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Majeed R, Sathi KV, Patil RS, Singh N, Duseja S, Kondreddy K. Association of the Antidepressants and the Periodontal Status: An Original Research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S215-S218. [PMID: 38595612 PMCID: PMC11000883 DOI: 10.4103/jpbs.jpbs_464_23] [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: 08/02/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 04/11/2024] Open
Abstract
Antidepressants have anti-inflammatory effects and boost immunity, and dentists should be aware. This case-control study included only those patients who consented to take part and had a ham-d score of at least 16 and a diagnosis of moderate-to-severe depression. Inclusion criteria included adults, those experiencing moderate to severe depression, taking fluoxetine or venlafaxine, and those with twenty or more teeth. Exclusion criteria included tobacco chewers, smokers, women expecting or nursing, periodontal treatment, antibiotics, anti-inflammatory medication, or vitamin/nutritional supplements. Patients who had had surgery or other therapy were excluded from the study. Three groups of patients were created: Control, venlafaxine, and fluoxetine. A periodontist assisted in the dental examination, and indices were observed. The analysis was done using Statistical Package for the Social Sciences (SPSS) version 24.0. Number, percentage, mean, and standard deviation were used to present the values. Results showed that antidepressants may be a risk factor for periodontal health, with increased periodontal parameters, and concluded that It is crucial to frequently check the periodontal health of depressed people using fluoxetine or venlafaxine since these drugs put good periodontal tissues at risk.
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Affiliation(s)
- Rizleena Majeed
- Department of Periodontology, Kannur Dental College, Anjarakandy, Kerala, India
| | - Krishna V. Sathi
- BDS, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Ruthika S. Patil
- Prosthodontics, Research Student Worker, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States
| | - Neetu Singh
- BDS Dentist, Dr. Neetu’s Dental Clinic, Noida, Uttar Pradesh, India
| | - Shilpa Duseja
- Department of Periodontology, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Kameswari Kondreddy
- Department of Periodontics, Faculty of Dentistry, AIMST University, Semeling, Bedong, Kedah, Malaysia
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ALHarthi SS, BinShabaib MS, Alwahibi A, Gamal S, Elashiry E, Almershed SE, Alkhamis HA, Anweigi L. Periodontal and peri-implant status and whole salivary interleukin 1-beta levels among individuals using selective serotonin reuptake inhibitors: an observational study. BMC Oral Health 2023; 23:310. [PMID: 37217913 DOI: 10.1186/s12903-023-02908-0] [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: 01/21/2023] [Accepted: 03/24/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Selective serotonin reuptake inhibitors (SSRI) are commonly used for managing psychological diseases such as depression. These disorders are also directly associated with periodontal and peri-implant diseases, namely periodontitis and peri-implantitis, respectively. It is hypothesized that there is no difference in periodontal and peri-implant clinicoradiographic status and unstimulated whole salivary interleukin (IL)-1β levels in participants using selective serotonin reuptake inhibitors (SSRI) and controls (individuals not using SSRI). The aim of the present observational case-control study was to compare periodontal and peri-implant clinicoradiographic statuses and whole salivary IL-1β in participants using SSRI and controls. METHODS Users of SSRI and controls were included. In all participants, periodontal (plaque index [PI], gingival index [GI], probing depth [PD], clinical attachment loss [AL] and marginal bone loss [MBL]) and peri-implant (modified PI [mPI], modified GI [mGI], PD and crestal bone loss [CBL]) were assessed. Unstimulated whole saliva was collected and IL-1β levels were determined. Information related to duration of implants in function, duration of depressive symptoms and treatment of depression was retrieved from healthcare records. Sample-size was estimated using 5% error and group comparisons were performed. P < 0.05 was considered statistically significant. RESULTS Thirty-seven SSRI users and 35 controls were assessed. Individuals using SSRI had a history of depression of 4.2 ± 2.5 years. The mean age of SSRI-users and controls were 48.7 ± 5.7 and 45.3 ± 5.1 years, respectively. Tooth brushing twice daily was reported by 75.7% and 62.9% SSRI-users and controls, respectively. There was no statistically significant difference in PI, mPI, GI, mGI, PD, clinical AL, numbers of MT and mesial and distal MBL and CBL among individuals using SSRI compared with controls (Tables 3 and 4). The unstimulated whole salivary flow rate in individuals using SSRI and controls was 0.11 ± 0.003 and 0.12 ± 0.001 ml/min, respectively. Whole salivary IL-1β levels in individuals using SSRI and controls were 57.6 ± 11.6 pg/ml and 34.6 ± 5.2 pg/ml, respectively. CONCLUSION Users of SSRI and controls demonstrate healthy periodontal and peri-implant tissue statuses with no marked differences in whole salivary IL-1β levels provided oral hygiene is stringently maintained.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Munerah S BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Abdulrahman Alwahibi
- Department of Psychiatry, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Shahinaz Gamal
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Eldin Elashiry
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Sarah E Almershed
- Specialist in Periodontics, Ministry of Health, Kuwait City, Kuwait
- Lecturer and Examiner at the Kuwait Board of Advanced General Dentistry, Kuwait University, Kuwait City, Kuwait
- Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
| | | | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Yanni P, Curtis DA, Kao RT, Lin GH. The Pattern of Tooth Loss for Periodontally Favorable Teeth: A Retrospective Study. BIOLOGY 2022; 11:1664. [PMID: 36421378 PMCID: PMC9687859 DOI: 10.3390/biology11111664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 07/30/2023]
Abstract
To retrospectively analyze local and systemic factors that resulted in the short-term tooth loss of teeth that were previously assigned a favorable prognosis in patients who were seen and treated over an observational five-year period. This retrospective study included the records of patients who had a minimum of two dental exams at least twelve months apart over a 5-year period. This study investigated extracted teeth with an initially favorable periodontal prognosis that were then divided into one of four categories based on the reason for extraction: caries, periodontal disease, endodontic reasons, or fracture. Patient- and tooth-related factors associated with the extracted teeth were recorded: crown-to-root ratio, initial pocket depth, initial periodontal diagnosis, maintenance interval, presence of existing restoration, furcation involvement, and systemic conditions. Data analysis was performed using a linear mixed model. A total of 50 patients with 111 teeth met the inclusion criteria for this study. A higher odds ratio (OR) for tooth loss due to caries, endodontic reasons, and fracture were found in teeth with a history of root canal treatment with an OR of 3.61, 3.86, and 2.52, respectively. For tooth loss due to periodontal disease, higher ORs were found in patients who were on anti-depressants (OR = 4.28) and patients who had an initial diagnosis of Stage III/IV periodontitis (OR = 2.66). In addition, teeth with initial probing depths ≥5 mm (OR = 4.32) and with furcation involvement (OR = 1.93) showed a higher OR for tooth loss due to periodontal disease. Within the limitations of this study, previously root-canal-treated teeth present a higher OR for early loss due to caries, recurrent endodontic lesions, or fracture. In addition, patients with anti-depressant medication use, sporadic maintenance, initial probing depths ≥5 mm, and furcation involvement represent a significantly higher OR of tooth loss due to periodontal disease even for initially favorable teeth.
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Affiliation(s)
| | - Donald A. Curtis
- Department of Preventive & Restorative Dental Sciences, University of California, San Francisco, CA 94143, USA
| | - Richard T. Kao
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA
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Li Y, Lu Z, Zhang L, Kirkwood CL, Kirkwood KL, Lopes-Virella MF, Huang Y. Inhibition of acid sphingomyelinase by imipramine abolishes the synergy between metabolic syndrome and periodontitis on alveolar bone loss. J Periodontal Res 2022; 57:173-185. [PMID: 34748647 PMCID: PMC8766925 DOI: 10.1111/jre.12951] [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: 07/08/2021] [Revised: 10/08/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Clinical studies have shown that metabolic syndrome (MetS) exacerbates periodontitis. However, the underlying mechanisms remain largely unknown. Since our animal study has shown that high-fat diet-induced MetS exacerbates lipopolysaccharide (LPS)-stimulated periodontitis in mouse model and our in vitro study showed that acid sphingomyelinase (aSMase) plays a key role in the amplification of LPS-triggered pro-inflammatory response by palmitic acid (PA) in macrophages, we tested our hypothesis that inhibitor of aSMase attenuates MetS-exacerbated periodontitis in animal model. Furthermore, to explore the potential underlying mechanisms, we tested our hypothesis that aSMase inhibitor downregulates pro-inflammatory and pro-osteoclastogenic gene expression in macrophages in vitro. MATERIAL AND METHODS We induced MetS and periodontitis in C57BL/6 mice by feeding high-fat diet (HFD) and periodontal injection of A. actinomycetemcomitans LPS, respectively, and treated mice with imipramine, a well-established inhibitor of aSMase. Micro-computed tomography (micro-CT), tartrate-resistant acid phosphatase staining, histological and pathological evaluations as well as cell cultures were performed to evaluate alveolar bone loss, osteoclast formation, periodontal inflammation and pro-inflammatory gene expression. RESULTS Analysis of metabolic parameter showed that while HFD induced MetS by increasing bodyweight, insulin resistance, cholesterol and free fatty acids, imipramine reduced free fatty acids but had no significant effects on other metabolic parameters. MicroCT showed that either MetS or periodontitis significantly reduced bone volume fraction (BVF) of maxilla and the combination of MetS and periodontitis further reduced BVF. However, imipramine increased BVF in mice with both MetS and periodontitis to a level similar to that in mice with periodontitis alone, suggesting that imipramine abolished the synergy between MetS and periodontitis on alveolar bone loss. Consistently, results showed that imipramine inhibited osteoclast formation and periodontal inflammation in mice with both MetS and periodontitis. To elucidate the mechanisms by which imipramine attenuates MetS-exacerbated periodontitis, we showed that imipramine inhibited the upregulation of pro-inflammatory cytokines and transcription factor c-FOS as well as ceramide production by LPS plus PA in macrophages. CONCLUSION This study has shown that imipramine as an inhibitor of aSMase abolishes the synergy between MetS and periodontitis on alveolar bone loss in animal model and inhibits pro-inflammatory and pro-osteoclastogenic gene expression in macrophages in vitro. This study provides the first evidence that aSMase is a potential therapeutic target for MetS-exacerbated periodontitis.
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Affiliation(s)
- Yanchun Li
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425
| | - Lixia Zhang
- Department of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Cameron L. Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Keith L. Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo,,Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14214
| | - Maria F. Lopes-Virella
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401
| | - Yan Huang
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401,Correspondence to Yan Huang, M.D., Ph.D., Ralph H. Johnson Veterans Affairs Medical Center, and Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, 114 Doughty St. Charleston, SC29403, Tel: (843) 789-6824; Fax: (843) 876-5133;
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Hakam AE, Duarte PM, Mbadu MP, Aukhil I, da Silva HDP, Chang J. Association of different antidepressant classes with clinical attachment level and alveolar bone loss in patients with periodontitis: A retrospective study. J Periodontal Res 2021; 57:75-84. [PMID: 34622954 DOI: 10.1111/jre.12939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/25/2021] [Accepted: 09/15/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Our study aimed to determine the relationship of antidepressant medicine use with periodontal diseases, exploring the association of different pharmacological classes of antidepressant with observations of clinical attachment loss (CAL) and alveolar bone level (BL) in patients with periodontitis. BACKGROUND Existing evidence on the impact of antidepressant medication on periodontal tissues has focused on some classes only and is still unclear. Therefore, this retrospective study evaluated the association of different antidepressant classes with clinical attachment loss (CAL) and alveolar bone level (BL). METHODS This study was carried out in a population of patients aged ≥ 30 years old with periodontitis who sought treatment at the University of Florida from 2014 to 2018. The following variables were obtained from patients' records; usage of antidepressant medications and their pharmacological classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic, atypical, and monoamine oxidase inhibitors [MAO]), age, gender, smoking habit, mild systemic diseases, CAL, and cement-enamel junction (CEJ) and alveolar bone crest (BC) distance, defined as BL, in the Ramfjord index teeth. RESULTS Five hundred and eighty-two periodontitis patients were evaluated, of which 113 (19.4%) were antidepressant users. Antidepressant users exhibited significantly lower BL and fewer sites with severe CAL (≥5 mm), than non-users (p < .05). Among all single-class antidepressant users, the SSRI users showed significantly less CAL and lower BL than non-users (p < .05). Patients taking combinations of the different classes of antidepressants also showed better CAL and BL than non-users. Generalized linear models, including variables such as gender, age, systemic diseases, and smoking, demonstrated that antidepressant users were more likely to have lower mean BL and fewer sites with severe bone loss (i.e. BL > 3 and >5 mm) than non-users (p < .05). CONCLUSIONS Antidepressant medications were associated with higher alveolar bone level and less clinical attachment loss in patients with periodontitis. When the different classes of antidepressants were analyzed individually, only the SSRI class users and the multiple-class users showed significantly less periodontal breakdown than non-users.
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Affiliation(s)
- Abeer Essam Hakam
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Poliana Mendes Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Marcia Phemba Mbadu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | - Jia Chang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
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