Systemic medication and the inflammatory cascade

Increased dental comorbidities in patients with psoriasis: a nationwide population-based cohort study in Korea

BACKGROUND

Limited data are available regarding the association between psoriasis and common dental conditions.

OBJECTIVES

To investigate the risk of potential dental comorbidities in patients with psoriasis.

METHODS

We conducted a nationwide population-based cohort study to analyse the claims data of patients with psoriasis (n = 15 165) and age- and sex-matched controls (n = 75 825). The incidence risk of the following potential dental conditions was analysed: dental caries, pulp and periapical disease, periodontal disease, gingival changes and tooth loss.

RESULTS

After adjusting for potential cofactors, the adjusted hazard ratios (aHRs) of dental caries [1.105; 95% confidence interval (CI) 1.078-1.132], pulp and periapical disease (1.07; 95% CI 1.044-1.096) and periodontal disease (1.108; 95% CI 1.088-1.129) were significantly higher than those in the control cohort (P < 0.001). However, among the subset of patients with psoriasis who received systemic antipsoriatic treatment (n = 4275), the aHR risk of all potential dental comorbidities was not significantly higher from that of the control cohort.

CONCLUSIONS

Patients with psoriasis have an increased risk of dental comorbidities, and systemic antipsoriatic treatment may help mitigate this increased risk.

Impact exerted by scaffolds and biomaterials in periodontal bone and tissue regeneration engineering: new challenges and perspectives for disease treatment

The periodontium is an appropriate target for regeneration, as it cannot restore its function following disease. Significantly, the periodontium's limited regenerative capacity could be enhanced through the development of novel biomaterials and therapeutic approaches. Notably, the regenerative potential of the periodontium depends not only on its tissue-specific architecture and function but also on its ability to reconstruct distinct tissues and tissue interfaces, implying that the development of tissue engineering techniques can offer new perspectives for the organized reconstruction of soft and hard periodontal tissues. With their biocompatible structure and one-of-a-kind stimulus-responsive property, hydrogels have been utilized as an excellent drug delivery system for the treatment of several oral diseases. Furthermore, bioceramics and three-dimensional (3D) printed scaffolds are also appropriate scaffolding materials for the regeneration of periodontal tissue, bone, and cartilage. This work aims to examine and update material-based, biologically active cues and the deployment of breakthrough bio-fabrication technologies to regenerate the numerous tissues that comprise the periodontium for clinical and scientific applications.

Computational drug repurposing by exploiting large-scale gene expression data: Strategy, methods and applications

De novo drug development is an extremely complex, time-consuming and costly task. Urgent needs for therapies of various diseases have greatly accelerated searches for more effective drug development methods. Luckily, drug repurposing provides a new and effective perspective on disease treatment. Rapidly increased large-scale transcriptome data paints a detailed prospect of gene expression during disease onset and thus has received wide attention in the field of computational drug repurposing. However, how to efficiently mine transcriptome data and identify new indications for old drugs remains a critical challenge. This review discussed the irreplaceable role of transcriptome data in computational drug repurposing and summarized some representative databases, tools and strategies. More importantly, it proposed a practical guideline through establishing the correspondence between three gene expression data types and five strategies, which would facilitate researchers to adopt appropriate strategies to deeply mine large-scale transcriptome data and discover more effective therapies.

Genotype-driven NPC1L1 and PCSK9 inhibition and reduced risk of periodontitis

AIM

Epidemiological and pre-clinical studies suggest a chemoprotective role of lipid-lowering agents in periodontitis. We tested the association of genetically proxied inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), Niemann-Pick C1-Like 1 (NPC1L1) and proprotein convertase subtilisin/kexin type 9 (PCSK9) with periodontitis.

MATERIALS AND METHODS

Genetic variants in HMGCR, NCP1L1 and PCSK9 associated with low-density lipoprotein (LDL) cholesterol in a genome-wide association study (GWAS) meta-analysis (N = 188,578) were used to proxy therapeutic inhibition of HMGCR, NPC1L1 and PCSK9. For these genetic variants, associations with periodontitis were obtained from GWAS of 17,353 cases and 28,210 controls in the GeneLifestyle Interactions in Dental Endpoints consortium. Generalized weighted least squares analysis accounted for linkage disequilibrium of genotypes to derive pooled estimates.

RESULTS

While genetically proxied HMGCR inhibition equivalent to 1 mmol/L reduction in LDL was not associated with odds of periodontitis (odds ratio [OR] = 0.92 [95% confidence interval [CI]: 0.73; 1.16]; p = .4905; false discovery rate [FDR] = 0.4905), genetically proxied NPC1L1 (OR = 0.53 [95% CI: 0.35; 0.81]; p = .0038; FDR = 0.0077) and PCSK9 (OR = 0.84 [95% CI: 0.74; 0.95]; p = .0051; FDR = 0.0077) inhibition lowered the odds of periodontitis.

CONCLUSIONS

Genetically proxied inhibition of NCP1L1 and PCSK9 was associated with lower odds of periodontitis.

The Effects of Prednisone/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy; seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II); seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy.

Association between motor proficiency and oral health in people with intellectual disabilities

BACKGROUND

People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver.

METHODS

In this cross-sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks-Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance.

RESULTS

The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06-1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33-0.75) and precision (PR = 0.50; 95% CI 0.26-0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49-0.77), presented better results.

CONCLUSION

Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.

Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention

Oral diseases are highly prevalent and a global burden. Accordingly, their prevention appears essential. Recently, different strategies have been developed, mainly focusing on the presence of singular oral diseases or conditions. This article aims to construct a contemporary concept of individualized preventive care in dentistry whereby the focus is switched from viewing oral health in isolation to viewing the patient as a whole. The basis for individualized prevention measures is the case-oriented profile, including the synthesis of risk- and need-oriented parameters. The risk profile comprises different risk factors within the fields of systemic diseases, medications, and lifestyle that inherently pose a potential risk of complications (e.g., infectious endocarditis) and/or oral diseases (e.g., periodontitis). The needs profile includes factors originating from the aspects of oral diseases, dental restorations/appliances, and dental results with a potential risk of pathogenesis (e.g., the de novo development of caries) and/or the potential progression of oral diseases (e.g., an existing caries lesion). Based on these parameters, the general framework and content of prevention measures, as well as the maintenance interval, should be adapted to the individual patient. The implications of this concept might increase the safety, effectiveness, and efficiency of prevention in dental care. A further area of focus is primary prevention, that is, a focus on the preservation of oral health instead of a disease-related approach. However, clinical validation is needed to prove the benefits of the model presented. Individualized prevention promotes a shift from a disease-focused model to a whole-patient-focused model and provides a potential approach for establishing a contemporary concept for preventive care in dentistry.

Clinical periodontal and dental findings in liver transplant patients: a systematic review and meta-analysis

Objectives This systematic review aimed to investigate the oral health of post-liver transplant recipients (postLTx), in terms of dental and periodontal clinical results.Data sources Pubmed/MEDLINE and Cochrane Library databases were searched electronically.Data selection Prospective, cross-sectional and case-control studies comparing periodontal and dental health of postLTx patients with healthy and/or pre-liver transplant patients.Data extraction This was performed independently by two authors. Quality assessment was done by using tools from the National Heart, Lung, and Blood Institute.Data synthesis Nine studies were eligible for inclusion in the systematic review. A meta-analysis was performed on gingival inflammation, expressed by scores, on four studies including healthy controls. The gingival index scores were significantly higher in postLTx patients compared with healthy controls (p <0.001). The weighted mean difference was 0.91 (95% confidence interval, 0.44 to 1.38, heterogeneity I² = 99.5%). Increased tendency of gingival enlargement was noticed in postLTx patients, especially after immunosuppression with Cyclosporine A. Controversial results were reported for the prevalence of caries in postLTx recipients, but there seems to be an increase.Conclusion The results suggest that patients with liver transplants, due to systemic condition and immunosuppressive therapy, exhibit a higher degree of gingival inflammation compared with unexposed patients.Prospero registration number: CRD42019121893.

Association between periodontitis and systemic medication intake: A case-control study

BACKGROUND

To investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis.

METHODS

A total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age- and gender-matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression.

RESULTS

The top three most common medications were angiotensin-converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid-lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally, intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity-dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively.

CONCLUSION

There was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity-dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis.

Factors affecting decision making at reassessment of periodontitis. Part 2: interpretation of clinical findings - systemic factors

This paper is the second in a four-part series outlining treatment planning at periodontal reassessment. The first article focussed on the information that should be gathered at the reassessment appointment. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option. Residual periodontal probing depths can be associated with both systemic and local factors. This article (part 2) outlines systemic factors that need to be assessed when faced with residual periodontal probing depths.

Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation

OBJECTIVE

To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed.

DESIGN

Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated.

RESULT

Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects.

CONCLUSION

Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.

Effects of Selective Versus Non-Selective COX-2 Inhibition on Experimental Periodontitis

In the present study we compared the effects of the selective COX-2 inhibitor etoricoxib with those of the classical non-selective NSAID diclofenac on the inflammatory process and alveolar bone loss in an experimental model of periodontitis in rats. Ninety male Holtzman rats (250 g) were randomly sorted into four experimental groups: Sham+CMC and Ligature+CMC (control) groups which received 0.5% carboxymethylcellulose sodium (CMC) solution; Ligature+Diclofenac and Ligature+Etoricoxib groups which received Potassium Diclofenac and Etoricoxib, respectively, suspended in 0.5% CMC (10 mg/kg/day). At 7, 14 and 21 days after placing ligatures in the cervical region of both the lower right and left first molars, the animals were euthanized. At the end of each period, the mandibles were collected for radiographic examination of alveolar bone loss. In addition, alveolar bone and periodontal ligament tissue samples were collected for COX-2 expression analysis and gingival tissues were collected for measurement of PGE2 contents. Animals with ligature-induced periodontal disease showed significant increased COX-2 gene expression at days 7, 14 and 21 (p<0.05) on alveolar bone and periodontal ligament. However, both treatments resulted in significantly reduced alveolar bone loss when compared to the untreated Ligature group (p<0.05), with no statistical difference between Etoricoxib and Diclofenac Potassium groups. This study shows that both drugs were able to reduce alveolar bone loss after periodontal disease induction.

Association of time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected bacteria of patients after solid organ transplantation

Background

Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT).

Material and Methods

169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Periodontal probing depth (PPD) and clinical attachment loss (CAL) were assessed. Periodontal disease severity was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were investigated for eleven selected potentially periodontal pathogenic bacteria using polymerasechainreaction.

Results

The mean PPD and CAL as well as prevalence of Treponema denticola and Capnocytophaga species was shown to be different but heterogeneous depending on time under immunosuppression (p<0.05). Furthermore, only the medication with Cyclosporine was found to show worse periodontal condition compared to patients without Cyclosporine (p<0.05). Prevalence of Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum was reduced and prevalence of Parvimonas micra and Capnocytophaga species was increased in patients under immunosuppression with Glucocorticoids, Mycophenolate as well as combination therapy.

Conclusions

Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT. Patients under Cyclosporine medication should receive increased attention. Differences in subgingival biofilm, but not in clinical parameters were found for Glucocorticoids, Mycophenolate and combination therapy, making the clinical relevance of this finding unclear.

Key words:Immunosuppression, organ transplantation, periodontitis, periodontal bacteria.

Periodontal status in chronic periodontitis depressed patients on desvenlafaxine: An observational study

Background:

A wide variety of drugs have the potential to affect immune and inflammatory responses of periodontium. A class of antidepressant drug, selective serotonin and norepinephrine reuptake inhibitors, has shown anti-inflammatory function. The aim of the present study is to explore the effect of desvenlafaxine on clinical periodontal parameters in patients with chronic periodontitis.

Materials and Methods:

The patients were divided into two groups as follows: test group (n = 63) comprised of participants on 50 mg once-daily dose of desvenlafaxine for ≥2 months and control group (n = 72) included participants who were yet to be prescribed medication for depression. Periodontal parameters of both the groups were analyzed and compared statistically.

Results:

Participants taking desvenlafaxine revealed lower values of periodontal parameters as compared to those in control group. The number of pockets with greater depth and clinical attachment loss was greater in control group.

Conclusion:

In our study, patients on desvenlafaxine were associated with less pocket depth and bleeding on probing.

Kava-241 reduced periodontal destruction in a collagen antibody primed Porphyromonas gingivalis model of periodontitis

AIM

The aim of this study was to evaluate the effect of Kava-241, an optimized Piper methysticum Kava compound, on periodontal destruction in a collagen antibody primed oral gavage model of periodontitis.

METHODS

Experimental periodontitis was induced by oral gavage of Porphyromonas gingivalis (P. gingivalis) + type II collagen antibody (AB) in mice during 15 days. Mice were treated with Kava-241 concomitantly or prior to P. gingivalis gavage and compared to untreated mice. Comprehensive histomorphometric analyses were performed.

RESULTS

Oral gavage with P. gingivalis induced mild epithelial down-growth and alveolar bone loss, while oral gavage with additional AB priming had greater tissular destruction in comparison with gavage alone (p < .05). Kava-241 treatment significantly (p < .05) reduced epithelial down-growth (72%) and alveolar bone loss (36%) in P. gingivalis+AB group. This Kava-241 effect was associated to a reduction in inflammatory cell counts within soft tissues and an increase in fibroblasts (p < .05).

CONCLUSION

Priming with type II collagen antibody with oral gavage is a fast and reproducible model of periodontal destruction adequate for the evaluation of novel therapeutics. The effect of Kava-241 shows promise in the prevention and treatment of inflammation and alveolar bone loss associated with periodontitis. Further experiments are required to determine molecular pathways targeted by this therapeutic agent.

Cross-Sectional Evaluation of Periodontal Status and Microbiologic and Rheumatoid Parameters in a Large Cohort of Patients With Rheumatoid Arthritis

BACKGROUND

This study evaluates periodontal conditions and microbiologic findings and their influence on rheumatologic disease parameters in patients with rheumatoid arthritis (RA).

METHODS

One hundred and sixty-eight patients with RA were included. A healthy control group (HC, n = 168) was composed according to age, sex, and smoking habits. Rheumatologic data (duration of illness, Disease Activity Score 28, rheumatic factor [RF], anti-cyclic citrullinated peptide [aCCP], medications) were extracted from patients' records. Dental examination included: 1) dental findings (decayed, missing, and/or filled adult teeth [DMF-T] index); 2) gingival inflammation (papillary bleeding index [PBI]); and 3) periodontal status (probing depth [PD], attachment loss [AL]). Periodontal condition was classified as healthy/mild, moderate, or severe periodontitis. Subgingival biofilm was analyzed regarding 11 periodontopathogenic bacteria. Statistical analyses included: 1) Kolmogorov-Smirnov test; 2) Mann-Whitney U test; 3) Pearson χ² test; 4) Kruskal-Wallis test; and 5) regression analysis; level of significance α = 5%.

RESULTS

Mean DMF-T was significantly higher in patients with RA (19.3 ± 4.8) than in HC group (16.9 ± 5.8), especially owing to number of missing teeth (RA = 6.0 ± 5.4, HC = 3.1 ± 3.3; P <0.01). Patients with RA had a significantly higher proportion of increased PD (P <0.01) and AL compared with HC group (P <0.01). Moderate to severe periodontitis was noted in 98% of patients with RA and 82% of the HC group (P <0.01). RF-positive patients with RA suffered from worse periodontal conditions than RF-negative patients (P = 0.01). Age, PBI, and presence of Treponema denticola (P <0.03) are related to periodontal condition in patients with RA. Although not statistically significant, Porphyromonas gingivalis and Fusobacterium nucleatum occur in higher concentrations more often in aCCP-positive patients with RA (P = 0.06).

CONCLUSIONS

Patients with RA had worse periodontal conditions than HC participants. Although a trend for higher F. nucleatum and P. gingivalis concentrations in aCCP-positive patients with RA was found, importance of periodontal pathogenic bacteria and rheumatoid parameters in the interrelationship between periodontitis and RA remains unclear.

Cytokines during periodontal wound healing: potential application for new therapeutic approach

Regeneration of periodontal tissues is one of the main goals of periodontal therapy. However, current treatment, including surgical approach, use of membrane to allow maturation of all periodontal tissues, or use of enamel matrix derivatives, presents limitations in their indications and outcomes leading to the development of new tissue engineering strategies. Several cytokines are considered as key molecules during periodontal destruction process. However, their role during each phase of periodontal wound healing remains unclear. Control and modulation of the inflammatory response and especially, release of cytokines or activation/inhibition in a time- and spatial-controlled manner may be a potential perspective for periodontal tissue engineering. The aim of this review was to summarize the specific role of several cytokines during periodontal wound healing and the potential therapeutic interest of inflammatory modulation for periodontal regeneration especially related to the expression sequence of cytokines.

Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

STUDY OBJECTIVES

To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis.

DESIGN

Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos.

SETTING

Community-based setting with probability sampling from four urban US communities.

PARTICIPANTS

12,469 adults aged 18-74 y.

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

Severe chronic periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology case classification based on full-mouth periodontal assessments performed by calibrated dentists. SDB was evaluated in standardized home sleep tests, and defined as the number of apnea plus hypopnea events associated with ≥ 3% desaturation, per hour of estimated sleep. SDB was quantified using categories of the apnea-hypopnea index (AHI): 0.0 events (nonapneic); 0.1-4.9 (subclinical); 5.0-14.9 (mild); and ≥ 15 (moderate/severe). Covariates were demographic characteristics and established periodontitis risk factors. C-reactive protein was a potential explanatory variable. Using survey estimation, multivariable binary logistic regression estimated odds ratios (OR) and 95% confidence limits (CL). Following adjustment for confounding, the SDB and periodontitis relationship remained statistically significant, but was attenuated in strength and no longer dose-response. Compared with the nonapneic referent, adjusted odds of severe periodontitis were 40% higher with subclinical SDB (OR = 1.4, 95% CL: 1.0, 1.9), 60% higher with mild SDB (OR = 1.6, 95% CL: 1.1, 2.2) and 50% higher with moderate/severe SDB (OR = 1.5, 95% CL: 1.0, 2.3) demonstrating an independent association between SDB and severe periodontitis.

CONCLUSIONS

This study identifies a novel association between mild sleep disordered breathing and periodontitis that was most pronounced in young adults.

Effect of Fluoxetine on Periodontal Status in Patients With Depression: A Cross-Sectional Observational Study

BACKGROUND

Fluoxetine, a selective serotonin reuptake inhibitor, has been reported to reduce periodontal disease severity in a rat ligature-induced periodontitis model. The objective of the present study is to investigate the influence of fluoxetine intake on periodontal parameters in patients with periodontitis with clinical depression.

METHODS

A sample of 236 patients with chronic periodontitis and clinical depression were assessed for clinical parameters of periodontal disease. Of these, 115 patients were taking fluoxetine (20 mg/day) for ≥2 months, and 121 patients were not. Participants taking fluoxetine were further analyzed for correlation between duration of drug intake and periodontal parameters.

RESULTS

All periodontal parameters, except plaque index, were significantly lower in participants taking fluoxetine (P <0.01). Partial correlation analysis, adjusted for confounders, revealed a significant and negative correlation between duration of fluoxetine intake and attachment loss (AL) (R(2) = -0.321, P <0.05). Logistic regression analysis revealed that fluoxetine intake was associated with a lower risk of having AL ≥3 (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.31 to 0.96) and lower odds of increased bleeding on probing (BOP) percentage values (OR = 0.62, 95% CI = 0.34 to 0.97).

CONCLUSION

In this observational study, use of fluoxetine was associated with lower BOP percentages and reduced AL.

Combination effects of baicalein with antibiotics against oral pathogens

BACKGROUND

Baicalein is one of the major flavonoids in Scutellaria baicalensis Georgi, which has long been used in Asia as herbal medicine. Several biological effects of baicalein, such as antiviral, anti-inflammatiom, anti-hepatotoxicity, and anti-tumour properties, have been reported.

OBJECTIVE AND DESIGN

In this study, the antibacterial activities of baicalein were investigated in combination with ampicillin and/or gentamicin against oral bacteria.

RESULTS

Baicalein was determined with MIC and MBC values ranging from 80 to 320 and 160 to 640 μg/mL against oral bacteria. The range of MIC₅₀ and MIC₉₀ were 20-160 μg/mL and 80-320 μg/mL, respectively. The combination effects of baicalein with antibiotics were synergistic (FIC index <0.375-0.5 and FBCI <0.5) against oral bacteria. Furthermore, a time-kill study showed that the growth of the tested bacteria was completely attenuated after 1-6 h of treatment with the MIC₅₀ of baicalein, regardless of whether it was administered alone or with ampicillin or gentamicin.

CONCLUSION

These results suggest that baicalein combined with other antibiotics may be microbiologically beneficial and not antagonistic.