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Xia Y, Zeng Y, Jiang R. Effect of chronic periodontitis on the endothelial glycocalyx of rat penile corpus cavernosum. Andrology 2024. [PMID: 39287569 DOI: 10.1111/andr.13765] [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: 02/22/2024] [Revised: 05/01/2024] [Accepted: 09/05/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Chronic periodontitis may induce erectile dysfunction (ED), however, the specific mechanism involved is unclear. The endothelial glycocalyx (eGlx) is a structure that can regulate endothelial nitric oxide synthase (eNOS) phosphorylation on the cavity surface of vessels. AIM To investigate whether chronic periodontitis leads to ED by affecting the eGlx. METHODS Twenty-four 4-week-old male Sprague‒Dawley rats were randomly divided into four groups (n = 6): the control group, chronic periodontitis group, chronic periodontitis + heparin group (subcutaneous heparin 200 U/kg/day, 7 days), and control + heparin group. Four weeks after the induction of periodontitis in the rats, the maximum intra-cavernous pressure/mean arterial pressure (ICPmax/MAP), serum C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), heparin sulfate (HS), syndecan-1 (SDC-1), heparanase (HPSE), eNOS, and phosphor-eNOS (p-eNOS) concentration were measured, and the eGlx of the penile corpus cavernosum was observed by transmission electron microscopy (TEM). OUTCOMES Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF-α, and IL-6 levels, reducing the p-eNOS/eNOS ratio and the NO concentration in the penile corpus cavernosum, and resulting in the inhibition of the erectile function. RESULTS Serum CRP, TNF-α, and IL-6 levels and HPSE expression in penile cavernous tissue were significantly greater in the chronic periodontitis group than in the control group and the chronic periodontitis + heparin group (P < 0.05). The average thickness of the eGlx muscle in the penile corpus cavernosum in the chronic periodontitis group was significantly lower than those in the control group and chronic periodontitis + heparin group (P < 0.05). The HS concentration, SDC-1 expression, p-eNOS/eNOS, NO concentration, and ICPmax/MAP in the chronic periodontitis group were significantly lower than those in the control group and chronic periodontitis+ heparin group (P < 0.01). CLINICAL IMPLICATIONS The eGlx on penile cavernosum vessels may be a new therapeutic target for the treatment of ED. STRENGTHS AND LIMITATIONS This study revealed that chronic periodontitis promotes the decomposition of vascular eGlx in the rat penile corpus cavernosum, however, it is not clear whether chronic periodontitis inhibits the synthesis of eGlx. CONCLUSION Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF-α, and IL-6 levels, reducing the p-eNOS/eNOS ratio and the NO concentration in penile cavernous tissue, and resulting in the inhibition of the erectile function. Heparin inhibited eGlx decomposition and improved erectile function in rats with chronic periodontitis.
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Affiliation(s)
- Yuanhang Xia
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yang Zeng
- Department of Orthodontics, Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Rui Jiang
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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Diouf A, Ndjidda Bakari W, Sounlin MH, Diallo AM, Thiam D, Guirassy ML, Diallo AS, Benoist HM. Periodontitis as a risk factor for organic erectile dysfunction: A case-control study in a sub-Saharan population. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:80-85. [PMID: 38357341 PMCID: PMC10862040 DOI: 10.34172/japid.2023.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/25/2023] [Indexed: 02/16/2024]
Abstract
Background This study investigated the association between periodontitis and organic erectile dysfunction (ED) in a sub-Saharan population. Methods This multicenter analytical study lasted from April to September 2021. A total of 114 patients (38 cases and 76 controls) were recruited and matched on age, diabetes, and smoking status. Medical history and ED were recorded, as well as the plaque index, bleeding index, maximum interdental clinical attachment loss (CALmax), maximum probing depth, clinically detectable furcation involv ement, number of teeth in the mouth, number of teeth lost for periodontal reasons, and tooth mobility. The analysis was performed with SPSS 20.0 with a significance threshold set at 5%. Results The two study groups were comparable regarding sociodemographic characteristics. Periodontitis was present in 76.31% of cases and 75% of controls without a significant difference (P=0.878). Logistic regression showed a significant association between high blood pressure and ED with an OR=4.78 (95% CI: 1.80‒12.70). Periodontitis was not associated with ED (OR=1.52, 95% CI: 0.55‒4.16); however, severe periodontitis was significantly associated with severe ED (OR=1.44, 95% CI: 1.11‒1.85, and OR=1.68, 95% CI: 1.15‒2.44, respectively for CALmax and tooth loss). Conclusion Within the limits of this study, periodontitis was not associated with organic ED. However, the severity of periodontal disease significantly increased in patients with organic ED.
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Affiliation(s)
| | - William Ndjidda Bakari
- Periodontology Department, Faculty of Medicine, Pharmacy and Odontology, University Cheikh Anta Diop of Dakar, Senegal
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Ghosh C, Maity R, Roy A, Mallick C. Dose-Dependent Protective Effect of Hygrophila auriculata Seeds on Cyproterone Acetate-Induced Testicular Dysfunction. Reprod Sci 2023; 30:3359-3371. [PMID: 37286756 DOI: 10.1007/s43032-023-01279-9] [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: 11/19/2022] [Accepted: 05/24/2023] [Indexed: 06/09/2023]
Abstract
Infertility affects 15% of global population. This study was designed to search out the most effective dose of chloroform fraction of hydro-ethanolic extract of Hygrophila auriculata seed to ameliorate cyproterone acetate (CPA)-treated male subfertility. The rats were made subfertile by CPA at the dose of 2.5 mg/100gm body weight for 45 days. The male subfertility represented by low sperm concentration, less motile, less viable, and less hypo osmotic tail swelled spermatozoa in CPA-treated group. Serum LH, FSH, and testosterone levels were significantly decreased in CPA-treated group in respect to control. Androgenic key enzyme Δ5,3β-HSD, 17β-HSD activities and gene expression pattern were also decreased significantly in respect to control. These antispermatogenic and antiandrogenic activities of CPA were significantly recovered after the treatment of Hygrophila auriculata at the dose of 2.5 mg, 5mg, and 10 mg/100gm body weight. CPA also generate oxidative free radical that indicated by altered catalase, superoxide dismutase, and peroxidase activities and protein expression pattern along with conjugated diene and thiobarbituric acid reactive substance levels in testis. Expression pattern of Bax and Bcl2 genes were deviated from control after CPA treatment. Significant diminution of body weight, organo-somatic indices, and SGOT, SGPT activities were observed in CPA-treated group. All these biomarkers significantly recovered towards control after the treatment of Hygrophila auriculata at different doses. More significant recovery was observed in 5 mg and 10 mg of chloroform fraction-treated group and 5 mg dose, i.e., the minimum therapeutic dose to recover the CPA-induced subfertility.
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Affiliation(s)
- Chaitali Ghosh
- Clinical Nutrition and Dietetics, Department of Biomedical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, 721 102, India
| | - Ratnabali Maity
- Clinical Nutrition and Dietetics, Department of Biomedical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, 721 102, India
| | - Aaishi Roy
- Clinical Nutrition and Dietetics, Department of Biomedical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, 721 102, India
| | - Chhanda Mallick
- Clinical Nutrition and Dietetics, Department of Biomedical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, 721 102, India.
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Kurtzman GM, Horowitz RA, Johnson R, Prestiano RA, Klein BI. The systemic oral health connection: Biofilms. Medicine (Baltimore) 2022; 101:e30517. [PMID: 36401454 PMCID: PMC9678577 DOI: 10.1097/md.0000000000030517] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
Frequently, periodontal health and it's associated oral biofilm has not been addressed in those patients who have systemic health issues, especially those who are not responding to medical treatment via their physician. Oral biofilm may be present in the periodontal sulcus in the absence of clinical disease of periodontal disease (bleeding on probing, gingival inflammation) and periodontal reaction is dependent on the patient's immune response to the associated bacterial and their byproducts. Increasing evidence has been emerging the past decade connecting oral biofilm with systemic conditions, either initiating them or complicating those medical conditions. The patient's health needs to be thought of as a whole-body system with connections that may originate in the oral cavity and have distant affects throughout the body. To maximize total health, a coordination in healthcare needs to be a symbiosis between the physician and dentist to eliminate the oral biofilm and aid in prevention of systemic disease or minimize those effects to improve the patient's overall health and quality of life. Various areas of systemic health have been associated with the bacteria and their byproducts in the oral biofilm. Those include cardiovascular disease, chronic kidney disease, diabetes, pulmonary disease, prostate cancer, colon cancer, pancreatic cancer, pre-term pregnancy, erectile dysfunction Alzheimer's disease and Rheumatoid arthritis. This article will discuss oral biofilm, its affects systemically and review the medical conditions associated with the oral systemic connection with an extensive review of the literature.
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Affiliation(s)
| | - Robert A. Horowitz
- Private periodontal practice Scarsdale, New York, USA
- Adjunct Clinical Assistant Professor, Department of Periodontology and Implant Dentistry, New York University College of Dentistry
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HATİPOĞLU H, KABAY Ş. PERIODONTAL AND SYSTEMIC DISEASES: ERECTILE DYSFUNCTION. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.928767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Periodontal hastalıklar toplumda yaygın bir şekilde görülmektedir. Son yıllarda yapılan çalışmalarla periodontal hastalıkların sistemik hastalıklara, benzer şekilde sistemik rahatsızlıklarında periodontal hastalıklara katkıda bulunabileceği bilinmektedir. Periodontal hastalıklar ve sistemik hastalıklar arasındaki bu iki yönlü ilişki son yıllarda dikkat çekici bir şekilde araştırmalara neden olmuştur. Bu konulardan biri de erektil disfonksiyondur. Periodontal hastalıkların erektil disfonksiyon ile ilişkisi ilgi çekicidir. Farklı etyolojiye sahip olan erektil disfonksiyonda periodontal hastalıkların etkisi son dönemde sıkça araştırılmıştır.
Bu geleneksel derlemede, tedavi sağlayıcılara periodontal hastalıkların genel özellikleri, erektil disfonksiyonun genel özellikleri ve birbiri ile olan ilişkiler üzerinde durulacaktır.
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Affiliation(s)
- Hasan HATİPOĞLU
- KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
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Farook F, Al Meshrafi A, Mohamed Nizam N, Al Shammari A. The Association Between Periodontitis and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Am J Mens Health 2021; 15:15579883211007277. [PMID: 34013796 PMCID: PMC8142012 DOI: 10.1177/15579883211007277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/21/2022] Open
Abstract
The objective of this study is to investigate the association between periodontitis (PD) and erectile dysfunction (ED).A systematic review and meta-analysis on data was extracted and conducted according to PRISMA. Relevant articles were selected from a literature search using MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL from inception until August 2, 2020. Both randomized and nonrandomized controlled studies were included. Case reports, case series, nonsystematic reviews and trials published as abstract were excluded. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to estimate the association between PD and the risk of ED. The meta-analysis was conducted with RevMan 5.3. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale and the quality of evidence was assessed using the GRADE approach.Six articles (215008 subjects) were included for analysis. Of the participants, 38,675 cases were compared to 1,76,333 healthy controls. Based on the random effects model, periodontitis was associated with an increased risk of ED (OR = 2.56, 95% CI: 1.70-3.85) as compared with the non-periodontitis individuals. The findings were statistically significant with a p < .0001. The statistical heterogeneity was high across all studies (I2 = 98%, p < .00001). Estimates of total effects were generally consistent with the sensitivity and subgroup analyses.Within the limits of the available evidence, our review and meta-analysis showed that a significant association exists between the PD and ED. The results should be interpreted with caution due to high degree of inconsistency across all the studies.
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Affiliation(s)
- Fathima Farook
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Azzam Al Meshrafi
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | | | - Abdulsalam Al Shammari
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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Abstract
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
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Updated Evidence of Association Between Periodontal Disease and Incident Erectile Dysfunction. J Sex Med 2020; 16:61-69. [PMID: 30621927 DOI: 10.1016/j.jsxm.2018.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/08/2018] [Accepted: 11/11/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The relationship between periodontal disease (PD) and erectile dysfunction (ED) is still conflicting. AIM To investigate whether a link between PD and ED exists, and if so, the degree to which it is significant. METHODS The search strategy included using electronic databases and hand searching works published up to June 2018. MEDLINE via PubMed, EMBASE, Proceedings Web of Science, and Current Contents Connect were searched by 2 independent reviewers. Case-control, cohort, or cross-sectional studies including patients with measures of periodontitis and ED were included in the analysis. Quality assessments and sensitivity analysis of selected studies were performed. MAIN OUTCOME MEASURE The strength of the association between PD and the prevalence of ED was evaluated. RESULTS 5 case-control studies with 213,076 participants met the eligibility criteria and were included in the meta-analysis. Patients with PD were 2.85-fold more likely to be diagnosed with ED (OR = 2.85, 95% CI = [1.83, 4.46]). Asian men were reported to be 3.07 times more likely to be at greater risk for the prevalence of ED. Moreover, studies with high quality and case-control design showed 2 times higher risk for ED in PD (OR = 2.44, 95% CI = [1.44, 4.14]). However, the present evidence was not robust enough owing to the high heterogeneity and instability in sensitivity analysis. CLINICAL IMPLICATIONS Patients with PD may have increased risk of ED, suggesting that dental hygiene should be of concern to clinicians when managing patients with ED. STRENGTH & LIMITATIONS This article includes a large literature search to confirm the evidence that PD increases the occurrence of ED. However, there are several confounders, such as age and the type of ED, that failed to be adjusted and that generate bias and affect the correlation between the incidence of ED and PD. CONCLUSION This system review and meta-analysis strengthens the evidence that PD might have important clinical implications for risk stratification of ED. Zhou X, Cao F, Lin Z. Updated evidence of association between periodontal disease and incident erectile dysfunction. J Sex Med 2019;16:61-69.
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Chiappelli F. Evidence-Based Dentistry: Two Decades and Beyond. J Evid Based Dent Pract 2018; 19:7-16. [PMID: 30926103 DOI: 10.1016/j.jebdp.2018.05.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/21/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 1999, the American Dental Association proffered a definition of the term evidence-based dentistry, which is still very much used to this day. It stated that "… evidence-based dentistry is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." Concerted research during the past 2 decades have defined and characterized the protocols that obtain the qualitative and quantitative consensus of the best evidence base. This component of evidence-based dentistry, which is referred to as evidence-based dental research, is brought about as comparative effectiveness research with the research synthesis design. The best evidence base is judiciously used to generate evidence-based clinical practice guidelines, which in turn inform evidence-based dental practice. DISCUSSION At this juncture, the complexity of the construct of evidence-based dentistry dictates several avenues of current and future inquiry and development. The most urgent and important of these is undoubtedly to craft and validate novel didactic and practical methodologies to teach evidence-based dentistry-both research and practice-to the next generation of dental researchers and clinical dentists and to optimize the integration of evidence-based dentistry in the dental curriculum. Secondarily, but certainly not of lesser importance, is the need to open and expand new research opportunities in subdomains critical to successful evidence-based dental practice, such as stakeholder engagement, teledentistry, patient-centered care, individual patient data analysis, and health literacy of the patients and caregivers. CONCLUSIONS The course that has led evidence-based dentistry from its infancy in 1999 to a state of relative recognition, if not acceptance across academic and private clinical dentistry in the United States and abroad that the field enjoys today, has been arduous. The concerted efforts by researchers and clinicians were aided considerably by the political environment, which, during the years, proffered funding to the Agency for Healthcare Research and Quality and the Patient-Centered Outcome Research Institute. These have been significant catalysts of the field of comparative effectiveness research and evidence-based research in medicine and dentistry and have fostered and defended the pursuit of evidence-based endeavors in translational health care. The road ahead does not promise to be easier in next 2 decades. In fact, it has become all the murkier and more complicated now as phrases such as science based and evidence based have presently been banned and declared politically incorrect.
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Affiliation(s)
- Francesco Chiappelli
- Division of Oral Biology & Medicine, School of Dentistry, Center for the Health Sciences University of California Los Angeles, Los Angeles, CA, USA; Health Sciences, California State University, Northridge, CA, USA; Evidence-Based Decisions Practice-Based Research Network, Los Angeles, CA, USA; Dental Group of Sherman Oaks, Los Angeles, CA, USA; International Research Consulting, Los Angeles, CA.
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