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Liang F, Zhou Y, Zhang Z, Zhang Z, Shen J. Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis. BMC Oral Health 2023; 23:387. [PMID: 37312090 PMCID: PMC10265775 DOI: 10.1186/s12903-023-03120-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/08/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND There are differences in vitamin D levels between periodontitis and healthy individuals, but the effect of vitamin D on periodontitis is controversial. The purpose of this Meta-analysis is twofold: (1) compare vitamin D levels in individuals with or without periodontitis; (2) assess the effects of vitamin D supplementation during scaling and root planing (SRP) on periodontal clinical parameters in individuals with periodontitis. METHODS A systematic search was conducted in five databases (PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library), published from the database inception to 12 September 2022. The Cochrane Collaboration Risk of bias (ROB) assessment tool, the risk of bias in non-randomized studies of intervention (ROBINS-I) tool, the Newcastle-Ottawa Quality Assessment Scale (NOS), and Agency for Healthcare Quality and Research (AHRQ) were used to evaluate randomized controlled trial (RCT), non-RCT, case-control study, and cross-sectional study, respectively. Statistical analysis was performed using RevMan 5.3 and Stata 14.0 software, with weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence intervals (CI) as the effect measures, and heterogeneity was tested by subgroup analysis, sensitivity analysis, Meta-regression. RESULTS A total of 16 articles were included. The results of Meta-analysis showed that periodontitis was associated with lower serum vitamin D levels compared to normal population (SMD = -0.88, 95%CI -1.75 ~ -0.01, P = 0.048), while there was no significant difference in serum or saliva 25(OH)D levels between periodontitis and normal population. Additionally, the Meta-analysis showed that SRP + vitamin D and SRP alone had a statistically significant effect on serum vitamin D levels in individuals with periodontitis (SMD = 23.67, 95%CI 8.05 ~ 32.29, P = 0.003; SMD = 1.57, 95%CI 1.08 ~ 2.06, P < 0.01). And SRP + vitamin D could significantly reduce clinical attachment level compared to SRP alone (WMD = -0.13, 95%CI -0.19 ~ -0.06, P < 0.01), but had no meaningful effect on probing depth, gingival index, bleeding index, respectively. CONCLUSION The evidence from this Meta-analysis suggests that the serum vitamin D concentration of individuals with periodontitis is lower than that of normal people, and SRP along with vitamin D supplementation has been shown to play a significant role in improving periodontal clinical parameters. Therefore, vitamin D supplementation as an adjuvant to nonsurgical periodontal therapy has a positive impact on the prevention and treatment of periodontal disease in clinical practice.
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Affiliation(s)
- Fangfang Liang
- School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, 300000, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Yuanzhu Zhou
- School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, 300000, China
| | - Zhenyu Zhang
- The School of Pharmacy, Jiamusi University, Jiamusi, 154007, China
| | - Zheng Zhang
- School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, 300000, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
| | - Jing Shen
- School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, 300000, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
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Li W, Zheng Q, Xu M, Zeng C, Deng X. Association between circulating 25-hydroxyvitamin D metabolites and periodontitis: Results from the NHANES 2009-2012 and Mendelian randomization study. J Clin Periodontol 2023; 50:252-264. [PMID: 36274052 DOI: 10.1111/jcpe.13736] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 10/07/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
AIM This study sought to investigate associations of 25-hydroxyvitamin D (25(OH)D) metabolites with periodontitis and to assess causality using Mendelian randomization (MR). MATERIALS AND METHODS This study included 7246 participants of the National Health and Nutrition Examination Survey, 2009-2012. The association of periodontitis with 25(OH)D metabolites was assessed using multivariable logistic regression analysis. Two-sample MR for 25(OH)D, 25(OH)D3 , and C3-epi-25(OH)D3 with periodontitis (n = 17,353 cases/28,210 controls) was conducted. The principal analysis employed the inverse-variance-weighted (IVW) approach. We controlled for horizontal pleiotropy using five additional methods. RESULTS Based on the observational study, each 1-point increase in standard deviation of 25(OH)D lowered the risk of periodontitis by 15% (OR = 0.85, 95% confidence interval [CI]: 0.78-0.93, p = .006) after multivariable adjustment. A similar relationship was observed between 25(OH)D3 and periodontitis (OR = 0.88, 95% CI: 0.80-0.97, p = .031). Furthermore, a potential non-linear association was found between periodontitis and both 25(OH)D and 25(OH)D3 . However, C3-epi-25(OH)D3 was not found to be associated with periodontitis risk. IVW-MR showed that periodontitis risk was not significantly associated with genetically increased levels of 25(OH)D (OR = 1.02, 95% CI: 0.90-1.16, p = .732), 25(OH)D3 (OR = 1.04, 95% CI: 0.93-1.17, p = .472), or C3-epi-25(OH)D3 (OR = 1.11, 95% CI: 0.87-1.41, p = .400). The pleiotropy-robust MR approaches yielded similar results after we had eliminated the variants with horizontal pleiotropy risk. CONCLUSIONS Cross-sectional observational analysis identified significant relationships between periodontitis with 25(OH)D metabolites, while findings based on MR study did not support a causal role.
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Affiliation(s)
- Wenjing Li
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Key Laboratory of Dental Material, National Medical Products Administration, Beijing, China.,Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Qiwen Zheng
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
| | - Mingming Xu
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Key Laboratory of Dental Material, National Medical Products Administration, Beijing, China
| | - Changqing Zeng
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China.,Henan Academy of Sciences, Henan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xuliang Deng
- Beijing Laboratory of Biomedical Materials, Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Key Laboratory of Dental Material, National Medical Products Administration, Beijing, China
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Therapeutic and Metagenomic Potential of the Biomolecular Therapies against Periodontitis and the Oral Microbiome: Current Evidence and Future Perspectives. Int J Mol Sci 2022; 23:ijms232213708. [PMID: 36430182 PMCID: PMC9693164 DOI: 10.3390/ijms232213708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
The principles of periodontal therapy are based on the control of microbial pathogens and host factors that contribute to biofilm dysbiosis, with the aim of modulating the progression of periodontitis and periodontal tissue destruction. It is currently known how differently each individual responds to periodontal treatment, depending on both the bacterial subtypes that make up the dysbiotic biofilm and interindividual variations in the host inflammatory response. This has allowed the current variety of approaches for the management of periodontitis to be updated by defining the goals of target strategies, which consist of reducing the periodontopathogenic microbial flora and/or modulating the host-mediated response. Therefore, this review aims to update the current variety of approaches for the management of periodontitis based on recent target therapies. Recently, encouraging results have been obtained from several studies exploring the effects of some targeted therapies in the medium- and long-term. Among the most promising target therapies analyzed and explored in this review include: cell-based periodontal regeneration, mediators against bone resorption, emdogain (EMD), platelet-rich plasma, and growth factors. The reviewed evidence supports the hypothesis that the therapeutic combination of epigenetic modifications of periodontal tissues, interacting with the dysbiotic biofilm, is a key step in significantly reducing the development and progression of disease in periodontal patients and improving the therapeutic response of periodontal patients. However, although studies indicate promising results, these need to be further expanded and studied to truly realize the benefits that targeted therapies could bring in the treatment of periodontitis.
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Severe, Treatment-Refractory Periodontitis and Vitamin D Deficiency: A Multidisciplinary Case Report. Case Rep Dent 2022; 2022:6469214. [PMID: 36267055 PMCID: PMC9578831 DOI: 10.1155/2022/6469214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Vitamin D deficiency and periodontitis are common diseases among people. These conditions interact with each other and worsen the patient's health. Modern dentistry aims to rehabilitate oral health and bring it back to the original state or even improve aesthetics. Without analysing the general health conditions of patients and without a multidisciplinary approach, it is sometimes not possible to solve a case such as we describe. This study shows how a vitamin D deficit can influence the choice of dental treatment. The patient, a 40-year-old woman, in generally good health, came to our observation complaining about pain during mastication, and profuse bleeding during home hygiene maneuvers. She wished to solve this situation. Materials and Methods Since the patient did not respond well to the initial periodontal therapy, we carried out some accurate research concerning the patient's previous clinical history, and as we suspected that a vitamin D deficit might be involved, a chemical test for vitamin D was carried out and the results confirmed our suspicions. The team programmed the following therapeutical plan: Phase 1—rehabilitation of normal values of vitamin D with the support of an endocrinologist; Phase 2—full mouth disinfection; Phase 3—periodontal surgical restorative therapy; and Phase 4—orthodontic therapy and fixed prosthetics rehabilitation. Results The results for this clinical case were extremely satisfying; we were able to bring the periodontal illness under control; resolve the orthodontic problems; and rehabilitate the patient both functionally and aesthetically. Conclusion Thanks to the collaboration and communication between specialists from different sectors of medicine and dentistry, the clinical case was solved with absolutely satisfactory results.
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Mishra SM, Ravishankar PL, Pramod V, Rajula PB, Gayathri K, Alam MK, Raj AT, Bhandi S, Patil S. Effect of Supplementation of Vitamin D in Patients with Periodontitis Evaluated before and after Nonsurgical Therapy. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5869676. [PMID: 35978636 PMCID: PMC9377921 DOI: 10.1155/2022/5869676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Background Vitamin D has anti-inflammatory properties and the potential to increase the generation of antimicrobial peptides like cathelicidin and defensins that may have a good impact on oral health. Higher vitamin D consumption has also been linked to a reduced risk of periodontal disease progression. Hence, the primary objective of this study was to evaluate and compare the clinical and laboratory parameters of oral supplementation of vitamin D as an adjuvant to scaling and root planing and to assess the bone mineral density via qualitative ultrasound bone density scanner in chronic periodontitis patients. Methodology. This study included 40 patients with periodontitis categorized into 2 groups with twenty patients each, Group I comprising scaling and root planing (SRP) alone and Group II comprising SRP along with vitamin D supplementation. Plaque index, gingival index, probing pocket depth, and clinical attachment loss was measured as clinical parameters. Serum vitamin D levels were assessed before and after SRP at both baseline and 6 weeks. Results The intergroup comparison of clinical parameters (PI, GI, PPD, and CAL) at 6 weeks for both the groups showed statistical significance. Intragroup comparison of clinical parameters from baseline to 6 weeks showed a statistically significant reduction in both groups. The mean bone mineral density level in both the control and test groups demonstrated a mean T score of -1.3 and -1.21, respectively. The mean vitamin D levels were 27.8460 and 28.1020 for the test and control groups, respectively, which was statistically insignificant (p = 0.705) and those at six-week intervals improved to 31.3650 and 28.0240 which were statistically significant (p ≤ 0.001). Conclusion It could be stated that a positive relationship exists between periodontitis and osteopenia which could aggravate periodontal destruction. All periodontitis cases should thus be evaluated for BMD and supplemented with vitamin D3 in an appropriate dosage and time frame to treat both these diseases.
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Affiliation(s)
- Shree Mohan Mishra
- Department of Periodontology, New Horizon Dental College, Bilaspur, 495001 Chattisgarh, India
| | - P. L. Ravishankar
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - V. Pramod
- Department of Periodontology, New Horizon Dental College, Bilaspur, 495001 Chattisgarh, India
| | - Prem Blaisie Rajula
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - K. Gayathri
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - Mohammad Khursheed Alam
- Orthodontics, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil lnternational University, Dhaka, Bangladesh
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Department of Cariology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600 077, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Science, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Jazan 45412, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600 077, India
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Sllamniku Dalipi Z, Dragidella F. Calcium and Vitamin D Supplementation as Non-Surgical Treatment for Periodontal Disease with a Focus on Female Patients: Literature Review. Dent J (Basel) 2022; 10:dj10070120. [PMID: 35877394 PMCID: PMC9319146 DOI: 10.3390/dj10070120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontal disease is a complex disease that involves an imbalance between the oral microbiota and an individual’s inflammatory response. Moreover, the inflammatory response contributes to further imbalance; if left untreated, periodontal disease may result in tooth loss. Vitamin D is intricately involved in the regulation of calcium–phosphate homeostasis and bone mineral metabolism; considering that periodontal surgery usually includes regenerative therapy, adequate vitamin D and calcium levels are essential. The benefits of vitamin D and calcium supplementation have been demonstrated in situations where deficiency is associated with adverse outcomes, such as periodontal disease and maternal health. However, knowledge and attitudes about supplementation, as well as the actual levels of supplementation, vary greatly in the general population; they also differ between men and women. The aim of this review is to discuss how vitamin D and calcium supplementation affect oral and periodontal health, especially in women. Additionally, this review provides suggestions for public health strategies regarding vitamin D and calcium supplementation, as well as the effects of both types of supplementation on maternal oral health.
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Leszczyszyn A, Hnitecka S, Dominiak M. Could Vitamin D3 Deficiency Influence Malocclusion Development? Nutrients 2021; 13:nu13062122. [PMID: 34205632 PMCID: PMC8234332 DOI: 10.3390/nu13062122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
The abnormal growth of the craniofacial bone leads to skeletal and dental defects, which result in the presence of malocclusions. Not all causes of malocclusion have been explained. In the development of skeletal abnormalities, attention is paid to general deficiencies, including of vitamin D3 (VD3), which causes rickets. Its chronic deficiency may contribute to skeletal malocclusion. The aim of the study was to assess the impact of VD3 deficiency on the development of malocclusions. The examination consisted of a medical interview, oral examination, an alginate impression and radiological imaging, orthodontic assessment, and taking a venous blood sample for VD3 level testing. In about 42.1% of patients, the presence of a skeletal defect was found, and in 46.5% of patients, dentoalveolar malocclusion. The most common defect was transverse constriction of the maxilla with a narrow upper arch (30.7%). The concentration of vitamin 25 (OH) D in the study group was on average 23.6 ± 10.5 (ng/mL). VD3 deficiency was found in 86 subjects (75.4%). Our research showed that VD3 deficiency could be one of an important factor influencing maxillary development. Patients had a greater risk of a narrowed upper arch (OR = 4.94), crowding (OR = 4.94) and crossbite (OR = 6.16). Thus, there was a link between the deficiency of this hormone and the underdevelopment of the maxilla.
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Affiliation(s)
- Anna Leszczyszyn
- Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (A.L.); (M.D.)
| | - Sylwia Hnitecka
- Maxillofacial Surgery Department, Wroclaw Medical University, 50-556 Wroclaw, Poland
- Correspondence:
| | - Marzena Dominiak
- Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (A.L.); (M.D.)
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Machado V, Lobo S, Proença L, Mendes JJ, Botelho J. Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12082177. [PMID: 32708032 PMCID: PMC7468917 DOI: 10.3390/nu12082177] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
To explore the vitamin D levels of periodontitis patients in comparison with periodontally healthy ones, and to assess the influence of vitamin D supplementation as an adjunctive during nonsurgical periodontal treatment (NSPT). Five databases (Pubmed, Embase, Scholar, Web of Sciences, and Cochrane Library) were searched until May 2020. Mean difference (MD) meta-analysis with corresponding 95% confidence interval (95% CI) and sensitivity tests via meta-regression were used. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Sixteen articles were included, fourteen case-control and two intervention studies, all reporting 25-hydroxyvitamin D (25(OH)D) levels. Compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in chronic periodontitis patients (pooled MD = −6.80, 95% CI: −10.59 to −3.02). Subgroup analysis revealed differences among 25(OH)D measurements, with liquid chromatography-mass spectrometry being the most homogeneous method (pooled MD = −2.05, 95% CI: −3.40 to −0.71). Salivary levels of 25(OH)D showed no differences between groups. Due to the low number of studies, conclusions on aggressive periodontitis and in the effect of vitamin D supplementation after NSPT were not possible to ascribe. Compared with healthy controls, 25(OH)D serum levels are significantly lower in chronic periodontitis patients, with an overall SORT A recommendation. Future studies are needed to clarify the effect of vitamin D supplementation and the biological mechanisms linking vitamin D to the periodontium.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
- Correspondence:
| | - Sofia Lobo
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - José João Mendes
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
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Dairy Food Consumption is Inversely Associated with the Prevalence of Periodontal Disease in Korean Adults. Nutrients 2019; 11:nu11051035. [PMID: 31075833 PMCID: PMC6566145 DOI: 10.3390/nu11051035] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 12/27/2022] Open
Abstract
Dairy food consumption is known to be inversely associated with periodontal disease. However, there are conflicting results depending on the type of dairy foods. The aim of this study was to determine the relationship between individual dairy food consumption and periodontal disease. A total of 9798 Korean adults, aged ≥30 years, who participated in the fifth and sixth Korea National Health and Nutrition Examination Survey were included in this study’s analysis. Dairy food consumption was measured by the semi-quantitative food frequency questionnaire. Periodontal disease was defined as Community Periodontal Index score ≥3 in more than one of six sextants. Frequent intake of dairy foods (≥7 servings/week) was associated with a 24% lower prevalence of periodontal disease compared with never consumers after adjustment for age, gender, income, education, smoking, alcohol consumption, body mass index, diabetes mellitus status, calcium intake, tooth brushing frequency, and use of dental floss (Odds ratio (OR)= 0.76, 95% CI = 0.63–0.91, p for trend = 0.052). Also, frequent intake of milk (≥7 servings/week) was associated with a 26% lower prevalence of periodontal disease after adjustment for potential confounders (OR = 0.74, 95% CI = 0.61–0.89, p for trend = 0.022). Frequent consumption of dairy food including milk may have a beneficial effect on periodontal disease in the Korean adult population.
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LEE DONGEUN, WON SUNGYOON. Relationship between Clinical Indicators of Periodontal Disease and Serum Level of Vitamin D. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2019. [DOI: 10.12944/crnfsj.7.1.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Vitamin D is obtained through food and nutritional supplements, or is synthesized in the skin by sunshine. It is then transferred to the liver and kidney through the bloodstream and hydroxylated by a specific enzyme (cytochrome P450 family 27 subfamilies A member 1, cytochrome P450 family 27 subfamily B member 1) to form 25-hydroxyvitamin D and 1,25-dihydroxy vitamin D. The vitamin D synthesis facilitates calcium and phosphorus absorption from the intestines. The parathyroid hormone helps to synthesize 1,25-dihydroxy vitamin D to aid calcium absorption. Objectives: Many researchers have investigated the relationship between serum vitamin D levels and periodontal disease. And periodontal disease indicators such as bleeding on probing, pocket depth, clinical attachment level, gingival index, and cementoenamel junction-alveolar cresthave been used to identify the effects of vitamin D on periodontal disease. The effects of vitamin D on bacteria or cytokines have also been investigated. In this review article, vitamin D levels according to the status of periodontal disease were summarized. Data sources: PubMed was searched electronically, and randomized clinical trials, cross-sectional studies, and case-control studies were included in the review. Study appraisal and synthesis methods: Articles that the classification of periodontitis was accurately described, indicators for identifying periodontitis was clearly marked, and the form of vitamin D measured in the study was accurately described were selected. Only highly relevant journals were selected and summarized. Results: Most of the research has found positive associations between the serum 25-hydroxyvitamin D level and periodontal health, and the clinical parameters of periodontal disease were reduced by vitamin D. Limitations: Detailed categorization of the characteristics associated with the 25-hydroxyvitamin D level should be needed in future studies. Conclusions: This review article can be used as a guide by clinicians and as a reference book for patients’ education.
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Affiliation(s)
- DONG-EUN LEE
- Department of Dental Hygiene, Ulsan College, Ulsan, 44022, South Korea
| | - SUNG-YOON WON
- Department of Occupational Therapy, Semyung University, Chung-buk, 27136, South Korea
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Calcium and vitamin D supplementation and/or periodontal therapy in the treatment of periodontitis among Brazilian pregnant women: protocol of a feasibility randomised controlled trial (the IMPROVE trial). Pilot Feasibility Stud 2019; 5:38. [PMID: 30873290 PMCID: PMC6402123 DOI: 10.1186/s40814-019-0417-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Periodontitis is a common oral inflammation, which is a risk factor for adverse pregnancy outcomes. Intakes of vitamin D and calcium are inversely associated with occurrence and progression of periodontitis. This study aims to assess the feasibility of a multi-component intervention, including provision of milk powder supplemented with calcium and vitamin D and periodontal therapy (PT), for improving maternal periodontal health and metabolic and inflammatory profiles of low-income Brazilian pregnant women with periodontitis. Methods The IMPROVE trial is a feasibility randomised controlled trial (RCT) with a 2 × 2 factorial design with a parallel process evaluation. Pregnant women with periodontitis, aged 18–40 years and with < 20 gestational weeks (n = 120) were recruited and randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus PT during pregnancy, (2) placebo sachet and powdered milk plus PT during pregnancy, (3) fortified sachet (vitamin D and calcium) and powdered milk plus PT after delivery and (4) placebo sachet and powdered milk plus PT after delivery. Dentists and participants are blinded to fortification. Acceptability of study design, recruitment strategy, random allocation, data collection procedures, recruitment rate, adherence and attrition rate will be evaluated. Data on serum levels of vitamin D, calcium and inflammatory biomarkers; clinical periodontal measurements; anthropometric measurements; and socio-demographic questionnaires are collected at baseline, third trimester and 6–8 weeks postpartum. Qualitative data are collected using focus group, for analysis of favourable factors and barriers related to study adherence. Discussion Oral health and mineral/vitamin supplementation are much overlooked in the public prenatal assistance in Brazil and of scarcity of clinical trials addressing these issues in low and middle-income countries,. To fill this gap the present study was designed to assess the feasibility of a RCT on acceptability of a multi-component intervention combining conventional periodontal treatment and consumption of milk fortified with calcium-vitamin D for improving periodontal conditions and maternal metabolic and inflammation status, among Brazilian low-income pregnant women with periodontitis. Thus, we hope that this relatively low-cost and safe multicomponent intervention can help reduce inflammation, improve maternal periodontal health and metabolic profile and consequently prevent negative gestational outcomes. Trial registration NCT, NCT03148483. Registered on May 11, 2017.
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