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Oliveira LM, Zanatta FB, Costa SA, Pelissari TR, Baumeister SE, Demarco FF, Nascimento GG. The Alcohol Harm Paradox in Periodontitis. J Dent Res 2024:220345241235614. [PMID: 38605651 DOI: 10.1177/00220345241235614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Individuals of lower socioeconomic position (SEP) experience a greater rate of alcohol-related harms, yet they consume equal or lower amounts of alcohol than higher-SEP individuals. This phenomenon, called the "alcohol harm paradox" (AHP), gained attention recently, and different mechanisms have been proposed to explain it. Since both SEP and alcohol have been suggested to be associated with periodontitis risk, we conducted a secondary analysis using data from the National Health and Nutrition Examination Survey 2011 to 2012 and 2013 to 2014 cycles, aiming to examine 1) whether the association between alcohol consumption and periodontitis is modified by SEP and 2) the extent to which the effect of SEP inequalities on periodontitis is mediated by and/or interacts with alcohol consumption. We set educational attainment as the main SEP proxy and tested the poverty income ratio in subsequent sensitivity analyses. Effect measure modification analysis was employed, considering heavy drinking as exposure, and causal mediation analysis based on the potential outcome's framework decomposed the effect of SEP on periodontitis in proportions attributable to mediation and interaction. Models were fitted using binary logistic regression and adjusted for sex, ethnicity, age, body mass index, smoking status, diabetes, binge drinking, and regular preventive dental visits. The analytical sample comprised 4,057 participants. After adjusting for covariates, less educated heavy drinkers presented 175% (odds ratio, 2.75; 95% confidence interval [CI], 2.04-3.72) higher odds of periodontitis than their counterparts, and super-additive associations were found (relative excess risk due to interaction: 1.35; 95% CI, 0.49-2.20). Additionally, -69.5% (95% CI, -122.1% to -16.8%) of the effects of education on periodontitis were attributable to interaction with heavy drinking, consistent with the AHP. No contribution was found for the mechanism of mediation. Heavy drinking disproportionately impacts the occurrence of periodontitis in lower-SEP individuals. Lower-SEP individuals seem to experience differential effects of heavy drinking on periodontitis.
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Affiliation(s)
- L M Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - F B Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - S A Costa
- Graduate Dentistry Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - T R Pelissari
- Department of Stomatology, Postgraduate Program in Dentistry, Santa Maria, Rio Grande do Sul, Brazil
- Emphasis on Endodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - S E Baumeister
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - F F Demarco
- Graduate Program in Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
- Graduate Program in Epidemiology, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - G G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
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Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J 2021; 54:712-735. [PMID: 33378579 DOI: 10.1111/iej.13467] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Apical periodontitis (AP) frequently presents as a chronic asymptomatic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations such as periapical or panoramic radiographs, or cone-beam computed tomography (CBCT). Thus, the worldwide burden of AP is probably underestimated or unknown. Previous systematic reviews attempted to estimate the prevalence of AP, but none have investigated which factors may influence its prevalence worldwide. OBJECTIVES To assess: (i) the prevalence of AP in the population worldwide, as well as the frequency of AP in all teeth, nontreated teeth and root filled teeth; (ii) which factors can modify the prevalence of AP. METHODS A search was conducted in the PubMed-MEDLINE, EMBASE, Cochrane-CENTRAL, LILACS, Google scholar and OpenGrey databases, followed by hand searches, until September 2019. Cross-sectional, case-control and cohort studies reporting the prevalence of AP in humans, using panoramic or periapical radiograph or CBCT as image methods were included. No language restriction was applied. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of AP at the individual level. Secondary outcomes were the frequency of AP in all teeth, nontreated teeth and rootfilled teeth. Subgroup analyses using random-effect models were carried out to analyse the influence of explanatory covariables on the outcome. RESULTS The search strategy identified 6670 articles, and 114 studies were included in the meta-analysis, providing data from 34 668 individuals and 639 357 teeth. The prevalence of AP was 52% at the individual level (95% CI 42%-56%, I2 = 97.8%) and 5% at the tooth level (95% CI 4%-6%; I2 = 99.5%). The frequency of AP in root-filled teeth and nontreated teeth was 39% (95% CI 36%-43%; I2 = 98.5%) and 3% (95% CI 2%-3%; I2 = 99.3%), respectively. The prevalence of AP was greater in samples from dental care services (DCS; 57%; 95% CI 52%-62%; I2 = 97.8%) and hospitals (51%; 95% CI 40%-63%; I2 = 95.9%) than in those from the general population (GP; 40%; 95% CI 33%-46%; I2 = 96.5%); it was also greater in people with a systemic condition (63%; 95% CI 56%-69%, I2 = 89.7%) compared to healthy individuals (48%; 95% CI 43%-53%; I2 = 98.3%). DISCUSSION The subgroup analyses identified explanatory factors related to the variability in the prevalence of AP. However, the high clinical heterogeneity and high risk of bias across the primary studies indicate that the findings must be interpreted with caution. CONCLUSIONS Half of the adult population worldwide have at least one tooth with apical periodontitis. The prevalence of AP is greater in samples from the dental care services, but it is also high amongst community representative samples from the general population. The present findings should bring the attention of health policymakers, medical and dental communities to the hidden burden of endodontic disease in the population worldwide.
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Affiliation(s)
- C S Tibúrcio-Machado
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - C Michelon
- Medical and Dental Center of the Brazilian Army, Santa Maria, Brazil
| | - F B Zanatta
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Medical and Dental Center of the Military Police, Porto Alegre, Brazil
| | - J A Marin
- Universidade Franciscana (UFN), Santa Maria, Brazil
| | - C A Bier
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Dutra D, Pereira G, Kantorski KZ, Valandro LF, Zanatta FB. Does Finishing and Polishing of Restorative Materials Affect Bacterial Adhesion and Biofilm Formation? A Systematic Review. Oper Dent 2018; 43:E37-E52. [PMID: 29284102 DOI: 10.2341/17-073-l] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Biofilm (bacterial plaque) accumulation on the surface of restorative materials favors the occurrence of secondary caries and periodontal inflammation. Surface characteristics of restorations can be modified by finishing and/or polishing procedures and may affect bacterial adhesion. The aim of this systematic review was to characterize how finishing and polishing methods affect the surface properties of different restorative materials with regard to bacterial adhesion and biofilm formation. Searches were carried out in MEDLINE-PubMed, EMBASE, Cochrane-CENTRAL, and LILACS databases. From 2882 potential articles found in the initial searches, only 18 met the eligible criteria and were included in this review (12 with in vitro design, four with in situ design, and two clinical trials). However, they presented high heterogeneity regarding materials considered and methodology for evaluating the desired outcome. Risk bias analysis showed that only two studies presented low risk (whereas 11 showed high and five showed medium risk). Thus, only descriptive analyses considering study design, materials, intervention (finishing/polishing), surface characteristics (roughness and surface free energy), and protocol for biofilm formation (bacterial adhesion) could be performed. Some conclusions could be drawn: the impact of roughness on bacterial adhesion seems to be related not to a roughness threshold (as previously believed) but rather to a range, the range of surface roughness among different polishing methods is wide and material dependent, finishing invariably creates a rougher surface and should always be followed by a polishing method, each dental material requires its own treatment modality to obtain and maintain as smooth a surface as possible, and in vitro designs do not seem to be powerful tools to draw relevant conclusions, so in vivo and in situ designs become strongly recommended.
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Dutra DAM, Pereira GKR, Kantorski KZ, Exterkate RAM, Kleverlaan CJ, Valandro LF, Zanatta FB. Grinding With Diamond Burs and Hydrothermal Aging of a Y-TZP Material: Effect on the Material Surface Characteristics and Bacterial Adhesion. Oper Dent 2017; 42:669-678. [DOI: 10.2341/16-108-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The aim of this study was to evaluate the effect of grinding with diamond burs and low-temperature aging on the material surface characteristics and bacteria adhesion on a yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) surface. Y-TZP specimens were made from presintered blocks, sintered as recommended by the manufacturer, and assigned into six groups according to two factors—grinding (three levels: as sintered, grinding with extra-fine diamond bur [25-μm grit], and grinding with coarse diamond bur [181-μm grit]) and hydrothermal aging—to promote low-temperature degradation (two levels: presence/absence). Phase transformation (X-ray diffractometer), surface roughness, micromorphological patterns (atomic force microscopy), and contact angle (goniometer) were analyzed. Bacterial adhesion (colony-forming units [CFU]/biofilm) was quantified using an in vitro polymicrobial biofilm model. Both the surface treatment and hydrothermal aging promoted an increase in m-phase content. Roughness values increased as a function of increasing bur grit sizes. Grinding with a coarse diamond bur resulted in significantly lower values of contact angle (p<0.05) when compared with the extra-fine and control groups, while there were no differences (p<0.05) after hydrothermal aging simulation. The CFU/biofilm results showed that neither the surface treatment nor hydrothermal aging simulation significantly affected the bacteria adherence (p>0.05). Grinding with diamond burs and hydrothermal aging modified the Y-TZP surface properties; however, these properties had no effect on the amount of bacteria adhesion on the material surface.
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Affiliation(s)
- DAM Dutra
- Danilo Antonio Milbradt Dutra, DDS, MSc, Post-graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Brazil
| | - GKR Pereira
- Gabriel Kalil Rocha Pereira, DDS, MSc, PhD, Graduate Program in Dentistry, School of Dentistry, Meridional Faculty – IMED, Passo Fundo, Brazil
| | - KZ Kantorski
- Karla Zanini Kantorski, DDS, MSc, PhD, Post-graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Brazil
| | - RAM Exterkate
- Rob A. M. Exterkate, BSc, PhD, Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Universiteit van Amsterdam, and Vrije Universiteit, Amsterdam, Netherlands
| | - CJ Kleverlaan
- Cornelis Johannes Kleverlaan, BCh, PhD, Department of Dental Material Sciences, Academic Centre for Dentistry Amsterdam, Universiteit van Amsterdam, and Vrije Universiteit, Amsterdam, Netherlands
| | - LF Valandro
- Luiz Felipe Valandro, DDS, MSc, PhD, Post-graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil
| | - FB Zanatta
- Fabrício Batistin Zanatta, DDS, MSc, PhD, Post-graduate Program in Oral Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul State, Brazil
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Antoniazzi RP, Zanatta FB, Ardenghi TM, Feldens CA. The use of crack and other illicit drugs impacts oral health-related quality of life in Brazilians. Oral Dis 2017; 24:482-488. [DOI: 10.1111/odi.12786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 09/14/2017] [Accepted: 09/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- RP Antoniazzi
- School of Dentistry; Master's Degree in Health and Life Sciences; Centro Universitário Franciscano; Santa Maria Brazil
| | - FB Zanatta
- Stomatology Department; School of Dentistry; Universidade Federal de Santa Maria (UFSM); Santa Maria Brazil
| | - TM Ardenghi
- Stomatology Department; School of Dentistry; Universidade Federal de Santa Maria (UFSM); Santa Maria Brazil
| | - CA Feldens
- Post-graduate Program in Dentistry; Universidade Luterana do Brasil (ULBRA); Canoas Brazil
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Casarin M, Antoniazzi RP, Vaucher RA, Feldens CA, Zanatta FB. RT-PCR quantification of periodontal pathogens in crack users and non-users. Oral Dis 2016; 23:324-330. [DOI: 10.1111/odi.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 10/07/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Affiliation(s)
- M Casarin
- Postgraduate Program in Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - RP Antoniazzi
- Dentistry Course; Franciscan University Center; Santa Maria Brazil
| | - RA Vaucher
- Postgraduate Program in Biochemistry and Bioprospecting; Center of Chemistry; Pharmaceutical and Food Science; Federal University of Pelotas (UFPel); Pelotas Rio Grande do Sul Brazil
| | - CA Feldens
- Postgraduate Program in Dentistry; Lutheran University of Brazil; Canoas Brazil
| | - FB Zanatta
- Postgraduate Program in Dentistry; Federal University of Santa Maria; Santa Maria Brazil
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