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Ma W, Zou Z, Yang L, Lin D, Guo J, Shan Z, Hu Q, Wang Z, Li B, Fang J. Exploring the bi-directional relationship between periodontitis and dyslipidemia: a comprehensive systematic review and meta-analysis. BMC Oral Health 2024; 24:508. [PMID: 38684998 PMCID: PMC11059608 DOI: 10.1186/s12903-023-03668-7] [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: 11/05/2022] [Accepted: 11/14/2023] [Indexed: 05/02/2024] Open
Abstract
AIM As periodontitis and dyslipidemia are diseases that occur with high incidence, the relationship between them has attracted much attention. Previous studies on these diseases have tended to focus on lipid parameters and periodontitis, we aimed to investigate the relationship between dyslipidemia and periodontitis. MATERIALS AND METHODS A comprehensive search to identify the studies investigating the relationship between dyslipidemia and periodontitis was performed on PubMed, Web of Science and Cochrane Library before the date of August, 2023. Studies were considered eligible if they contained data on abnormal blood lipid parameters and periodontitis. Studies that reported mean differences and 95% confidence intervals or odds ratios were used. RESULTS A total of 73 publications were included in the meta-analysis. Hyper total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and lower high-density lipoprotein (HDL) levels are risk factors for periodontitis. Periodontal disease is a risk factor for high TG and low HDL levels. Three months after periodontal treatment, the levels of TC, TG and HDL were significantly improved, and statin treatment only improved gingival index (GI) levels compared to that of the dietary control. CONCLUSIONS The findings reported here suggest that the mutual promotion of periodontitis and dyslipidemia can be confirmed. Non-surgical periodontal therapy may improve lipid abnormalities. It can't be demonstrated whether systematic application of statins have a better effect on the improvement in periodontal status in patients with dyslipidemia compared to that of the control.
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Affiliation(s)
- Wanting Ma
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
- Central Laboratory, No. 1, Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Yunnan University of Traditional Chinese Medicine, Yunnan, 650021, Kunming, China
| | - Zhaolei Zou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Lisa Yang
- Department of Stomatology, Binzhou Medical University Hospital, Binzhou Medical University Hospital, 661 Huanghe Second Road, Shandong, 256603, Binzhou, China
| | - Dongjia Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Junyi Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Zhongyan Shan
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Qiannan Hu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Zhi Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China
| | - Bin Li
- Clinical Trials Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, No. 58, Zhongshan Er Road, Guangzhou, Guangdong, 510080, People's Republic of China.
| | - Juan Fang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, 510055, Guangdong, China.
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Kapp M, Holtfreter B, Kocher T, Friedrich N, Pink C, Völzke H, Nauck M. Serum lipoprotein subfractions are associated with the periodontal status: Results from the population-based cohort SHIP-TREND. J Clin Periodontol 2024; 51:390-405. [PMID: 38098273 DOI: 10.1111/jcpe.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 03/16/2024]
Abstract
AIM To investigate the medium-term associations of serum protein subfractions derived from proton nuclear magnetic resonance (1 H-NMR) spectroscopy with periodontitis and tooth loss. MATERIALS AND METHODS A total of 3031 participants of the cohort Study of Health in Pomerania (SHIP-TREND) were included. In addition to conventional serum testing, serum lipoprotein contents and subfractions were analysed by 1 H-NMR spectroscopy. Confounder-adjusted associations of lipoprotein variables with periodontitis and the number of missing teeth variables were analysed using mixed-effects models with random intercepts for time across individuals, accounting for multiple testing. RESULTS While only spurious associations between lipoprotein levels from conventional blood tests were found-that is, triglycerides were associated with mean clinical attachment level (CAL) and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with the number of missing teeth - several associations emerged from serum lipoprotein subfractions derived from 1 H-NMR analysis. Specifically, elevated LDL triglycerides were associated with higher levels of mean probing depth (PD), mean CALs, and increased odds of having <20 teeth. HDL-4 cholesterol levels were inversely associated with mean PD. Systemic inflammation (C-reactive protein) might mediate the effects of LDL and HDL triglyceride contents on periodontitis severity. CONCLUSIONS Several associations between serum lipoprotein subfractions and periodontitis were observed. As the underlying biochemical mechanisms remain unclear, further research is needed.
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Affiliation(s)
- Marius Kapp
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christiane Pink
- Department of Orthodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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Ohshima H, Mishima K. Oral biosciences: The annual review 2023. J Oral Biosci 2024; 66:1-4. [PMID: 38309695 DOI: 10.1016/j.job.2024.01.011] [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: 01/12/2024] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The Journal of Oral Biosciences is dedicated to advancing and disseminating fundamental knowledge with regard to every aspect of oral biosciences. This review features review articles in the fields of "bone regeneration," "periodontitis," "periodontal diseases," "salivary glands," "sleep bruxism," and "Sjögren's syndrome." HIGHLIGHT This review focuses on human demineralized dentin and cementum matrices for bone regeneration, oxidized low-density lipoprotein in periodontal disease and systemic conditions, the relationship between inflammatory mediators in migraine and periodontitis, phosphoinositide signaling molecules in the salivary glands, and the pathophysiologies of sleep bruxism and Sjögren's syndrome. CONCLUSION The review articles featured in the Journal of Oral Biosciences have broadened the knowledge of readers regarding various aspects of oral biosciences. The current editorial review discusses the findings and significance of these review articles.
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Affiliation(s)
- Hayato Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Kenji Mishima
- Division of Pathology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
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Ayoobi F, Salari Sedigh S, Khalili P, Sharifi Z, Hakimi H, Sardari F, Jamali Z. Dyslipidemia, diabetes and periodontal disease, a cross-sectional study in Rafsanjan, a region in southeast Iran. BMC Oral Health 2023; 23:549. [PMID: 37563720 PMCID: PMC10416538 DOI: 10.1186/s12903-023-03262-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: 10/25/2022] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
THE OBJECTIVES The association between dyslipidemia, diabetes and alterations in periodontal health are inconsistent. The aim of this study was to determine the association between dyslipidemia, diabetes and periodontal disease in the Oral Health Branch of Rafsanjan Cohort Study (OHBRCS). METHODS Rafsanjan Cohort Study (RCS) was launched in 2015 in Rafsanjan City a region in the southeast of Iran. A total of 8682 participants aged 35-70 years of both gender were recruited into the OHBRCS as a part of RCS. Bleeding on probing (BOP), probing pocket depth (PPD) and Clinical attachment loss (CAL) were used to assess periodontal health status. When CAL progression was ≥ 1 mm and PPD was > 3 mm, it was defined as periodontitis. RESULTS The final sample consisted of 6751 individuals with mean age of 47.67 ± 8.79 years. Among this population, 73.32% (n = 4949), 13.75% (n = 928), 59.67% (n = 4028) and 11.76% (n = 794) had BOP, PPD > 3 mm, CAL ≥ 1 mm and periodontitis respectively. The odds of CAL ≥ 1 mm increased 14% in subjects with high LDL cholesterol (OR: 1.14; 95% CI: 1.01-1.30), 17% in subjects with diabetes (OR: 1.17; 95% CI: 1.01-1.36) and 23% in subjects with both dyslipidemia and diabetes (OR: 1.23; 95% CI: 1.05-1.44). Also, the odds of PPD > 3 mm in the group with high total cholesterol (TC) was 16% higher compared to those with normal TC (OR: 1.16; 95% CI: 1.01-1.34). CONCLUSIONS There was an increased odds in periodontal disease in association with high TC, high LDL cholesterol, diabetes and having both dyslipidemia and diabetes. This suggests that high TC, high LDL cholesterol, diabetes and having both dyslipidemia and diabetes might be potential indicators for the presence of periodontal disease.
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Affiliation(s)
- Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit (CRDU), Moradi Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Somaye Salari Sedigh
- Department of Periodontology, Dental School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zeinab Sharifi
- Department of Pediateric Dentistry, Dental School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hamid Hakimi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Microbiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farimah Sardari
- Department of Oral Medicine, Dental School, Non-communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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The etiological consideration of oxidized low-density lipoprotein in periodontitis. J Oral Biosci 2023; 65:19-23. [PMID: 36206991 DOI: 10.1016/j.job.2022.09.006] [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: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Epidemiologically, correlations between periodontal disease activity and CVD/serum lipid-related condition have been reported. Known mediators of these links include triglycerides, oxidized LDL (oxLDL) and inflammatory cytokines such as TNF-α supplied by adipocytes as well as oxidative degeneration products of these lipids. In this review, we focused on oxidized LDL and considered the relationship between periodontal disease and systemic conditions. HIGHLIGHT The degree of oxidation in the periodontal pocket can be evaluated by analyzing the Gingival Cervicular Fluid (GCF), which can be easily collected with paperpoint. The oxLDL/LDL ratio in GCF has been shown to be 17 times as high as that in blood, and IL-8 and IL-1β were also abundantly found in GCF. Periodontal treatment significantly lowers oxLDL levels in not only GCF but also plasma. In addition, there has been growing body of evidence that periodontal infections by periodontopathic bacteria affect arteriosclerosis. On the other hands, neutrophil extracellular traps (NETs), a form of innate immune responses, reportedly play a role as a defense mechanism in the periodontal pockets. However, the regulatory mechanism of NETs in periodontal pocket is still unknown. Recently, NETs induced by oxidized cholesterol have been reported to be involved in inflammatory damage to vascular endothelial cells. CONCLUSION Further understanding of the newly discovered roles of oxLDL in the defense and destruction of periodontal tissues are anticipated.
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Kosho MXF, Verhelst ARE, Teeuw WJ, Gerdes VEA, Loos BG. Cardiovascular risk assessment in periodontitis patients and controls using the European Systematic COronary Risk Evaluation (SCORE) model. A pilot study. Front Physiol 2023; 13:1072215. [PMID: 36794206 PMCID: PMC9923497 DOI: 10.3389/fphys.2022.1072215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/20/2022] [Indexed: 01/31/2023] Open
Abstract
Aim: To investigate the use of the European SCORE model in a dental setting by exploring the frequency of a 'high' and 'very high' 10-year CVD mortality risk in patients with and without periodontitis. The secondary aim was to investigate the association of SCORE with various periodontitis parameters adjusting for remaining potential confounders. Material and methods: In this study, we recruited periodontitis patients and non-periodontitis controls, all aged ≥40 years. We determined the 10-year CVD mortality risk per individual with the European Systematic Coronary Risk Evaluation (SCORE) model by using certain patient characteristics and biochemical analyses from blood by finger stick sampling. Results: In total, 105 periodontitis patients (61 localized, 44 generalized stage III/IV) and 88 non-periodontitis controls were included (mean age: 54.4 years). The frequency of a 'high' and 'very high' 10-year CVD mortality risk was 43.8% in all periodontitis patients and 30.7% in controls (p = .061). In total, 29.5% generalized periodontitis patients had a 'very high' 10-year CVD mortality risk, compared to 16.4% in localized periodontitis patients and 9.1% in controls (p = .003). After adjustment for potential confounders, the total periodontitis group (OR 3.31; 95% CI 1.35-8.13), generalized periodontitis group (OR 5.32; 95% CI 1.90-14.90), lower number of teeth (OR .83; 95% CI .73-1.00) and higher number of teeth with radiographic bone loss ≥33% (OR 1.06; 95% CI 1.00-1.12) were associated with a "very high" SCORE category. In addition, various biochemical risk markers for CVD were more frequently elevated in periodontitis compared to controls (e.g., total cholesterol, triglycerides, C-reactive protein). Conclusion: The periodontitis group as well as the control group had a sizable frequency of a 'high' and 'very high' 10-year CVD mortality risk. The presence and extent of periodontitis, lower number of teeth and higher number of teeth with bone loss ≥33% are significant risk indicators for a 'very high' 10-year CVD mortality risk. Therefore, SCORE in a dental setting can be a very useful tool to employ for primary and secondary prevention of CVD, especially among the dental attenders who have periodontitis.
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Affiliation(s)
- Madeline X. F. Kosho
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands,*Correspondence: Madeline X. F. Kosho,
| | - Alexander R. E. Verhelst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Center (AUMC), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Yang T, Tang S, Kuo S, Freitas D, Edwards M, Wang H, Sun Y, Yan X. Lipid Mass Tags via Aziridination for Probing Unsaturated Lipid Isomers and Accurate Relative Quantification**. Angew Chem Int Ed Engl 2022; 61:e202207098. [DOI: 10.1002/anie.202207098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Tingyuan Yang
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
| | - Shuli Tang
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
| | - Syuan‐Ting Kuo
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
| | - Dallas Freitas
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
| | - Madison Edwards
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
| | - Hongying Wang
- Department of Nutrition Texas A&M University 373 Olsen Blvd. College Station TX 77845 USA
| | - Yuxiang Sun
- Department of Nutrition Texas A&M University 373 Olsen Blvd. College Station TX 77845 USA
| | - Xin Yan
- Department of Chemistry Texas A&M University 580 Ross St. College Station TX 77843 USA
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Yang T, Tang S, Kuo ST, Freitas D, Edwards M, Wang H, Sun Y, Yan X. Lipid Mass Tags via Aziridination for Probing Unsaturated Lipid Isomers and Accurate Relative Quantification. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202207098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Shuli Tang
- Texas A&M University Chemistry UNITED STATES
| | | | | | | | - Hongying Wang
- Texas A&M University Department of Nutrition UNITED STATES
| | - Yuxiang Sun
- Texas A&M University Department of Nutrition UNITED STATES
| | - Xin Yan
- Texas A&M University Chemistry 580 Ross St 77840 College Station UNITED STATES
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Gomes-Filho IS, Oliveira MT, Cruz SSD, Cerqueira EDMM, Trindade SC, Vieira GO, Couto Souza PH, Adan LFF, Hintz AM, Passos-Soares JDS, Scannapieco FA, Loomer PM, Seymour GJ, Figueiredo ACMG. Periodontitis is a factor associated with dyslipidemia. Oral Dis 2022; 28:813-823. [PMID: 33486821 DOI: 10.1111/odi.13779] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/31/2020] [Accepted: 01/13/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate the association between the severity of periodontitis (exposure) and dyslipidemia (outcome). METHODS This was a cross-sectional study of users of public health services. Periodontitis was defined using the Center for Disease Prevention and Control and the American Academy of Periodontology criteria. Lipid evaluation used data on systemic biomarkers. Dyslipidemia diagnosis was based on the Guidelines of total cardiovascular risk of the World Health Organization. Weight, height, waist circumference, and blood pressure were measured, and socioeconomic-demographic, lifestyle behavior factors, general and oral health conditions of the participants were collected. Hierarchical and logistic regression analyzes were used to determine the association between the exposures and the outcome. Odds Ratios, unadjusted and adjusted, and 95% confidence intervals were estimated. RESULTS Of 1,011 individuals examined, 75.17% had dyslipidemia, and 84.17% had periodontitis, 0.2% with mild, 48.56% moderate, and 35.41% severe disease. The association between periodontitis and dyslipidemia was maintained through hierarchical analysis and in the multiple regression modeling, showing that the occurrences of dyslipidemia in the group with periodontitis, and its moderate and severe levels, were, respectively, 14%, 30%, and 16% higher compared with those without periodontitis. CONCLUSIONS The results showed a positive association between moderate and severe periodontitis and dyslipidemia.
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Affiliation(s)
| | | | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Bahia, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | | | | | | | | | | | | | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Bahia, Brazil
- Department of Preventive Dentistry, Federal University of Bahia, Bahia, Brazil
| | | | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Sanikop MV, Aspalli S, G N, Jabeen RN, Aspalli N, Babu CH. Assessment of Serum Parameters in Stable Coronary Artery Disease Patients in Correlation with Healthy and Chronic Periodontitis Patients. Contemp Clin Dent 2022; 13:50-55. [PMID: 35466295 PMCID: PMC9030312 DOI: 10.4103/ccd.ccd_659_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/29/2020] [Accepted: 12/22/2020] [Indexed: 11/15/2022] Open
Abstract
Background Periodontitis is a chronic inflammatory disease and has been strongly associated with elevation of systemic markers such as C-reactive protein (CRP), fibrinogen (FIB), and lipid profile, which have also been significantly associated with coronary heart disease (CHD). Hence, there is a need to assess the possible association between chronic periodontitis and coronary artery disease. Materials and Methods A study included 100 subjects divided into four groups. Group I: stable coronary artery disease with chronic periodontitis, Group II: stable coronary artery disease without chronic periodontitis, Group III: chronic periodontitis without coronary artery disease, and Group IV: healthy controls. Gingival index, Russell's periodontal index, pocket depth, and clinical attachment level were recorded. Venous blood was collected from the patients, and serum fibrinogen, CRP, and lipid profile levels were estimated. Results The intragroup comparison of biochemical and periodontal parameters showed statistically significant results with P < 0.05. The intergroup comparison of serum FIB, total cholesterol, high density lipoprotein, low density lipoprotein, and clinical attachment level showed statistical significant results (P = 0.000, P = 0.000, P = 0.001, P = 0.025, and P = 0.000, respectively) between Groups I and III. Conclusion The results of the study indicate that there might a possible correlation between coronary artery disease and chronic periodontitis, but periodontitis-cardiovascular link is complex and difficult to define though there is sufficient evidence for their association. Leakage of pro-inflammatory cytokines from the ulcerated periodontium causes the production of acute-phase proteins by the liver. To prove the relationship, further studies should be considered making use of other markers of inflammation with prospective randomized controlled studies involving large population.
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Affiliation(s)
- Mukta V Sanikop
- Department of Periodontics and Oral Implantology, Meghna Institute of Dental Sciences, Nizamabad, Telangana, India
| | - Shivanand Aspalli
- Department of Periodontics and Oral Implantology, A.M.E's Dental College & Hospital, Raichur, Karnataka, India
| | - Nagappa G
- Department of Periodontics and Oral Implantology, A.M.E's Dental College & Hospital, Raichur, Karnataka, India
| | | | - Nagaveni Aspalli
- Department of Conservative Dentistry and Endodontics, HKDET's Dental College and Hospital, Humnabad, Karnataka, India
| | - C. Hemachandra Babu
- Department of Periodontics and Oral Implantology, Meghna Institute of Dental Sciences, Nizamabad, Telangana, India
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de Carvalho RDP, Côrrea Viana Casarin R, Lima POD, Cogo-Müller K. STATINSWITH POTENTIAL TO CONTROL PERIODONTITIS: FROM BIOLOGICAL MECHANISMS TO CLINICAL STUDIES. J Oral Biosci 2021; 63:232-244. [PMID: 34146687 DOI: 10.1016/j.job.2021.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Statins are widely used for the treatment of hyperlipidemia. However, these drugs have pleiotropic effects that can be promising for the prevention and treatment of oral diseases, such as periodontitis. HIGHLIGHT This review aimed to identify preclinical, observational, and clinical studies that evaluate the effects and biological mechanisms of statins on oral cells and tissues and those using these drugs to treat periodontitis. A LITERATURE SURVEY HAS BEEN CONDUCTED IN PUBMED USING COMBINATIONS OF THE UNITERMS: "statins," "dentistry," "periodontal disease," and "periodontal treatment." In vitro findings showed positive statin results in cell lines related to alveolar bone metabolism by altering the signaling pathway Osteoprotegerin/Receptor Activator of Nuclear Factor Kappa B/Receptor Activator of Nuclear Factor Kappa B Ligand (OPG/RANK/RANKL), stimulating the production of alkaline phosphatase and osteocalcin, and reducing the production of matrix metalloproteinases (MMPs). Animal studies have shown a reduction in alveolar bone loss and osteoclastic activity, in addition to a reduction in inflammatory markers, such as IL-1, IL-6, and TNF-α, when statins were used prophylactically. Clinical trials showed a positive impact on clinical parameters, leading to a higher reduction in probing depth and gain in clinical attachment when a local statin was adjunctively associated with mechanical therapy. CONCLUSION Statins were shown to be promising for regenerating and stimulating bone activity, with great potential for treating chronic periodontitis. However, further studies are required to confirm its effectiveness.
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Affiliation(s)
| | | | | | - Karina Cogo-Müller
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
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Brasil SC, Santos RMM, Fernandes A, Lima RS, Costa CAS, Pinto KMMDC, Pires FR, Santos MDD, Siqueira JF, Armada L. Influence of a High-fat Diet in the Progression of Apical Periodontitis. J Endod 2020; 47:600-605. [PMID: 33387552 DOI: 10.1016/j.joen.2020.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study evaluated the effects of a high-fat diet (HFD) on the progression of apical periodontitis (AP) in rats. METHODS Eight-week old Wistar rats (N = 24) were included in this study. Half of the animals received an HFD and the other half a control diet (CD). AP lesions were induced 8 weeks later by creating pulp exposure of the mandibular left first molars. The animal's body mass was verified on a weekly basis. After 21 and 40 days, the animals were sacrificed. Blood was collected for biochemical tests, and the liver was removed for hepatic triglycerides analysis. The left hemimandibles were removed, radiographed, and then prepared for histologic evaluation. The right hemimandibles (region near molars) were removed for bone mineral density analysis by dual-energy X-ray absorptiometry. RESULTS Radiographs showed that AP lesions were significantly larger in the HFD group compared with the CD group (P < .05). Histologic analysis confirmed that the AP lesions were larger and revealed a more severe inflammatory infiltrate in the HFD group. Bone mineral density was reduced in the HFD group compared with the CD groups (P < .05). The HFD resulted in a significant increase in body mass (P < .05), liver mass (P < .05), relative liver mass (P < .05), and hepatic triglycerides (P < .05). The levels of triglycerides and very-low-density lipoprotein were significantly higher in the 40-day HFD group compared with the 21-day HFD and 21- and 40-day CD groups (P < .05). CONCLUSIONS Findings suggest that an HFD can influence the progression and severity of AP.
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Affiliation(s)
- Sabrina C Brasil
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rachel M M Santos
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminens Federal University, Niterói, Rio de Janeiro, Brazil
| | - Arlete Fernandes
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminens Federal University, Niterói, Rio de Janeiro, Brazil
| | - Renan S Lima
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminens Federal University, Niterói, Rio de Janeiro, Brazil
| | - Carlos Alberto S Costa
- Department of Physiology and Pharmacology, Biomedical Institute, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | | | - Fábio R Pires
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia de Deus Santos
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Armada
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
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13
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Ustaoğlu G, Erdal E. Relationship between risk markers for cardiovascular disease and peri-implant diseases. Int J Implant Dent 2020; 6:73. [PMID: 33236168 PMCID: PMC7686405 DOI: 10.1186/s40729-020-00273-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this paper is to explore the serum biochemical parameters also known as risk markers for cardiovascular system, in individuals who have received dental implant treatment, and to reveal risk factors for peri-implant diseases. Methods The study included 58 subjects with peri-implantitis, 49 subjects with peri-implant mucositis, and 49 healthy subjects. All the subjects were assessed in terms of both peri-implant clinical parameters—probing depth (PD), bleeding on probing (BOP), the type of prosthesis, gingival index (GI), keratinized mucosa width (KMW), and plaque index (PI)—and serum biochemical parameters (e.g., LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, vitamin D, uric acid, white blood cell (WBC), neutrophil, hemoglobin (Hb), and platelet counts). Results KMW was the lowest in the peri-implantitis group. Compared with the other groups, the peri-implantitis group showed significantly higher levels of triglyceride, uric acid, and WBC. The peri-implantitis group had the lowest level of vitamin D. Triglyceride and uric acid levels had positive correlations with peri-implant clinical parameters. Conclusion High levels of triglyceride and uric acid may pose a risk for both peri-implant diseases and cardiovascular diseases. Prior to dental implant surgery, patients’ serum biochemical parameters should be checked.
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Affiliation(s)
- Gülbahar Ustaoğlu
- Dentistry Faculty, Department of Periodontology, Bolu Abant İzzet Baysal University, 14300, Bolu, Turkey.
| | - Emrah Erdal
- Medical Faculty, Department of Cardiology, Bolu Abant İzzet Baysal University, Bolu, Turkey
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14
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Song TJ, Kim JW, Kim J. Oral health and changes in lipid profile: A nationwide cohort study. J Clin Periodontol 2020; 47:1437-1445. [PMID: 32996160 DOI: 10.1111/jcpe.13373] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/22/2020] [Indexed: 12/22/2022]
Abstract
AIM We aimed to investigate the association of periodontitis and oral hygiene indicators with changes in blood lipid parameters in a nationwide, population-based cohort in a longitudinal setting. MATERIALS AND METHODS We included nationwide health screening program participants who underwent oral health examination in 2009-2010 and follow-up examinations for lipid profile without exposure to lipid-lowering agents. RESULTS During the 5.19-year median follow-up, 65,078 individuals (mean age at baseline examination: 55.41 ± 7.30 years) underwent 286,218 health examinations. The prevalence of periodontitis was 39%. In the multivariate mixed model analysis, periodontitis and tooth loss were associated with decreased high-density lipoprotein cholesterol levels (β = -0.0066 mmol/L, standard error = 0.0026, p = .013) and increased triglyceride levels (β=0.0307, mmol/L, standard error = 0.0049, p < .001), respectively. Compared with tooth brushing ≤1 time/day, tooth brushing ≥3 times/day was associated with increased high-density lipoprotein cholesterol levels (β = 0.0176 mmol/L, standard error = 0.0052, p = .006) and decreased triglyceride levels (β = -0.0285 mmol/L, standard error = 0.0090, p = .001). CONCLUSIONS Periodontitis and tooth loss may be attenuating factors for blood high-density lipoprotein cholesterol and triglyceride levels, respectively. Frequent tooth brushing may improve dyslipidaemia, particularly blood high-density lipoprotein cholesterol and triglyceride levels. Oral hygiene improvement may reduce the risk of dyslipidaemia.
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Affiliation(s)
- Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jin-Woo Kim
- Department of Oral Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jinkwon Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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15
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Xu J, Duan X. Association between periodontitis and hyperlipidaemia: A systematic review and meta-analysis. Clin Exp Pharmacol Physiol 2020; 47:1861-1873. [PMID: 32623762 DOI: 10.1111/1440-1681.13372] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022]
Abstract
To date, it has been reported that periodontitis (PD) may be associated with hyperlipidaemia in clinical practice. However, data on this issue are inconsistent and controversial. The purpose of this meta-analysis was to identify the association between PD and hyperlipidaemia. Here, 21 case-control and eight cross-sectional studies on PD and hyperlipidaemia were included in the random-effects meta-analysis, involving 2060 patients with PD and 2776 healthy controls (HC). Meta-analysis showed that serum triglyceride (TG) and total cholesterol (TC) levels in the PD group were significantly higher than those in the HC group [TG, weighted mean difference (WMD) = 19.4 mg/dL, 95% confidence interval (CI) 13.3-25.5 mg/dL, P = .000; TC, WMD = 15.4 mg/dL, 95%CI 10.2-20.6 mg/dL, P = .000]. Subgroup analysis stratified by study design validated that PD was associated with higher serum TG and TC levels. In addition, compared with the HC group, serum low-density lipoprotein (LDL) in patients with PD showed a markedly higher level (WMD = 11.7 mg/dL, 95% CI 8.3-15.0 mg/dL, P = .000), whereas serum high-density lipoprotein (HDL) in PD group exhibited a significantly lower level (WMD = -4.5 mg/dL, 95%CI -6.4 - -2.7 mg/dL, P = .000). Finally, no significant publication bias was observed and sensitivity analysis also confirmed the stability of our meta-analyses. In conclusion, the accumulated evidence suggests that PD is indeed associated with hyperlipidaemia in humans. More interventions for lowering lipids or increasing HDL may benefit the patients with PD, which need be further investigated in prospective clinical trials.
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Affiliation(s)
- Jing Xu
- Department of Periodontology, Jinan Stomatological Hospital, Jinan, China
| | - Xiaoqi Duan
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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16
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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17
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Gharbi A, Hamila A, Bouguezzi A, Dandana A, Ferchichi S, Chandad F, Guezguez L, Miled A. Biochemical parameters and oxidative stress markers in Tunisian patients with periodontal disease. BMC Oral Health 2019; 19:225. [PMID: 31640685 PMCID: PMC6805394 DOI: 10.1186/s12903-019-0912-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 09/17/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Oxidative stress is involved in many diseases including diabetes and cancer. Numbers of studies have suggested its involvement in the pathogenesis of periodontal diseases. The aim of this study was to evaluate the levels of biochemical parameters and oxidative stress markers in plasma of healthy and chronic periodontitis patients. METHODS One hundred thirty subjects were divided into two groups; patients (mean age = 42 ± 13.6 y.o) and control (mean age = 44.8 ± 12.6 y.o). Patients and healthy subjects were free from any infection, coronary or heart disease, diabetes or liver failure. Total cholesterol, LDLc, HDLc, Triglycerides (TG), creatinine, uric acid (UA), glucose and urea levels as well as the activities of enzymatic antioxidants such as catalase, glutathione reductase (GR) and total antioxidant capacity (TAOC), were measured in plasma samples using colorimetric assays. Statistical differences between groups were determined by Student's t-test and p ≤ 0.05 was considered as significant. RESULTS Periodontitis patients exhibited significant decrease in the activities of catalase, TAOC, GR and TG, cholesterol, LDLc, glucose, HDLc, uric acid levels in plasma samples in comparison with healthy subjects. However, no statistically significant differences in the levels of creatinine and urea were observed between the two groups. CONCLUSION The reduction of plasma antioxidant activities (Catalase, TAOC, GR) may have a role in the pathogenesis of periodontal diseases. Our findings suggest a decrease in the host capacity to control the damage caused by oxidative stress. Therefore, therapeutic strategies, aiming at modulating the oxidative stress could be considered as potential tools for the prevention or treatment of periodontal diseases and their potential systemic effects on the general health.
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Affiliation(s)
- Ahmed Gharbi
- Biochemistry Laboratory CHU Farhat Hached, Sousse, Tunisia.
- Biological and Clinical Dento-facial Approach Laboratory LR12ES10, Monastir, Tunisia.
| | - Ali Hamila
- Laboratory of Physiology, Faculty of Medicine Sousse, Sousse, Tunisia
| | - Adel Bouguezzi
- Department of Oral Medicine and Surgery, School of Dental Medicine, University of Monastir, Sousse, Tunisia
| | - Azza Dandana
- Biochemistry Laboratory CHU Farhat Hached, Sousse, Tunisia
| | | | - Fatiha Chandad
- Oral Ecology Research Group, Faculty of Dental Medicine, Laval University, Sousse, Tunisia
| | - Leila Guezguez
- Department of Periodontology, School of Dental Medicine, University of Monastir, Sousse, Tunisia
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18
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The association between periodontitis and dyslipidemia according to smoking and harmful alcohol use in a representative sample of Korean adults. Clin Oral Investig 2019; 24:937-944. [DOI: 10.1007/s00784-019-02989-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/27/2019] [Indexed: 01/17/2023]
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19
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Konkel JE, O'Boyle C, Krishnan S. Distal Consequences of Oral Inflammation. Front Immunol 2019; 10:1403. [PMID: 31293577 PMCID: PMC6603141 DOI: 10.3389/fimmu.2019.01403] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 06/03/2019] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is an incredibly prevalent chronic inflammatory disease, which results in the destruction of tooth supporting structures. However, in addition to causing tooth and alveolar bone loss, this oral inflammatory disease has been shown to contribute to disease states and inflammatory pathology at sites distant from the oral cavity. Epidemiological and experimental studies have linked periodontitis to the development and/or exacerbation of a plethora of other chronic diseases ranging from rheumatoid arthritis to Alzheimer's disease. Such studies highlight how the inflammatory status of the oral cavity can have a profound impact on systemic health. In this review we discuss the disease states impacted by periodontitis and explore potential mechanisms whereby oral inflammation could promote loss of homeostasis at distant sites.
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Affiliation(s)
- Joanne E. Konkel
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, United Kingdom
| | - Conor O'Boyle
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Siddharth Krishnan
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, United Kingdom
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Yokoji-Takeuchi M, Tabeta K, Takahashi N, Arimatsu K, Miyazawa H, Matsuda-Matsukawa Y, Sato K, Yamada M, Yamazaki K. Indirect regulation of PCSK9 gene in inflammatory response by Porphyromonas gingivalis infection. Heliyon 2019; 5:e01111. [PMID: 30671557 PMCID: PMC6328067 DOI: 10.1016/j.heliyon.2018.e01111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/23/2018] [Accepted: 12/27/2018] [Indexed: 11/12/2022] Open
Abstract
Pro-protein convertase subtilisin/kexin type 9 (PCSK9), a secreted serine protease, regulates serum low-density lipoprotein (LDL) cholesterol levels by targeting the degradation of LDL receptor (LDLR) in the liver. Although previous reports describe elevated levels of PCSK9 in patients with periodontitis, the mechanisms that trigger this increase in serum PCSK9 levels and induce the related inflammatory response remain unclear. In an unc93b1-deficient mouse of Porphyromonas gingivalis infection, nucleic acid antigen recognition via Toll-like receptors was found to promote PCSK9 production, suggesting an indirect role for tumor necrosis factor-α as an inducer of PCSK9 in contrast to that reported in previous studies. Furthermore, PCSK9 production was independent of the TIR domain-containing adapter-inducing interferon-β-dependent signaling pathway. These results indicate that changes in LDLR expression precede an increase in the serum PCSK9 level in the context of an infectious disease such as periodontitis.
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Affiliation(s)
- Mai Yokoji-Takeuchi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Tabeta
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Takahashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kei Arimatsu
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruna Miyazawa
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Matsuda-Matsukawa
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keisuke Sato
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Miki Yamada
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Jain A, Gupta J, Bansal D, Sood S, Gupta S, Jain A. Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis: A systematic review and meta-analysis. J Indian Soc Periodontol 2019; 23:303-310. [PMID: 31367125 PMCID: PMC6628769 DOI: 10.4103/jisp.jisp_417_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with chronic periodontitis (CP). This meta-analysis is aimed to explore the effect of NSPT, exclusively scaling and root planing (SRP) as monotherapy on glycemic control and periodontal parameters in patients of T2DM with CP. Materials and Methods: Two databases, MEDLINE and EMBASE, were searched from June 2006 to June 2016. Initially, 464 potentially relevant studies were evaluated. Randomized controlled trials with duration of ≥3 months, based on the treatment group managed with SRP without any supportive use of local drug delivery or systemic antibiotics, while the control group received no periodontal therapy, were selected. This resulted in six appropriate articles with a total of 812 patients of T2DM with CP. Alteration in glycated hemoglobin (HbA1c) was the primary outcome measure, whereas the changes in clinical attachment level (CAL) and probing pocket depth (PPD) were the secondary outcome measures. Results: SRP treatment resulted in a decrease in HbA1c by 0.26% (P = 0.17) at 3–4 months compared to the control group. Further, on subgroup analysis, SRP therapy revealed a decrease in PPD and CAL at 3–4 months, though statistically insignificant. Conclusion: SRP treatment leads to modest improvement in glycemic status and periodontal parameters in T2DM patients with CP at 3–4 months.
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Affiliation(s)
- Akanksha Jain
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Punjab, India
| | - Jyoti Gupta
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Punjab, India
| | - Dipika Bansal
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India
| | - Shaveta Sood
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Punjab, India
| | - Shipra Gupta
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Punjab, India
| | - Ashish Jain
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Punjab, India
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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23
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Pham T. The association between periodontal disease severity and metabolic syndrome in Vietnamese patients. Int J Dent Hyg 2018; 16:484-491. [PMID: 29900658 DOI: 10.1111/idh.12350] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the association between periodontal disease severity and metabolic syndrome (MetS) in a group of Vietnamese patients. METHODS A total of 412 participants (114 males, 298 females, average age 57.8 ± 5.7 years) including 206 patients with MetS and 206 participants without MetS were selected for this study. Information on sociodemographic characteristics, dental behaviours and smoking status was collected from a self-administrated questionnaire. Periodontal status including plaque index (PI), gingival index (GI) pocket depth (PD) and clinical attachment level (CAL) was recorded. Logistic regression analyses were used to evaluate the association between severity of periodontal disease and MetS with adjustments for related confounders. RESULTS The prevalence of moderate and severe periodontitis assessed by GI, PD and CAL was all significantly higher in the MetS group than in the control group and was significantly increased by a number of MetS components. Logistic regression, adjusted for confounders, showed that people with mean PI ≥2.51 or GI ≥1.01 or number of teeth with bleeding on probing of ≥20 teeth or PD ≥3.66 or CAL ≥3.66 showed a significant association with greater OR for MetS compared to counterparts (P < .05). The OR for MetS was 4.06 (95% CI 2.11-7.84) in severe periodontitis patients compared to non-periodontitis participants (P < .001). CONCLUSION Much severe and extensive periodontal disease was found in MetS participants and increased with number of MetS components. Participants with higher periodontal parameters had a higher risk of MetS.
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Affiliation(s)
- Tav Pham
- Department of Periodontology, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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Kim HJ, Cha GS, Kim HJ, Kwon EY, Lee JY, Choi J, Joo JY. Porphyromonas gingivalis accelerates atherosclerosis through oxidation of high-density lipoprotein. J Periodontal Implant Sci 2018. [PMID: 29535891 PMCID: PMC5841268 DOI: 10.5051/jpis.2018.48.1.60] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate the ability of Porphyromonas gingivalis (P. gingivalis) to induce oxidation of high-density lipoprotein (HDL) and to determine whether the oxidized HDL induced by P. gingivalis exhibited altered antiatherogenic function or became proatherogenic. Methods P. gingivalis and THP-1 monocytes were cultured, and the extent of HDL oxidation induced by P. gingivalis was evaluated by a thiobarbituric acid-reactive substances (TBARS) assay. To evaluate the altered antiatherogenic and proatherogenic properties of P. gingivalis-treated HDL, lipid oxidation was quantified by the TBARS assay, and tumor necrosis factor alpha (TNF-α) levels and the gelatinolytic activity of matrix metalloproteinase (MMP)-9 were also measured. After incubating macrophages with HDL and P. gingivalis, Oil Red O staining was performed to examine foam cells. Results P. gingivalis induced HDL oxidation. The HDL treated by P. gingivalis did not reduce lipid oxidation and may have enhanced the formation of MMP-9 and TNF-α. P. gingivalis-treated macrophages exhibited more lipid aggregates than untreated macrophages. Conclusions P. gingivalis induced HDL oxidation, impairing the atheroprotective function of HDL and making it proatherogenic by eliciting a proinflammatory response through its interaction with monocytes/macrophages.
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Affiliation(s)
- Hyun-Joo Kim
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Gil Sun Cha
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Hyung-Joon Kim
- Department of Oral Physiology, Institute of Translational Dental Sciences, Pusan National University School of Dentistry, Yangsan, Korea
| | - Eun-Young Kwon
- Dental Clinic Center, Pusan National University Hospital, Busan, Korea
| | - Ju-Youn Lee
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Jeomil Choi
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Ji-Young Joo
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.,Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
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Lutfioğlu M, Aydoğdu A, Atabay VE, Sakallioğlu EE, Avci B. Gingival crevicular fluid oxidative stress level in patients with periodontal disease and hyperlipidemia. Braz Oral Res 2017; 31:e110. [DOI: 10.1590/1807-3107bor-2017.vol31.0110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/23/2017] [Indexed: 11/22/2022] Open
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Vadakkekuttical RJ, Kaushik PC, Mammen J, George JM. Does periodontal inflammation affect glycosylated haemoglobin level in otherwise systemically healthy individuals? - A hospital based study. SINGAPORE DENTAL JOURNAL 2017; 38:55-61. [PMID: 29229075 DOI: 10.1016/j.sdj.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 02/04/2017] [Accepted: 08/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Microbial biofilm and host susceptibility play an important role in the initiation and progression of periodontitis. Periodontitis is considered the sixth complication of diabetes mellitus and a bidirectional relationship exists between diabetes and periodontitis. This cross-sectional observational study was undertaken to evaluate the glycosylated haemoglobin (HbA1c) level in chronic periodontitis. METHODS The study involved 100 subjects. The case group consisted of 50 subjects with chronic periodontitis and the control group consisted of 50 periodontally healthy subjects. Periodontal parameters including plaque index, oral hygiene index, modified gingival index, probing pocket depth, and clinical attachment level were measured and recorded. Systemic parameters like Body Mass Index (BMI), Waist Hip Ratio (WHR), C- Reactive Protein (CRP), Glycosylated haemoglobin (HbA1c), lipid profile, fasting blood sugar, post prandial blood sugar and serum albumin were assessed in all subjects. RESULTS The mean HbA1C for the case group was 6.27±1.5 and for the control was 5.36±0.4 and the difference was statistically significant (p = 0.001). The mean FBS, PPBS, LDL, WHR, CRP was statistically significant between groups (p ≤0.05). Periodontal parameters like PI, OHI, MGI, PD and CAL were significantly higher in the case group than the control group (p value ≤ 0.05). The multivariate linear regression model with the dependent variable HbA1c showed chronic periodontitis was significantly associated with HbA1c level. CONCLUSION In chronic periodontitis patients (otherwise systemically healthy) the presence of periodontal inflammation affected the glycosylated haemoglobin level and they were in prediabetes stage. Therefore, it is plausible that the prediabetes stage might be reduced via appropriate periodontal therapy.
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Affiliation(s)
- Rosamma Joseph Vadakkekuttical
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut, Kerala 673008, India.
| | - Priyanka Chand Kaushik
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut, Kerala 673008, India
| | - Jerry Mammen
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut, Kerala 673008, India
| | - Joseraj Manaloor George
- Department of Biochemistry, Government Medical College (Affiliated to Kerala University of Health Sciences), Calicut, Kerala 673008, India
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Nepomuceno R, Pigossi SC, Finoti LS, Orrico SRP, Cirelli JA, Barros SP, Offenbacher S, Scarel-Caminaga RM. Serum lipid levels in patients with periodontal disease: A meta-analysis and meta-regression. J Clin Periodontol 2017; 44:1192-1207. [DOI: 10.1111/jcpe.12792] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Rafael Nepomuceno
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Suzane C. Pigossi
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Livia S. Finoti
- Department of Periodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA USA
| | - Silvana R. P. Orrico
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Joni A. Cirelli
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Silvana P. Barros
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Steven Offenbacher
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Raquel M. Scarel-Caminaga
- Department of Morphology; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
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Sibyl S, Bennadi D, Kshetrimayum N, Manjunath M. Correlations between gingival crevicular blood glucose and capillary blood glucose: A preliminary report. J Lab Physicians 2017; 9:260-263. [PMID: 28966487 PMCID: PMC5607754 DOI: 10.4103/jlp.jlp_141_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Oral health plays an important role for screening of many systemic diseases. Hence, dentists play an important role in screening for systemic diseases as well. Early diagnosis of any systemic diseases can prevent long-term complications. Diabetic is one of the common chronic diseases. Hence, the study had been undertaken to evaluate whether gingival crevicular blood (GCB) can be used to screen for diabetes during routine oral health checkups. MATERIALS AND METHODS This analytical study included thirty participants who visited the Department of Periodontics, who fulfilled inclusion criteria and were willing to participate. Blood samples were collected by finger stick method and periodontal probing. The glucose levels of both the samples were estimated using glucometer and correlated the levels from both the methods. RESULTS Correlation between capillary finger stick blood glucose and GCB glucose was high (0.97) and was significant at 0.01 level. CONCLUSION Blood oozing during routine periodontal examination can be used for diabetes mellitus screening in dental office.
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Affiliation(s)
- Siluvai Sibyl
- Department of Public Health Dentistry, SRM Kattankulathur Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Darshana Bennadi
- Department of Public Health Dentistry, Sree Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
| | - Nandita Kshetrimayum
- Department of Public Health Dentistry, Regional Institute of Medical sciences, Dental College, Lamphelpat, Imphal, West Manipur, India
| | - Maurya Manjunath
- Department of Public Health Dentistry, JSS Dental College and Hospital, Mysore, Karnataka, India
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Lee S, Im A, Burm E, Ha M. Association Between Periodontitis With Blood Lipid Levels in Korean Population. J Periodontol 2017; 89:28-35. [DOI: 10.1902/jop.2017.170111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/20/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Seyoung Lee
- Department of Public Health, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Aejung Im
- Department of Public Health, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Eunae Burm
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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Lianhui Y, Meifei L, Zhongyue H, Yunzhi F. [Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:419-426. [PMID: 28853511 PMCID: PMC7030217 DOI: 10.7518/hxkq.2017.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 05/10/2017] [Indexed: 12/22/2022]
Abstract
Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cholesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.
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Affiliation(s)
- Yang Lianhui
- Dept. of Prosthodontics, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Lian Meifei
- Dept. of Prosthodontics, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Hu Zhongyue
- Dept. of Prosthodontics, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Feng Yunzhi
- Dept. of Prosthodontics, The Second Xiangya Hospital of Central South University, Changsha 410000, China
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Bolla V, Kumari PS, Munnangi SR, Kumar DS, Durgabai Y, Koppolu P. Evaluation of Serum C-reactive Protein Levels in Subjects with Aggressive and Chronic Periodontitis in Comparison with Healthy Controls: A Clinico-biochemical Study. Int J Appl Basic Med Res 2017; 7:121-124. [PMID: 28584744 PMCID: PMC5441260 DOI: 10.4103/2229-516x.205814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: Evaluation and comparison of serum C-reactive protein (CRP) levels in subjects with chronic and aggressive periodontitis. Materials and Methods: Based on the periodontal status, 45 subjects were selected and divided into three groups. Group I – subjects with clinically healthy periodontium, Group II – generalized aggressive periodontitis (GAP), and Group III – chronic periodontitis (CP). Blood samples were collected from subjects for measurement of CRP. Periodontal parameters include plaque index (PI), gingival index, bleeding index (BI), probing pocket depth (PPD), and clinical attachment loss (CAL) were assessed. CRP levels were assessed by means of a commercially available high sensitivity-CRP enzyme immunoassay kit. Results: CRP levels were increased in Group III (6.0671 ± 3.15639 mg/L) and Group II subjects (4.5453 ± 2.88116 mg/L) compared to the Group I (1.0180 ± 0.94069 mg/L). CRP levels showed a positive correlation with all clinical parameters in Group I subjects. BI (r = 0.073), PI (r = 0.120) showed a positive correlation with CRP level in Group II and a positive correlation was also seen for PI (r = 0.492), PPD (r = 0.340), CAL (r = 0.160), and CRP level in Group III subjects. Conclusion: The mean CRP levels were found to be greater in CP compared to GAP subjects, but there was no statistically significant difference.
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Affiliation(s)
- Vijayalakshmi Bolla
- Department of Periodontology, S.V.S. Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - P Santha Kumari
- Department of Periodontology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Surendra Reddy Munnangi
- Department of Pedodontics and Preventive Dentistry, S.V.S. Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - D Sunil Kumar
- Department of Periodontology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Y Durgabai
- Department of Periodontology, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Pradeep Koppolu
- Department of Preventive Dental Sciences, Al-Farabi Colleges, Riyadh, KSA
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Joseph R, Sasikumar M, Mammen J, Joseraj MG, Radhakrishnan C. Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis. World J Diabetes 2017; 8:213-221. [PMID: 28572882 PMCID: PMC5437619 DOI: 10.4239/wjd.v8.i5.213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/22/2017] [Accepted: 03/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis (CHP).
METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters (plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin (HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.
RESULTS Both groups were comparable at baseline. Three months after non surgical periodontal therapy (NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was -0.056 ± 0.10 and -1.66 ± 6.04 respectively, which was significant between case and control group (P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT (P < 0.05).
CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.
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Sayar F, Akhondi N, Fallah S, Moalemnia AA, Cheraghi A. Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status. J Periodontol 2017; 88:457-463. [DOI: 10.1902/jop.2016.160366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ferena Sayar
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
| | - Nasrin Akhondi
- Department of Mathematics, South Tehran Branch, Islamic Azad University
| | | | | | - Azra Cheraghi
- Department of Periodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
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Ameijeira P, Leira Y, Blanco J, Leira R. Periodontal disease as a potential factor of migraine chronification. Med Hypotheses 2017; 102:94-98. [PMID: 28478842 DOI: 10.1016/j.mehy.2017.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/26/2017] [Accepted: 03/11/2017] [Indexed: 01/03/2023]
Abstract
Migraine is a hereditary constitutional base disorder, which is characterized by recurrent episodes of headache pulsatile characteristics associated with photophobia/phonophobia, nausea and/or vomiting. The main complication in migraine is the chronicity of the process, now recognized as a chronic migraine. Although pathogenic mechanisms that may influence the pathophysiology of migraine and its possible chronicity are not fully understood, previous studies have shown in patients with migraine molecular alterations of systemic inflammation, neurogenic inflammation, endothelial dysfunction, innate immunity, dysfunction of matrix proteases and blood-brain barrier. Periodontal disease is an inflammatory lesion caused by bacteria. After the bacterial infection begins, an immune response that will be responsible for individual susceptibility appears. More advanced forms of periodontitis have demonstrated molecular alterations of inflammation, endothelial dysfunction, dysfunction of matrix proteases and innate immunity, similar to those observed in migraine. Furthermore, the main molecular mediators of neurogenic inflammation related to activation of the trigeminovascular system, which are characteristic of migraine, are overexpressed in gingival crevicular fluid and mucosa in patients with periodontal disease. Hypertension, hypercholesterolemia, insulin resistance, stroke or coronary artery disease are comorbidities that periodontal disease and migraine could share. Therefore, several mechanisms and hypotheses could explain the possible association between both diseases. However, epidemiological and molecular studies will be necessary to provide a better understanding of this potential association, which could be implicated in the chronification of migraine.
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Affiliation(s)
- Pablo Ameijeira
- Department of Periodontology, School of Dentistry, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Yago Leira
- Department of Periodontology, School of Dentistry, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Juan Blanco
- Department of Periodontology, School of Dentistry, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rogelio Leira
- Department of Neurology, Headache Unit, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
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Cury EZ, Santos VR, Maciel SDS, Gonçalves TED, Zimmermann GS, Mota RMS, Figueiredo LC, Duarte PM. Lipid parameters in obese and normal weight patients with or without chronic periodontitis. Clin Oral Investig 2017; 22:161-167. [DOI: 10.1007/s00784-017-2095-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/01/2017] [Indexed: 01/10/2023]
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Ishizuka M, Kato R, Moriya Y, Noguchi E, Koide Y, Inoue S, Itabe H, Yamamoto M. Changes in apolipoprotein B and oxidized low-density lipoprotein levels in gingival crevicular fluids as a result of periodontal tissue conditions. J Periodontal Res 2017; 52:594-602. [DOI: 10.1111/jre.12427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 01/09/2023]
Affiliation(s)
- M. Ishizuka
- Department of Periodontology; Showa University School of Dentistry; Tokyo Japan
- Division of Biological Chemistry; Department of Molecular Biology; Showa University School of Pharmacy; Tokyo Japan
| | - R. Kato
- Division of Biological Chemistry; Department of Molecular Biology; Showa University School of Pharmacy; Tokyo Japan
| | - Y. Moriya
- Department of Periodontology; Showa University School of Dentistry; Tokyo Japan
- Division of Biological Chemistry; Department of Molecular Biology; Showa University School of Pharmacy; Tokyo Japan
| | - E. Noguchi
- Department of Periodontology; Showa University School of Dentistry; Tokyo Japan
| | - Y. Koide
- Department of Periodontology; Showa University School of Dentistry; Tokyo Japan
| | - S. Inoue
- Division of General Medicine; Department of Perioperative Medicine; Showa University School of Dentistry; Tokyo Japan
| | - H. Itabe
- Division of Biological Chemistry; Department of Molecular Biology; Showa University School of Pharmacy; Tokyo Japan
| | - M. Yamamoto
- Department of Periodontology; Showa University School of Dentistry; Tokyo Japan
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Thomas B, Prasad RB, Shetty S, Vishakh R. Comparative Evaluation of the Lipid Profile in the Serum of Patients with Type II Diabetes Mellitus and Healthy Individuals with Periodontitis. Contemp Clin Dent 2017; 8:96-101. [PMID: 28566858 PMCID: PMC5426175 DOI: 10.4103/ccd.ccd_1160_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Periodontal disease is an immuno-inflammatory disease that is initiated by the interaction between microbial plaque and the periodontal tissues. The data available on the association of periodontal diseases with the lipid profile are conflicting. Therefore, a need for a study in this area was felt. AIMS To evaluate the lipid profile in the serum of patients with chronic periodontitis and chronic periodontitis with Type II diabetes mellitus (DM) patients and to compare it with healthy controls, to see whether they can serve as potential markers for chronic periodontitis and also to assess whether periodontitis can have systemic effects. SETTINGS AND DESIGN This study is a cross-sectional study. SUBJECTS AND METHODS This cross-sectional study was conducted involving 300 participants in the age group of 30-60 years from October 2010 to May 2015. Five milliliters of venous blood was collected from each of the study participants, from the antecubital vein. Lipid profile was assessed using the ERBA commercially available kit. STATISTICAL ANALYSIS Statistical analysis was carried out using SPSS software version 17. Multigroup comparison was carried out using ANOVA. The honest significant difference Tukey's test was used in conjunction with ANOVA to find means which are significantly different from each other. RESULTS When the lipid profile was estimated, total cholesterol (TC) levels were seen to be significantly higher (P < 0.001) in the DM with periodontitis group. High-density lipoprotein (HDL) levels were seen to be significantly higher (P < 0.001) in the control group. Mean serum low-density lipoprotein (LDL) and very LDL (VLDL) levels were seen to be significantly higher (P < 0.001) in the DM with periodontitis group. The triglyceride (TGL) values were also significantly higher (P < 0.001) in the DM with periodontitis group. The HDL and LDL levels were seen to be nonsignificant between chronic periodontitis and chronic periodontitis with diabetic group. CONCLUSIONS The findings of the study showed that the lipid profile was significantly altered in patients with chronic periodontitis as compared to healthy controls. There was a potentiated difference in the values for TC, VLDL cholesterol, and TGL in patients with chronic periodontitis when compared to patients with Type II DM. HDL cholesterol and LDL cholesterol did not show a significant difference.
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Affiliation(s)
- Biju Thomas
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India
| | - Rajendra B Prasad
- Department of Oral and Maxillofacial Surgery, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India
| | - Sucheta Shetty
- Department of Biochemistry, K S Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
| | - R Vishakh
- Department of Biochemistry, Central Research Laboratory, Nitte University, Mangalore, Karnataka, India
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Shimazaki Y, Saito T, Yonemoto K, Kiyohara Y, Iida M, Yamashita Y. Relationship of Metabolic Syndrome to Periodontal Disease in Japanese Women: The Hisayama Study. J Dent Res 2016; 86:271-5. [PMID: 17314261 DOI: 10.1177/154405910708600314] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Recent studies have suggested that several systemic conditions—such as obesity, hypertension, hyperlipidemia, and diabetes—are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome—abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level—in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6–16.4) and 4.2 (95% confidence interval = 1.2–14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.
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Affiliation(s)
- Y Shimazaki
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, 3-1-1 Maidashi, Fukuoka, Japan.
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Oliveira LS, Lira-Junior R, Figueredo CM, Gomes MB, Fischer RG. Self-Reported Periodontitis and Complications in Type 1 Diabetes Patients: A Brazilian Nationwide Survey. Braz Dent J 2016; 27:599-603. [DOI: 10.1590/0103-6440201601054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 07/15/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to evaluate the possible association between periodontitis and systemic complications in a Brazilian type 1 diabetes population. A multicentre, sectional study was carried out in 28 public clinics located in 20 Brazilian cities. Data from 3,591 patients were obtained (56.0% females, 57.2% Caucasians), with an average age of 21.2 ± 11.7 years and whose mean duration of type 1 diabetes was 9.6 ± 8.1 years. Periodontitis was evaluated through self-report. Odds ratios (OR) and 95% confidence intervals were calculated to evaluate the association between periodontitis and systemic diabetes complications (chronic micro and macrovascular complications and hospitalizations by hyperglycemia and diabetic ketoacidosis). The prevalence of periodontitis was 4.7% (n=170). Periodontitis patients had mean age of 27.4 ± 12.9. This group was older (p<0.001), exhibited longer diabetes duration (p<0.0001) and had elevated total cholesterol (p<0.05), triglycerides (p<0.001) and lower HDL (p<0.05) values than patients without periodontitis. Systolic and diastolic blood pressures were significantly increased in periodontitis patients (p<0.01). Periodontitis patients had increased odds of microvascular complications (2.43 [1.74-3.40]) and of hospitalizations related to hyperglycemia (2.76 [1.72-4.42]) and ketoacidosis (2.72 [1.53-4.80]). In conclusion, periodontitis was associated to systemic complications in Brazilian type 1 diabetes patients.
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Sayar F, Fallah S, Akhondi N, Jamshidi S. Association of serum lipid indices and statin consumption with periodontal status. Oral Dis 2016; 22:775-780. [DOI: 10.1111/odi.12545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 01/10/2023]
Affiliation(s)
- F Sayar
- Department of Periodontics; Tehran Dental Branch; Islamic Azad University; Tehran Iran
| | - S Fallah
- Gastroenterology Department; Milad Hospital; Tehran Iran
| | - N Akhondi
- Department of Mathematics; South Tehran Branch; Islamic Azad University; Tehran Iran
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Li J, Yang H, Meng S, Zhou J, Ding Y. Metabonomic profiles reveal dose-dependent effects of Bu-Shen-Gu-Chi-Wan on the serum in experimental periodontitis of rat model. JOURNAL OF ETHNOPHARMACOLOGY 2016; 193:248-254. [PMID: 27475973 DOI: 10.1016/j.jep.2016.07.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/28/2016] [Accepted: 07/16/2016] [Indexed: 02/05/2023]
Abstract
ETHNO-PHARMACOLOGICAL RELEVANCE Bu-Shen-Gu-Chi-Wan is a Chinese patent medicine for the treatment of chronic periodontitis. It has an anti-inflammatory function in experimental periodontitis and can improve alveolar bone remodeling. AIM OF THE STUDY This study aims to explore the effects of Bu-Shen-Gu-Chi-Wan on serum metabolism in a rat model of periodontitis using 1H nuclear magnetic resonance (1H NMR) based metabonomics. MATERIALS AND METHODS The model of experimental periodontitis in a rat was established by steel wire ligation, plus a high glucose diet and Porphyromonas gingivalis inoculation. When the models had been established, 6-week-old Sprague-Dawley female rats (n=31) were divided into 5 groups: high dose group (Group H), medium dose group (Group M), low dose group (Group L), periodontitis group (Group P) and healthy control group (Group N). Rats in Group H, M and L were given the Bu-Shen-Gu-Chi-Wan solution (0.8, 2 and 4g/kg of body weight) daily for 60 days. Rats in Group P and N were administered normal saline (10ml/kg of body weight) in the same period. All rats were sacrificed at the end of the study and serum samples were collected. The metabolites in the serum were analyzed using 1H NMR in conjunction with principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). RESULTS The metabonomic profiles of five groups showed the clustering of individual dataset in every group, and the 1st principal component and the 2nd principal component could significantly differentiate the datasets of medium dose or high dose group from other groups. The chemical shift regions at δ 1.22ppm, 1.86ppm, 2.26ppm, 2.34ppm and 2.42ppm showed the most obvious differences among the five groups. The correspondent metabolites were high density lipoprotein, pyruvate/oxaloacetate, arginine and glutamine. CONCLUSION The effects of Bu-Shen-Gu-Chi-Wan on the rat serum metabolites were dose dependent. High density lipoprotein, pyruvate/oxaloacetate, arginine and glutamine may be the serum biomarkers of Bu-Shen-Gu-Chi-Wan.
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Affiliation(s)
- J Li
- Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Implantology, the Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, PR China.
| | - H Yang
- Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - S Meng
- Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - J Zhou
- Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - Y Ding
- Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China; Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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Thapa S, Wei F. Association Between High Serum Total Cholesterol and Periodontitis: National Health and Nutrition Examination Survey 2011 to 2012 Study of American Adults. J Periodontol 2016; 87:1286-1294. [PMID: 27452393 DOI: 10.1902/jop.2016.150648] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clinical studies have suggested that lipids increase activity of white blood cells. The objective of this study is to examine whether high serum total cholesterol (STC) is associated with periodontitis. METHODS A total of 1,061 participants from the 2011 to 2012 National Health and Nutrition Examination Survey who underwent both periodontal examination and laboratory test for STC was included. To examine effects of high STC on periodontitis, odds ratios were calculated, adjusting for age, sex, education, income, smoking status, diabetes, body mass index, and calcium levels. RESULTS Statistically significant associations were observed between borderline as well as high STC and periodontitis. Study participants with STC between 200 and 239 mg/dL (borderline) were 1.67 times (95% confidence interval [CI]: 1.13 to 2.47) as likely to have periodontitis as those with normal levels (≤199 mg/dL), and those with STC ≥240 mg/dL (high) were 2.22 times (95% CI: 1.27 to 3.87) as likely to have periodontitis as those with normal levels. CONCLUSIONS Positive significant association was observed between STC and periodontitis. Results of the present study provide insight into potential risk factors for periodontitis. High STC levels could be a potential risk factor for the disease; however, further studies need to be conducted to understand the actual relationship between STC levels and periodontitis and to establish causality and directional association.
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Affiliation(s)
- Susan Thapa
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Feifei Wei
- Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
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Mammen J, Vadakkekuttical RJ, George JM, Kaziyarakath JA, Radhakrishnan C. Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index. ACTA ACUST UNITED AC 2016; 8. [PMID: 27282797 DOI: 10.1111/jicd.12221] [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: 02/16/2016] [Accepted: 03/19/2016] [Indexed: 12/12/2022]
Abstract
AIM A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. METHODS Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. RESULTS All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P < 0.05). There was a significant decrease in fasting blood glucose and glycosylated hemoglobin A1c from baseline to 3 months in the case group (P < 0.05). CONCLUSION The present study showed that periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis.
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Affiliation(s)
- Jerry Mammen
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
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Krane V, Wanner C. Should we aim for oral health to improve outcomes in chronic kidney disease? Nephrol Dial Transplant 2016; 31:1551-4. [PMID: 27190378 DOI: 10.1093/ndt/gfw049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vera Krane
- Department of Medicine 1, Division of Nephrology, University of Würzburg, Würzburg, Germany Comprehensive Heart Failure Centre, University of Würzburg, Würzburg, Germany
| | - Christoph Wanner
- Department of Medicine 1, Division of Nephrology, University of Würzburg, Würzburg, Germany Comprehensive Heart Failure Centre, University of Würzburg, Würzburg, Germany
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Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol 2016; 40 Suppl 14:S51-69. [PMID: 23627334 DOI: 10.1111/jcpe.12060] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/17/2022]
Abstract
AIMS In this article, inflammatory mechanisms that link periodontal diseases to cardiovascular diseases are reviewed. METHODS This article is a literature review. RESULTS Studies in the literature implicate a number of possible mechanisms that could be responsible for increased inflammatory responses in atheromatous lesions due to periodontal infections. These include increased systemic levels of inflammatory mediators stimulated by bacteria and their products at sites distant from the oral cavity, elevated thrombotic and hemostatic markers that promote a prothrombotic state and inflammation, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma, promotion of dyslipidemia with consequent increases in pro-inflammatory lipid classes and subclasses, and common genetic susceptibility factors present in both disease leading to increased inflammatory responses. CONCLUSIONS Such mechanisms may be thought to act in concert to increase systemic inflammation in periodontal disease and to promote or exacerbate atherogenesis. However, proof that the increase in systemic inflammation attributable to periodontitis impacts inflammatory responses during atheroma development, thrombotic events or myocardial infarction or stroke is lacking.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA 23298-0566, USA.
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Zhang Z, Ma N, Zheng Y, Zhang L. Association of serum immunoglobulin-G to Porphyromonas gingivalis with acute cerebral infarction in the Chinese population. J Indian Soc Periodontol 2016; 19:628-32. [PMID: 26941512 PMCID: PMC4753706 DOI: 10.4103/0972-124x.164750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background/Purpose: There is evidence supporting an association between ischemic stroke and periodontitis in western countries. Differing genetic backgrounds and lifestyles among populations may affect this association. The aim of our study was to determine whether antibody titers to Porphyromonas gingivalis are associated with acute cerebral infarction in the Chinese population. Materials and Methods: This case-control study was conducted on 88 acute cerebral infarction patients and 40 healthy control subjects. Serum immunoglobulin-G (IgG) antibody to P. gingivalis was analyzed by enzyme-linked immune sorbent assay. Serum lipids were determined with the automatic biochemical analyzer. Fibrinogen was measured using automated coagulation analyzer. High-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were quantified using commercial ELISA kits. The intima-media thickness of the common carotid arteries (IMT-CCA) was measured by ultrasonography. Results: The results showed that P. gingivalis IgG antibody levels were significantly higher in acute cerebral infarction cases than in healthy controls (mean ± standard deviation, 11.06 ± 1.49 vs. 9.15 ± 1.70, P < 0.001). There were significant correlations of P. gingivalis IgG titer with total cholesterol (r = 0.34, P = 0.001), low-density lipoprotein (r = 0.39, P < 0.001), apolipoprotein-B (r = 0.30, P = 0.004), hs-CRP (r = 0.35, P = 0.001), IL-6 (r = 0.27, P = 0.011), and IMT-CCA (left: r = 0.306, P = 0.004; right: r = 0.241, P = 0.024). Conclusion: Antibody titers to P. gingivalis are associated with acute cerebral infarction in the Chinese population.
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Affiliation(s)
- Zheng Zhang
- Department of Periodontology, Stomatological Hospital, Jilin University, Changchun, China; Department of Periodontology, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
| | - Ning Ma
- Department of Periodontology, Stomatological Hospital, Jilin University, Changchun, China
| | - Youli Zheng
- Department of General Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin, China
| | - Li Zhang
- Department of Emergency, Stomatological Hospital, Jilin University, Changchun, China
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Zuza EP, Barroso EM, Fabricio M, Carrareto ALV, Toledo BEC, R. Pires J. Lipid profile and high-sensitivity C-reactive protein levels in obese and non-obese subjects undergoing non-surgical periodontal therapy. J Oral Sci 2016; 58:423-30. [DOI: 10.2334/josnusd.16-0173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Elizangela P. Zuza
- Department of Master in Dental Sciences, School of Dentistry, Educational Foundation of Barretos
| | - Eliane M. Barroso
- Department of Master in Dental Sciences, School of Dentistry, Educational Foundation of Barretos
| | | | - Ana Luiza V. Carrareto
- Department of Master in Dental Sciences, School of Dentistry, Educational Foundation of Barretos
| | - Benedicto E. C. Toledo
- Department of Master in Dental Sciences, School of Dentistry, Educational Foundation of Barretos
| | - Juliana R. Pires
- Department of Master in Dental Sciences, School of Dentistry, Educational Foundation of Barretos
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Doğan B, Fentoğlu Ö, Kırzıoğlu FY, Kemer ES, Köroğlu BK, Aksu O, Çarsancaklı SA, Orhan H. Lipoxin A4 and Neutrophil/Lymphocyte Ratio: A Possible Indicator in Achieved Systemic Risk Factors for Periodontitis. Med Sci Monit 2015; 21:2485-93. [PMID: 26298769 PMCID: PMC4551304 DOI: 10.12659/msm.895115] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background The aim of this study was to evaluate the serum lipoxin A4 (LXA4) and neutrophil/lymphocyte (Ne/Ly) ratio in individuals with achieved systemic risk factors for periodontitis. Material/Methods One hundred and eighty volunteers (69 male, 111 female) who were categorized as systemically healthy control, diabetes, hyperlipidemia, obese and menopause were recruited for this cross-sectional study. Sociodemographic characteristics and oral health behaviors were recorded via questionnaire. Clinical periodontal parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI) and decayed, missing, and filled teeth index (DMFT), were assessed. Systemic parameters and LXA4 levels were evaluated in serum samples. Results Clinical periodontal parameters and DMFT were higher in subjects with achieved systemic risk factors than in healthy subjects. The systemically healthy with periodontitis group had higher serum LXA4 levels than the systemically healthy with non-periodontitis group (P<0.05). The Ne/Ly ratio was higher in the hyperlipidemic group with periodontitis than in the hyperlipidemic group with non-periodontitis (P<0.05). In the control group, serum LXA4 levels were positively correlated with the PD, CAL and SBI. Conclusions In the presence of periodontitis, an increase in LXA4 levels and the Ne/Ly ratio in hyperlipidemic patients could contribute to the hypothesis that these parameters could be an indicator in periodontitis and its systemic risk factors.
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Affiliation(s)
- Burak Doğan
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Özlem Fentoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Fatma Yeşim Kırzıoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Esra Sinem Kemer
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Banu Kale Köroğlu
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Oğuzhan Aksu
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | | | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Süleyman Demirel University, Faculty of Medicine, Isparta, Turkey
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Major Adverse Cardiovascular Events in Treated Periodontitis: A Population-Based Follow-Up Study from Taiwan. PLoS One 2015; 10:e0130807. [PMID: 26114433 PMCID: PMC4482590 DOI: 10.1371/journal.pone.0130807] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 05/26/2015] [Indexed: 02/07/2023] Open
Abstract
Background The aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in treated periodontitis patients in Taiwan. Methods From the National Health Insurance Research Database (2001-2010), adult patients (≥ 18 years) with treated periodontitis were identified. Comparison was made between patients with mild form and severe form of treated periodontitis after propensity score matching. The primary end point was the incidence of MACE. Results A total of 32,504 adult patients with treated periodontitis were identified between 2001 and 2010. After propensity score matching, 27,146 patients were preserved for comparison, including 13,573 patients with mild form and 13,573 patients with severe form of treated periodontitis. During follow-up, 728 individuals in mild treated periodontitis group and 1,206 individuals in severe treated periodontitis group had at least 1 MACE event. After adjustment for gender, hyperlipidemia, hypertension and diabetes mellitus, severe treated periodontitis was associated with a mildly but significantly increased risk of MACE among older patients > 60 years of age (incidence rate ratio, 1.26; 95% confidence interval, 1.08–1.46). No association was found among younger patients ≤ 60 years of age. Conclusions Severe form of treated periodontitis was associated with an increased risk of MACE among older Taiwanese patients, but not among younger Taiwanese patients. We should put more efforts on the improvement of periodontal health to prevent further MACE.
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Tawfig A. Effects of non-surgical periodontal therapy on serum lipids and C-reactive protein among hyperlipidemic patients with chronic periodontitis. J Int Soc Prev Community Dent 2015; 5:S49-56. [PMID: 25984468 PMCID: PMC4428020 DOI: 10.4103/2231-0762.156524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: To evaluate the effect of non-surgical periodontal therapy on plasma lipid levels in hyperlipidemic patients with chronic periodontitis. Materials and Methods: After considering the inclusion and exclusion criteria, 30 hyperlipidemic patients with chronic periodontitis in the age group of 30–70 years, undergoing treatment in Ahmed Gasim Cardiac and Renal transplant Centre in north Sudan were recruited for the study. Patients were randomly assigned to the study and control groups. The study group received non-surgical periodontal therapy – oral hygiene instructions, scaling and root planing. The control group participants received only oral hygiene instructions. Lipid profile [total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG)], C-reactive protein (CRP), and periodontal parameters [Plaque index (PI), Gingival index (GI), probing pocket depth (PD), and attachment loss (ATL)] were measured and compared at baseline and after 3 months of the respective intervention. Between-groups analysis was done using independent “t” test and within-group analysis was done using dependent “t” test. Results: At baseline, groups were comparable based on lipid profile and periodontal parameters. After 3 months, the control group showed significant decrease in the PI and GI scores while there was no significant change in the other parameters. However, the study group showed significant decrease in the LDL and CRP levels along with a significant decrease in PD, ATL, PI, and GI scores, compared to the baseline values. Conclusion: Local non-surgical periodontal therapy resulted in improved periodontal health, with significant decrease in the LDL and CRP levels in hyperlipidemic patients with chronic periodontitis. Hence, local non-surgical periodontal therapy may be considered as an adjunct in the control of hyperlipidemia, along with standard care.
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Affiliation(s)
- Ahmed Tawfig
- Department of Preventive Dentistry, Division of Periodontics, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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