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Adam HS, Molinsky R, Bohn B, Roy S, Rosenbaum M, Paster B, Yuzefpolskaya M, Colombo PC, Papapanou PN, Desvarieux M, Jacobs DR, Demmer RT. Clinical attachment loss is cross-sectionally associated with elevated glucose among adults without diabetes. J Clin Periodontol 2024; 51:522-535. [PMID: 38343130 PMCID: PMC11023769 DOI: 10.1111/jcpe.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/19/2023] [Accepted: 01/01/2024] [Indexed: 04/18/2024]
Abstract
AIM We investigated whether periodontal measures are cross-sectionally associated with prediabetes and cardiometabolic biomarkers among non-diabetic younger adults. MATERIALS AND METHODS One thousand seventy-one participants (mean age = 32.2 years [SE = 0.3]; 73% female) from the Oral Infections, Glucose Intolerance and Insulin Resistance Study were enrolled. Full-mouth clinical attachment loss (fm-CAL), probing depth (fm-PD) and bleeding on probing were ascertained. Interproximal CAL (i-CAL) and probing depths (i-PD) served as our primary exposures. Glucose, HbA1c, insulin and insulin resistance (HOMA-IR) outcomes were assessed from fasting blood. Prediabetes was defined per American Diabetes Association guidelines. Prediabetes prevalence ratios (PR [95% CI]) and mean [SE] cardiometabolic biomarkers were regressed on periodontal variables via multivariable robust variance Poisson regression or multivariable linear regression. RESULTS Prevalence of prediabetes was 12.5%. Fully adjusted prediabetes PR in Tertiles 3 versus 1 of mean i-CAL was 2.42 (1.77, 3.08). Fully adjusted fasting glucose estimates across i-CAL tertiles were 83.29 [0.43], 84.31 [0.37], 86.48 [0.46]; p for trend <.01. Greater percent of sites with i-PD ≥3 mm showed elevated natural-log-HOMA-IR after adjustment (0%-12% of sites = 0.33 [0.03], 13%-26% of sites = 0.39 [0.03], ≥27% of sites = 0.42 [0.03]; p for trend = .04). CONCLUSIONS i-CAL (vs. fm-CAL) was associated with elevated fasting glucose and prediabetes, whereas i-PD (vs. fm-PD) was associated with insulin resistance. Future studies are needed to examine periodontal disease and incident prediabetes.
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Affiliation(s)
- Hamdi S. Adam
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
| | - Sumith Roy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | | | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Paolo C. Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Panos N. Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, New York, NY, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David R. Jacobs
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
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Lee T, Han K, Yun KI. Association between dental scaling and metabolic syndrome and lifestyle. PLoS One 2024; 19:e0297545. [PMID: 38573898 PMCID: PMC10994476 DOI: 10.1371/journal.pone.0297545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/09/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Periodontal disease is a risk factor for diabetes and metabolic syndrome, and non-surgical periodontal treatment has been shown to help maintain stable blood sugar in diabetic patients. Determining the level of preventive scaling in patients with metabolic syndrome will help manage the disease. The purpose of this study was to investigate the extent to which people with metabolic syndrome or bad lifestyle performed scaling and the association between preventive scaling and metabolic syndrome or lifestyle in a large population. METHODS This study was conducted on adults aged 20 years or older from January 2014 to December 2017 in the National Health Insurance System (NHIS) database. Among 558,067 people who underwent health checkups, 555,929 people were included. A total of 543,791 people were investigated for preventive scaling. Metabolic syndrome components were abdominal obesity, lower high density lipoprotein cholesterol (HDL)-C, high triglycerides, high blood pressure and hyperglycemia. Unhealthy lifestyle score was calculated by assigning 1 point each for current smokers, drinkers, and no performing regular exercise. RESULTS When multiple logistic regression analysis was performed after adjusting for age, sex, income, body mass index (BMI), smoking, drinking and regular exercise, the Odds ratios (OR) and 95% confidence intervals (CI) of the group with 5 metabolic syndrome components were 0.741 (0.710, 0.773) (p<0.0001). After adjustment for age, sex, income, BMI, smoking, drinking, regular exercise, diabetes, hypertension and dyslipidemia, the OR (95% CI) of the group with unhealthy lifestyle score = 3 was 0.612 (0.586, 0.640) (p<0.0001). CONCLUSIONS The more metabolic syndrome components, and the higher unhealthy lifestyle score, the less scaling was performed.
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Affiliation(s)
- TaeYeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyoung-In Yun
- Department of Oral and Maxillofacial Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Owosho AA, Aguirre SE, Dayo AF, Omolehinwa TT, Shintaku WH. Radiographic Orofacial Findings of Systemic Diseases. Dent Clin North Am 2024; 68:409-427. [PMID: 38417998 DOI: 10.1016/j.cden.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article discusses the orofacial clinicoradiographic features of systemic diseases that manifest in the orofacial region. The systemic diseases discussed are grouped into the following: autoimmune diseases, endocrine diseases, bone diseases, hematologic diseases, syndromes, and malignancies. The radiographic manifestation ranges from radiolucent bony destruction, increased bone density, calcification, thinning of cortical plate, loss of trabeculation, missing teeth, and supernumerary teeth. It is imperative for clinicians to be cognizant of these findings, as they may be the first manifestation of these systemic diseases.
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Affiliation(s)
- Adepitan A Owosho
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Sarah E Aguirre
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adeyinka F Dayo
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Temitope T Omolehinwa
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Werner H Shintaku
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
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Wang Y, He F. Meta-analysis of the efficacy of alendronate-assisted cleansing and root planing in the treatment of periodontitis. Panminerva Med 2024; 66:90-92. [PMID: 34664488 DOI: 10.23736/s0031-0808.21.04565-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Yan Wang
- Department of Stomatology, Tibet Corps Hospital, Chinese People's Armed Police Forces, Lhasa, China -
| | - Fuming He
- Department of Stomatology, The Affiliated Dental Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Figueredo CA, Catunda RQ, Gibson MP, Major PW, Almeida FT. Use of ultrasound imaging for assessment of the periodontium: A systematic review. J Periodontal Res 2024; 59:3-17. [PMID: 37872805 DOI: 10.1111/jre.13194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 10/25/2023]
Abstract
The objective of this study was to systematically review the literature regarding diagnostic applications of ultrasound imaging for evaluation of the periodontium in humans. The search was conducted on Medline, EMBASE, Web of Science, Scopus, Cochrane, and PubMed up to April 3, 2023. The studies included were exclusively human studies that assessed the periodontium with ultrasound (US) imaging (b-mode). Outcomes measured included alveolar bone level, alveolar bone thickness, gingival thickness, and blood flow quantification. References were imported to Covidence. Two reviewers conducted phases 1 and 2. The JBI risk assessment tool for cross-sectional studies was used. Extracted data included the transducer and measurements used and the study's outcomes. The search yielded 4892 studies after removing duplicates. From these, 25 studies were included and selected for extraction. Included studies retrieved outcomes from US examinations of the periodontal tissues. From the selected studies, 15 used US on natural teeth, 4 used US on implants, 2 used US on edentulous ridges, and 4 used color flow/power in US to evaluate the blood flow. The results of the present systematic review suggest that US might be a feasible and valuable diagnostic tool for the periodontium, with the potential to complement shortfalls of current radiographic technologies.
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Affiliation(s)
- Carlos Alberto Figueredo
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Raisa Queiroz Catunda
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Monica P Gibson
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Tang M, Wang G, Li J, Wang Y, Peng C, Chang X, Guo J, Gui S. Flavonoid extract from propolis alleviates periodontitis by boosting periodontium regeneration and inflammation resolution via regulating TLR4/MyD88/NF-κB and RANK/NF-κB pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117324. [PMID: 37852336 DOI: 10.1016/j.jep.2023.117324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/20/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In traditional Chinese medicine, propolis has been used for treating oral diseases for centuries, widely. Flavonoid extract is the main active ingredient in propolis, which has attracted extensive attention in recent years. AIM OF THE STUDY The objective and novelty of the current study aims to identify the mechanism of total flavonoid extract of propolis (TFP) for the treatment of periodontitis, and evaluate the therapeutic effect of TFP-loaded liquid crystal hydrogel (TFP-LLC) in rats with periodontitis. METHODS In this study, we used lipopolysaccharide-stimulated periodontal ligament stem cells (PDLSCs) to construct in vitro inflammation model, and investigated the anti-inflammatory effect of TFP by expression levels of inflammatory factors. Osteogenic differentiation was assessed using alkaline phosphatase activity and alizarin red staining. Meanwhile, the expression of toll like receptor 4 (TLR4), myeloid differentiation primary response 88 (MyD88), nuclear factor-kappa B (NF-κB), receptor activator of NF-κB (RANK) etc, were quantitated to investigate the therapeutic mechanism of TFP. Finally, we constructed TFP-LLC using a self-emulsification method and administered it to rats with periodontitis via periodontal pocket injection to evaluate the therapeutic effects. The therapeutic index, microcomputed tomography (Micro-CT), H&E staining, TRAP staining, and Masson staining were used for this evaluation. RESULTS TFP reduced the expression of TLR4, MyD88, NF-κB and inflammatory factor in lipopolysaccharide-stimulated PDLSCs. Meanwhile, TFP simultaneously regulating alkaline phosphatase, RANK, runt-associated transcription factor-2 and matrix metalloproteinase production to accelerate osteogenic differentiation and collagen secretion. In addition, TFP-LLC can stably anchor to the periodontal lesion site and sustainably release TFP. After four weeks of treatment with TFP-LLC, we observed a decrease in the levels of NF-κB and interleukin-1β (IL-1β) in the periodontal tissues of rats, as well as a significant reduction in inflammation in HE staining. Similarly, Micro CT results showed that TFP-LLC could significantly inhibit alveolar bone resorption, increase bone mineral density (BMD) and reduce trabecular bone space (Tb.Sp) in rats with periodontitis. CONCLUSION Collectively, we have firstly verified the therapeutic effects and mechanisms of TFP in PDLSCs for periodontitis treatment. Our results indicate that TFP perform anti-inflammatory and tissue repair activities through TLR4/MyD88/NF-κB and RANK/NF-κB pathways in PDLSCs. Meanwhile, for the first time, we employed LLC delivery system to load TFP for periodontitis treatment. The results showed that TFP-LLC could be effectively retained in the periodontal pocket and exerted a crucial role in inflammation resolution and periodontal tissue regeneration.
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Affiliation(s)
- Maomao Tang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Guichun Wang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Jiaxin Li
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Yuxiao Wang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Chengjun Peng
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Xiangwei Chang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China; Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, Anhui, China; Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei, Anhui, China
| | - Jian Guo
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China; Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, Anhui, China; Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei, Anhui, China.
| | - Shuangying Gui
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China; Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei, Anhui, China; Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei, Anhui, China; Engineering Technology Research Center of Modernized Pharmaceutics, Anhui Education Department (AUCM), Hefei, Anhui, China.
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Cai Z, Du S, Zhao N, Huang N, Yang K, Qi L. Periodontitis promotes the progression of diabetes mellitus by enhancing autophagy. Heliyon 2024; 10:e24366. [PMID: 38288023 PMCID: PMC10823111 DOI: 10.1016/j.heliyon.2024.e24366] [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: 07/17/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
Objective This study aims to identify the periodontitis factor that activates excessive autophagy in pancreatic β cells, resulting in organic lesions of pancreatic islet tissues and diminished insulin secretion, thereby accelerating the progression of diabetes mellitus (DM). Methods Sprague-Dawley (SD) rats were induced with periodontitis (PD), type 2 diabetes mellitus (T2DM), or the combination of T2DM and PD (DP) through a high-sugar/high-fat diet and ligation of the tooth neck with silk thread. Alveolar bone resorption was assessed using Micro-CT, blood glucose levels were measured with a blood glucose meter, pancreatic tissue pathology was examined through HE staining, and the expression of autophagy-related proteins Beclin1 and LC3II/LC3I was analyzed using Western blotting. Results Micro-CT results revealed more pronounced alveolar bone resorption and root bifurcation exposure in the PD and DP groups compared to the control group, with the DP group exhibiting the most severe condition. HE staining demonstrated the formation of periodontal pockets, severe alveolar bone destruction, and abnormal pancreatic islet tissue morphology in the PD and DP groups. The serum levels of IL-6, TNF-α, and IL-1β increased sequentially in the control, DM, PD, and DP groups (P < 0.05). Relative expressions of GCK and GLUT-2 mRNA decreased in the PD group compared to the control group (P > 0.05), while the mRNA expressions in the DP and DM groups increased (P < 0.05), with the DP group exhibiting higher levels than the DM group (P < 0.05). Western blot results indicated increased expression levels of autophagy proteins Beclin1 and LC3II/LC3I in the DM and DP groups compared to the control group (P < 0.05), with the DP group exhibiting higher levels than the DM group (P < 0.05). Conclusion The findings demonstrate that periodontal inflammatory factors may promote the enhancement of pancreatic cell autophagy in diabetic rats.
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Affiliation(s)
- Zhiguo Cai
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Department of Periodontology, Stomatological Hospital Zunyi, Zunyi Medical University, Zunyi, Guizhou, China
- Honghuagang District Stomatological Hospital, Zunyi, Guizhou, China
| | - Shasha Du
- Department of Periodontology, Stomatological Hospital Zunyi, Zunyi Medical University, Zunyi, Guizhou, China
| | - Na Zhao
- Department of Periodontology, Stomatological Hospital Zunyi, Zunyi Medical University, Zunyi, Guizhou, China
| | - Nanqu Huang
- National Drug Clinical Trial Institution, Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China
| | - Kun Yang
- Department of Periodontology, Stomatological Hospital Zunyi, Zunyi Medical University, Zunyi, Guizhou, China
| | - Liu Qi
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
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Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
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Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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Zhao Z, Sun X, Cao L, Zhu C, He K, Hu X, Liu C, Feng Q, Qin Y. Salivary Proteome and Intact N-Glycopeptides Analysis Reveal Specific Signatures in Periodontitis. J Proteome Res 2024; 23:25-39. [PMID: 38088868 DOI: 10.1021/acs.jproteome.3c00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Periodontitis is a prevalent oral inflammatory disease that can result in tooth loss and is closely linked to type 2 diabetes (T2D). In this study, we analyzed the salivary proteome and intact N-glycopeptides (IGPs) of individuals with mild-moderate, severe, aggressive periodontitis, and periodontitis with T2D, including those treated with antidiabetic drugs, to identify specific signatures associated with the disease. Our results revealed that salivary proteins and glycoproteins were altered in all periodontitis groups (PRIDE ID: 1-20230612-72345), with fucose- and sialic acid-containing N-glycans showing the greatest increase. Additionally, differentially expressed proteins were classified into 9 clusters, including those that were increased in all periodontitis groups and those that were only altered in certain types of periodontitis. Interestingly, treatment with antidiabetic drugs reversed many of the changes observed in the salivary proteome and IGPs in T2D-related periodontitis, suggesting a potential therapeutic approach for managing periodontitis in patients with T2D. Consistent with MS/MS results, the expression of salivary IGHA2 and Fucα1-3/6GlcNAc (AAL) was significantly increased in MP. These findings provide new insights into the pathogenesis of periodontitis and highlight the potential of salivary biomarkers for diagnosis, prognosis, and monitoring of disease progression and treatment response.
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Affiliation(s)
- Zhirong Zhao
- Department of Cell Biology and Genetics and Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
- Xi'an Dian Medical Laboratory Co., Ltd., Xi'an, Shaanxi 710000, China
| | - Xiaoyu Sun
- Key Laboratory of Oral Diseases Research of Anhui Province, Department of Periodontology, Stomatologic Hospital & College, Anhui Medical University, Hefei 230032, China
| | - Li Cao
- Department of Cell Biology and Genetics and Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Chunhui Zhu
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710069, China
| | - Kang He
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710069, China
| | - Xiaoyi Hu
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710069, China
| | - Chengcheng Liu
- Department of Cell Biology and Genetics and Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Qiang Feng
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Human Microbiome, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yannan Qin
- Department of Cell Biology and Genetics and Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
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Abdulkareem AA, Al-Taweel FB, Al-Sharqi AJ, Gul SS, Sha A, Chapple IL. Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis. J Oral Microbiol 2023; 15:2197779. [PMID: 37025387 PMCID: PMC10071981 DOI: 10.1080/20002297.2023.2197779] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
The primary etiological agent for the initiation and progression of periodontal disease is the dental plaque biofilm which is an organized aggregation of microorganisms residing within a complex intercellular matrix. The non-specific plaque hypothesis was the first attempt to explain the role of the dental biofilm in the pathogenesis of periodontal diseases. However, the introduction of sophisticated diagnostic and laboratory assays has led to the realisation that the development of periodontitis requires more than a mere increase in the biomass of dental plaque. Indeed, multispecies biofilms exhibit complex interactions between the bacteria and the host. In addition, not all resident microorganisms within the biofilm are pathogenic, since beneficial bacteria exist that serve to maintain a symbiotic relationship between the plaque microbiome and the host’s immune-inflammatory response, preventing the emergence of pathogenic microorganisms and the development of dysbiosis. This review aims to highlight the development and structure of the dental plaque biofilm and to explore current literature on the transition from a healthy (symbiotic) to a diseased (dysbiotic) biofilm in periodontitis and the associated immune-inflammatory responses that drive periodontal tissue destruction and form mechanistic pathways that impact other systemic non-communicable diseases.
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Affiliation(s)
- Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
- CONTACT Ali A. Abdulkareem College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Firas B. Al-Taweel
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ali J.B. Al-Sharqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Sarhang S. Gul
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Aram Sha
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Iain L.C. Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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Basu A, Richardson LA, Carlos A, Abubakr NH, Weltman RL, Ebersole JL. The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2023; 16:81. [PMID: 38201914 PMCID: PMC10780717 DOI: 10.3390/nu16010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case-control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann-Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Leigh Ann Richardson
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Alicia Carlos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Robin L. Weltman
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Jeffrey L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
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Xu HM, Shen XJ, Liu J. Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus. World J Diabetes 2023; 14:1793-1802. [PMID: 38222787 PMCID: PMC10784791 DOI: 10.4239/wjd.v14.i12.1793] [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: 08/08/2023] [Revised: 10/20/2023] [Accepted: 11/27/2023] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with periodontitis. Currently, there are few studies proposing predictive models for periodontitis in patients with T2DM. AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models. METHODS In this a retrospective study, 300 patients with T2DM who were hospitalized at the First People's Hospital of Wenling from January 2022 to June 2022 were selected for inclusion, and their data were collected from hospital records. We used logistic regression to analyze factors associated with periodontitis in patients with T2DM, and random forest and logistic regression prediction models were established. The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve (AUC). RESULTS Of 300 patients with T2DM, 224 had periodontitis, with an incidence of 74.67%. Logistic regression analysis showed that age [odds ratio (OR) = 1.047, 95% confidence interval (CI): 1.017-1.078], teeth brushing frequency (OR = 4.303, 95%CI: 2.154-8.599), education level (OR = 0.528, 95%CI: 0.348-0.800), glycosylated hemoglobin (HbA1c) (OR = 2.545, 95%CI: 1.770-3.661), total cholesterol (TC) (OR = 2.872, 95%CI: 1.725-4.781), and triglyceride (TG) (OR = 3.306, 95%CI: 1.019-10.723) influenced the occurrence of periodontitis (P < 0.05). The random forest model showed that the most influential variable was HbA1c followed by age, TC, TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showed that in the training dataset, the AUC of the random forest model was higher than that of the logistic regression model (AUC = 1.000 vs AUC = 0.851; P < 0.05). In the validation dataset, there was no significant difference in AUC between the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915; P > 0.05). CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the risk of periodontitis in patients with T2DM.
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Affiliation(s)
- Hong-Miao Xu
- Department of Stomatology, The First People’s Hospital of Wenling, Taizhou 317500, Zhejiang Province, China
| | - Xuan-Jiang Shen
- Department of Stomatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Jia Liu
- Department of Stomatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
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Hao Y, Li S, Dong S, Niu L. The Association between Tooth Loss and Insulin Resistance Mediated by Diet Quality and Systemic Immunoinflammatory Index. Nutrients 2023; 15:5008. [PMID: 38068866 PMCID: PMC10708050 DOI: 10.3390/nu15235008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
(1) Background: Both tooth loss and diabetes have high global prevalence, and both have a significant influence on patients' general health and quality of life. Previous research has indicated a possible connection between tooth loss and diabetes, but it has been unclear whether tooth loss has an effect on the development of diabetes and how it affects it. We aim to investigate the relationship between insulin resistance (IR) and tooth loss and examine how the systemic immune-inflammation index (SII) level and diet quality mediate it. (2) Methods: The cross-sectional study data were obtained from the National Health and Nutrition Examination Survey (NHANES). After describing and comparing baseline data, we used regression models to evaluate the relationship between IR and tooth loss, diet quality and tooth loss and IR, SII and tooth loss and IR. Furthermore, we applied bootstrapping to test the mediation effect of diet quality and SII between tooth loss and IR. Diet quality is reflected by the HEI (Healthy Eating Index)-2015 score. (3) Results: The total number of subjects included was 8197, with 3861 individuals belonging to the IR group (HOMA-IR ≥ 2.5) and 4336 in the non-IR group (HOMA-IR < 2.5). In the model with all covariates adjusted, tooth loss in the fourth quartile was found to be positively correlated with an increase in HOMA-IR (OR = 1.301; 95% confidence interval (CI) = [1.102, 1.537]; p < 0.001) compared to the first quartile; tooth loss in the fourth quartile correlated with the HEI-2015 score compared to the first quantile (β = -0.121, 95% CI = [-4.839, -2.974], p < 0.001); and the highest number of tooth loss was found to have a significant effect on SII (β = 0.032; 95%CI = [1.777, 47.448]; p < 0.05). Compared to average diet quality, best diet quality acts as a safeguard against elevated HOMA-IR (OR = 0.776; 95% CI = [0.641, 0.939]; p < 0.01); inadequate diet quality is a risk factor (OR = 1.267; 95%CI = [1.138, 1.411]; p < 0.001) conversely. Meanwhile, it can be seen that compared with the first quantile of SII, the highest score is significantly correlated with the higher incidence of IR (OR = 1.363; 95%CI = [1.179, 1.575]; p < 0.001). Diet quality and SII played a partial mediating role in the relationship between HOMA-IR and tooth loss, and the mediating effect ratio for the total effect value was 4.731% and 4.576%, respectively. The mediating effect of SII and diet quality in the association of the relationship between HOMA-IR and tooth loss both was 0.003 (95%CI = [0.001, 0.004]). (4) Conclusions: Our study revealed the relationship between IR and tooth loss, and further explored the mediating role of SII and diet quality between the number of missing teeth and IR, emphasizing that improving diet quality and reducing SII can effectively prevent and treat IR and related diseases. It provides new theoretical support for the study of IR mechanisms and new ideas and approaches to deal with related diseases.
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Affiliation(s)
- Yaqi Hao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.H.); (S.D.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
| | - Shaoru Li
- Experimental Teaching Center, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Shaojie Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.H.); (S.D.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Lin Niu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.H.); (S.D.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
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14
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Shafaee H, Asgari R, Bardideh E, Rangrazi A, Sedigh S, Kerayechian N. The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 44:103759. [PMID: 37604216 DOI: 10.1016/j.pdpdt.2023.103759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/23/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients. Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis. Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods. Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.
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Affiliation(s)
- Hooman Shafaee
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Erfan Bardideh
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran.
| | - Abdolrasoul Rangrazi
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran
| | - Sadaf Sedigh
- Student of Dentistry, University of Pittsburgh School of Dental Medicine, PA, USA
| | - Navid Kerayechian
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
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15
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Wu SY, Wu CY, Lin LY, Chen YH, Huang HY, Lai YL, Lee SY. Systemic antibiotics adjuvants to scaling and root planing in type 2 diabetic and periodontitis individuals: Systematic review with network meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:167-178. [PMID: 38152384 PMCID: PMC10751746 DOI: 10.1016/j.jdsr.2023.06.001] [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: 01/10/2023] [Accepted: 06/04/2023] [Indexed: 12/29/2023] Open
Abstract
Targeting inflammatory pathways is considered a common strategy to control type 2 diabetes (T2D) and periodontitis. This overview was to validate systemic antibiotics as an adjuvant to scaling and root planing (SRP) for the treatments of periodontal patients with T2D. Literature searches were conducted using Web of Science, PubMed, Cochrane, and EMBASE. Randomized trials comparing SRP and systemic antibiotics on glycated hemoglobin (HbA1c) and probing pocket depth (PPD) in adults with T2D and periodontitis were analyzed using network meta-analysis and meta-regression. At 3-month postintervention, meta-analyses of 16 studies revealed that SRP and SRP plus systemic antibiotics (SRPa) had similar significant effects in reducing HbA1c levels of - 0.72% and - 0.96% respectively. While SRP and SRPa also, respectively, reduced PPD of - 0.67 and - 0.89 mm, SRPa showed a better reduction than SRP. At 6-month postintervention, meta-analyses of 7 trials revealed that only SRP was effective in reducing HbA1c levels (-0.29%) but not SRPa. Although both SRP and SRPa still significantly reduced PPD by - 0.56 and - 0.81 mm, respectively, there was no difference between them. The current overview suggested that routine SRP alone is highly recommended for patients with T2D and periodontitis, since systemic antibiotics as an adjuvant provide a rather short-term effect.
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Affiliation(s)
- Shih-Yun Wu
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Yu Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-hsuan Chen
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yi Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shyh-Yuan Lee
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
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16
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Zhang Y, Leveille SG, Camhi SM, Shi L. Association of oral care with periodontitis and glycemic control among US adults with diabetes. BMC Oral Health 2023; 23:903. [PMID: 37990177 PMCID: PMC10664594 DOI: 10.1186/s12903-023-03580-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Studies indicate that treating periodontitis may benefit glycemic control among people with diabetes. It is unclear whether oral self-care such as flossing may reduce risk for periodontitis and improve glycemic control among people with diabetes. The purpose of this study was to examine associations between oral care, specifically, flossing and preventive dental care, with periodontitis and glycemic control, among US dentate adults with diabetes. METHODS We analyzed data from the National Health and Nutrition Examination Survey 2011-2014 for 892 participants aged 30 years and older with diabetes who completed the periodontal examination and lab test for hemoglobin A1c (HbA1c). Sampling weights were applied. Multivariable logistic regression and multivariable linear modeling were performed to examine the associations of flossing and preventive dental services on periodontal health and HbA1c levels, respectively, controlling for sociodemographic characteristics, health behaviors, and other risk factors. RESULTS Among U.S. dentate adults with diabetes, 52.1% of flossers and 72.1% of non-flossers had periodontitis (p < 0.001). Flossers were 39% less likely to have periodontitis (Adj. OR 0.61, 95% CI 0.43-0.88) compared to non-flossers. Flossers had an average HbA1c reading 0.30% (95% CI 0.02%-0.58%) lower than non-flossers, adjusted for covariates (p = 0.037). Preventive dental visits were associated with reduced risk for periodontitis (Adj. OR 0.54, 95%CI, 0.38-0.75) but not glycemic control. CONCLUSION Flossing was associated with periodontal health and glycemic control among US adults with diabetes. Although further research is needed, the findings support that oral self-care may be particularly beneficial for adults with diabetes.
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Affiliation(s)
- Yuqing Zhang
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
- College of Nursing, University of Cincinnati, 3110 Vine Street, Cincinnati, OH, 45221, USA.
| | - Suzanne G Leveille
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
| | - Sarah M Camhi
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
- College of Arts and Sciences, Department of Kinesiology, University of San Francisco, Fulton Street, San Francisco, CA, 94117, USA
| | - Ling Shi
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA
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17
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Hessain D, Andersen A, Fredslund EK. Inequalities in healthcare utilisation among adults with type 2 diabetes. Diabetes Res Clin Pract 2023; 205:110982. [PMID: 37890705 DOI: 10.1016/j.diabres.2023.110982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
AIMS To examine inequality in dentist, ophthalmologist, and podiatrist attendance among adults with type 2 diabetes in a country with varying degrees of co-payment. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study with a population of 41,181 people with type 2 diabetes resident in the Central Denmark Region in 2019, identified through Danish registers using a prespecified diabetes algorithm. Descriptive statistics and multiple logistic regression were used to examine the attendance at dentist, ophthalmologist, and podiatrist, controlling for sociodemographic and clinical factors. Attendance at dentist, ophthalmologist, and podiatrist were examined separately. RESULTS The majority (59.7 %) had attended the ophthalmologist at least once in the preceding year, whereas 46.5 % and 34.2 % had visited the dentist/dental hygienist and podiatrist, respectively. Disposable household income increased attendance significantly, with a clear gradient in the OR of attending the dentist (p < 0.001), whereas age significantly magnified the OR of podiatrist and ophthalmologist attendance (p < 0.001). CONCLUSIONS This study provides circumstantial evidence that co-payment can increase inequality in health care attendance, especially for dental attendance, and it further shows that there is significant sociodemographic inequality in healthcare utilisation among people with type 2 diabetes.
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Affiliation(s)
- Dunia Hessain
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Anette Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark
| | - Eskild Klausen Fredslund
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus N, Denmark.
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Zhu J, Zhang S, Shi J, ning N, Wei Y, Zhang Y. Periodontitis is associated with the increased levels of visfatin: a meta-analysis. BMC Oral Health 2023; 23:799. [PMID: 37884949 PMCID: PMC10601249 DOI: 10.1186/s12903-023-03384-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/04/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Periodontitis is a common inflammatory disease associated with systemic factors. Visfatin is a pleiotropic adipokine that exerts metabolic and immune functions. Studies have shown visfatin played roles in the development of periodontitis. The present study aims to compare the levels of visfatin in body fluids including serum, saliva, and gingival crevicular fluid (GCF) between periodontitis patients and healthy individuals, and to elucidate the alteration of visfatin levels after periodontal treatments. MATERIALS AND METHODS The database searched included Pubmed, Embase, Web of Science, and Cochrane Library. According to the Eligibility criteria, the records were screened and the eligible studies were included. The methodological qualities of the included case-controlled studies were assessed according to the Newcastle-Ottawa scale (NOS). The Methodological Index for Nonrandomized Studies (MINORS) was applied for assessing the qualities of the included clinical trials. The statistical analyses were processed using STATA 15.0. RESULTS Twenty-three studies were included in the statistical analyses. The meta-analysis showed significantly elevated visfatin levels of GCF, serum, and saliva in the periodontitis population compared with the controls (GCF: SMD = 5.201, 95% CI: 3.886-6.516, Z = 7.75, P < 0.05; Serum: SMD = 7.417, 95% CI: 3.068-11.767, Z = 3.34, P = P < 0.05; Saliva: SMD = 2.683, 95% CI: 1.202-4.163, Z = 3.34, P < 0.05). Visfatin levels of saliva serum and GCF were significantly decreased after periodontal treatment. (Saliva: SMD = -1.338, 95% CI: -2.289-0.487, Z = 39.77, P < 0.05; Serum: SMD = -2.890, 95% CI: -5.300-0.480, Z = 2.35, P < 0.05; GCF: SMD = -6.075, 95% CI: -11.032-1.117, Z = 2.40, P = 0.016; I 2 = 95.9%, P < 0.05). CONCLUSIONS Periodontitis elevated the visfatin levels in GCF, serum, and saliva. Additionally, GCF, serum, and saliva visfatin levels could be reduced after periodontal treatment.
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Affiliation(s)
- Junfei Zhu
- Stomatology Center, China Japan Friendship Hospital, Beijing, China
| | - Suhan Zhang
- Department of Dermatology, China Japan Friendship Hospital, Beijing, China
| | - Jing Shi
- The ward of stomatology center, China Japan friendship hospital, Beijing, China
| | - Ning ning
- The ward of stomatology center, China Japan friendship hospital, Beijing, China
| | - Ying Wei
- The Second Department of Proctology, China Japan Friendship Hospital, Beijing, China
| | - Ye Zhang
- Stomatology Center, China Japan Friendship Hospital, Beijing, China
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Jansen P, Conrads G, Wenzler JS, Krause F, Braun A. Bacteremia Prevention during Periodontal Treatment-An In Vivo Feasibility Study. Antibiotics (Basel) 2023; 12:1555. [PMID: 37887256 PMCID: PMC10604622 DOI: 10.3390/antibiotics12101555] [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: 09/27/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
The link between periodontitis and systemic diseases has increasingly become a focus of research in recent years. In this context, it is reasonable-especially in vulnerable patient groups-to minimize bacteremia during periodontal treatment. The aim of the present in vivo feasibility study was to investigate the possibility of laser-based bacteremia prevention. Patients with stage III, grade B generalized periodontitis were therefore treated in a split-mouth design either with prior 445 nm laser irradiation before nonsurgical periodontal therapy or without. During the treatments, clinical (periodontal measures, pain sensation, and body temperature), microbiological (sulcus samples and blood cultures before, 25 min after the start, and 10 min after the end of treatment), and immunological parameters (CRP, IL-6, and TNF-α) were obtained. It was shown that periodontal treatment-related bacteremia was detectable in both patients with the study design used. The species isolated were Schaalia georgiae, Granulicatella adiacens, and Parvimonas micra. The immunological parameters increased only slightly and occasionally. In the laser-assisted treatments, all blood cultures remained negative, demonstrating treatment-related bacteremia prevention. Within the limitations of this feasibility study, it can be concluded that prior laser disinfection can reduce bacteremia risk during periodontal therapy. Follow-up studies with larger patient numbers are needed to further investigate this effect, using the study design presented here.
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Affiliation(s)
- Patrick Jansen
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany; (J.-S.W.); (F.K.); (A.B.)
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, 52074 Aachen, Germany;
| | - Johannes-Simon Wenzler
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany; (J.-S.W.); (F.K.); (A.B.)
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany; (J.-S.W.); (F.K.); (A.B.)
| | - Andreas Braun
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany; (J.-S.W.); (F.K.); (A.B.)
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20
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Gündüz G, Beler M, Ünal İ, Cansız D, Emekli-Alturfan E, Kose KN. Endotoxin of Porphyromonas gingivalis amplifies the inflammatory response in hyperglycemia-induced zebrafish through a mechanism involving chitinase-like protein YKL-40 analogs. Toxicol Res 2023; 39:625-636. [PMID: 37779592 PMCID: PMC10541394 DOI: 10.1007/s43188-023-00190-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 10/03/2023] Open
Abstract
Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontal diseases, is also associated with hyperglycemia-associated systemic diseases, including diabetes mellitus (DM). Gingipains are the most important endotoxins of P. gingivalis, and in vivo studies using gingipains are scarce. Zebrafish (Danio rerio) is a vertebrate with high physiological and genetic homology with humans that has multiple co-orthologs for human genes, including inflammation-related proteins. The aim of our study was to determine the effects of gingipain in a hyperglycemia-induced zebrafish model by evaluating inflammation, oxidant-antioxidant status, and the cholinergic system. Adult zebrafish were grouped into the control group (C), hyperglycemia-induced group subjected to 15 days of overfeeding (OF), gingipain-injected group (GP), and gingipain-injected hyperglycemic group (OF + GP). At the end of 15 days, an oral glucose tolerance test (OGTT) was performed, and fasting blood glucose (FBG) levels were measured. Lipid peroxidation (LPO), nitric oxide (NO), glutathione (GSH), glutathione S-transferase, catalase, acetylcholinesterase (AChE), alkaline phosphatase (ALP), and sialic acid (SA) levels were determined spectrophotometrically in the hepatopancreas. The expression levels of tnf-⍺, il-1β, ins, crp, and the acute phase protein YKL-40 analogs chia.5 and chia.6 were evaluated by RT‒PCR. After two weeks of overfeeding, significantly increased weight gain, FBG, and OGTT confirmed that the zebrafish were hyperglycemic. Increased oxidative stress, inflammation, and AChE and ALP activities were observed in both the overfeeding and GP groups. Amplification of inflammation and oxidative stress was evident in the OF + GP group through increased expression of crp, il-1β, chia.5, and chia.6 and increased LPO and NO levels. Our results support the role of gingipains in the increased inflammatory response in hyperglycemia-associated diseases.
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Affiliation(s)
- Gizem Gündüz
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Merih Beler
- Department of Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - İsmail Ünal
- Department of Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Derya Cansız
- Department of Biochemistry, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ebru Emekli-Alturfan
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Kemal Naci Kose
- Department of Periodontology, Faculty of Dentistry, Marmara University, Marmara University Basibuyuk Medical Campus, Basibuyuk, Maltepe, 34854 Istanbul, Turkey
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21
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Karimi N, Samiee N, Moradi Y. The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta-analysis of analytical observational studies. Health Sci Rep 2023; 6:e1630. [PMID: 37867783 PMCID: PMC10587389 DOI: 10.1002/hsr2.1630] [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: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
Background and Aim The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE), premature rupture of the amniotic sac, gestational diabetes (GDM), or low birth weight (LBW) in pregnant women, which should be investigated in a systematic meta-analysis. Methods Studies that reported the association between PD and pregnancy or neonatal outcomes and were published from January 1990 to December 2022, were identified by an extensive search in PubMed (Medline), Scopus, Web of Sciences, and Medline (Elsevier). After retrieving the studies, the screening stage was performed based on their titles, abstracts, and full texts, and after selecting the final articles, their information was extracted and their quality was assessed using the Newcastle Ottawa Scale checklist. Results Pregnant women with PD had a 1.39 higher chance of developing GDM than those who did not have the infection (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.21-1.61; I square: 49.67%; p: 0.03). Additionally, the pooled RR of LBW was 2.19, which indicates that pregnant women with PD had a 2.19-fold higher risk of LBW than pregnant women who do not have the infection (RR: 2.19; 95% CI: 1.82-2.64; I square: 0.00%; p: 0.65). The relationship between the risk of PE and the existence of PD was examined in 33 cohort and case-control studies for this meta-analysis. These results were combined, and the pooled RR was 1.43. This indicates that pregnant women with PD are 1.43 times more likely to experience PE than pregnant women without PD (RR: 1.43; 95% CI: 1.32-1.54; I square: 82.64%; p: 0.00). Conclusion According to the findings of the current meta-analysis, PD may contribute to a higher risk of poor maternal and newborn outcomes in pregnant women.
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Affiliation(s)
- Newsha Karimi
- Student Research Committee, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Negin Samiee
- Oral and Maxillofacial Medicine Department, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Social Determinant of the Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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22
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Güvenç KK, Fentoğlu Ö, Calapoğlu M, Aksoy F, Orhan H. Periodontal and cardiovascular therapies modify specialized pro-resolving lipid mediator (sPRLM) (LPXA4, PD1, RvE1, RvD1, and MaR1)-mediated pathway: the first pilot clinical study. Clin Oral Investig 2023; 27:5549-5558. [PMID: 37535198 DOI: 10.1007/s00784-023-05174-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/15/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Cardiovascular disease (CVD) and periodontal disease have a common pathogenesis with inflammation and resolution steps. Although the relationships among periodontal disease, CVD, and specialized pro-resolving lipid mediator (sPRLM)s are well known, there is no study about the combined effects of cardiovascular and periodontal treatments on sPRLM levels. It was aimed to evaluate the effects of periodontal and cardiovascular therapies on sPRLMs (lipoxin A4, protectin (PD)1, resolvin (Rv) E1, RvD1, and maresin (MaR)1) in patients with CVD and periodontal disease. METHODS This observational study consisted of fifty-five patients with CVD and mild or moderate periodontitis. The clinical periodontal parameters (plaque index, gingival index, probing pocket depth, percentage of bleeding on probing, and clinical attachment level) and blood and unstimulated total saliva samples were obtained at baseline, at 3 months (following only cardiovascular therapy), and at 6 months (following cardiovascular and periodontal therapies). The blood count and serum levels of cardiometabolic biomarkers (white blood cell, neutrophil/lymphocyte, serum total cholesterol (TC), triglyceride, and low and high-density lipoprotein (HDL) levels) were evaluated. sPRLMs were evaluated by ELISA. RESULTS There were significant decreases in body mass index, clinical periodontal parameters, WBC, LDL, PD1, and RvD1 at 6 months compared to baseline. The decreases in TC/HDL, RvE1, and MaR1 levels were significant at 3 and 6 months compared to baseline (p < 0.05). CONCLUSION(S) The combination of cardiovascular and periodontal treatments leads to significant reductions in clinical periodontal and cardiometabolic parameters and sPRLMs. CLINICAL RELEVANCE Our report, which is the first in their field, suggested that cardiovascular and periodontal therapies provide an important contribution via decreasing the periodontal and atherosclerotic inflammation modulating sPRLMs. This finding will be a big step toward increasing the quality of life in these patients by drawing attention to importance of public health associated with oral hygiene, periodontal health, and systemic phase of periodontal treatment.
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Affiliation(s)
- Kübra Karakoç Güvenç
- Faculty of Dentistry, Department of Periodontology, Süleyman Demirel University, Isparta, Turkey
| | - Özlem Fentoğlu
- Faculty of Dentistry, Department of Periodontology, Süleyman Demirel University, Isparta, Turkey.
| | - Mustafa Calapoğlu
- Faculty of Science, Department of Biochemistry, Süleyman Demirel University, Isparta, Turkey
| | - Fatih Aksoy
- Faculty of Medicine, Department of Cardiology, Süleyman Demirel University, Isparta, Turkey
| | - Hikmet Orhan
- Faculty of Medicine, Department of Biostatistics, Süleyman Demirel Üniversitesi, Isparta, Turkey
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23
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Garrido L, Lyra P, Rodrigues J, Viana J, Mendes JJ, Barroso H. Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness. J Pers Med 2023; 13:1332. [PMID: 37763100 PMCID: PMC10532628 DOI: 10.3390/jpm13091332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.
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Affiliation(s)
| | | | | | | | | | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal (P.L.); (J.V.); (J.J.M.)
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24
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Zhao M, Xie Y, Gao W, Li C, Ye Q, Li Y. Diabetes mellitus promotes susceptibility to periodontitis-novel insight into the molecular mechanisms. Front Endocrinol (Lausanne) 2023; 14:1192625. [PMID: 37664859 PMCID: PMC10469003 DOI: 10.3389/fendo.2023.1192625] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Diabetes mellitus is a main risk factor for periodontitis, but until now, the underlying molecular mechanisms remain unclear. Diabetes can increase the pathogenicity of the periodontal microbiota and the inflammatory/host immune response of the periodontium. Hyperglycemia induces reactive oxygen species (ROS) production and enhances oxidative stress (OS), exacerbating periodontal tissue destruction. Furthermore, the alveolar bone resorption damage and the epigenetic changes in periodontal tissue induced by diabetes may also contribute to periodontitis. We will review the latest clinical data on the evidence of diabetes promoting the susceptibility of periodontitis from epidemiological, molecular mechanistic, and potential therapeutic targets and discuss the possible molecular mechanistic targets, focusing in particular on novel data on inflammatory/host immune response and OS. Understanding the intertwined pathogenesis of diabetes mellitus and periodontitis can explain the cross-interference between endocrine metabolic and inflammatory diseases better, provide a theoretical basis for new systemic holistic treatment, and promote interprofessional collaboration between endocrine physicians and dentists.
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Affiliation(s)
- Mingcan Zhao
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yuandong Xie
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Wenjia Gao
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Chunwang Li
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Qiang Ye
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yi Li
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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25
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Michalowicz BS, Anderson JP, Kottke TE, Dehmer SP, Worley DC, Kane S, Basile S, Rindal DB. Periodontal treatment and subsequent clinical outcomes and medical care costs: A retrospective cohort study. PLoS One 2023; 18:e0290028. [PMID: 37578943 PMCID: PMC10424874 DOI: 10.1371/journal.pone.0290028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION Periodontitis is a common oral disease associated with coronary artery disease (CAD), cerebrovascular disease (CBVD) and type 2 diabetes (T2D). We studied if periodontitis treatment improves clinical outcomes and reduces medical care costs in patients with CAD, CBVD or T2D. METHODS We used clinic records and claims data from a health care system to identify patients with periodontitis and CAD, CBVD or T2D, and to assess periodontal treatments, hospitalizations, medical costs (total, inpatient, outpatient, pharmacy), glycated hemoglobin, cardiovascular events, and death following concurrent disease diagnoses. We compared clinical outcomes according to receipt of periodontal treatment and/or maintenance care in the follow-up period, and care costs according to treatment status within one year following concurrent disease diagnoses, while adjusting for covariates. The data were analyzed in 2019-21. RESULTS We identified 9,503 individuals, 4,057 of whom were in the CAD cohort; 3,247 in the CBVD cohort; and 4,879 in the T2D cohort. Patients who were selected and elected to receive treatment and maintenance care were less likely to be hospitalized than untreated individuals (CAD: OR = 0.71 (95% CI: 0.55, 0.92); CBVD: OR = 0.73 (0.56, 0.94); T2D: OR = 0.80 (0.64, 0.99)). Selection to treatment and/or maintenance care was not significantly associated with cardiovascular events, mortality, or glycated hemoglobin change. Total care costs did not differ significantly between treated and untreated groups over 4 years. Treated patients experienced lower inpatient costs but higher pharmacy costs. CONCLUSIONS Patients with periodontitis and CAD, CBVD or T2D who were selected and elected to undergo periodontal treatment or maintenance care had lower rates of hospitalizations, but did not differ significantly from untreated individuals in terms of clinical outcomes or total medical care costs.
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Affiliation(s)
| | | | - Thomas E. Kottke
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Steven P. Dehmer
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Donald C. Worley
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Sheryl Kane
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - Sarah Basile
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - D. Brad Rindal
- HealthPartners Institute, Bloomington, Minnesota, United States of America
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26
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Oliveira VB, Costa FWG, Haas AN, Júnior RMM, Rêgo RO. Effect of subgingival periodontal therapy on glycaemic control in type 2 diabetes patients: Meta-analysis and meta-regression of 6-month follow-up randomized clinical trials. J Clin Periodontol 2023; 50:1123-1137. [PMID: 37257917 DOI: 10.1111/jcpe.13830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/05/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Periodontitis worsens the hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). Subgingival instrumentation, with or without surgical access, is the gold-standard treatment for periodontitis. The aim was to summarize the evidence on the effect of subgingival instrumentation (with or without open flap) on the reduction of glycosylated haemoglobin (HbA1c). METHODS Nine electronic databases were searched up to 15 February 2023. Twelve randomized controlled trials with at least 6 months of follow-up were included. Studies using systemic or local-delivery antimicrobial therapies were excluded. Meta-analyses were performed using the random-effects model. The sources of heterogeneity were assessed by applying linear meta-regression. Risk of bias was assessed by RoB 2, and certainty of evidence by GRADE. RESULTS Eleven studies were included in the quantitative analyses (1374 patients). Subgingival instrumentation resulted in 0.29% lower HbA1c (95% confidence interval: 0.10-0.47; p = .03) compared with non-active treatment. DISCUSSION None of the 12 studies were assessed as having low risk of bias. The percentage of females and the time of diabetes diagnosis significantly explained the high level of heterogeneity. Subgingival periodontal therapy results in a significant and clinically relevant improvement in glycaemic control over 6 months in patients with T2DM and periodontitis. The grade of evidence was moderate.
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Affiliation(s)
- Victor Bento Oliveira
- Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Alex Nogueira Haas
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodrigo Otávio Rêgo
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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27
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Zhu Z, Qi X, Zheng Y, Pei Y, Wu B. Age differences in the effects of multi-component periodontal treatments on oral and metabolic health among people with diabetes mellitus: A meta-epidemiological study. J Dent 2023; 135:104594. [PMID: 37355088 PMCID: PMC10437212 DOI: 10.1016/j.jdent.2023.104594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/07/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVE To explore the age differences in the effects of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes. DATA Trials reporting the effects of multi-component periodontal treatments on oral and metabolic indicators among participants aged 18 and above with periodontitis and diabetes were included. SOURCES Six databases (PubMed/Medline, Embase, CINHAL, Web of Science, Cochrane Library, and ProQuest) were searched from database inception to August 2022. STUDY SELECTION Two reviewers selected the included studies independently. We used bivariate and multivariate meta-regression models to examine the association between age and treatment effect size. The primary outcomes were changes in probing depth (PD), clinical attachment level (CAL), and hemoglobin A1c (HbA1c). RESULTS A total of 18,067 articles were identified in the database search. Of these, 115 trials (119 articles) met inclusion criteria. The mean age of participants was 58 years old, ranging from 35 to 73 years. The pooled evidence demonstrated that multi-component periodontal treatment significantly reduced PD (g=0.929 [0.689-1.169], I2=94.1%), CAL (g=0.879 [0.669-1.089], I2=92.1%), and HbA1c (g=0.603 [0.443-0.763], I2=87.5%). A significant decreasing trend was observed in the effect size for PD (P for trend = 0.020) and CAL (P for trend = 0.028) as age increases. Results from multivariate meta-regression showed that mean age was associated with a smaller effect size for PD (β=-0.123 [0.041], P = 0.004) and CAL (β=-0.159 [0.055], P = 0.006). Compared to their younger counterparts, the effect size for HbA1c was smaller among participants aged 55 and older (β=-0.792 [0.322], P = 0.017). CONCLUSIONS Multi-component periodontal treatments may be more effective in younger populations in terms of effects on PD, CAL, and HbA1c. CLINICAL SIGNIFICANCE Our study highlights the importance of early intervention and tailored treatment approaches. Clinicians should take into account the patient's age when developing periodontal treatment plans and may need to employ more aggressive or personalized strategies for older adults to achieve optimal outcomes.
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Affiliation(s)
- Zheng Zhu
- Rory Meyers College of Nursing, New York University, New York, NY, USA; School of Nursing, Fudan University, Shanghai, China
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Yaguang Zheng
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA; NYU Aging Incubator, New York University, New York, NY, USA.
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28
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Fujii T, Aoyama N, Kida S, Taniguchi K, Yata T, Minabe M, Komaki M. Associations between Periodontal Status and Liver Function in the Japanese Population: A Cross-Sectional Study. J Clin Med 2023; 12:4759. [PMID: 37510874 PMCID: PMC10381182 DOI: 10.3390/jcm12144759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
A relationship between periodontitis and liver function has been suggested. Indeed, patients with severe periodontal disease have been found to be more prone to liver dysfunction. The periodontal inflammatory surface area (PISA) has been shown to be a useful indicator of periodontal and systemic diseases. However, little information is available regarding whether the PISA is associated with liver function markers, such as gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). This study aimed to clarify relationship between liver function markers, AST, ALT, and GGT, and PISA level in a cross-sectional study. The subjects were recruited between 2018 and 2021 at the Medical and Dental Collaboration Center of Kanagawa Dental College Hospital. A periodontal clinical examination was performed, and the PISA was calculated. Peripheral blood samples were collected, and serum levels of liver function markers were measured. The levels of liver function markers were examined in different values of PISA. Participants with high PISA scores were more likely to have increased GGT levels while AST and ALT were not changed with PISA. Increased GGT was found in 10.8% and 29.4% (p = 0.0056), increased AST in 48.2% and 52.9% (p = 0.62), and increased ALT in 35.2% and 47.0% (p = 0.20) among <300 mm2 and ≧300 mm2 PISA groups, respectively. It was found that males with a PISA of 300 mm2 or higher had an elevated level of serum GGT. In conclusion, elevated GGT was found in the high PISA group, particularly in males, while AST and ALT did not differ by PISA.
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Affiliation(s)
- Toshiya Fujii
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Sayuri Kida
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Kentaro Taniguchi
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Tomomi Yata
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Masato Minabe
- Bunkyou Dori Dental Clinic, 2-4-1 Anagawa, Chiba 263-0024, Chiba, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
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29
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Gibson AA, Cox E, Gale J, Craig ME, Eberhard J, King S, Chow CK, Colagiuri S, Nassar N. Oral health status and risk of incident diabetes: a prospective cohort study of 213,389 individuals aged 45 and over. Diabetes Res Clin Pract 2023; 202:110821. [PMID: 37453513 DOI: 10.1016/j.diabres.2023.110821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/18/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
AIMS To examine whether simple measures of oral health are associated with incident diabetes. METHODS This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study participants were 213,389 men and women, aged ≥ 45 years, with no diabetes at baseline. The oral health of participants was assessed by questionnaire. Incident diabetes cases were ascertained based on self-report in follow-up questionnaires, linked data on medical and pharmaceutical claims, and hospitalisation data up until 2019. The association between oral health and incident diabetes were calculated using multivariable cox proportional hazards models. RESULTS During 2,232,215 person-years of follow-up, 20,487 (9.6%) participants developed diabetes. Compared with those with ≥20 teeth, the adjusted hazard ratio (aHR) for incident diabetes was 1.12 (95% Confidence Interval (CI): 1.08, 1.17) for 10-19 teeth, 1.20 (1.14, 1.26) for 1-9 teeth and 1.15 (1.09, 1.21) for no teeth. Compared with those with excellent/very good teeth and gums, the aHR for incident diabetes was 1.07 (1.03, 1.12) for fair and 1.13 (1.07, 1.20) for poor teeth and gums. CONCLUSIONS Simple measures of oral health were associated with risk of developing diabetes, demonstrating the potential importance of oral health screening for diabetes prevention.
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Affiliation(s)
- Alice A Gibson
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
| | - Emma Cox
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Joanne Gale
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Maria E Craig
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Joerg Eberhard
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Shalinie King
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Clara K Chow
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, NSW, Australia
| | - Stephen Colagiuri
- Charles Perkins Centre, The University of Sydney, NSW, Australia; The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Natasha Nassar
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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30
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Stojilković M, Gušić I, Prodanović D, Ilić M, Pecikozić N, Veljović T, Mirnić J, Đurić M. Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study. BMC Oral Health 2023; 23:449. [PMID: 37408017 DOI: 10.1186/s12903-023-03143-3] [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: 04/07/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Strong evidence supports the association between periodontitis and certain systemic diseases. The aim of the present study was to evaluate the knowledge of a group of physicians and dentists in Serbia regarding this topic and assess their professional actions to prevent and control both periodontal and systemic diseases. METHODS An anonymous self-administered structured questionnaire was sent to the available e-mail addresses of randomly selected healthcare providers working in Serbia. According to the inclusion criteria, general practitioners, specialists, general dentists, and specialists working in government hospitals and private practices in various cities in Serbia were recruited in the study. The questionnaire consisted of 17 questions divided into three parts. The first part recorded the sociodemographic characteristics of participants, the second part included questions about the clinical manifestation and etiology of periodontitis, as well as knowledge of the association between periodontitis and systemic diseases, and the third part included questions about professional procedures for the prevention and control of periodontitis and systemic diseases. RESULTS A total of 1301 health participants, 739 (57.8%) physicians and 562 (43.2%) dentists, were included in this cross-sectional study. Most respondents (94.7%) were aware of the association between periodontitis and general health. The highest percentage of respondents associated diabetes mellitus and periodontitis. Factors significantly associated with higher knowledge were female sex (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.37-2.52; p < 0.001) and dental profession (OR, 5.86; 95% CI], 4.03-8.53; p < 0.001). Participants who had higher knowledge score were more likely to ask their patients about gum/systematic health (p < 0.001) and refer them to dentists/physicians (p < 0.001). CONCLUSIONS It was concluded that compared to the group of dentists, the group of physicians had less knowledge of the relationship between periodontitis and systemic diseases. The female gender was significantly associated with better knowledge. A better understanding of this topic is associated with better clinical practice.
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Affiliation(s)
- Marija Stojilković
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia.
| | - Ivana Gušić
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
- Dentistry Clinic of Vojvodina, Hajduk Veljkova 12, Novi Sad, 21000, Novi Sad, Serbia
| | - Dušan Prodanović
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Miloš Ilić
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Nevena Pecikozić
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Tanja Veljović
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Jelena Mirnić
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Milanko Đurić
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
- Dentistry Clinic of Vojvodina, Hajduk Veljkova 12, Novi Sad, 21000, Novi Sad, Serbia
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Sáenz-Ravello G, Matamala L, Cisternas P, Gamonal J, Hernández P, Santos NCD, Deng K, Baeza M. Association between the Mediterranean Diet Index and self-reported Gingival Health Status Indicators in a population of Chilean adults: a cross-sectional study. J Appl Oral Sci 2023; 31:e20230100. [PMID: 37403879 DOI: 10.1590/1678-7757-2023-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Despite the recognized impact of diet on non-communicable diseases, the association between the Mediterranean diet and periodontal diseases is still uncertain. This study aimed to determine the association between adherence to the Mediterranean Diet Index (MDI) and self-reported gingival health status in Chilean adults, exploring the feasibility of using validated web-based survey questionnaires. METHODOLOGY Cross-sectional data were collected from a representative sample of a population of Chilean adults (18-60 years old) using a low-cost and time-saving methodology. By the PsyToolkit platform, anonymous survey data were downloaded and analyzed in bivariate (crude) and backward stepwise selection multivariate logistic regression models adjusted for sociodemographic determinants, smoking, and dental attendance using STATA 17. Odds ratios (OR) [95% confidence intervals] were estimated. RESULTS In total, 351 complete statistical data were mostly obtained from female university students who had never smoked and reported having visited a dentist in the previous year. Multivariate regression models showed an association between MDI and very good/good gingival health status (OR 1.18 [95% CI 1.04-1.34], p=0.013), absence of bleeding on toothbrushing (OR 1.12 [95% CI 1.01-1.25], p=0.035), and absence of clinical signs of gingival inflammation (OR 1.24 [95% CI 1.10-1.40], p<0.001), after controlling for age, sex, educational level, smoking, and dental attendance. CONCLUSIONS We associated adherence to the Mediterranean diet with better self-reported gingival health status in a population of Chilean adults in an entirely web-based research environment. Longitudinal studies with random sampling are required to establish the effect of diet on gingival and periodontal health. Nevertheless, this evidence could contribute to the design of low-cost surveillance programs to reduce the burden of periodontal disease and related "common risk factors".
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Affiliation(s)
- Gustavo Sáenz-Ravello
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Loreto Matamala
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | | | - Jorge Gamonal
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Patricia Hernández
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Nidia Castro Dos Santos
- Universidade Guarulhos, Divisão de Pesquisa Odontológica, Guarulhos, SP, Brasil
- The Forsyth Institute, Cambridge, MA, United States
| | - Ke Deng
- The University of Hong Kong, Faculty of Dentistry, Division of Periodontology and Implant Dentistry, Hong Kong SAR, China
| | - Mauricio Baeza
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
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32
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Ryu SH, Wang ZL, Kim SJ, Cho HJ. Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015. Epidemiol Health 2023; 45:e2023063. [PMID: 37448125 PMCID: PMC10667581 DOI: 10.4178/epih.e2023063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis. METHODS We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization's Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables. RESULTS The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91). CONCLUSIONS Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.
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Affiliation(s)
- Seung-Hee Ryu
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Zi-lan Wang
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Seon-Jip Kim
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Heikkinen AM, Sokka TT, Torppa-Saarinen E, Pimiä E, Jokinen M, Maijala M, Rantala I, Tervahartiala T, Sorsa T, Kauppila T. aMMP-8 Point-of-Care Test (POCT) Identifies Reliably Periodontitis in Patients with Type 2 Diabetes as well as Monitors Treatment Response. Diagnostics (Basel) 2023; 13:2224. [PMID: 37443617 DOI: 10.3390/diagnostics13132224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The link between diabetes and periodontitis is bi-directional: high glucose levels increase the risk of periodontitis and elevated oral fluid aMMP-8 as well as diabetic development while untreated periodontitis worsens glycaemic control. METHODS Type-2 patients (N = 161) underwent an aMMP-8 Point-of-Care Test (POCT) at diabetes clinics. If the test was positive, the patient was sent to an oral health care clinic and oral health examination, health-promoting as well as necessary treatment procedures were carried out. Only 41 patients underwent full clinical evaluations. At the end of the treatment, an aMMP-8 POCT (B) was performed and if the test was positive, the treatment was continued and a new test (C) was performed, aiming for test negativity. The glycated haemoglobin (GHbA1c) test was performed approximately 6 months from the original appointment. RESULTS GHbA1c concentrations did not decrease during the follow-up. The concentrations of aMMP-8 assessed by POCT, and clinical parameters decreased. Changes in GHbA1c and aMMP-8 levels assessed by POCT during the treatment correlated positively with each other (p < 0.01). CONCLUSION aMMP-8 POCT proved its reliability, and that its use is beneficial in the diabetes clinic, it enables identifying patients with periodontal findings reliably and guides them directly to an oral health clinic.
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Affiliation(s)
- Anna Maria Heikkinen
- Faculty of Medicine and Health Technology, University of Tampere, 33100 Tampere, Finland
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | | | | | - Elina Pimiä
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Minna Jokinen
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Minna Maijala
- Wellbeing Services County of Pirkanmaa, 33400 Tampere, Finland
| | - Iina Rantala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
| | - Timo Kauppila
- Faculty of Medicine and Health Technology, University of Tampere, 33100 Tampere, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland
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Rodrigues JVS, Cláudio MM, Franciscon JPS, Rosa RAC, Cirelli T, de Molon RS, Figueredo CMS, Garcia VG, Theodoro LH. The Effect of Non-Surgical Periodontal Treatment on Patients with Combined Refractory Arterial Hypertension and Stage III, Grade B Periodontitis: A Preliminary Prospective Clinical Study. J Clin Med 2023; 12:4277. [PMID: 37445313 DOI: 10.3390/jcm12134277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP), and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted for statistical analysis (α = 0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD, and CAL, which were statistically significant at 90 and 180 days (p < 0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p < 0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.
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Affiliation(s)
- João Victor Soares Rodrigues
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
| | - Marina Módulo Cláudio
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - João Paulo Soares Franciscon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Rossana Abud Cabrera Rosa
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Thamiris Cirelli
- Department of Dentistry, University Center of Associated School-UNIFAE, São João da Boa Vista 13870-377, SP, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Carlos Marcelo S Figueredo
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, OF Odontologi, OF Orala sjukdomar, 171 77 Stockholm, Sweden
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Curitiba 80710-150, PR, Brazil
| | - Leticia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
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Tian Z, Fan Y, Sun X, Wang D, Guan Y, Zhang Y, Zhang Z, Guo J, Bu H, Wu Z, Wang H. Predictive value of TCM clinical index for diabetic peripheral neuropathy among the type 2 diabetes mellitus population: A new observation and insight. Heliyon 2023; 9:e17339. [PMID: 37389043 PMCID: PMC10300217 DOI: 10.1016/j.heliyon.2023.e17339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
Aims The objectives of this study were to identify clinical predictors of the Traditional Chinese medicine (TCM) clinical index for diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients, develop a clinical prediction model, and construct a nomogram. Methods We collected the TCM clinical index from 3590 T2DM recruited at the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2019 to October 2020. The participants were randomly assigned to either the training group (n = 3297) or the validation group (n = 1426). TCM symptoms and tongue characteristics were used to assess the risk of developing DPN in T2DM patients. Through 5-fold cross-validation in the training group, the least absolute shrinkage and selection operator (LASSO) regression analysis method was used to optimize variable selection. In addition, using multifactor logistic regression analysis, a predictive model and nomogram were developed. Results A total of eight independent predictors were found to be associated with the DPN in multivariate logistic regression analyses: advanced age of grading (odds ratio/OR 1.575), smoke (OR 2.815), insomnia (OR 0.557), sweating (OR 0.535), loose teeth (OR 1.713), dry skin (OR 1.831), purple tongue (OR 2.278). And dark red tongue (OR 0.139). The model was constructed using these eight predictor's medium discriminative capabilities. The area under the curve (AUC) of the training set is 0.727, and the AUC of the validation set is 0.744 on the ROC curve. The calibration plot revealed that the model's goodness-of-fit is satisfactory. Conclusions We established a TCM prediction model for DPN in patients with T2DM based on the TCM clinical index.
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Affiliation(s)
- Zhikui Tian
- School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yadong Fan
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210004, China
| | - Xuan Sun
- School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Dongjun Wang
- College of Traditional Chinese Medicine, North China University of Science and Technology, Tangshan, 063000, China
| | - Yuanyuan Guan
- School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Ying Zhang
- Fengnan District Hospital of Traditional Chinese Medicine, Tangshan, 063000, China
| | - Zhaohui Zhang
- Surgery of TCM, Second Affiliated Hospital of Tianjin University of TCM, Tianjin, 301617, China
| | - Jing Guo
- Surgery of TCM, Second Affiliated Hospital of Tianjin University of TCM, Tianjin, 301617, China
| | - Huaien Bu
- School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Zhongming Wu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Hongwu Wang
- School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
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Zheng X, Xie T, Sun S, Sun L. Application of periodontal tissue regeneration combined with orthodontics in oral prosthodontics and its influence and significance on the expressions of IL-1β, TNF-α and IL-5 in periodontal tissue. Biotechnol Genet Eng Rev 2023:1-13. [PMID: 37036953 DOI: 10.1080/02648725.2023.2199242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
The aim is to investigate the application of periodontal tissue regeneration combined with orthodontics in oral restoration, and explore its effect and significance on the expressions of Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) in periodontal tissue. The patients in observation group were treated with orthodontics combined with periodontal tissue regeneration, and the control group was treated with periodontal tissue regeneration. The total effective rate, adverse reactions, recurrence rate and treatment satisfaction were compared. The masticatory function, language function, aesthetic level, VAS score, quality of life, gingival index (GI), plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), IL-1β, TNF-α and IL-5 levels were compared. The recurrence rate of observation group was lower than control group, while the treatment satisfaction was higher after treatment. After treatment, the scores of masticatory, language, aesthetics, physiological, social, emotional, cognitive, and emotional functions and overall health score were higher than before treatment. After treatment, the scores of masticatory and language functions, aesthetics and quality of life of observation group were significantly higher than control group. After treatment, the VAS score, GI, PLI, SBI, PD, IL-1β, TNF-α and IL-5 levels were lower than before. The VAS score, GI, PLI, SBI, PD levels, IL-1β, TNF-α and IL-5 levels of observation group were lower after treatment. Orthodontics combined with periodontal tissue regeneration can help improve the periodontal condition of patients with periodontitis, reduce inflammatory response, improve the level of efficacy and overall safety, and further improve patients' quality of life and treatment satisfaction.
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Affiliation(s)
- Xiumei Zheng
- Department of Implantology, Stomatological Hospital of Xiamen Medical College and Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, Fujian, China
| | - Tian Xie
- Department of Neurology (I), Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Shaoni Sun
- Department of Emergency Centre, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Lizhi Sun
- Department of Medical Laboratory Diagnosis Center, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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Recent Clinical Treatment and Basic Research on the Alveolar Bone. Biomedicines 2023; 11:biomedicines11030843. [PMID: 36979821 PMCID: PMC10044990 DOI: 10.3390/biomedicines11030843] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey’s fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research.
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Végh D, Bencze B, Banyai D, Vegh A, Rózsa N, Nagy Dobó C, Biczo Z, Kammerhofer G, Ujpal M, Díaz Agurto L, Pedrinaci I, Peña Cardelles JF, Magrin GL, Padhye NM, Mente L, Payer M, Hermann P. Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4745. [PMID: 36981651 PMCID: PMC10048655 DOI: 10.3390/ijerph20064745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines.
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Affiliation(s)
- Dániel Végh
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Bulcsú Bencze
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Dorottya Banyai
- Department of Pedodontics and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Adam Vegh
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Noémi Rózsa
- Department of Pedodontics and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Csaba Nagy Dobó
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Zita Biczo
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Gabor Kammerhofer
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Marta Ujpal
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Leonardo Díaz Agurto
- Faculty of Dentistry, Postgraduate School, Universidad de Chile, Santiago 7520355, Chile
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA 02115, USA
| | - Juan Francisco Peña Cardelles
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Oral and Maxillofacial Surgery Department, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Gabriel Leonardo Magrin
- Section of Graduate Periodontology, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), 88040-900 Florianopolis, Brazil
| | - Ninad Milind Padhye
- Centre for Oral Clinical Research, Queen Mary University and The London School of Medicine and Dentistry, The Royal London Dental Hospital, London E1 1FR, UK
| | - Laura Mente
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Peter Hermann
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
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Madsen GR, Bertl K, Pandis N, Stavropoulos A, Burisch J. The Impact of Periodontitis on Inflammatory Bowel Disease Activity. Inflamm Bowel Dis 2023; 29:396-404. [PMID: 35552410 DOI: 10.1093/ibd/izac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarly complex pathogeneses that involve an interplay between dysbiotic microbiota and dysregulated immune-inflammatory responses. However, whether the presence of periodontitis is associated with IBD activity and/or its severity remains unknown. METHODS An online, questionnaire-based study was answered by 1093 patients with IBD, comprising 527 patients with Crohn's disease and 566 patients with ulcerative colitis. The survey included questions on social demographics; oral health, including the Periodontal Screening Score (PESS); and IBD-related characteristics, including validated disease indices. RESULTS Irrespective of disease subtype, patients with a reduced number of teeth and those with self-reported severe periodontitis scored significantly higher on the IBD disability index (number of teeth: coefficient, 4.93 [95% confidence interval {CI}, 1.21-8.66; P = .010]; periodontitis: coefficient, 3.54 [95% CI, 0.27-6.80; P = .034]) and reported increased disease activity in the preceding 12 months (number of teeth: odds ratio [OR], 1.91 [95% CI, 1.36-2.69; P < .001]; periodontitis: OR, 1.71 [95% CI, 1.27-2.31; P < .001]). There was also evidence of a weak association between self-reported severe periodontitis and current disease activity (OR, 1.33; 95% CI, 0.95-1.86; P = .099). However, IBD severity, as a composite parameter of a history of surgery due to IBD and/or treatment with biological therapy, was not associated with possessing a reduced number of teeth (OR, 1.18; 95% CI, 0.77-1.80; P = .451), nor with self-reported severe periodontitis (OR, 1.15; 95% CI, 0.79-1.66; P = .467). CONCLUSIONS Periodontitis and tooth loss were significantly associated with increased IBD-related disability and more disease activity in the preceding 12 months. Our results suggest that greater attention should be paid to IBD patients' oral health.
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Affiliation(s)
- Gorm Roager Madsen
- Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.,Gastrounit, Medical Division, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Johan Burisch
- Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.,Gastrounit, Medical Division, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
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40
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Loughman A, Adler CJ, Macpherson H. Unlocking Modifiable Risk Factors for Alzheimer's Disease: Does the Oral Microbiome Hold Some of the Keys? J Alzheimers Dis 2023; 92:1111-1129. [PMID: 36872775 DOI: 10.3233/jad-220760] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Advancing age is recognized as the primary risk factor for Alzheimer's disease (AD); however approximately one third of dementia cases are attributable to modifiable risk factors such as hypertension, diabetes, smoking, and obesity. Recent research also implicates oral health and the oral microbiome in AD risk and pathophysiology. The oral microbiome contributes to the cerebrovascular and neurodegenerative pathology of AD via the inflammatory, vascular, neurotoxic, and oxidative stress pathways of known modifiable risk factors. This review proposes a conceptual framework that integrates the emerging evidence regarding the oral microbiome with established modifiable risk factors. There are numerous mechanisms by which the oral microbiome may interact with AD pathophysiology. Microbiota have immunomodulatory functions, including the activation of systemic pro-inflammatory cytokines. This inflammation can affect the integrity of the blood-brain barrier, which in turn modulates translocation of bacteria and their metabolites to brain parenchyma. Amyloid-β is an antimicrobial peptide, a feature which may in part explain its accumulation. There are microbial interactions with cardiovascular health, glucose tolerance, physical activity, and sleep, suggesting that these modifiable lifestyle risk factors of dementia may have microbial contributors. There is mounting evidence to suggest the relevance of oral health practices and the microbiome to AD. The conceptual framework presented here additionally demonstrates the potential for the oral microbiome to comprise a mechanistic intermediary between some lifestyle risk factors and AD pathophysiology. Future clinical studies may identify specific oral microbial targets and the optimum oral health practices to reduce dementia risk.
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Affiliation(s)
- Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, Barwon Health, Geelong, Victoria, Australia
| | - Christina J Adler
- Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Helen Macpherson
- Deakin University, IPAN - the Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
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Keskin M, Rintamarttunen J, Gülçiçek E, Räisänen IT, Gupta S, Tervahartiala T, Pätilä T, Sorsa T. A Comparative Analysis of Treatment-Related Changes in the Diagnostic Biomarker Active Metalloproteinase-8 Levels in Patients with Periodontitis. Diagnostics (Basel) 2023; 13:diagnostics13050903. [PMID: 36900047 PMCID: PMC10001139 DOI: 10.3390/diagnostics13050903] [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: 01/04/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Previous studies have revealed the potential diagnostic utility of aMMP-8, an active form of MMP-8, in periodontal and peri-implant diseases. While non-invasive point-of-care (PoC) chairside aMMP-8 tests have shown promise in this regard, there is a dearth of literature on the evaluation of treatment response using these tests. The present study aimed to investigate treatment-related changes in aMMP-8 levels in individuals with Stage III/IV-Grade C periodontitis compared to a healthy control group, using a quantitative chairside PoC aMMP-8 test, and to determine its correlation with clinical parameters. METHODS The study included 27 adult patients (13 smoker, 14 non-smoker) with stage III/IV-grade C periodontitis and 25 healthy adult subjects. Clinical periodontal measurements, real-time PoC aMMP-8, IFMA aMMP-8, and Western immunoblot analyses were performed before and 1 month after anti-infective scaling and root planing periodontal treatment. Time 0 measurements were taken from the healthy control group to test the consistency of the diagnostic test. RESULTS Both PoC aMMP-8 and IFMA aMMP-8 tests showed a statistically significant decrease in aMMP-8 levels and improvement in periodontal clinical parameters following treatment (p < 0.05). The PoC aMMP-8 test had high diagnostic sensitivity (85.2%) and specificity (100.0%) for periodontitis and was not affected by smoking (p > 0.05). Treatment also reduced MMP-8 immunoreactivity and activation as demonstrated by Western immunoblot analysis. CONCLUSION The PoC aMMP-8 test shows promise as a useful tool for the real-time diagnosis and monitoring of periodontal therapy.
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Affiliation(s)
- Mutlu Keskin
- Oral and Dental Health Department, Altınbaş University, Istanbul 34140, Turkey
- Correspondence: ; Tel.: +90-5365246000
| | - Juulia Rintamarttunen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Emre Gülçiçek
- Fulya Oral and Dental Health Clinic, Tekirdağ 59030, Turkey
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh 160012, India
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Tommi Pätilä
- Department of Pediatric Surgery, Children’s Hospital University, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
- Department of Oral Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden
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Lee HJ, Lee JW, Kim S, Kwon YJ. Comparison of the triglyceride glucose index and modified triglyceride glucose indices in assessing periodontitis in Korean adults. J Periodontal Res 2023; 58:503-510. [PMID: 36840374 DOI: 10.1111/jre.13108] [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: 09/19/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Periodontal diseases are closely connected with insulin resistance (IR) and metabolic syndrome. The Triglyceride Glucose Index (TyG) assesses IR, and recently, a few indices combining TyG and body composition have emerged with higher IR predictive performance than TyG alone. We aimed to examine which TyG-related parameters are most helpful in predicting the risk of periodontal disease. METHODS From 2013 to 2015, data were collected through the Korean National Health and Nutrition Examination Survey. Periodontitis was defined using the Community Periodontal Index. TyG-body mass index (BMI), TyG-waist circumference (WC), and TyG-waist-to-height ratio (WHtR) were calculated by multiplying TyG index score by BMI, WC, and WHtR, respectively. Multiple logistic regression analysis was used to calculate odds ratio (OR) and 95% confidence intervals (CI). Receiver operating characteristic curves were used to estimate areas under the curve (AUC). RESULTS Compared to each reference quartile (Q)1, Q4 of the TyG index, TyG-BMI, TyG-WC, and TyG-WHtR were significantly associated with a higher risk of periodontitis after adjusting for confounders (OR, 95% CI; 1.23, 1.01-1.49 for TyG; 1.63, 1.22-2.17 for TyG-BMI; 1.37, 1.04-1.81 for TyG-WC; and 1.53, 1.16-2.02 for TyG-WHtR). The AUC and 95% CIs of TyG, TyG-BMI, TyG-WC, and TyG-WHtR in predicting periodontitis were 0.609 (0.600-0.617), 0.605 (0.596-0.617), 0.629 (0.621-0.637), and 0.636 (0.628-0.644), respectively (all p < .001). CONCLUSIONS TyG, TyG-BMI, TyG-WC, and TyG-WHtR appear to be significantly associated with the prevalence of periodontitis. Among the TyG and modified TyG indices, TyG-WHtR exhibited the highest predictive performance for periodontitis.
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Affiliation(s)
- Hyun-Jeong Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sue Kim
- International Health Care Center, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
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Chang Y, Chung MK, Park JH, Song TJ. Association of Oral Health with Risk of Rheumatoid Arthritis: A Nationwide Cohort Study. J Pers Med 2023; 13:jpm13020340. [PMID: 36836574 PMCID: PMC9960411 DOI: 10.3390/jpm13020340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
Periodontitis and rheumatoid arthritis (RA) are inflammatory diseases that share many similarities. We aimed to investigate the associations of periodontitis and oral hygiene status and behaviors with RA in a nationwide general population cohort. Participants from the National Health Screening cohort database of Korea who underwent oral health screening by dentists between 2003 and 2004 were included. The occurrence of RA was analyzed according to the presence of periodontitis, oral health examination findings, and behaviors. Overall, 2,239,586 participants were included. During a median of 16.7 years, RA occurred in 27,029 (1.2%) participants. The risk for incident RA was higher when participants had periodontitis (hazard ratio (HR) 1.2, 95% confidence interval (CI), 1.08-1.24) and an increased number of missing teeth (HR 1.5, 95% CI, 1.38-1.69). In contrast, better oral hygiene behaviors, such as a higher frequency of daily tooth brushing (HR 0.76, 95% CI 0.73-0.79, p for trend <0.001) and a recent history of dental scaling (HR 0.96, 95% CI 0.94-0.99), were associated with a lower occurrence of RA. Periodontitis and increased missing teeth were associated with an increased risk of RA. Maintaining good oral hygiene through frequent tooth brushing and regular dental scaling may reduce the risk of RA occurrence.
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Affiliation(s)
- Yoonkyung Chang
- Department of Neurology, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Min Kyung Chung
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Correspondence: ; Tel.: +82-2-6986-1672
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Han Y, Luo Z, Yue Z, Miao L, Xv M, Chang S, Zhan Y, Hou J. The tendency of anemia of inflammation in periodontal diseases. Clin Sci (Lond) 2023; 137:251-264. [PMID: 36705427 PMCID: PMC9908573 DOI: 10.1042/cs20220524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 01/28/2023]
Abstract
Anemia of inflammation (AI) is associated with inflammatory diseases, and inflammation-induced iron metabolism disorder is the major pathogenic factor. Earlier studies have reported a tendency of AI in periodontitis patients, but the explicit relationship and possible pathological mechanisms remain unclear. Here, the analyses of both periodontitis patients and a mouse model of ligature-induced experimental periodontitis showed that periodontitis was associated with lower levels of hemoglobin and hematocrit with evidence of systemic inflammation (increased white blood cell levels) and evidence of iron restriction (low serum iron along with a high serum hepcidin and ferritin levels), in accordance with the current diagnosis criteria for AI. Moreover, periodontal therapy improved the anemia status and iron metabolism disorders. Furthermore, the increased level of hepcidin and significant correlation between hepcidin and key indicators of iron metabolism emphasized the pivotal role of hepcidin in the pathogenesis of periodontitis-related AI. Administration of the signal transducer and activator of transcription 3 (STAT3) inhibitors Stattic suggested that the IL-6-STAT3-hepcidin signaling pathway participated in this regulatory process. Together, these findings demonstrated that periodontitis should be considered an inflammatory disease that contributes to the development of AI; furthermore, IL-6-STAT3-hepcidin signaling pathway plays a key regulatory role in the pathogenesis of periodontitis-related AI. Our study will provide new insights into the systemic effects of periodontitis, while meaningfully expanding the spectrum of inflammatory diseases that contribute to AI.
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Affiliation(s)
- Ye Han
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Zhiqiang Luo
- One stop dental, Beijing, PR China, Beijing, China
| | - Zhao Guo Yue
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Li Li Miao
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Min Xv
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Shu Chang
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yalin Zhan
- First Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
- Correspondence: Jianxia Hou () or Yalin Zhan ()
| | - Jianxia Hou
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
- Correspondence: Jianxia Hou () or Yalin Zhan ()
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Xiao X, Liu S, Deng H, Song Y, Zhang L, Song Z. Advances in the oral microbiota and rapid detection of oral infectious diseases. Front Microbiol 2023; 14:1121737. [PMID: 36814562 PMCID: PMC9939651 DOI: 10.3389/fmicb.2023.1121737] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
Several studies have shown that the dysregulation of the oral microbiota plays a crucial role in human health conditions, such as dental caries, periodontal disease, oral cancer, other oral infectious diseases, cardiovascular diseases, diabetes, bacteremia, and low birth weight. The use of traditional detection methods in conjunction with rapidly advancing molecular techniques in the diagnosis of harmful oral microorganisms has expanded our understanding of the diversity, location, and function of the microbiota associated with health and disease. This review aimed to highlight the latest knowledge in this field, including microbial colonization; the most modern detection methods; and interactions in disease progression. The next decade may achieve the rapid diagnosis and precise treatment of harmful oral microorganisms.
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Affiliation(s)
- Xuan Xiao
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Shangfeng Liu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Hua Deng
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuhan Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Liang Zhang
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China,Liang Zhang,
| | - Zhifeng Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China,*Correspondence: Zhifeng Song,
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Tang Z, Fan Q, Jiang Q, Li X, Wang Y, Long H, Lai W, Jian F. The effect of antibiotics on the periodontal treatment of diabetic patients with periodontitis: A systematic review and meta-analysis. Front Pharmacol 2023; 14:1013958. [PMID: 36762104 PMCID: PMC9905685 DOI: 10.3389/fphar.2023.1013958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Background: The aim of this meta-analysis was to compare the effects of periodontal treatment with or without adjunctive antibiotic on periodontal status and blood glucose level in diabetic patients with periodontitis. Methods: A search using electronic database (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials) and a manual search were performed up to July 2022. Eligible 13 RCTs were included according to inclusion and exclusion criteria. Reviewers independently performed data screening, data selection, data extraction, and risk of bias. Quality assessment was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Weighted mean differences and 95% confidence intervals (CIs) for continuous outcomes were calculated using random or fixed-effects models. This review is registered in the PROSPERO database (CRD42022347803). Results: Of the 13 included articles, eight were on the use of systemic antibiotics and five on topical antibiotics. The results showed statistically significant improvement in periodontal status (probing depth, clinical attachment loss and bleeding on probing) at 6 months with systematic antibiotics use (PD-6M p = 0.04, BOP-6M p < 0.0001, CAL-6M p = 0.002). The improvement in PD with topical antibiotics was statistically significant at 1 month (p = 0.0006). However, there was no statistically significant improvement in periodontal status at 3 months with adjuvant systemic antibiotics. Conclusion: Antibiotics can improve the periodontal condition of diabetic patients with periodontitis to a certain extent. In clinical practice, it is necessary to comprehensively consider the balance of benefits and risks before deciding whether to use antibiotics. Systematic Review Registration: Identifier CRD42022347803, https://www.crd.york.ac.uk/PROSPERO/.
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Luthra S, Orlandi M, Hussain SB, Leira Y, Botelho J, Machado V, Mendes JJ, Marletta D, Harden S, D'Aiuto F. Treatment of periodontitis and C-reactive protein: A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2023; 50:45-60. [PMID: 35946825 PMCID: PMC10087558 DOI: 10.1111/jcpe.13709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/25/2022] [Accepted: 07/23/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation. PURPOSE To comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum C-reactive protein (CRP) levels. DATA SOURCES Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only. STUDY SELECTION Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment. DATA EXTRACTION Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models. RISK OF BIAS Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed. DATA SYNTHESIS Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to -0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline. LIMITATIONS High level of heterogeneity. CONCLUSIONS Treatment of periodontitis reduces serum CRP levels (up to 6 months follow-up) to a degree equivalent to that observed after traditional lifestyle or drug interventions. This evidence supports a causal association between periodontitis and systemic inflammation.
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Affiliation(s)
- Shailly Luthra
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | | | - Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | - José João Mendes
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
| | | | - Simon Harden
- Department of Statistical Science, UCL Eastman Dental Institute, London, UK
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Wang J, Guo S, Xu X, Zhang C. 1,25-Dihydroxyvitamin D3: A Positive Factor for the Osteogenic Differentiation of hPDLSCs and for the Tissue Regenerative Activity of Cell Sheets. Cell Transplant 2023; 32:9636897231202541. [PMID: 37798942 PMCID: PMC10557410 DOI: 10.1177/09636897231202541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/12/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
This study aims to investigate the effects of 1,25-dihydroxyvitamin D3 (1,25(OH)2VitD3) on osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and the activity of hPDLSC sheets and the differences in the tissue regeneration activity of hPDLSC sheets on tooth root fragment treated by different methods. Healthy caries-free premolars were collected. The hPDLSCs were obtained by enzymatic digestion. Surface markers of stem cells were analyzed by flow cytometry and the multidirectional differentiation ability of hPDLSCs was detected. During the osteogenic differentiation of hPDLSCs, 1,25(OH)2VitD3 was added and the effect of 1,25(OH)2VitD3 on osteogenic differentiation of hPDLSCs was assessed using Western blotting, quantitative reverse transcription-polymerase chain reaction (qRT-PCR), enzyme-linked immunosorbent assay, cell staining, and immunofluorescence. After hPDLSC sheets were prepared, histology and immunofluorescence analysis of the effect of 1,25(OH)2VitD3 on sheet activity were performed. In addition, root fragments were prepared and treated with scaling, 24% EDTA (ethylenediamide tetraacetic acid), and Er,Cr:YSGG lasers, respectively, and the tissue regeneration activity of hPDLSC sheets on different root fragments were observed. 1,25(OH)2VitD3 promoted the high gene and protein expressions of osteogenic markers ALP (alkaline phosphatase), Runx2, and OPN (osteopontin antibody) in hPDLSCs, along with enhanced ALP activity and staining, alizarin red staining, and immunofluorescence staining, indicating that the osteogenic differentiation ability of hPDLSCs was improved. Extracellular matrix secretion was increased in hPDLSC sheets, along with the positive expressions of the protein markers fibronectin and collagen I, suggesting that 1,25(OH)2VitD3 could enhance these effects. In addition, the root fragments treated by Er,Cr:YSGG laser were more suitable for the attachment and regeneration of hPDLSC sheets, demonstrating that 1,25(OH)2VitD3 could improve the tissue regeneration performance of these sheets. 1,25(OH)2VitD3 can promote osteogenic differentiation of hPDLSCs and thus plays an active role in hPDLSC sheet formation and tissue regeneration. In addition, the Er,Cr:YSGG laser can be used as the recommended treatment method for the root surface regenerated by hPDLSCs.
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Affiliation(s)
- Jingjiao Wang
- Department of Stomatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Songlin Guo
- Institute of Stem Cells, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xiaobo Xu
- School of Stomatology, Ningxia Medical University, Yinchuan, China
| | - Chenglei Zhang
- Medical Laboratory, General Hospital of Ningxia Medical University, Yinchuan, China
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Li B, Xin Z, Gao S, Li Y, Guo S, Fu Y, Xu R, Wang D, Cheng J, Liu L, Zhang P, Jiang H. SIRT6-regulated macrophage efferocytosis epigenetically controls inflammation resolution of diabetic periodontitis. Theranostics 2023; 13:231-249. [PMID: 36593966 PMCID: PMC9800730 DOI: 10.7150/thno.78878] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/19/2022] [Indexed: 12/03/2022] Open
Abstract
Rationale: Diabetes exacerbates the prevalence and severity of periodontitis, leading to severe periodontal destruction and ultimately tooth loss. Delayed resolution of inflammation is a major contributor to diabetic periodontitis (DP) pathogenesis, but the underlying mechanisms of this imbalanced immune homeostasis remain unclear. Methods: We collected periodontium from periodontitis with or without diabetes to confirm the dysfunctional neutrophils and macrophages in aggravated inflammatory damage and impaired inflammation resolution. Our in vitro experiments confirmed that SIRT6 inhibited macrophage efferocytosis by restraining miR-216a-5p-216b-5p-217 cluster maturation through ''non-canonical'' microprocessor complex (RNA pulldown, RIP, immunostaining, CHIP, Luciferase assays, and FISH). Moreover, we constructed m6SKO mice that underwent LIP-induced periodontitis to explore the in vitro and in vivo effect of SIRT6 on macrophage efferocytosis. Finally, antagomiR-217, a miRNA antagonism, was delivered into the periodontium to treat LIP-induced diabetic periodontitis. Results: We discovered that insufficient SIRT6 as a histone deacetylase in macrophages led to unresolved inflammation and aggravated periodontitis in both human and mouse DP with accumulated apoptotic neutrophil (AN) and higher generation of neutrophil extracellular traps. Mechanistically, we validated that macrophage underwent high glucose stimulation resulting in disturbance of the SIRT6-miR-216/217 axis that triggered impeded efferocytosis of AN through targeting the DEL-1/CD36 axis directly. Furthermore, we demonstrated the inhibitory role of SIRT6 for MIR217HG transcription and identified a non-canonical action of microprocessor that SIRT6 epigenetically hindered the splicing of the primary miR-216/217 via the complex of hnRNPA2B1, DGCR8, and Drosha. Notably, by constructing myeloid-specific deletion of SIRT6 mice and locally delivering antagomir-217 in DP models, we strengthened the in vivo effect of this axis in regulating macrophage efferocytosis and inflammation resolution in DP. Conclusions: Our findings delineated the emerging role of SIRT6 in mediating metabolic dysfunction-associated inflammation, and therapeutically targeting this regulatory axis might be a promising strategy for treating diabetes-associated inflammatory diseases.
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Affiliation(s)
- Bang Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Zhili Xin
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Shiyu Gao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yangjie Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Songsong Guo
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, Jiangsu Province, China
| | - Yu Fu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Rongyao Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Dongmiao Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jie Cheng
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Laikui Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Ping Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,✉ Corresponding author: Hongbing Jiang, D.D.S, Ph.D. E-mail: or Ping Zhang, D.D.S, Ph.D. E-mail: . Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 136 Hanzhong Road, Nanjing, Jiangsu Province 210029, China. Tel: +86-25-85031914, Fax: +86-25-85031910
| | - Hongbing Jiang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, Jiangsu Province, China.,✉ Corresponding author: Hongbing Jiang, D.D.S, Ph.D. E-mail: or Ping Zhang, D.D.S, Ph.D. E-mail: . Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 136 Hanzhong Road, Nanjing, Jiangsu Province 210029, China. Tel: +86-25-85031914, Fax: +86-25-85031910
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Sun DD, Wu X, Lin SC, Duan SY. Anti-apoptosis and anti-inflammation activity of circ_0097010 downregulation in lipopolysaccharide-stimulated periodontal ligament cells by miR-769-5p/Krüppel like factor 6 axis. J Dent Sci 2023; 18:310-321. [PMID: 36643256 PMCID: PMC9831795 DOI: 10.1016/j.jds.2022.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/25/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Periodontitis is a prevalent infectious inflammatory disease. Growing evidence has revealed important roles for circular RNAs (circRNAs) and circRNA sponge activity in periodontitis. Here, we elucidated the precise part of circ_0097010 in periodontitis pathogenesis. Materials and methods Human periodontal ligament cells (hPDLCs) were exposed to lipopolysaccharide (LPS). Cell viability, proliferation and apoptosis were evaluated by CCK-8 assay, EdU incorporation assay and flow cytometry, respectively. Circ_0097010, microRNA (miR)-769-5p and Krüppel like factor 6 (KLF6) were quantified by qRT-PCR and Western blot. Interleukin 6 (IL-6) level, tumor necrosis factor-α (TNF-α) secretion, superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were detected by enzyme-linked immunosorbent assay (ELISA). Dual-luciferase reporter, RNA immunoprecipitation (RIP) and RNA pull-down assays were used to confirm the direct relationship between miR-769-5p and circ_0097010 or KLF6. Results Our data showed that LPS repressed cell proliferation and induced cell apoptosis and inflammation in hPDLCs. Circ_0097010 was upregulated in periodontitis samples and LPS-exposed hPDLCs. Downregulation of circ_0097010 exerted anti-apoptosis and anti-inflammation functions in LPS-exposed hPDLCs. Mechanistically, circ_0097010 acted as a miR-769-5p sponge, and reduced abundance of miR-769-5p reversed the anti-apoptosis and anti-inflammation effects of circ_0097010 suppression. KLF6 was a direct miR-769-5p target, and miR-769-5p-mediated inhibition of KLF6 possessed anti-apoptosis and anti-inflammation functions in LPS-induced hPDLCs. Moreover, circ_0097010 controlled KLF6 expression by miR-769-5p. Conclusion These data identify circ_0097010 as a key regulator of LPS-induced inflammation and apoptosis in hPDLCs and highlight a novel mechanism of circ_0097010 regulation through miR-769-5p/KLF6 axis.
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Affiliation(s)
| | | | | | - Shao-Yu Duan
- Corresponding author. Department of Stomatology, Electric Power Teaching Hospital, Capital Medical University, No.1, Taipingqiao Xili, Fengtai District, Beijing 100073, China.
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