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Kandaswamy E, Lee CT, Gururaj SB, Shivanaikar S, Joshi VM. Association of adipokine levels with obesity in periodontal health and disease: A systematic review with meta-analysis and meta-regression. J Periodontal Res 2024. [PMID: 38594806 DOI: 10.1111/jre.13263] [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: 10/03/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
This study aimed to investigate the levels of serum, gingival crevicular fluid (GCF), and salivary adipokines and their possible relationship with periodontitis and obesity. An electronic search was conducted in the following databases: PubMed/ Medline, Scopus, and EBSCOhost through February 2023. Two independent reviewers screened the titles, abstracts, and full text of all the studies. Studies comparing the levels of adipokines in GCF, serum, and/or saliva in subjects with obesity and periodontitis (group 1), subjects with normal weight and periodontitis (group 2), and subjects with obesity and gingival health (group 3) were included. Meta-analyses and meta-regression were performed on the data from included studies. Seventeen studies with study participants ranging from 30 to 120 were included with subjects in each group ranging from 10 to 40. There was a significant increase in levels of serum TNF-α, leptin, IL-6, and CRP between groups 1 and 2 (p < .05). In GCF, TNF-α and resistin levels were significantly higher (p < .05) in Group 1 vs. 2. Serum level of leptin was higher for group 1 vs. 3 (p < .05). Meta-regression analysis revealed that the obesity definition (body mass index (BMI) cut-off value >25 or >30) was significant for serum resistin (p < .05) and GCF resistin (p < .05) between group 1 and 2. The current analysis indicates that both periodontitis and obesity can modulate the pro-inflammatory cytokines at systemic and local levels. This bidirectional interaction of periodontitis and obesity via the inflammation pathway seems likely plausible. Further studies are required to elucidate this mechanism in more detail.
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Affiliation(s)
- Eswar Kandaswamy
- Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Soumya Bardvalli Gururaj
- Department of Periodontics, Sharavathi Dental College and Hospital, Rajiv University of Health Sciences, Bangalore, Karnataka, India
| | - Sachin Shivanaikar
- Department of Periodontology, Maratha Mandal's Nathajirao G Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
| | - Vinayak M Joshi
- Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Menezes CCD, Barbirato DDS, Fogacci MF, Marañón-Vásquez GA, Carneiro JRI, Maia LC, Barros MCMD. Systemic benefits of periodontal therapy in patients with obesity and periodontitis: a systematic review. Braz Oral Res 2024; 38:e031. [PMID: 38597549 DOI: 10.1590/1807-3107bor-2024.vol38.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/09/2023] [Indexed: 04/11/2024] Open
Abstract
This systematic review aimed to answer the focused question: "What are the benefits of subgingival periodontal therapy on blood hematological and biochemical index, biomarkers of inflammation and oxidative stress, quality of life, and periodontal pathogen counts in patients with obesity and periodontitis?". A systematic literature search was performed in six databases: PubMed, Embase, LILACS, Web of Science, Cochrane and SCOPUS and other sources, and a manual search was conducted as well. Inclusion criteria were randomized and non-randomized clinical trials, and before-and-after studies on patients with obesity subjected to periodontal therapy. The results were synthesized qualitatively. Risk of bias within studies was assessed using RoB 2 and ROBINS-I tools. The certainty of evidence was evaluated following the GRADE approach. Three randomized controlled trials and 15 before-and-after studies were included. Randomized controlled trials were considered to have a low risk of bias, as compared to before-and-after studies assessed as having low, serious, and critical risks of bias. Non-surgical periodontal therapy plus azithromycin, chlorhexidine, and cetylpyridinium chloride reduced blood pressure and decreased serum levels of HbA1c, hsCRP, IL-1β, and TNF-α. Salivary resistin level also decreased in patients with obesity and periodontitis after therapy and chlorhexidine mouth rinse. Before-and-after data suggest an improvement in total cholesterol, LDL, triglycerides, insulin resistance, C3, GCF levels of TNF-α, chemerin, vaspin, omentin-1, visfatin, 8-OHdG, and periodontal pathogen counts after therapy.
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Affiliation(s)
- Cláudia Callegaro de Menezes
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Davi da Silva Barbirato
- Universidade Federal do Rio de Janeiro - UFRJ, Dental School, Division of Periodontics, Rio de Janeiro, RJ, Brazil
| | - Mariana Fampa Fogacci
- Universidade Federal de Pernambuco - UFPE, Department of Clinical and Preventive Dentistry, Recife, PE, Brazil
| | | | - João Régis Ivar Carneiro
- Universidade Federal do Rio de Janeiro - UFRJ, Clementino Fraga Filho Hospital University, Department of Nutrology/Bariatric Surgery, Rio de Janeiro, RJ, Brazil
| | - Lucianne Copple Maia
- Universidade Federal do Rio de Janeiro - UFRJ, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
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Arzu Yoldaş M, Vural Yılmazel S, Bolu S, Danış A. The relationship between blood biochemical parameters and oral health in children with obesity/overweight. Br Dent J 2023; 235:968-972. [PMID: 38102273 DOI: 10.1038/s41415-023-6593-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/17/2023] [Accepted: 08/07/2023] [Indexed: 12/17/2023]
Abstract
Aim The purpose of this study was to evaluate the effects of obesity and overweight on the oral/dental health and blood biochemistry parameters in children.Methods A total of 87 children (29 boys, 58 girls) aged 1-18 presenting to our paediatric endocrinology outpatient clinic were included in the study. The patient group consisted of children with obesity/overweight and the control group consisted of children with normal weight. Paediatric patients were examined simultaneously by a paediatrician and a paediatric dentist. Oral/dental health examinations of all children included in the study were performed by a specialist paediatric dentist and dmft/DMFT (decayed, missing and filled teeth) values were calculated separately in the mixed dentition period. The Community Periodontal Index of Treatment Needs 23 index and the dental plaque 35 index were evaluated at oral/dental health examinations. Oral and dental health examination findings and blood biochemistry parameters were compared between the two groups.Results While DMFT, dental plaque index, blood c-reactive protein (CRP) and parathyroid hormone (PTH) levels were significantly increased in children with overweight/obesity compared to children with normal weight, there was no difference in terms of daily toothbrushing habits and last dental examination times. Overweight/obesity was found to be associated with the dental plaque and DMFT/dmft index, and elevation in the blood biochemistry parameters CRP and PTH among the children in this study.Conclusion The observation of significant elevation in DMFT and dental plaque indices and numbers of filled deciduous teeth showed that oral/dental health problems and dental decay may emerge more frequently in children with overweight/obesity. Children with overweight should be routinely provided with dental care as part of a multidisciplinary team that includes paediatricians and dentists.
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Affiliation(s)
- Meyri Arzu Yoldaş
- Department of Paediatrics, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey.
| | - Simge Vural Yılmazel
- Department of Paediatric Dentistry, Ankara Medipol University, Faculty of Dentistry, Ankara, Turkey
| | - Semih Bolu
- Department of Paediatric Endocrinology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Ayşegül Danış
- Department of Paediatric Neurology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
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Zhang Y, Jia R, Zhang Y, Sun X, Mei Y, Zou R, Niu L, Dong S. Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis. BMC Oral Health 2023; 23:717. [PMID: 37798684 PMCID: PMC10552206 DOI: 10.1186/s12903-023-03383-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The objective of this systematic review and meta-analysis was to evaluate the effects of non-surgical periodontal therapy (NSPT) on inflammatory-related cytokines/adipocytokines in periodontitis patients with or without obesity. METHODS We followed the preferred reporting items for systematic reviews and meta-analyses statement and registered the study (CRD42022375331) in the Prospective International Register of Systematic Reviews. We screened randomized-controlled trials and controlled clinical trials from six databases up to December 2022. Quality assessment was performed with RoB-2 and ROBINS-I tools for randomized trials and non-randomized trials, respectively. Meta-analysis was carried out using a random-effect model. RESULTS We included seventeen references in the systematic analysis, and sixteen in the meta-analysis. Baseline results of pro-inflammatory biomarkers, including serum interleukin (IL)-6, serum and gingival crevicular fluid (GCF), tumor necrosis factor (TNF)-a, serum C-reactive protein (CRP)/hs-CRP, and serum and GCF resistin, were higher in obesity subjects than in normal weight subjects. The effect of NSPT with respect to levels of cytokines/adipocytokines, including IL-6, TNF-a, CRP/hs-CRP, resistin, adiponectin, leptin and retinol binding protein 4 (RBP4), were then analyzed in the systematic and meta-analysis. After three months of NSPT, serum (MD = -0.54, CI = -0.62 - -0.46), and GCF (MD = -2.70, CI = -4.77 - -0.63) levels of IL-6, along with the serum RBP4 (MD = -0.39, CI = -0.68-0.10) decreased in periodontitis individuals with obesity. NSPT also improved GCF adiponectin levels after three months (MD = 2.37, CI = 0.29 - 4.45) in periodontitis individuals without obesity. CONCLUSIONS Obese status altered the baseline levels of cytokines/adipocytokines (serum IL-6, serum and GCF TNF-a, serum CRP/hs-CRP, and serum and GCF resistin). Then NSPT can shift the levels of specific pro-inflammatory mediators and anti-inflammatory mediators in biological fluids, both in obesity and non-obesity individuals. NSPT can reduce serum and GCF IL-6 levels together with serum RBP4 level in individuals with obesity after 3 months, besides, there is no sufficient evidence to prove that obese patients have a statistically significant decrease in the levels of other cytokines compared to patients with normal weight. NSPT can also increase GCF adiponectin level in normal weight individuals after 3 months. Our findings imply the potential ideal follow-up intervals and sensitive biomarkers for clinical bioanalysis in personalized decision-making of effect of NSPT due to patients' BMI value.
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Affiliation(s)
- Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
| | - Ru Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
| | - Yifei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
| | - Xuefei Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China
| | - Yukun Mei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China.
| | - Lin Niu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China.
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.
| | - Shaojie Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi'an, 710004, Shaanxi Province, China.
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.
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Cai Y, Zuo X, Zuo Y, Wu S, Pang W, Ma K, Yi Q, Tan L, Deng H, Qu X, Chen X. Transcriptomic analysis reveals shared gene signatures and molecular mechanisms between obesity and periodontitis. Front Immunol 2023; 14:1101854. [PMID: 37063877 PMCID: PMC10090675 DOI: 10.3389/fimmu.2023.1101854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
BackgroundBoth obesity (OB) and periodontitis (PD) are chronic non-communicable diseases, and numerous epidemiological studies have demonstrated the association between these two diseases. However, the molecular mechanisms that could explain the association between OB and PD are largely unclear. This study aims to investigate the common gene signatures and biological pathways in OB and PD through bioinformatics analysis of publicly available transcriptome datasets.MethodsThe RNA expression profile datasets of OB (GSE104815) and PD (GSE106090) were used as training data, and GSE152991 and GSE16134 as validation data. After screening for differentially expressed genes (DEGs) shared by OB and PD, gene enrichment analysis, protein-protein interaction (PPI) network construction, GeneMANIA analysis, immune infiltration analysis and gene set enrichment analysis (GSEA) were performed. In addition, receiver operating characteristic (ROC) curves were used to assess the predictive accuracy of the hub gene. Finally, we constructed the hub gene-associated TF-miRNA-mRNA regulatory network.ResultsWe identified a total of 147 DEGs shared by OB and PD (38 down-regulated and 109 up-regulated). Functional analysis showed that these genes were mainly enriched in immune-related pathways such as B cell receptor signalling, leukocyte migration and cellular defence responses. 14 hub genes (FGR, MNDA, NCF2, FYB1, EVI2B, LY86, IGSF6, CTSS, CXCR4, LCK, FCN1, CXCL2, P2RY13, MMP7) showed high sensitivity and specificity in the ROC curve analysis. The results of immune infiltration analysis showed that immune cells such as macrophages, activated CD4 T cells and immune B cells were present at high infiltration levels in both OB and PD samples.The results of GeneMANIA analysis and GSEA analysis suggested that five key genes (FGR, LCK, FYB1, LY86 and P2RY13) may be strongly associated with macrophages. Finally, we constructed a TF-miRNA-mRNA regulatory network consisting of 233 transcription factors (TFs), 8 miRNAs and 14 mRNAs based on the validated information obtained from the database.ConclusionsFive key genes (FGR, LCK, FYB1, LY86, P2RY13) may be important biomarkers of OB and PD. These genes may play an important role in the pathogenesis of OB and PD by affecting macrophage activity and participating in immune regulation and inflammatory responses.
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Affiliation(s)
- Yisheng Cai
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Xuemei Zuo
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Yuyang Zuo
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Shuang Wu
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Weiwei Pang
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Keqiang Ma
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Qiaorong Yi
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Lijun Tan
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Hongwen Deng
- Tulane Center for Biomedical Informatics and Genomics, Deming Department of Medicine, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Xiaochao Qu
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
- *Correspondence: Xiaochao Qu, ; Xiangding Chen,
| | - Xiangding Chen
- Laboratory of Molecular and Statistical Genetics and Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
- *Correspondence: Xiaochao Qu, ; Xiangding Chen,
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Oliveira MOA, Leonço ÁR, Pavani VB, Barbosa IR, Campos MM. Omega-3 Effects on Ligature-Induced Periodontitis in Rats with Fructose-Induced Metabolic Syndrome. Inflammation 2023; 46:388-403. [PMID: 36171491 DOI: 10.1007/s10753-022-01741-x] [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: 05/10/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
Abstract
Both periodontal disease (PD) and metabolic syndrome (MS) represent disorders of concern worldwide. Current evidence indicates that PD and MS might negatively influence each other, increasing the risk for cardiovascular diseases (CVD), via mutual inflammatory pathways. A failure of the inflammation resolution mechanisms is crucial for these comorbidities. Fish oil-derived omega-3 has been linked with resolution-driven responses in different pathological conditions during the last years. This study evaluated the impacts of omega-3 supplementation in a rat model combining ligature-induced PD and 10% fructose intake-elicited MS. Our main findings show that 10% fructose ingestion led to an elevation of Lee index and white adipose tissue (WAT) weight, along with hepatic alterations, accompanied by an increase of leptin, and a decrement of adiponectin serum amounts, regardless of PD induction. Noteworthy, the co-induction of PD and MS resulted in higher levels of glycemia and triglycerides, being this latter effect lessened by omega-3 supplementation. In this case, the beneficial effects of omega-3 might be associated with its ability to recover the decline of serum adiponectin levels in rats with PD plus MS. As expected, PD induction led to alveolar bone loss, independent of MS induction. However, the supplementation with omega-3 restored alveolar bone in PD control animals, but not in the rats with PD combined with MS. Our study extends the knowledge about PD and MS as comorbidities, showing novel effects of omega-3 supplementation in this context.
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Affiliation(s)
- Maysa O A Oliveira
- Programa de Pós-Graduação em Biologia Celular e Molecular, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Álvaro R Leonço
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Curso de Graduação em Medicina, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vinícius B Pavani
- Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Avenida Ipiranga, 6681, Partenon, Porto Alegre, RS, 90619-900, Brazil
| | - Isadora R Barbosa
- Programa de Pós-Graduação em Biologia Celular e Molecular, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria M Campos
- Programa de Pós-Graduação em Biologia Celular e Molecular, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Curso de Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Avenida Ipiranga, 6681, Partenon, Porto Alegre, RS, 90619-900, Brazil.
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Rajasekar A. Correlation of salivary visfatin levels in obese and NON-OBESE population with periodontal status. J Oral Biol Craniofac Res 2023; 13:67-70. [PMID: 36465888 PMCID: PMC9712686 DOI: 10.1016/j.jobcr.2022.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/23/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background Visfatin is an inflammatory adipokine that has been linked to obesity and plays a key function in immune response modulation. It's also been proposed that it's a pro-inflammatory marker for periodontitis. Hence, the aim of the present study was to assess the salivary Visfatin levels in obese and non-obese population and correlate with the periodontal status. Materials and methods A total of 40 individuals aged between 21 and 35 years (Group 1: n = 20, non-obese and Group 2: n = 20, obese) were enrolled in this case-control study. Clinical parameters such as periodontal probing depth (PPD) and clinical attachment level (CAL) were recorded. Body Mass Index (BMI) was recorded. Unstimulated salivary samples were collected and the samples were assayed for Visfatin using human Visfatin ELISA kit. The results were analysed using SPSS Software, Version 23.0. Unpaired t-test and Mann-Whitney U test was used to compare the clinical parameters and salivary Visfatin level between both the groups. Also, Spearman's rank correlation test was done for correlation of BMI with salivary Visfatin levels and clinical parameters. Results The salivary Visfatin level was higher in group 2 (33.1070 ± 0.81 ng/mL) as compared to group 1 (22.2310 ± 1.33 ng/mL). Moderate positive statistically significant association was found between BMI and Visfatin (r = 0.738, p = 0.000). Also when Visfatin and PPD and CAL were correlated, moderate positive statistically significant association was found (r = 0.625, p = 0.000 and r = 0.630, p = 0.000). Conclusion The present study suggests that there exists a positive correlation between BMI and salivary Visfatin and BMI and periodontal parameters including probing depth and clinical attachment level. This illustrates that salivary Visfatin may be a potential marker for periodontal inflammation in obese population.
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Affiliation(s)
- Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Chennai, 600077, India
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Periodontal Disease in Obese Patients; Interleukin-6 and C-Reactive Protein Study: A Systematic Review. Dent J (Basel) 2022; 10:dj10120225. [PMID: 36547041 PMCID: PMC9777236 DOI: 10.3390/dj10120225] [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: 08/24/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Periodontal disease (PD) and obesity are characterized by a dysregulated inflammatory state. Both conditions trigger inflammatory and immune responses with an increase in proinflammatory cytokines such as Interleukin 6 (IL-6) and the release of inflammatory mediators such as C-reactive protein (CRP). Individuals with a high body mass index (BMI) present a chronic inflammatory state. The aim of the present study was to perform a systematic review of inflammatory markers (IL-6 and CRP) in obese patients with PD and their possible relationship by analyzing the levels of these markers. A digital literature search was performed in three databases-PubMed, SciElo and Medigraphic-through an advanced search for original articles, employing IL-6 and CRP in obese patients with PD, within a publication period from 2010 to 2021. PRISMA guidelines, the JADAD scale and a qualitative analysis of scientific evidence were performed using the Cochrane collaboration method and the RoB 2 assessment tool. Ten articles were included in this analysis with the variables recorded and associated with subjects with obesity and PD. Of the ten articles included, three analyzed IL-6 and CRP, four analyzed IL-6 and three analyzed CRP. In conclusion, and based on the available evidence, the aforementioned markers of inflammation demonstrate that there is a relationship between PD and obesity.
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Abu-Shawish G, Betsy J, Anil S. Is Obesity a Risk Factor for Periodontal Disease in Adults? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12684. [PMID: 36231983 PMCID: PMC9566678 DOI: 10.3390/ijerph191912684] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 05/14/2023]
Abstract
There is inconclusive evidence about the link between the severity and prevalence of periodontitis in obese adults. Therefore, this systematic review aims to explore the possibility of significant evidence on the association between obesity and periodontitis and to determine the necessity to consider obesity as a risk factor for periodontitis. We followed the PRISMA protocol, and studies that met the eligibility criteria were included in this review. The risk of bias in individual studies was also evaluated. This review included 15 observational studies (9 cross-sectional studies, 2 case-control, and 4 cohort studies). The total study subjects from these studies were 6603 (males = 3432; females = 3171). Most studies showed a significant association between obesity and periodontitis. Among these studies, a few showed obese females to be at a higher risk, and one study found no association between obesity and periodontal disease at all. Based on the evidence obtained from this review, the body mass index (BMI) should be routinely assessed in patients to assess the risk for periodontal disease and to offer personalized management of periodontitis. Based on the findings of this review, we recommend the need to initiate awareness among clinicians and implement dental hygiene care prevention measures for obese patients.
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Affiliation(s)
- Ghadah Abu-Shawish
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar University, Doha 3050, Qatar
| | - Joseph Betsy
- Department of Periodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
| | - Sukumaran Anil
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar University, Doha 3050, Qatar
- Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences and Research Centre Thiruvalla, Pathanamthitta 689101, India
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Pamuk F, Kantarci A. Inflammation as a link between periodontal disease and obesity. Periodontol 2000 2022; 90:186-196. [PMID: 35916870 DOI: 10.1111/prd.12457] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.
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Affiliation(s)
- Ferda Pamuk
- Forsyth Institute, Cambridge, Massachusetts, USA.,Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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11
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Evaluation of Common Factors of Periodontitis and Cardiovascular Disease in Patients with the Acute Coronary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138139. [PMID: 35805797 PMCID: PMC9265665 DOI: 10.3390/ijerph19138139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 02/01/2023]
Abstract
Periodontitis is a multifactorial disease causing inflammatory destruction of supporting structures of the dentition and eventually leading to its loss. This study was designed to evaluate common risk factors for periodontitis and acute coronary syndrome in the study population and demonstrate the systemic impact of periodontitis on the occurrence of acute coronary syndrome. A total of 160 patients (35 female and 125 male) were enrolled in the study. Considering the age range, the largest group of patients (118 patients) was between 55 and 65 years, which accounted for 73.8% of the total study population. There were 35 patients (21.9%) in the age group of 45 to 54 years, while the youngest age group of 35 to 44 years had as many as seven patients. Medical history and physical examination, including periodontal status, were performed. API, PD, CAL, and CPITN were evaluated. Common risk factors for periodontitis and acute coronary syndrome were assessed. The study assessed risk factors such as hypertension, diabetes, dyslipidemia, general health, smoking, height, weight, and hip circumference. In light of the above-described etiopathogenesis of atherosclerotic disease and its association with periodontal disease, it is important to emphasize preventing and treating periodontitis, especially in patients in the so-called high-risk group for cardiovascular disease. Dentists’ introduction of an appropriate prophylactic and therapeutic plan may constitute both primary and secondary prevention of cardiovascular diseases.
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12
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Maruyama T, Kobayashi T, Sugiura Y, Yoneda T, Ekuni D, Morita M. Association between serum miRNAs and gingival gene expression in an obese rat model. J Periodontal Res 2022; 57:502-509. [PMID: 35234284 DOI: 10.1111/jre.12979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/19/2022] [Accepted: 02/07/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Recent studies have reported a relationship between periodontitis and obesity; however, the mechanisms of obesity's effects on periodontitis are not well understood. On the other hand, microRNAs (miRNAs) are known to play key roles in the post-transcriptional regulation gene expression by suppressing translation and protein synthesis. We examined the association between obesity-related miRNAs and gene expression in gingival tissue using miRNA-messenger RNA (mRNA) pairing analysis in an obese rat model. METHODS Sixteen male Wistar rats aged 8 weeks old were divided into two groups: the control group was fed a normal powdered food for 8 weeks, and the obesity group was fed a high-fat diet for 8 weeks. Distance from the cement-enamel junction to the alveolar bone crest of the first molars was measured. miRNA microarray analysis was performed on samples of serum and gingival tissue; the resulting data were used to calculate fold changes in miRNA levels in the obesity group relative to the control group, and miRNA-mRNA pairing analysis was performed to identify mRNAs potentially targeted by miRNAs of interest. RESULTS Alveolar bone loss in the obesity group exceeded that in the control group (p = .017). miRNA-mRNA pairing analysis identified an association between 4 miRNAs (miR-759, miR-9a-3p, miR-203b-3p, and miR-878) that were differentially expressed in the obesity and control groups and 7 genes (Ly86, Arid5b, Rgs18, Mlana, P2ry13, Kif1b, and Myt1) expressed in gingival tissue. CONCLUSION This study revealed that several miRNAs play an important role in the mechanism of periodontal disease progression induced by the obesity.
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Affiliation(s)
- Takayuki Maruyama
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama, Japan
| | - Terumasa Kobayashi
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshio Sugiura
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiki Yoneda
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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ArefNezhad R, Motedayyen H, Roghani-Shahraki H. Do cytokines associate periodontitis with metabolic disorders? An overview of current documents. Endocr Metab Immune Disord Drug Targets 2022; 22:778-786. [PMID: 35043774 DOI: 10.2174/1871530322666220119112026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/28/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
Periodontitis is an oral chronic inflammatory condition affecting the adult population worldwide. Many microorganisms act as an initiator for induction of inflammatory immune responses, which participate in the destruction of connective tissue surrounding the teeth and thereby result in tooth loss. Cytokines may have indispensable roles in its pathogenesis through enhancing inflammatory and immune responses. Cytokines can affect functions of some cells of different tissues, such as the cells of the pancreas, liver, and adipose tissues. There is evidence that periodontitis is associated with metabolic disorders, like liver cirrhosis, obesity, and diabetes mellitus. Hence, this review was focused on determining how cytokines can participate in the correlation of periodontitis with metabolic disorders.
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Affiliation(s)
- Reza ArefNezhad
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
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14
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Kouanda B, Sattar Z, Geraghty P. Periodontal Diseases: Major Exacerbators of Pulmonary Diseases? Pulm Med 2021; 2021:4712406. [PMID: 34765263 PMCID: PMC8577952 DOI: 10.1155/2021/4712406] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/16/2021] [Indexed: 12/13/2022] Open
Abstract
Periodontal diseases are a range of polymicrobial infectious disorders, such as gingivitis and periodontitis, which affect tooth-supporting tissues and are linked to playing a role in the exacerbation of several pulmonary diseases. Pulmonary diseases, such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, tuberculosis, COVID-19, and bronchiectasis, significantly contribute to poor quality of life and mortality. The association between periodontal disease and pulmonary outcomes is an important topic and requires further attention. Numerous resident microorganisms coexist in the oral cavity and lungs. However, changes in the normal microflora due to oral disease, old age, lifestyle habits, or dental intervention may contribute to altered aspiration of oral periodontopathic bacteria into the lungs and changing inflammatory responses. Equally, periodontal diseases are associated with the longitudinal decline in spirometry lung volume. Several studies suggest a possible beneficial effect of periodontal therapy in improving lung function with a decreased frequency of exacerbations and reduced risk of adverse respiratory events and morbidity. Here, we review the current literature outlining the link between the oral cavity and pulmonary outcomes and focus on the microflora of the oral cavity, environmental and genetic factors, and preexisting conditions that can impact oral and pulmonary outcomes.
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Affiliation(s)
- Bakey Kouanda
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Zeeshan Sattar
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Patrick Geraghty
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
- Department of Cell Biology, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
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Ganesan SM, Vazana S, Stuhr S. Waistline to the gumline: Relationship between obesity and periodontal disease-biological and management considerations. Periodontol 2000 2021; 87:299-314. [PMID: 34463987 DOI: 10.1111/prd.12390] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obesity is a pandemic and periodontitis is the sixth most prevalent disease in the world. These two noncommunicable diseases share several risk determinants. Epidemiologic evidence from the last 2 decades has established an increase in periodontitis prevalence in obese and overweight individuals. Biologic mechanisms potentially linking obesity and periodontal disease are adiposity-associated hyperinflammation, microbial dysbiosis, altered immune response, specific genetic polymorphisms, and increased stress. However, because of the lack of longitudinal interventional studies and randomized clinical trials, there is insufficient evidence to determine the cause-effect relationship between these two diseases. Despite this, the negative impact of obesity on oral health is well established. Several logistic and physiologic complications are associated with treating obese patients in a dental setting, and it requires an interprofessional team approach. Oral health care professionals need to be aware of the specific management considerations while rendering for this cohort, including modified practice facility and equipment, tailored supportive periodontal therapy, and heightened precaution during conscious sedation and surgical procedures.
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Affiliation(s)
- Sukirth M Ganesan
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Stephanie Vazana
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Sandra Stuhr
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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Adiponectin inhibits lipoplysaccharide-induced inflammation and promotes osteogenesis in hPDLCs. Biosci Rep 2021; 41:227897. [PMID: 33616153 PMCID: PMC7926180 DOI: 10.1042/bsr20192668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/21/2020] [Accepted: 02/16/2021] [Indexed: 11/17/2022] Open
Abstract
Periodontal diseases are infections of the structures that surround and support the teeth; they are characterized by local inflammation and alveolar bone loss. Most treatments focus on only one aspect, inhibiting inflammation, or promoting osteoblasts. We set out to develop a new method that would intervene in the two aspects simultaneously. Adiponectin (APN), secreted by adipocytes, inhibits the inflammatory response and promotes osteogenesis. However, its role in human periodontal ligament cells (hPDLCs) is unclear. Therefore, we aim to investigate whether APN could suppress lipopolysaccharide (LPS)-induced inflammation and promote osteogenesis in hPDLCs. In the present study, we stimulated hPDLCs with LPS in the presence or absence of APN. Real-time PCR and Western blotting results demonstrated that APN partially inhibited the activation of the classical nuclear factor κ-B (NF-κB) pathway. These results were confirmed by a change of expressions of NF-κB downstream inflammatory genes, such as decreased cyclooxygenase (COX)-2 and tumor necrosis factor α (TNF-α), along with increased interleukin (IL)-10. As for the role of APN in osteogenesis, Alizarin Red S staining showed that APN treatment induced more calcium deposition nodules than controls. We also found that APN enhanced the expression of osteoblast-related genes (osteopontin (OPN), collagen 1, osteocalcin, alkaline phosphatase, runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein 2) in hPDLCs via the APPL1 (the adaptor protein containing PH domain, PTB domain, and leucine zipper motif 1)/p38 signal transduction pathway. Therefore, APN inhibits LPS-induced inflammation and promotes osteogenesis in hPDLCs and may have potential therapeutic value in treating periodontitis by inhibiting the inflammatory lesions and contributing to bone tissue regeneration.
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17
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Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses 2020; 144:109969. [PMID: 32592918 PMCID: PMC7303044 DOI: 10.1016/j.mehy.2020.109969] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.
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Affiliation(s)
- Viviana Pitones-Rubio
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - E G Chávez-Cortez
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Angélica Hurtado-Camarena
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Anna González-Rascón
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Nicolás Serafín-Higuera
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico.
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18
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A Population-Based Study on the Association between Periodontal Disease and Major Lifestyle-Related Comorbidities in South Korea: An Elderly Cohort Study from 2002-2015. ACTA ACUST UNITED AC 2020; 56:medicina56110575. [PMID: 33138320 PMCID: PMC7693625 DOI: 10.3390/medicina56110575] [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: 10/06/2020] [Revised: 10/24/2020] [Accepted: 10/28/2020] [Indexed: 01/15/2023]
Abstract
This study determined the association between periodontal disease (PD) and major lifestyle-related comorbidities (LCs) using the database of the nationwide population-based National Health Insurance Service–Elderly Cohort 2002–2015. A nationwide representative sample comprising 558,147 participants, aged 60 years, was analyzed. Univariate and multivariate logistic regression analyses adjusted for sociodemographic and economic factors (sex, age, household income, insurance status, health status, and living area) and major LCs (hypertension, diabetes mellitus, rheumatoid arthritis, osteoporosis, cerebral infarction, angina pectoris, myocardial infarction, erectile dysfunction, lipoprotein disorder, and obesity) were used to determine the association between PD and major LCs. Elderly participants with PD had a higher risk of major LCs (hypertension: odds ratio (OR) = 1.40, diabetes mellitus: OR = 1.22, rheumatoid arthritis: OR = 1.16, osteoporosis: OR = 1.37, erectile dysfunction: OR = 1.73, lipoprotein disorder: OR = 1.50, and obesity: OR = 1.59). Our longitudinal cohort study provided evidence that PD was significantly associated with major LCs in elderly participants. In particular, the association between PD and erectile dysfunction had the highest OR in the multivariate analyses.
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Zuza EC, Pires JR, de Almeida AA, Toledo BEC, Guimaraes-Stabili MR, Junior CR, Barroso EM. Evaluation of recurrence of periodontal disease after treatment in obese and normal weight patients: Two-year follow-up. J Periodontol 2020; 91:1123-1131. [PMID: 32010963 DOI: 10.1002/jper.19-0534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/30/2019] [Accepted: 01/21/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Obesity may represent a chronic low-grade inflammation, but there is a lack of long-term longitudinal studies. The aim of this longitudinal study was to evaluate the recurrence of periodontal disease in obese and normal weight patients submitted to scaling and root planing. METHODS The study included 22 patients who had received periodontal treatment 2 years previously, 13 obese and nine non-obese. The patients were evaluated for anthropometric measurements of body mass index, waist circumference, waist-to-hip ratio, and fat percentage through bioimpedance. The following periodontal parameters were recorded: visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). The immunological evaluation analyzed the proinflammatory cytokines interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) in the gingival crevicular fluid (GCF). RESULTS Obese and normal weight patients did not differ in relation to the periodontal parameters of VPI, GBI, PD, CAL, or BOP 2 years after completion of the periodontal therapy. Sites with periodontitis in obese individuals showed higher levels of IL-6 and TNF-α in the gingival fluid (P <0.05). CONCLUSION Obese and normal weight individuals had similar periodontal behaviors, with low recurrence of the periodontal disease; however, obesity was related to increased inflammatory activity in gingival fluid, which may become a risk indicator for future greater recurrence of the disease in the presence of inadequate plaque control.
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Affiliation(s)
- Elizangela C Zuza
- Postgraduate Program in Dentistry of the Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, São Paulo, Brazil
| | - Juliana R Pires
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
| | - Ana Alice de Almeida
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
| | - Benedicto E C Toledo
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Morgana R Guimaraes-Stabili
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Carlos Rossa Junior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Eliane M Barroso
- Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil
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Di Spirito F, Sbordone L, Pilone V, D’Ambrosio F. Obesity and Periodontal Disease: A Narrative Review on Current Evidence and Putative Molecular Links. Open Dent J 2019. [DOI: 10.2174/1874210601913010526] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background:
Obesity represents one of the main health problems worldwide and is considered a risk factor for several diseases, including periodontitis, which is a microbially-associated inflammatory disease affecting the tooth-supporting structures.
Objective:
The aim of this review was to report the current direct and indirect evidence concerning the possible association between obesity and periodontitis and their putative molecular links.
Methods:
A literature search was conducted between January 1999 and September 2019, in PubMed/MEDLINE and Science Direct databases, using pertinent keyword combined by Boolean operators. Through a multi-step screening process (literature search; articles title and abstract evaluation and full-text reading), studies fitting inclusion/exclusion criteria were considered for the review.
Results:
35 studies were included in the present review (17 observational studies; 7 systematic reviews; 11 systematic reviews with meta-analysis), focusing on the direct and indirect evidence of the possible association between obesity and periodontitis and their potential etiopathogenic molecular links
Conclusion:
Although the majority of the studies reported a positive association between obesity and periodontitis, the heterogeneity of the classification criteria and of the clinical parameters employed in the studies for both obesity and periodontitis evaluation, complicated the comparison of the results, thus considered inconclusive. Although several putative molecular pathogenic links between obesity and periodontitis have been highlighted, further studies, with longer follow-ups and with homogeneous clinical criteria, are needed to better understand the putative relation between obesity and periodontal disease.
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Dhaifullah E, Al-Maweri SA, Koppolu P, Elkhtat E, Mostafa D, Mahgoub M. Body mass index and periodontal health status among young Saudi adults: a cross-sectional study. Ann Saudi Med 2019; 39:433-440. [PMID: 31804133 PMCID: PMC6894456 DOI: 10.5144/0256-4947.2019.433] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity has been suggested as a risk factor for periodontal disease. Despite the high prevalence of obesity and over-weight among Saudi population, no study has assessed whether there is an association between periodontal health status and body mass index (BMI). OBJECTIVES Assess the association between BMI and other variables with periodontal health status among young Saudi adults. DESIGN Analytical, hospital-based cross-sectional study. SETTING University dental hospital, Riyadh. PATIENTS AND METHODS All dental students aged 21-35 years who met inclusion criteria were invited to participate in the study. Periodontal health status was assessed by the plaque index (PI), gingival index (GI) and community periodontal index (CPI) scores. Biometric measurements included weight, height and BMI. Multiple logistic regression was used to assess the association of independent variables with periodontal disease (CPI>2 vs CPI ≤2) and multiple linear regression models to assess associations with PI and GI. MAIN OUTCOME MEASURES Periodontal health by BMI and other variables. SAMPLE SIZE 308. RESULTS Of 700 participants invited, 380 participated for a response rate of 54.2%. Slightly more than half of the obese subjects 54 (52%) did not brush their teeth regularly. The mean (standard deviation) PI and GI scores were significantly higher among the obese (PI score: 1.54 [0.45]); GI score: 1.52 [0.51]) and overweight (PI score: 1.36 [0.47]) and (GI score: 1.42 [0.57]) subjects when compared with subjects with normal weight (PI score: 1.27 [0.51]); (GI score: 1.31 [0.48]); ( P<.05). No significant differences were seen between BMI groups in CPI scores. There were also no significant differences in the mean number and percentage of sextants between different BMI groups. The only signficant factor for periodontal disease in the multivariable analysis was toothbrushing. CONCLUSION The present study shows a significant positive correlation between BMI and PI and GI scores. However, no statistically significant association was found between BMI and periodontal health status. LIMITATION Cross-sectional, so not possible to assess the association of oral health and BMI over time. CONFLICT OF INTEREST None.
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Affiliation(s)
- Esam Dhaifullah
- Department of Preventive Dental Sciences, Alfarabi College, Riyadh Saudi Arabia
| | | | - Pradeep Koppolu
- From the Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Essam Elkhtat
- Department of Preventive Dental Sciences, Alfarabi College, Riyadh Saudi Arabia
| | - Diana Mostafa
- Department of Preventive Dental Sciences, Alfarabi College, Riyadh Saudi Arabia
| | - Muna Mahgoub
- Department of Preventive Dental Sciences, Alfarabi College, Riyadh Saudi Arabia
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Animal Experiments in Periodontal and Peri-Implant Research: Are There Any Changes? Dent J (Basel) 2019; 7:dj7020046. [PMID: 31052358 PMCID: PMC6631533 DOI: 10.3390/dj7020046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/13/2019] [Accepted: 04/03/2019] [Indexed: 11/23/2022] Open
Abstract
Animal experiments are a source of debate. This bibliometric study aims to identify published research in two representative dental journals: the Journal of Periodontology (JP) and the Journal of Clinical Periodontology (JCP). Two time points (1982/83 and 2012/13) covering 30 years were chosen. Articles describing data from animal experiments were identified and the data were extracted and compared between journals and time points. In 1982/83, 27 animal studies were published in JP and 17 in JCP. For 2012/13, 54 animal studies were considered in JP and 37 in JCP. The species examined were predominantly dogs (37%) in JCP and rats (61%) in JP in 1982/83. In 2012/13, rodents accounted for 85% in JP and for 54% in JCP. The number of animals used per study increased by a factor of 1.6–2.6. The diversity of geographic origin and articles from emerging countries increased over time. The number of animals examined per study and the publications describing these experiments seemed to have increased in the journals analyzed in the last decades.
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Abstract
The purpose of this paper was to identify and summarize current evidence describing periodontal complications associated with obesity. Electronic searches supplemented with manual searches were carried out to identify relevant systematic reviews. Identification, screening, eligibility, and inclusion of studies were performed independently by two reviewers. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess the quality and risk of bias of the included reviews. From 430 titles and abstracts screened, 14 systematic reviews were considered as eligible for inclusion in this meta-review. Eight reviews reported on cross-sectional studies investigating the association of obesity and periodontal diseases, 4 included longitudinal studies, 5 addressed response to periodontal therapy, 5 reported on studies investigating biomarkers, and only 2 were related to pediatric population samples. Systematic review summaries in the various study design domains (cross-sectional, longitudinal and experimental) report that obese individuals are more likely to have periodontal diseases, with more severe periodontal conditions, than nonobese individuals, with cross-sectional evidence congruent with longitudinal studies showing that obesity or weight gain increases the risk of periodontitis onset and progression. Published research on the effect of obesity on responses to periodontal therapy, or systemic or local biomarkers of inflammation, is variable and therefore inconclusive based on the evidence currently available, which suggests that overweight/obesity contributes to periodontal complications independently of other risk factors, such as age, gender, smoking, or ethnicity. This evidence supports the need for risk assessments for individual patients to facilitate personalized approaches in order to prevent and treat periodontal diseases.
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Affiliation(s)
- Jean E Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Nicholas Finer
- National Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science, London, UK
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Virto L, Cano P, Jiménez-Ortega V, Fernández-Mateos P, González J, Haugen HJ, Esquifino AI, Sanz M. Melatonin as adjunctive therapy in the treatment of periodontitis associated with obesity. J Clin Periodontol 2018; 45:1336-1346. [DOI: 10.1111/jcpe.13013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/21/2018] [Accepted: 09/16/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Leire Virto
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group; University Complutense; Madrid Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Madrid Spain
| | - Pilar Cano
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Madrid Spain
- Department of Biochemical and Molecular Biology (Sección Departamental, Faculty of Medicine); University Complutense; Madrid Spain
| | - Vanesa Jiménez-Ortega
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Madrid Spain
- Department of Biochemical and Molecular Biology (Sección Departamental, Faculty of Medicine); University Complutense; Madrid Spain
| | - Pilar Fernández-Mateos
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Madrid Spain
- Department of Cellular Biology; Faculty of Medicine; University Complutense; Madrid Spain
| | - Jerián González
- Department of Clinical Dental Specialties; Faculty of Odontology; University Complutense; Madrid Spain
| | - Håvard J. Haugen
- Department of Biomaterials; Institute for Clinical Dentistry; University of Oslo; Oslo Norway
| | - Ana Isabel Esquifino
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC); Madrid Spain
- Department of Biochemical and Molecular Biology (Sección Departamental, Faculty of Medicine); University Complutense; Madrid Spain
| | - Mariano Sanz
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group; University Complutense; Madrid Spain
- Department of Clinical Dental Specialties; Faculty of Odontology; University Complutense; Madrid Spain
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Maria de Souza G, Willya Douglas de Oliveira D, Santos Lages F, Andrade Fernandes I, Gabriel Moreira Falci S. Relationship between bariatric surgery and periodontal status: a systematic review and meta-analysis. Surg Obes Relat Dis 2018; 14:1205-1216. [DOI: 10.1016/j.soard.2018.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/01/2018] [Accepted: 04/29/2018] [Indexed: 12/24/2022]
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Damanaki A, Nokhbehsaim M, Hiththetiya K, Memmert S, Gao J, Nguyen KA, Götz W, Jäger A, Wahl G, Deschner J. Characterization of a diet-induced obesity rat model for periodontal research. Clin Oral Investig 2018; 23:937-946. [PMID: 29907930 DOI: 10.1007/s00784-018-2514-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/04/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Obesity is associated with periodontitis, but the mechanisms underlying this association have yet to be unraveled. The present investigation was to evaluate a common rat model, in which obesity is induced by high-fat, high-sucrose diet (HFSD), for its applicability in periodontal research. MATERIALS AND METHODS Ten male Wistar rats were fed a 3-month HFSD along with a matching control group. Afterwards, the body weight, adipocyte morphology, leptin and adiponectin levels in adipose tissue, gingiva, and serum as well as the serum levels of triglyceride, cholesterol, and glucose were analyzed. For statistical analyses, parametric and non-parametric tests were applied (p < 0.05). RESULTS Body weight was significantly higher in the HFSD group after dieting as compared to control. HFSD caused a significant increase in serum triglyceride, low-density lipoprotein cholesterol, and leptin levels and a significant decrease in high-density lipoprotein cholesterol. Furthermore, adipose tissue from HFSD rats exhibited significantly larger adipocytes, displayed a significant upregulation of leptin and, surprisingly, elevated adiponectin levels, which is in contrast to chronic obesity in humans. Although leptin and adiponectin were also observed in gingival biopsies, no obvious differences between the groups were found. CONCLUSIONS Although this rat diet-induced obesity model is characterized by changes typical of obesity, it also has limitations, which have to be considered when data, especially with regard to adipokines, are extrapolated to humans. CLINICAL RELEVANCE The rodent diet-induced obesity model may be useful for unraveling pathomechanisms underlying the association between obesity and periodontal destruction but conclusions have to be drawn with caution.
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Affiliation(s)
- Anna Damanaki
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | | | - Svenja Memmert
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Jinlong Gao
- Westmead Institute for Medical Research and Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Ky-Anh Nguyen
- Westmead Institute for Medical Research and Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Werner Götz
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Gerhard Wahl
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - James Deschner
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany.
- Noel Martin Visiting Chair, Faculty of Dentistry, University of Sydney, Sydney, Australia.
- Department of Periodontology and Operative Dentistry, University Medical Center, Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Australia.
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Damanaki A, Memmert S, Nokhbehsaim M, Sanyal A, Gnad T, Pfeifer A, Deschner J. Impact of obesity and aging on crestal alveolar bone height in mice. Ann Anat 2018; 218:227-235. [PMID: 29730468 DOI: 10.1016/j.aanat.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 12/20/2022]
Abstract
Obesity and aging are associated with periodontitis, which represents a chronic inflammatory disease of the tooth-supporting tissues, i.e. the periodontium. However, if both risk factors also have a negative impact on crestal alveolar bone in a clinically healthy periodontium, has yet to be elucidated and was analyzed in this in-vivo study. Eight C57BL/6 mice were fed a normal diet during the entire study. Half of these mice were sacrificed at week 19 (group 1: younger lean mice), whereas the other half of the animals were sacrificed at week 25 (group 2: older lean mice). In addition, four mice were fed a high-fat diet until their sacrifice at week 19 (group 3: younger obese mice). Mandibles and maxillae were scanned by micro-computed tomography and, subsequently, the distance between the cementoenamel junction and alveolar bone crest (CEJ-ABC) at all molars was determined. Levels of interleukin-6, cyclooxygenase-2, visfatin and adiponectin in gingival samples were quantified by real-time PCR. For statistical analyses, the Mann-Whitney-U test was applied (p<0.05). As compared to lean mice, obese animals presented a significantly increased CEJ-ABC distance, i.e. reduced alveolar bone crest height, at week 19. The alveolar bone loss was mainly found at the first molars of the mandibles. In animals fed a normal diet, the alveolar bone crest height in the mandibles and maxillae was significantly lower in the older mice as compared to the younger animals. Furthermore, gingival cyclooxygenase-2 and visfatin expressions were higher in the obese versus lean mice and in the older versus younger mice. This in-vivo investigation shows that obesity and older age can result in reduced alveolar bone crest height and suggests that they represent risk factors even in a clinically healthy periodontium.
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Affiliation(s)
- Anna Damanaki
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Svenja Memmert
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany; Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Marjan Nokhbehsaim
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Abhishek Sanyal
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Thorsten Gnad
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Alexander Pfeifer
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany.
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Culebras-Atienza E, Silvestre FJ, Silvestre-Rangil J. Possible association between obesity and periodontitis in patients with Down syndrome. Med Oral Patol Oral Cir Bucal 2018; 23:e335-e343. [PMID: 29680852 PMCID: PMC5945240 DOI: 10.4317/medoral.22311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/07/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The present study was carried out to evaluate the possible association between obesity and periodontitis in patients with DS, and to explore which measure of obesity is most closely correlated to periodontitis. MATERIAL AND METHODS A prospective observational study was made to determine whether obesity is related to periodontal disease in patients with DS. The anthropometric variables were body height and weight, which were used to calculate BMI and stratify the patients into three categories: < 25(normal weight), 25-29.9 (overweight) and ≥ 30.0 kg/m2 (obese). Waist circumference and hip circumference in turn was recorded as the greatest circumference at the level of the buttocks, while the waist/hip ratio (WHR) was calculated. Periodontal evaluation was made of all teeth recording the plaque index (PI), pocket depth (PD), clinical attachment level (CAL) and the gingival index. We generated a multivariate linear regression model to examine the relationship between PD and the frequency of tooth brushing, gender, BMI, WHI, WHR, age and PI. RESULTS Significant positive correlations were observed among the anthropometric parameters BMI, WHR, WHI and among the periodontal parameters PI, PD, CAL and GI. The only positive correlation between the anthropometric and periodontal parameters corresponded to WHR. Upon closer examination, the distribution of WHR was seen to differ according to gender. Among the women, the correlation between WHR and the periodontal variables decreased to nonsignificant levels. In contrast, among the males the correlation remained significant and even increased. In a multivariate linear regression model, the coefficients relating PD to PI, WHR and age were positive and significant in all cases. CONCLUSIONS Our results suggest that there may indeed be an association between obesity and periodontitis in male patients with DS. Also, we found a clear correlation with WHR, which was considered to be the ideal adiposity indicator in this context.
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Affiliation(s)
- E Culebras-Atienza
- Dentistry and Medicine Faculty, University of Valencia, C/ Gasco Oliag n 1, Valencia 46010, SPAIN,
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Zuza EP, Garcia VG, Theodoro LH, Ervolino E, Favero LFV, Longo M, Ribeiro FS, Martins AT, Spolidorio LC, Zuanon JAS, de Toledo BEC, Pires JR. Influence of obesity on experimental periodontitis in rats: histopathological, histometric and immunohistochemical study. Clin Oral Investig 2017; 22:1197-1208. [DOI: 10.1007/s00784-017-2207-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/11/2017] [Indexed: 01/03/2023]
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Shikama Y, Kudo Y, Ishimaru N, Funaki M. Potential Role of Free Fatty Acids in the Pathogenesis of Periodontitis and Primary Sjögren's Syndrome. Int J Mol Sci 2017; 18:ijms18040836. [PMID: 28420093 PMCID: PMC5412420 DOI: 10.3390/ijms18040836] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/07/2017] [Accepted: 04/11/2017] [Indexed: 12/15/2022] Open
Abstract
Clinical studies have shown that metabolic disorders such as type 2 diabetes and dyslipidemia are associated with increased risk of oral-related diseases, such as periodontitis and Sjögren’s syndrome. Although changes in the immune system are critical in both of these metabolic disorders and oral-related diseases, the mechanism underlying the interaction between these diseases remains largely unknown. Obesity and type 2 diabetes are known to be associated with higher concentrations of free fatty acids in blood. Among free fatty acids, saturated fatty acids such as palmitic acid have been demonstrated to induce inflammatory responses mainly via the innate immune systems, and to be involved in the pathogenesis of type 2 diabetes in tissues such as adipose tissue, liver, pancreas, and skeletal muscle. Here, we highlight recent advances in evidence for the potential involvement of palmitic acid in the pathogenesis of periodontitis and Sjögren’s syndrome, and discuss the possibility that improvement of the lipid profile could be a new strategy for the treatment of these diseases.
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Affiliation(s)
- Yosuke Shikama
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Japan.
| | - Yasusei Kudo
- Department of Oral Molecular Pathology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan.
| | - Naozumi Ishimaru
- Department of Oral Molecular Pathology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan.
| | - Makoto Funaki
- Clinical Research Center for Diabetes, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima 770-8503, Japan.
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Correlation of crevicular fluid and serum levels of retinol-binding protein 4 and leptin in chronic periodontitis and obesity. Clin Oral Investig 2016; 21:2319-2325. [PMID: 27933445 DOI: 10.1007/s00784-016-2025-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/02/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Retinol-binding protein 4 (RBP4) and leptin are both adipokines and involved in the pathophysiology of different vascular and inflammatory diseases and selectively elevated in patients with obesity. The aim of the present study was to determine and correlate the levels of RBP4 and leptin in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis (CP) and obesity. MATERIALS AND METHODS A total of 70 patients with age group 25 to 45 years were divided into four groups based on gingival index (GI), probing depth (PD), clinical attachment level (CAL), body mass index (BMI) and radiographic evidence of bone loss. The groups were (1) group I (non-obese periodontally healthy), (2) group II (obese periodontally healthy), (3) group III (non-obese with chronic periodontitis) and (4) group IV (obese with chronic periodontitis). The GCF and serum levels of human RBP4 and leptin were quantified using ELISA. RESULTS An increase in RBP4 levels from group I to group IV was found in both GCF and serum. However, GCF leptin levels was found to be greatest in group II, then group I, group IV and group III showing the least while an increase in serum levels from group I to group IV was found. The GCF and serum values of the inflammatory mediator correlated with the evaluated periodontal parameters and with each other (p < 0.05). CONCLUSION RBP4 and leptin can be considered as possible GCF and serum markers of inflammatory activity in CP and obesity, which further longitudinal studies are needed.
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ASSI SP, PIRES JR, PONTES AEF, BARROSO EM, ZUZA EP. Oral conditions and body weight in children from a public school in Manaus, AM, Brazil. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.09816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Some studies have pointed to links between the prevalence of caries and periodontal disease, and the occurrence of overweight or obesity; but, few studies have been conducted in children. Objective To assess the relationship between periodontal disease, tooth decay and body weight in children from a public school in Manaus, AM, Brazil. Material and method The study included one hundred and sixty-nine children. Records were obtained of decayed, missing and filled (DMFT) permanent teeth, and of decayed, extracted, or filled (DEF) deciduous teeth, as well as the record of the community periodontal index (CPI). The classification of body weight category was obtained in percentile using the z-Score table. Result Higher averages of weight and body mass index (BMI) were seen in the overweight and obesity groups (p<0.05). All groups were similar regarding the DMFT /DEF and CPI codes from 0 to 4 (p>0.05). All groups showed higher averages of CPI 0 in comparison with other CPI codes from 1 to 4 (p<0.05), and most of the children showed sites with probing depth <3.5 mm and without bleeding on probing. Conclusion There was no relationship between body weight and the occurrence of dental caries and periodontal disease in the studied population. Obesity and overweight showed no negative influence on the increase in the prevalence of these diseases.
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Affiliation(s)
- Samara Pinho ASSI
- Centro Universitário da Fundação Educacional de Barretos, Brasil; Faculdade do Amazonas, Brasil
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Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, Inflammation, and Periodontal Disease. J Dent Res 2016; 86:400-9. [PMID: 17452558 DOI: 10.1177/154405910708600503] [Citation(s) in RCA: 248] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The prevalence of obesity has increased substantially over the past decades in most industrialized countries. Obesity is a systemic disease that predisposes to a variety of co-morbidities and complications that affect overall health. Cross-sectional studies suggest that obesity is also associated with oral diseases, particularly periodontal disease, and prospective studies suggest that periodontitis may be related to cardiovascular disease. The possible causal relationship between obesity and periodontitis and potential underlying biological mechanisms remain to be established; however, the adipose tissue actively secretes a variety of cytokines and hormones that are involved in inflammatory processes, pointing toward similar pathways involved in the pathophysiology of obesity, periodontitis, and related inflammatory diseases. We provide an overview of the definition and assessment of obesity and of related chronic diseases and complications that may be important in the periodontist’s office. Studies that have examined the association between obesity and periodontitis are reviewed, and adipose-tissue-derived hormones and cytokines that are involved in inflammatory processes and their relationship to periodontitis are discussed. Our aim is to raise the periodontist’s awareness when treating obese individuals.
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Affiliation(s)
- N Pischon
- Dept. of Periodontology, Charité University Medical Center, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
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Gerber FA, Sahrmann P, Schmidlin OA, Heumann C, Beer JH, Schmidlin PR. Influence of obesity on the outcome of non-surgical periodontal therapy - a systematic review. BMC Oral Health 2016; 16:90. [PMID: 27590050 PMCID: PMC5010690 DOI: 10.1186/s12903-016-0272-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity and periodontitis are important chronic health problems. Obesity is associated with an increased prevalence of periodontitis. Whether obesity also affects the outcome of non-surgical periodontal therapy is to date still unclear. METHODS A systematic review of studies referenced in SCOPUS, MEDLINE, PubMed, Cochrane, CINAHL, Biosis and Web of Science was performed. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. Probing pocket depth reduction was analyzed as primary surrogate parameter for therapeutic success after non-surgical periodontal therapy. RESULTS One-hundred-and-fifty-nine potentially qualifying studies were screened. Eight studies fulfilled the inclusion criteria and were analyzed. Three of eight studies failed to show an influence of obesity on pocket depth reduction after non-surgical therapy. The remaining five studies documented a clear negative effect on the outcome of non-surgical periodontal therapy. The finally included studies did not correspond to the highest level of quality (RCTs). Due to the heterogeneity of the data a meta-analysis was not possible. CONCLUSION The literature on the effect of obesity on the treatment outcome of non-surgical periodontal therapy remains controversial. The data, however, support that obesity is not only a factor associated with poorer periodontal health but might also result in inferior response to non-surgical treatment of periodontitis.
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Affiliation(s)
- Fabienne A. Gerber
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Oliver A. Schmidlin
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürg Hans Beer
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
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Kumar N, Bhardwaj A, Negi PC, Jhingta PK, Sharma D, Bhardwaj VK. Association of chronic periodontitis with metabolic syndrome: A cross-sectional study. J Indian Soc Periodontol 2016; 20:324-9. [PMID: 27563208 PMCID: PMC4976555 DOI: 10.4103/0972-124x.183096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Prevalence of metabolic syndrome (MeS) is high among Asians, including Indians and is rising, particularly with the adoption of modernized lifestyle. Various studies have reported a significant relationship between periodontal status and MeS. The objective of this study is to investigate the association between periodontitis and MeS. Materials and Methods: The study included 259 subjects (130 cases with chronic periodontitis, 129 controls without chronic periodontitis) who underwent medical and periodontal checkup. Five components (obesity, high blood pressure, low- and high-density lipoproteins, cholesterol, hypertriglyceridemia, and high plasma glucose) of MeS were evaluated, and individuals with ≥3 positive components were defined as having MeS. The periodontal parameter was clinical attachment level (CAL) on the basis of which cases were selected with moderate (CAL loss 3–4 mm) and severe (CAL loss ≥5 mm) generalized chronic periodontitis. The association between chronic periodontitis and MeS components was investigated using odds ratios (ORs) and 95% confidence intervals (CIs). Results: The association of MeS and chronic periodontitis was strong and significant with OR: 2.64, 95% CI: 1.36–5.18, and P < 0.003. Comparison of mean values of components of MeS between cases and controls reveals that the mean waist circumference (mean difference: −4.8 [95% CI: 7.75–−1.84], P < 0.002) and mean triglycerides level (mean difference: −25.75 [95% CI: −49.22–−2.28], P < 0.032) were significantly higher in cases than in control groups. Although mean systolic blood pressure, diastolic blood pressure, and fasting blood sugar level were higher in cases (125.77, 82.99 and 86.38, respectively) compared with control (122.81, 81.3 and 83.68, respectively), it was statistically insignificant. Conclusion: The results of this study suggest that there is a strong association between chronic periodontitis and MeS. The association was independent of the various potential confounding risk factors affecting the chronic periodontitis such as age, sex, residential background, and tobacco consumption.
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Affiliation(s)
- Naresh Kumar
- Department of Periodontology, Maharaj Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
| | - Ashu Bhardwaj
- Department of Periodontology, Dental Faculty, Jamia Millia Islamia, New Delhi, India
| | - Prakash Chand Negi
- Department of Cardiology, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India
| | - Pravesh Kumar Jhingta
- Department of Periodontology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Deepak Sharma
- Department of Periodontology, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Vinay Kumar Bhardwaj
- Department of Public Health Dentistry, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
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Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
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Akram Z, Safii SH, Vaithilingam RD, Baharuddin NA, Javed F, Vohra F. Efficacy of non-surgical periodontal therapy in the management of chronic periodontitis among obese and non-obese patients: a systematic review and meta-analysis. Clin Oral Investig 2016; 20:903-14. [DOI: 10.1007/s00784-016-1793-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 03/14/2016] [Indexed: 01/09/2023]
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Atabay VE, Lutfioğlu M, Avci B, Sakallioglu EE, Aydoğdu A. Obesity and oxidative stress in patients with different periodontal status: a case-control study. J Periodontal Res 2016; 52:51-60. [DOI: 10.1111/jre.12368] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 12/15/2022]
Affiliation(s)
- V. E. Atabay
- Sinop State Oral Health Care Center; Sinop Turkey
| | - M. Lutfioğlu
- Department of Periodontology; Ondokuz Mayis University Faculty of Dentistry; Samsun Turkey
| | - B. Avci
- Department of Medical Biochemistry; Ondokuz Mayis University Medical Faculty; Samsun Turkey
| | - E. E. Sakallioglu
- Department of Periodontology; Ondokuz Mayis University Faculty of Dentistry; Samsun Turkey
| | - A. Aydoğdu
- Department of Periodontology; Başkent University Faculty of Dentistry Istanbul Research Center; İstanbul Turkey
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Khan S, Saub R, Vaithilingam RD, Safii SH, Vethakkan SR, Baharuddin NA. Prevalence of chronic periodontitis in an obese population: a preliminary study. BMC Oral Health 2015; 15:114. [PMID: 26419358 PMCID: PMC4589070 DOI: 10.1186/s12903-015-0098-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 09/18/2015] [Indexed: 04/28/2023] Open
Abstract
Background Chronic periodontitis (CP) is a global public health issue. Studies have suggested CP could be linked to obesity due to their similar pathophysiological pathway. The aim of this study is to determine the prevalence of CP and to assess the predictors for CP among the obese Malaysian population. Methods This is a cross-sectional study on obese participants. Obesity is defined as an individual who has Body Mass Index (BMI) ≥27.5 kg/m2. A convenience sampling method was used. A total of 165 paricipants were recruited. This study involved answering questionnaires, obtaining biometric and clinical measurements of Visible plaque index (VPI), Gingival bleeding index (GBI), Probing pocket depth (PPD) and Clinical attachment loss (CAL). Data analysis was carried out using SPSS statistical software (SPSS Inc., version 20, US). Results A total of 165 participants; 67 (40.6 %) males and 98 (59.4 %) females participated in the study. Mean age of the participants was 43.9 (±8.9). The prevalence of CP among the obese population was found to be 73.9 %. Out of this, 43 and 55 % were categorised as moderate and severe CP respectively. Around 64 % of participants had sites with CAL ≥4 mm and participants with sites with PPD ≥4 mm were reported to be 25 %. Around 83 % of the participants had sites with GBI ≥30 and 92 % of participants had sites with VPI ≥20 %. GBI and VPI were found to have significantly higher odds for CP. Conclusion Prevalence of CP was high among obese Malaysians. GBI and VPI were potential predictors for CP in this obese population.
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Affiliation(s)
- Shahrukh Khan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Roslan Saub
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | | | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
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Park HS, Nam HS, Seo HS, Hwang SJ. Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: a pilot study. BMC Oral Health 2015; 15:109. [PMID: 26385382 PMCID: PMC4575481 DOI: 10.1186/s12903-015-0094-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 09/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. Exercise training in high fat mice or rats can inhibit gingival inflammation effectively. The objective of this human intervention study was to investigate whether short-term weight control could affect periodontal indexes and serum and gingival crevicular fluid (GCF) biomarkers in young Koreans. METHODS Forty-one obese volunteers (body mass index (BMI) > 25.0) and 12 normal weight subjects (18.5 ≤ BMI ≤ 23.0) participated in a four-week weight control program to analyze the changes in anthropometric criteria, the concentrations of C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides in serum, gingival index, bleeding on probing, periodontal biomarkers in GCF, and dental plaque index at the first and the 27th days. RESULTS The means of obesity measures decreased significantly more in the obese group (BMI 2.53 ± 0.96, waist-to-hip ratio (WHR) 4.88 ± 1.58 %, LDL 35.85 ± 21.74 mgdL(-1)) than in the normal weight group (BMI 0.78 ± 0.72, WHR 2.00 ± 0.95 %, LDL 15.58 ± 18.07 mgdL(-1)). While the obese group showed significant decreases in the biomarkers in GCF (IL-1β 58.38 ± 65.55 pgmL(-1), MMP-8 4.19 ± 5.61 ngmL(-1), MMP-9 3.36 ± 6.30 ngmL(-1)), the mean changes for the normal weight group (IL-1β 10.07 ± 21.08 pgmL(-1), MMP-8 1.49 ± 4.61 ngmL(-1), MMP-9 -1.52 ± 9.71 ngmL(-1)) were not statistically significant. Anthropometric measures and the amounts of GCF biomarkers had weak positive correlations (0.242 ≤ r ≤ 0.340), and LDL in serum correlated with MMP-8 (r = 0.332) and IL-1β (r = 0.342) in the obese group. Stepwise multiple linear regression analysis in the obese group showed that the relationship between the amount of IL-1β in GCF and predictor variables including LDL and BMI was highly significant and accounted for 19.1 % of the variance in IL-1β in GCF. CONCLUSIONS In periodontally healthy subjects, weight control could reduce the amounts of MMP-8, MMP-9, and IL-1β in GCF of the obese subjects. Further studies with periodontally unhealthy and obese people are needed to identify the mechanism of decreases in inflammation biomarkers in GCF through weight control. TRIAL REGISTRATION ISRCTN86753073 (2015.08.14).
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Affiliation(s)
- Hoo-Seob Park
- Department of Preventive Medicine and Public Health, School of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Hae-Sung Nam
- Department of Preventive Medicine and Public Health, School of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Hyung-Seok Seo
- Department of Sports Medicine, College of Culture, Science & Technology, Konyang University, Nonsan, Chungcheongnamdo, South Korea.
| | - Soo-Jeong Hwang
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea. .,Department of Dental Hygiene, College of Medical Science, Konyang University, Daejeon, South Korea.
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Jaiswal GR, Jain VK, Dhodapkar SV, Kumathalli KI, Kumar R, Nemawat A, Jain A. Impact of Bariatric Surgery and Diet Modification on Periodontal Status: A Six Month Cohort Study. J Clin Diagn Res 2015; 9:ZC43-5. [PMID: 26501011 DOI: 10.7860/jcdr/2015/14663.6489] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 08/03/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nutrition is an essential component of oral health and improper nutrition is an important aetiological factor in the development of obesity as well. AIMS AND OBJECTIVES This study aimed to evaluate effect of diet modification and oral hygiene maintenance after bariatric surgery on the periodontal status of Class III and IV obese patients. MATERIALS AND METHODS Two hundred and twenty four patients between the age ranges of 18 -64 years, from both sexes, were subjected to complete periodontal examination prior to bariatric surgery and 6 months post surgery. Patients were advised diet modification which included more fibrous food intake & decreased intake of soft and sugary food along with supragingival scaling & oral health care regime after bariatric surgery with a 6 month follow up. No periodontal surgical intervention was performed. RESULTS The patients showed a mean differences in the bleeding score, plaque and gingival index which was found to be statistically significant (p<0.001). The improvement in clinical attachment level and probing pocket depth before and after surgery were found to be statistically insignificant (p>0.05). CONCLUSION Thus we conclude that fibrous diet along with good periodontal care can help to improve the oral hygiene status of patients undergoing bariatric surgery, even if periodontal surgical intervention is not performed resulting in freedom from periodontitis, thus improving quality of life of the patient.
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Affiliation(s)
- Gagan Rajesh Jaiswal
- Reader, Department of Periodontics, Sri Aurobindo College of Dentistry , Indore, India
| | - Vijayendra Kumar Jain
- PG student, Department of Periodontics, Sri Aurobindo College of Dentistry , Indore, India
| | | | | | - Rajesh Kumar
- Reader, Department of Periodontics, Sri Aurobindo College of Dentistry , Indore, India
| | - Arun Nemawat
- PG student, Department of Periodontics, Sri Aurobindo College of Dentistry , Indore, India
| | - Ankita Jain
- PG student, Department of Periodontics, Sri Aurobindo College of Dentistry , Indore, India
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Zhou X, Zhang W, Liu X, Zhang W, Li Y. Interrelationship between diabetes and periodontitis: Role of hyperlipidemia. Arch Oral Biol 2015; 60:667-74. [DOI: 10.1016/j.archoralbio.2014.11.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 12/11/2022]
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Keller A, Rohde JF, Raymond K, Heitmann BL. Association between periodontal disease and overweight and obesity: a systematic review. J Periodontol 2015; 86:766-76. [PMID: 25672656 DOI: 10.1902/jop.2015.140589] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Periodontitis and obesity are among the most common chronic disorders affecting the world's populations, and recent reviews suggest a potential link between overweight/obesity and periodontitis. However, because of the scarcity of prospective evidence, previous reviews were primarily based on cross-sectional studies, with only a few longitudinal or intervention studies included. This study's objective is to examine the time-dependent association between obesity and periodontitis and how weight changes may affect the development of periodontitis in the general population. Therefore, longitudinal and experimental studies that assessed the association among overweight, obesity, weight gain, waist circumference, and periodontitis are reviewed. METHODS Intervention and longitudinal studies with overweight or obesity as exposure and periodontitis as outcome were searched through the platforms PubMed/Medline and Web of Knowledge. RESULTS Eight longitudinal and five intervention studies were included. Two of the longitudinal studies found a direct association between degree of overweight at baseline and subsequent risk of developing periodontitis, and a further three studies found a direct association between obesity and development of periodontitis among adults. Two intervention studies on the influence of obesity on periodontal treatment effects found that the response to non-surgical periodontal treatment was better among lean than obese patients; the remaining three studies did not report treatment differences between obese and lean participants. Among the eight longitudinal studies, one study adjusted for C-reactive protein (CRP) and biologic markers of inflammation such as CRP, interleukin-6, and tumor necrosis factor-α, and inflammation markers were analyzed separately in three of the five intervention studies. CONCLUSION This systematic review suggests that overweight, obesity, weight gain, and increased waist circumference may be risk factors for development of periodontitis or worsening of periodontal measures.
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Affiliation(s)
- Amélie Keller
- *Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,†Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals
| | - Jeanett F Rohde
- *Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,†Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals.,‡Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kyle Raymond
- *Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,†Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals
| | - Berit L Heitmann
- *Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,†Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals.,‡Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,§The Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Australia
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Deschner J, Eick S, Damanaki A, Nokhbehsaim M. The role of adipokines in periodontal infection and healing. Mol Oral Microbiol 2014; 29:258-69. [PMID: 25052571 DOI: 10.1111/omi.12070] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 11/27/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the periodontium, which is caused by pathogenic bacteria in combination with other risk factors. The bacteria induce an immunoinflammatory host response, which can lead to irreversible matrix degradation and bone resorption. Periodontitis can be successfully treated. To achieve regenerative periodontal healing, bioactive molecules, such as enamel matrix derivative (EMD), are applied during periodontal surgery. Recently, it has been shown that obesity is associated with periodontitis and compromised healing after periodontal therapy. The mechanisms underlying these associations are not well understood so far, but adipokines may be a pathomechanistic link. Adipokines are bioactive molecules that are secreted by the adipose tissue, and that regulate insulin sensitivity and energy expenditure, but also inflammatory and healing processes. It has also been demonstrated that visfatin and leptin increase the synthesis of proinflammatory and proteolytic molecules, whereas adiponectin downregulates the production of such mediators in periodontal cells. In addition, visfatin and leptin counteract the beneficial effects of EMD, whereas adiponectin enhances the actions of EMD on periodontal cells. Since visfatin and leptin levels are increased and adiponectin levels are reduced in obesity, these adipokines could be a pathomechanistic link whereby obesity and obesity-related diseases enhance the risk for periodontitis and compromised periodontal healing. Recent studies have also revealed that adipokines, such as visfatin, leptin and adiponectin, are produced in periodontal cells and regulated by periodontopathogenic bacteria. Therefore, adipokines may also represent a mechanism whereby periodontal infections can impact on systemic diseases.
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Affiliation(s)
- J Deschner
- Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany; Clinical Research Unit 208, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
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45
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Levine RS. Obesity, diabetes and periodontitis--a triangular relationship? Br Dent J 2014; 215:35-9. [PMID: 23846063 DOI: 10.1038/sj.bdj.2013.627] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 12/13/2022]
Abstract
The global rise of obesity, both adult and childhood, has been paralleled by a rise in type 2 diabetes, a trend predicted to continue for at least the next two decades. The combined effect will create a burden of direct and co-morbidities that will strain the physical and financial resources of all countries. While it is accepted that both type 1 and type 2 diabetes are major risk factors for the development and progression of periodontal disease, there is growing evidence that obesity is both an indirect risk factor because it affects glycaemic control and a direct risk factor because secretion of pro-inflammatory agents by adipose tissue modifies the periodontal reaction to the plaque biofilm. Recent research suggests that periodontitis may adversely affect glycaemic control, which can be improved by periodontal treatment with reduced risk of diabetic co-morbidity, thereby creating a two-way relationship. Furthermore it appears possible that periodontitis may stimulate inflammatory change in adipose tissue, creating a triangular self-generating cycle of morbidity linking obesity, diabetes and periodontal disease. Dentists should recognise these interlinked risk factors and consider including an assessment of glycaemic control and adiposity, possibly by waist-to-hip ratio, when periodontitis is diagnosed and in collaboration with medical practitioners provide treatment to help reduce the development of systemic disease.
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Affiliation(s)
- R S Levine
- Department of Oral Surgery, Leeds Dental Institute and Academic Unit of Obstetrics, Gynaecology and Paediatrics, University of Leeds, UK.
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46
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Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, Buekens P. Prepregnancy Obesity and Periodontitis Among Pregnant Females With and Without Gestational Diabetes Mellitus. J Periodontol 2014; 85:890-8. [DOI: 10.1902/jop.2013.130502] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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47
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Kondo K, Ishikado A, Morino K, Nishio Y, Ugi S, Kajiwara S, Kurihara M, Iwakawa H, Nakao K, Uesaki S, Shigeta Y, Imanaka H, Yoshizaki T, Sekine O, Makino T, Maegawa H, King GL, Kashiwagi A. A high-fiber, low-fat diet improves periodontal disease markers in high-risk subjects: a pilot study. Nutr Res 2014; 34:491-8. [PMID: 25026916 DOI: 10.1016/j.nutres.2014.06.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 04/24/2014] [Accepted: 06/04/2014] [Indexed: 01/29/2023]
Abstract
Periodontal disease is related to aging, smoking habits, diabetes mellitus, and systemic inflammation. However, there remains limited evidence about causality from intervention studies. An effective diet for prevention of periodontal disease has not been well established. The current study was an intervention study examining the effects of a high-fiber, low-fat diet on periodontal disease markers in high-risk subjects. Forty-seven volunteers were interviewed for recruitment into the study. Twenty-one volunteers with a body mass index of at least 25.0 kg/m(2) or with impaired glucose tolerance were enrolled in the study. After a 2- to 3-week run-in period, subjects were provided with a test meal consisting of high fiber and low fat (30 kcal/kg of ideal body weight) 3 times a day for 8 weeks and followed by a regular diet for 24 weeks. Four hundred twenty-five teeth from 17 subjects were analyzed. Periodontal disease markers assessed as probing depth (2.28 vs 2.21 vs 2.13 mm; P < .0001), clinical attachment loss (6.11 vs 6.06 vs 5.98 mm; P < .0001), and bleeding on probing (16.2 vs 13.2 vs 14.6 %; P = .005) showed significant reductions after the test-meal period, and these improvements persisted until the follow-up period. Body weight (P < .0001), HbA1c (P < .0001), and high-sensitivity C-reactive protein (P = .038) levels showed improvement after the test-meal period; they returned to baseline levels after the follow-up period. In conclusion, treatment with a high-fiber, low-fat diet for 8 weeks effectively improved periodontal disease markers as well as metabolic profiles, at least in part, by effects other than the reduction of total energy intake.
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Affiliation(s)
- Keiko Kondo
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Atsushi Ishikado
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan; R&D Department, Sunstar Inc, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Katsutaro Morino
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Yoshihiko Nishio
- Division of Diabetes, Metabolism and Endocrinology, Department of Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8544, Japan.
| | - Satoshi Ugi
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Sadae Kajiwara
- Sunstar Foundation for Oral Health Promotion, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Mika Kurihara
- Division of Clinical Nutrition, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
| | - Hiromi Iwakawa
- Division of Clinical Nutrition, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
| | - Keiko Nakao
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Syoko Uesaki
- R&D Department, Sunstar Inc, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Yasutami Shigeta
- R&D Department, Sunstar Inc, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Hiromichi Imanaka
- R&D Department, Sunstar Inc, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Takeshi Yoshizaki
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Osamu Sekine
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Taketoshi Makino
- R&D Department, Sunstar Inc, 3-1 Asahi-machi, Takatsuki, Osaka 569-1195, Japan.
| | - Hiroshi Maegawa
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - George L King
- Section on Vascular Cell Biology, Research Division, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA 02215, USA.
| | - Atsunori Kashiwagi
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
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Mizutani K, Park K, Mima A, Katagiri S, King GL. Obesity-associated Gingival Vascular Inflammation and Insulin Resistance. J Dent Res 2014; 93:596-601. [PMID: 24744283 DOI: 10.1177/0022034514532102] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/26/2014] [Indexed: 11/15/2022] Open
Abstract
Obesity is a risk factor for periodontitis, but the pathogenic mechanism involved is unclear. We studied the effects of insulin in periodontal tissues during the state of obesity-induced insulin resistance. Gingival samples were collected from fatty (ZF) and lean (ZL, control) Zucker rats. Endothelial nitric oxide synthase (eNOS) expression was decreased, and activities of protein kinase C (PKC) α, ß2, δ, and ϵ isoforms were significantly increased in the gingiva from ZF rats compared with those from ZL rats. Expression of oxidative stress markers (mRNA) and the p65 subunit of NF-κB was significantly increased in ZF rats. Immunohistochemistry revealed that NF-κB activation was also increased in the gingival endothelial cells from transgenic mice overexpressing NF-κB-dependent enhanced green fluorescent protein (GFP) and on a high-fat vs. normal chow diet. Analysis of the gingiva showed that insulin-induced phosphorylation of IRS-1, Akt, and eNOS was significantly decreased in ZF rats, but Erk1/2 activation was not affected. General PKC inhibitor and an anti-oxidant normalized the action of insulin on Akt and eNOS activation in the gingiva from ZF rats. This provided the first documentation of obesity-induced insulin resistance in the gingiva. Analysis of our data suggested that PKC activation and oxidative stress may selectively inhibit insulin-induced Akt and eNOS activation, causing endothelial dysfunction and inflammation.
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Affiliation(s)
- K Mizutani
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Park
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - A Mima
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA Department of Nephrology and Hematology, Nara Hospital, Kinki University Faculty of Medicine, Osaka, Japan
| | - S Katagiri
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - G L King
- Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
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Suresh S, Mahendra J. Multifactorial relationship of obesity and periodontal disease. J Clin Diagn Res 2014; 8:ZE01-3. [PMID: 24959524 DOI: 10.7860/jcdr/2014/7071.4227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/11/2014] [Indexed: 12/18/2022]
Abstract
Obesity is a chronic disease of mutifactorial origin, where there is increase in body fat. Periodontitis is an inflammatory disease of tooth supporting tissues resulting in destruction of periodontal ligament and alveolar bone. Periodontitis and obesity are both chronic health problems and the literature supports this association. A hyperinflammatory state observed in obesity is proposed as a mechanism to explain this association. This low grade inflammation in obese subjects triggers the worsening of non transmissible chronic diseases like periodontitis. So the aim of this article is to get the overview of association between adipose tissue derived cytokines and periodontal disease.
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Affiliation(s)
- Snophia Suresh
- Professor, Department of Periodontology, Thaimoogambigai Dental College and Hospital , Golden George Nagar, Chennai, India
| | - Jaideep Mahendra
- Professor, Department of Periodontics, Meenakshiammal Dental College , Chennai, India
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50
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Hein C, Batista EL. Obesity and cumulative inflammatory burden: a valuable risk assessment parameter in caring for dental patients. J Evid Based Dent Pract 2014; 14 Suppl:17-26.e1. [PMID: 24929585 DOI: 10.1016/j.jebdp.2014.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
UNLABELLED A new model of risk assessment that recognizes the importance of reducing patients' cumulative inflammatory burden by targeting overweight and obesity, in individuals with periodontal disease, may be a valuable risk assessment parameter in caring for dental patients. BACKGROUND The growing body of evidence that suggests obesity, Metabolic Syndrome and periodontal disease are interrelated offers an unprecedented opportunity to adopt a new model of risk assessment that has the potential to beneficially influence not only the periodontal health of obese and overweight patients, but simultaneously may also reduce a person's overall risk for developing heart disease and type 2 diabetes, and perhaps other inflammatory driven disease states. METHODS This paper presents an overview of research that builds the case for a new model of risk assessment that focuses on the cumulative inflammatory burden that may be elevated by the presence of periodontal disease in obese patients. In addition, the biological plausibility of the concepts of inflammatory priming and inflammatory loading is discussed, and several simple ideas are suggested for identifying at-risk patients. CONCLUSIONS Given the significant rise in obesity and the impact that obesity has on periodontal health and other inflammatory driven, systemic disease states, adoption of a new model of risk assessment is suggested-one that considers an individual's cumulative inflammatory burden which may be amplified as a result of coexisting obesity and other components of Metabolic Syndrome and periodontal disease. Knowledge gathered thus far combined with further clinical research must be translated into better ways to treat and maintain obese periodontal patients. These measures may pave the way for prevention of metabolic diseases and obesity with a relevant impact on patients' periodontal status.
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Affiliation(s)
- Casey Hein
- Division of Periodontics, International Centre for Oral-Systemic Health, College of Dentistry, University of Manitoba, Canada; Division of Continuing Professional Development, College of Medicine, Faculty of Health Sciences, University of Manitoba, Canada; Casey Hein & Associates, USA.
| | - Eraldo L Batista
- Division of Periodontics, Department of Dental Diagnostics & Surgical Sciences and Department of Oral Biology, College of Dentistry, Faculty of Health Sciences, University of Manitoba, Canada
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