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Patridge E, Gorakshakar A, Molusky MM, Ogundijo O, Janevski A, Julian C, Hu L, Vuyisich M, Banavar G. Microbial functional pathways based on metatranscriptomic profiling enable effective saliva-based health assessments for precision wellness. Comput Struct Biotechnol J 2024; 23:834-842. [PMID: 38328005 PMCID: PMC10847690 DOI: 10.1016/j.csbj.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
It is increasingly recognized that an important step towards improving overall health is to accurately measure biomarkers of health from the molecular activities prevalent in the oral cavity. We present a general methodology for computationally quantifying the activity of microbial functional pathways using metatranscriptomic data. We describe their implementation as a collection of eight oral pathway scores using a large salivary sample dataset (n = 9350), and we evaluate score associations with oropharyngeal disease phenotypes within an unseen independent cohort (n = 14,129). Through this validation, we show that the relevant oral pathway scores are significantly worse in individuals with periodontal disease, acid reflux, and nicotine addiction, compared with controls. Given these associations, we make the case to use these oral pathway scores to provide molecular health insights from simple, non-invasive saliva samples, and as molecular endpoints for actionable interventions to address the associated conditions.
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Affiliation(s)
- Eric Patridge
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | - Anmol Gorakshakar
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | | | - Oyetunji Ogundijo
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | - Angel Janevski
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | - Cristina Julian
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | - Lan Hu
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
| | | | - Guruduth Banavar
- Viome Research Institute, Viome Life Sciences Inc., New York City, USA
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Joshi NP, Shrestha A, Bhagat T, Agrawal SK, Chhetri R. The Oral Health Condition of Patients on Hemodialysis at a Tertiary Healthcare Facility in Eastern Nepal. Int J Dent 2024; 2024:3776702. [PMID: 38375436 PMCID: PMC10876310 DOI: 10.1155/2024/3776702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives This study was done to compare the oral health of chronic kidney disease (CKD) patients on hemodialysis to healthy individuals and to assess the effect of the duration of dialysis on oral health. Materials and Methods A comparative cross-sectional study was conducted among purposively selected 54 cases undergoing dialysis and 54 apparently healthy controls. Caries experience and periodontal status were recorded under similar examination conditions and compared between cases and controls. The correlation between oral health and the duration of dialysis was assessed. A p value of <0.05 was considered significant. Results The mean age of the participants was 47.09 ± 12.23 years. Median caries experience among cases and controls was two (0-26) and three (0-15), respectively (p=0.013). Periodontitis among the two groups was found to be significantly different with a greater number of cases showing increased severity (p < 0.001). The severe form of periodontitis was associated with a greater mean duration of dialysis. Conclusion Significant differences exist between the periodontal health of patients undergoing dialysis compared to healthy controls. Longitudinal studies are required to check the causal effect of CKD on periodontitis.
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Affiliation(s)
| | - Ashish Shrestha
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Tarakant Bhagat
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Santosh Kumari Agrawal
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Roshan Chhetri
- Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
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Albagieh H, Alosimi A, Aldhuhayan A, AlAbdulkarim A, Fatani B, Alabood A. Dental management of patients with renal diseases or undergoing renal transplant. Saudi Dent J 2024; 36:270-276. [PMID: 38420005 PMCID: PMC10897630 DOI: 10.1016/j.sdentj.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The kidneys carry out many essential processes. A reduced glomerular filtration rate is the primary cause of renal failure. Patients with chronic kidney disease are significantly increasing all around the world. Patients with varying degrees of renal disease will be seen on the dental chair, and the dentist must be aware of dental considerations when treating such patient. Dental clinicians should carefully evaluate the oral findings and general condition of the renal disease patient. OBJECTIVE To increase the awareness of dentists in the dental management of patients with renal diseases or undergoing renal transplant. METHODS This study reviews 56 articles searched on two databases PubMed and Google Scholar with English language. CONCLUSION Every dentist should be well-informed regarding dental considerations and oral manifestations when treating a patient with any renal disease. Simple treatment plan modification can prevent the evolution of mild to critical medical or dental complications in renal disease patients.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Asim Alosimi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Bader Fatani
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Teodoro Nepomuceno G, Silva Neres Dos Santos R, Avance Pavese L, Parize G, Pallos D, Sorelli Carneiro-Ramos M, da Silva Martinho H. Periodontal disease in chronic kidney disease patients: salivomics by Fourier-transform infrared spectroscopy. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2023; 40:C93-C100. [PMID: 37132977 DOI: 10.1364/josaa.482903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
It has been reported that 58% of individuals with chronic kidney disease (CKD) have moderate to advanced periodontitis due to alterations of pH and biochemical composition in the saliva. In fact, the composition of this important biofluid may be modulated by systemic disorders. Here we investigate the micro-reflectance Fourier-transform infrared spectroscopy (FTIR) spectra of saliva that CKD patients submitted to periodontal treatment, aiming to identify spectral biomarkers of kidney disease evolution and the effectiveness of periodontal treatment, proposing possible biomarkers of disease evolution. Saliva from 24 CKD patients-stage-5 men, 29 to 64 years old-was evaluated in (i) patients starting periodontal treatment; (ii) patients 30 days after periodontal treatment; and (iii) patients 90 days after periodontal treatment. Our findings indicated that there are statistically relevant changes among the groups after 30 and 90 days of periodontal treatment, when considering the overall spectra in the fingerprint region (800-1800cm-1). The key bands presenting good prediction power (area under the receiver operating characteristic curve >0.70) were related to poly (ADP-ribose) polymerase (PARP) conjugated to DNA at 883, 1031, and 1060cm-1 (carbohydrates at 1043 and 1049cm-1) and triglycerides (1461cm-1). Interestingly when analyzing the derivative spectra in the secondary structure region (1590-1700cm-1), we detected over-expression of the β-sheet class of secondary structures in 90 days of periodontal treatment, possibly related to over-expression of human B-defensins. Conformational changes in ribose sugar in this region corroborate the interpretation concerning PARP detection. To our knowledge, PARP was detected for the first time in saliva samples of stage-5 CKD patients by FTIR. All observed changes were correctly interpreted in terms of intensive apoptosis and dyslipidemia due to kidney disease progression. Biomarkers due to CKD predominate in saliva, and the relative improvement in the periodontal state did not cause remarkable changes in the spectra of saliva.
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Chaudhry A, Kassim NK, Zainuddin SLA, Taib H, Ibrahim HA, Ahmad B, Hanafi MH, Adnan AS. Potential Effects of Non-Surgical Periodontal Therapy on Periodontal Parameters, Inflammatory Markers, and Kidney Function Indicators in Chronic Kidney Disease Patients with Chronic Periodontitis. Biomedicines 2022; 10:biomedicines10112752. [PMID: 36359271 PMCID: PMC9687126 DOI: 10.3390/biomedicines10112752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) and chronic periodontitis (CP) contribute to the increased level of inflammatory biomarkers in the blood. This study hypothesized that successful periodontal treatment would reduce the level of inflammatory biomarkers in CKD patients. This prospective study recruited two groups of CP patients: 33 pre-dialysis CKD patients and 33 non-CKD patients. All patients underwent non-surgical periodontal therapy (NSPT). Their blood samples and periodontal parameters were taken before and after six weeks of NSPT. The serum level of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and periodontal parameters were compared between groups. On the other hand, kidney function indicators such as serum urea and estimated glomerular filtration rate (eGFR) were only measured in CKD patients. Clinical periodontal parameters and inflammatory markers levels at baseline were significantly higher (p < 0.05) in the CKD group than in the non-CKD group and showed significant reduction (p < 0.05) after six weeks of NSPT. CKD patients demonstrated a greater periodontitis severity and higher inflammatory burden than non-CKD patients. Additionally, CKD patients with CP showed a good response to NSPT. Therefore, CKD patients’ periodontal health needs to be screened for early dental interventions and monitored accordingly.
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Affiliation(s)
- Ahmed Chaudhry
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nur Karyatee Kassim
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Basic Sciences and Medical Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Chemical Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: ; Tel.: +60-199-822-305
| | - Siti Lailatul Akmar Zainuddin
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Haslina Taib
- Periodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Hanim Afzan Ibrahim
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Basic Sciences and Medical Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Chemical Pathology Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Basaruddin Ahmad
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Biostatics Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Muhammad Hafiz Hanafi
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Azreen Syazril Adnan
- Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, Jalan Tun Hamdan Sheikh Tahir, Pulau Pinang 13200, Malaysia
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Tavares LTR, Saavedra-Silva M, López-Marcos JF, Veiga NJ, Castilho RDM, Fernandes GVDO. Blood and Salivary Inflammatory Biomarkers Profile in Patients with Chronic Kidney Disease and Periodontal Disease: A Systematic Review. Diseases 2022; 10:diseases10010012. [PMID: 35225864 PMCID: PMC8883939 DOI: 10.3390/diseases10010012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Periodontitis is the most prevalent inflammatory disease worldwide. Its inflammatory levels spread systemically, which can be associated with chronic kidney disease. Biomarkers have the potential to diagnose and correlate periodontitis and chronic kidney disease, helping to monitor systemic inflammation. Thereby, this study aimed to analyze the association between chronic kidney disease and periodontitis by conducting a biomarker analysis on blood and saliva. Material and methods: An electronic search through PubMed/MEDLINE, EMBASE, and Web of Science databases was conducted to identify clinical studies published in the last ten years, with no language restrictions. Twelve articles met all the inclusion criteria, two randomized controlled trials, one cohort study, and nine observational studies. Results: The studies included a total of 117 patients for saliva biomarkers, with a mean age of approximately 57 years old, and 56.68% of the subjects were female. After analyzing all the included studies, it was possible to verify the following biomarkers assessed: CRP, WBC, fibrinogen, IL-4 and -6, cardiac troponin T, NOx, ADMA, albumin, osteocalcin, cystatin C, PGLYRP1, cholesterol, HDL, LDL, triglycerides, and hemoglobin. Conclusion: A direct cause–effect association between periodontitis and CKD could not be established. However, it was possible to conclude that there was a correlating effect present, through the analyzed biomarkers.
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Affiliation(s)
- Lisandra Taísa Reginaldo Tavares
- Departamento de Cirurgía (Área de Estomatología), Facultad de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain; (L.T.R.T.); (J.F.L.-M.)
| | - Mariana Saavedra-Silva
- Biomedicine at the Medical Science Department, University of Beira Interior, 6201-506 Covilhã, Portugal;
| | - Joaquín Francisco López-Marcos
- Departamento de Cirurgía (Área de Estomatología), Facultad de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain; (L.T.R.T.); (J.F.L.-M.)
| | - Nélio Jorge Veiga
- Center for Interdisciplinary Research in Health (CIIS), Facultade de Medicina Dentária, Universidade Católica, 3504-505 Viseu, Portugal;
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Abou-Bakr A, Hussein RR, Khalil E, Ahmed E. The frequency of periodontitis in end-stage renal disease on hemodialysis in a sample of Egyptian population: multi-center clinical cross-sectional study. BMC Oral Health 2022; 22:1. [PMID: 34980089 PMCID: PMC8725326 DOI: 10.1186/s12903-021-02032-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/22/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND There is a general assumption that periodontal disease is highly prevalent among patients with chronic renal failure undergoing hemodialysis. The aim of the study to estimate the frequency of periodontitis in patients on hemodialysis among a sample of the Egyptian population, as well as the correlation between different clinical parameters of periodontal status with serum creatinine and blood urea. This may rule out the bidirectional relationship between periodontitis and renal failure in patients on hemodialysis. METHODS The study was conducted on 263 hemodialysis patients (165 males and 98 females) at three dialysis centers in Benha Governorate, Egypt (Benha Hospital, Tukh hospital, Qalyub hospital). Periodontal parameters including plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) had been recorded in these patients. Serum urea and creatinine levels had been measured, the data had been collected and undergone statistical analysis. RESULTS Frequency of periodontitis was 85.6% with stage III is the most prevalent stage. There was a significant positive strong correlation between age and periodontitis stage (rs = 0.707, p < 0.001). There was a positive correlation between clinical parameters and serum creatinine level. CONCLUSION In the present study, a high frequency of periodontitis had been found among ESRD patients on hemodialysis in the severe form (stage III) periodontitis. There was a significant direct correlation between the severity of periodontitis and CAL with a duration of hemodialysis. There was a weak insignificant association between periodontal indices (PD, BOP, and plaque score) and duration of hemodialysis.
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Affiliation(s)
- Asmaa Abou-Bakr
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Radwa R. Hussein
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Eman Khalil
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Enji Ahmed
- Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
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Kılıç Akça N, Efe Arslan D, İn H. Examination of factors affecting oral health in patients receiving haemodialysis. J Ren Care 2021; 48:262-271. [PMID: 34346175 DOI: 10.1111/jorc.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/14/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients receiving haemodialysis suffer from oral problems, pain, deteriorated nutrition, and decreased self-confidence and quality of life. Nurses have a critical role in the evaluation and care of oral health. OBJECTIVES The aim was to investigate the associations between socio-demographic characteristics, medication use, and biochemical blood levels and oral health in adult patients receiving haemodialysis treatment. DESIGN This study was conducted as a descriptive study. PARTICIPANTS The sample study was made up of one hundred and fifty individuals treated with haemodialysis between March and June 2018. MEASUREMENTS Patient diagnosis and Bedside Oral Exam guide was the tool used to examine oral health. RESULTS It was seen that patients' oral health worsened as the number of dental caries increased. It was found that low level of education, those with nonregular oral care and brushing teeth, those using parathyroid hormone-lowering agents and who stated they complied with the drug and diet therapy had higher mean Bedside Oral Exam guide scores, meaning their oral health was statistically significantly worse (p < 0.05). Bedside Oral Exam guide scores were weakly negatively correlated with predialysis serum potassium levels (r = -0.213; p = 0.009), weakly positively correlated with the daily fluid amount consumed (r = -0.185; p = 0.024), and decayed teeth (r = -0.224; p = 0.006). CONCLUSIONS Use of parathyroid hormone-lowering agents, low level of education, insufficient oral care, decayed teeth, compliance with diet and medication, daily liquid consumption, and low potassium levels could lead to an increased severity of poor oral health in patients receiving haemodialysis. Oral and dental health protocols should be developed for all haemodialysis units.
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Affiliation(s)
- Nazan Kılıç Akça
- Department of Nursing, İnternal Medicine Nursing, Faculty of Health Science, Izmir Bakırcay University, İzmir, Turkey
| | - Dilek Efe Arslan
- Halil Bayraktar Health Services Vocational College, University of Erciyes, Kayseri, Turkey
| | - Harun İn
- Aksaray Gülağaç Hospital, Erzurum, Turkey
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Sharma P, Fenton A, Dias IHK, Heaton B, Brown CLR, Sidhu A, Rahman M, Griffiths HR, Cockwell P, Ferro CJ, Chapple IL, Dietrich T. Oxidative stress links periodontal inflammation and renal function. J Clin Periodontol 2021; 48:357-367. [PMID: 33368493 PMCID: PMC7986430 DOI: 10.1111/jcpe.13414] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/06/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
Aims Patients with chronic kidney disease (CKD) are also susceptible to periodontitis. The causal link between periodontitis and CKD may be mediated via systemic inflammation/oxidative stress. Using structural equation modelling (SEM), this cross‐sectional study aimed to explore the causal relationship between periodontal inflammation (PI) and renal function. Materials and methods Baseline data on 770 patients with stage 3–5 (pre‐dialysis) CKD from an ongoing cohort study were used. Detailed, bioclinical data on PI and renal function, as well as potential confounders and mediators of the relationship between the two, were collected. SEMs of increasing complexity were created to test the causal assumption that PI affects renal function and vice versa. Results Structural equation modelling confirmed the assumption that PI and renal function are causally linked, mediated by systemic oxidative stress. The magnitude of this effect was such that a 10% increase in PI resulted in a 3.0% decrease in renal function and a 10% decrease in renal function resulted in a 25% increase in PI. Conclusions Periodontal inflammation represents an occult source of oxidative stress in patients with CKD. Further clinical studies are needed to confirm whether periodontal therapy, as a non‐pharmacological approach to reducing systemic inflammatory/oxidative stress burden, can improve outcomes in CKD.
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Affiliation(s)
- Praveen Sharma
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Anthony Fenton
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | | | - Brenda Heaton
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | | | - Amneet Sidhu
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Mutahir Rahman
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | | | - Paul Cockwell
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | - Charles J Ferro
- Department of Nephrology, University Hospital Birmingham, Birmingham, UK
| | - Iain L Chapple
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, School of Dentistry, University of Birmingham and Birmingham Community Healthcare Trust, Birmingham, UK
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Focal Infection and Periodontitis: A Narrative Report and New Possible Approaches. Int J Microbiol 2020; 2020:8875612. [PMID: 33488729 PMCID: PMC7803120 DOI: 10.1155/2020/8875612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
The "focal infection theory" is a historical concept based on the assumption that some infections may cause chronic and acute diseases in different districts of the body. Its great popularity spanned from 1930 to 1950 when, with the aim to remove all the foci of infection, drastic surgical interventions were performed. Periodontitis, a common oral pathology mainly of bacterial origin, is the most evident example of this phenomenon today: in fact, bacteria are able to migrate, develop and cause health problems such as cardiovascular and respiratory diseases, diabetes, and osteoporosis. The aim of this narrative report is to verify the hypothesis of the association between oral infections and systemic diseases by different ways of approach and, at the same time, to propose new kinds of treatment today made possible by technological progress. The analysis of the literature demonstrated a strong relationship between these conditions, which might be explained on the basis of the recent studies on microbiota movement inside the body. Prevention of the oral infections, as well as of the possible systemic implications, may be successfully performed with the help of new technologies, such as probiotics and laser.
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Han K, Park JB. Tooth loss and risk of end-stage renal disease: A nationwide cohort study. J Periodontol 2020; 92:371-377. [PMID: 32770669 DOI: 10.1002/jper.19-0679] [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: 11/29/2019] [Revised: 05/18/2020] [Accepted: 06/07/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND The association between renal disease and oral health has been studied in previous researches. The purpose of this study is to evaluate whether oral health, depicted by number of natural teeth was associated with an increased risk of kidney diseases. METHODS The present study analysed data from the Korean National Health Insurance from 2007 to 2008. Database of 4,544,610 individuals who received routine health checkups and dental examinations were included in this study. RESULTS There was an increase in end-stage renal disease with lower number of natural teeth and longer follow-up periods. Hazard ratios and their 95% confidence intervals for end-stage renal disease in participants with a number of natural teeth of 28, 24 to 27, 20 to 23, and <20 were one (reference), 1.066(0.997,1.139), 1.285(1.161,1.422), and 1.285(1.155,1.429), respectively. The association was significantly noted with age and body mass index (P < 0.05). In general, the substantial increase in hazard ratios is seen with loss of teeth and smoking. Hazard ratios and their 95% confidence intervals for end-stage renal disease in male smoking participants with a number of natural teeth <28 is 1.631(1.339,1.988). However, this association was not noted in female group. CONCLUSIONS The association between number of natural teeth and end-stage renal disease was suggested after adjusting for confounding factors by using multiple logistic regression analyses from the entire South Korean population. Oral health, depicted by the number of tooth loss showed strong and dose-dependent association with end-stage renal disease in a large population-based cohort.
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Affiliation(s)
- Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Sharma L, Pradhan D, Srivastava R, Shukla M, Singh O, Pratik. Assessment of oral health status and inflammatory markers in end stage chronic kidney disease patients: A cross-sectional study. J Family Med Prim Care 2020; 9:2264-2268. [PMID: 32754485 PMCID: PMC7380786 DOI: 10.4103/jfmpc.jfmpc_101_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/12/2020] [Accepted: 03/26/2020] [Indexed: 12/03/2022] Open
Abstract
Aim: To assess the oral health status and inflammatory markers in end stage chronic kidney disease (CKD) patients. Objectives: To study and compare oral health status of end stage CKD patients with the control group (matched health individuals) and to study and compare inflammatory biomarkers in study and control groups. Materials and Methods: A cross-sectional study was conducted among 50 patients of end stage CKD and 50 matched healthy individual, who were taken as control in the study. Convenience sampling technique was used. Oral health status was recorded by using WHO proforma (2013). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP ) were also measured in the both groups. These are inflammatory markers which show systemic inflammation. Statistical analysis was done by using IBM SPSS Statistics-version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Results: The study revealed that patients on dialysis going for transplantation have evidence of increased inflammation as indicated by raised CRP values. Conclusion: The present study concludes that the oral hygiene of the patients is deteriorated who are having chronic kidney disease. Good oral and dental care in CKD patients can improve the transplant outcomes.
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Affiliation(s)
- Lokesh Sharma
- Dental Surgeon and Consultant- Kanpur, Uttar Pradesh, India
| | - Devina Pradhan
- Department of Public Health Dentistry, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Rahul Srivastava
- Oral Medicine and Radiology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Manas Shukla
- Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Omveer Singh
- Department of Public Health Dentistry, Career Dental College, Lucknow, Uttar Pradesh, India
| | - Pratik
- Department of Orthodontics and Dentofacial Orthopaedics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Križan Smojver B, Altabas K, Knotek M, Bašić Jukić N, Aurer A. Periodontal inflamed surface area in patients on haemodialysis and peritoneal dialysis: a Croatian cross-sectional study. BMC Oral Health 2020; 20:95. [PMID: 32245460 PMCID: PMC7118952 DOI: 10.1186/s12903-020-01086-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 03/25/2020] [Indexed: 01/10/2023] Open
Abstract
Background The decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) often involves the consideration of complex factors and remains a matter of debate. The purpose of this study was to quantify the inflammatory burden that periodontitis causes in dialysis patients and to examine whether patients on PD and HD differ in terms of the periodontal inflamed surface area (PISA), which can be helpful for selecting the most appropriate dialysis modality. Methods A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression. Results Patients on PD had a 746 mm2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with the PISA (semipartial correlation: − 0.50; p = 0.017; false discovery rate < 5%). After adjusting for confounding factors, the correlation between the duration and type of dialysis was not significant (F (2,44) = 0.01; p = 0.994; η2 = 0.00). Differences in the PISA between patients who had undergone dialysis for less than a year, 2–3 years or ≥ 3 years were not significantly different in either of the two dialysis groups. Conclusions PISA levels in Croatian patients on dialysis indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels. Trial registration ISRCTN17887630. A clinical study to investigate gum infection in patients undergoing kidney dialysis.
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Affiliation(s)
- Bojana Križan Smojver
- Department of Endodontics with Restorative Dentistry, Oral Medicine and Periodontology, Dental Clinic Zagreb, Perkovčeva ulica 3, 10000, Zagreb, Croatia.
| | - Karmela Altabas
- Clinic of Internal Medicine, University Hospital Center "Sestre milosrdnice", Vinogradska cesta 29, 10000, Zagreb, Croatia
| | - Mladen Knotek
- Clinic of Internal Medicine, University Hospital Center Merkur, Zajčeva ulica, 10000, Zagreb, Croatia
| | - Nikolina Bašić Jukić
- Clinic of Internal Medicine, University Hospital Center Zagreb, Kišpatićeva ulica 12, 10000, Zagreb, Croatia
| | - Andrej Aurer
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva ulica 5, 10000, Zagreb, Croatia
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Hickey NA, Shalamanova L, Whitehead KA, Dempsey-Hibbert N, van der Gast C, Taylor RL. Exploring the putative interactions between chronic kidney disease and chronic periodontitis. Crit Rev Microbiol 2020; 46:61-77. [PMID: 32046541 DOI: 10.1080/1040841x.2020.1724872] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) and chronic periodontitis (CP) are both common diseases, which are found disproportionately comorbid with each other and have been reported to have a detrimental effect on the progression of each respective disease. They have an overlap in risk factors and both are a source of systemic inflammation along with a wide selection of immunological and non-specific effects that can affect the body over the lifespan of the conditions. Previous studies have investigated the directionality of the relationship between these two diseases; however, there is a lack of literature that has examined how these diseases may be interacting at the localized and systemic level. This review discusses how oral microorganisms have the ability to translocate and have distal effects and provides evidence for microbial involvement in a systemic disease. Furthermore, it summarizes the reported local and systemic effects of CKD and CP and discusses how the interaction of these effects may be responsible for directionality associations reported.
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Affiliation(s)
- Niall A Hickey
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Liliana Shalamanova
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kathryn A Whitehead
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Nina Dempsey-Hibbert
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Christopher van der Gast
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Rebecca L Taylor
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
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Dannewitz B, Sommerer C, Stölzel P, Baid‐Agrawal S, Nadal J, Bärthlein B, Wanner C, Eckardt K, Zeier M, Schlagenhauf U, Krane V, Jockel‐Schneider Y. Status of periodontal health in German patients suffering from chronic kidney disease—Data from the GCKD study. J Clin Periodontol 2019; 47:19-29. [DOI: 10.1111/jcpe.13208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/03/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Bettina Dannewitz
- Department of Periodontology Johann Wolfgang Goethe‐University Frankfurt Frankfurt Germany
- Private Dental Practice Weilburg Germany
| | - Claudia Sommerer
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | - Peggy Stölzel
- Division of Periodontology University Hospital of Würzburg Würzburg Germany
| | - Seema Baid‐Agrawal
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Transplant Center Sahlgrenska University Hospital University of Gothenburg Gothenburg Sweden
| | - Jennifer Nadal
- Department of Medical Biometry, Informatics, and Epidemiology (IMBIE) University Hospital Bonn Germany
| | - Barbara Bärthlein
- Chair of Medical Informatics University of Erlangen‐Nürnberg Erlangen Germany
| | - Christoph Wanner
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
| | - Kai‐Uwe Eckardt
- Department of Nephrology and Medical Intensive Care University Hospital Charité Berlin Germany
- Department of Nephrology and Hypertension Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU) University Hospital Erlangen Erlangen Germany
| | - Martin Zeier
- Division of Nephrology Heidelberg University Hospital Heidelberg Germany
| | | | - Vera Krane
- Department of Medicine 1 Division of Nephrology University of Würzburg Würzburg Germany
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16
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Periodontal Disease in Patients Receiving Dialysis. Int J Mol Sci 2019; 20:ijms20153805. [PMID: 31382656 PMCID: PMC6695931 DOI: 10.3390/ijms20153805] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.
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17
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Association between Diabetic Retinopathy and Chronic Periodontitis-A Cross-Sectional Study. Med Sci (Basel) 2018; 6:medsci6040104. [PMID: 30477167 PMCID: PMC6313732 DOI: 10.3390/medsci6040104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/17/2018] [Accepted: 11/19/2018] [Indexed: 12/14/2022] Open
Abstract
Periodontal disease (PD), a chronic inflammatory condition characterized by destruction of the supporting tissues of the teeth, increases the risk of complications in diabetics. Diabetic retinopathy (DR) is a microvascular complication of prolonged hyperglycaemia. There appears to be a similarity in the pathogenesis of DR and PD. Hence, this study aimed to investigate the association, if any, between DR and PD, correlate the severity of DR with the severity of PD, and investigate the association between glycated haemoglobin (HbA1c), serum creatinine and periodontal variables. The periodontal status of 200 adult diabetic patients in the age group of 30⁻65 years with varying severity of DR was assessed. Evaluation of the severity of PD was assessed by recording clinical parameters. Haematological investigations including glycated haemoglobin (HbA1c) and serum creatinine were estimated before the initiation of treatment for DR. A statistically significant association between the mean duration of diabetes mellitus (DM) and the severity of DR and PD was found. The severity of PD was directly correlated with the severity of DR. There was a significant association between the levels of HbA1c and serum creatinine and severity of DR and PD. There could be a plausible relationship between DR and PD. Further prospective studies on a larger population with longer follow-ups are required to ascertain whether PD and its severity directly affect the progression and severity of DR.
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Shetty P, Hegde MN, Eraly SM. Evaluation of salivary parameters and dental status in adult hemodialysis patients in an indian population. J Clin Exp Dent 2018; 10:e419-e424. [PMID: 29849964 PMCID: PMC5971067 DOI: 10.4317/jced.54633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/17/2018] [Indexed: 11/05/2022] Open
Abstract
Background Renal failure is a process that expresses a loss of functional capacity of the nephrons, independently of its etiology. The most widely used technique to combat renal failure is hemodialysis. Renal failure causes various systemic alterations including oral complications such as variations in the flow and composition of the saliva. Caries is a multifactorial disease and impaired stimulated salivary flow rate and buffering capacity are the best-known risk factors. The present study aims to evaluate the salivary pH, buffering capacity and the flow rate of saliva to the DMFT status in adult hemodialysis patients among the Indian population. Material and Methods Twenty healthy individuals and sixty patients undergoing hemodialysis were divided into four groups based on the following criteria: Group 1: Control group; healthy individuals,Group 2: Patients before undergoing dialysis or undergoing dialysis<3 months, Group 3: Patients undergoing dialysis since 6 months-2 years, Group 4: Patients undergoing dialysis>2 years. Dental examinations were performed according to the modified WHO oral health survey 2013 criteria and DMFT index. Saliva was collected after pre-stimulation to measuring the flow rate, buffering capacity and pH. Results The results exhibited a decrease in the salivary flow rate and buffering capacity with the increase in the time interval of hemodialysis, but salivary pH was found to be increasing with time. A direct relationship was seen between the DMFT scores with the increasing time interval. There was a significant correlation between DMFT index, stimulated salivary flow rate, and buffering capacity in the patients. Conclusions Oral health impairment can beacon to grave problems in infection-prone hemodialysis patients. Hence, the patients on hemodialysis should have regular dental examinations and treatment. Regular dental examination and instruction in patients awaiting a renal transplantation is of vital importance to ensure optimal oral health. Key words:Saliva, pH, Buffering Capacity, Flow Rate, Hemodialysis, DMFT.
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Affiliation(s)
- Preethesh Shetty
- MDS [Conservative Dentistry & Endodontics], A.B.Shetty Memorial Institute Of Dental Sciences, Nitte University, Deralakatte, Mangalore-575018
| | - Mithra N Hegde
- MDS [Conservative Dentistry & Endodontics], Ph.D, MAMS, A.B.Shetty Memorial Institute Of Dental Sciences, Nitte University, Deralakatte, Mangalore-575018
| | - Sunil M Eraly
- MDS [Conservative Dentistry & Endodontics], Malabar Dental College, KUHAS University, Kerala
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Rodakowska E, Wilczyńska-Borawska M, Fryc J, Baginska J, Naumnik B. Oral health-related quality of life in patients undergoing chronic hemodialysis. Patient Prefer Adherence 2018; 12:955-961. [PMID: 29910608 PMCID: PMC5987751 DOI: 10.2147/ppa.s161638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS The aims of the study were to determine oral health-related quality of life (OHRQoL) in chronic hemodialysis (HD) patients and to estimate which scale describing OHRQoL, Oral Health Impact Profile (OHIP-14) or Geriatric/General Oral Health Assessment Index (GOHAI), was more useful in this particular group. METHODS This was a cross-sectional study conducted by means of a census survey. The Polish versions of OHIP-14 and GOHAI were used to assess OHRQoL. The oral examination included decayed, missing and filled teeth (DMF-T) Index; Oral Hygiene Index simplified; Plaque Index and Gingival Index. In the statistical analysis, the Kruskal-Wallis test, Mann-Whitney U test, Pearson's χ2 test and Spearman's rank correlation coefficients were used as appropriate. RESULTS The final sample consisted of 72 patients (mean age 63.2±15.2 years). The mean duration of HD treatment was 43.8 months. The mean number of teeth was 10.9. The majority of participants (81.9%) were dentate; only 22.2% of the respondents had >20 teeth. Among the dentate subjects, 44.1% wore removable dental prostheses (60.7% women). The most prevalent items for GOHAI (mean 14.71; SD 7.21) were uncomfortable to swallow, discomfort when eating and unhappy with appearance. The most prevalent items for OHIP-14 (mean 8.87; SD 10.95) were uncomfortable to eat foods, and diet has been unsatisfactory. The internal reliability (Cronbach's alpha) was 0.637 for GOHAI and 0.918 for OHIP-14. Chewing problems were significantly related to GOHAI (p=0.001) and OHIP-14 (p<0.001) scales. Higher OHIP-14 scores were significantly associated with dental treatment needs (p=0.029) and poor self-rated oral status (p=0.001). CONCLUSION The HD patients had an unsatisfactory oral status, but using only OHRQoL scale was insufficient to capture all their oral health problems. The scales did not fully reflect poor oral health in HD patients. The oral problems were not a major concern for this group of patients, which could indicate the adaptation to impaired oral health or a change in health priorities. Regular dental examinations together with the assessment of OHRQoL in HD patients are required for a comprehensive patients' state. In our study, more variables were significantly related to the OHIP-14 scale than to the GOHAI scale. Thus, the OHIP-14 scale may be more useful in assessing OHRQoL in HD patients.
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Affiliation(s)
- Ewa Rodakowska
- Department of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland
- Correspondence: Ewa Rodakowska, Department of Restorative Dentistry, Medical University of Bialystok, ul Marii Skłodowskiej-Curie 24 A, 15-276 Bialystok, Poland, Tel +48 85 7468 5760, Email
| | | | - Justyna Fryc
- Faculty of Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Baginska
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland
| | - Beata Naumnik
- I Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
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20
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Altamimi AG, AlBakr SA, Alanazi TA, Alshahrani FA, Chalisserry EP, Anil S. Prevalence of Periodontitis in Patients Undergoing Hemodialysis: a Case Control Study. Mater Sociomed 2018; 30:58-61. [PMID: 29670479 PMCID: PMC5857055 DOI: 10.5455/msm.2018.30.58-61] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives: To assess the prevalence of periodontal disease among patients undergoing renal dialysis. Methods: Sixty hemodialysis patients (30 males, 30 females) with a mean age of 44.4±9.5 years comprised the study group. Periodontal parameters such as plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL) were measured in these patients and 60 age and sex-matched control subjects. The data was tabulated and analyzed. Results: The mean duration of dialysis was 5.50±3.02 years. The plaque index (PI) bleeding on probing (BOP), Periodontal probing depth (PPD) and clinical attachment level (CAL) were significantly higher in patients undergoing hemodialysis than in control subjects. The mean clinical attachment level was significantly higher among the dialysis patients (2.78±0.83 mm) than the control subjects (1.97±0.53 mm). The plaque index and bleeding on probing also showed a similar pattern in patients undergoing hemodialysis compared to control patients. The prevalence and severity of periodontal disease seems to be higher in patients undergoing dialysis. Conclusion: From the observations of this study, it can be concluded that patients undergoing hemodialysis are more prone to periodontal diseases. Further studies with a larger population and a comparison with the duration of dialysis may further substantiate the current findings.
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Affiliation(s)
| | | | | | - Faleh A Alshahrani
- Department of Oral and Maxillofacial Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Elna Paul Chalisserry
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Sukumaran Anil
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha University, Poonamallee High Road, Chennai, India
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21
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Panny A, Glurich I, Haws RM, Acharya A. Oral and Craniofacial Anomalies of Bardet-Biedl Syndrome: Dental Management in the Context of a Rare Disease. J Dent Res 2017; 96:1361-1369. [PMID: 28662344 DOI: 10.1177/0022034517716913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Standardized guidelines for the oral health management of patients with rare diseases exhibiting morphologic anomalies are currently lacking. This review considers Bardet-Biedl syndrome (BBS), a monogenic autosomal recessive nonmotile ciliopathy, as an archetypal condition. Dental anomalies are present in a majority of individuals affected by BBS due to abnormal embryonic orofacial and tooth development. Genetically encoded intrinsic oral structural anomalies and heterogeneous BBS clinical phenotypes and consequent oral comorbidities confound oral health management. Since the comorbid spectrum of BBS phenotypes spans diabetes, renal disease, obesity, sleep apnea, cardiovascular disease, and cognitive disorders, a broad spectrum of collateral oral disease may be encountered. The genetic impact of BBS on the anatomic development of oral components and oral pathology encountered in the context of various BBS phenotypes and their associated comorbidities are reviewed herein. Challenges encountered in managing patients with BBS are highlighted, emphasizing the spectrum of oral pathology associated with heterogeneous clinical phenotypic expression. Guidelines for provision of care across the spectrum of BBS clinical phenotypes are considered. Establishment of integrated medical-dental delivery models of oral care in the context of rare diseases is emphasized, including involvement of caregivers in the context of managing these patients with special needs.
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Affiliation(s)
- A Panny
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - I Glurich
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - R M Haws
- 2 Center for Clinical Research, Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | - A Acharya
- 1 Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, WI, USA
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22
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Chan S, Pasternak GM, West MJ. The place of periodontal examination and referral in general medicine. Periodontol 2000 2017; 74:194-199. [DOI: 10.1111/prd.12199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 12/13/2022]
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Medical and Periodontal Clinical Parameters in Patients at Different Levels of Chronic Renal Failure. Int J Dent 2017; 2017:9858073. [PMID: 28473854 PMCID: PMC5394392 DOI: 10.1155/2017/9858073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/13/2017] [Accepted: 02/27/2017] [Indexed: 02/02/2023] Open
Abstract
Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF) at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG), predialysis group (PDG), and hemodialysis group (HDG). The medical parameters were taken from the patients' records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (p = 0.0364); the same was observed in the Plaque Index (p = 0.0296); the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (p < 0.0001), and fibrinogen was higher in PDG compared with the others (p < 0.0001); the triglycerides also showed higher values in the HDG compared with the other groups (p < 0.0001). Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health.
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Yoshihara A, Iwasaki M, Miyazaki H, Nakamura K. Bidirectional relationship between renal function and periodontal disease in older Japanese women. J Clin Periodontol 2016; 43:720-6. [DOI: 10.1111/jcpe.12576] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Masanori Iwasaki
- Department of Community Oral Health Development; Kyushu Dental University; Fukuoka Japan
| | - Hideo Miyazaki
- Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Kazutoshi Nakamura
- Department of Community Preventive Medicine; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Limeres J, Garcez JF, Marinho JS, Loureiro A, Diniz M, Diz P. Early tooth loss in end-stage renal disease patients on haemodialysis. Oral Dis 2016; 22:530-5. [PMID: 27038430 DOI: 10.1111/odi.12486] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 03/16/2016] [Accepted: 03/29/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This article sets out to evaluate the prevalence and aetiopathogenesis of edentulism in patients on haemodialysis. SUBJECTS AND METHODS The study group comprised 44 adult patients with end-stage renal disease (ESRD) on haemodialysis. A control group was formed of 44 individuals matched for age and sex and with a glomerular filtration rate >90 ml min(-1) . All participants underwent intra-oral examination, gathering information on dental and periodontal status, and a saliva sample was taken to determine saliva debit and its biochemical composition. RESULTS The average number of missing teeth was higher in ESRD patients than in controls (P = 0.018). Six (13.6%) fully edentulous individuals were detected in the study group and 1 (2.2%) in the control group. Some of the clinical and biochemical variables with statistically significant differences between the study group and the control group showed a significant relationship with the number of missing teeth, but the depth of the periodontal pockets presented the highest coefficient of determination (OR = 3511.1; 95%CI = 82.2-6834.3; P < 0.001; R(2) = 0.827). CONCLUSIONS Premature tooth loss is common in haemodialysis patients. Although the aetiology and pathogenesis of this finding has still not been fully clarified, it appears that severe periodontal disease may play a relevant role.
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Affiliation(s)
- J Limeres
- Special Needs Unit and OMEQUI Research Group, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
| | - J F Garcez
- Instituto Superior de Ciências da Saúde-Norte (ISCS-N), Gandra, Portugal
| | - J S Marinho
- Stomatology Department. Instituto Portugués de Oncología Francisco Gentil (IPO), Porto, Portugal
| | - A Loureiro
- Nephrology Department. Instituto Portugués de Oncología Francisco Gentil (IPO), Porto, Portugal
| | - M Diniz
- Special Needs Unit and OMEQUI Research Group, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
| | - P Diz
- Special Needs Unit and OMEQUI Research Group, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
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Dioguardi M, Caloro GA, Troiano G, Giannatempo G, Laino L, Petruzzi M, Lo Muzio L. Oral manifestations in chronic uremia patients. Ren Fail 2015; 38:1-6. [DOI: 10.3109/0886022x.2015.1103639] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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27
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Urinary enzymatic markers (N-acetyl-beta-D-glucosaminidase) in assessing the tubulointerstitial compartment in chronic glomerulonephritis related to odontogenic foci. Wien Klin Wochenschr 2015; 128:102-8. [PMID: 26377174 DOI: 10.1007/s00508-015-0841-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/29/2015] [Indexed: 12/21/2022]
Abstract
Chronic glomerulonephritis is related to focus infection. Odontogenic foci are frequently involved in glomerulonephritis. The relationship with the odontogenic focus infection can be demonstrated by the occurrence or aggravation of the symptoms of glomerulonephritis: proteinuria, haematuria, high blood pressure and oedema. Glomerular impairment in glomerulonephritis occurs together with inflammatory alterations of the tubulointerstitial compartment that can play an important part in the evolution of the disease. Tubular urinary markers can indicate the activation of this compartment during an infection of a focus, an odontogenic focus in our study.The paper aims at demonstrating the relationship between the odontogenic focus infection and tubulointerstitial lesions, assessed by a tubular urinary marker, N-acetyl beta-D glucosaminidase (NAG).We investigated the urinary N-acetyl beta-D glucosaminidase of 20 patients with chronic glomerulonephritis who presented odontogenic focus infections, comparing them with patients with chronic glomerulonephritis without odontogenic foci and of 20 controls, clinically healthy persons.Chronic glomerulonephritis patients with odontogenic focus infection presented clearly increased values as compared to clinically healthy control persons of urinary N-acetyl beta-D glucosaminidase.These patients underwent surgical intervention on the odontogenic focus under antibacterial prophylactic treatment. In 75% cases, the values of N-acetyl beta-D glucosaminidase diminished, indicating the favourable effect of the treatment of the odontogenic focus on the tubulointerstitial compartment in patients with chronic glomerulonephritis. In 25% cases this therapeutic treatment was associated with an increase of the values of urinary N-acetyl beta-D glucosaminidase, expressing its unfavourable effect on chronic glomerulonephritis.Urinary N-acetyl beta-D glucosaminidase indicated an etiopathogenetic relationship between the odontogenic focus and the tubulointerstitial compartment in chronic glomerulonephritis.
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Pallos D, Leão MVP, Togeiro FCFB, Alegre L, Ricardo LH, Perozini C, Ruivo GF. Salivary markers in patients with chronic renal failure. Arch Oral Biol 2015; 60:1784-8. [PMID: 26451646 DOI: 10.1016/j.archoralbio.2015.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/15/2015] [Accepted: 09/10/2015] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Chronic renal failure (CRF) is a progressive loss of renal function over a period of months or years. The major function of the kidneys is the removal of metabolic waste products, electrolytes and water. When this function is impaired, systemic changes, oral complications and alterations in salivary composition may occur. OBJECTIVE This study aimed to compare the levels of immunological and inflammatory components in the saliva samples from patients that undergo to hemodialysis treatment (HD), without HD and control. DESIGN This study evaluated IgA, IgG, C reactive protein (CRP) and nitric oxide (NO) in saliva samples from 119 patients, who were divided into the control group (C), chronic renal failure (CRF) patient group and CRF patients on hemodialysis treatment (HD) group. IgA and IgG levels were analyzed by ELISA. Nitric oxide levels were determined indirectly by the nitrite concentration using Griess reagent; CRP by agglutination tests; and total proteins, by Bradford assay. RESULTS The HD group showed significantly higher levels of IgG, IgA and CRP compared with the control and CRF groups. The CRF group presented the same amounts of IgG, IgA and CRP as the C group but significantly higher levels of NO similar to the HD group. CONCLUSION Renal disease, particularly hemodialysis treatment during renal disease, seems to alter salivary immunological and inflammatory components. Thus, analyzing the levels of IgA, IgG, NO and CRP in saliva may be beneficial for monitoring renal disease.
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Affiliation(s)
- Debora Pallos
- Implantology Department, Universidade de Santo Amaro, São Paulo, Brazil; Dept. of Periodontics, Universidade de Taubaté, Taubaté, Brazil.
| | - Mariella V P Leão
- Basic Bioscience Institute and Bioscience and Oral Diagnosis, University of Taubate, Brazil.
| | | | - Larissa Alegre
- Dept. of Periodontics, Universidade de Taubaté, Taubaté, Brazil.
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Abstract
PRACTICAL RELEVANCE Periodontal disease is commonly encountered in feline practice. Gingivitis, followed by inflammation of the rest of the periodontal tissues, can lead to chronic oral infection, bacteraemia, pain and ultimately tooth loss. Given adequate plaque control and thorough, consistent dental home care, gingivitis is a reversible and controllable condition. Periodontitis, however, is an essentially irreversible and progressive condition. Treatment aims to control tissue inflammation, returning the gingiva to clinical health and preventing destruction of the periodontium in other parts of the mouth. CLINICAL CHALLENGES Diagnosis must be established using a combination of oral examination under anaesthesia and dental radiography. Periodontitis leads to tooth attachment loss, and given the short length of most cat teeth, probing depths of 1 mm or more should alert the clinician to the presence of periodontitis. The decision of whether to extract or preserve affected teeth needs careful consideration. In practice, as periodontitis is often associated with type 1 tooth resorption, extraction is often required, but the slender and delicate nature of feline tooth roots, compounded by the destructive nature of tooth resorption, can frustrate extraction attempts. As highlighted in this article, iatrogenic damage to teeth is also a real risk if periodontal therapy procedures (including scaling and polishing) are not performed carefully. The challenges of providing home care in the cat are additionally discussed. EVIDENCE BASE The authors have drawn upon, wherever possible, an evidence base relating strictly to the feline patient. Where there is a lack of published research, evidence from canine and human studies is assessed.
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Affiliation(s)
- Rachel Perry
- Perrydental Vet Ltd, Grove Lodge Veterinary Hospital, Upper Brighton Road, Worthing, West Sussex, BN14 9DL, UK
| | - Cedric Tutt
- Cape Animal Dentistry Service, 78 Rosmead Avenue, Kenilworth, 7708, Cape Town, South Africa
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Siribamrungwong M, Chinudomwong P. Periodontitis: Tip of the iceberg in chronic kidney disease. World J Clin Urol 2014; 3:295-303. [DOI: 10.5410/wjcu.v3.i3.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/02/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
The prevalence of chronic kidney disease (CKD) is constantly escalating not only in industrialized countries but throughout the world. It is of major significance because of to its high morbidity and mortality. Strategies to tackle this worldwide health problem include identification of its associated risk factors, comorbidities, and complications as well as proper management to handle all the pertinent issues. Periodontal disease, a treatable infectious state of the dental supporting tissues, is common in CKD patients. Its association with CKD is believed to be in a reciprocal or bidirectional fashion and has been massively studied. This paper, therefore, aims to review the recent evidence pertaining to the association between periodontal disease and a variety of renal illnesses. Most of the current evidence was collected from cross-sectional studies and clinical trials. There is substantial evidence indicating that periodontal disease contributes markedly to the chronic systemic inflammatory burden, leading to cardiovascular and cerebrovascular complications, the principal causes of death among chronic renal disease patients. Furthermore, several studies demonstrated that proper periodontal intervention could help improve systemic inflammation and even nutritional status among CKD patients, resulting in a better quality of life. Suggestions have been made that periodontal disease should be diagnosed early, and managed and controlled to, at least, eradicate a source of inflammation in this population. Awareness of such an important issue should be increased in the relevant medical personnel.
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Salimi S, Ng N, Seliger SL, Parsa A. Periodontal Disease, Renal Dysfunction and Heightened Leukocytosis. ACTA ACUST UNITED AC 2014; 128:107-14. [DOI: 10.1159/000366445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/04/2014] [Indexed: 11/19/2022]
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Rodrigues VP, Libério SA, Lopes FF, Thomaz EBFA, Guerra RNM, Gomes-Filho IS, Pereira ALA. Periodontal status and serum biomarkers levels in haemodialysis patients. J Clin Periodontol 2014; 41:862-8. [DOI: 10.1111/jcpe.12283] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Silvana A. Libério
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luís Brazil
| | - Fernanda F. Lopes
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luís Brazil
| | | | - Rosane N. M. Guerra
- Laboratory of Immunophysiology; Federal University of Maranhão; São Luís Brazil
| | - Isaac S. Gomes-Filho
- Department of Periodontics; Feira de Santana State University; Feira de Santana Brazil
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Effect of nonsurgical periodontal therapy verses oral hygiene instructions on type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial. BMC Oral Health 2014; 14:79. [PMID: 24965218 PMCID: PMC4082680 DOI: 10.1186/1472-6831-14-79] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/20/2014] [Indexed: 02/06/2023] Open
Abstract
Background 40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals. Methods 40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals. Results 15 subjects from NSPT group and 17 from OHI group completed the study. The difference in plaque index (PI) between NSPT and OHI groups were significant at 2 months recall (p = 0.013). There was no significant difference between NSPT and OHI group for all other clinical periodontal parameters, HbA1c and CRP levels. At 3 months post-therapy, periodontal parameters improved significantly in both groups with sites with probing pocket depth (PPD) < 4 mm reported as 98 ± 1.8% in NSPT group and 92 ± 14.9% in OHI group. Mean PPD and mean probing attachment loss (PAL) within the NSPT group reduced significantly from baseline (2.56 ± 0.57 mm, 3.35 ± 0.83 mm) to final visit (1.94 ± 0.26 mm, 2.92 ± 0.72 mm) (p = 0.003, p < 0.001). For OHI group, improvements in mean PPD and mean PAL were also seen from baseline (2.29 ± 0.69 mm, 2.79 ± 0.96 mm) to final visit (2.09 ± 0.72 mm, 2.62 ± 0.97 mm) (p < 0.001 for both). Similarly, HbA1c levels decreased in both groups with NSPT group recording statistically significant reduction (p = 0.038). Participants who demonstrated ≥ 50% reduction in PPD showed significant reductions of HbA1c and hs-CRP levels (p = 0.004 and p = 0.012). Conclusion NSPT significantly reduced PI at 2 months post-therapy as compared to OHI. Both NSPT and OHI demonstrated improvements in other clinical parameters as well as HbA1c and CRP levels. Trial registration ClinicalTrials.gov: NCT01951547.
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Wahid A, Chaudhry S, Ehsan A, Butt S, Ali Khan A. Bidirectional Relationship between Chronic Kidney Disease & Periodontal Disease. Pak J Med Sci 2014; 29:211-5. [PMID: 24353542 PMCID: PMC3809193 DOI: 10.12669/pjms.291.2926] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 09/24/2012] [Accepted: 11/20/2012] [Indexed: 02/06/2023] Open
Abstract
Non communicable diseases (NCDs) affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus (DM), cardiovascular diseases (CVD), pulmonary diseases, osteoporosis and chronic kidney diseases (CKD). About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Sources of Data: Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. Data Extraction: The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Conclusion: Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy.
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Affiliation(s)
- Arsalan Wahid
- Arsalan Wahid, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Saima Chaudhry
- Saima Chaudhry, PhD, Lecturer (Oral Pathology),Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Afifa Ehsan
- Afifa Ehsan, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Sidra Butt
- Sidra Butt, M. Phil Scholar, Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Ayyaz Ali Khan
- Ayyaz Ali Khan, PhD, Head (Community Dentistry), Department of Oral Health Sciences, Shaikh Zayed Medical Complex, Lahore, Pakistan
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Nabi SU, Wani AR, Shah OS, Dey S. Association of periodontitis and chronic kidney disease in dogs. Vet World 2014. [DOI: 10.14202/vetworld.2014.403-407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Archana V, Ambili R, Nisha KJ, Seba A, Preeja C. Acute-phase reactants in periodontal disease: Current concepts and future implications. ACTA ACUST UNITED AC 2014; 6:108-17. [DOI: 10.1111/jicd.12069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 06/09/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Vilasan Archana
- Department of Periodontics; PMS College of Dental Science and Research; Thiruvananthapuram India
| | - Ranjith Ambili
- Department of Periodontics; PMS College of Dental Science and Research; Thiruvananthapuram India
| | | | - Abraham Seba
- Department of Periodontics; PMS College of Dental Science and Research; Thiruvananthapuram India
| | - Chandran Preeja
- Department of Periodontics; PMS College of Dental Science and Research; Thiruvananthapuram India
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Abstract
The endocrine system plays a major role in human survival. Endocrine glands secrete chemical messengers or hormones that affect every tissue of the body, including the periodontium, during the life of the individual. As the endocrine system influences a broad assortment of biological activities necessary for life, a general understanding of the principal components and functions of this system is essential. A fundamental assessment of hormone structure, mechanism of action and hormone transport, as well as influence on homeostasis is reviewed. A concise evaluation of the functions of the central endocrine glands, the functions of the major peripheral endocrine glands (other than gonadal tissues) and the known relationships of these hormones to the periodontium is examined.
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Allen MR, Chen NX, Gattone VH, Moe SM. Adverse mandibular bone effects associated with kidney disease are only partially corrected with bisphosphonate and/or calcium treatment. Am J Nephrol 2013; 38:458-64. [PMID: 24280830 DOI: 10.1159/000356335] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/14/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Patients with chronic kidney disease (CKD) have a high prevalence of periodontal disease that may predispose to tooth loss and inflammation. The goal of this study was to test the hypotheses that a genetic rat model of progressive CKD would exhibit altered oral bone properties and that treatment with either bisphosphonates or calcium could attenuate these adverse changes. METHODS At 25 weeks of age, rats were treated with zoledronate (ZOL), calcium gluconate, or their combination for 5 or 10 weeks. Mandible bone properties were assessed using micro-computed tomography to determine bone volume (BV/TV) and cementum-enamel junction to alveolar crest distance (CEJ-AC). RESULTS Untreated CKD animals had significantly lower BV/TV at both 30 (-5%) and 35 (-14%) weeks of age and higher CEJ-AC (+27 and 29%) compared to normal animals. CKD animals had a significantly higher parathyroid hormone (PTH) compared to normal animals, yet similar levels of C-reactive protein (CRP). ZOL treatment normalized BV/TV over the first 5 weeks but this benefit was lost by 10 weeks. Calcium treatment, alone or in combination with ZOL, was effective in normalizing BV/TV at both time points. Neither ZOL nor calcium was able to correct the higher CEJ-AC caused by CKD. Calcium, but not ZOL, significantly reduced serum PTH, while neither treatment affected CRP. CONCLUSIONS (i) This progressive animal model of CKD shows a clear mandibular skeletal phenotype consistent with periodontitis, (ii) the periodontitis is not associated with systemic inflammation as measured by CRP, and (iii) reducing PTH has positive effects on the mandible phenotype.
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Affiliation(s)
- Matthew R Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Ind., USA
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Swapna LA, Reddy RS, Ramesh T, Reddy RL, Vijayalaxmi N, Karmakar P, Pradeep K. Oral health status in haemodialysis patients. J Clin Diagn Res 2013; 7:2047-50. [PMID: 24179940 DOI: 10.7860/jcdr/2013/5813.3402] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/13/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the oral and dental manifestations in non- diabetic and diabetic uraemic patients who were undergoing haemodialysis and to estimate and compare the salivary pH in these two groups. MATERIAL AND METHODS Ninety Seven uraemic patients who were undergoing maintenance haemodialysis were included in the study. Subjective and objective findings were evaluated and recorded in a specially designed proforma. Predialytic unstimulated whole salivary pH was recorded by using pH-measuring strips. Dental health assessment consisted of DMFT and CPITN indices. RESULTS A subjective oral manifestation of dysguesia was found to be more significant in non-diabetic patients (p<0.008). Statistically, a high significance was observed with mucosal petechiae in 31.9% patients of diabetic group .The overall DMFT score was significantly higher in diabetic group. A moderate significance was found with a CPI score of 5 (p<0.015). The pH of saliva was significantly higher among diabetic patients. CONCLUSION The diabetic subjects who were on haemodialysis were at a high risk for developing periodontal disease and they exhibited a potential threat for dental decay and xerostomia. A lower salivary pH and a poor glycaemic control may affect their oral health. Further research is required to clarify the combined influence of diabetic nephropathy on oral health.
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Affiliation(s)
- Lingam Amara Swapna
- Assistant Professor, Sri Sai College of Dental Surgery , Vikarabad, Andhra Pradesh, India
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Yazdi FK, Karimi N, Rasouli M, Roozbeh J. Effect of nonsurgical periodontal treatment on C-reactive protein levels in maintenance hemodialysis patients. Ren Fail 2013; 35:711-7. [PMID: 23534529 DOI: 10.3109/0886022x.2013.777890] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE C-reactive protein (CRP) has been implicated as a possible mediator of the association between periodontitis and several systemic diseases. This study evaluated the impact of nonsurgical periodontal treatment on the serum levels of CRP in chronic kidney disease (CKD) patients on hemodialysis. METHODS A total of 77 CKD patients on hemodialysis were included in this study. At baseline, periodontal examination was assessed for all the patients, and chronic periodontitis was defined through clinical attachment level and probing pocket depth, according to the American Association of Periodontology. Nonsurgical periodontal treatment was performed and serum levels of CRP were evaluated at baseline and 8 weeks after periodontal treatment. RESULTS Periodontal treatment resulted in significant reductions in CRP levels (p < 0.001). The difference between pre- and posttreatment CRP concentrations did not show any significant relationship with the severity of periodontitis. CONCLUSIONS Periodontitis is an important source of systemic inflammation in CKD patients. Nonsurgical periodontal treatment can effectively reduce the serum level of CRP in these patients.
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Affiliation(s)
- Farin Kiany Yazdi
- Department of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Yoshihara A, Iwasaki M, Miyazaki H, Nakamura K. Association between low renal function and tooth loss over 5 years. Gerodontology 2012; 31:111-6. [DOI: 10.1111/ger.12015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare; Graduate School of Medical and Dental Sciences, Niigata University; Niigata Japan
| | - Masanori Iwasaki
- Department of Oral Health Science; Graduate School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Hideo Miyazaki
- Department of Oral Health Science; Graduate School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Kazutoshi Nakamura
- Department of Community Preventive Medicine; Graduate School of Medical and Dental Sciences, Niigata University; Niigata Japan
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Craig RG, Pernat AM, Pecoits-Filho R, Levin NW, Kotanko P. Periodontal Diseases and Systemic Inflammation. Semin Dial 2012; 26:23-8. [DOI: 10.1111/sdi.12022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
The aim of the study was to assess the periodontal status of patients among group of patients receiving hemodialysis in two super specialty renal institutes in the state of Gujarat. A cross-sectional study of 304 subjects, 152 subjects each in dialysis, and control group was conducted. Oral hygiene status was assessed using a Simplified Oral Hygiene Index, and periodontal status was assessed using the Community Periodontal Index (CPI) and Loss of Attachment (LOA) as per WHO methodology 1997. The dialysis group had poor oral hygiene than the control group (P<0.001). There was high severity of periodontitis in the dialysis group as compared with the control group (P<0.001). None of the subjects had healthy periodontium. There was high severity of periodontitis (for both in terms of CPI and LOA) in the dialysis group as compared with control group that was found to be statistically highly significant (P<0.001). However, no statistically significant difference was observed (P>0.05) when the intergroup comparison for CPI and LOA were made among the subgroups according to the duration of dialysis. Periodontal disease is prevalent in chronic renal failure patients who showed the unacceptable level of oral hygiene and hence there is need for oral health promotion and preventive programs among the patients receiving dialysis.
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Affiliation(s)
- S. M. Parkar
- Department of Public Health Dentistry, Ahmedabad Dental College and Hospital, Gandhinagar, Gujarat, India
- Address for correspondence: Dr. Parkar Sujal M, B-25 Krishna Bunglows, Gandhinagar Highway, Motera, Ahmedabad- 380 005, Gujarat, India. E-mail:
| | - C. G. Ajithkrishnan
- Department of Public Health Dentistry, K.M. Shah Dental College and Hospital, Vadodara, Gujarat, India
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Analysis of the association of an MMP1 promoter polymorphism and transcript levels with chronic periodontitis and end-stage renal disease in a Brazilian population. Arch Oral Biol 2012; 57:954-63. [DOI: 10.1016/j.archoralbio.2012.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 01/17/2012] [Accepted: 01/28/2012] [Indexed: 11/17/2022]
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Bhatsange A, Patil SR. Assessment of periodontal health status in patients undergoing renal dialysis: A descriptive, cross-sectional study. J Indian Soc Periodontol 2012; 16:37-42. [PMID: 22628961 PMCID: PMC3357032 DOI: 10.4103/0972-124x.94602] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Accepted: 11/19/2011] [Indexed: 11/25/2022] Open
Abstract
Objective: An inter-relationship between periodontal disease and systemic health has been suspected for centuries, but evidence to explain the connection has only been elucidated in the past few decades. Among the systemic diseases, end stage renal disease has been shown to affect not only the general health of the patient but also oral and periodontal health. This study was undertaken to gain an insight into whether duration of dialysis therapy influences the oral and periodontal health of these patients and also to see if these parameters reflect their biochemical values. Materials and Methods: The study was conducted on 75 patients undergoing dialysis and a control group of 25 subjects. The study group was divided into three subgroups depending upon the duration of dialysis. Oral hygiene and periodontal disease status were measured by Simplified Oral Hygiene Index by Greene and Vermillion and Periodontal Disease Index by Ram-fjord. Biochemical parameters measured were blood urea nitrogen and salivary urea levels. Comparison of these parameters was made between the study and control groups through analysis of variance (ANOVA) and student's t-test. Results: Prevalence of periodontal disease was evident in the dialysis group. Oral hygiene status was poor in comparison with the control group. Clinical and biochemical parameters showed statistically significant difference between the groups rather than within the groups. Conclusion: Oral and periodontal health appeared to be compromised. Their deteriorating general health is anticipated to cause negligence towards oral health care. This population needs comprehensive oral and periodontal care right from the diagnosis of chronic renal failure. There exists a need for communication between nephrologists and oral health care professionals. Longitudinal studies warranted in this regard.
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Affiliation(s)
- Anuradha Bhatsange
- Department of Periodontics, JMF'S ACPM Dental Collage and Hospital, Sakri Road, Dhule, Maharastra, India
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Sekiguchi RT, Pannuti CM, Silva Jr. HT, Medina-Pestana JO, Romito GA. Decrease in oral health may be associated with length of time since beginning dialysis. SPECIAL CARE IN DENTISTRY 2012; 32:6-10. [DOI: 10.1111/j.1754-4505.2011.00223.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Carlo Reis EC, Borges APB, Araújo MVF, Mendes VC, Guan L, Davies JE. Periodontal regeneration using a bilayered PLGA/calcium phosphate construct. Biomaterials 2011; 32:9244-53. [PMID: 21885122 DOI: 10.1016/j.biomaterials.2011.08.040] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 08/14/2011] [Indexed: 10/17/2022]
Abstract
The regeneration of tissues affected by periodontal disease is a complex process; it encompasses the formation of bone, cementum and periodontal ligament. We developed a semi-rigid PLGA (polylactide-co-glycolide acid)/CaP (calcium phosphate) bilayered biomaterial construct to promote periodontal regeneration, which has a continuous outer barrier membrane and an inner topographically complex component. Our experimental model compared periodontal prophylaxis alone with prophylaxis and biomaterial implantation in the treatment of class II furcation defects in dogs. Clinical evaluation, micro-computed tomography, histology and backscattered electron imaging were used for data analysis. Healing occurred uneventfully and bone volumetric values, trabecular number and trabecular thickness were all significantly greater in the treated group; while trabecular separation was significantly greater in the control group. New cementum, bone, and periodontal ligament with Sharpey fibre insertions were only seen in the treated group. Although periodontal regeneration has been reported elsewhere, the advantages of employing our bilayered PLGA + CaP construct are twofold: 1)it did not collapse into the defect; and, 2) its inner side was able to retain the blood clot throughout the buccal defect. The result was greater periodontal regeneration than has previously been reported with traditional flexible membranes.
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Affiliation(s)
- Emily C Carlo Reis
- Departamento de Veterinária, Universidade Federal de Viçosa, Campus Universitário s/n, Viçosa, Minas Gerais, CEP 36570-000, Brazil
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Artese HPC, Sousa COD, Luiz RR, Sansone C, Torres MCMDB. Effect of non-surgical periodontal treatment on chronic kidney disease patients. Braz Oral Res 2011; 24:449-54. [PMID: 21180967 DOI: 10.1590/s1806-83242010000400013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 10/05/2010] [Indexed: 12/11/2022] Open
Abstract
Chronic kidney disease (CKD) is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1) and 19 individuals without clinical evidence of kidney disease (group 2) with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002). Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.
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Ardalan MR, Ghabili K, Pourabbas R, Shoja MM. A causative link between periodontal disease and glomerulonephritis: a preliminary study. Ther Clin Risk Manag 2011; 7:93-8. [PMID: 21445283 PMCID: PMC3061848 DOI: 10.2147/tcrm.s14106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Indexed: 12/11/2022] Open
Abstract
Background: Periodontal disease has been associated with a number of systemic diseases. A high prevalence of periodontitis among individuals with chronic kidney diseases and end-stage renal disease has been reported. However, no association between periodontal diseases and glomerulonephritis has previously been investigated. Objective: The aim of this study was to assess the severity and possible role of periodontitis in a group of patients with unknown primary glomerulonephritis. Methods: Ten patients with unknown primary glomerulonephritis, and who had a renal biopsy with stable renal function and serum creatinine <1.6 mg/dL, were recruited. Severity of the periodontal disease was clinically measured with plaque index (PI), gingival index (GI), and periodontal pocket depth (PD). The subjects received appropriate dental treatments where indicated. The patients were also put on angiotensin-converting enzyme inhibitor or angiotensin receptor blockers for controlling blood pressure and proteinuria. Six months following appropriate periodontal treatment, renal function, degree of proteinuria, and level of C-reactive protein (CRP) were measured in each individual. Results: The median age of the patients was 30 (15.8) years. The median urine protein excretion was lower following the periodontal therapy (P=008). Prior to the dental and/or periodontal therapies, the median PI, PD, and GI were 57.5%, 4.3, and 1.1, respectively. The majority of the patients had advanced periodontal disease. In four patients, +2/+3 CRP turned negative after periodontal treatment. Conclusions: The present study revealed that a causative link might exist between periodontal disease and glomerulonephritis.
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Ebersole JL, Steffen MJ, Holt SC, Kesavalu L, Chu L, Cappelli D. Systemic inflammatory responses in progressing periodontitis during pregnancy in a baboon model. Clin Exp Immunol 2011; 162:550-9. [PMID: 21070210 DOI: 10.1111/j.1365-2249.2010.04202.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This study tested the hypothesis that pregnant female baboons exhibit increased levels of various inflammatory mediators in serum resulting from ligature-induced periodontitis, and that these profiles would relate to periodontal disease severity/extent in the animals. The animals were sampled at baseline (B), mid-pregnancy (MP; two quadrants ligated) and at delivery (D; four quadrants ligated). All baboons developed increased plaque, gingival inflammation and bleeding, pocket depths and attachment loss following placement of the ligatures. By MP, both prostaglandin E(2) (PGE(2)) and bactericidal permeability inducing factor (BPI) were greater than baseline, while increased levels of interleukin (IL)-6 occurred in the experimental animals by the time of delivery. IL-8, MCP-1 and LBP all decreased from baseline through the ligation phase of the study. Stratification of the animals by baseline clinical presentation demonstrated that PGE(2), LBP, IL-8 and MCP-1 levels were altered throughout the ligation interval, irrespective of baseline clinical values. IL-6, IL-8 and LBP were significantly lower in the subset of animals that demonstrated the least clinical response to ligation, indicative of progressing periodontal disease. PGE(2), macrophage chemotactic protein (MCP)-1, regulated upon activation, normal T cell expressed and secreted (RANTES) and LBP were decreased in the most diseased subset of animals at delivery. Systemic antibody responses to Fusobacterium nucleatum, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Campylobacter rectus were associated most frequently with variations in inflammatory mediator levels. These results provide a profile of systemic inflammatory mediators during ligature-induced periodontitis in pregnant baboons. The relationship of the oral clinical parameters to systemic inflammatory responses is consistent with a contribution to adverse pregnancy outcomes in a subset of the animals.
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Affiliation(s)
- J L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA.
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