Zinc in etiology of periodontal disease

Association of dietary zinc consumption with periodontitis in diabetes mellitus patients: A cross-sectional study of national health and nutrition examination surveys database (2009-2014)

Background/purpose

Periodontitis is an independent risk factor for diabetes mellitus (DM), and DM patients had an increased risk in susceptibility to periodontitis. And serum zinc (Zn) levels were low in patients with periodontitis combined with DM. Herein, this study aimed to explore the association between dietary Zn intake and the risk of periodontitis in DM patients, in order to provide some scientific references for the prevention and treatment for periodontitis clinically.

Materials and methods

Demographic and clinical data of DM patients were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2009-2014 in this cross-sectional study. Weighted univariate logistic regression and backward regression analyses were used for covariates screening. Weighted univariate and multivariate logistic regression analyses were used to explore the association between Zn and periodontitis with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age and gender were also performed.

Results

Of the eligible participants, 1281 had moderate or severe periodontitis. After adjusting for the covariates, we found that comparing to DM patients who had not reach the recommended Zn intake level, those who reached had low odds for periodontitis [OR = 0.76, 95% CI: (0.58-0.99)]. In patients who aged ≥65 years old [OR = 0.59, 95% CI: (0.36-0.97)] and were female [OR = 0.71, 95% CI: (0.51-0.99)], reaching the recommended level of Zn intake was related to low odds of periodontitis.

Conclusion

Sufficient dietary Zn intake antagonized the risk of periodontitis, which may provide some references for diet management in DM patients to reduce the risk of periodontitis.

Macro and trace elements signature of periodontitis in saliva: A systematic review with quality assessment of ionomics studies

Objectives

The present systematic review examined the available evidence on distinctive salivary ion profile in periodontitis compared to periodontal health and provided a qualitative assessment of the literature.

Background

Macro and trace elements are essential for cellular physiology, and their changes in biological fluids can be revelatory of an underlying pathological status.

Methods

Data from relevant studies identified from PubMed, Embase, and Scopus databases were retrieved to answer the following PECO question: “In systemically healthy individuals, are there any differences in any salivary macro or trace element concentration between periodontally healthy subjects (H) and patients with periodontitis (P)?” Quality of included studies was rated using a modified version of the QUADOMICS tool. A consistency analysis was performed to identify significantly discriminant chemical elements.

Results

After the screening of 873 titles, 13 studies were included reporting data on 22 different elements. Among them, levels of sodium and potassium were consistently and significantly higher in P compared to H. Conflicting results were found for all the other elements, despite concentration of calcium, copper, and manganese mostly increased in saliva of P. Levels of magnesium were found higher in P than in H in 2 studies but lower in 3. Zinc resulted significantly increased in saliva from H compared to P individuals in 2 studies, but one study reported opposite results. Four studies were considered as high quality, while reporting of operative protocols and statistical analysis was a major limitation for the others. Due to high methodologic heterogeneity, meta‐analysis was not performed.

Conclusions

Levels of macro or trace elements were differentially identified in saliva across diverse periodontal conditions, having a major potential for investigation of oral homeostasis and for high‐resolution periodontal diagnosis. Products of inflammatory physiologic cellular impairment, such as sodium and potassium, were the most consistently associated with periodontitis (PROSPERO CRD42021235744).

Dysregulation of metallothionein and zinc aggravates periodontal diseases

BACKGROUND

Periodontitis (PD) is a multifaceted inflammatory disease connected to bacterial infection that results in the destruction of tooth supporting structures and eventually tooth loss. Given their involvement in infection and inflammation, both metallothionein (MT) and zinc (Zn) might play vital roles in the development and progression of PD. More specifically, both MT and Zn are heavily involved in regulating immune functions, controlling bacterial infection, balancing inflammatory responses, and reducing oxidative stress, all of which are associated with the pathogenesis of PD.

OBJECTIVE

This review paper will explore the physiological functions of MT and Zn and hypothesise how dysregulation could negatively affect periodontal health, leading to PD.

FINDINGS

Bacterial lipopolysaccharide (LPS) derived from periodontal pathogens, namely P. gingivalis initiates the acute phase response, thus upregulating the expression of MT which leads to the subsequent deficiency of Zn, a hallmark of periodontal disease. This deficiency leads to ineffective NETosis, increases the permeability of the gingival epithelium, and disrupts the humoral immune response, collectively contributing to PD. In addition, the presence of LPS in Zn deficient conditions favours M1 macrophage polarisation and maturation of dendritic cells, and also inhibits the anti-inflammatory activity of regulatory T cells. Collectively, these observations could theoretically give rise to the chronic inflammation seen in PD.

CONCLUSION

A disrupted MT and Zn homeostasis is expected to exert an adverse impact on periodontal health and contribute to the development and progression of PD.

Trace Mineral Micronutrients and Chronic Periodontitis-a Review

Trace mineral micronutrients are imperative for optimum host response. Populations worldwide are prone to their insufficiency owing to lifestyle changes or poor nutritional intake. Balanced levels of trace minerals like iron (Fe), zinc (Zn), selenium (Se) and copper (Cu) are essential to prevent progression of chronic conditions like periodontitis. Their excess as well as deficiency is detrimental to periodontal health. This is specifically true in relation to Fe. Furthermore, some trace elements, e.g. Se, Zn and Cu are integral components of antioxidant enzymes and prevent reactive oxygen species induced destruction of tissues. Their deficiency can worsen periodontitis associated with systemic conditions like diabetes mellitus. With this background, the present review first focusses on the role of four trace minerals, namely, Fe, Zn, Se and Cu in periodontal health followed by an appraisal of the data from case control studies related to their association with chronic periodontitis.

Synchrotron radiation analysis of possible correlations between metal status in human cementum and periodontal disease

Periodontitis is a serious disease that affects up to 50% of an adult population. It is a chronic condition involving inflammation of the periodontal ligament and associated tissues leading to eventual tooth loss. Some evidence suggests that trace metals, especially zinc and copper, may be involved in the onset and severity of periodontitis. Thus we have used synchrotron X-ray fluorescence imaging on cross sections of diseased and healthy teeth using a microbeam to explore the distribution of trace metals in cementum and adhering plaque. The comparison between diseased and healthy teeth indicates that there are elevated levels of zinc, copper and nickel in diseased teeth as opposed to healthy teeth. This preliminary correlation between elevated levels of trace metals in the cementum and plaque of diseased teeth suggests that metals may play a role in the progress of periodontitis.

The efficacy of '0.05% Clobetasol + 2.5% zinc sulphate' cream vs. '0.05% Clobetasol alone' cream in the treatment of the chronic hand eczema: a double-blind study

BACKGROUND

Many therapeutic modalities have been suggested for treatment of the chronic hand eczema. Despite good immediate efficacy of some of these treatments, there is high recurrence of the dermatitis following cessation of the treatment.

AIM

Regarding the beneficial effects of the zinc sulfate on the skin, we designed a double blind study to evaluate the efficacy of the '0.05% Clobetasol + 2.5% zinc sulphate' cream versus '0.05% Clobetasol alone' cream in the treatment of the chronic hand eczema.

SUBJECTS AND METHODS

This study was a double-blind, right to left, prospective, clinical trial. In total, 47 patients with chronic hand eczema admitted to dermatology center of Isfahan University of Medical Sciences were selected and their right hand or left hand were selected at random to be treated with either the '0.05% Clobetasol + 2.5% zinc sulphate' cream or '0.05% Clobetasol alone' cream twice daily for 2 weeks. All of the patients were treated for 2 weeks and were followed up at weeks 2, 4, 6 and 8 after starting the treatment. For determining the severity of chronic hand eczema, we assessed and scored 4 different characteristics of the lesions including redness; scaling; lichenification and pruritus. The data were analyzed using SPSS program (release 13) and statistical tests including Mann-Whitney test.

RESULTS

Overall, 47 patients (94 samples) were evaluated. All of these patients had similar and symmetrical lesions on their right and left hands. Out of them, 35 patients were females and 12 patients were male. In all of the evaluated characterisitics, the '0.05% Clobetasol + 2.5% zinc sulphate' cream was more effective than '0.05% Clobetasol alone' cream (P < 0.05). The recurrence rate of eczema was significantly lower in the group treated with this combination treatment (P < 0.05).

CONCLUSION

With regard to the encouraging results of the combination treatment with Clobetasol + zinc sulphate, we suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated. In addition, evaluation of this combination therapy against other inflammatory dermatosis seems to be logical.

The serum levels of calcium, magnesium, iron and zinc in patients with recurrent vulvovaginal candidosis during attack, remission and in healthy controls

The real cause of recurrent vulvovaginal candidosis (RVVC) is concealed and the etiopathogenesis of this disease remains to be determined. In a cohort study, concentrations of metals in 44 patients with RVVC and 30 healthy age-matched women were measured and compared. The concentrations of serum calcium (Ca), magnesium (Mg) and iron (Fe) were measured photometrically, the zinc (Zn) levels were determined using flame atomic absorption spectrometry. For statistical analysis were used the Student's t-tests (paired analysis for attack vs. remission; non-paired analysis for patient vs. control). Although all measured metals were within normal ranges the patients with RVVC had in contrast to the healthy controls significantly lower levels of serum Ca, Mg and Zn and insignificantly higher levels of Fe. These relative changes may contribute to the development of attacks in patients with RVVC.