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Saade Y, Deraz O, Chatzopoulou E, Rangé H, Boutouyrie P, Perier MC, Guibout C, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Recalled body silhouette trajectories over the lifespan and oral conditions in adulthood: A cross-sectional analysis of the Paris Prospective Study 3. Community Dent Oral Epidemiol 2024; 52:518-526. [PMID: 38273719 DOI: 10.1111/cdoe.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To examine the association between life-course body silhouette changes and oral conditions in adulthood. METHODS At study recruitment (2008-2012), 5430 adults underwent a full-mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life-course trajectories of body silhouettes were computed using group-based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression. RESULTS The final analysis included 4472 participants. Five body silhouette trajectories were established: lean-stable (30.0%), lean-increased (19.3%), moderate stable (18.1%), lean-marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean-increased trajectory were 58% more likely than those with a lean-stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides. CONCLUSIONS A life-course lean-increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood.
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Affiliation(s)
- Yara Saade
- Department of Periodontology, Université Paris Cité, Paris, France
- Rothschild Hospital, APHP, Paris, France
| | - Omar Deraz
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Eirini Chatzopoulou
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Hélène Rangé
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
- Department of Periodontology, Service of Odontology, University hospital of Rennes, University of Rennes 1, U.F.R. of Odontology, Paris, France
- INSERM, INRAE, University of Rennes 1 NUMECAN Institute (Nutrition Metabolisms and Cancer), Rennes, France
- FHU PaCeMM Paris Center for Microbiome Medicine, Paris, France
| | - Pierre Boutouyrie
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Catherine Guibout
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | | | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
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Holtfreter B, Kuhr K, Borof K, Tonetti MS, Sanz M, Kornman K, Jepsen S, Aarabi G, Völzke H, Kocher T, Krois J, Papapanou PN. ACES: A new framework for the application of the 2018 periodontal status classification scheme to epidemiological survey data. J Clin Periodontol 2024; 51:512-521. [PMID: 38385950 DOI: 10.1111/jcpe.13965] [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: 06/07/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
AIM To propose a framework for consistently applying the 2018 periodontal status classification scheme to epidemiological surveys (Application of the 2018 periodontal status Classification to Epidemiological Survey data, ACES). PROPOSED FRAMEWORK We specified data requirements and workflows for either completed or planned epidemiological surveys, utilizing commonly collected measures of periodontal status (clinical attachment levels [CAL], probing depths, bleeding on probing), as well as additional necessary variables for the implementation of the 2018 periodontal status classification (tooth loss due to periodontitis and complexity factors). Following detailed instructions and flowcharts, survey participants are classified as having periodontal health, gingivitis or periodontitis. Rates of edentulism must also be reported. In cases of periodontitis, instructions on how to compute the stage and extent are provided. Assessment of grade can be derived from CAL measurements (or from radiographic alveolar bone loss data) in relation to root length and the participant's age. CONCLUSIONS ACES is a framework to be used in epidemiological studies of periodontal status that (i) have been completed, and in which stage and grade according to the 2018 classification are inferred retroactively, or (ii) are being planned. Consistent use of the proposed comprehensive approach will facilitate the comparability of periodontitis prevalence estimates across studies.
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Affiliation(s)
- Birte Holtfreter
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Kuhr
- Health Care Research and Epidemiology, Institute of German Dentists (IDZ), Cologne, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Mariano Sanz
- Department of Dental Clinical Specialties, ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Kenneth Kornman
- Department of Periodontics and Oral Medicine, The University of Michigan-School of Dentistry, Ann Arbor, Michigan, USA
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Cao R, Li C, Geng F, Pan Y. J-shaped association between systemic immune-inflammation index and periodontitis: Results from NHANES 2009-2014. J Periodontol 2024; 95:397-406. [PMID: 37713193 DOI: 10.1002/jper.23-0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND To examine the relationship between the systemic immune-inflammation index (SII) and periodontitis and to investigate possible effect modifiers. METHODS Data used in the present cross-sectional study are from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 (N = 10,301). The SII was calculated using the following formula: (neutrophils count × platelet count)/lymphocytes count. The category of periodontitis was defined by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP) classification. We employed natural cubic spline and multivariable logistic regression analyses to evaluate the associations of the SII with periodontitis. RESULTS The associations between SII and periodontal health followed a J-shape (p < 0.001). The risk of periodontitis tended to reduce with the increment of log2(SII) in participants with log2(SII) ≤ 8.66 (odds radio [OR] = 0.83; 95% CI: 0.69-0.999), especially among non-Hispanic Whites (OR = 0.70; 95% CI: 0.52-0.95), and increased with the increment of log2(SII) in participants with log2(SII) > 8.66 (OR = 1.19; 95% CI: 1.02-1.38). A similar trend was also observed between the SII and the number of sites with probing pocket depth (PPD) ≥4 mm and clinical attachment loss (CAL) ≥ 3 or 5 mm. Furthermore, we found a significantly stronger correlation between lymphocytes and either neutrophils or platelets in individuals with log2(SII) > 8.66, as opposed to those with log2(SII) ≤ 8.66. CONCLUSIONS There is a J-shaped association between SII and periodontitis in US adults, with an inflection point of log2(SII) at 8.66, which may provide potential adjunctive treatment strategies for periodontitis with different immune response states. Further prospective trials are still required to confirm our findings.
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Affiliation(s)
- Ruoyan Cao
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Chen Li
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yaping Pan
- Department of Periodontics, Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
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Liu Y, Liu N, Xiong W, Wang R. Association between blood ethylene oxide levels and periodontitis risk: a population-based study. Front Public Health 2024; 12:1338319. [PMID: 38384884 PMCID: PMC10879552 DOI: 10.3389/fpubh.2024.1338319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
Background The etiopathogenesis of periodontitis is closely associated with environmental conditions. However, the relationship between ethylene oxide exposure and periodontitis risk remains unclear. Methods We selected qualified participants from National Health and Nutrition Examination Survey (NHANES) 2013-2014. Periodontitis was identified according to the criteria of the Community Periodontal Index (CPI), Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) definition. Ethylene oxide exposure was quantified by hemoglobin adducts of ethylene oxide (HbEO) levels. Log2-transformation was used to normalize HbEO levels. We designed three logistic regression models to explore potential relationship between HbEO and periodontitis. Restricted cubic spline (RCS) and subgroup analysis were also conducted with all covariates adjusted. We performed multivariable linear regression to appraise the association between the risk of periodontitis and different indicators of inflammation, including white blood cells, neutrophils, lymphocytes, and monocytes. Mediation analysis was subsequently performed to examine whether ethylene oxide exposure contributed to periodontitis development through systemic body inflammation. Results A total of 1,065 participants aged more than 30 were incorporated in this study. We identified that participants with higher HbEO levels showed increased risk of periodontitis after adjusting for all covariates (OR = 1.49, 95% CI: 1.14, 1.95, p = 0.0014). The results of subgroup analysis remained stable. The restricted cubic spline (RCS) curve also revealed a non-linear correlation between log2-transformed HbEO levels with the risk of periodontitis (p for nonlinear < 0.001). Mediation analysis indicated that HbEO level was significantly associated with four inflammatory mediators, with the mediated proportions of 14.44% (p < 0.001) for white blood cell, 9.62% (p < 0.001) for neutrophil, 6.17% (p = 0.006) for lymphocyte, and 6.72% (p < 0.001) for monocyte. Conclusion Participants with higher ethylene oxide exposure showed higher risk of periodontitis, which was partially mediated by systemic body inflammation. More well-designed longitudinal studies should be carried out to validate this relationship.
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Affiliation(s)
- Yixuan Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nuozhou Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Wei Xiong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Ruiyu Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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Liu P, Wang Z, Liu N, Peres MA. A scoping review of the clinical application of machine learning in data-driven population segmentation analysis. J Am Med Inform Assoc 2023; 30:1573-1582. [PMID: 37369006 PMCID: PMC10436153 DOI: 10.1093/jamia/ocad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE Data-driven population segmentation is commonly used in clinical settings to separate the heterogeneous population into multiple relatively homogenous groups with similar healthcare features. In recent years, machine learning (ML) based segmentation algorithms have garnered interest for their potential to speed up and improve algorithm development across many phenotypes and healthcare situations. This study evaluates ML-based segmentation with respect to (1) the populations applied, (2) the segmentation details, and (3) the outcome evaluations. MATERIALS AND METHODS MEDLINE, Embase, Web of Science, and Scopus were used following the PRISMA-ScR criteria. Peer-reviewed studies in the English language that used data-driven population segmentation analysis on structured data from January 2000 to October 2022 were included. RESULTS We identified 6077 articles and included 79 for the final analysis. Data-driven population segmentation analysis was employed in various clinical settings. K-means clustering is the most prevalent unsupervised ML paradigm. The most common settings were healthcare institutions. The most common targeted population was the general population. DISCUSSION Although all the studies did internal validation, only 11 papers (13.9%) did external validation, and 23 papers (29.1%) conducted methods comparison. The existing papers discussed little validating the robustness of ML modeling. CONCLUSION Existing ML applications on population segmentation need more evaluations regarding giving tailored, efficient integrated healthcare solutions compared to traditional segmentation analysis. Future ML applications in the field should emphasize methods' comparisons and external validation and investigate approaches to evaluate individual consistency using different methods.
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Affiliation(s)
- Pinyan Liu
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Ziwen Wang
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Nan Liu
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Institute of Data Science, National University of Singapore, Singapore, Singapore
| | - Marco Aurélio Peres
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
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Hussein M, Farag YMK, Sonis S. Differential associations of rheumatoid arthritis and periodontitis or tooth loss: A cross-sectional study. J Clin Periodontol 2023; 50:307-315. [PMID: 36444518 DOI: 10.1111/jcpe.13757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/04/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022]
Abstract
AIM To study the association between periodontitis, tooth loss, and rheumatoid arthritis (RA) by using a large national dataset. MATERIALS AND METHODS An observational cross-sectional study was performed using the National Health and Nutrition Examination Survey cycles (2009-2014). RA status was detected using a questionnaire. Periodontal status was assigned on the basis of the clinical attachment level and periodontal pocket depth. Dentition status was assessed by the number of permanent teeth observed. We examined the association between RA as exposure and moderate/severe periodontitis and non-functional dentition as outcomes. We progressively adjusted our models for different sets of potential confounders. RESULTS Moderate/severe periodontitis was more prevalent in participants reporting RA (53% vs. 41.5%, p = .0003). Non-functional dentition was more prevalent in participants with RA (41% vs. 15.5%, p = .0001). The fully adjusted model showed that participants with RA had higher odds of having non-functional dentition (odds ratio 1.8, 95% confidence interval [CI] 1.3-2.3, p = .0001) but no association with moderate/severe periodontitis (prevalence ratio 1.01, 95% CI 0.9-1.1, p = .9). CONCLUSION RA was associated with a higher likelihood of having non-functional dentition but did not show any association with periodontitis after adjusting for the risk factors to control their confounding effect.
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Affiliation(s)
- Mai Hussein
- Department of Clinical Investigation, Harvard Medical School, Boston, Massachusetts, USA
- Ministry of Health and Population, Cairo, Egypt
| | - Youssef M K Farag
- Department of Clinical Investigation, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Primary Endpoint Solutions, LLC, Waltham, Massachusetts, USA
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Hussein M, Farag YMK, Sonis S. Psoriasis and oral health in adult United States population: a cross-sectional study. BMC Oral Health 2023; 23:66. [PMID: 36732740 PMCID: PMC9896729 DOI: 10.1186/s12903-022-02689-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To detect the association between psoriasis as an exposure and oral health conditions as outcomes represented by periodontal and dentition status. This was addressed by analysis of a large number of adults in the United States. METHODS By using The National Health and Nutrition Examination Survey datasets from 2009 to 2014, we performed a cross-sectional analysis of 11,726 participants included in our study population. For participants aged ≥ 30 years, the psoriasis status was assessed from the medical questionnaire. We used data from periodontal and oral examinations to assess the oral conditions of our participants. We examined the association between psoriasis as exposure and moderate/severe periodontitis and non-functional dentition as outcomes. RESULTS The weighted prevalence of psoriasis was 3%, 44% for moderate/severe periodontitis, and 20.5% for non-functional dentition. The fully adjusted model showed no significant association between psoriasis and moderate/severe periodontitis (Prevalence Ratio 1.02, 95% CI 0.9-1.2, p = 0.8). There was no statistically significant association between psoriasis and non-functional dentition except in the fully adjusted model it became statistically significant (Prevalence Ratio 0.8, 95% CI 0.7-0.9, p = 0.04). CONCLUSION Our results showed no association between psoriasis and periodontal or dentition status except in a fully adjusted model for non-functional dentition.
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Affiliation(s)
- Mai Hussein
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
- Ministry of Health and Population, Cairo, Egypt.
| | - Youssef M K Farag
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
- Primary Endpoint Solutions, LLC, Waltham, MA, USA
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Trindade D, Carvalho R, Machado V, Chambrone L, Mendes JJ, Botelho J. Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies. J Clin Periodontol 2023; 50:604-626. [PMID: 36631982 DOI: 10.1111/jcpe.13769] [Citation(s) in RCA: 60] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Diogo Trindade
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - Rui Carvalho
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal.,Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - Leandro Chambrone
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal.,Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogotá, Colombia.,Department of Periodontics, School of Dental Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José João Mendes
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal.,Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
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Zhong Y, Zheng XT, Zhao S, Su X, Loh XJ. Stimuli-Activable Metal-Bearing Nanomaterials and Precise On-Demand Antibacterial Strategies. ACS NANO 2022; 16:19840-19872. [PMID: 36441973 DOI: 10.1021/acsnano.2c08262] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Bacterial infections remain the leading cause of death worldwide today. The emergence of antibiotic resistance has urged the development of alternative antibacterial technologies to complement or replace traditional antibiotic treatments. In this regard, metal nanomaterials have attracted great attention for their controllable antibacterial functions that are less prone to resistance. This review discusses a particular family of stimuli-activable metal-bearing nanomaterials (denoted as SAMNs) and the associated on-demand antibacterial strategies. The various SAMN-enabled antibacterial strategies stem from basic light and magnet activation, with the addition of bacterial microenvironment responsiveness and/or bacteria-targeting selectivity and therefore offer higher spatiotemporal controllability. The discussion focuses on nanomaterial design principles, antibacterial mechanisms, and antibacterial performance, as well as emerging applications that desire on-demand and selective activation (i.e., medical antibacterial treatments, surface anti-biofilm, water disinfection, and wearable antibacterial materials). The review concludes with the authors' perspectives on the challenges and future directions for developing industrial translatable next-generation antibacterial strategies.
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Affiliation(s)
- Yingying Zhong
- Department of Pharmaceutical Engineering, School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
- Institute of Materials Research and Engineering, Agency for Science Technology and Research (A*STAR), 138634 Singapore
| | - Xin Ting Zheng
- Institute of Materials Research and Engineering, Agency for Science Technology and Research (A*STAR), 138634 Singapore
| | - Suqing Zhao
- Department of Pharmaceutical Engineering, School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Xiaodi Su
- Institute of Materials Research and Engineering, Agency for Science Technology and Research (A*STAR), 138634 Singapore
- Department of Chemistry, National University of Singapore, Block S8, Level 3, 3 Science Drive 3, 117543 Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering, Agency for Science Technology and Research (A*STAR), 138634 Singapore
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Li W, Song J, Chen Z. The association between dietary vitamin C intake and periodontitis: result from the NHANES (2009-2014). BMC Oral Health 2022; 22:390. [PMID: 36076176 PMCID: PMC9454137 DOI: 10.1186/s12903-022-02416-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of this study was to investigate whether periodontitis is associated with dietary vitamin C intake, using data from The National Health and Nutrition Examination Survey (NHANES) 2009–2014.
Methods The study included 5145 adults (age ≥ 30 years) with periodontitis as a dichotomous variable and daily intake of vitamin C as a continuous variable. Multiple sets of covariates, such as age, sex, number of flossing, etc., were selected. Using EmpowerStats version 3.0, multivariate logistic regression analysis and hierarchical analysis were performed on the data, and curve fitting graphs were made.
Results There were no statistically significant differences (P > 0.05) between the four dietary vitamin C intake groups (quartiles, Q1–Q4) and covariates (drinking alcohol and hypertension). The low VC intake group (Q1) was more prone to periodontitis than Q2, Q3, and Q4 (all OR < 1.00). A threshold nonlinear association was found between vitamin C (mg) log10 transformation and periodontitis in a generalized additive model (GAM) (P = 0.01). Conclusion The relationship between dietary vitamin C intake and the likelihood of periodontitis was non-linear. The smallest periodontitis index occurred when dietary vitamin C intake was 158.49 mg. Too little or too much vitamin C intake increases periodontitis.
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Affiliation(s)
- Wei Li
- Medical College of Guizhou University, Guiyang, Guizhou, 550025, China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Guizhou Medical University, Guiyang, Guizhou, 550001, China
| | - Zhu Chen
- Zunyi Medical University, Guiyang Hospital of Stomatology, Guiyang, Guizhou, 550005, China.
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11
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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12
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Costa CA, Vilela ACS, Oliveira SA, Gomes TD, Andrade AAC, Leles CR, Costa NL. Poor oral health status and adverse COVID-19 outcomes: A preliminary study in hospitalized patients. J Periodontol 2022; 93:1889-1901. [PMID: 35294780 PMCID: PMC9088593 DOI: 10.1002/jper.21-0624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes. METHODS We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages. RESULTS Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. CONCLUSION There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients.
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Affiliation(s)
- Camila Alves Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | - Suzane Aparecida Oliveira
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | | | - Cláudio Rodrigues Leles
- Department of Oral RehabilitationSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | - Nádia Lago Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
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13
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Alshihayb TS, Sharma P, Dietrich T, Heaton B. Exploring periodontitis misclassification mechanisms under partial-mouth protocols. J Clin Periodontol 2022; 49:448-457. [PMID: 35246856 DOI: 10.1111/jcpe.13611] [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: 11/11/2021] [Revised: 01/25/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
AIM To investigate the sources of periodontitis misclassification under partial-mouth protocols (PMPs) and to explore possible approaches to enhancing protocol validity. MATERIALS AND METHODS Using data from 10,680 adults with 244,999 teeth from the National Health and Nutrition Examination Survey, we compared tooth-, site-, and quadrant-specific periodontal parameters and case identification under full-mouth protocols and PMPs. Separately, we utilized population measures of tooth-specific periodontal severity to generate PMPs with tooth selection based on the population ranking of clinical severity and assessed the sensitivity of case identification. RESULTS Symmetry of clinical severity was generally confirmed, with the exception of lingual inter-proximal sites, which yielded greater sensitivity in identifying periodontitis compared to buccal sites due to more severe pocketing and attachment loss on average. Misclassification of severe periodontitis occurred more frequently under commonly implemented PMPs compared to ranking-based selection of teeth, which yielded sensitivity estimates of 70.1%-79.4% with the selection of 8 teeth and reached 90% with the selection of only 14 teeth. CONCLUSIONS Clinical symmetry and sources of periodontitis misclassification were confirmed. The proposed selection of teeth based on population rankings of clinical severity yielded optimal sensitivity estimates for the detection of severe periodontitis and may present a favourable alternative to current options.
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Affiliation(s)
- Talal S Alshihayb
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Praveen Sharma
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Periodontal Research Group, University of Birmingham, Birmingham, UK
| | - Thomas Dietrich
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK.,Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - Brenda Heaton
- Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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14
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Deraz O, Rangé H, Boutouyrie P, Chatzopoulou E, Asselin A, Guibout C, Van Sloten T, Bougouin W, Andrieu M, Vedié B, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Oral Condition and Incident Coronary Heart Disease: A Clustering Analysis. J Dent Res 2021; 101:526-533. [PMID: 34875909 DOI: 10.1177/00220345211052507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor oral health has been linked to coronary heart disease (CHD). Clustering clinical oral conditions routinely recorded in adults may identify their CHD risk profile. Participants from the Paris Prospective Study 3 received, between 2008 and 2012, a baseline routine full-mouth clinical examination and an extensive physical examination and were thereafter followed up every 2 y until September 2020. Three axes defined oral health conditions: 1) healthy, missing, filled, and decayed teeth; 2) masticatory capacity denoted by functional masticatory units; and 3) gingival inflammation and dental plaque. Hierarchical cluster analysis was performed with multivariate Cox proportional hazards regression models and adjusted for age, sex, smoking, body mass index, education, deprivation (EPICES score; Evaluation of Deprivation and Inequalities in Health Examination Centres), hypertension, type 2 diabetes, LDL and HDL serum cholesterol (low- and high-density lipoprotein), triglycerides, lipid-lowering medications, NT-proBNP and IL-6 serum level. A sample of 5,294 participants (age, 50 to 75 y; 37.10% women) were included in the study. Cluster analysis identified 3,688 (69.66%) participants with optimal oral health and preserved masticatory capacity (cluster 1), 1,356 (25.61%) with moderate oral health and moderately impaired masticatory capacity (cluster 2), and 250 (4.72%) with poor oral health and severely impaired masticatory capacity (cluster 3). After a median follow-up of 8.32 y (interquartile range, 8.00 to 10.05), 128 nonfatal incident CHD events occurred. As compared with cluster 1, the risk of CHD progressively increased from cluster 2 (hazard ratio, 1.45; 95% CI, 0.98 to 2.15) to cluster 3 (hazard ratio, 2.47; 95% CI, 1.34 to 4.57; P < 0.05 for trend). To conclude, middle-aged individuals with poor oral health and severely impaired masticatory capacity have more than twice the risk of incident CHD than those with optimal oral health and preserved masticatory capacity (ClinicalTrials.gov NCT00741728).
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Affiliation(s)
- O Deraz
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France.,Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France
| | - H Rangé
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - P Boutouyrie
- Université de Paris, INSERM U970, Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, Paris, France
| | - E Chatzopoulou
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - A Asselin
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - C Guibout
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - T Van Sloten
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht, The Netherlands
| | - W Bougouin
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - M Andrieu
- Université de Paris, Cochin Institute, Platform CYBIO, INSERM U1016, Paris, France
| | - B Vedié
- AP-HP, Georges Pompidou European Hospital, Department of Biochemistry, Tissue and Blood Samples Biobank, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - N Danchin
- Preventive and Clinical Investigation Center, Paris, France
| | - X Jouven
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France.,AP-HP, Georges Pompidou European Hospital, Department of Cardiology, Paris, France
| | - P Bouchard
- Université de Paris, UFR of Odontology, Department of Periodontology, Paris, France.,AP-HP, Rothschild Hospital, Department of Odontology, Paris, France.,Université de Paris, URP 2496, Paris, France
| | - J P Empana
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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15
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Ren Z, Fu X. Stroke Risk Factors in United States: An Analysis of the 2013-2018 National Health and Nutrition Examination Survey. Int J Gen Med 2021; 14:6135-6147. [PMID: 34611428 PMCID: PMC8487286 DOI: 10.2147/ijgm.s327075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/09/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose This research intended to identify significant risk factors of stroke among the elderly population in the United States using the k-means clustering method. Patients and Methods In this cross-sectional study, we analyzed data of 4346 subjects aged ≥60 years using the National Health and Nutrition Examination Survey (NHANES) 2013-2018 datasets. Questionnaire data, dietary data, and laboratory data were accessed to acquire measurements of the potential risk factors. A pre-defined classification method was used based on the Medical Condition Questionnaire to define the stroke group. K-means clustering analysis used all potential risk factors for differentiating both groups. A stepwise logistic regression analysis examined the association between significant risk factors and the odds of stroke. Results Age (OR:1.053, 95% CI:1.029-1.077), diabetes (OR: 28.019, 95% CI: 19.139-41.020), glycohemoglobin (OR: 2.309, 95% CI: 1.818-2.934), plasma fasting glucose (OR: 1.017, 95% CI: 1.010-1.024), hypertension (OR: 2.343, 95% CI: 1.602-3.426), dietary fiber consumption (OR:0.980, 95% CI:0.964-0.995), and education level (OR:0.541, 95% CI: 0.411-0.713) were identified as significant risk factor for stroke among the elderly population in the k-means clustering method. In the pre-defined grouping method, age (OR:1.093, 95% CI:1.054-1.132), diabetes (OR:2.228, 95% CI: 1.432-3.466), hypertension (OR:2.295, 95% CI:1.338-3.938), and dietary fiber consumption (OR: 0.966, 95CI%:0.947-0.985) were found to influence to the risk of stroke. Conclusion Age, hypertension, dietary fiber consumption, and education level are the significant risk factors of stroke among elders aged >60 years. Among all the risk factors, diabetes is the strongest predictor of stroke. Glycohemoglobin and plasma fasting glucose are also associated with stroke risks, implying that glycemic control is particularly crucial in stroke prevention and management among older adults.
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Affiliation(s)
- Zhouming Ren
- Department of Neurology, Haining People's Hospital, Haining, Zhejiang, People's Republic of China
| | - Xinzheng Fu
- Department of Neurology, Haining People's Hospital, Haining, Zhejiang, People's Republic of China
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16
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Li J, Song S, Meng J, Tan L, Liu X, Zheng Y, Li Z, Yeung KWK, Cui Z, Liang Y, Zhu S, Zhang X, Wu S. 2D MOF Periodontitis Photodynamic Ion Therapy. J Am Chem Soc 2021; 143:15427-15439. [PMID: 34516125 DOI: 10.1021/jacs.1c07875] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Traditional surgical intervention and antibiotic treatment are poor and even invalid for chronic diseases including periodontitis induced by diverse oral pathogens, which often causes progressive destruction of tissues, even tooth loss, and systemic diseases. Herein, an ointment comprising atomic-layer Fe2O3-modified two-dimensional porphyrinic metal-organic framework (2D MOF) nanosheets is designed by incorporating a polyethylene glycol matrix. After the atomic layer deposition surface engineering, the enhanced photocatalytic activity of the 2D MOF heterointerface results from lower adsorption energy and more charge transfer amounts due to the synergistic effect of metal-linker bridging units, abundant active sites, and an excellent light-harvesting network. This biocompatible and biodegradable 2D MOF-based heterostructure exhibits broad-spectrum antimicrobial activity (99.87 ± 0.09%, 99.57 ± 0.21%, and 99.03 ± 0.24%) against diverse oral pathogens (Porphyromonas gingivalis, Fusobacterium nucleatum, and Staphylococcus aureus) by the synergistic effect of reactive oxygen species and released ions. This photodynamic ion therapy exhibits a superior therapeutic effect to the reported clinical periodontitis treatment owing to rapid antibacterial activity, alleviative inflammation, and improved angiogenesis.
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Affiliation(s)
- Jun Li
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
| | - Shuang Song
- School of Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Jiashen Meng
- School of Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Lei Tan
- Biomedical Materials Engineering Research Center, Collaborative Innovation Center for Advanced Organic Chemical Materials Co-constructed by the Province and Ministry, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering, Hubei University, Wuhan 430062, China
| | - Xiangmei Liu
- Biomedical Materials Engineering Research Center, Collaborative Innovation Center for Advanced Organic Chemical Materials Co-constructed by the Province and Ministry, Hubei Key Laboratory of Polymer Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering, Hubei University, Wuhan 430062, China
| | - Yufeng Zheng
- School of Materials Science & Engineering, State Key Laboratory for Turbulence and Complex System, Peking University, Beijing 100871, China
| | - Zhaoyang Li
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
| | - Kelvin Wai Kwok Yeung
- Department of Orthopaedics & Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong 999077, China
| | - Zhenduo Cui
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
| | - Yanqin Liang
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
| | - Shengli Zhu
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
| | - Xingcai Zhang
- School of Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States.,School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts 02138, United States
| | - Shuilin Wu
- School of Materials Science & Engineering, the Key Laboratory of Advanced Ceramics and Machining Technology by the Ministry of Education of China, Tianjin University, Tianjin 300072, China
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17
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Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073459. [PMID: 33810461 PMCID: PMC8037399 DOI: 10.3390/ijerph18073459] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. METHODS We included 488 participants aged 35-74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). RESULTS The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III-IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. CONCLUSION It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.
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