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Tranfić Duplančić M, Pecotić R, Lušić Kalcina L, Pavlinac Dodig I, Valić M, Roguljić M, Rogić D, Lapić I, Grdiša K, Peroš K, Đogaš Z. Salivary parameters and periodontal inflammation in obstructive sleep apnoea patients. Sci Rep 2022; 12:19387. [PMID: 36371504 PMCID: PMC9653442 DOI: 10.1038/s41598-022-23957-5] [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: 05/05/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of this cross-sectional study was to objectively assess the salivary flow rate and composition and periodontal inflammation in obstructive sleep apnoea (OSA) patients. The subjects, who underwent whole-night polysomnography or polygraphy, were referred for saliva sampling and periodontal examination. According to the severity of OSA based on the Apnoea Hypopnea Index (AHI) value, the subjects were classified into groups: no OSA (AHI < 5; N = 17), mild to moderate OSA (AHI 5-29.9; N = 109), and severe OSA (AHI > 30; N = 79). Salivary flow rate, pH, salivary electrolytes, and cortisol were measured from collected saliva samples. Periodontal examination included assessment of the number of teeth, dental plaque, bleeding on probing and periodontal measurements: gingival recession, probing pocket depth, clinical attachment level (CAL) and periodontal inflamed surface area (PISA) score. There were no significant differences in salivary flow rate, salivary pH, salivary electrolyte concentrations or electrolyte ratios among the groups classified according to the severity of OSA. However, subjects without OSA had higher salivary cortisol concentrations than OSA groups (p < 0.001). Increased plaque scores were associated with a higher AHI (r = 0.26; p = 0.003). According to the salivary flow rate, subjects with hyposalivation and reduced salivation had higher concentrations of salivary electrolytes and lower salivary pH than subjects with normal salivation. Subjects with hyposalivation had an increased Mg/PO4 ratio (p < 0.001) and a reduced Ca/Mg ratio (p < 0.001). Furthermore, subjects with severe OSA tended to have higher CALs and plaque volumes. In conclusion, under pathological conditions, such as OSA, multiple interactions might impact salivary flow and electrolyte composition. Complex interrelationships might affect the integrity of oral health, especially considering OSA severity, inflammation, concomitant diseases and medications.
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Affiliation(s)
- Mia Tranfić Duplančić
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Renata Pecotić
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Linda Lušić Kalcina
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Ivana Pavlinac Dodig
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Maja Valić
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Marija Roguljić
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
| | - Dunja Rogić
- grid.412688.10000 0004 0397 9648University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Ivana Lapić
- grid.412688.10000 0004 0397 9648University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Katarina Grdiša
- grid.412688.10000 0004 0397 9648University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Kristina Peroš
- grid.4808.40000 0001 0657 4636Department of Pharmacology, School of Dental Medicine, University of Zagreb, Šalata 11, Zagreb, Croatia
| | - Zoran Đogaš
- grid.38603.3e0000 0004 0644 1675School of Medicine, University of Split, 21000 Split, Croatia
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Severity of Dementia Is Associated with Increased Periodontal Inflamed Surface Area: Home Visit Survey of People with Cognitive Decline Living in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211961. [PMID: 34831719 PMCID: PMC8618461 DOI: 10.3390/ijerph182211961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022]
Abstract
No studies have measured the periodontal inflamed surface area in people with dementia, although periodontal disease is a major health issue in this group. This study aimed to determine the relationship between dementia severity and periodontal inflamed surface area. An interdisciplinary team, including a dentist and psychiatrist, conducted an in-home survey of older people living in the community. This cross-sectional study was designed as part of a larger cohort study. The interdisciplinary team visited 198 individuals with cognitive decline. We surveyed the clinical dementia rating, periodontal inflamed surface area, number of teeth, and other health issues. We used multiple linear regression analysis to assess the 75 people who were able to take part in all the visits. Number of teeth (Beta = 0.479, p < 0.001), clinical dementia rating (Beta = 0.258, p = 0.013), and age (Beta = 0.250, p = 0.017) were independently associated with periodontal inflamed surface area after adjusting for biological sex, depression, diabetes, collagen disease, visual disorder, and osteoporosis medication. To make communities more dementia-friendly, we must protect older people with dementia from developing poor oral health, which may require home visits for dental assessment.
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Laheij A, Rooijers W, Bidar L, Haidari L, Neradova A, de Vries R, Rozema F. Oral health in patients with end-stage renal disease: A scoping review. Clin Exp Dent Res 2021; 8:54-67. [PMID: 34459147 PMCID: PMC8874082 DOI: 10.1002/cre2.479] [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: 03/23/2021] [Accepted: 07/13/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES In patients with end stage, renal disease a high rate of morbidity and mortality is present. Studies suggest that end stage renal disease may affect oral health. Therefore, the aim of this study was to perform a scoping review on periodontal disease, dental caries, xerostomia, and hyposalivation in end stage renal disease patients. MATERIALS AND METHODS A literature search (in PubMed and Embase.com) was performed up to September 29, 2020, in collaboration with a medical information specialist. Included outcome variables were the community periodontal index, probing pocket depth, gingival index, bleeding on probing, decayed-missing-filled-teeth, carious-absent-obturated index, Xerostomia Inventory and the (un)stimulated whole salivary flow rate. RESULTS Forty three out of 1293 studies were included in the final review comprising 7757 end stage renal disease patients. The average age was 58.3 ± 29.4 years. 28.2%-78.8% of patients reported xerostomia and the (un)stimulated salivary flow rates were significantly lower. Higher community periodontal index scores were measured in end stage renal disease patients. More decayed-missing-filled-teeth were recorded, but no differences were found between groups. CONCLUSIONS Xerostomia and hyposalivation were highly prevalent in end stage renal disease patients. Patients have more deepened pockets, but an equal number of carious teeth compared to healthy controls.
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Affiliation(s)
- Alexa Laheij
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Netherlands
| | - Wietse Rooijers
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Netherlands
| | - Lela Bidar
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Netherlands
| | - Lema Haidari
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Netherlands
| | - Aegida Neradova
- Department of Nephrology, Dianet Amsterdam, and Amsterdam UMC, Netherlands
| | | | - Frederik Rozema
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, location AMC, Netherlands
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Musić L, Par M, Peručić J, Badovinac A, Plančak D, Puhar I. Relationship Between Halitosis and Periodontitis: a Pilot Study. Acta Stomatol Croat 2021; 55:198-206. [PMID: 34248153 PMCID: PMC8255038 DOI: 10.15644/asc55/2/9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Halitosis, or oral malodour, is an unpleasant smell emanating from the oral cavity. It is a common complaint among patients with periodontitis, however, their relationship is not fully elucidated. This study aimed to evaluate the association between halitosis measures, clinical indicators of periodontitis and tongue coating, as well as a novel measure, periodontal inflamed surface area (PISA). Material and methods Data of 10 patients with periodontitis and halitosis were included in this study. Halitosis was assessed by the organoleptic method and the portable sulphide monitor, measuring volatiles sulphur compounds. A comprehensive periodontal examination was conducted, and the parameters of probing depth, gingival recession, clinical attachment level, bleeding on probing, plaque and tongue coating were registered. The PISA was calculated using clinical attachment level, gingival recession and bleeding on probing. Results A correlation between organoleptic score and tongue coating (r=0.554) and plaque (r=0.614) could be observed. No correlation between measures of halitosis and probing depth or the PISA could be detected. A significant correlation was found between organoleptic scores and volatiles sulphur compounds values (r=0.931). Conclusion This pilot study has shown and further reiterated a complex interplay between different factors causative to halitosis in patients affected by periodontitis. The results suggest that tongue coating and oral hygiene may have an important role in halitosis in patients with periodontitis.
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Affiliation(s)
- Larisa Musić
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Matej Par
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Jasna Peručić
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ana Badovinac
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Darije Plančak
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ivan Puhar
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
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Estimation of the Periodontal Inflamed Surface Area by Simple Oral Examination. J Clin Med 2021; 10:jcm10040723. [PMID: 33673121 PMCID: PMC7917734 DOI: 10.3390/jcm10040723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022] Open
Abstract
The periodontal inflamed surface area (PISA) is a useful index for clinical and epidemiological assessments, since it can represent the inflammation status of patients in one contentious variable. However, calculation of the PISA is difficult, requiring six point probing depth measurements with or without bleeding on probing on 28 teeth, followed by data input in a calculation program. More simple methods are essential for screening periodontal disease or in epidemiological studies. In this study, we tried to establish a convenient partial examination method to estimate PISA. Cross-sectional data of 254 subjects who completed active periodontal therapy were analyzed. Teeth that represent the PISA value were selected by an item response theory approach. The maxillary second molar, first premolar, and lateral incisor and the mandibular second molar and lateral incisor were selected. The sum of the PISAs of these teeth was significantly correlated with the patient’s PISA (R2 = 0.938). More simply, the sum of the maximum values of probing pocket depth with bleeding for these teeth were also significantly correlated with the patient’s PISA (R2 = 0.6457). The simple model presented in this study may be useful to estimate PISA.
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