Effect of cigarette smoking on the periodontal health status: A comparative, cross sectional study

Prevalence and Severity of Periodontal Disease and its Association with Type-II Diabetes Mellitus and Smoking by Using Periodontal Screening and Recording: A Retrospective Study

Background

Periodontal screening recording (PSR) is considered a quick, reliable, reproducible valuable screening tool for periodontal disease. This study aims to find the prevalence and severity of periodontal disease and its association with self-reported diabetic status and smoking history of the patients by using PSR codes over a period of 2 years.

Material and Methods

This was a cross-sectional retrospective study in a dental hospital in Chandigarh. Data of 10,882 patients comprising self-reported history of smoking (893) and diabetes (725) patients were assessed for the prevalence of periodontal disease by using PSR codes. Pearson Chi-Square test was used for statistical evaluation of PSR codes data.

Results

Out of a total of 65,292 sextants assessed, the maximum and minimum reported PSR codes were 2 and 4, respectively. Gingivitis was found to be the most prevalent, followed by periodontitis and periodontal health in the total assessed population (P < 0.001). Mucogingival problems and complete edentulism were found to be more prevalent in posterior sextants in comparison to anterior sextants. Both self-reported smokers and type-II diabetes mellitus patients presented gingivitis as the most common clinical presentation, with the highest prevalence seen in the 55-74-year age group, which also comprised the group with maximum mucogingival problems and edentulism.

Conclusion

This study gives an overview of patients' general oral health status and reflects the burden of periodontal disease in the Chandigarh region, thus contributing to the national oral health data.

Association between Body Mass Index and Severity of Periodontal Disease among Adult South Indian Population: A Cross-sectional Study

Background

Periodontal disease is one of the top six chronic noncommunicable diseases (NCDs) and is recognized as a severe global public health problem. This study aimed to assess the association between various levels of body mass index (BMI) and periodontal disease severity in Indian adults.

Material and Methods

The study was designed as a hospital-based cross-sectional study involving 212 participants aged between 18 and 65. A questionnaire assessed by an investigator was used to assess oral health-associated risky behavior and demographical factors. Participants were also assessed using full-mouth clinical periodontal and anthropometric measurements. The mean number of sites with pocket probing depth (PPD) ≥4 mm and the presence of periodontal disease were used as outcome measures. Bivariate analysis and multiple logistic regressions were performed.

Results

The overall proportion of participants with periodontal disease was 50%, that is, sites with PPD ≥4 mm (n = 106). Multivariate analysis showed that BMI (odds ratio (OR) = 0.77, 95% confidence interval (CI): 0.43, 1.37) was not associated with periodontal disease, but smoking (OR = 3.90, 95% CI: 1.63, 5.89), alcohol consumption (OR = 1.24, 95% CI: 0.72, 2.13), age (OR = 2.51, 95% CI: 1.08, 5.84), and diabetic mellitus (OR = 1.69, 95% CI: 0.92, 3) were positively associated with periodontal disease.

Conclusion

A positive association was found between smoking, alcohol consumption, age, gender, history of diabetic mellitus, and periodontal disease. No significant association exists between obesity and periodontal disease in South Indian adults.

Soluble Receptor Activator of Nuclear Factor Ligand and Osteoprotegerin Levels in Gingival Crevicular Fluid among Cigarette Smokers and Non-smokers with and without Periodontitis

AIM

This study aimed to measure and compare the levels of soluble receptor activator of nuclear factor ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF), as well as their ratio, in smokers and nonsmokers with periodontitis.

MATERIALS AND METHODS

Gingival crevicular fluid samples were collected using PerioPaper strips, from 150 individuals, who were categorized into three groups: current smokers with periodontitis stage III grades C and B (n = 50), nonsmokers with periodontitis stages I and II grade A (n = 50), and control healthy individuals (n = 50). The concentrations (pg/mL) of sRANKL and OPG in the GCF were measured by enzyme-linked immunesorbent assays (ELISA).

RESULT

The smokers' group exhibited the highest sRANKL (pg/mL) concentration as a subsequent lead to a higher sRANKL/OPG ratio. The healthy control group exhibited higher OPG and lower sRANKL concentration, subsequently, the sRANKL/OPG ratio was reduced compared with the other study groups. However, there was no statistical significance of sRANKL and its relative ratio between periodontitis stage III grades C and B, periodontitis stages I and II grade A, and healthy control individuals. There was a statistically significant positive moderate correlation between smoking duration (years) and the sRANKL (pg/mL) concentration and a statistically significant negative moderate correlation between OPG (pg/mL) concentration and cigarettes smoked per day.

CONCLUSION

As a result, compared to the other research groups, smokers with periodontitis stage III grades C and B had greater GCF concentrations of sRANKL, lower OPG, and a higher sRANKL/OPG ratio. The difference in OPG (pg/mL) level was statistically significant. However, there was no statistically significant difference in sRANKL (pg/mL) or its relative ratio, sRANKL/OPG, across the groups.

CLINICAL SIGNIFICANCE

A characteristic that sets periodontitis apart is alveolar bone loss. Resorption is induced by RANKL and inhibited by OPG, resulting in a relative ratio. In light of this, the levels of RANKL and OPG may be helpful indicators for monitoring the activity of periodontal disease in both smokers and nonsmokers with and without periodontitis.

The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

Introduction

Periodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases.

Objective

To evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals.

Material and Method

A total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups.

Result

There was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001).

Conclusion

The present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.

Salivary cortisol, dehydroepiandrosterone, and chromogranin A levels in patients with gingivitis and periodontitis and a novel biomarker for psychological stress

Introduction

This study aimed to investigate the neuroendocrine responses based on cortisol, dehydroepiandrosterone (DHEA), cortisol/DHEA ratio, and chromogranin A levels, which reflect the activity of the hypothalamic-pituitary-adrenal axis, according to the presence or absence of psychological stress in patients with gingivitis and periodontitis compared to that in healthy controls.

Methods

In total, 117 patients (60 women, mean age: 36.29 ± 19.03 years) participated in this case-control study, comprising 32 healthy controls, 49 patients with gingivitis, and 36 patients with periodontitis. We investigated the presence of psychological stress and salivary characteristics, and analyzed the stress-related biomarkers of cortisol, DHEA, cortisol/DHEA ratio, and chromogranin A in the stimulated saliva.

Results

Salivary cortisol and chromogranin A levels increased with the severity of periodontal disease; their levels were the highest in the periodontitis group and were significantly higher in the following descending order: periodontitis, gingivitis, and healthy control groups (all values of p < 0.001). Additionally, the DHEA levels and cortisol/DHEA ratio were higher in the periodontitis group than those in the healthy control group (all values of p < 0.001). A multivariate logistic regression analysis revealed that the factors predicting above-average cortisol levels were periodontitis (odds ratio [OR] = 256.829; p < 0.001), women (OR = 6.365; p = 0.004), and psychological stress (OR = 6.036; p = 0.007); those predicting above-average cortisol/DHEA ratios were periodontitis (OR = 11.436; p < 0.001), psychological stress (OR = 3.977; p = 0.003), and women (OR = 2.890; p = 0.026). Thus, periodontitis and psychological stress were significant and strong predictors of above-average cortisol levels and cortisol/DHEA ratios. In the gingivitis group, salivary cortisol levels (r = 0.381, p = 0.007) and cortisol/DHEA ratios (r = 0.479, p < 0.001) were correlated with the presence of psychological stress. In the periodontitis group, increased cortisol/DHEA ratios (r = 0.412, p = 0.013) and lowered salivary buffer capacities (r = -0.334, p = 0.047) were correlated with the presence of psychological stress.

Conclusion

Periodontitis is a multifactorial disease resulting in inflammatory tissue destruction, which differs from gingivitis and a healthy state. Differences in stress-related neuroendocrine markers were revealed based on the severity of periodontal disease. The biomarkers that could be classified according to disease severity were salivary cortisol and chromogranin A levels. Above-average cortisol levels and cortisol/DHEA ratios are significant predictors of psychological stress in patients with gingivitis and periodontitis.

The impact of smoking on periodontal status and dental caries

INTRODUCTION

Investigations to explore the relationship between smoking and its oral manifestations are important to clinicians. Among these oral manifestations, periodontal diseases and dental caries have still a controversial association. This study aims to analyze the effect of smoking on periodontal disease and caries and their relevance to each other.

METHODS

Data on demographic and clinical features were retrieved from 7028 patients. Smoking status was categorized as a smoker, non-smoker, former smoker and passive smoker. Each patient received a diagnosis according to the new classification system for periodontal disease, in which periodontal disease is divides into stages (PS). The carries status was diagnosed by evaluating the decayed, missing, and filled teeth (DMFT) index.

RESULTS

Of the patients, 66.6% were non-smoker women, whereas 53.7 % of passive smokers were women. Being a worker and having a Bachelor’s degree was associated with a higher likelihood of getting diagnosed with periodontal disease and caries in smokers. Smoking significantly influences periodontal disease severity and DMFT values (p<0.001). This becomes more evident in former smokers by showing the highest severe periodontal problems (PS3: 29.7% and PS4: 18.9%), and the highest DMFT mean (16.4 ± 7.4) Accordingly, persons having high DMFT had significantly the most severe periodontal disease, namely PS4 (p<0.05).

CONCLUSIONS

Smoking is associated with higher caries prevalence and more severe periodontal disease, and DMFT tend to increase with the severity of periodontitis in the same subjects.

Evaluation of stress, serum and salivary ghrelin and cortisol levels in smokers and non-smokers with stage iii periodontitis - A cross-sectional study

BACKGROUND

The present study aimed to investigate the serum and salivary ghrelin and cortisol levels in smokers and non-smokers with Stage III Periodontitis.

METHODS

The present study comprised of a total of 90 systemically healthy patients categorized in three groups: Group I- Periodontally healthy patients; Group II- Non-smokers with Stage III Periodontitis and Group III- Smokers with Stage III periodontitis. Clinical parameters of Probing pocket depth (PPD), Clinical attachment levels (CAL), Plaque Index (PI), Gingival Index (GI) and Papillary Bleeding Index (PBI)were recorded and biochemical parameters of serum and salivary ghrelin and cortisol levels were analyzed via Enzyme Linked Immunosorbent Assay (ELISA). Stress levels were assessed using Zung's self-rating depression scale.

RESULTS

Serum and salivary ghrelin values were found to be higher in Group II (620.25 ± 260.86 pg/ml, 892.40 ± 271.65 pg/ml respectively) as compared to Group III. Similarly, salivary as well as serum cortisol levels were higher in Group III (20.78 ± 9.23 pg/ml, 399.37 ±189.21 pg/ml respectively) as compared to Group II (16.36 ± 8.88 pg/ml, 320.68 ± 107.01 pg/ml respectively). In Group III, a direct correlation was observed between stress, serum and salivary cortisol levels while an inverse correlation was found between stress, serum and salivary ghrelin levels. Group III showed a greater number of depressed patients followed by Group II and I.

CONCLUSION

As per the results smokers with Stage III Periodontitis exhibit an elevated stress and cortisol levels, lower serum and salivary ghrelin levels as compared to the non-smokers. This article is protected by copyright. All rights reserved.

Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and meta-analysis

OBJECTIVES

Cardiovascular disease (CVD) is a major cause of mortality; periodontal disease (PD) affects up to 50% of the world's population. Observational evidence has demonstrated association between CVD and PD. Absent from the literature is a systematic review and meta-analysis of longitudinal cohort studies quantifying CVD risk in PD populations compared to non-PD populations. To examine the risk of incident CVD in people with PD in randomised controlled trials and longitudinal cohort studies.

MATERIAL AND METHODS

We searched Medline, EMBASE and Cochrane databases up to 9th Oct 2019 using keywords and MeSH headings using the following concepts: PD, CVD, longitudinal and RCT study design. CVD outcomes included but were not restricted to any CVD, myocardial infarction, coronary heart disease (CHD) and stroke. Diagnosis method and severity of PD were measured either clinically or by self-report. Studies comparing incident CVD in PD and non-PD populations were included. Meta-analysis and meta-regression was performed to determine risk of CVD in PD populations and examine the effects of PD diagnosis method, PD severity, gender and study region.

RESULTS

Thirty-two longitudinal cohort studies were included after full text screening; 30 were eligible for meta-analysis. The risk of CVD was significantly higher in PD compared to non-PD (relative risk [RR]: 1.20, 95% CI: 1.14-1.26). CVD risk did not differ between clinical or self-reported PD diagnosis (RR = 0.97, 95% CI: 0.87-1.07,). CVD risk was higher in men (RR: 1.16, 95% CI: 1.08-1.25) and severe PD (RR: 1.25, 95% CI: 1.15-1.35). Among all types of CVD, the risk of stroke was highest (RR = 1.24; 95% CI:1.12-1.38), the risk of CHD was also increased (RR = 1.14; 95% CI:1.08-1.21).

CONCLUSION

This study demonstrated modest but consistently increased risk of CVD in PD populations. Higher CVD risk in men and people with severe PD suggests population-targeted interventions could be beneficial.

Evaluation of Oral Health Status and Oral Care of Patients with Rheumatoid Arthritis

Objective

Rheumatoid arthritis (RA) and periodontal disease (PD) are common chronic, immunoinflammatory, destructive, and progressive diseases; however, the correlations between those two are not yet widely discussed. The purpose of this study was to evaluate the relationship between the selected demographic and clinical parameters of RA patients and oral health status parameters, on the basis of self-assessment.

Materials and Methods

Three hundred patients under treatment were included in the study. Questionnaires were completed by 164 out of 300 patients.

Results

A total of 100 females and 64 males took part in the study, with a mean age of 65 ± 11.1 years. In younger patients, the disease activity score (DAS28) was higher, and it was associated with pain or discomfort in the oral cavity and with difficulties in toothbrushing. Discomfort or pain in the oral cavity was to a significant extent associated with the poor gingival state, gingival bleeding, and difficulties in biting or chewing.

Conclusions

In RA patients, difficulties in biting or chewing, discomfort or pain in oral cavity, feeling of the presence of movable teeth, and gingival bleeding are indications of periodontal infection. Maintaining awareness of oral health and RA is a key issue in the simultaneous management of proper oral care and RA due to the mutual influence of those two factors.

The Association Between Smoking and Gut Microbiome in Bangladesh

INTRODUCTION

Epidemiological studies that investigate alterations in the gut microbial composition associated with smoking are lacking. This study examined the composition of the gut microbiome in smokers compared with nonsmokers.

AIMS AND METHODS

Stool samples were collected in a cross-sectional study of 249 participants selected from the Health Effects of Arsenic Longitudinal Study in Bangladesh. Microbial DNA was extracted from the fecal samples and sequenced by 16S rRNA gene sequencing. The associations of smoking status and intensity of smoking with the relative abundance or the absence and presence of individual bacterial taxon from phylum to genus levels were examined.

RESULTS

The relative abundance of bacterial taxa along the Erysipelotrichi-to-Catenibacterium lineage was significantly higher in current smokers compared to never-smokers. The odds ratio comparing the mean relative abundance in current smokers with that in never-smokers was 1.91 (95% confidence interval = 1.36-2.69) for the genus Catenibacterium and 1.89 (95% confidence interval = 1.39-2.56) for the family Erysipelotrichaceae, the order Erysipelotrichale, and the class Erysipelotrichi (false discovery rate-adjusted p values = .0008-.01). A dose-response association was observed for each of these bacterial taxa. The presence of Alphaproteobacteria was significantly greater comparing current with never-smokers (odds ratio = 4.85, false discovery rate-adjusted p values = .04).

CONCLUSIONS

Our data in a Bangladeshi population are consistent with evidence of an association between smoking status and dosage with change in the gut bacterial composition.

IMPLICATIONS

This study for the first time examined the relationship between smoking and the gut microbiome composition. The data suggest that smoking status may play an important role in the composition of the gut microbiome, especially among individuals with higher levels of tobacco exposure.

Effects of alcohol and nicotine consumption on the development of apical periodontitis in rats: a correlative micro-computed tomographic, histological and immunohistochemical study

AIM

To evaluate the effects of alcohol and nicotine, when used alone or simultaneously, in the development of apical periodontitis induced in rats, using a correlative analytic approach with micro-CT, histological and immunohistochemical analysis.

METHODOLOGY

Twenty-eight male Wistar rats were arranged into four groups: Control, Nicotine, Alcohol and Alcohol + Nicotine. The alcohol groups were exposed to self-administration of a 25% alcohol solution, whilst the other groups drunk only filtered water. The nicotine groups received daily intraperitoneal injections of a solution with 0.19 μL of nicotine per mL, whilst the other groups received saline solution. The pulps of the left mandibular first molars were exposed for 28 days to induce periapical lesions. Throughout the experiment, drug administration was maintained, and the animals had their weight and solid and liquid consumption measured. After euthanasia, the mandibles were removed and the area, volume and major diameter of the periapical lesions were measured using micro-computed tomography images. The samples were submitted to histopathological evaluation and immunohistochemistry for RANKL and PTHrP. Statistical analysis was undertaken with a significance level of 5%. Nonparametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, whilst one-way anova followed by Tukey's test was performed for parametric data.

RESULTS

The alcohol groups had lower solid and liquid consumption and gained less weight when compared to the nonalcohol groups (P < 0.05). The Alcohol + Nicotine group had lesions with significantly larger volume and area when compared to the other groups (P < 0.05), whilst the Alcohol or Nicotine groups had significantly larger lesions than the control group (P < 0.05). There was no significant difference in the largest diameter of the lesions amongst groups (P > 0.05). The experimental groups had greater inflammatory response scores than the control group (P < 0.05), and the representative samples had more pronounced immunoreaction against RANKL and PTHrP antibodies.

CONCLUSIONS

Alcohol and nicotine consumption exacerbated the inflammatory response and the development of periradicular lesions in rats. The association of both substances enhanced their harmful effects.

The influence of tobacco consumption on periodontal health: A stratified analysis based on type of tobacco use

Introduction

Though the negative influence of tobacco consumption on the periodontal status of an individual is established, the magnitude of this association based on the type of tobacco used is seldom investigated.

Aim

The aim of this study is to check the differences in the periodontal status of individuals based on their current tobacco consumption status and type of tobacco consumption.

Materials and Methods

This study was conducted among subjects attending a teaching dental institution in Andhra Pradesh. Subjects were divided into three groups based on their current tobacco consumption status. The following parameters were recorded after examination by two calibrated investigators: number of sites with bleeding on probing; number of teeth with periodontal pockets; number of teeth with clinical attachment loss of ≥5 mm; number of teeth lost. SPSS version 20 software was used to analyze the data.

Results

While current users demonstrated poor periodontal status than the former and nonusers, there was a significant difference in periodontal health between former users and nonusers in all the study parameters except the mean number of teeth lost. Among current users, the mean percentage of sites with bleeding and attachment loss >5 mm were found to be least among smokers compared to tobacco chewers and those who consume both smoke and smokeless forms of tobacco.

Conclusion

The study confirms the negative influence of tobacco consumption on periodontal health and also establishes the increased destruction of clinical attachment levels among tobacco chewers compared to smokers.

Periodontitis and oral Cancer-A striking link

Oral squamous cell carcinoma (OSCC) has become a major public health problem in the worldwide for its increasing incidence and mortality, especially in younger trends. Risk factors for OSCC apart from alcohol and tobacco use, include poor oral hygiene, inflammation caused by inadequately fitting dentures and other rough teeth surfaces, poor nutrition and some chronic infections caused by fungi, bacteria or viruses. Several studies have also found that the risk of developing OSCC may increase with periodontal disease (PD). In addition to reduce harm caused by tobacco, alcohol and betel quid it seems prudent to take measures to improve oral hygiene in periodontally compromised patients to minimize OSCC risks. This further intensifies the need for oral health education programs and large cohurt studies to edify individuals about the importance of regular oral health maintenance and routine dental care towards the prevention of oral diseases including OSCC.

Prophylactic extraction of non-impacted third molars: is it necessary?

BACKGROUND

The decision of removing a non-impacted 3rd molar, unlike extraction of an impacted 3rd molar, is challenging for dentists as well as patients. This study investigates the pathologies affecting second molars situated adjacent to asymptomatic non-impacted 3rd molars.

METHODS

This retrospective study included digital radiographs of 749 patients taken between April to October 2015. Panoramic radiographs were evaluated for the presence of erupted asymptomatic non-impacted 3rd molars and pathologies on adjacent second molars. The patients were reviewed according to age and gender.

RESULTS

A total of 2342 asymptomatic 3rd molars were assessed in the study based on the inclusion and exclusion criteria, and 2112 of them were found to be non-impacted. The second molars adjacent to non-impacted 3rd molars were shown to be significantly associated with distal caries (25.2%), mesial bone loss (10.5%) and total bone loss (37.2%), i.e., mesial as well as distal bone loss.

CONCLUSIONS

Pathologies of the 3rd molars and teeth adjacent to 3rd molars can occur as a result of multiple factors. Caries and periodontal disease may also occur due to the inaccessibility to maintain oral hygiene. With a regular follow-up schedule, reinforced by the dentist and good oral hygiene, several pathologies that are significantly associated with non-impacted 3rd molars can be prevented and may not require prophylactic extraction.

Dental care during pregnancy based on the pregnancy risk assessment monitoring system in Utah

BACKGROUND

Although receiving dental care is recommended for women during pregnancy, getting such care remains low. This study will identify the level of dental care received during pregnancy and factors associated with care for a group of pregnant women in Utah.

METHODS

Analyses were based on 2793 pregnant women completing the 2014-2015 Utah PRAMS survey. Descriptive and bivariate techniques were used.

RESULTS

Approximately 91.2% knew it was important to care for their teeth and gums during pregnancy, yet only 58.8% had their teeth cleaned during pregnancy. Those who knew such care was important were 1.4 (95% CI 1.1-2.0) times more likely to have their teeth cleaned during pregnancy. Although 18.8% needed to see a dentist for a problem, only 74.5% of them received treatment for the problem during pregnancy. Approximately 76.0% had dental insurance during pregnancy. Those with dental insurance were 1.9 (95% CI 1.5-2.4) times more likely to have their teeth cleaned and 1.6 (95% CI 1.2-2.2) times more likely to go to a dentist for needed treatment during pregnancy. Approximately 51.4% had a dental/health care worker talk with them about how to care for their teeth and gums. These women were more likely to know it was important to care for their teeth and gums during pregnancy (97.4% vs 87.6%, p < 0.0001). For women who received care for a problem during pregnancy, 70.0% had a dental/health care worker talk with them about how to care for their teeth and gums. These women were more likely to know it was important to care for their teeth and gums during pregnancy (95.2% vs 82.8%, p < 0.0001). Women who had their teeth cleaned the year prior to pregnancy were more likely to have their teeth cleaned during pregnancy (78.5% vs 21.5%, p < 0.0001).

CONCLUSIONS

A large proportion of women knowing of the importance of dental care during pregnancy did not receive care. Knowledge of its importance during pregnancy, having a dental/health care worker talk with them about how to care for their teeth and gums, and having dental insurance during pregnancy are positively associated with dental care during pregnancy.

Mechanism and role of nitric oxide signaling in periodontitis

The present study investigated the role of the nitric oxide (NO) signaling pathway in the progression of periodontal disease, and explored the related genetic mechanisms. An experimental model of periodontitis was established in Sprague-Dawley rats, then they were divided into normal control, and 2, 4 and 6 weeks post-surgery groups. NO content was determined in the saliva of rats from each group by the Griess reagent method. Pathological changes of the periodontal tissue sections were evaluated with hematoxylin-eosin staining. The periodontal tissue sections were also evaluated by immunohistochemistry to detect the expression of inducible nitric oxide synthase 2 (iNOS2). Significant differences were detected in the iNOS2 expression of the periodontal tissue based on immunohistochemistry. There was a significant time-dependent increase in NO serum levels post-surgery. Two single nucleotide polymorphisms (SNP), rs2297518 in the iNOS gene and rs841 of the GTP cyclohydrolase I gene, were identified to be closely related to alveolar bone resorption, which is associated with the SNP rs1049255 of the cytochrome b-245 α chain gene. The present findings demonstrated that iNOS2 values increased and NO levels increased with the progression of periodontitis. These results are in agreement with the previous literature. It was hypothesized that NO has a role in the occurrence and development of periodontal disease by regulating the action of certain cytokines.

[Preliminary study on the effects of smoking on gingival microcirculation in chronic periodontitis]

OBJECTIVE

To explore the mechanism of smoking that promotes chronic periodontitis from the perspective of gingival microcirculation.

METHODS

In experiment one, upper anterior teeth (n=102) from smokers with chronic periodontitis (Group A), nonsmokers with chronic periodontitis (Group B), and nonsmokers with healthy periodontal conditions (Group C) were selected to undergo gingival blood flow (GBF) through laser doppler flowmetry. In experiment two, the tissues obtained from gums during periodontal flap surgery were divided into smoking (Group A') and nonsmoking (Group B') groups, and the gingival tissue obtained from periodontal healthy nonsmokers treated with crown lengthening surgery or impacted wisdom tooth extraction served as the control group (Group C'). The microvessels density (MVD) of the gingival tissue from the three groups was determined in the tissue sections. SPSS 22.0 was used for statistical analysis.

RESULTS

Compared with group C, GBF of all teeth increased in group B, and there were significant differences among 12, 21 and 23 teeth. MVD significantly differed between Group B' and C' (P<0.05), but they did not significantly differ between Group A' and B'.

CONCLUSIONS

Periodontitis can increase GBF and MVD, but smoking does not cause significant changes. However, the mechanism by which smoking promotes the occurrence and development of chronic periodontitis by influencing gingival microcirculation has not been discussed in this research.

Mechanism and role of nitric oxide signaling in periodontitis

The present study investigated the role of the nitric oxide (NO) signaling pathway in the progression of periodontal disease, and explored the related genetic mechanisms. An experimental model of periodontitis was established in Sprague-Dawley rats, then they were divided into normal control, and 2, 4 and 6 weeks post-surgery groups. NO content was determined in the saliva of rats from each group by the Griess reagent method. Pathological changes of the periodontal tissue sections were evaluated with hematoxylin-eosin staining. The periodontal tissue sections were also evaluated by immunohistochemistry to detect the expression of inducible nitric oxide synthase 2 (iNOS2). Significant differences were detected in the iNOS2 expression of the periodontal tissue based on immunohistochemistry. There was a significant time-dependent increase in NO serum levels post-surgery. Two single nucleotide polymorphisms (SNP), rs2297518 in the iNOS gene and rs841 of the GTP cyclohydrolase I gene, were identified to be closely related to alveolar bone resorption, which is associated with the SNP rs1049255 of the cytochrome b-245 α chain gene. The present findings demonstrated that iNOS2 values increased and NO levels increased with the progression of periodontitis. These results are in agreement with the previous literature. It was hypothesized that NO has a role in the occurrence and development of periodontal disease by regulating the action of certain cytokines.

The effect of smoking on the marginal bone loss around implant-supported prostheses

INTRODUCTION

Implantology has led to several changes in the planning process involved in the application of dental prostheses to diminish bone level changes along the margins of dental implants. However, the relationship between smoking and marginal bone loss around dental implants, supporting both fixed and removable prostheses has not been investigated. We hypothesize that the design of different prostheses alter the effects of smoking, which consequently affects the amount of supporting alveolar bone.

METHODS

In this study, we included 137 implants in the ‘implant-supported fixed prostheses’ (ISFP) group (31 smokers, 106 non-smokers) and 94 implants (21 smokers, 73 non-smokers) in the ‘implant-supported removable prostheses’ (ISRP) group. The corresponding patients were examined in routine recall sessions conducted at 6, 12 and 24 months after the placement of the dental prostheses. The recorded clinical periodontal parameters were the presence/ absence of a plaque index, bleeding index, and the probing depths. These periodontal parameters were assessed in conjunction with marginal bone level measurements. Comparative bone level measurements were obtained from radiographical images at ×20 magnification using the CorelDraw 11.0 software program. Statistical analysis was performed using the SPSS Statistical Software version 21.0.

RESULTS

The overall clinical parameters were found to be poorer in smokers than in non-smokers (p<0.05). In all the groups, time-dependent bone loss was observed. However, among the patients with ISRPs, smokers were associated with significantly greater marginal bone loss compared to patients with ISFPs (p<0.05).

CONCLUSIONS

In smokers with dental ISRPs, the marginal bone loss rates are likely to reach critical levels. Therefore, after the placement of prostheses, strict recall periods with a dental professional should be observed, and their guidance should be implemented in order to monitor the health of the bones around the implants.

Oral hygiene status, oral hygiene practices and periodontal health of brick kiln workers of Odisha

Aim and Objective:

The aim of this study was to assess the oral hygiene status, oral hygiene practices, and periodontal health among brick kiln workers of Odisha.

Materials and Methods:

Four hundred and eight subjects (300 males and 108 females) between the ages of 22 and 65 years with mean age of 33.44 ± 2.34 years working in various brick kilns in the district of Khordha, Odisha, participated in the survey. Data were collected through personal interview and clinical examinations.

Results:

Overall prevalence of periodontal diseases among brick kiln workers was 86.27%. There was a statistically significant difference in the distribution of Community periodontal index (CPI) (P < 0.001) and loss of attachment score scores (P < 0.001). Periodontal disease was significantly associated with age, oral hygiene status, practices, and tissues abuse habits. Most of the workers were males (59%), in the age group of 30–40 years (40.69%), having only a primary level of education (75.98%) and were married (80.88%). Majority of the workers brushed their teeth once daily (78.9%) with toothbrush (51.5%) and used toothpaste (41.2%). Most of them were found to be consuming paan or gutkha as compared to cigarette or beedi smoking. Among the subjects with a CPI >2, higher prevalence of periodontal disease was seen in subjects older than 50 years of age (86.7%), those brushing once daily only (75.2%), brushing with finger (82.8%), with higher frequency and duration of consumption of tobacco and alcohol, and having a poor oral hygiene (85.5%).

Conclusion:

The survey among brick kiln workers revealed that the oral hygiene status was poor, they had ill-informed oral hygiene practices and most of them were suffering from periodontal disease.

Effect of Cigarette Smoking on Haematological Parameters in Healthy Population

Objective:

Tobacco cigarette smoking is one of the major leading causes of death throughout the world. Smoking has both acute and chronic effect on haematological parameters. The aim of the present study was to assess the extent of adverse effects of cigarette smoking on biochemical characteristics in healthy smokers.

Subjects and Method:

One hundred and fifty six subjects participated in this study, 56 smokers and 100 non-smokers. The smokers were regularly consuming 10-20 cigarettes per day for at least 3 years. Complete blood cell count was analyzed by CELL-DYN 3700 fully automatic haematological analyzer.

Results:

The smokers had significantly higher levels of white blood cell (p<0,001), hemoglobin (p=0,042), mean corpuscular volume (p=0,001) and mean corpuscular hemoglobin concentration (p<0,001). All other measured parameters did not differ significantly. Cigarette smoking caused a significant increase (p<0,001) in red blood cells, white blood cells (p=0,040), hemoglobin (p<0,001), hematocrit (p=0,047) and mean corpuscular hemoglobin (p<0,001) in males in comparison to female smokers.

Conclusion:

In conclusion, our study showed that continuous cigarette smoking has severe adverse effects on haematological parameters (e.g., hemoglobin, white blood cells count, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cells count, hematocrit) and these alterations might be associated with a greater risk for developing atherosclerosis, polycythemia vera, chronic obstructive pulmonary disease and/or cardiovascular diseases.

Assessment of Periodontal Health Status in Smokers and Smokeless Tobacco Users: A Cross-Sectional Study

INTRODUCTION

Oral smokeless tobacco consumption has been considered as a major risk factor for oral cancer, its role as a risk factor for periodontal disease is less well documented when compared to that of relationship between smoking and periodontal disease.

AIM

The aim of the present cross-sectional study was to evaluate the effect of various forms of tobacco consumption i.e., smoking and smokeless tobacco forms on periodontal status.

MATERIALS AND METHODS

The study population included 120 subjects with the habit of tobacco consumption, based on form of tobacco use they were divided into Group 1 (smoking), Group 2 (Smokeless tobacco), and Group 3 (smokers and smokeless tobacco users). The periodontal status for each group was evaluated by measuring Oral Hygiene Index- Simplified (OHI-S) and Community Periodontal Index (CPI) for Probing Depth (CPI-PD) and Attachment Loss (CPI-AL).

RESULTS

OHI-S mean scores in Group 1 (3.53±1.03), Group 2 (3.06±0.92) and Group 3 (3.45±0.96) were similar, which were not statistically significant (p>0.076). The mean values of CPI-PD were 3.75±0.44 in Group 1, 3.65±0.48 in Group 2, 3.80±0.41 in Group 3 with no significant difference between the three Groups (p> 0.309). When the mean values of CPI-AL (0.95±0.75 in Group 1, 1.40±0.74 in group 2, and 1.55±0.60 in Group 3) were compared in between the Groups, a statistically significant difference was observed in Group 3 (p<0.001).

CONCLUSION

The results showed that tobacco consumption in both forms caused poor periodontal status, with smokeless tobacco users having more amount of attachment loss than smokers.

Comparison of various risk indicators among patients with chronic and aggressive periodontitis in davangere population

Background:

The aim of the present study was to compare various risk indicators of chronic periodontitis (CP) and aggressive periodontitis (AP) among patients of Davangere population.

Materials and Methods:

Totally, 89 CP and 90 AP patients were selected from outpatient Department of Periodontics, College of Dental Sciences, Davangere. Various clinical parameters proven to be risk indicators were determined for each patient such as age, gender, occupation, oral hygiene habits, personal habits, income, level of education, place of residence, frequency of dental visits, various oral hygiene indices, gingival status, wasting diseases, malocclusion, laboratory investigations, and the results were subjected to statistical analysis.

Results:

This study demonstrated that AP is manifested early in life in susceptible individuals. Proven risk indicators for AP and CP in the present study population included young age, place of residence, income and education levels, frequency of dental visits. Patients with AP had better oral hygiene habits and oral hygiene index results than patients with CP. Paan chewing and smoking could be considered as risk factors, both in CP and AP cases. The similar association of plaque scores but higher bleeding tendency in AP patients supported the fact of higher susceptibility of AP patients to periodontal breakdown. Malocclusion being present in the majority of cases could also be put forth as a risk factor for AP and CP.

Conclusion:

This study identifies the different risk indicators for CP and AP and demonstrates the need for constructing nationwide oral health promotion programs to improve the level of oral health awareness and standards in Indian population.

Analysis of interleukin-8 gene variants reveals their relative importance as genetic susceptibility factors for chronic periodontitis in the Han population

Interleukin (IL)-8, an important chemokine that regulates the inflammatory response, plays an important role in periodontitis. Previous studies indicate that certain IL-8 gene polymorphisms are associated with periodontitis susceptibility in some populations. However, the literature is somewhat contradictory, and not all IL-8 polymorphisms have been examined, particularly in Han Chinese individuals. The aim of this study was to investigate the association of every IL-8 SNP with chronic periodontitis in Han Chinese individuals. We analyzed 23 SNPs with minor allele frequency (MAF)≥0.01, which were selected from 219 SNPs in the NCBI dbSNP and preliminary HapMap data analyses from a cohort of 400 cases and 750 controls from genetically independent Han Chinese individuals. Single SNP, haplotype and gender-specific associations were performed. We found that rs4073 and rs2227307 were significantly associated with chronic periodontitis. Further haplotype analysis indicated that a haplotype block (rs4073-rs2227307-rs2227306) that spans the promoter and exon1 of IL-8 was highly associated with chronic periodontitis. Additionally, the ATC haplotype in this block was increased 1.5-fold in these cases. However, when analyzing the samples by gender, no significant gender-specific associations in IL-8 were observed, similar to the results of haplotype association analyses in female and male subgroups. Our results provide further evidence that IL-8 is associated with chronic periodontitis in Han Chinese individuals. Furthermore, our results confirm previous reports suggesting the intriguing possibilities that IL-8 plays a role in the pathogenesis of chronic periodontitis and that this gene may be involved in the etiology of this condition.