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Herrera D, Chapple I, Jepsen S, Berglundh T, Tonetti MS, Kebschull M, Sculean A, Papapanou PN, Sanz M. Consensus report of the second European Consensus Workshop on Education in Periodontology. J Clin Periodontol 2024. [PMID: 38710626 DOI: 10.1111/jcpe.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/21/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND The second European Consensus Workshop on Education in Periodontology was commissioned, as a result of the changes in the discipline and the advances in educational methods/technology, to update the 2009 Consensus report of the first European Federation of Periodontology (EFP) Workshop on the same topic that was jointly authored by the Association for Dental Education in Europe. AIM To identify and propose changes necessary in periodontal education at three levels, namely undergraduate, specialist and continuing professional development (CPD), with respect to learning outcomes, competencies and methods of learning/training and evaluation. METHODS Four working groups (WGs) considered education in periodontology at the undergraduate, specialist and CPD levels, and education methods. Four commissioned position papers, one per WG, summarized the relevant information. Workshop participants gathered at an in-person consensus meeting to discuss the individual reviews, and this consensus report summarizes the conclusions. RESULTS The learning outcomes for undergraduate and specialist education in periodontology have been updated, and a proposal for learning outcomes for CPD programmes was made. Learning/teaching/training and evaluation methods were proposed for each level of education, which included face-to-face, virtual and blended learning methods. CONCLUSION Developments in oral/dental medicine and in contemporary educational technologies have been translated into updated learning outcomes and learning/teaching/ training/evaluation methods relevant to education in periodontology.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Centre for Oral Diseases, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
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Olofsson R, Korytowska M, Almhöjd U, Almståhl A, Cevik-Aras H. Oral health, dental treatment, and medication related osteonecrosis of the jaw in multiple myeloma - a longitudinal cohort study. BMC Oral Health 2024; 24:184. [PMID: 38317122 PMCID: PMC10840162 DOI: 10.1186/s12903-024-03943-1] [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: 10/19/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE The objective of the present study was to investigate oral health status, oral health related quality of life, and identify risk factors associated with invasive dental treatment and medication related osteonecrosis of the jaw in patients with multiple myeloma. MATERIAL AND METHODS Patients newly diagnosed with multiple myeloma (n = 144) referred between January 2015 and September 2022 were retrospectively included. The patients underwent a thorough clinical and radiological oral examination and odontogenic infections were treated before the start of bisphosphonate treatment. The patients were followed annually, including clinical and radiological examinations. The oral health related quality of life was investigated by the OHIP-14 questionnaire. RESULTS Dental treatment (RR = 7.75), receiving combination antineoplastic therapy≥3 (RR =4.13), periodontitis (RR = 4.21), and reduced number of teeth (RR = 2.87) were associated with an increased risk of medication related osteonecrosis of the jaw. The response rate of the OHIP-14 questionnaire was 70.2%. Oral pain or discomfort in the mouth related to the medical treatment was reported by 30.5%. CONCLUSION Dental screening and treatment planning in patients with Multiple Myeloma may result in fewer oral infections and fewer interruptions of the medical treatment of myeloma.
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Affiliation(s)
- Richard Olofsson
- Specialist Clinic for Orofacial Medicine Uddevalla - Trollhättan, Public Dental Service, Region Västra Götaland, Uddevalla, Sweden.
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
| | - Magdalena Korytowska
- Specialist Clinic for Orofacial Medicine, Karlstad, Public Dental Service, Region Värmland, Sweden
- Department of Oral Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Ulrica Almhöjd
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annica Almståhl
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Section 4 - Oral health, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Hülya Cevik-Aras
- Specialist Clinic for Orofacial Medicine Uddevalla - Trollhättan, Public Dental Service, Region Västra Götaland, Uddevalla, Sweden
- Department of Oral Pathology and Medicine, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Shoaee S, Ghasemi E, Sofi-Mahmudi A, Shamsoddin E, Tovani-Palone MR, Roshani S, Heydari MH, Yoosefi M, Masinaei M, Azadnaejafabadi S, Mohammadi E, Rezaei N, Larijani B, Fakhrzadeh H, Farzadfar F. Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990-2017. BMC Oral Health 2024; 24:116. [PMID: 38243206 PMCID: PMC10799423 DOI: 10.1186/s12903-023-03808-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/19/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. METHODS We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. RESULTS Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. CONCLUSION The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders.
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Affiliation(s)
- Shervan Shoaee
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Sofi-Mahmudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Erfan Shamsoddin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | | | - Shahin Roshani
- The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Mohammad-Hossein Heydari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnaejafabadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Pietropaoli D, Altamura S, Ortu E, Guerrini L, Pizarro TT, Ferri C, Del Pinto R. Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study. J Transl Med 2023; 21:252. [PMID: 37038173 PMCID: PMC10088168 DOI: 10.1186/s12967-023-04072-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/21/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of atherosclerotic risk factors that increases cardiovascular risk. MetS has been associated with periodontitis, but the contribution of single MetS components and any possible sexual dimorphism in this relation remain undetermined. METHODS Using the third National Health and Nutrition Examination Survey (NHANES III), we performed a nested cross-sectional study to test whether individuals aged > 30 years undergoing periodontal evaluation (population) exposed to ≥ 1 MetS component (exposure) were at increased risk of bleeding/non-bleeding periodontal diseases (outcome) compared to nonexposed individuals, propensity score matched for sex, age, race/ethnicity, and income (controls). The association between MetS components combinations and periodontal diseases was explored overall and across subgroups by sex and smoking. Periodontal health status prediction based on MetS components was assessed. RESULTS In total, 2258 individuals (n. 1129/group) with nested clinical-demographic features were analyzed. Exposure was associated with gingival bleeding (+ 18% risk for every unitary increase in MetS components, and triple risk when all five were combined), but not with stable periodontitis; the association was specific for women, but not for men, irrespective of smoking. The only MetS feature with significant association in men was high BP with periodontitis. CRP levels significantly increased from health to disease only among exposed women. MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease. CONCLUSION The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. Further research is needed to validate and expand these findings.
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Affiliation(s)
- Davide Pietropaoli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Serena Altamura
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
| | - Eleonora Ortu
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | - Luca Guerrini
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research-Dental Clinic, L'Aquila, Italy
| | - Theresa T Pizarro
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Claudio Ferri
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
| | - Rita Del Pinto
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy.
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.
- Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy.
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Pitchika V, Jordan RA, Norderyd O, Rolander B, Welk A, Völzke H, Holtfreter B, Kocher T. Factors influencing tooth loss in European populations. J Clin Periodontol 2022; 49:642-653. [PMID: 35569026 DOI: 10.1111/jcpe.13642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to identify the factors influencing the changes in the number of teeth present and the number of healthy or filled surfaces between two time points. MATERIALS AND METHODS Repeated cross-sectional data from population-based studies, namely the German Oral Health Studies (DMS-III vs. DMS-V), the Studies of Health in Pomerania (SHIP-START-0 vs. SHIP-TREND-0), and the Jönköping study (2003 vs. 2013), were analysed. Oaxaca decomposition models were constructed for the outcomes (number of teeth, number of healthy surfaces, and number of filled surfaces). RESULTS The number of teeth increased between examinations (DMS: +2.26 [adults], +4.92 [seniors], SHIP: +1.67, Jönköping: +0.96). Improvements in education and dental awareness brought a positive change in all outcomes. An increase in powered toothbrushing and inter-dental cleaning had a great impact in DMS (adults: +0.25 tooth, +0.78 healthy surface, +0.38 filled surface; seniors: +1.19 teeth, 5.79 healthy surfaces, +0.48 filled surface). Inter-dental cleaning decreased by 4% between SHIP-START-0 and SHIP-TREND-0, which negatively affected the outcomes. CONCLUSIONS From this study, it can be concluded that education may be the most important factor having a direct and indirect effect on the outcomes. However, for better oral health, powered toothbrushing and inter-dental cleaning should not be neglected.
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Affiliation(s)
- Vinay Pitchika
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | | | - Ola Norderyd
- Department of Periodontology, The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bo Rolander
- Futurum, Academy for Health and Care, Region Jönköping County and Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Tafaj G, Iniesta M, Sanz M, Herrera D. The subgingival cultivable bacteria of Albanian subjects with different periodontal status compared to a similar population of Spanish subjects: a case control study. BMC Oral Health 2022; 22:89. [PMID: 35321708 PMCID: PMC8944025 DOI: 10.1186/s12903-022-02121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background The objective was to qualitatively and quantitatively describe the subgingival cultivable bacteria in Albanian subjects and to compare it with a similar Spanish population.
Materials and methods Consecutive patients, diagnosed as periodontitis in stages I–II or III–IV, and as periodontally healthy or with gingivitis, were studied clinically and microbiologically by means of microbiological culture, including total anaerobic counts, proportions, and frequency of detection of target species. Outcome variables were analysed by Mann–Whitney, Kruskal–Wallis, ANOVA, ANCOVA and Chi-square tests.
Results In this cross-sectional study, 83 (Albania) and 90 (Spain) subjects were included. No statistically significant differences were observed between test and control populations regarding demographic variables or smoking habit. Significantly higher total anaerobic counts in the Albanian population (p = 0.022) were observed, especially in the periodontal health/gingivitis group (p = 0.001). In the test population, the proportions of the cultivable bacteria of Fusobacterium nucleatum were significantly lower in both the healthy/gingivitis (p = 0.022) and stages I–II periodontitis (p = 0.034) groups.
Conclusions The subgingival cultivable bacteria in both periodontitis and non-periodontitis subjects from Albania showed significantly higher total anaerobic counts and lower proportions of the cultivable bacteria of F. nucleatum than a similar population of subjects from Spain. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02121-5.
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Affiliation(s)
- Gerila Tafaj
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain.,Dental Clinic, School of Dentistry, Albanian University, Tirana, Albania
| | - Margarita Iniesta
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain.
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
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Candida albicans and Candida dubliniensis in Periodontitis in Adolescents and Young Adults. Int J Microbiol 2022; 2022:4625368. [PMID: 35058983 PMCID: PMC8766183 DOI: 10.1155/2022/4625368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022] Open
Abstract
Aim This study aims to evaluate the association of Candida albicans and Candida dubliniensis with periodontitis in adolescents and young adults in a Moroccan population. Methods 426 subjects aged between 12 and 25 years were recruited for the study. A pool of plaque sample was taken. Samples were cultured on Sabouraud Chloramphenicol medium at 37°C for 24–48 hours and then identified by the Vitek 2 YST system. Clinical data and presence of Candida albicans and Candida dubliniensis were analyzed using Jamovi (Version 1.8). Results Candida albicans was observed in 25 subjects among 68 diseased patients (37%) and in 60 subjects among 358 healthy patients (17%). It can be reported that under normal yeast conditions, there is a statistically significant difference between these two groups (P < 0.001). Candida dubliniensis was more prevalent in periodontitis than in healthy subjects (P=0.026). Regarding clinical variables, subgroups of periodontitis subjects showed significant statistical differences for periodontal probing depth, clinical attachment loss, and number of decayed teeth in advanced periodontitis in comparison with initial or mild periodontitis. The results also indicate that the presence of the two species of Candida is not related to gender or age (P > 0.05) nor related to the severity of the periodontal disease in this population. Conclusion Within the limits of our study, Candida albicans is more frequently associated with periodontitis. The potential role of C. albicans in periodontitis pathogenesis is very complex. More studies on biofilm associated with different forms of periodontitis are necessary. It is also important to assess the coexistence of periodontitis and caries and the associated biofilms.
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Blanco-Pintos T, Regueira-Iglesias A, Balsa-Castro C, Tomás I. Update on the Role of Cytokines as Oral Biomarkers in the Diagnosis of Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:283-302. [DOI: 10.1007/978-3-030-96881-6_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Diamanti I, Polychronopoulou A, Papaioannou W, Theodoridis C, Margaritis V, Mamai-Homata E, Kalfas S. Socio-behavioral factors, oral hygiene level and periodontitis prevalence in a 35-44-year-old Greek adult population: A cross-sectional survey. J Clin Exp Dent 2021; 13:e1021-e1029. [PMID: 34667498 PMCID: PMC8501865 DOI: 10.4317/jced.58507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/24/2021] [Indexed: 11/05/2022] Open
Abstract
Background Sub-optimal oral hygiene is considered as a primary risk factor for periodontitis occurrence. Various socio-behavioral determinants may contribute either independently or by influencing adversely the oral hygiene (OH) level. The aim of the present study was to examine the periodontal status of 35-44-year-old Greek adults and determine the contribution of risk indicators, including the socio-behavioral aspects and the population’s oral hygiene level, on disease prevalence.
Material and Methods In 1218 participants, Community Periodontal Index (CPI), Loss of Attachment (LoA) and simplified Oral Hygiene Index (OHI-S) were calculated. Multivariable regression models examined the effect of socio-behavioral factors with/without the inclusion of OHI-S level on pocket depth (PD)≥4mm and LoA≥4mm presence.
Results 11.8% of the participants had healthy periodontium, whereas 37.3% and 5.6% presented with shallow and deep pocketing, respectively. 60.4%, 28.8%, and 10.8.% of the adults demonstrated LoA≤3mm, 4-5mm, and ≥6mm, accordingly. Fair and poor oral hygiene significantly increased the likelihood for PD≥4mm (OR=4.8-20.3) and LoA≥4mm (OR=3.3-6.0) presence. ‘Emergency-oriented dental visiting pattern’ significantly elevated the chance for PD≥4mm presence (OR=1.7). ‘Lower education level’ ‘urban location’, and ‘using an interdental brush’ were significantly independently linked to LoA≥4mm occurrence (OR=1.7-2.1, 1.5, and 2.0, respectively). Lower educated individuals demonstrated inferior oral hygiene status, which in turn elevated significantly the chances of PD≥4mm presence. Smoking more than 10 cigarettes/day, emergency-oriented dental attendance pattern and not flossing were linked to worse oral hygiene levels, which consequently increased significantly the likelihood of LoA≥4mm occurrence.
Conclusions Fair and poor oral hygiene contribute strongly to periodontitis occurrence. Various socio-behavioral factors may influence adversely oral hygiene maintenance, leading to periodontitis manifestations. Key words:Community periodontal index, periodontal attachment loss, oral hygiene, adults 35-44, cross-sectional survey, socio-behavioral indicators.
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Affiliation(s)
- Iliana Diamanti
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Argy Polychronopoulou
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - William Papaioannou
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Charis Theodoridis
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Eleni Mamai-Homata
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Kalfas
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073459. [PMID: 33810461 PMCID: PMC8037399 DOI: 10.3390/ijerph18073459] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. METHODS We included 488 participants aged 35-74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). RESULTS The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III-IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. CONCLUSION It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.
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The lived experience of performing a periodontal treatment in the context of general dentistry. BDJ Open 2021; 7:7. [PMID: 33510136 PMCID: PMC7843605 DOI: 10.1038/s41405-021-00059-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 11/30/2022] Open
Abstract
Aim To describe what characterises the lived experience of performing a periodontal treatment in the context of general dentistry. Materials and methods Three dental hygienists from general dentistry in Sweden, were purposively selected as participants and interviewed. The participants described a situation in which they had performed a periodontal treatment. The descriptions were analysed using the descriptive phenomenological psychological method. Results The general meaning structure of the lived experience of performing a periodontal treatment comprised five constituents, (a) an established treatment routine, (b) importance of oral hygiene, (c) self-awareness and motivation of the patient, (d) support and doubt, and (e) mechanical infection control. The periodontal treatment is perceived as being set prior to its commencement and as following established routines, in which the patients’ oral hygiene is experienced as a crucial part. The patients’ self-awareness and a supportive clinician are seen as important factors in motivating the patient towards positive behavioural change, although there is a presence of doubt in patients’ ability to maintain this positive change. Mechanical infection control is perceived as successful but sometimes difficult to perform. Conclusions Important, patient-related, factors are constituting the phenomenon of performing a periodontal treatment but an experience that the pre-existing standardised workflow influences patient management was also present.
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Pająk-Łysek E, Polak M, Kopeć G, Podolec M, Desvarieux M, Pająk A, Zarzecka J. Associations between Pharmacotherapy for Cardiovascular Diseases and Periodontitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020770. [PMID: 33477530 PMCID: PMC7831110 DOI: 10.3390/ijerph18020770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 02/04/2023]
Abstract
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). Background: Xerostomia increases the risk of PD and is a side effect of some pharmacotherapies. Information about the effect of cardioprotective treatment of periodontal status is scarce. Methods: We studied 562 dentate residents of Krakow at the age of 50 to 70 years. Information about treatment was collected using a standardized questionnaire. The pocket depth and clinical attachment level (CAL) were used to ascertain PD. Multivariate logistic regression was applied to assess the relation between cardioprotective medications and PD. Results: PD was found in 74% of participants. The range of cardioprotective drug use among participants was 7% (ARBs) to 32% (beta-blockers). After adjusting for age, sex, number of teeth, smoking, and education, ASA’s use was related to a lower prevalence of PD in all dentate participants (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.40–0.99). The use of ARBs and statins was found to be associated with a higher prevalence of PD in persons having ≥6 teeth (odds ratio (OR) = 3.57, 95% CI: 1.06–11.99 and OR = 1.81, 95% CI: 1.03–3.16, respectively). Further adjustment for CVD risk factors, history of coronary heart disease, and other chronic diseases did not attenuate the results. There was no significant relation between PD and the use of other cardioprotective drugs.
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Affiliation(s)
- Ewa Pająk-Łysek
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Kraków, Poland;
- Correspondence: ; Tel.: +48-500031556
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (M.P.); (A.P.)
| | - Grzegorz Kopeć
- Pulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- John Paul II Hospital, 31-202 Kraków, Poland;
| | - Mateusz Podolec
- John Paul II Hospital, 31-202 Kraków, Poland;
- Department of Coronary Artery Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, John Paul II Hospital, 31-008 Kraków, Poland
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
- INSERM UMR 1153, Center de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, 75004 Paris, France
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (M.P.); (A.P.)
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Kraków, Poland;
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Roa López A, Moreu Burgos G, Aguilar Salvatierra A, Fernández Delgado J, Bravo M, González Jaranay M. Efficacy of dental floss with ellipsoidal knots vs conventional dental floss for plaque removal: A split-mouth randomized trial. Int J Dent Hyg 2020; 19:209-214. [PMID: 33001564 DOI: 10.1111/idh.12473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/30/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare clinical efficacy for plaque removal between dental floss with soft ellipsoidal knots and conventional floss. MATERIALS AND METHODS We studied 33 university students (29 females and 4 males, 13 of them undergraduate/postgraduate students of dentistry), including regular and sporadic (less once/wk) users of dental floss, with interproximal spaces ≤1 mm, who used floss with and without knots in a randomized manner following a split-mouth design. The Modified Navy Plaque Index (RMNPI) by Rustogi et al. was applied to determine the total removed plaque (TPI) and that removed in the gingival area (GPI) and interproximal spaces (IPI). RESULTS The reduction in GPI was greater with the knotted vs conventional floss in all cases (14.77 ± 12.38; 64.79% vs 17.38 ± 13.66; 57.51%) and especially among no floss users (12.469 ± 10.98; 68.02% vs 15.833 ± 11.88; 58.55%). No statistically significant difference between floss types was found in TPI and IPI (globally or by floss utilization frequency) or in the mean GPI of floss users. CONCLUSION Floss with ellipsoidal knots showed similar efficacy to remove plaque in patients with less experience of flossing (but without statistically significant differences) compared with flossing themselves with conventional floss, and it may be an optimal solution for patients starting to use dental floss and for those with a lesser or only sporadic history of floss utilization.
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Affiliation(s)
- Antonio Roa López
- Department of Periodontology, Faculty of Dentistry, Granada University, Granada, Spain
| | - Gerardo Moreu Burgos
- Department of Periodontology, Faculty of Dentistry, Granada University, Granada, Spain
| | | | | | - Manuel Bravo
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Granada University, Granada, Spain
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Sekundo C, Langowski E, Kilian S, Frese C. Periodontal and peri-implant diseases in centenarians. J Clin Periodontol 2020; 47:1170-1179. [PMID: 32748427 DOI: 10.1111/jcpe.13350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/18/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
AIMS To report the prevalence of periodontal and peri-implant diseases in centenarians in South-Western Germany, examine associations with sociodemographic factors and explore age-related trends. MATERIAL AND METHODS Eligible persons born before 1920 were identified from population registries in South-Western Germany. A total of 55 centenarians were visited at home or in nursing care facilities. Of them, 35 were dentate, 33 of which underwent periodontal examination. Implants in 2 edentulous patients were also registered. RESULTS The mean number of teeth was 9.5 ± 7.1; centenarians in need of nursing care had considerably less teeth than others (8.5 versus. 17.0 teeth, p = .03). Mean probing depth was 2.7 ± 0.8mm; mean clinical attachment loss was 4.2 ± 1.7 mm. Severe tooth mobility (degree 2 or 3) and furcation involvement were present in approximately 3% of eligible teeth. According to CDC/AAP classification, 25.8% of centenarians had no or mild periodontitis, 54.8% of centenarians had moderate periodontitis, and only 19.4% were severely affected. Of 27 implants examined in 5 centenarians, 59.3% were classified as healthy, 29.6% had peri-implant mucositis, and 11.1% had peri-implantitis. CONCLUSIONS This study reveals the predominance of moderately severe disease in centenarians. While there were high levels of moderate periodontitis and peri-implant mucositis, signs of severe periodontitis, severe furcation involvement, tooth mobility or peri-implantitis were less frequent.
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Affiliation(s)
- Caroline Sekundo
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Langowski
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Samuel Kilian
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Cornelia Frese
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
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Roumeau S, Thevenon J, Ouchchane L, Maqdasy S, Batisse-Lignier M, Duale C, Pham Dang N, Caron P, Tauveron I, Devoize L. Assessment of oro-dental manifestations in a series of acromegalic patients, the AcroDent study. Endocr Connect 2020; 9:824-833. [PMID: 32738132 PMCID: PMC7487182 DOI: 10.1530/ec-20-0176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/30/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The dental and periodontal impact of GH/IGF-1 hypersecretion has been poorly investigated until now. Our aim is to precisely describe the oro-dental state of acromegalic patients and to study the impact of GH/IGF-1 hypersecretion on patients' reported oral health-related quality of life (OHRQoL). METHODS After collecting characteristics of their disease, acromegalic patients answered the GOHAI questionnaire assessing their OHRQoL, the AcroQoL questionnaire and then benefited from a complete stomatological and radiological examination (orthopantomogram systematically, retro-alveolar radiography or Cone Beam CT if necessary). RESULTS In total, 29 patients aged 59.1 ± 16.0 years were included. The average DMFT index (sum of Decayed, Missing and Filled Teeth per patient) was 19.0 ± 7.8. 16/29 patients had a gingivitis and 18/29 a mild to moderate chronic periodontitis, but no case of severe chronic periodontitis was found, probably because the frequency of a protective thick gingival biotype was increased (9/29). No case of generalized gingival hypertrophy or diffuse hypercementosis was observed. According to the Add-GOHAI score, only 8/26 patients had a satisfactory OHRQoL. This parameter was correlated to the acromegaly-specific quality of life according to the AcroQoL score. Interestingly, 11/29 patients had bulky oral bony outgrowths (OBO), such as large maxillary or mandibular tori and multiple vestibular exostosis. CONCLUSIONS The unsatisfactory OHRQoL reported by acromegalic patients contrasts with a rather good objective oro-dental state and annual oral examination seems relevant in this population. Finally, we report that huge OBO could be helpful signposts for the diagnosis of acromegaly.
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Affiliation(s)
- Sylvain Roumeau
- CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
- Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
- Correspondence should be addressed to S Roumeau:
| | - Joannice Thevenon
- CHU Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand, France
| | - Lemlih Ouchchane
- Université Clermont Auvergne, CNRS, ISIT, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service de Biostatistiques, Clermont-Ferrand, France
| | - Salwan Maqdasy
- Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
- CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
- Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France
| | - Marie Batisse-Lignier
- CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
- Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France
| | - Christian Duale
- Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Inserm CIC 1405, Clermont-Ferrand, France
| | - Nathalie Pham Dang
- Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
- Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
- CHU de Clermont-Ferrand, Service de chirurgie maxillo-faciale, Clermont-Ferrand, France
| | - Philippe Caron
- CHU Larrey-Rangueil, Service Endocrinologie et Maladies Métaboliques, Pôle Cardio-Vasculaire et Métabolique, Toulouse, France
| | - Igor Tauveron
- CHU de Clermont-Ferrand, Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Clermont-Ferrand, France
- Université Clermont Auvergne, Faculté de Médecine, Clermont-Ferrand, France
- Laboratoire GReD: UMR Université Clermont Auvergne-CNRS 6293, INSERM U1103, Clermont-Ferrand, France
| | - Laurent Devoize
- CHU Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand, France
- Université Clermont Auvergne, Inserm, Neuro-Dol, Clermont-Ferrand, France
- Université Clermont Auvergne, Faculté de Chirurgie Dentaire, Clermont-Ferrand, France
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Analysis of the Relation between Periodontitis and Chronic Gastritis/Peptic Ulcer: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124387. [PMID: 32570864 PMCID: PMC7344436 DOI: 10.3390/ijerph17124387] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022]
Abstract
The aim of the present study was to investigate the association between periodontitis and chronic gastritis/peptic ulcer using a cross-sectional study design. The present prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study (KoGES) recorded from 2004 to 2016. Among 173,209 participants, 9983 with periodontitis and 125,336 with no periodontitis were selected. Histories of chronic gastritis and peptic ulcer between periodontitis and no periodontitis participants were analyzed. The participants were questioned around any history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, ischemic heart disease, periodontitis, body mass index, smoking, alcohol consumption, nutritional intake, and financial income. Chi-square tests, independent t-tests, two-tailed analyses were used in statistical analysis of the data. The adjusted odds ratio of chronic gastritis was 2.22 (95% confidence interval [CI] = 2.10–2.34, p < 0.001) and that of peptic ulcer was 1.86 (95% CI = 1.74–1.98, p < 0.001) in model 2. This study demonstrated that periodontitis was associated with an increased risk of chronic gastritis/peptic ulcer. These findings provide additional evidence for an association between periodontitis and chronic gastritis/peptic ulcer.
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Machado V, Aguilera EM, Botelho J, Hussain SB, Leira Y, Proença L, D’Aiuto F, Mendes JJ. Association between Periodontitis and High Blood Pressure: Results from the Study of Periodontal Health in Almada-Seixal (SoPHiAS). J Clin Med 2020; 9:jcm9051585. [PMID: 32456145 PMCID: PMC7291060 DOI: 10.3390/jcm9051585] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure (BP). This study aimed to explore (a) the association between periodontal health and BP in a large representative cohort, (b) the predictive value of diagnosis of periodontitis in undiagnosed raised BP and (c) whether age is a mediator of this relationship. In total, 1057 randomly recruited individuals (mean age, 60.9 ± 16.3 years, 57.7% women) underwent periodontal clinical assessment and one-single BP measurement using an automated sphygmomanometer device. Logistic and linear regression models were used to estimate the odds of hypertension based on periodontitis case definitions. Mediation analysis was performed to understand the effect of age on the association of periodontitis with hypertension. Adjusted logistic model for gender, smoking habits and body mass index confirmed the association between high BP and periodontitis (OR = 2.31, 95%CI: 1.75-3.04, p < 0.001). Among 168 participants with undiagnosed high BP (15.9% of the study sample), 62.5% had periodontitis (n = 105). In this study, the association between periodontitis with both systolic blood pressure (SBP) (77.6%, p < 0.001) and diastolic blood pressure (DBP) (66.0%, p < 0.001) was mediated by age. Periodontitis is closely linked to BP in a representative Portuguese population.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Correspondence:
| | - Eva Muñoz Aguilera
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, 08195 Barcelona, Spain
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - Syed Basit Hussain
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
| | - Yago Leira
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
- Medical-Surgical Research Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - Francesco D’Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
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Sun H, Du M, Tai B, Chang S, Wang Y, Jiang H. Prevalence and associated factors of periodontal conditions among 55- to 74-year-old adults in China: results from the 4th National Oral Health Survey. Clin Oral Investig 2020; 24:4403-4412. [PMID: 32382923 DOI: 10.1007/s00784-020-03306-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 04/23/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this study was to assess periodontal health conditions among 55- to 74-year-old Chinese people and to analyze the factors associated with periodontal diseases. MATERIALS AND METHODS In total, 9054 subjects aged 55-74 years were enrolled from all 31 provinces using a stratified multistage probability sampling method, autonomous regions and municipalities of the Chinese mainland, the response rate was 86.9%. All subjects underwent clinical examinations on the severest site for every tooth and completed a questionnaire that collected information on their sociodemographic characteristics and oral habits. T tests, chi-square tests and binary logistic regression analysis were performed to analyze the data. RESULTS The percentage of people without bleeding on probing, probing depth ≥ 4 mm and attachment loss > 3 mm was 5.0 and 9.3% in the 55- to 64-year-old and the 65- to 74-year-old age group. The prevalence of bleeding on probing was 88.4% among 55 to 64 years old and 82.6% among 65 to 74 years old. Mean number of teeth with bleeding on probing were 13.87 among 55 to 64 years old and 11.25 among 65 to 74 years old. The prevalence of probing depth ≥ 4 mm and attachment loss > 3 mm were 69.3 and 69.9% in people aged 55-64 years and were 64.6 and 74.2% in people aged 65-74 years. Mean number of teeth with probing depth = 4-5 mm and probing depth ≥ 6 mm were 4.48 and 0.36 in 55-64 age group and 3.70 and 0.33 in 65-74 age group. And mean number of teeth with attachment loss > 3 mm were 5.17 among 55 to 64 years old and 5.63 among 65 to 74 years old. Besides, attachment loss > 3 mm was associated with age, gender, smoking, toothbrushing frequency and toothpick use. CONCLUSIONS Periodontitis was not highly prevalent among 55- to 74-year-old Chinese adults. Age, gender, smoking, toothbrushing frequency and toothpick use could be risk factors. CLINICAL RELEVANCE Scientific rationale for the study: The periodontal conditions among 55 to 64 and 65 to 74 years old Chinese population were not highly serious, but prevalence of bleeding on probing, periodontal pockets and attachment loss should be drawn enough attention by relevant public health administrations. PRINCIPAL FINDINGS The prevalence of periodontal diseases was evaluated in 55- to 64-year-old and 65- to 74-year-old subjects in a nationally representative Chinese sample population. The prevalence of probing depth ≥ 4 mm and AL > 3 mm were high; these values were 69.3% and 69.9%, respectively, in the 55-64 age group and 64.6% and 74.2%, respectively, in the 65-74 age group. In addition, case percentage of AL = 4-5 mm combined with PD < 6 mm were 23.1 and 19.4% among 55- to 64-year-old and 65- to 74-year-old people. And case percentage of AL> 5 mm combined with PD ≥ 6 mm were 11.1% and 12.1% among 55- to 64-year-old and 65- to 74-year-old people, respectively. PRACTICAL IMPLICATIONS The present study provides a reference for the epidemiological analysis of periodontal diseases. To reduce widespread inadequate treatment of periodontal diseases, clinical management should be performed in dental practices. Furthermore, oral health recommendations should be made at multiple levels.
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Affiliation(s)
- Haoyun Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Minquan Du
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Baojun Tai
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Shuli Chang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Yixuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China
| | - Han Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, China.
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El-Makaky Y, Shalaby HK. The effects of non-surgical periodontal therapy on glycemic control in diabetic patients: A randomized controlled trial. Oral Dis 2019; 26:822-829. [PMID: 31834660 DOI: 10.1111/odi.13256] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/12/2019] [Accepted: 12/07/2019] [Indexed: 12/16/2022]
Abstract
AIM The present study aimed to monitor the clinical outcomes and the metabolic response of periodontal therapy (non-surgical) in patients with periodontitis (chronic) and uncontrolled diabetes (type 2). METHODS Eighty-eight subjects with periodontitis (chronic) and uncontrolled diabetes (type 2) were enrolled in this controlled trial and allocated randomly to the test group (44 patients were received immediate periodontal therapy) or the control group (44 patients were received delayed periodontal therapy). The metabolic and clinical evaluations were conducted at baseline and 3 months. This included clinical attachment level, glycated hemoglobin (HbA1c), bleeding on probing, visible plaque, and pocket depth. The periodontal therapy in this study consists of one-stage scaling and root planning, a combination of systemic antibiotics (amoxicillin 500 mg and metronidazole 400 mg), and oral hygiene instructions. RESULTS Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at 3-month follow-up period the patients within the test group demonstrated significantly better clinical and metabolic outcomes than patients in the control group. CONCLUSION The non-surgical periodontal treatment using a combination of metronidazole and amoxicillin significantly improved the metabolic outcome in addition to periodontal health in diabetic subjects with chronic periodontitis.
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Affiliation(s)
- Yasser El-Makaky
- Department of Periodontology, Faculty of Dentistry, Tanta University, Tanta, Egypt.,Department of Periodontology, College of Dentistry, Taibah University, Saudi Arabia
| | - Hany K Shalaby
- Department of Periodontology, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Ullah R, Adnan S, Afzal AS. Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis. J Dent Educ 2019; 83:1382-1391. [PMID: 31501253 DOI: 10.21815/jde.019.153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/22/2019] [Indexed: 12/29/2022]
Abstract
The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education.
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Affiliation(s)
- Rizwan Ullah
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan.
| | - Samira Adnan
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan
| | - Azam S Afzal
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan
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21
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Radwan-Oczko M, Duś-Ilnicka I, Richards P, Thomsen AM, Rasmussen C. Rheumatoid arthritis patients' oral health and disease activity. Int J Rheum Dis 2019; 22:1538-1543. [PMID: 31062938 DOI: 10.1111/1756-185x.13590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 02/25/2019] [Accepted: 04/01/2019] [Indexed: 01/22/2023]
Abstract
AIM Rheumatoid arthritis (RA) and periodontal diseases (PD) are common chronic, inflammatory, destructive and progressive diseases that may have similar pathophysiological mechanisms and risk factors. RA affects more than 1.5% of the world's population, with a higher percentage of females than males. PD is present in around 20% of the population and has multifactorial etiology. The purpose of this study is to describe patients' self-reported oral health and the association with RA disease activity. METHOD Three hundred patients under treatment for RA from the Division of Rheumatology, Clinical Medicine, North Jutland Region Hospital, Hjørring, Denmark and were eligible for the study. Questionnaires were emailed to the patients and 164 completed answers were received. RESULTS The mean age of the group of 164 patients (61% female) was 65 ± 11 years. The average value of Disease Activity Score of 28 joints was 2.31 ± 0.83. Only 12% of responders were active smokers. Patients estimated their status of their teeth and gingiva respectively as poor in 13% and 11% of cases, good, in 46% and 49%, and excellent, both as 40%. Spontaneous and/or provoked gingival bleeding were experienced by 15% and 49% of patients. Only 14% of patients declared feelings of loose or movable teeth and 10% declared difficulties in biting or chewing. CONCLUSIONS The status of oral cavity reported by Danish patients indicates a significant proportion with symptoms of gingival/periodontal disease, which may negatively influence RA activity and disease management. Cooperation between rheumatologists and dentists is important in oral health management in periodontal inflammation.
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Affiliation(s)
| | - Irena Duś-Ilnicka
- Department and Division of Oral Pathology, Wrocław Medical University, Wrocław, Poland
| | - Pamela Richards
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Marie Thomsen
- Rheumatology Department, Clinic of Medicine, North Denmark Regional Hospital, Hjoerring, Denmark
| | - Claus Rasmussen
- Rheumatology Department, Clinic of Medicine, North Denmark Regional Hospital, Hjoerring, Denmark
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Romano F, Perotto S, Castiglione A, Aimetti M. Prevalence of periodontitis: misclassification, under-recognition or over-diagnosis using partial and full-mouth periodontal examination protocols. Acta Odontol Scand 2019; 77:189-196. [PMID: 30623706 DOI: 10.1080/00016357.2018.1535136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to assess the bias in estimating the prevalence of periodontitis due to partial-mouth periodontal examination protocols (PMPE) and to relate the severity and extent of periodontal damage to periodontitis misclassification when applying case definitions by Centres of Disease Control and Prevention and American Academy of Periodontology (CDC/AAP). MATERIALS AND METHODS A full-mouth periodontal examination (FMPE) was performed in 721 adults living in North Italy to identify moderate and severe periodontitis. These results were compared with those obtained with two PMPE protocols analyzing two interproximal sites on all teeth (fMB-DL) or four interproximal sites in two random diagonal quadrants (pMDB-MDL). RESULTS Both PMPE systems estimated the prevalence of moderate periodontitis with limited bias (-2.79% for pMDB-MDL and -3.49% for fMB-DL), whereas produced larger relative biases for severe periodontitis (-28.74% versus - 14.55%). The percentage of under-recognition of existing periodontal disease was 8.9% under fMB-DL and 15.5% under pMDB-MDL. The diagnosis of moderate and severe periodontal disease was correctly assigned to individuals with on average 8% and 30% of pathological sites, respectively. CONCLUSION These findings suggest that PMPE systems provide high level of bias when using CDC/AAP case definitions.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School University of Turin, Turin, Italy
| | - Stefano Perotto
- Postgraduate Program in Periodontology, University of Turin, Turin, Italy
| | - Anna Castiglione
- Città della Salute e della Scienza and CPO Piedmont, Unit of Clinical Epidemiology, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School University of Turin, Turin, Italy
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Prediabetes and diabetes prevalence in the Workers’ Oral Health Study. Clin Oral Investig 2019; 23:4233-4241. [DOI: 10.1007/s00784-019-02875-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/21/2019] [Indexed: 12/27/2022]
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Vergnes JN, Canceill T, Monsarrat P. Intensive periodontal therapy and type 2 diabetes. Lancet Diabetes Endocrinol 2019; 7:174-175. [PMID: 30782466 DOI: 10.1016/s2213-8587(19)30029-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/14/2019] [Indexed: 11/21/2022]
Affiliation(s)
- Jean-Noel Vergnes
- Department of Epidemiology and Public Health, Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31400 Toulouse, France; Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
| | - Thibault Canceill
- Department of Oral Rehabilitation, Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31400 Toulouse, France
| | - Paul Monsarrat
- Department of Oral Rehabilitation, Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31400 Toulouse, France; STROMALab, University of Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM U1031), Toulouse, France
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Stańdo M, Lewkowicz N. Omega‐3 Polyunsaturated Fatty Acids as an Adjunct to Non‐Surgical Treatment of Periodontitis. EUR J LIPID SCI TECH 2019. [DOI: 10.1002/ejlt.201800345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mirella Stańdo
- Department of Periodontology and Oral DiseasesMedical University of Lodzul. Pomorska 25192‐213 LodzPoland
| | - Natalia Lewkowicz
- Department of Periodontology and Oral DiseasesMedical University of Lodzul. Pomorska 25192‐213 LodzPoland
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Di Nardo D, Passariello C, Polimeni A, Testarelli L. A review on the prevention of inflammatory periimplant diseases. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_45_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Periodontitis in 14th–17th century inhabitants of Brześć Kujawski in north-central Poland. ANTHROPOLOGICAL REVIEW 2018. [DOI: 10.2478/anre-2018-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Manifestations of periodontitis, the destructive form of periodontal disease affecting the alveolar bone, are often clearly recognizable in archaeological human remains. Analysis of this disease allows to obtain data not only about biological condition but also diet and nutrition of past populations.
The objective of this paper was to asses periodontitis in the Polish urban population of Brześć Kujawski during Medieval – Modern transition (14th–17th centuries AD). An attempt was also made to explain the relationship between atrophy of alveolar bones and the type of diet. Lowering of alveolar crests was diagnosed based on measurements of the cementoenamel junction and the alveolar crest edge (CEJ– AC) distance and morphology of the alveolar edge. In studied population periodontitis affected 77.1% of individuals and 41.4% of all alveoli. Frequency, intensity and severity of the disease was higher in males and increased with the individual’s age. Severity of alveolar destruction was associated with dental calculus accumulation. It seems that a high prevalence of the disease may be, among others, result of carbohydrate-rich diet and fragmented food. Sex differences could be related to differences in diet (especially in protein intake) and hormone levels or lack of oral hygiene in part of the population.
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28
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Glurich I, Bartkowiak B, Berg RL, Acharya A. Screening for dysglycaemia in dental primary care practice settings: systematic review of the evidence. Int Dent J 2018; 68:369-377. [DOI: 10.1111/idj.12405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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29
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Kocher T, Holtfreter B, Petersmann A, Eickholz P, Hoffmann T, Kaner D, Kim T, Meyle J, Schlagenhauf U, Doering S, Gravemeier M, Prior K, Rathmann W, Harks I, Ehmke B, Koch R. Effect of Periodontal Treatment on HbA1c among Patients with Prediabetes. J Dent Res 2018; 98:171-179. [DOI: 10.1177/0022034518804185] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Evidence is limited regarding whether periodontal treatment improves hemoglobin A1c (HbA1c) among people with prediabetes and periodontal disease, and it is unknown whether improvement of metabolic status persists >3 mo. In an exploratory post hoc analysis of the multicenter randomized controlled trial “Antibiotika und Parodontitis” (Antibiotics and Periodontitis)—a prospective, stratified, double-blind study—we assessed whether nonsurgical periodontal treatment with or without an adjunctive systemic antibiotic treatment affects HbA1c and high-sensitivity C-reactive protein (hsCRP) levels among periodontitis patients with normal HbA1c (≤5.7%, n = 218), prediabetes (5.7% < HbA1c < 6.5%, n = 101), or unknown diabetes (HbA1c ≥ 6.5%, n = 8) over a period of 27.5 mo. Nonsurgical periodontal treatment reduced mean pocket probing depth by >1 mm in both groups. In the normal HbA1c group, HbA1c values remained unchanged at 5.0% (95% CI, 4.9% to 6.1%) during the observation period. Among periodontitis patients with prediabetes, HbA1c decreased from 5.9% (95% CI, 5.9% to 6.0%) to 5.4% (95% CI, 5.3% to 5.5%) at 15.5 mo and increased to 5.6% (95% CI, 5.4% to 5.7%) after 27.5 mo. At 27.5 mo, 46% of periodontitis patients with prediabetes had normal HbA1c levels, whereas 47.9% remained unchanged and 6.3% progressed to diabetes. Median hsCRP values were reduced in the normal HbA1c and prediabetes groups from 1.2 and 1.4 mg/L to 0.7 and 0.7 mg/L, respectively. Nonsurgical periodontal treatment may improve blood glucose values among periodontitis patients with prediabetes (ClinicalTrials.gov NCT00707369).
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Affiliation(s)
- T. Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Unit of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - B. Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Unit of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - A. Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - P. Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - T. Hoffmann
- Department of Periodontology, Faculty of Medicine, Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - D. Kaner
- Department of Periodontology, Witten/Herdecke University, Witten, Germany
- Department of Periodontology and Synoptic Dentistry, Charité Centrum 3, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - T.S. Kim
- Section of Periodontology, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - J. Meyle
- Department of Periodontology, Justus-Liebig University Giessen, Giessen, Germany
| | - U. Schlagenhauf
- Department of Periodontology, University Hospital Würzburg, Würzburg, Germany
| | - S. Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - M. Gravemeier
- Department of Periodontology, University Hospital Münster, Münster, Germany
| | - K. Prior
- Department of Periodontology, University Hospital Münster, Münster, Germany
| | - W. Rathmann
- German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, Germany
| | - I. Harks
- Department of Periodontology, University Hospital Münster, Münster, Germany
| | - B. Ehmke
- Department of Periodontology, University Hospital Münster, Münster, Germany
| | - R. Koch
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
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Gürsoy M, Wilensky A, Claffey N, Herrera D, Preshaw PM, Sanz M, Schlagenhauf U, Trombelli L, Demirel K. Periodontal education and assessment in the undergraduate dental curriculum-A questionnaire-based survey in European countries. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e488-e499. [PMID: 29460375 DOI: 10.1111/eje.12330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This survey aimed to evaluate whether periodontal education and assessment in undergraduate dental curricula amongst the member countries of the European Federation of Periodontology (EFP) follow the competency-based curricular guidelines and recommendations developed by the Association for Dental Education in Europe. MATERIALS AND METHODS A multiple-choice questionnaire was emailed to 244 dental institutes amongst the 24 EFP member countries between November 2014 and July 2015. RESULTS Data were received from 16 (66.7%) EFP member countries. Out of 117 responding dental institutes, 76 (64.95%) were included as valid responders. In most of the institutes (86.3%), a minimum set of competencies in periodontology was taken into account when constructing their dental education programmes. Out of 76 responders, 98.1% included lecture-based, 74.1% case-based and 57.1% problem-based teaching in their periodontal curricula, whilst a minority (15.9%) also used other methods. A similar pattern was also seen in the time allocation for these four educational methods, that is, the highest proportion (51.8%) was dedicated to lecture-based teaching and only a small proportion (5.7%) to other methods. Periodontal competencies and skills were most frequently assessed by clinical grading on clinic, multiple-choice examination (written examination) and oral examination, whereas competency tests and self-assessment were rarely used. Only in 11 (14.5%) cases, access flap procedures were performed by students. CONCLUSION Great diversity in teaching methodology amongst the surveyed schools was demonstrated, and thus, to harmonise undergraduate periodontal education and assessment across Europe, a minimum set of recommendations could be developed and disseminated by the EFP.
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Affiliation(s)
- M Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - A Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - N Claffey
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - D Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
| | - P M Preshaw
- Centre for Oral Health Research and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - M Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
| | - U Schlagenhauf
- Department of Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - L Trombelli
- School of Dentistry & Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - K Demirel
- Department of Periodontology, Istanbul University, Istanbul, Turkey
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Aarabi G, Schnabel RB, Heydecke G, Seedorf U. Potential Impact of Oral Inflammations on Cardiac Functions and Atrial Fibrillation. Biomolecules 2018; 8:biom8030066. [PMID: 30071583 PMCID: PMC6164509 DOI: 10.3390/biom8030066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/14/2018] [Accepted: 07/26/2018] [Indexed: 02/07/2023] Open
Abstract
Inflammation may be a risk factor for atrial fibrillation (AF). Oral infections frequently lead to chronic inflammation, such as gingivitis, periodontitis, and endodontic lesions. In this narrative review, we consider five basic pathogenic mechanisms that involve oral infections and inflammations in the pathogenesis of AF: (1) low level bacteremia by which oral bacteria enter the blood stream at inflamed sites of the oral cavity and invade the heart; (2) Systemic inflammation induced by inflammatory mediators, which are released from the sites of oral inflammation into the blood stream, affecting cardiac remodeling; (3) autoimmunity against molecular structures expressed in the heart caused by the host immune response to specific components of oral pathogens; (4) potentially arrhythmic effects mediated by activation of the autonomous nervous system triggered by oral inflammations; and (5) arrhythmic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. A number of studies support the involvement of all five mechanisms, suggesting a potentially complex contribution of oral inflammations to the pathogenesis of AF.
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Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany.
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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Roles of Oral Infections in the Pathomechanism of Atherosclerosis. Int J Mol Sci 2018; 19:ijms19071978. [PMID: 29986441 PMCID: PMC6073301 DOI: 10.3390/ijms19071978] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 12/14/2022] Open
Abstract
Oral infections occur frequently in humans and often lead to chronic inflammations affecting the teeth (i.e., caries), the gingival tissues surrounding the teeth (i.e., gingivitis and endodontic lesions), and the tooth-supporting structures (i.e., periodontitis). At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. In this narrative review, we summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis.
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Suominen AL, Varsio S, Helminen S, Nordblad A, Lahti S, Knuuttila M. Dental and periodontal health in Finnish adults in 2000 and 2011. Acta Odontol Scand 2018; 76:305-313. [PMID: 29546776 DOI: 10.1080/00016357.2018.1451653] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We assessed dental and periodontal health in adults aged ≥30 years living in southern and northern Finland as part of the Health 2000/2011 Surveys (BRIF8901). MATERIAL AND METHODS Clinical findings in 2000 (n = 2967) and 2011 (n = 1496) included the presence of teeth and number of teeth with caries, fillings, fractures or periodontal pockets. RESULTS Edentulousness decreased in all age groups. The prevalence of those with no caries increased from 67% to 69% in men and from 80% to 85% in women, and of those with no periodontal pocketing from 26% to 30% in men and from 39% to 42% in women. In 2011, the mean number of decayed teeth was 0.8 in men and 0.3 in women, and the corresponding mean numbers of teeth with deepened periodontal pockets 5.6 and 3.7. The gender difference had levelled concerning edentulousness, number of teeth and DMF teeth, but still existed in the occurrence of caries and periodontal pocketing. CONCLUSION The findings were in line with other population-based reports in the 2000s. However, periodontal health in Finland seems not to be as good as in many European countries and in the USA.
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Affiliation(s)
- Anna L. Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Sinikka Varsio
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland
| | - Sari Helminen
- Insurance Medicine Unit, Benefit Services, The Social Insurance Institution, Helsinki, Finland
| | - Anne Nordblad
- Department for Social and Health Services, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital & Oulu University, Oulu, Finland
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Bahrami G, Vaeth M, Wenzel A, Isidor F. Marginal bone level in two Danish cross-sectional population samples in 1997-1998 and 2007-2008. Acta Odontol Scand 2018; 76:357-363. [PMID: 29648489 DOI: 10.1080/00016357.2018.1460492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to compare the marginal bone level of two randomly selected population samples from 1997/1998 and 2007/2008, with special emphasis on the role of smoking habits and gender. MATERIALS AND METHODS Two cross-sectional randomly selected population samples [1997/1998 (N = 616) and 2007/2008 (N = 396)] were analysed with respect to the marginal bone level. The marginal bone level was measured in full-mouth intraoral radiographs. Information on smoking was gathered using questionnaires. Multiple regression analysis was used in order to adjust for correlating factors (gender, age, smoking habits and number of teeth). RESULTS After adjusting for confounding factors, the population sample from 2007/2008 had on average a slightly, but statistically significantly, more reduced average marginal bone level (0.15 mm) than the population sample from 1997/1998. Men had more reduced marginal bone level than women (0.12 mm). Smokers in both population samples had more reduced marginal bone level than non-smokers (0.39 mm and 0.12 mm for 1997/1998; 0.65 mm and 0.16 mm for 2007/2008). CONCLUSIONS In these populations, sampled 10 years apart, the 2007/2008 population sample had a slightly more reduced marginal bone level than the 1997/1998 population sample. Men had more reduced marginal bone level than women, and smoking is considered a major risk factor for a reduced marginal bone level.
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Affiliation(s)
- Golnosh Bahrami
- Section of Prosthetic Dentistry, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michael Vaeth
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Samietz S, Jürgens C, Ittermann T, Holtfreter B, Pink C, Schipf S, Biffar R, Völzke H, Kocher T, Tost F. Cross-sectional association between oral health and retinal microcirculation. J Clin Periodontol 2018; 45:404-412. [DOI: 10.1111/jcpe.12872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Stefanie Samietz
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Clemens Jürgens
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Till Ittermann
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Christiane Pink
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Sabine Schipf
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Henry Völzke
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Frank Tost
- Department of Ophthalmology; University Medicine Greifswald; Greifswald Germany
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Collecting standardised oral health data via mobile application: A proof of concept study in the Netherlands. PLoS One 2018; 13:e0191385. [PMID: 29415025 PMCID: PMC5802860 DOI: 10.1371/journal.pone.0191385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
FDI World Dental Federation, founded as Fédération Dentaire Internationale, has taken the initiative to develop the Oral Health Observatory, a mobile application to conduct oral health surveys worldwide. The aim is to collect reliable standardized international data on oral health and oral health care via a network of dentists. A proof of concept study project was set up in the Netherlands to test the methodology and to validate the approach. Data about caries, gingivitis, oral self-care and oral health related quality of life were analysed and compared to datasets validated in other studies. The Android app embeds three questionnaires addressing oral health history, status and patient behaviour. One questionnaire was completed by the patient and two by the dentist. The proof of concept study involved two phases: in the first phase, five dentists, regular participants in KNMT-surveys, evaluated the usability of the app; after the first phase, the app was adjusted for a second phase. For this phase an extra 15 dentists were recruited from a group of 20 other dentists: five of them declined to participate. Attention was paid to ensuring there was a proportional representation of gender, age and region. In the second phase the five first and 15 new participants collected data on up to a maximum of 38 patients. Data from this 653 patients correspond with results from previously published surveys on the prevalence of caries and gingivitis in the Netherlands. Hence demonstrating an association between caries and gingivitis with oral self-care, problems eating and experiencing oral pain. This proof of concept study shows that the app makes it possible to collect reliable information on oral health in a short period of time. Both dentists and patients evaluated the methodology as user-friendly. Altogether, the results of this proof of concept study are promising.
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Bullon P, Pavillard LE, de la Torre-Torres R. Inflammasome and Oral Diseases. EXPERIENTIA SUPPLEMENTUM (2012) 2018; 108:153-176. [PMID: 30536171 DOI: 10.1007/978-3-319-89390-7_7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
One of the main steps in the development of the life in the earth is multicellularity. It enables cell differentiation and the development of morphological structures within an organism and is an essential factor in how to recognize friendly cells that are part of the multicellular organism and which foreign organisms can be harmful. Recognition includes devices such as the major histocompatibility complex (MHC), and the pattern recognition receptors (PRRs). PRRs are a group of proteins expressed by cells of the innate immune system that identify two classes of products: pathogen-associated molecular patterns (PAMPs), related to microbial pathogens, and damage-associated molecular patterns (DAMPs), associated with cell components that are released during cell damage or death. All these activate the inflammasome, which is a multiprotein oligomer that includes caspase 1, PYCARD, NALP, and caspase 5 (also known as caspase 11 or ICH-3). It is responsible for activation of inflammatory processes and has been shown to induce cell pyroptosis, a programmed cell death distinct from apoptosis, and promotes the maturation of the inflammatory cytokines interleukin 1β (IL-1β) and interleukin 18 (IL-18). We review whether inflammasome is related to diseases that can occur in the oral cavity. The mouth is always a possible environment for the development of pathological conditions because of the wide variety of microorganisms. Small variations in the equilibrium of the oral flora can cause disorders that could affect the organism in a systemic form. We provide data on periodontal disease, candidiasis, herpes virus, oral cancer, caries, and other oral diseases. There are very few papers that study this issue; therefore, we need more investigation and publications about inflammatory molecular processes, and more specifically, related to the inflammasome complex.
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Affiliation(s)
- Pedro Bullon
- Departament Periodontology, Facultad de Odontología, Universidad de Sevilla, Sevilla, Spain.
| | - Luis E Pavillard
- Departament Periodontology, Facultad de Odontología, Universidad de Sevilla, Sevilla, Spain
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El Tantawi M, AlAgl A. Disability and the impact of need for periodontal care on quality of life: A cross-sectional study. J Int Med Res 2017. [PMID: 28635358 PMCID: PMC5805219 DOI: 10.1177/0300060517715376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective The need for periodontal care may negatively impact daily life. We compared
the need for periodontal care and its impact on daily life between disabled
and healthy adults in the Eastern Province, Saudi Arabia. Methods In this cross-sectional study of 819 adults, a questionnaire was used to
assess personal background factors; the impact of periodontitis on pain,
avoiding foods, embarrassment, sleeplessness, work absence, and
discontinuing daily activities; and risk factors (smoking, diabetes,
toothbrushing, insurance, professional tooth cleaning, and dental visits).
The outcome was clinically assessed need for periodontal care impacting
daily life. The relationship between the outcome and risk factors adjusted
for personal background and disability was assessed using ordinal
regression. Results Healthy and disabled persons had a high need for periodontal care (66.8%).
Current smokers had a higher likelihood and health-insured persons had a
lower likelihood of need for periodontal care impacting daily life
regardless of whether disability was considered. Conclusions Most adults needed periodontal care, and disabled persons experienced a
greater impact on life. Current smokers and uninsured persons were more
likely to need periodontal care impacting daily life. Our findings are
important for the prevention of periodontitis through tobacco cessation and
extending insurance coverage.
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Affiliation(s)
- Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia
| | - Adel AlAgl
- Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia
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Holde GE, Oscarson N, Trovik TA, Tillberg A, Jönsson B. Periodontitis Prevalence and Severity in Adults: A Cross-Sectional Study in Norwegian Circumpolar Communities. J Periodontol 2017; 88:1012-1022. [DOI: 10.1902/jop.2017.170164] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Gro Eirin Holde
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
- Department of Clinical Dentistry, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Nils Oscarson
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
- Department of Clinical Dentistry, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Tordis A. Trovik
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway
| | - Anders Tillberg
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
- Department of Clinical Dentistry, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Center of Northern Norway, Tromsø, Norway
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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Román-Malo L, Bullon P. Influence of the Periodontal Disease, the Most Prevalent Inflammatory Event, in Peroxisome Proliferator-Activated Receptors Linking Nutrition and Energy Metabolism. Int J Mol Sci 2017; 18:ijms18071438. [PMID: 28678155 PMCID: PMC5535929 DOI: 10.3390/ijms18071438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 12/14/2022] Open
Abstract
Periodontal disease is considered one of the main pathologic diseases occurring in humans. Its pathologic process involves inflammatory reactions producing periodontal bone resorption and the tooth loss. But some patients do not present an evident clinical inflammation with bone resorption, and in others, the inflammation is prominent without bone resorption. A key question could be to investigate a different way of responding to aggression. Inflammation requires a complex intracellular metabolic process, starting with the harmful recognition and activation of the inflammasome, continues the energy supply with the alteration of oxidative stress conditions, and finishes with the elimination of the aggression with autophagy/apoptosis mechanisms, then concludes with recovery. Peroxisome proliferator-activated receptors (PPARs) are essential molecules produced in inflammation, and its genes and its activation have been related to periodontal disease. Also, an important aspect is the influence of PPARs in bone metabolism; the main periodontitis symptom is bone loss and PPARγ activation that can downregulate the bone resorption in experimental periodontitis, PPARγ-coated titanium dental implant surfaces could carry the antiinflammatory gene and restrain inflammation. PPARs could be one of the meeting background points with atherosclerosis/cardiovascular disease, diabetes and metabolic syndrome showing a modified proinflammatory statement such as it is described in periodontitis.
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Affiliation(s)
- Lourdes Román-Malo
- Laboratorio de Investigacion, Departamento de Estomatologia, Universidad de Sevilla, c/ Avicena s/n, Sevilla 41009, Spain.
| | - Pedro Bullon
- Laboratorio de Investigacion, Departamento de Estomatologia, Universidad de Sevilla, c/ Avicena s/n, Sevilla 41009, Spain.
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Shi Q, Cai C, Xu J, Liu J, Liu H, Huo N. Is there an association between IFN-γ +874A/T polymorphism and periodontitis susceptibility?: A meta-analysis. Medicine (Baltimore) 2017; 96:e7288. [PMID: 28640144 PMCID: PMC5484252 DOI: 10.1097/md.0000000000007288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Interferon-γ (IFN-γ) is a key proinflammatory cytokine which plays a critical role in the pathogenesis and progression of periodontitis. The single nucleotide polymorphism of +874A/T in human IFN-γ gene can influence the secretion of IFN-γ and affect periodontitis susceptibility. However, the findings of published studies are inconsistent. Therefore, the goal of this meta-analysis is to investigate whether there is an association between IFN-γ +874A/T polymorphism and periodontitis susceptibility. METHODS PubMed and the Cochrane Library were searched for eligible clinical studies. The odds ratio (OR) and 95% confidence interval (CI) of each study were pooled to estimate the strength of association between +874A/T and periodontitis. Subgroup analyses were performed to explore whether particular characteristics of studies were related to the overall results. RESULTS Seven studies and a total of 1252 periodontitis patients and 1622 periodontitis-free control subjects were included. No difference was observed in genotype distribution and allele frequency between periodontitis patients and control (T vs A: OR = 1.01, 95% CI: 0.90-1.13, P = .878; TT vs AA: OR = 1.07, 95% CI: 0.87-1.32, P = .537; AT vs AA: OR = 1.00, 95% CI: 0.81-1.23, P = .996; TT+AT vs AA: OR = 1.00, 95% CI: 0.84-1.19, P = .990; TT vs AA+AT: OR = 1.03, 95% CI: 0.86-1.23, P = .733). Besides, the subgroup analysis based on ethnicity, type of periodontitis, and smoking status failed to identify significant differences in each model, either. CONCLUSIONS The results of this meta-analysis suggest that IFN-γ +874 A/T polymorphism may not contribute to periodontitis susceptibility. High quality and well-designed studies which combine genetic and other environmental risk factors are needed to validate this conclusion in the future.
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Persson GR. Dental geriatrics and periodontitis. Periodontol 2000 2017; 74:102-115. [DOI: 10.1111/prd.12192] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 01/10/2023]
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Thevissen E, De Bruyn H, Colman R, Koole S. Attitude of dental hygienists, general practitioners and periodontists towards preventive oral care: an exploratory study. Int Dent J 2017; 67:221-228. [PMID: 28303564 DOI: 10.1111/idj.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Promoting oral hygiene and stimulating patient's responsibility for his/her personal health remain challenging objectives. The presence of dental hygienists has led to delegation of preventive tasks. However, in some countries, such as Belgium, this profession is not yet legalized. The aim of this exploratory study was to compare the attitude towards oral-hygiene instructions and patient motivational actions by dental hygienists and by general practitioners/periodontists in a context without dental hygienists. MATERIALS AND METHODS A questionnaire on demographics (six items), oral-hygiene instructions (eight items) and patient motivational actions (six items) was distributed to 241 Dutch dental hygienists, 692 general practitioners and 32 periodontists in Flanders/Belgium. Statistical analysis included Fisher's exact-test, Pearson's chi-square test and multiple (multinomial) logistic regression analysis to observe the influence of profession, age, workload, practice area and chair-assistance. RESULTS Significant variance was found between general practitioners and dental hygienists (in 13 of 14 items), between general practitioners and periodontists (in nine of 14 items) and between dental hygienists and periodontists (in five of 14 items). In addition to qualification, chair-assistance was also identified as affecting the attitude towards preventive oral care. CONCLUSION The present study identified divergence in the application of, and experienced barriers and opinions about, oral-hygiene instructions and patient motivational actions between dental hygienists and general practitioners/periodontists in a context without dental hygienists. In response to the barriers reported it is suggested that preventive oriented care may benefit from the deployment of dental hygienists to increase access to qualified preventive oral care.
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Affiliation(s)
- Eric Thevissen
- Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium.,Praktijk voor Parodontologie, Hasselt, Belgium
| | - Hugo De Bruyn
- Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium.,Department of Prosthodontics, School of Dentistry, Malmö University, Malmö, Sweden
| | - Roos Colman
- Biostatistics Unit, Department of Public Health, Ghent University, Ghent, Belgium
| | - Sebastiaan Koole
- Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
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Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A Two-Domain Self-Report Measure of Periodontal Disease Has Good Accuracy for Periodontitis Screening in Dental School Outpatients. J Periodontol 2016; 87:1165-73. [DOI: 10.1902/jop.2016.160043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Raitapuro-Murray T, Molleson TI, Hughes FJ. The prevalence of periodontal disease in a Romano-British population c. 200-400 AD. Br Dent J 2016; 217:459-66. [PMID: 25342357 PMCID: PMC4340975 DOI: 10.1038/sj.bdj.2014.908] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/09/2022]
Abstract
Describes the prevalence of periodontal and other dental disease in an ancient British population from the examination of dried skulls. Estimates that the prevalence of established periodontitis in this population was around 5%, considerably lower than prevalence estimates for modern humans.
Objective The aim of this study was to investigate the prevalence of moderate to severe periodontitis in an ancient British cohort c. 200-400 AD. Design Observational study to assess periodontal and other oral disease parameters. Setting Natural History Museum, London. Subjects and methods 303 skulls from a Romano-British burial site in Poundbury, Dorset were examined for evidence of dental disease. Main outcome measures The primary outcome measure was presence of moderate to severe periodontitis. Secondary outcomes included: amount of horizontal bone loss; prevalence of ante-mortem tooth loss; and presence of other dental pathologies. Results The overall prevalence of moderate to severe periodontitis was just greater than 5%. The prevalence rate remained nearly constant between ages 20 to 60, after which it rose to around 10%. The number of affected teeth increased with age. Horizontal bone loss was generally minor. Caries was seen in around 50% of the cohort, and evidence of pulpal and apical pathology was seen in around 25%. Conclusions The prevalence of moderate to severe periodontitis was markedly decreased when compared to the prevalence in modern populations, underlining the potential importance of risk factors such as smoking and diabetes in determining susceptibility to progressive periodontitis in modern populations.
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Affiliation(s)
- T Raitapuro-Murray
- 1] [2] Barts &The London School of Medicine &Dentistry, Queen Mary University of London
| | | | - F J Hughes
- 1] Barts &The London School of Medicine &Dentistry, Queen Mary University of London [2] Kings College London Dental Institute, Floor 21 Tower Wing, Guys Hospital. London, SE1 9RT
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Wambier LM, de Geus JL, Chibinski ACR, Wambier DS, Rego RO, Loguercio AD, Reis A. Intra-pocket anaesthesia and pain during probing, scaling and root planing: a systematic review and meta-analysis. J Clin Periodontol 2016; 43:754-66. [PMID: 27097588 DOI: 10.1111/jcpe.12565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2016] [Indexed: 12/17/2022]
Abstract
AIM A systematic review/meta-analysis was performed to evaluate pain during probing, scaling and root planing using intra-pocket anaesthesia versus placebo in adult patients. METHODS A search was performed in PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library and Grey literature. IADR abstracts, unpublished trials registries, dissertations and theses were also searched for randomized clinical trials comparing the clinical effectiveness of intra-pocket anaesthesia and placebo. Risk/intensity of pain was the primary outcome. The risk of bias tool from the Cochrane Collaboration was used for quality assessment. Meta-analysis was performed on studies considered at low risk of bias. RESULTS A total of 1740 articles were identified. Eleven remained in the qualitative synthesis, and nine studies were considered at "low" risk of bias for meta-analysis. Standardized Hedge's g mean difference for pain intensity using visual analogue scale and Heft-Parker pain scales was -0.576 (95% confidence interval [CI] -0.94 to -0.22; p = 0.002) and for verbal rating scale pain scale it was -1.814 (95% CI -3.38 to -0.245; p = 0.023). The odds ratio for the risk of pain was 0.025 (95% CI 0.003 to 0.25; p = 0.002) and the odds ratio for the need for rescue anaesthesia it was 0.358 (95% CI 0.174 to 0.736; p = 0.005). CONCLUSIONS The anaesthetic gel decreases the risk and intensity of pain during probing/SRP.
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Affiliation(s)
- Letícia M Wambier
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Juliana L de Geus
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Ana C R Chibinski
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Denise S Wambier
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Rodrigo O Rego
- Department of Dentistry, Federal University of Ceará, Sobral, CE, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Pérez-Losada FL, Jané-Salas E, Sabater-Recolons MM, Estrugo-Devesa A, Segura-Egea JJ, López-López J. Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review. Med Oral Patol Oral Cir Bucal 2016; 21:e440-6. [PMID: 26827070 PMCID: PMC4920457 DOI: 10.4317/medoral.21048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/11/2015] [Indexed: 12/23/2022] Open
Abstract
Background Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. Material and Methods A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms “periodontal disease” AND “diabetes mellitus”. The review analyzed clinical trials of humans published in English and Spanish. Results Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of <40 patients, making a total of 108 patients and the remaining ten samples had >40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (p<
0.05) as a result of periodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. Conclusions The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitus. Key words:Diabetes, periodontal disease, HbA1c, metabolic control.
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Affiliation(s)
- F-L Pérez-Losada
- Department of Odontostomatology, School of Dentistry, Pabellón de Gobierno, Bellvitge University Campus, C/Feixa LLarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain,
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Carasol M, Llodra JC, Fernández-Meseguer A, Bravo M, García-Margallo MT, Calvo-Bonacho E, Sanz M, Herrera D. Periodontal conditions among employed adults in Spain. J Clin Periodontol 2016; 43:548-56. [DOI: 10.1111/jcpe.12558] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Miguel Carasol
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | | | | | - Manuel Bravo
- Faculty of Odontology; University of Granada; Granada Spain
| | | | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
- Spanish Society of Periodontology (SEPA); Spain
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Madianos P, Papaioannou W, Herrera D, Sanz M, Baeumer A, Bogren A, Bouchard P, Chomyszyn-Gajewska M, Demirel K, Gaspersic R, Giurgiu M, Graziani F, Jepsen K, Jepsen S, O′Brien T, Polyzois I, Preshaw PM, Rakic M, Reners M, Rincic N, Stavropoulos A, Sütcü S, Verner C, Llodra JC. EFP Delphi study on the trends in Periodontology and Periodontics in Europe for the year 2025. J Clin Periodontol 2016; 43:472-81. [DOI: 10.1111/jcpe.12551] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Phoebus Madianos
- School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - William Papaioannou
- School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Amelie Baeumer
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg Germany
| | - Anna Bogren
- Specialistkliniken för Parodontologi; Folktandvården Västra Götaland Göteborg; Göteborg Sweden
| | - Philippe Bouchard
- Department of Periodontology; Rothschild Hospital (AP-HP); UFR of Odontology; University of Paris Diderot; Paris France
- EA 2496; UFR of Odontology; University of Paris Descartes; Montrouge France
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine; Jagiellonian University; Collegium Medicum Cracow Poland
| | - Korkud Demirel
- Department of Periodontology; Istanbul University; Istanbul Turkey
| | - Rok Gaspersic
- Department of Oral Medicine and Periodontology; Faculty of Medicine; University of Ljubljana; Ljubljana Slovenia
| | - Marina Giurgiu
- Department of Periodontology; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - Filippo Graziani
- Department of Surgical; Medical and Molecular Pathology and Critical Care Medicine; Section of Dentistry; University of Pisa; Pisa Italy
| | - Karin Jepsen
- Department of Periodontology; Operative and Preventive Dentistry; University of Bonn; Bonn Germany
| | - Sören Jepsen
- Department of Periodontology; Operative and Preventive Dentistry; University of Bonn; Bonn Germany
| | | | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology; Dublin Dental University Hospital; Trinity College; Dublin Ireland
| | - Philip M. Preshaw
- Centre for Oral Health Research and Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - Mia Rakic
- Department for Periodontology and Oral Medicine; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | | | | | - Andreas Stavropoulos
- Department of Periodontology; Faculty of Odontology; Malmö University; Malmö Sweden
| | | | - Christian Verner
- Department of Periodontolgy; University of Nantes; Nantes France
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[Relation between diabetes and periodontal disease in an Spanish adult population]. Aten Primaria 2016; 48:558-559. [PMID: 27142592 PMCID: PMC6877878 DOI: 10.1016/j.aprim.2015.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 11/21/2022] Open
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