Body mass index and periodontal health status among young Saudi adults: a cross-sectional study

Association between weight-adjusted-waist index and periodontitis risk: A cross-sectional study

BACKGROUND

There may be an association between obesity and periodontitis, yet no studies have investigated the correlation between the new obesity indicator, the weight-adjusted-waist Index (WWI), and periodontitis.

OBJECTIVE

This study aims to investigate the association between the novel obesity index, weight-adjusted-waist index, and periodontitis.

SUBJECTS AND METHODS

WWI was utilized to assess obesity, through measuring waist circumference (WC) and body weight. We analyzed cross-sectional NHANES data from 2009 to 2014 (1) using multivariate logistic regression to explore WWI's association with moderate/severe periodontitis; (2) conducting subgroup analyses and interaction tests; and (3) fitting smoothed curves to the age-stratified logistic regression model.

RESULTS

The study involved 11,256 individuals, with 48.55% having moderate/severe periodontitis. Upon adjusting for all relevant variables, a significant correlation between WWI and moderate/severe periodontitis was observed (OR = 1.08, 95% CI: 1.01-1.17). Compared to the lowest quartile of WWI, there was a significant increase in the likelihood of moderate/severe periodontitis in Quartile 2 (OR = 1.21, 95% CI: 1.06-1.39) and Quartile 3 (OR = 1.23, 95% CI: 1.07-1.42). Subgroup analyses for gender, age, education, smoking, and diabetes highlighted a positive association between WWI and moderate/severe periodontitis in all subgroups, except for the diabetic population and individuals aged 65 years and older.

CONCLUSION

The analysis revealed a positive correlation between WWI, a novel obesity index, and moderate/severe periodontitis prevalence through diverse modeling approaches.

The relationship between obesity and oral-health status in North African adults: A comparative study

INTRODUCTION

The strength of the association between obesity and oral health is still indecisive.

OBJECTIVE

The objectives of the study were to compare some oral-health data between two groups involving obese (OG) and normal weight (NWG) participants and determine the influencing factors of the periodontal probing depth (PPD).

METHODS

This was a cross-sectional study including 67 Tunisian adults [OG (n = 33, body mass index (BMI) > 30 kg/m2 ), NWG (n = 34, BMI: 18.5-25.0 kg/m2 )]. The plaque level was recorded using the plaque index (PI). Gingival index (GI) was used to evaluate gingival inflammation. The depths of the sulci/pockets were probed using a periodontal probe. Stimulated saliva was collected for 5 min, and salivary flow rate (SFR) was determined. Salivary baseline pH (SBpH) was measured. A multivariable regression analysis was performed between PPD and some independent variables [i.e. obesity status, age, sex, socioeconomic status, systemic diseases and PI data].

RESULTS

The OG and NWG were age- and sex-matched and included comparable percentages of participants with systemic diseases (27.3 vs. 29.4%, respectively). The OG included a higher percentage of participants having a low socioeconomic status (87.9 vs. 64.7%, respectively). Compared with the NWG, the OG: (i) had comparable values of daily toothbrushing frequency, PI, GI and tooth mobility, (ii) included comparable percentages of irregular brushers, of participants with periodontitis, PI classes [0-1]and [1-2]; and GI classes [0-1], [1-2] and [2, 3]; (iii) had a higher PPD (2.02 ± 0.41 vs. 2.35 ± 0.22 mm, respectively), (iv) had lower SBpH (7.59 ± 0.21 vs. 7.45 ± 0.22, respectively) and SFR (1.98 ± 0.28 vs. 1.60 ± 0.32 mL/mn, respectively) and (v) included a higher percentage of participants having a PI class [2, 3] (67.6 vs. 87.9%, respectively). The multivariable regression analysis revealed that only obesity status, age and PI classes influenced the PPD, altogether explained 29.62% of the PPD variance.

CONCLUSION

Obesity poses a risk for oral health, and obese adults had altered PPD and lower BSpH and SFR. Dentists should make obese patients aware of the health risks of obesity in an attempt to reduce the potential oral complications associated with this epidemic.

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

BACKGROUND

A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes.

MATERIALS AND METHODS

PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software.

RESULTS

A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001).

CONCLUSIONS

The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

A cross-sectional study on the relationship between visceral adiposity index and periodontitis in different age groups

Obesity and periodontitis are significantly related, and the visceral adiposity index (VAI) is an important indicator of obesity. This study aimed to investigate the association between VAI and periodontitis. The study included participants from the 2009-2014 cycle of the National Health and Nutrition Examination Survey who received a complete periodontal exam and VAI record. Periodontitis, according to the Centers for Disease Control and Prevention-American Academy of Periodontology periodontitis case definitions, is categorized into the following: no periodontitis, moderate periodontitis, mild periodontitis, and severe periodontitis. Hierarchical analysis, multivariable logistic regression, and restricted cubic spline regression were conducted to investigate the relationship between periodontitis and VAI in adults. There was no significant relationship between VAI and the prevalence of periodontitis in all age groups (P = 0.08). Age-stratified analysis showed a significant association between periodontitis and VAI in adults aged 40-50 years (P < 0.001). After adjusting for all covariates, the association between periodontitis and VAI remained significant in the 40-50-years age group (the trend P value = 0.014). Restricted cubic spline analysis showed a non-linear relationship between VAI and periodontitis (P for non-linear = 0.002). Visceral adiposity index was significantly associated with periodontitis risk in the 40-50-year-old group, and the relationship between VAI and periodontitis risk was found to be non-linear.

Relationship between body mass index and oral health indicators: a cross-sectional study

Today's prevalence of obesity is dramatically increasing and a two-way interaction between higher body mass index (BMI) and oral health is described in scientific litterature. Accordingly, the present study was aimed to evaluate the relation of BMI and oral health indicators. In this cross-sectional study, 240 individuals according to their BMI were placed in the following experimental groups; underweight (BMI<18), normal weight (18≤BMI≤24.9), overweight (25≤BMI≤29.9) and obese (30≤BMI). Plaque index (PI), gingival index (GI), bleeding on probing (BOP) and decayed, missed and filled teeth (DMFT) were obtained. Data was analyzed by SPSS 26 using descriptive tests and one-way ANOVA at the level of 0.05. The mean age and sex distribution of participants of experimental groups had no significant difference (p>0.05). GI and BOP were significantly lower in normal weight persons than individuals with high BMI (p<0.05). DMFT, the number of decayed, missed and filled teeth was approximately similar in all experimental groups (p>0.05). Pearson correlation coefficient showed a positive significant relation between GI as well as BOP with BMI (p=0.000). Based on the results achieved by the present study, although periodontal health status of overweight and obese individuals was significantly compromised compared to normal weight persons, the dental health status was not affected by BMI.

Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies

AIM

The aim of the study was to evaluate the prevalence of periodontitis in dentate people between 2011 and 2020.

MATERIALS AND METHODS

PUBMED, Web of Science, and LILACS were searched up to and including December 2021. Epidemiological studies reporting the prevalence of periodontitis conducted between 2011 and 2020 were eligible for inclusion in this review. Studies were grouped according to the case definition of confidence as confident (Centers for Disease Control [CDC] AAP 2012; CDC/AAP 2007; and Armitage 1999) and non-confident (community periodontal index of 3 or 4, periodontal pocket depth >4 mm, and clinical attachment level ≥1 mm). Random effects meta-analyses with double arcsine transformation were conducted. Sensitivity subgroup and meta-regression analyses explored the effect of confounding variables on the overall estimates.

RESULTS

A total 55 studies were included. The results showed a significant difference, with confident case definitions (61.6%) reporting nearly twice the prevalence as non-confident classifications (38.5%). Estimates using confident periodontal case definitions showed a pooled prevalence of periodontitis of 61.6%, comprising 17 different countries. Estimates reporting using the CDC/AAP 2012 case definition presented the highest estimate (68.1%) and the CDC/AAP 2007 presented the lowest (48.8%). Age was a relevant confounding variable, as older participants (≥65 years) had the highest pooled estimate (79.3%).

CONCLUSION

Between 2011 and 2020, periodontitis in dentate adults was estimated to be around 62% and severe periodontitis 23.6%. These results show an unusually high prevalence of periodontitis compared to the previous estimates from 1990 to 2010.

Study on the Mechanism of miR-146a in Gingival Mesenchymal Stem Cells

This study aimed to investigate the molecular mechanisms of microRNA-146a (miR-146a) on gingival mesenchymal stem cells (MSCs). Gingival MSCs were isolated from the gingiva tissues of patients with periodontal disease to reveal the function of miR-146a in regulating osteoblast differentiation. miR-146a inhibits osteoblast differentiation by inhibiting phosphorylated cyclic-AMP response binding (CREB) protein translocation into the nucleus and ultimately attenuating runt-related transcription factor 2 (Runx2) expression. Furthermore, silencing miR-146a promotes the proliferation of gingival MSCs. Of note, targeted inhibition of miR-146a also inhibited LPS-induced inflammatory response and promoted the proliferation of gingival MSCs via CREB/Runx2 axis. MiR-146a is a key negative regulator of gingival MSCs proliferation and osteogenic differentiation, and targeting to reduce the miR-146a expression is essential for bone formation signaling. Therefore, we propose that miR-146a is a useful therapeutic target for the development of bone anabolic strategies.

Masulili SL, Kusdhany LS, Prahasanti C, Soedarsono N. Obesity correlated to a higher risk of acquiring periodontitis: a cross-sectional study

Background: The present study aimed to investigate the correlation between obesity and periodontitis, among other risk factors for periodontitis.  

Methods:  In total, 262 Indonesian male and female subjects were analysed for body mass index (BMI), oral hygiene, plaque index, and clinically evaluated periodontitis. Statistical analysis was performed using Spearman tests and Pearson chi-square tests to estimate the correlation between BMI and periodontitis. Multivariate binary logistic analysis was conducted between covariate and periodontitis. P<0.05 was considered as statistically significant.  

Results: The prevalence of obesity was 48.47%. There were positive correlations between BMI and periodontal status for healthy-mild periodontitis, moderate, and severe periodontitis respectively. BMI and periodontitis crude odds ratio (OR) = 2.31 (95% CI 1.41-3.78); p < 0.05, adjusted OR of BMI among other variables, was 1.88 (95%CI 1.05-3.37); p < 0.05. Exploration of the ROC curve found a BMI cut off point of 24.785 kg/m2. 

Conclusion: Obesity by BMI measurement of ≥ 25kg/m2 correlated to a higher risk of acquiring periodontitis compared to normal-weight individuals.

The relationship between body mass index and stage/grade of periodontitis: a retrospective study

OBJECTIVES

Possible impact of obesity on stage and grade of periodontitis has never been investigated before. This study aimed to examine the association between body mass index (BMI) and stage/grade of periodontitis per the current classification of periodontal diseases.

MATERIAL AND METHODS

A total of 142 patients (82 males/60 females) were included in this study. "2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions" was taken as basis to characterize the stage/grade of periodontitis. Age, gender, smoking status, and frequency of tooth brushing, and medical data of the patients including hypertension, hyperlipidemia, BMI, and diabetes mellitus were obtained from the patient's hospital records. Obesity was assessed by BMI using the "World Health Organization" criteria. For estimating the association between BMI and periodontitis, logistic regression analysis was utilized.

RESULTS

BMI was statistically associated with clinical attachment loss (CAL), probing pocket depth (PPD), Plaque index (PI), stage and grade of periodontitis, and number of remaining teeth (p < 0.001, p < 0.05, p < 0.05, p < 0.05, p < 0.001, respectively). According to the multiple regression analysis results, those with BMI 25-29.9 were found to be at risk of being stage III-IV 3.977 times (95% CI: 1.831-8.640, p < 0.001) higher than those with BMI < 25, and similarly, those with BMI ≥ 30 were found to be at risk of being stage III-IV 4.062 times (95% CI: 1.315-12.549, p = 0.015) higher than those with BMI < 25. No relationship was found between obesity and grade of periodontitis according to multivariate analysis.

CONCLUSIONS

BMI increases the likelihood of stage III and stage IV periodontitis; however, it does not have an impact on the grade of periodontitis.

CLINICAL RELEVANCE

It seems that obesity is related to the severity of periodontitis.

Effect of obesity on risk and severity of periodontitis: a cross-sectional study

Background: The present study aimed to investigate the correlation between obesity and periodontitis, among other risk factors for periodontitis.   Methods:  In total, 262 Indonesian male and female subjects were analysed for body mass index (BMI), oral hygiene, plaque index, and clinically evaluated periodontitis. Statistical analysis was performed using Spearman tests and Pearson chi-square tests to estimate the correlation between BMI and periodontitis. Multivariate binary logistic analysis was conducted between covariate and periodontitis. P<0.05 was considered as statistically significant.   Results: The prevalence of obesity was 48.47%. There were positive correlations between BMI and periodontal status for healthy-mild periodontitis, moderate, and severe periodontitis respectively. BMI and periodontitis crude odds ratio (OR) = 2.31 (95% CI 1.41-3.78); p < 0.05, adjusted OR of BMI among other variables, was 1.88 (95%CI 1.05-3.37); p < 0.05. Exploration of the ROC curve found a BMI cut off point of 24.785 kg/m2.  Conclusion: Obesity by BMI measurement of ≥ 25kg/m2 correlated to a higher risk of acquiring periodontitis compared to normal-weight individuals.

Association between clinical measures of gingival inflammation and obesity in adults: systematic review and meta-analyses

OBJECTIVE

This study aimed to systematically review the literature about the association between clinical measures of gingival inflammation and obesity in adults.

MATERIAL AND METHODS

Searches for studies were performed in five databases (Medline-PubMed, Scopus, Web of Science, Cochrane Library, and Embase) to compile studies of any design that evaluated the association between clinical measures of gingival inflammation and obesity in adults. Selection of studies, data extraction and risk of bias analysis were performed independently by two reviewers, and a third researcher was involved to resolve disagreements. Meta-analyses were performed for measures of gingival inflammation as compared to body mass index (BMI). Independent analyses were performed for studies involving periodontitis, gingivitis, and population-based/studies that did not provide a periodontal diagnosis. Standard mean deviation (SMD) and its 95% confidence interval (95%CI) were estimated.

RESULTS

Ninety studies were included (cross-sectional/clinical trials [n=82], case-control [n=3], cohorts [n=5]). Most of the studies demonstrated no significant difference in the measures of gingival inflammation regardless of the comparison performed. However, meta-analysis showed that among individuals with periodontitis, significantly higher levels of gingival inflammation are observed in those with obesity (n of individuals=240) when compared to those who were not obese (n of individuals=574) (SMD:0.26; 95%CI:0.07-0.44). When considering population-based/those studies that did not provide periodontal diagnosis, significantly higher measures of gingival inflammation were observed in the groups with higher BMI.

CONCLUSIONS

Within the limitations of the present study, it was concluded that higher measures of gingival inflammation may be expected for those with higher BMI.

CLINICAL RELEVANCE

Clinicians must be aware that higher measures of gingival inflammation may be expected for individuals with higher BMI. However, there is a necessity for further longitudinal studies regarding the association between obesity and gingival inflammation.