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Gao C, Iles M, Larvin H, Bishop DT, Bunce D, Ide M, Sun F, Pavitt S, Wu J, Kang J. Genome-wide association studies on periodontitis: A systematic review. PLoS One 2024; 19:e0306983. [PMID: 39240858 DOI: 10.1371/journal.pone.0306983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/26/2024] [Indexed: 09/08/2024] Open
Abstract
OBJECTIVES This study aims to systematically review the existing literature and critically appraise the evidence of genome-wide association studies (GWAS) on periodontitis. This study also aims to synthesise the findings of genetic risk variants of periodontitis from included GWAS. METHODS A systematic search was conducted on PubMed, GWAS Catalog, MEDLINE, GLOBAL HEALTH and EMBASE via Ovid for GWAS on periodontitis. Only studies exploring single-nucleotide polymorphisms(SNPs) associated with periodontitis were eligible for inclusion. The quality of the GWAS was assessed using the Q-genie tool. Information such as study population, ethnicity, genomic data source, phenotypic characteristics(definition of periodontitis), and GWAS methods(quality control, analysis stages) were extracted. SNPs that reached conventional or suggestive GWAS significance level(5e-8 or 5e-06) were extracted and synthesized. RESULTS A total of 15 good-quality GWAS on periodontitis were included (Q-genie scores ranged from 38-50). There were huge heterogeneities among studies. There were 11 identified risk SNPs (rs242016, rs242014, rs10491972, rs242002, rs2978951, rs2738058, rs4284742, rs729876, rs149133391, rs1537415, rs12461706) at conventional GWAS significant level (p<5x10-8), and 41 at suggestive level (p<5x10-6), but no common SNPs were found between studies. Three SNPs (rs4284742 [G], rs11084095 [A], rs12461706 [T]) from three large studies were from the same gene region-SIGLEC5. CONCLUSION GWAS of periodontitis showed high heterogeneity of methodology used and provided limited SNPs statistics, making identifying reliable risk SNPs challenging. A clear guidance in dental research with requirement of expectation to make GWAS statistics available to other investigators are needed.
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Affiliation(s)
- Chenyi Gao
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Mark Iles
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Harriet Larvin
- Wolfson Institute of Population Health, Queen Mary, University of London, London, United Kingdom
| | - David Timothy Bishop
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - David Bunce
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Mark Ide
- Centre for Host Microbial Interactions, Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, United Kingdom
| | - Fanyiwen Sun
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Susan Pavitt
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Jianhua Wu
- Wolfson Institute of Population Health, Queen Mary, University of London, London, United Kingdom
| | - Jing Kang
- Oral Clinical Research Unit, Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, United Kingdom
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Gao C, Larvin H, Bishop DT, Bunce D, Pavitt S, Wu J, Kang J. Oral diseases are associated with cognitive function in adults over 60 years old. Oral Dis 2024; 30:3480-3488. [PMID: 37811600 DOI: 10.1111/odi.14757] [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: 04/19/2023] [Revised: 08/14/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To investigate the bidirectional association between oral diseases and cognitive function comprehensively. SUBJECTS AND METHODS This cross sectional study utilized data from the National Health and Nutrition Examination Survey. Oral diseases include periodontitis, dental caries, and tooth loss (end point of oral disease resulting in tooth extraction). Cognitive function included three domains: memory, processing speed, and executive function. A global cognitive score was then derived from sum of the three cognitive domains. Oral cognition associations were examined using various statistical models: (1) Regress oral disease on cognitive function; (2) Regress cognitive function on oral disease; and (3) Structural equation modelling treating cognition and oral disease as latent variables. RESULTS There were 2508 participants aged 60+ who had both oral and cognitive information. Associations between various oral disease and global cognitive score were observed (Odds ratio ORcog->periodontitis 0.95, 95% Confidence Interval [0.92, 0.99]; βcog->caries -0.13, [-0.23, -0.04]; βcog->tooth loss -0.03 [-0.04, -0.01]; βtooth loss->cog -0.04 [-0.06, -0.02]; βcaries->cog -0.03 [-0.06, -0.01]; βperiodontitis->cog -0.39 [-0.69, -0.10]). Significant correlation was also found between these oral disease and cognitive function using structural equation model (r -0.22, [-0.34, -0.10]). CONCLUSIONS This study found robust bidirectional associations between oral disease and cognitive function using various modelling approaches among the aging population.
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Affiliation(s)
- Chenyi Gao
- School of Dentistry, University of Leeds, Leeds, UK
| | - Harriet Larvin
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
| | - David Timothy Bishop
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
| | - David Bunce
- School of Psychology, University of Leeds, Leeds, UK
| | - Susan Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
| | - Jing Kang
- School of Dentistry, University of Leeds, Leeds, UK
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Keykha E, Khodadadifard L, Moosavi MS, Fathi Y, Hajisadeghi S. Proposed Mechanisms for the Relationship between Periodontal Diseases and the Severity of Covid-19: Common Pathogens, Inflammatory Mediators, and Risk Factors. Adv Biomed Res 2024; 13:28. [PMID: 39234437 PMCID: PMC11373721 DOI: 10.4103/abr.abr_116_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 09/06/2024] Open
Abstract
Periodontal disease (PD) is a chronic inflammatory disease with some cytokine involvement, associated with several risk factors such as diabetes, obesity, etc., Corona Virus Disease 2019 (COVID-19), a new viral infection, also appears to be related to cytokine storm and similar risk factors. In this review, we intend to evaluate the possible relationship between PD and COVID-19. For data collection, English literature was searched in databases including PubMed and Google Scholar. The keywords searched were COVID-19, SARS-CoV-2, PD, respiratory Impact of Oral pathogens on respiratory diseases: Epidemiological studies indicated that oral pathogens are related to acute and chronic lung disease, and dental plaque is a likely reservoir for respiratory pathogens. Viral presence in the periodontal pocket: SARS-CoV-2 may be released from infected periodontal cells into periodontal pockets. Common inflammatory mediators: Several studies showed that the serum levels of interleukins (IL)-1, 6, 17, etc., increase in most patients with severe COVID-19. C-reactive protein (CRP) and endothelin 1(ET-1) may also be related to COVID-19 progression, and these mediators also increase in periodontitis. Common risk factors: Due to studies, diabetes mellitus (DM), obesity, aging, and male sex are the most important risk factors common between PDs and COVID-19 and may affect treatment outcomes and prognosis. PD seems to play a significant role in exacerbating COVID-19 and even affects the mortality rate of disease.
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Affiliation(s)
- Elham Keykha
- Department of Oral and Maxillofacial Medicine, Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Leila Khodadadifard
- Department of Periodontology, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mahdieh-Sadat Moosavi
- Dental Research Center, Dentistry Research Institute, Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Fathi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Alborz University of Medical Sciences, Alborz, Iran
| | - Samira Hajisadeghi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Medicine, Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
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4
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Yun HR, Koh HB, Park JT, Han SH, Kang SW, Yoo TH, Ahn SS. Presence of periodontal disease and the incidence of inflammatory arthritides in the general population: data from the UK Biobank. Rheumatology (Oxford) 2024; 63:1084-1092. [PMID: 37436715 DOI: 10.1093/rheumatology/kead345] [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: 02/05/2023] [Revised: 06/11/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES To investigate the association between periodontal disease and the development of inflammatory arthritides in the general population. METHODS In total, 489 125 participants from the UK Biobank without a previous history of RA, AS and PsA were enrolled. The primary outcome was the incidence of inflammatory arthritides, which was a composite of RA, AS and PsA according to the presence of periodontal disease based on self-reported oral health indicators. Multivariate Cox proportional hazard regression analyses using four different models were performed to assess the association between periodontal disease and inflammatory arthritides development. RESULTS In all, 86 905 and 402 220 individuals were categorized as with and without periodontal disease, respectively. Cox hazard analysis indicated that the presence of periodontal disease was an independent predictor of the occurrence of composite outcomes of inflammatory arthritides, which was also consistent for RA and AS. Significant associations were found to be consistent in the four Cox models and were replicated even when different criteria were used to define periodontal disease. Subgroup analyses indicated that periodontal disease was associated with an increased RA risk in those aged <60 years, and this risk was persistent for both male and female patients and for patients with seropositive/seronegative RA. CONCLUSION Self-reported periodontal disease is associated with inflammatory arthritides incidence in participants included in the UK Biobank, particularly for RA and AS. Higher clinical attention and optimal dental care in patients with signs of periodontal disease may be recommended for early disease detection and for reducing this risk.
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Affiliation(s)
- Hae-Ryong Yun
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Byung Koh
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
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Zhang Z, Wen S, Liu J, Ouyang Y, Su Z, Chen D, Liang Z, Wang Y, Luo T, Jiang Q, Guo L. Advances in the relationship between periodontopathogens and respiratory diseases (Review). Mol Med Rep 2024; 29:42. [PMID: 38240101 PMCID: PMC10828996 DOI: 10.3892/mmr.2024.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/04/2023] [Indexed: 01/23/2024] Open
Abstract
Periodontitis is a common chronic inflammatory and destructive disease in the mouth and is considered to be associated with systemic diseases. Accumulating evidence has suggested that periodontitis is a risk factor for pulmonary diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, coronavirus disease 2019 (COVID‑19) and lung cancer. The presence of common periodontal pathogens has been detected in samples from a variety of pulmonary diseases. Periodontal pathogens can be involved in lung diseases by promoting the adhesion and invasion of respiratory pathogens, regulating the apoptosis of respiratory epithelium and inducing overexpression of mucin and disrupting the balance of immune systemin respiratory epithelium cells. Additionally, measures to control plaque and maintain the health of periodontal tissue can decrease the incidence of respiratory adverse events. This evidence suggests a close association between periodontitis and pulmonary diseases. The present study aimed to review the clinical association between periodontitis and pneumonia, COPD, asthma, COVID‑19 and lung cancer, and propose a possible mechanism and potential role of periodontal pathogens in linking periodontal disease and lung disease. This could provide a direction for further research on the association between periodontitis and lung disease and provide novel ideas for the clinical diagnosis and treatment management of these two diseases.
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Affiliation(s)
- Zhiyi Zhang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Siyi Wen
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Jiaohong Liu
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Yuanting Ouyang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Zhikang Su
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Ding Chen
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Zitian Liang
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Yan Wang
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, State Key Laboratory of Respiratory Diseases, Guangzhou, Guangdong 510182, P.R. China
| | - Tao Luo
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Qianzhou Jiang
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
| | - Lvhua Guo
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, P.R. China
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Banks JM, Capistrano KJ, Brandini DA, Zaidi F, Thakkar P, Rahat R, Schwartz J, Naqvi AR. Herpesviruses and SARS-CoV-2: Viral Association with Oral Inflammatory Diseases. Pathogens 2024; 13:58. [PMID: 38251365 PMCID: PMC10819702 DOI: 10.3390/pathogens13010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
The oral cavity is a niche for diverse microbes, including viruses. Members of the Herpesviridae family, comprised of dsDNA viruses, as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an ssRNA virus, are among the most prevalent viruses infecting the oral cavity, and they exhibit clinical manifestations unique to oral tissues. Viral infection of oral mucosal epithelia triggers an immune response that results in prolonged inflammation. The clinical and systemic disease manifestations of HHV have been researched extensively, and several recent studies have illuminated the relationship between HHV and oral inflammatory diseases. Burgeoning evidence suggests the oral manifestation of SARS-CoV-2 infection includes xerostomia, dysgeusia, periodontal disease, mucositis, and opportunistic viral and bacterial infections, collectively described as oral post-acute sequelae of COVID-19 (PASC). These diverse sequelae could be a result of intensified immune responses initially due to the copious production of proinflammatory cytokines: the so-called "cytokine storm syndrome", facilitating widespread oral and non-oral tissue damage. This review explores the interplay between HHV, SARS-CoV-2, and oral inflammatory diseases such as periodontitis, endodontic disease, and peri-implantitis. Additionally, the review discusses proper diagnostic techniques for identifying viral infection and how viral diagnostics can lead to improved overall patient health.
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Affiliation(s)
- Jonathan M. Banks
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
| | - Kristelle J. Capistrano
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
| | - Daniela A. Brandini
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil;
| | - Filza Zaidi
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
| | - Pari Thakkar
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
| | - Rani Rahat
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
| | - Joel Schwartz
- Department of Oral Medicine and Diagnostics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Afsar R. Naqvi
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.B.); (K.J.C.); (F.Z.); (P.T.); (R.R.)
- Department of Microbiology and Immunology, College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA
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Bemquerer LM, Oliveira SR, de Arruda JAA, Costa FPD, Miguita L, Bemquerer ALM, de Sena ACVP, de Souza AF, Mendes DF, Schneider AH, Azevedo MDCS, Travassos DV, Garlet GP, Cunha FDQ, de Aguiar RS, de Souza RP, Gomez RS, Spahr A, Obregon-Miano F, Abreu LG, Costa FO, Silva TA. Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study. Odontology 2024; 112:208-220. [PMID: 37058199 PMCID: PMC10103045 DOI: 10.1007/s10266-023-00811-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/29/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints. METHODS Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1β, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records. RESULTS Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1β after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola. CONCLUSIONS Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.
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Affiliation(s)
- Larissa Marques Bemquerer
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
- Department of Periodontics, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Sicília Rezende Oliveira
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Fernanda Pereira Delgado Costa
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucyene Miguita
- Department of Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Luisa Marques Bemquerer
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Ana Carolina Velasco Pondé de Sena
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Alessandra Figueiredo de Souza
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Daniel Fajardo Mendes
- Department of Dentistry, Hospital Eduardo de Menezes, Fundação Hospitalar Do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ayda Henriques Schneider
- Department of Pharmacology, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Denise Vieira Travassos
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, School of Dentistry of Bauru, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | - Fernando de Queiroz Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renato Santana de Aguiar
- Department of Genetics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Renan Pedra de Souza
- Department of Genetics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Axel Spahr
- Department of Periodontics, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Fabian Obregon-Miano
- Department of Periodontics, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, CEP: 31.270-910, Brazil.
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8
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Wang D, Dai L, Cui Z, Xing W, Huang X, Yang H, Shan Y. Association between periodontal diseases and chronic obstructive pulmonary disease: Evidence from sequential cross-sectional and prospective cohort studies based on UK Biobank. J Clin Periodontol 2024; 51:97-107. [PMID: 37850252 DOI: 10.1111/jcpe.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
AIM To investigate the association between periodontal diseases, airflow limitation and incident chronic obstructive pulmonary disease (COPD) in a large-scale prospective UK Biobank cohort. MATERIALS AND METHODS Our approach comprised a cross-sectional study and a prospective cohort. Periodontal diseases were determined based on the participants' self-reported dental symptoms, including painful gums, bleeding gums and loose teeth. Logistic regression and Cox proportional hazards models were used to evaluate the association of periodontal diseases with airflow limitation and incident COPD in the cross-sectional study and the prospective cohort, respectively. RESULTS The cross-sectional study involved 495,610 participants. Multivariable analysis found that periodontal diseases were significantly associated with airflow limitation (odds ratio = 1.036, 95% confidence interval [CI]: 1.015-1.059). The cohort study included 379,266 participants with a median follow-up period of 12.68 years. An elevated risk of incident COPD was associated with the presence of periodontal diseases (hazard ratio: 1.248, 95% CI: 1.174-1.326). The effect was consistent among subgroups, including baseline age (≤65 or >65 years), sex, smoking status and diabetes mellitus. CONCLUSIONS Periodontal diseases are associated with airflow limitation and elevated COPD incidence. Maintaining good periodontal health in patients with chronic bronchitis and emphysema may help prevent the onset of COPD.
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Affiliation(s)
- Dongyun Wang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Liang Dai
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Zhengqian Cui
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Weili Xing
- Internal Medicine, Distinct Health Care, Guangzhou, China
| | - Xiaoyan Huang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hongyu Yang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Ying Shan
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, China
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9
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Bachtiar EW, Soeroso Y, Haerani N, Ismah N, Adiati EC, Bachtiar BM. Immunoglobulin A response to SARS-CoV-2-N-protein potentially persists in oral fluids of patients with periodontitis six months after mRNA vaccine administration. J Dent Sci 2024; 19:652-655. [PMID: 38303837 PMCID: PMC10829667 DOI: 10.1016/j.jds.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/21/2023] [Indexed: 02/03/2024] Open
Abstract
Few studies have investigated the mucosal immune response after BNT162b2-booster vaccination in individuals with periodontitis. In this study, we evaluated the persistence of IgA anti-SARS-CoV-2-N-protein in saliva and gingival crevicular fluid (GCF) of patients with periodontitis for at least six months post BNT162b2 vaccine booster. We included patients with moderate (n = 7) and severe (n = 7) periodontitis and participants without periodontitis (n = 7) as controls. The Bradford method measured the protein concentrations in the samples, and an enzyme-linked immunosorbent assay of the SARS-CoV-2 N protein was performed to analyze the targeted IgA level. For the tested SARS-CoV-2 antigen (N-protein), IgA levels in saliva and GCF showed a strong and significant correlation. Therefore, in patients with moderate or severe periodontitis, saliva and GCF can provide information regarding the IgA response against SARS-CoV-2-N-protein. The neutralizing activity of IgA against SARS-CoV-2 was not investigated in this study, necessitating further research.
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Affiliation(s)
- Endang W. Bachtiar
- Department of Oral Biology and Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Yuniarti Soeroso
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Natalina Haerani
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Nada Ismah
- Department of Orthodontic, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Esti Chahyani Adiati
- Resident Department of Periodontic, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Boy M. Bachtiar
- Department of Oral Biology and Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
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10
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Sari A, Dikmen NK, Nibali L. Association between periodontal diseases and COVID-19 infection: a case-control study with a longitudinal arm. Odontology 2023; 111:1009-1017. [PMID: 36867280 PMCID: PMC9982775 DOI: 10.1007/s10266-023-00797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/15/2023] [Indexed: 03/04/2023]
Abstract
Some studies have suggested potential relationships between periodontal disease and COVID-19, explained by many possible pathological pathways. The aim of this case-control study with a longitudinal arm was to investigate this association. 80 systemically healthy individuals (apart from COVID-19) were involved in this study, divided into 40 patients who had recently had COVID-19 (test, divided into severe and mild/moderate cases) and 40 who had not had COVID-19 (control). Clinical periodontal parameters and laboratory data were recorded. Mann-Whitney U test, Wilcoxon test, and chi-square test were performed to compare variables. Multiple binary logistic regression method was used to estimate adjusted ORs and 95% confidence interval. Hs-CRP-1 and 2, Ferritin-1 and 2, lymphocyte count-1 values, and neutrophil/lymphocyte ratio-1 were higher in patients with severe COVID-19 than patients with mild/moderate COVID-19 (p < 0.05). All of these laboratory values significantly decreased after COVID-19 treatment (p < 0.05) in the test group. Presence of periodontitis (p = 0.015) was higher and periodontal health was lower (p = 0.002) in the test group than in the control group. All clinical periodontal parameters were significantly higher in the test group than in the control group (p < 0.05), except plaque index. Prevalence of periodontitis was associated with increased odds of having COVID-19 infection (PR = 1.34; 95% CI 0.23-2.45) in the multiple binary logistic regression. COVID-19 is associated with periodontitis prevalence, through a series of possible mechanisms including local and systemic inflammatory responses. Further studies should investigate whether the maintenance of periodontal health may be a factor in the reduction of the severity of COVID-19 infections.
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Affiliation(s)
- Aysegul Sari
- Faculty of Dentistry, Department of Periodontology, Mustafa Kemal University, Hatay, Turkey.
- Faculty of Dentistry, Periodontology Unit, Centre for Host-Microbiome Interactions, Oral and Craniofacial Sciences, Kings College London, London, UK.
| | - Nursel Kaya Dikmen
- Faculty of Dentistry, Department of Chest Diseases, Mustafa Kemal University, Hatay, Turkey
| | - Luigi Nibali
- Faculty of Dentistry, Periodontology Unit, Centre for Host-Microbiome Interactions, Oral and Craniofacial Sciences, Kings College London, London, UK
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11
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Periodontitis and risk of immune-mediated systemic conditions: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2023; 51:705-717. [PMID: 36377800 DOI: 10.1111/cdoe.12812] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/22/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this review is to examine and quantify the long-term risk of immune-mediated systemic conditions in people with periodontitis compared to people without periodontitis. METHODS Medline, EMBASE and Cochrane databases were searched up to June 2022 using keywords and MeSH headings. The 'Risk of Bias in Non-Randomised Studies of Interventions' tool was used to assess bias. Cohort studies comparing incident metabolic/autoimmune/inflammatory diseases in periodontitis to healthy controls were included. Meta-analysis and meta-regression quantified risks and showed impact of periodontitis diagnosis type and severity. RESULTS The search retrieved 3354 studies; 166 studies were eligible for full-text screening, and 30 studies were included for review. Twenty-seven studies were eligible for meta-analysis. The risks of diabetes, rheumatoid arthritis (RA) and osteoporosis were increased in people with periodontitis compared to without periodontitis (diabetes-relative risk [RR]: 1.22, 95% CI: 1.13-1.33; RA-RR: 1.27, 95% CI: 1.07-1.52; osteoporosis-RR: 1.40, 95% CI: 1.12-1.75). Risk of diabetes showed gradient increase by periodontitis severity (moderate-RR = 1.20, 95% CI = 1.11-1.31; severe-RR = 1.34, 95% CI = 1.10-1.63). CONCLUSION People with moderate-to-severe cases of periodontitis have the highest risk of developing diabetes, while the effect of periodontal severity on risk of other immune-mediated systemic conditions requires further investigation. More homologous evidence is required to form robust conclusions regarding periodontitis-multimorbidity associations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Susan Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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12
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Kang J, Palmier-Claus J, Wu J, Shiers D, Larvin H, Doran T, Aggarwal VR. Periodontal disease in people with a history of psychosis: Results from the UK biobank population-based study. Community Dent Oral Epidemiol 2023; 51:985-996. [PMID: 36258297 DOI: 10.1111/cdoe.12798] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/04/2022] [Accepted: 09/29/2022] [Indexed: 03/09/2023]
Abstract
OBJECTIVES To test the hypotheses that: (1) Prevalence of periodontal disease would be higher in people with a history of psychosis when compared to the general population and (2) Demographic, life-style related factors and co-morbid medical conditions would predict periodontal disease in people experiencing psychosis. METHODS The authors performed cross-sectional analysis of baseline data from the UK Biobank study (2007-2010), identifying cases with psychosis using clinical diagnosis, antipsychotic medication, and self-report. Demographic (age, gender, ethnicity, socioeconomic status), lifestyle-related(BMI, blood pressure, smoking and alcohol intake, physical activity) and physical co-morbidities (cancer, cardiovascular, respiratory, inflammatory disease and metabolic conditions) were included as potential risk factors for periodontal disease among people with a history of psychosis using logistic regression analyses. The analysis sample included 502,505 participants. RESULTS Risk of periodontal disease was higher in people with psychosis, regardless of how cases were identified. Patients with a clinical diagnosis had the highest proportion of periodontal disease compared to the general population (21.3% vs. 14.8%, prevalence ratio 1.40, 95% CI: 1.26-1.56). Older and female cases were more likely to experience periodontal disease. Lifestyle factors (smoking) and comorbidities (cardiovascular, cancer or respiratory disease) were associated with periodontal disease among people with a history of psychosis. CONCLUSIONS The findings suggest that periodontal disease is more common in people with a history of psychosis, compared to the general population. Prevention and early diagnosis of periodontal disease should be a priority for oral health promotion programmes, which should also address modifiable risk factors like smoking which also contribute to co-morbid systemic disease.
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Affiliation(s)
- Jing Kang
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
- Lancashire & South Cumbria NHS Foundation Trust, Preston, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK
| | - David Shiers
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
- School of Medicine, Keele University, Keele, UK
| | | | - Tim Doran
- Health Services & Policy, University of York, York, UK
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13
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Al-Maweri SA, Alhajj MN, Halboub E, Tamimi F, Salleh NM, Al-Ak'hali MS, Kassim S, Abdulrab S, Anweigi L, Mohammed MMA. The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis. BMC Oral Health 2023; 23:658. [PMID: 37689665 PMCID: PMC10493030 DOI: 10.1186/s12903-023-03378-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.
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Affiliation(s)
| | - Mohammed Nasser Alhajj
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Nosizana Mohd Salleh
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Saba Kassim
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Saleem Abdulrab
- Al Khor Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Marwan Mansoor Ali Mohammed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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14
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Tang K, Wu Y, Zheng Q, Chen X. Bibliometric research on analysis of links between periodontitis and cardiovascular diseases. Front Cardiovasc Med 2023; 10:1255722. [PMID: 37745126 PMCID: PMC10512184 DOI: 10.3389/fcvm.2023.1255722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/10/2023] [Indexed: 09/26/2023] Open
Abstract
Background Periodontitis (PD) and cardiovascular diseases (CVD) rank among the most prevalent pathologies worldwide, and their correlation has been a subject of prolonged investigation. Numerous studies suggest shared etiological factors; however, a definitive causal connection remains unestablished. The objective of this study was to employ bibliometric and visual analyses in order to comprehensively examine the overarching characteristics, focal areas of research, and prospective trends pertaining to the PD-CVD relationship. Methods We sourced articles, reviews, and online publications on PD- and CVD- research from the Web of Science Core Collection (WoSCC) spanning from January 1, 1993, to May 15, 2023. A triad of analytical tools (R-Bibliometrix, VOSviewer 1.6.19, and CiteSpace 6.2.R3) were utilized to facilitate collaboration network analysis, co-citation analysis, co-occurrence analysis, and citation burst detection. Results Out of the 1,116 publications that fulfilled the eligibility criteria in the WoSCC database, the comprehensive characteristics analysis divulged a sustained growth trend in publication frequency. In the cluster analysis of reference co-citation and keyword co-occurrence, prominent themes such as "periodontitis", "cardiovascular diseases", "inflammation", "Porphyromonas gingivalis", and "atherosclerosis" consistently emerged. Contemporary topics such as "peri-implantitis," "COVID-19", "cardiovascular risk factors," and "endocarditis" were pinpointed as burgeoning research hotspots. Conclusion Based on this bibliometric study, in the field of association studies between PD and CVD, the etiologic mechanisms of both diseases have been intensively studied in the last three decades. Periodontal pathogens might serve as potential initiating factors linking PD and CVD. Inflammation may constitute a significant etiological factor shared by both diseases. Several emerging topics, such as COVID-19 and peri-implantitis, exhibit promising potential. This exhaustive overview casts light on pivotal research arenas, augmenting the field's understanding and stimulating further scholarly investigations.
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Affiliation(s)
| | | | | | - Xuepeng Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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15
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Ohara H, Odanaka K, Shiine M, Hayasaka M. Antimicrobial effect of oral care gel containing hinokitiol and 4-isopropyl-3-methylphenol against intraoral pathogenic microorganisms. PLoS One 2023; 18:e0283295. [PMID: 37656688 PMCID: PMC10473516 DOI: 10.1371/journal.pone.0283295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE Deterioration of oral hygiene is closely related to an increase in severity and mortality of corona virus disease-19 (COVID-19), and also contributes to the development of various diseases such as aspiration pneumonia or Alzheimer's. Oral care is attracting high interest in Japan, which has entered a super-aging society. In this study, we aimed to investigate whether commercially available Hinora® (HO), an oral care gel containing hinokitiol and 4-isopropyl-3-methylphenol (IPMP), has biofilm formation inhibitory and antimicrobial activities against various intraoral pathogen microorganisms. METHOD Candida species, Aggregatibacter actinomycetemcomitans, Staphylococcus aureus, and Pseudomonas aeruginosa were selected during the study period, all of which were analyzed using antimicrobial disc, microorganism turbidity, and crystal violet assays. In addition, the germ tube test using Candida albicans (C. albicans) was performed with a modification of Mackenzie's method. Images for morphological observation of the germ tubes were acquired using an inverted microscope. For comparison between products, we used Refrecare® (RC), which only contains hinokitiol (not containing IPMP). RESULTS All the intraoral pathogenic microorganisms showed drug susceptibility against undiluted forms of HO and/or RC. In particular, HO was more effective at lower concentrations than RC. In the HO-added group, inhibition circles were observed in all bacteria except P. aeruginosa when added at a concentration of 0.5 g/mL or more. The optical density values at 590 nm (crystal violet) and/or 600 nm (microorganism turbidity) of all the fungi and bacteria were significantly lower when cultured in medium with HO. Inhibition of growth or biofilm formation was observed when HO was added at a concentration of 0.05 g/mL or higher. To investigate the action mechanism of HO, germ tube tests were performed in C. albicans. The results showed that culturing C. albicans in soybean-casein digest broth with HO (0.05 g/mL) significantly suppressed germ tube formation. CONCLUSIONS These data suggest that oral care gel-containing hinokitiol and IPMP has strong biofilm formation inhibitory activity, as well as antifungal and antimicrobial effects against Candida fungi and multiple intraoral pathogenic microorganisms. Therefore, it may be a promising treatment option for oral infections.
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Affiliation(s)
- Hiroshi Ohara
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Ohu University, Koriyama, Japan
- Department of Pharmacy, Ohu University Hospital, Koriyama, Japan
| | - Keita Odanaka
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Ohu University, Koriyama, Japan
| | - Miku Shiine
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Ohu University, Koriyama, Japan
| | - Masataka Hayasaka
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Ohu University, Koriyama, Japan
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16
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Qin D, Yu F, Wu D, Han C, Yao X, Yang L, Yang X, Wang Q, He D, Zhao B. The underlying molecular mechanisms and biomarkers between periodontitis and COVID-19. BMC Oral Health 2023; 23:524. [PMID: 37495990 PMCID: PMC10369766 DOI: 10.1186/s12903-023-03150-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVE Emerging evidence shows the clinical consequences of patient with COVID-19 and periodontitis are not promising, and periodontitis is a risk factor. Periodontitis and COVID-19 probably have a relationship. Hence, this study aimed to identify the common molecular mechanism that may help to devise potential therapeutic strategies in the future. MATERIAL AND METHODS We analyzed two RNA-seq datasets for differential expressed genes, enrichment of biological processes, transcription factors (TFs) and deconvolution-based immune cell types in periodontitis, COVID-19 and healthy controls. Relationships between TFs and mRNA were established by Pearson correlation analysis, and the common TFs-mRNA regulatory network and nine co-upregulated TFs of the two diseases was obtained. The RT-PCR detected the TFs. RESULTS A total of 1616 and 10201 differentially expressed gene (DEGs) from periodontitis and COVID-19 are found. Moreover, nine shared TFs and common biological processes associated with lymphocyte activation involved in immune response were identified across periodontitis and COVID-19. The cell type enrichment revealed elevated plasma cells among two diseases. The RT-PCR further confirmed the nine TFs up-regulation in periodontitis. CONCLUSION The pathogenesis of periodontitis and COVID-19 is closely related to the expression of TFs and lymphocyte activation, which can provide potential targets for treatment.
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Affiliation(s)
- Danlei Qin
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Feiyan Yu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Dongchao Wu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Chong Han
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Xuemin Yao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Lulu Yang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Xi Yang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Qianqian Wang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Dongning He
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China.
| | - Bin Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, No 63, New South Road, Yingze District, Taiyuan, 030001, Shanxi, China.
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17
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Molina A, Huck O, Herrera D, Montero E. The association between respiratory diseases and periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:842-887. [PMID: 36606394 DOI: 10.1111/jcpe.13767] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
AIM To evaluate (1) whether periodontitis has an influence on the prevalence/incidence of respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma, community-acquired pneumonia [CAP], obstructive sleep apnoea [OSA] and COVID-19), and (2) what is the impact of periodontal therapy on the onset or progression of respiratory diseases. MATERIALS AND METHODS An electronic search was performed on Pubmed, Cochrane Library and Scopus databases up to October 2021, to identify studies answering the PECOS and PICOS questions. RESULTS Seventy-five articles were selected. Meta-analyses identified statistically significant associations of periodontitis with COPD (nstudies = 12, odds ratio [OR] = 1.28, 95% confidence interval [CI] [1.16; 1.42], p < .001), and OSA (ns = 6, OR = 1.65, 95% CI [1.21; 2.25], p = .001), but not for asthma (ns = 9, OR = 1.53, 95% CI [0.82; 2.86], p = .181). For acute conditions, two studies were found for CAP, while for COVID-19, significant associations were found for the need of assisted ventilation (ns = 2, OR = 6.24, 95% CI [2.78; 13.99], p < .001) and COVID-related mortality (ns = 3, OR = 2.26, 95% CI [1.36, 3.77], p = .002). Only four intervention studies were found, showing positive effects of periodontal treatment on COPD, asthma and CAP. CONCLUSIONS A positive association between periodontitis and COPD, OSA and COVID-19 complications has been found, while there is a lack of intervention studies.
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Affiliation(s)
- Ana Molina
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Olivier Huck
- Dental Faculty Robert Franck, Université de Strasbourg, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Strasbourg, France
| | - David Herrera
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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18
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Martínez-García M, Rodríguez-Hernández AP, Gutiérrez-Esparza GO, Castrejón-Pérez RC, Hernández-Lemus E, Borges-Yáñez SA. Relationship between the Social Development Index and Self-Reported Periodontal Conditions. Healthcare (Basel) 2023; 11:healthcare11111548. [PMID: 37297688 DOI: 10.3390/healthcare11111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Inequalities in oral health are influenced by the social strata of the population. Few studies have focused on the multitude of factors related to social development as indicators of living conditions and periodontal health status. The aim of this study is to evaluate the association between self-reported periodontal conditions and the Social Development Index (SDI). A cross-sectional validated questionnaire was carried out among 1294 Mexican adults. Descriptive statistics and multivariate logistic regression models were used to identify the best predictors of self-reported periodontal conditions. Bone loss reporting was used as a proxy for the presence of periodontal disease. We found that higher global scores on the SDI and quality and available space in the home (QASH) increase the probability of having bone loss. Global SDI (OR = 7.27) and higher QASH (OR = 3.66) were indeed the leading societal factors related to periodontal disease. These results have pointed out how SDI and its indicators, in particular QASH, can be used to further explore inequities related to privileged access to dental care in the context of periodontal diseases.
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Affiliation(s)
- Mireya Martínez-García
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Adriana-Patricia Rodríguez-Hernández
- Laboratory of Molecular Genetics, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Guadalupe O Gutiérrez-Esparza
- Cátedras CONACYT Consejo Nacional de Ciencia y Tecnología, Mexico City 08400, Mexico
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Roberto Carlos Castrejón-Pérez
- Department of Clinical and Epidemiological Geriatric Research, Instituto Nacional de Geriatría, Mexico City 10200, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Socorro Aída Borges-Yáñez
- Dental Public Health Department, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Kaur Boparai A, Jain A, Arora S, Abullais Saquib S, Abdullah Alqahtani N, Fadul A Elagib M, Grover V. Dental calculus - An emerging bio resource for past SARS CoV2 detection, studying its evolution and relationship with oral microflora. JOURNAL OF KING SAUD UNIVERSITY. SCIENCE 2023; 35:102646. [PMID: 36987442 PMCID: PMC10023199 DOI: 10.1016/j.jksus.2023.102646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 02/20/2023] [Accepted: 03/13/2023] [Indexed: 05/28/2023]
Abstract
The most grievous threat to human health has been witnessed worldwide with the recent outbreak of Corona virus disease 2019 (COVID-19). There is mounting evidence available regarding theconnect of COVID -19 and oral cavity, particularly periodontal disease. The current review provides an update on the diagnostic potential of dental calculus and how this bio resource may help in providing us huge amount of diagnostic regarding the causative virus. Contemporary standard method of diagnosis via nasopharyngeal swabs (NPS) is tedious, may enhance the risk of aerosol contamination by inducing sneezing and detects the presence of active infection only.However,dental calculus being a mineralized deposit serves as a reservoir for biomoleculesand provides detection of past SARS CoV2 infection. Further, the abundance of information that can be obtained from this remarkable mineralized deposit on teeth regarding the viral genome, its evolution and interactions with the oral microflora shall enhance the understanding of the viral disease process and its connection with the periodontal disease. Additional diagnostic information, which may be obtained from this simple bio reservoir can complement the contemporary diagnostic strategies adopted in the management of COVID-19pandemic and enhance our existing knowledge for developing improvised novel approaches to mitigate the effects of mutated variants of the infectious agent.
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Affiliation(s)
| | - Ashish Jain
- Department of Periodontology & Oral Implantology, Dr. H. S. J. lnstitute Dental Sciences & Hospital, Punjab University, Chandigarh, India
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Shahabe Abullais Saquib
- Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Nabeeh Abdullah Alqahtani
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | | | - Vishakha Grover
- Department of Periodontology & Oral Implantology, Dr. H. S. J. lnstitute Dental Sciences & Hospital, Punjab University, Chandigarh, India
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Herrera D, Serrano J, Roldán S, Alonso B, Sanz M. Oral and systemic health: is there a "new" link with COVID-19? Clin Oral Investig 2023:10.1007/s00784-023-04950-2. [PMID: 37133697 PMCID: PMC10154181 DOI: 10.1007/s00784-023-04950-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/12/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The objective of the present narrative review was to evaluate the evidence of a possible association between periodontitis and COVID-19, and its biological plausibility, using as models the potential associations with cardiovascular diseases, diabetes, and some respiratory diseases. METHODS A recent systematic review was used as main reference to explore the associations of periodontitis with different respiratory diseases, including COVID-19, following two focussed questions: a PECOS question, aimed to explore epidemiological evidence, and a PICOS question, designed to explore the evidence derived from intervention studies. In addition to that evidence, other relevant scientific documents, including consensus papers, were carefully selected and appraised. FINDINGS Convincing evidence was found to support the association of periodontitis and cardiovascular diseases, diabetes, and some respiratory diseases. The biological plausibility behind those associations is based on four factors: (1) bacteraemia of oral bacteria and periodontal pathogens, (2) increased systemic inflammation, (3) common genetic factors, and (4) common environmental risk factors. Limited initial evidence is available to support an association between periodontitis and COVID-19 complications. Among the proposed factors to explain the suggested association, a combination of the previously mentioned factors, plus additional factors related with SARS-CoV-2 characteristics and pathogenicity, has been suggested. CONCLUSIONS Initial evidence suggests that periodontitis may be associated with a more severe COVID-19 and with a higher risk of death due to COVID-19. CLINICAL RELEVANCE Due to the possible association between periodontitis and an increased severity for COVID-19, additional efforts should be made to improve oral and periodontal health, including the promotion of oral healthy habits, such as oral hygiene.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
| | - Jorge Serrano
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Silvia Roldán
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
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Gupta I, Patel SA, Kondal D, Goodman M, Mohan S, Ali MK, Tandon N, Narayan KMV, Prabhakaran D, Shridhar K. Epidemiological pattern of COVID-19 and its association with periodontal health in an urban Indian cohort. Front Public Health 2023; 11:1108465. [PMID: 37050946 PMCID: PMC10083433 DOI: 10.3389/fpubh.2023.1108465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/02/2023] [Indexed: 03/28/2023] Open
Abstract
BackgroundStudies have highlighted a possible influence of gingival and periodontal disease (PD) on COVID-19 risk and severity. However, the evidence is based on hospital-based studies and community-level data are sparse.ObjectivesWe described the epidemiological pattern of SARS-CoV-2 infection in Delhi and evaluated the associations of gingival and PD with incident COVID-19 disease in a regionally representative urban Indian population.MethodsIn a prospective study nested within the Centre for Cardiometabolic Risk Reduction in South-Asia (CARRS) study, participants with clinical gingival and periodontal status available at baseline (2014–16) (n = 1,727) were approached between October 2021 to March 2022. Information on COVID-19 incidence, testing, management, severity was collected as per the WHO case criteria along with COVID-19 vaccination status. Absolute incidence of COVID-19 disease was computed by age, sex, and oral health. Differences in rates were tested using log-rank test. Poisson regression models were used to evaluate independent associations between gingival and PD and incidence of COVID-19, adjusted for socio-demographic and behavioral factors, presence of comorbidity, and medication use.ResultsAmong 1,727 participants, the mean age was 44.0 years, 45.7% were men, 84.5% participants had baseline gingival or PD and 89.4% participants had received at least one dose of COVID-19 vaccine. Overall, 35% (n = 606) participants were tested for COVID-19 and 24% (n = 146/606) tested positive. As per the WHO criteria total number of cases was 210, constituting 12% of the total population. The age and sex-specific rates of COVID-19 were higher among men and older participants, but women aged >60 years had higher rates than men of same age. The incidence rate did not differ significantly between those having gingival or PD and healthy periodontium (19.1 vs. 16.5/1,000 person-years) and there was no difference in risk of COVID-19 by baseline oral disease status.ConclusionGingival and PD were not associated with increased risk of COVID-19.
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Affiliation(s)
- Ishita Gupta
- Centre for Chronic Disease Control, New Delhi, India
- *Correspondence: Ishita Gupta,
| | - Shivani A. Patel
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, United States
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Dimple Kondal
- Centre for Chronic Disease Control, New Delhi, India
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sailesh Mohan
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurgaon, Haryana, India
- Deakin University, Melbourne, Australia
| | - Mohammed K. Ali
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, United States
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - K. M. Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, United States
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Public Health Foundation of India, Gurgaon, Haryana, India
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Krithiga Shridhar
- Centre for Chronic Disease Control, New Delhi, India
- Public Health Foundation of India, Gurgaon, Haryana, India
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22
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Carmona Loayza DA, Lafebre MF. Periodontal disease and COVID-19: Prognosis and potential pathways of association in their pathogenesis. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2023; 57:44-51. [PMID: 36968799 PMCID: PMC10032643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/22/2022] [Accepted: 09/30/2022] [Indexed: 03/29/2023]
Abstract
Objective The objective of this narrative review is to determine if periodontal disease is a factor in the development of a poor prognosis for COVID-19. Method A bibliographic search was conducted in PubMed, Virtual Health Library, Google Scholar, and in the databases of Science Direct, Scopus, Lilacs, Bireme, Scielo, and Web of Science, using the following keywords: "COVID-19," "SARS-CoV-2," and "periodontal diseases." Results Fifty-six records were retrieved from the database searches. After screening, 39 articles were selected for study: 13 reviews, 2 case-control studies, 1 systematic review, 8 letters to the editor, 2 cohort studies, 1 thesis, 7 hypotheses, 1 short communication, 3 commentaries, and 1 scoping review. Discussion Both periodontal disease and COVID-19 produce an inflammatory response. This immune response generates an over-production of inflammatory cytokines that can harm overall health. Conclusion The mouth serves as the entryway for many microorganisms that can harm health in general, among them SARS-CoV-2. It is important to maintain good oral health to lower the inflammatory load present in periodontal disease, lessening the possibility of complications from COVID-19.
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23
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Meng Z, Ma Y, Li W, Deng X. Association between periodontitis and COVID-19 infection: a two-sample Mendelian randomization study. PeerJ 2023; 11:e14595. [PMID: 36718446 PMCID: PMC9884046 DOI: 10.7717/peerj.14595] [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: 04/29/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023] Open
Abstract
Background and Objective Epidemiological studies report associations between coronavirus disease 2019 (COVID-19) and periodontitis; however, causality has not been proven. The aim of this study is to assess the associations between COVID-19 susceptibility and periodontitis with two-sample Mendelian randomization (MR) analyses. Methods A two-sample summary MR analysis was performed using data for outcome and exposure from the OpenGWAS database on people of European descent. Periodontal complex traits (PCTs) were chosen as a proxy for the periodontitis phenotype. The causal association between PCT3 (Aggregatibacter actinomycetemcomitans), PCT5 (Porphyromonas gingivalis), and gingival crevicular fluid (GCF) interleukin-1β (IL-1β) and COVID-19 were considered. Genome-wide association study (GWAS) data with the two largest sample sizes were selected as COVID-19 outcomes (datasets ebi-a-GCST010776 and ebi-a-GCST010777). Single-nucleotide polymorphisms (SNPs) associated with PCT3, PCT5, and GCF IL-1β at statistical significance at genome-wide level (P < 5 × 10-8) were identified as genetic instruments. We used two-sample summary MR methods and tested the existence of a pleiotropic effect with MR-Egger. Results Inverse-variance weighted (IVW) estimates showed that there was a positive association between COVID-19 risk and periodontitis (ebi-a-GCST010776: odds ratio [OR] = 1.02 (95% confidence interval (CI), 1.00-1.05), P = 0.0171; ebi-a-GCST010777: OR = 1.03 (95% CI, 1.00-1.05), P = 0.0397). The weighted median also showed directionally similar estimates. Exploration of the causal associations between other PCTs and COVID-19 identified a slight effect of local inflammatory response (GCF IL-1β) on COVID-19 risk across the two datasets (ebi-a-GCST010776: IVW OR = 1.02 (95% CI, [1.01-1.03]), P < 0.001; ebi-a-GCST010777: IVW OR = 1.03 (95% CI, [1.02-1.04]), P < 0.001). The intercepts of MR-Egger yielded no proof for significant directional pleiotropy for either dataset (ebi-a-GCST010776: P = 0.7660; ebi-a-GCST010777: P = 0.6017). Conclusions The findings suggests that periodontitis and the higher GCF IL-1β levels is causally related to increase susceptibility of COVID-19. However, given the limitations of our study, the well-designed randomized controlled trials are needed to confirm its findings, which may represent a new non-pharmaceutical intervention for preventing COVID-19.
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Affiliation(s)
- Zhaoqiang Meng
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yujia Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, P. R. China
| | - Wenjing Li
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China,Peking University Health Science Center, Institute of Medical Technology, Beijing, P. R. China,Key Laboratory of Dental Material, National Medical Products Administration, Beijing, China
| | - Xuliang Deng
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China,Key Laboratory of Dental Material, National Medical Products Administration, Beijing, China
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Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence. Metabolites 2022; 13:metabo13010040. [PMID: 36676965 PMCID: PMC9865290 DOI: 10.3390/metabo13010040] [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: 11/03/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Periodontitis is a microbially driven, host-mediated disease that leads to loss of periodontal attachment and resorption of bone. It is associated with the elevation of systemic inflammatory markers and with the presence of systemic comorbidities. Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients have mild symptoms, others experience important complications that can lead to death. After the spread of the COVID-19 pandemic, several investigations demonstrating the possible relationship between periodontitis and COVID-19 have been reported. In addition, both periodontal disease and COVID-19 seem to provoke and/or impair several cardiometabolic complications such as cardiovascular disease, type 2 diabetes, metabolic syndrome, dyslipidemia, insulin resistance, obesity, non-alcoholic fatty liver disease, and neurological and neuropsychiatric complications. Therefore, due to the increasing number of investigations focusing on the periodontitis-COVID-19 relationship and considering the severe complications that such an association might cause, this review aims to summarize all existing emerging evidence regarding the link between the periodontitis-COVID-19 axis and consequent cardiometabolic impairments.
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25
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Wadhwa S, Dave S, Daily M, Nardone A, Li R, Rosario J, Cantos A, Shah J, Lu H, McMahon D, Yin M. The Role of Oral Health in the Acquisition and Severity of SARS-CoV-2: A Retrospective Chart Review. Saudi Dent J 2022; 34:596-603. [PMID: 35974970 PMCID: PMC9371763 DOI: 10.1016/j.sdentj.2022.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Studies have shown that gingival crevices may be a significant route for SARS-CoV-2 entry. However, the role of oral health in the acquisition and severity of COVID-19 is not known. Design A retrospective analysis was performed using electronic health record data from a large urban academic medical center between 12/1/2019 and 8/24/2020. A total of 387 COVID-19 positive cases were identified and matched 1:1 by age, sex, and race to 387 controls without COVID-19 diagnoses. Demographics, number of missing teeth and alveolar crestal height were determined from radiographs and medical/dental charts. In a subgroup of 107 cases and controls, we also examined the rate of change in alveolar crestal height. A conditional logistic regression model was utilized to assess association between alveolar crestal height and missing teeth with COVID-19 status and with hospitalization status among COVID-19 cases. Results Increased alveolar bone loss, OR = 4.302 (2.510 - 7.376), fewer missing teeth, OR = 0.897 (0.835-0.965) and lack of smoking history distinguished COVID-19 cases from controls. After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641 ± 0.613 mm vs 0.260 ± 0.631 mm, p < 0.01.) Among cases with COVID-19, increased number of missing teeth OR = 2.1871 (1.146- 4.174) was significantly associated with hospitalization. Conclusions Alveolar bone loss and missing teeth are positively associated with the acquisition and severity of COVID-19 disease, respectively.
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Affiliation(s)
- S. Wadhwa
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - S. Dave
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - M.L. Daily
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - A. Nardone
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - R. Li
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - J. Rosario
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - A. Cantos
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - J. Shah
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - H.H. Lu
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - D.J. McMahon
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - M.T. Yin
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
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Gutierrez-Camacho JR, Avila-Carrasco L, Martinez-Vazquez MC, Garza-Veloz I, Zorrilla-Alfaro SM, Gutierrez-Camacho V, Martinez-Fierro ML. Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11383. [PMID: 36141654 PMCID: PMC9517300 DOI: 10.3390/ijerph191811383] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Some oral lesions have been described in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the possibility has been raised that the buccal lesions observed in patients with the coronavirus disease 2019 (COVID-19) are due to this virus and the patient's systemic condition. The aim of this review was to integrate the knowledge related to the oral lesions associated with COVID-19 and the participation of the buccal cavity in the establishment of immunity against SARS-CoV-2. METHODS A literature search on the manifestations of buccal lesions from the beginning of the pandemic until October 2021 was carried out by using the PubMed database. A total of 157 scientific articles were selected from the library, which included case reports and reports of lesions appearing in patients with COVID-19. RESULTS Oral lesions included erosions, ulcers, vesicles, pustules, plaques, depapillated tongue, and pigmentations, among others. The oral cavity is a conducive environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, immunodeficiencies, and autoimmunity primarily. CONCLUSIONS The oral cavity is an accessible and privileged environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; the direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, in particular those related to immunodeficiencies and autoimmunity.
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Guardado-Luevanos I, Bologna-Molina R, Zepeda-Nuño JS, Isiordia-Espinoza M, Molina-Frechero N, González-González R, Pérez-Pérez M, López-Verdín S. Self-Reported Periodontal Disease and Its Association with SARS-CoV-2 Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610306. [PMID: 36011941 PMCID: PMC9407774 DOI: 10.3390/ijerph191610306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 06/12/2023]
Abstract
Introduction: Knowledge of the oral manifestations associated with SARS-CoV-2 infection, the new coronavirus causing the COVID-19 pandemic, was hindered due to the restrictions issued to avoid proximity between people and to stop the rapid spread of the disease, which ultimately results in a hyperinflammatory cytokine storm that can cause death. Because periodontal disease is one of the most frequent inflammatory diseases of the oral cavity, various theories have emerged postulating periodontal disease as a risk factor for developing severe complications associated with COVID-19. This motivated various studies to integrate questions related to periodontal status. For the present work, we used a previously validated self-report, which is a useful tool for facilitating epidemiological studies of periodontal disease on a large scale. Methodology: A blinded case-control study with participants matched 1:1 by mean age (37.7 years), sex, tobacco habits and diseases was conducted. After the diagnostic samples for SARS-CoV-2 detection were taken in an ad hoc location at Guadalajara University, the subjects were interviewed using structured questionnaires to gather demographic, epidemiological and COVID-19 symptom information. The self-reported periodontal disease (Self-RPD) questionnaire included six questions, and subjects who met the criteria with a score ≥ 2 were considered to have periodontal disease. Results: In total, 369 participants were recruited, with 117 participants included in each group. After indicating the subjects who had self-reported periodontal disease, a statistically significant difference (p value ≤ 0.001) was observed, showing that self-reported periodontal disease (n = 95, 85.1%) was higher in SARS-CoV-2-positive individuals than in controls (n = 66, 56.4%), with an OR of 3.3 (1.8-6.0) for SARS-CoV-2 infection in people with self-reported periodontal disease. Cases reported a statistically higher median of symptoms (median = 7.0, Q1= 5.5, Q3 = 10.0) than controls (p value ≤ 0.01), and cases with positive self-RPD had a significantly (p value ≤ 0.05) higher number of symptoms (median = 8.0, Q1 = 6.0, Q3 = 10.0) in comparison with those who did negative self-RPD (median = 6.0, Q1 = 5.0, Q3 = 8.0). Conclusions: According to this study, self-reported periodontal disease could be considered a risk factor for SARS-CoV-2 infection, and these individuals present more symptoms.
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Affiliation(s)
- Israel Guardado-Luevanos
- Postgraduate in Periodontology and Implant Dentistry, Faculty of Dentistry, Autonomous University of Guadalajara, Guadalajara 44100, Mexico
| | - Ronell Bologna-Molina
- Molecular Pathology Area, Faculty of Dentistry, Montevideo Republic University, Montevideo 11200, Uruguay
- Research Department, School of Dentistry, Juarez University of the State of Durango, Durango 34100, Mexico
| | - José Sergio Zepeda-Nuño
- Microbiology and Pathology Department, Pathology Laboratory, University Center of Health Sciences, University of Guadalajara, Guadalajara 44100, Mexico
| | - Mario Isiordia-Espinoza
- Clinical Department, Biomedical Science Division, Los Altos University Center, University of Guadalajara, Guadalajara 44100, Mexico
| | - Nelly Molina-Frechero
- Health Care Department, Autonomous Metropolitan University, Mexico City 14387, Mexico
| | - Rogelio González-González
- Research Department, School of Dentistry, Juarez University of the State of Durango, Durango 34100, Mexico
| | - Mauricio Pérez-Pérez
- Periodontology Postgraduate, Comprehensive Dental Clinics Department, University Center of Health Sciences, University of Guadalajara, Guadalajara 44100, Mexico
| | - Sandra López-Verdín
- Research Institute of Dentistry, Comprehensive Dental Clinics Department, University Center of Health Sciences, University of Guadalajara, Guadalajara 44100, Mexico
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28
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Association of periodontal therapy, with inflammatory biomarkers and complications in COVID-19 patients: a case control study. Clin Oral Investig 2022; 26:6721-6732. [PMID: 35906340 DOI: 10.1007/s00784-022-04631-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND In previous studies, COVID-19 complications were reported to be associated with periodontitis. Accordingly, this study was designed to test the hypothesis that a history of periodontal therapy could be associated with lower risk of COVID-19 complications. METHODS A case-control study was performed using the medical health records of COVID-19 patients in the State of Qatar between March 2020 and February 2021 and dental records between January 2017 and December 2021. Cases were defined as COVID-19 patients who suffered complications (death, ICU admissions and/or mechanical ventilation); controls were COVID-19 patients who recovered without major complications. Associations between a history of periodontal therapy and COVID-19 complications were analysed using logistic regression models adjusted for demographic and medical factors. Blood parameters were compared using Kruskal-Wallis test. RESULTS In total, 1,325 patients were included. Adjusted odds ratio (AOR) analysis revealed that non-treated periodontitis was associated with significant risk of need for mechanical ventilation (AOR = 3.91, 95% CI 1.21-12.57, p = 0.022) compared to periodontally healthy patients, while treated periodontitis was not (AOR = 1.28, 95% CI 0.25-6.58, p = 0.768). Blood analyses revealed that periodontitis patients with a history of periodontal therapy had significantly lower levels of D-dimer and Ferritin than non-treated periodontitis patients. CONCLUSION Among COVID-19 patients with periodontal bone loss, only those that have not received periodontal therapy had higher risk of need for assisted ventilation. COVID-19 patients with a history of periodontal therapy were associated with significantly lower D-dimer levels than those without recent records of periodontal therapy. CLINICAL RELEVANCE The fact that patients with treated periodontitis were less likely to suffer COVID-19 complications than non-treated ones further strengthen the hypothesis linking periodontitis to COVID-19 complications and suggests that managing periodontitis could help reduce the risk for COVID-19 complications, although future research is needed to verify this.
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Drozdzik A. Covid-19 and SARS-CoV-2 infection in periodontology: A narrative review. J Periodontal Res 2022; 57:933-941. [PMID: 35839286 PMCID: PMC9350118 DOI: 10.1111/jre.13034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/09/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
The present review examined the available evidence on possible involvement of gingival tissues in SARS‐CoV‐2 infection. Gingival tissue possess SARS‐CoV‐2 entry and transmission factors, among them ACE2 (angiotensin‐converting enzyme 2) and TMPRSS2 (transmembrane protease serine 2), which are the principal mediators of the virus cell invasion. Clinical observations reveal SARS‐CoV‐2 RNA in periodontal tissues and crevicular fluid, suggesting that the periodontium may act as an entry point for the virus and/or as a dissemination site. The preliminary observations prove infection potential of gingival crevicular fluid and shed epithelial cells from the periodontium. There are also findings on potential associations between periodontitis and Covid‐19 (coronavirus disease 2019). PubMed and Scopus databases were used to search for suitable keywords such as: SARS‐CoV‐2, Covid‐19, oral virus infection, gingival crevicular fluid, oral mucosa, periodontium, gingiva, ACE2, TMPRSS2, Furin, diagnosis, topical treatment, vaccine and the related words for relevant publications. Data extraction and quality valuation of articles were performed by the author. The review addressed seven major domains: periodontal structures as SARS‐CoV‐2 infection site, the periodontal changes under SARS‐CoV‐2 infection, potential associations between periodontitis and Covid‐19, periodontal oral care in Covid‐19, crevicular fluid as potential transmission factor and preventive measures. The search process in PubMed and Scopus was updated up to 31 March 2022. Finally 68 articles were retrieved for the final analysis, from the initial database searches. According to the inclusion criteria articles in English language without any date restriction were included. The included studies were mostly original articles, and published in 2020 and 2021 with the aim to describe Covid‐19 and SARS‐CoV‐2 infection in periodontology. As a conclusion it can be stated that gingival tissues may play a role in SARS‐CoV‐2 infection.
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Affiliation(s)
- Agnieszka Drozdzik
- Department of Interdisciplinary Dentistry, Pomeranian Medical University, Szczecin, Poland
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30
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Trukhan DI, Sulimov AF, Trukhan LY. Changes in the organs and tissues of the oral cavity in the new coronavirus infection (COVID-19): A review. CONSILIUM MEDICUM 2022. [DOI: 10.26442/20751753.2022.5.201755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
SARS-CoV-2 infection can cause changes in the organs and tissues of the oral cavity, which is associated with a wide distribution of angiotensin-converting enzyme type 2 in the oral cavity, mainly epithelial cells of the oral mucosa, gums and fibroblasts of the periodontal ligament. Thus, the oral mucosa is susceptible to SARS-CoV-2 infection and may act as a gateway for the virus, as well as a reservoir for SARS-CoV-2. We searched the literature for the period from the beginning of the pandemic until May 30, 2022, devoted to the study of changes in the organs and tissues of the oral cavity with a new coronavirus infection (COVID-19) in the electronic search engines PubMed/MEDLINE and Scopus. A special place in the study of changes in the organs and tissues of the oral cavity with a new coronavirus infection (COVID-19) is occupied by periodontal pathology. A number of reviews and clinical studies conclude the importance of good oral hygiene and periodontal health as an important aspect of COVID-19 prevention and management. Oral probiotics can be considered as a promising direction for correcting changes in organs and tissues of the oral cavity in COVID-19.
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Dong J, Gong Y, Chu T, Wu L, Li S, Deng H, Hu R, Wang Y. Mendelian randomization highlights the causal association of obesity with periodontal diseases. J Clin Periodontol 2022; 49:662-671. [PMID: 35569024 DOI: 10.1111/jcpe.13640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/21/2022] [Accepted: 04/26/2022] [Indexed: 12/11/2022]
Abstract
AIM The underlying mechanisms connecting obesity and periodontal diseases remain unclear. This study investigates the potential causal association of obesity with periodontal diseases using Mendelian randomization (MR). MATERIALS AND METHODS Single-nucleotide polymorphisms of obesity traits including body mass index (BMI), waist circumference (WC), and WC adjusted for BMI (WCadjBMI) from large-scale genome-wide association studies were screened for instrumental variables. The single trait periodontitis and the combined trait comprising periodontitis and loose teeth were adopted as surrogates for periodontal diseases. Inverse-variance weighted (IVW), series of sensitivity analyses and multivariable MR were employed to determine the association of obesity with periodontal diseases. RESULTS IVW results showed that per 1-SD increment in BMI (odds ratio, OR = 1.115; 95% confidence interval [CI] = 1.064-1.169; p < .001) and WC (OR = 1.117; 95% CI = 1.052-1.185; p < .001), but not WCadjBMI, were significantly associated with an increased risk of periodontitis/loose teeth. Moreover, the MR estimates were consistent across other MR sensitivity analyses and multivariable MR. However, a causal association of obesity with the single trait periodontitis was not identified. CONCLUSIONS The presented evidence supports previous epidemiological findings by showing a potential causal association of genetic liability to obesity with periodontal diseases. The biological mechanisms underlying this association warrant further investigation.
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Affiliation(s)
- Jingya Dong
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yixuan Gong
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tengda Chu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lixia Wu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Sisi Li
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Deng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rongdang Hu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. The additive effect of periodontitis with hypertension on risk of systemic disease and mortality. J Periodontol 2022; 93:1024-1035. [PMID: 35460076 PMCID: PMC9544472 DOI: 10.1002/jper.21-0621] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that periodontitis (PD) causes hypertension, which is a precursor to development of other systemic diseases. The aim of this study was to examine the effect of hypertension and PD on the risk of subsequent systemic disease. METHODS This longitudinal cohort study included 244,393 UK Biobank participants who were free of systemic disease other than hypertension at baseline. Self-reported responses of painful gums or loose teeth were surrogates for PD. Hypertensives were identified by clinical diagnosis, or elevated blood pressure (≥140/90 mmHg). Systemic diseases including cancer, cardiovascular disease (CVD), and diabetes were identified from linked diagnostic codes. Multivariable Cox proportional hazard models were used to quantify the risk of systemic diseases and all-cause mortality, stratified by hypertensive and PD status. RESULTS The average age of the study population was 55.4 years (standard deviation [SD:] 8.1 years), and 130,220 (53.3%) participants were female. At baseline, 131,566 (53.8%) participants were hypertensive and 4.5% reported PD. The incidence rates of all systemic diseases were higher in hypertensive than non-hypertensive participants of the same PD status. In hypertensives, an additive effect was observed for PD on the risks of CVD (adjusted hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.21-1.53) and respiratory disease (HR: 1.11, 95% CI: 0.95-1.30) compared to hypertensive healthy controls. CONCLUSIONS Hypertensives with PD have exacerbated risks of several systemic diseases. Future interventional studies should consider the effect of periodontal treatment on systemic outcomes in targeted hypertensive populations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of DentistryUniversity of LeedsLeedsUK
| | | | - Sue Pavitt
- School of DentistryUniversity of LeedsLeedsUK
| | - Jianhua Wu
- School of DentistryUniversity of LeedsLeedsUK
- Leeds Institute for Data AnalyticsUniversity of LeedsLeedsUK
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Grigoriadis A, Räisänen IT, Pärnänen P, Tervahartiala T, Sorsa T, Sakellari D. Is There a Link between COVID-19 and Periodontal Disease? A Narrative Review. Eur J Dent 2022; 16:514-520. [PMID: 34991165 PMCID: PMC9507582 DOI: 10.1055/s-0041-1740223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic greatly affected human well-being, social behavior, global economy, and healthcare systems. Everyday clinical practice in dentistry has been adjusted to the increased hazards of aerosol production by routine dental procedures. The objective of this study was to assess the existing literature to determine possible mechanisms of a relationship between COVID-19 and periodontitis, as well as describe findings from relevant epidemiological studies.Scarce data exist in the literature that directly addresses the relationship between the two diseases. However, several data describe the role of the oral cavity and periodontal tissues as portals of entry of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), and the contribution of cytokines known to be produced in periodontal disease to severe forms of COVID-19. It is also suggested from the current literature that periodontal disease, shown to be associated with systemic diseases such as diabetes mellitus, cardiovascular and respiratory diseases, shares common risk factors with-especially-severe forms of COVID-19.Further clinical studies are required to establish the relationship between these diseases. Oral hygiene performance and intact periodontal tissues can assist in mitigating the pandemic, and it is suggested that dental practitioners can contribute to identifying at-risk patients.
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Affiliation(s)
- Andreas Grigoriadis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Periodontology, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Baima G, Marruganti C, Sanz M, Aimetti M, Romandini M. Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence. J Dent Res 2022; 101:1430-1440. [PMID: 35774019 DOI: 10.1177/00220345221104725] [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] Open
Abstract
Since the beginning of 2020, the entire global health care system has been severely challenged by the outbreak of coronavirus 2019 disease (COVID-19). Robust evidence has demonstrated a more severe course of COVID-19 in the presence of several comorbidities, such as cardiovascular diseases, diabetes mellitus, and obesity. Here, we critically appraise the recent research discoveries linking periodontitis to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to severe COVID-19, with a special focus on the associated biological mechanisms and the available epidemiological evidence. SARS-CoV-2 main receptors and coreceptors (ACE2, TMPRSS2, furin, CD147) are overexpressed in periodontal tissues of periodontitis patients, with inflammation, periodontal pathogens, and damage-induced pyroptosis triggering a positive feedback loop. However, meta-analyses of epidemiological studies only indicated a nonstatistically significant tendency for an increased risk of SARS-CoV-2 infection in subjects with periodontitis (odds ratio [OR] = 1.69; 95% CI, 0.91-3.13, P = 0.09). Furthermore, periodontitis may worsen clinical COVID-19 courses through multiple direct and indirect pathways, including damage to lower airways due to aspiration of periodontal pathogens, exacerbation of the cytokine storm via the low-grade chronic systemic inflammation, and SARS-CoV-2 dissemination through the ulcerated gingival epithelium with consequent induced pulmonary vessels vasculopathy. Indeed, meta-analyses of epidemiological studies indicated that periodontitis subjects are more likely to experience a more severe course of COVID-19. Specifically, periodontitis was associated with a 4-fold increased odds of hospitalization (OR = 4.72; 95% CI, 1.11-20.03, P = 0.04), 6-fold of requiring assisted ventilation (OR = 6.24; 95% CI, 2.78-14.02, P = 0.00), and more than 7-fold of death due to COVID-19 complications (OR = 7.51; 95% CI, 2.16-26.10, P = 0.00). The breakthrough analyzed here emphasizes the relevance of the mouth-systemic connection as a target to mitigate the current COVID-19 emergency and the future predicted coronavirus pandemics.
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Affiliation(s)
- G Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - C Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - M Sanz
- Section of Post-Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - M Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - M Romandini
- Section of Post-Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
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Abstract
The coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 is usually a mild condition; however, in some cases it can result in severe sickness and even death. Thus, understanding the reasons behind these grave outcomes is of great importance. Coronavirus disease 2019 and periodontitis share some intriguing characteristics. They can both lead to systemic inflammation and alterations of coagulation pathways, and both share confounding factors, such as diabetes, hypertension, and obesity. Accordingly, a possible association between these conditions has been hypothesized in the literature. The objective of this review was to evaluate the scientific evidence linking these diseases and the possible underlying mechanisms. Evidence has shown that coronavirus disease 2019 presents oral manifestations and can even affect periodontal tissues. Moreover, some studies have shown a possible association between coronavirus disease 2019 severity and the presence of periodontitis. Current evidence suggests that this association could be explained through the direct role of periodontal bacteria in aggravating lung infections, as well as through the indirect effect of periodontitis in inducing systemic inflammation and priming of the immune system to an exacerbated reaction to severe acute respiratory syndrome coronavirus 2 infection. Future research is needed to confirm these observations and explore the possible role that periodontal care might play in the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Faleh Tamimi
- College of Dental MedicineQU HealthQatar UniversityDohaQatar
| | - Shiraz Altigani
- College of Dental MedicineQU HealthQatar UniversityDohaQatar
| | - Mariano Sanz
- Faculty of DentistryUniversidad Complutese De MadridMadridSpain
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36
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Ghosh A, Joseph B, Anil S. Does periodontitis influence the risk of COVID-19? A scoping review. Clin Exp Dent Res 2022; 8:1011-1020. [PMID: 35578891 PMCID: PMC9348428 DOI: 10.1002/cre2.584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 04/08/2022] [Accepted: 04/20/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Research has shown that the novel severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) significantly influences the oral microbiome to expedite systemic diseases by invading harmful oral pathogens near and distant organs. To identify, explore, and map the possible mechanisms underlying periodontitis in severe coronavirus disease 2019 (COVID‐19) cases. Material and Methods Relevant articles published from December 2019 to February 2022 were identified and screened using keywords and inclusion criteria from various databases. Results This review sheds light on multiple pathways of periodontitis, the spread of periodontal infection and microbial metabolites to the lungs, and the dysregulated immune system with elevated cytokines, reactive oxygen species generation, nuclear DNA damage, and senescence, which have the potential to promote stronger viral attachment to host cells and the onset of COVID‐19 manifestation with increased severity and risk of mortality. In addition, the cytokine connection to SARS‐CoV‐2, T‐cell responses against periodontitis, its connection with COVID‐19, the role of host factors, and periodontal therapy have been discussed. Conclusions The relationship between COVID‐19 and periodontitis needs further investigation along with the development of alternative therapies to prevent periodontitis for better management and control of COVID‐19.
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Affiliation(s)
- Arunibha Ghosh
- SN Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, India
| | - Betsy Joseph
- Department of Periodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Sukumaran Anil
- Hamad Medical Corporation, Doha, Qatar.,College of Dental Medicine, Qatar University, Doha, Qatar
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Vitkov L, Knopf J, Krunić J, Schauer C, Schoen J, Minnich B, Hannig M, Herrmann M. Periodontitis-Derived Dark-NETs in Severe Covid-19. Front Immunol 2022; 13:872695. [PMID: 35493525 PMCID: PMC9039207 DOI: 10.3389/fimmu.2022.872695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022] Open
Abstract
The frequent severe COVID-19 course in patients with periodontitis suggests a link of the aetiopathogenesis of both diseases. The formation of intravascular neutrophil extracellular traps (NETs) is crucial to the pathogenesis of severe COVID-19. Periodontitis is characterised by an increased level of circulating NETs, a propensity for increased NET formation, delayed NET clearance and low-grade endotoxemia (LGE). The latter has an enormous impact on innate immunity and susceptibility to infection with SARS-CoV-2. LPS binds the SARS-CoV-2 spike protein and this complex, which is more active than unbound LPS, precipitates massive NET formation. Thus, circulating NET formation is the common denominator in both COVID-19 and periodontitis and other diseases with low-grade endotoxemia like diabetes, obesity and cardiovascular diseases (CVD) also increase the risk to develop severe COVID-19. Here we discuss the role of propensity for increased NET formation, DNase I deficiency and low-grade endotoxaemia in periodontitis as aggravating factors for the severe course of COVID-19 and possible strategies for the diminution of increased levels of circulating periodontitis-derived NETs in COVID-19 with periodontitis comorbidity.
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Affiliation(s)
- Ljubomir Vitkov
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany.,Department of Environment & Biodiversity, University of Salzburg, Salzburg, Austria.,Department of Dental Pathology, University of East Sarajevo, East Sarajevo, Bosnia and Herzegovina
| | - Jasmin Knopf
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jelena Krunić
- Department of Dental Pathology, University of East Sarajevo, East Sarajevo, Bosnia and Herzegovina
| | - Christine Schauer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Janina Schoen
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bernd Minnich
- Department of Environment & Biodiversity, University of Salzburg, Salzburg, Austria
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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Watson S, Woodside JV, Winning L, Wright DM, Srinivasan M, McKenna G. Associations between self-reported periodontal disease and nutrient intakes and nutrient-based dietary patterns in the UK Biobank. J Clin Periodontol 2022; 49:428-438. [PMID: 35170067 PMCID: PMC9315140 DOI: 10.1111/jcpe.13604] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/21/2022] [Accepted: 02/06/2022] [Indexed: 12/12/2022]
Abstract
AIM To examine the cross-sectional associations between single nutrient intakes and posteriori nutrient-based dietary patterns and periodontal disease risk in a subset of the UK Biobank cohort. MATERIALS AND METHODS Dietary data were collected by 24-h dietary recall on up to five separate occasions over 16 months. A touchscreen questionnaire was used to collect oral health information. Participants were considered at high risk of periodontal disease if they reported having painful gums and/or bleeding gums and/or loose teeth. Principal component analysis identified four nutrient-based dietary patterns from 20 nutrients. Logistic regression was used to estimate the odds ratio of periodontal disease risk for single nutrients and nutrient-based dietary patterns. RESULTS A total of 9476 participants (mean age 56.2 years [SD 8.0]) were included in the analysis. Higher intakes of vitamin B6, B12, C, and E, folate, iron, potassium, magnesium, polyunsaturated fatty acids, and total sugar were associated with a lower risk of periodontal disease. Higher intake of saturated fat was associated with an increased risk. A dietary pattern characterized by high micronutrients and fibre intake was associated with low risk of periodontal disease. CONCLUSION Within this sample of middle-aged and older adults, a "high micronutrient and fibre" dietary pattern was associated with reduced risk of periodontal disease.
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Affiliation(s)
- Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Jayne V. Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
- Institute for Global Food Security, School of Biological SciencesQueen's University BelfastBelfastUK
| | - Lewis Winning
- Dublin Dental University HospitalTrinity College DublinDublinIreland
| | - David M. Wright
- Centre for Public Health, School of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Murali Srinivasan
- Clinic of General, Special Care and Geriatric DentistryCentre of Dental Medicine, University of ZurichZurichSwitzerland
| | - Gerald McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
- Centre for Dentistry, School of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
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Grillo R, Lopes T, Teixeira RG. Top 50 covid and oral health articles: A 2021 altmetric analysis. J Oral Biol Craniofac Res 2022; 12:458-464. [PMID: 35664949 PMCID: PMC9142403 DOI: 10.1016/j.jobcr.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 04/18/2022] [Accepted: 05/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives There is a world of information at our disposal, and it is increasingly difficult to transform this dull amount of data into knowledge. How to be constantly actualized? This study aims to create an altmetric list of the top 50 articles related to COVID-19 and oral health. Methods Research of terms COVID-19 and oral health was done using Dimensions app. Results were ranked in altmetric citations and analyzed through Microsoft Excel. Some tables and graphics were created. Graphical illustration of keywords was created using VOSviewer. Results Some interesting facts can be seen, like growing interest in dental aerosols, perspectives, and virucidal activity of some mouthwashes. Conclusions Altmetric analysis is a helpful manner to scientific updates, supplementing bibliometric analysis. A terrific manner to see trends. The scientific community goes to great lengths to solve problems with dental aerosols, particularly to reduce contamination. Some adjustments to dental office and the use of barriers are recommended.
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Affiliation(s)
- Ricardo Grillo
- Corresponding author. School of Dentistry – Faculdade São Leopoldo Mandic, São Paulo/Brazil. Rua Dr. José Rocha Junqueira 13 Ponte Preta, Campinas/São Paulo, ZIP Code: 13045-755, Brazil.
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40
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Qi X, Northridge ME, Hu M, Wu B. Oral health conditions and COVID-19: A systematic review and meta-analysis of the current evidence. AGING AND HEALTH RESEARCH 2022; 2:100064. [PMID: 35281130 PMCID: PMC8896863 DOI: 10.1016/j.ahr.2022.100064] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 01/06/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of understanding the underlying conditions that lead to COVID-19. Oral health has systemic implications in the maintenance of a healthy state. This study aimed to summarize evidence on the prevalence of oral health conditions in participants with COVID-19 and assess the associations between oral health conditions and COVID-19 related outcomes. Methods Article searches were conducted in five databases and the gray literature from December 1, 2019 to March 1, 2021. Studies that reported oral health conditions for participants with COVID-19 and/or examined associations between oral health and COVID-19 were included. Results We identified 15 articles that encompassed 5,377 participants with COVID-19 from 10 countries. Dry mouth was the most common oral health condition reported (41.0%), followed by oral lesions (38.8%), orofacial pain (18.3%), and periodontal symptoms (11.7%). Based on the pooled odds ratios (ORs), periodontal symptoms were not associated with COVID-19 positivity (OR = 1.1; 95% confidence intervals [CI], 0.73-1.65) or mortality (OR = 2.71; 95% CI, 0.64-11.51), but were associated with COVID-19 severity (OR = 3.18; 95% CI, 1.81-5.58). Conclusions Oral health conditions are common in participants with COVID-19 and should be considered in both the onset and progression of this disease. Knowledge in this area is still limited, and the quality of the data extracted was low. Further longitudinal studies are needed to ascertain whether oral health conditions are a consequence of infection with SARS-CoV-2 or whether they predate infection and are risk factors for COVID-19.
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Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, 433 First Avenue, Room 520, New York, NY 10010, USA
| | - Mary E Northridge
- Grossman School of Medicine, New York University, New York 10016, USA
| | - Mengyao Hu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, Room 520, New York, NY 10010, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, Room 520, New York, NY 10010, USA
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Mancini L, Americo LM, Pizzolante T, Donati R, Marchetti E. Impact of COVID-19 on Periodontitis and Peri-Implantitis: A Narrative Review. FRONTIERS IN ORAL HEALTH 2022; 3:822824. [PMID: 35224542 PMCID: PMC8866640 DOI: 10.3389/froh.2022.822824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/17/2022] [Indexed: 01/02/2023] Open
Abstract
COVID-19 is reported as one of the most widespread diseases in the world. An extraordinary number of articles and manuscripts have focused on the inflammatory cascade and sequelae, showing the important roles of cytokines and renin-angiotensin levels and possible links to other pathologies. Nowadays, interest regarding the possible correlation between COVID-19 and periodontal and Peri-implant diseases is increasing. This mini-review aims to collect data regarding the possible correlation between COVID-19 and periodontitis or Peri-implantitis through the analysis of articles published in the last 3 years. The following keywords were used: ([periodontitis OR periodontal disease] AND [COVID-19]); ([Peri-implantitis OR mucositis] AND [COVID-19 OR Sars-CoV-2]). The inclusion criteria were studies on COVID-19 or SARS-CoV-2 and periodontitis or Peri-implantitis, and studies on the molecular and cellular aspect of COVID-19 in periodontal or Peri-implant tissues. The search revealed 484 articles in total (PubMed 208 and Scopus 276). After a screening of titles and abstracts, 47 articles were included in the full-text analysis. Two articles comprised the Peri-implant group: a short communication and a review. Regarding the periodontal group, 45 articles were selected and analyzed according to the type of study, population, and aim. Of these, 10 articles were clinical studies, and the other 35 were hypotheses, reviews, letters to the editor, or commentaries. In conclusion, according to the data extracted, a mutual correlation between COVID-19 and periodontitis can be stated; however, data linked to Peri-implantitis are still missing, and future clinical studies are still needed.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- PerioAQ Group, Clinica Odontoiatrica Delta Sei, L'Aquila, Italy
| | - Lorenzo Maria Americo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- PerioAQ Group, Clinica Odontoiatrica Delta Sei, L'Aquila, Italy
| | - Tommaso Pizzolante
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- PerioAQ Group, Clinica Odontoiatrica Delta Sei, L'Aquila, Italy
| | - Raffaele Donati
- Department of Experimental and Clinical Medicine, School of Dentistry, University of Florence, Florence, Italy
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- PerioAQ Group, Clinica Odontoiatrica Delta Sei, L'Aquila, Italy
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42
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Silvestre FJ, Márquez-Arrico CF. COVID-19 and Periodontitis: A Dangerous Association? Front Pharmacol 2022; 12:789681. [PMID: 35095500 PMCID: PMC8793128 DOI: 10.3389/fphar.2021.789681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Francisco Javier Silvestre
- Department of Stomatology, University of Valencia, Valencia, Spain.,Department of Stomatology, University Hospital Doctor Peset-FISABIO, Valencia, Spain
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43
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COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3918980. [PMID: 35047633 PMCID: PMC8763038 DOI: 10.1155/2022/3918980] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.
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44
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Wang Y, Deng H, Pan Y, Jin L, Hu R, Lu Y, Deng W, Sun W, Chen C, Shen X, Huang XF. Periodontal disease increases the host susceptibility to COVID-19 and its severity: a Mendelian randomization study. J Transl Med 2021; 19:528. [PMID: 34952598 PMCID: PMC8708510 DOI: 10.1186/s12967-021-03198-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/14/2021] [Indexed: 01/10/2023] Open
Abstract
Background Emerging evidence shows that periodontal disease (PD) may increase the risk of Coronavirus disease 2019 (COVID-19) complications. Here, we undertook a two-sample Mendelian randomization (MR) study, and investigated for the first time the possible causal impact of PD on host susceptibility to COVID-19 and its severity. Methods Summary statistics of COVID-19 susceptibility and severity were retrieved from the COVID-19 Host Genetics Initiative and used as outcomes. Single nucleotide polymorphisms associated with PD in Genome-wide association study were included as exposure. Inverse-variance weighted (IVW) method was employed as the main approach to analyze the causal relationships between PD and COVID-19. Three additional methods were adopted, allowing the existence of horizontal pleiotropy, including MR-Egger regression, weighted median and weighted mode methods. Comprehensive sensitivity analyses were also conducted for estimating the robustness of the identified associations. Results The MR estimates showed that PD was significantly associated with significantly higher susceptibility to COVID-19 using IVW (OR = 1.024, P = 0.017, 95% CI 1.004–1.045) and weighted median method (OR = 1.029, P = 0.024, 95% CI 1.003–1.055). Furthermore, it revealed that PD was significantly linked to COVID-19 severity based on the comparison of hospitalization versus population controls (IVW, OR = 1.025, P = 0.039, 95% CI 1.001–1.049; weighted median, OR = 1.030, P = 0.027, 95% CI 1.003–1.058). No such association was observed in the cohort of highly severe cases confirmed versus those not hospitalized due to COVID-19. Conclusions We provide evidence on the possible causality of PD accounting for the susceptibility and severity of COVID-19, highlighting the importance of oral/periodontal healthcare for general wellbeing during the pandemic and beyond.
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Affiliation(s)
- Yi Wang
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Deng
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yihuai Pan
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lijian Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Rongdang Hu
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yongyong Lu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenhai Deng
- Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weijian Sun
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chengshui Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Interventional Pulmonology of Zhejiang Province, Wenzhou, Zhejiang, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Xiu-Feng Huang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. .,Wenzhou Medical University-Monash BDI Alliance in Clinical and Experimental Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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45
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Cai W, Marouf N, Said KN, Tamimi F. Nature of the Interplay Between Periodontal Diseases and COVID-19. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.735126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is mostly a mild condition, however, in some patients, it could progress into a severe and even fatal disease. Recent studies have shown that COVID-19 infection and severity could be associated with the presence of periodontitis, one of the most prevalent chronic diseases. This association could be explained by the fact that periodontitis and COVID-19 share some common risk factors that included chronic diseases, such as diabetes and hypertension as well as conditions such as age, sex, and genetic variants. Another possible explanation could be the systemic inflammation and the aspiration of periodontopathogens seen in patients with periodontitis, which could have a synergism with the virus or compromise the reaction of the body against COVID-19. This narrative review explores the nature of these associations, the evidence behind them, and their implications.
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46
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Ting M, Suzuki JB. SARS-CoV-2: Overview and Its Impact on Oral Health. Biomedicines 2021; 9:biomedicines9111690. [PMID: 34829919 PMCID: PMC8615973 DOI: 10.3390/biomedicines9111690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its virulent variants causing coronavirus disease 2019 (COVID-19) COVID-19 has spread rapidly worldwide, and is highly contagious. A comprehensive search was conducted for the most current published information about SARS-CoV-2, COVID-19, and oral health. Clinical studies, case reports, in vivo studies, and any current published evidence on SARS-CoV-2 and COVID-19 were included in this review. Survival against SARS-CoV-2 infection may be partially dependent on periodontal health, good oral hygiene, and access to dental care. Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficial for the prevention and management of COVID-19 infections.
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Affiliation(s)
- Miriam Ting
- Think Dental Learning Institute, Paoli, PA 19301, USA
- Correspondence: ; Tel.: +1-610-601-8898
| | - Jon B. Suzuki
- School of Medicine and School of Dentistry, University of Maryland, Baltimore, MD 20742, USA;
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47
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Espinoza-Espinoza DAK, Dulanto-Vargas JA, Cáceres-LaTorre OA, Lamas-Castillo FE, Flores-Mir C, Cervantes-Ganoza LA, López-Gurreonero C, Ladera-Castañeda MI, Cayo-Rojas CF. Association Between Periodontal Disease and the Risk of COVID-19 Complications and Mortality: A Systematic Review. J Int Soc Prev Community Dent 2021; 11:626-638. [PMID: 35036371 PMCID: PMC8713491 DOI: 10.4103/jispcd.jispcd_189_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/12/2021] [Accepted: 08/04/2021] [Indexed: 01/08/2023] Open
Abstract
AIM The COVID-19 pandemic has strained the world's healthcare systems. Studies have identified how the COVID-19 infections are linked to several co-morbidities such as hypertension, diabetes, cardiovascular disease, renal and pulmonary disease. It is known that periodontal disease (PD) shares the same risk factors. Moreover, both diseases are characterized by an exaggerated immune response. The aim of the study was to investigate the available evidence of a potential association between PD and the risk of COVID-19 complications and mortality. MATERIALS AND METHODS MEDLINE/PubMed, EMBASE, Scopus, and ProQuest were searched. Studies that assess the association between PD and the risk of COVID-19 complications and mortality were eligible for inclusion. Two independent reviewers performed the selection of articles and data extraction. The New Castle Ottawa Scale was used to assess the quality of the selected studies, and the GRADE system was used to evaluate the level of confidence to support the conclusions. RESULTS Only two studies met the eligibility criteria. One study had a low risk of bias, whereas the other had a high risk of bias. CONCLUSION The level of confidence in the available evidence is very low. A close association between periodontitis and the risk of COVID-19 complications and mortality can neither be supported nor refuted.
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Affiliation(s)
| | | | | | | | - Carlos Flores-Mir
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Marysela Irene Ladera-Castañeda
- Academic Program of Stomatology, Universidad Privada San Juan Bautista, Lima e Ica 15066, Peru
- Universidad Nacional Federico Villarreal, Postgraduate School, “Grupo de Investigación Salud y Bienestar Global” and Faculty of Dentistry, Lima 15084, Peru
| | - César Félix Cayo-Rojas
- Academic Program of Stomatology, Universidad Privada San Juan Bautista, Lima e Ica 15066, Peru
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48
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Is There a Link between COVID-19 Infection, Periodontal Disease and Acute Myocardial Infarction? Life (Basel) 2021; 11:life11101050. [PMID: 34685421 PMCID: PMC8538734 DOI: 10.3390/life11101050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023] Open
Abstract
Both periodontal disease and atherosclerosis are chronic disorders with an inflammatory substrate that leads to alteration of the host's immune response. In PD, inflammation is responsible for bone tissue destruction, while in atherosclerosis, it leads to atheromatous plaque formation. These modifications result from the action of pro-inflammatory cytokines that are secreted both locally at gingival or coronary sites, and systemically. Recently, it was observed that in patients with PD or with cardiovascular disease, COVID-19 infection is prone to be more severe. While the association between PD, inflammation and cardiovascular disease is well-known, the impact of COVID-19-related inflammation on the systemic complications of these conditions has not been established yet. The purpose of this review is to bring light upon the latest advances in understanding the link between periodontal-cardiovascular diseases and COVID-19 infection.
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49
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Basso L, Chacun D, Sy K, Grosgogeat B, Gritsch K. Periodontal Diseases and COVID-19: A Scoping Review. Eur J Dent 2021; 15:768-775. [PMID: 34500484 PMCID: PMC8630939 DOI: 10.1055/s-0041-1729139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of this scoping review was to present the existing literature regarding the relationship between periodontal diseases and coronavirus disease 2019 (COVID-19). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines was followed. Articles were retrieved from PubMed/MEDLINE and Scopus databases and screened to include studies relating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 to periodontal cells and/or tissues and/or diseases. Twenty-five papers were included; consisting of six reviews, seven original articles, six short reports, four letters to the editor, one commentary, and one case report. The articles were allocated to three different topics: (i) hypotheses on the relationship between periodontal diseases and COVID-19; (ii) risk factors and comorbidities common to periodontitis and COVID-19; (iii) periodontal manifestations of COVID-19. Certain molecules (angiotensin-converting enzyme-2, furin, cathepsin, TMPRSS2...) that are found at a high level in periodontal tissues, particularly in patients with periodontitis, are involved in the mechanism of entry of SARS-CoV-2 into cells. Periodontopathic bacteria could also play a direct role in the mechanism of entry of SARS-CoV-2 by cleaving the S-protein, and the cytokines produced during periodontitis could add to the cytokine storm found in the severe forms of COVID-19. It thus appears that the treatment of periodontitis, which allows a reduction in periodontopathic bacteria and of the local and systemic inflammation state, could be part of a strategy to prevent the development of severe forms of COVID-19.
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Affiliation(s)
- Lisa Basso
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France
| | - Doriane Chacun
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France
| | - Kadiatou Sy
- Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France.,Univ Lille, INSERM, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Brigitte Grosgogeat
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité de Recherche Clinique, Lyon, France
| | - Kerstin Gritsch
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire des Multimatériaux et Interfaces (UMR CNRS 5615), Villeurbanne, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Unité Fonctionnelle de Parodontologie, Lyon, France
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50
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Gupta S, Mohindra R, Singla M, Khera S, Sahni V, Kanta P, Soni RK, Kumar A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Bhalla A, Sorsa T, Räisänen I. The clinical association between Periodontitis and COVID-19. Clin Oral Investig 2021; 26:1361-1374. [PMID: 34448073 PMCID: PMC8390180 DOI: 10.1007/s00784-021-04111-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes. MATERIAL AND METHODS Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed. RESULTS Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests. CONCLUSIONS Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner. CLINICAL RELEVANCE The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.
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Affiliation(s)
- Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Ritin Mohindra
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mohita Singla
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Sagar Khera
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | | | - Poonam Kanta
- Department of Virology, PGIMER, Chandigarh, India
| | | | - Amit Kumar
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, PGIMER, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Varun Mahajan
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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