BACKGROUND

Obesity is increasing in prevalence and is a major contributor to worldwide morbidity. One consequence of obesity might be an increased risk for periodontal disease, although periodontal inflammation might, in turn, exacerbate the metabolic syndrome, of which obesity is one component. This review aims to systematically compile the evidence of an obesity-periodontal disease relationship from epidemiologic studies and to derive a quantitative summary of the association between these disease states.

METHODS

Systematic searches of the MEDLINE, SCOPUS, BIOSIS, LILACS, Cochrane Library, and Brazilian Bibliography of Dentistry databases were conducted with the results and characteristics of relevant studies abstracted to standardized forms. A meta-analysis was performed to obtain a summary measure of association.

RESULTS

The electronic search identified 554 unique citations, and 70 studies met a priori inclusion criteria, representing 57 independent populations. Nearly all studies matching inclusion criteria were cross-sectional in design with the results of 41 studies suggesting a positive association. The fixed-effects summary odds ratio was 1.35 (Shore-corrected 95% confidence interval: 1.23 to 1.47), with some evidence of a stronger association found among younger adults, women, and non-smokers. Additional summary estimates suggested a greater mean clinical attachment loss among obese individuals, a higher mean body mass index (BMI) among periodontal patients, and a trend of increasing odds of prevalent periodontal disease with increasing BMI. Although these results are highly unlikely to be chance findings, unmeasured confounding had a credible but unknown influence on these estimates.

CONCLUSIONS

This positive association was consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease. However, with few quality longitudinal studies, there is an inability to distinguish the temporal ordering of events, thus limiting the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain. In clinical practice, a higher prevalence of periodontal disease should be expected among obese adults.

The association of metabolic syndrome with periodontal disease is confounded by age and smoking in a Korean population: the Shiwha-Banwol Environmental Health Study

AIM

Because metabolic syndrome (MS) is pro-inflammatory and periodontitis is inflammatory, we issued the hypothesis that MS (the explanatory variable) is associated with periodontitis (the outcome variable). This study aimed to examine the link between MS and periodontitis among Koreans.

MATERIALS AND METHODS

From the Shiwha-Banwol Environmental Health Study, 1046 subjects aged 18 years or older were cross-sectionally surveyed. All participants underwent comprehensive dental and medical health examinations. The community periodontal index was used to assess periodontitis. Age, gender, monthly family income, smoking, drinking, frequency of daily teeth brushing, and physical activity were evaluated as confounders.

RESULTS

MS was strongly associated with periodontitis [odds ratio (OR): 1.7, 95% confidence interval (CI): 1.22-2.37], and MS with more components had a higher association. The association was higher for elders aged 65 years or more, males, and smokers. MS including both high glucose and hypertension had a higher association with the OR of 2.19 (95% CI: 1.23-3.90) comparing with other types of MS.

CONCLUSIONS

Our results suggested that MS might be associated with periodontitis and the association was confounded by age, gender, and smoking. MS with high glucose and hypertension showed the higher impact on this link.

Metabolic syndrome and periodontitis: is oxidative stress a common link?

A review of pathological mechanisms that can explain the relationship between periodontitis and cardiovascular disease (CVD) is necessary to improve the management of both conditions. Metabolic syndrome is a combination of obesity, hypertension, impaired glucose tolerance or diabetes, hyperinsulinemia, and dyslipidemia. All these have been examined in recent years in terms of their relationship to periodontitis. Reviewed data indicate an association between some of them (body mass index, high-density lipoprotein-cholesterol [HDL-C], triglycerides, high blood pressure, among others) and periodontitis. Oxidative stress may act as a potential common link to explain relationships between each component of metabolic syndrome and periodontitis. Both conditions show increased serum levels of products derived from oxidative damage, with a pro-inflammatory state likely influencing each other bidirectionally. Adipocytokines might modulate the oxidant/anti-oxidant balance in this relationship.