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Cassiano BA, Silveira ALPA, Kim YJ, do Amaral JB, da Silva Nali LH, Bachi ALL, Resende LD, Fonseca FAH, de Oliveira Izar MC, Tuleta ID, Victor JR, Pallos D, França CN. Role of circulating microparticles and cytokines in periodontitis associated with diabetes. Front Med (Lausanne) 2024; 11:1394300. [PMID: 39253540 PMCID: PMC11381390 DOI: 10.3389/fmed.2024.1394300] [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: 03/01/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024] Open
Abstract
Background Periodontitis is a chronic inflammatory condition that affects the supporting tissues of the teeth, and can lead to serious complications such as tooth loss and systemic health problems, including diabetes, which have a bidirectional relationship with periodontitis. Circulating microparticles originate from different cell types after stimuli such as activation or apoptosis. Interleukins are related to processes in the regulation of the immune response, inflammation, and cell growth. This study aimed to evaluate circulating microparticles as well as interleukins in the plasma, at baseline and 1 month after the end of the non-surgical periodontal treatment. Methods Samples were collected from 45 patients, with moderate to severe periodontitis with diabetes (N = 25) and without diabetes (N = 20). Microparticles were evaluated in the platelet-poor plasma by flow cytometer. Cytokine levels were evaluated by the enzyme immunoabsorption assay (ELISA). Results Higher levels of the pro-inflammatory cytokines were found in the group with diabetes compared to the non-diabetic group both at baseline and 1 month after the end of the treatment. A higher IL-6/IL-10 ratio was found in patients with diabetes compared to the group without diabetes at T0 and T1, whereas an increased IFN-γ/IL-10 ratio was only found at T1 in patients with diabetes in comparison to the group without diabetes. In the group with diabetes, it was verified positive correlations between IL-10 and IL-6 or IFN-γ and a negative correlation between IL-6 and PMP, at T0; in contrast, in the T1, negative correlations were found between TNF-α and IL-10 or PMP. Besides, at T0, it was evidenced positive correlations both between circulating TNF-α and IL-6, and IL-10 and EMP, as well as a negative correlation between IL-10 and PMP in the group with diabetes. In addition, it was observed in T1 positive correlations between levels of TNF-α and IL-6, IFN-γ, or IL-10, and between PMP and IFN-γ, and between EMP and IL-6, TNF-α and IFN-γ in this group. Conclusion The results suggest a modulatory effect of the periodontitis associated with diabetes, as well as the periodontal treatment, in the systemic inflammatory status of the participants of the study.
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Affiliation(s)
| | | | - Yeon Jung Kim
- Odontology Post Graduation, Santo Amaro University, São Paulo, Brazil
| | - Jônatas Bussador do Amaral
- ENT Research Laboratory, Otorhinolaryngology-Head and Neck Surgery Department, Federal University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | - Izabela Dorota Tuleta
- Department of Medicine-Cardiology, Albert Einstein College of Medicine, New York, NY, United States
| | | | - Débora Pallos
- Odontology Post Graduation, Santo Amaro University, São Paulo, Brazil
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Tan H. Equity and Prediction of Bed Allocation of the Department of Stomatology in Chinese Hospitals. Risk Manag Healthc Policy 2024; 17:1465-1476. [PMID: 38855045 PMCID: PMC11162239 DOI: 10.2147/rmhp.s461085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/25/2024] [Indexed: 06/11/2024] Open
Abstract
Objective To analyze the equity of bed allocation of the department of stomatology in Chinese hospitals and predict the development in the next 5 years, so as to provide a scientific basis for promoting the development of oral health. Methods Data on the beds of the department of stomatology in Chinese hospitals from 2017 to 2021 were obtained from the China Health Statistical Yearbook. The Gini coefficient, Lorenz curve, Theil index and agglomeration degree were used to analyze the equity of the bed allocation, and the grey prediction model GM(1,1) was used to predict the development from 2022 to 2026. Results From 2017 to 2020, the Gini coefficient of bed allocation of the department of stomatology in Chinese hospitals was below 0.2 by population. From 2017 to 2021, the Gini coefficient of beds was above 0.6 by geography and between 0.2 and 0.3 by economy. The Theil index of beds ranged from 0.022 to 0.056 by population, from 0.532 to 0.564 by geography, and from 0.042 to 0.047 by economy. The inequity in the allocation by population was mainly from between regions, and the inequity in the allocation by geography and economy was mainly from within regions. Health resource agglomeration degree (HRAD) was greater than 2 in the eastern and central regions and less than 1 in the western region. HRAD/ population agglomeration degree (PAD) was greater than 1 in the northeast, eastern, and central regions and less than 1 in the western region. According to the prediction, the number of beds of the department of stomatology in Chinese hospitals will continue to increase, reaching 47,862.485 in 2026. Conclusion The equity of bed allocation was better by population and economy than by geography. The equity of beds in the western region is insufficient equity by population and geography, and the equity of beds in the eastern region is insufficient equity by economy.
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Affiliation(s)
- Hong Tan
- Department of Periodontal Mucosal Disease, The Affiliated Stomatology Hospital of Southwest Medical University, Oral & Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, People’s Republic of China
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Chan AKY, Tsang YC, Lai EHH, Chu CH. Tooth Wear in Older Adults: A Review of Clinical Studies. Geriatrics (Basel) 2024; 9:12. [PMID: 38247987 PMCID: PMC10801519 DOI: 10.3390/geriatrics9010012] [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: 11/18/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Tooth wear is a prevalent dental condition among older adults, leading to pain and adversely affecting aesthetics, functionality, and their overall quality of life. This review aims to update the information on tooth wear in older adults from the past five years and to provide guidance on the clinical management of tooth wear in older adults. METHODS A literature search was conducted in three electronic databases, Scopus, Pubmed, and Embase, for English publications from January 2019 to December 2023 on clinical studies with participants aged 65 or above on tooth wear. A total of 307 articles were retrieved and 14 articles were finally included as references for this study. RESULTS This review highlights the common causes of tooth wear and various risk factors, such as medical conditions, hyposalivation, dietary habits, oral hygiene practices, parafunctional habits, and occlusal factors, associated with tooth wear. It is crucial for oral health care professionals to diagnose and manage tooth wear at an early stage through a risk assessment and a clinical examination to avoid complex restorative procedures. Tooth wear management should prioritize prevention, aiming to control etiological and risk factors while employing non-restorative treatments. Restorative intervention, if indicated, should be simple, minimally invasive, and cost-effective. Tooth wear progression should be monitored regularly to determine if a further intervention is needed. CONCLUSION Since the clinical studies on tooth wear in older adults over the past five years are limited and mainly cross-sectional, more interventional clinical studies are warranted to provide more clinical guidance on tooth wear management in older adults.
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Affiliation(s)
- Alice Kit Ying Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 99907, China; (A.K.Y.C.); (Y.C.T.)
| | - Yiu Cheung Tsang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 99907, China; (A.K.Y.C.); (Y.C.T.)
| | - Eddie Hsiang-Hua Lai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 99907, China; (A.K.Y.C.); (Y.C.T.)
- School of Dentistry, College of Medicine, National Taiwan University, Taipei 103247, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei 103247, Taiwan
- Department of Oral Health, Ministry of Health and Welfare, Taipei 103247, Taiwan
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 99907, China; (A.K.Y.C.); (Y.C.T.)
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Chan AKY, Chu CH, Ogawa H, Lai EHH. Improving oral health of older adults for healthy ageing. J Dent Sci 2024; 19:1-7. [PMID: 38303786 PMCID: PMC10829734 DOI: 10.1016/j.jds.2023.10.018] [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: 10/05/2023] [Revised: 10/13/2023] [Indexed: 02/03/2024] Open
Abstract
The objective of this article is to discuss the importance of oral health in achieving healthy ageing and the role of all stakeholders in improving oral health for older adults. The World Health Organization defined healthy ageing as the process of developing and maintaining the functional ability that enables well-being in older age. It recognized healthy ageing as an important goal and the key to turn population ageing from a challenge to an opportunity. Healthy ageing has positive impacts on individual older adults, their families and societies. It enhances quality of life of older adults, strengthen family bonding of families and reduce resource demand of the societies. Maintaining oral health and function is essential in healthy ageing. Oral health affects systemic health, cognitive health and psychological health. Oral functions such as eating ensure nutritional health in older adults. Most oral diseases are preventable and oral function decline can be recovered by intervention. Unfortunately, oral diseases remain prevalent and oral function decline is being neglected in older adults. Policy makers, national dental associations, academics and healthcare professionals should collaborate to provide a patient-centred, comprehensive and integrated care to older adults. Health policy reforms are needed to reduce the global oral health inequalities in older adults. Population-wide prevention should be accessible, affordable and available to older adults. Universal oral health coverage is crucial for integration of oral health into general health care.
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Affiliation(s)
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Hiroshi Ogawa
- Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Eddie Hsiang-Hua Lai
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Oral Health, Ministry of Health and Welfare, Taipei, Taiwan
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Dalirsani Z, Ghazi A, Firouzabadi MG. Frequency of Systemic Diseases and Oral Lesions Among the Institutionalized Elderly Subjects in the Northeast of Iran. Indian J Dermatol 2023; 68:723. [PMID: 38371557 PMCID: PMC10868977 DOI: 10.4103/ijd.ijd_246_23] [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] [Indexed: 02/20/2024] Open
Abstract
Background With ageing, the number of systemic diseases and the consumption of drugs increase. Moreover, some oral lesions, especially denture-related lesions, are commonly observed. Aim and Objective The purpose of this study was to determine the frequency of systemic diseases and oral lesions in the elderly in the Mashhad Geriatric Institutes. Methods Institutionalized elderly people, who could cooperate for oral examination, enrolled in this descriptive cross-sectional study. The frequency of oral lesions and their systemic diseases were recorded in the self-made checklist. For statistical analysis, Student's t-test and Chi-square test were utilized. The significance level was considered to be 0.05. Results During the study, 224 elderly subjects with a mean age of 75.63 ± 11.22 years were evaluated. The mean duration of residency in the elderly nursing centres was 1.87 ± 1.37 years. Hypertension, Alzheimer's disease and diabetes were the most common systemic diseases, and about 47% of the patients had two or multiple concurrent diseases. Among participants, 97.1% had at least one oral lesion. The most common oral lesions were fissured tongue (75%), sublingual varicosity (68.3%) and hairy or coated tongue (38.4%), respectively, which are classified as normal variations of oral mucosa. The most common pathological lesions were denture stomatitis, frictional keratosis and lichenoid reactions. Conclusion Regarding to the high frequency of oral lesions among ageing people, regular examination of the oral mucosa for early detection of oral lesions and appropriate treatments is recommended.
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Affiliation(s)
- Zohreh Dalirsani
- From the Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- From the Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Chan AKY, Tsang YC, Jiang CM, Leung KCM, Lo ECM, Chu CH. Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature. Dent J (Basel) 2023; 11:222. [PMID: 37754342 PMCID: PMC10528506 DOI: 10.3390/dj11090222] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/07/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
Diet, nutrition, and oral health are closely linked. Malnutrition is a challenging health concern in older adults that is associated with physical decline affecting their daily activities and quality of life. The aim of this review is to provide an evidence-based summary of the relationship between diet and nutrition and oral health in older adults and its implications. The World Health Organization has declared healthy ageing a priority of its work on ageing. The American Dental Association confirmed the bidirectional relationship between diet and nutrition and oral health. The literature shows that diet and nutrition are related to oral diseases, including dental caries, periodontal diseases, tooth wear, and even oral cancer. Insufficient nutritional intake and poor dietary habits increase the risk of oral diseases, such as dental caries, in older adults. On the other hand, in older adults, poor oral conditions such as periodontal disease may induce pain, infection, and tooth loss, affecting nutritional intake. Surveys have shown that older adults, in particular, those in disadvantaged communities, suffered from nutritional deficiencies or imbalances affecting their oral health. In addition, the current literature shows that malnutrition is associated with frailty, hospitalization, mortality, and morbidity. Good oral health and functional dentition are essential to maintain sufficient nutritional intake among older adults and reduce the risk of malnutrition. Therefore, integrating oral health into general health care service in older adults is imperative to improve their nutritional and oral health status to achieve healthy ageing.
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Affiliation(s)
| | | | | | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (A.K.Y.C.); (Y.C.T.); (C.M.J.); (K.C.M.L.); (E.C.M.L.)
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