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Ren Z, Xue Y, Zhang H, Guo T, Yi W, Li L, Wang M, Xie J, Li Y. Systemic Immune-Inflammation Index and Systemic Inflammation Response Index are Associated With Periodontitis: Evidence From NHANES 2009 to 2014. Int Dent J 2024; 74:1033-1043. [PMID: 38688802 DOI: 10.1016/j.identj.2024.03.019] [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: 01/03/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION AND AIMS Periodontitis, a chronic inflammatory condition affecting the supporting structures of the teeth, is a substantial public health burrden whilst impacting the life quality of those affected. Elevated levels of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have been implicated in various inflammatory conditions. This study aimed to investigate the relationship between SII and SIRI with periodontitis. METHODS The study examined a total of 8666 participants in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES). The study compared the weighted prevalence of periodontitis among various groups. The association between SII, SIRI levels, and periodontitis was analyzed using binary logistic regression. Additionally, we explored nonlinear relationships between SII, SIRI, and the prevalence of periodontitis using restricted cubic spline (RCS) plots. RESULTS Among participants in the fourth quartile (Q4) of SII and SIRI, the highest prevalence of periodontitis was observed, with rates of 44.87% and 48.41%, respectively. After adjusting for all covariates, the odds ratio (OR) for periodontitis associated with SII Q4 was 1.19 (95% CI 1.02, 1.39, P = .03), while for SIRI Q4, it was 1.18 (95% CI 1.01, 1.39, P = .04). In addition, the results of sensitivity analysis revealed consistent findings, indicating that after adjusting for all covariates, the OR for periodontitis associated with SII Q4 and SIRI Q4 remained statistically significant. Specifically, the OR for periodontitis associated with SII Q4 was 1.19 (95% CI 1.02, 1.39, P = .03), while for SIRI Q4, it was 1.19 (95% CI 1.01, 1.40, P = .04). CONCLUSIONS These results indicate that elevated SII and SIRI levels are associated with an increased prevalence of periodontitis. CLINICAL RELEVANCE These findings suggest a potential connection between systemic inflammation and periodontitis, highlighting the importance of periodontitis patients being aware of their systemic diseases that are inflammatory in nature such as chronic cardiovascular afflictions.
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Affiliation(s)
- Zhengyun Ren
- Department of General Surgery, Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China; Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Yan Xue
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Hui Zhang
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Tailin Guo
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Wei Yi
- Department of General Surgery, Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China; Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Linke Li
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Mengyuan Wang
- Department of stomatology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Jiang Xie
- Department of pediatrics, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China.
| | - Yi Li
- Department of Radiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China.
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Sun H, Chen S, Yang C, Kuang H, Huang Y, He X, Luo W. Advances in the use of chlorhexidine for periodontitis treatment in diabetic patients: A review. Medicine (Baltimore) 2024; 103:e39627. [PMID: 39252223 PMCID: PMC11383263 DOI: 10.1097/md.0000000000039627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
Periodontitis and diabetes mellitus exhibit a bidirectional relationship. This narrative review descriptively outlines the role of chlorhexidine in the periodontal treatment of diabetic patients, focusing on its antimicrobial mechanisms against microbial communities and its antiplaque effects. Although chlorhexidine is proven to be effective in combating microbial presence and improving gingivitis with substantial supporting evidence, its impact on glycemic control and insulin resistance in diabetic patients remains contentious. Additionally, the effectiveness of chlorhexidine as an adjunctive chemotherapeutic in the periodontal treatment of gestational diabetes has not yet been studied, highlighting a gap in research that necessitates further prospective studies and randomized controlled trials. Considering the interconnection between periodontal inflammation and glycemic levels, this article finally advocates for collaborative care between dental and medical professionals to manage periodontitis in diabetic patients effectively.
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Affiliation(s)
- Honglan Sun
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Shizhao Chen
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Chao Yang
- Research and Development Department, Shenzhen Uni-medica Technology Co., Ltd, Shenzhen, Guangdong Province, China
| | - Huifang Kuang
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Yuqi Huang
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Xiaoning He
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Wen Luo
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
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Zhang G, Zhang M, Feng Q, Wang R, Mei H, Xing K, Li J. Supramolecular Composite Hydrogel Loaded with CaF 2 Nanoparticles Promotes the Recovery of Periodontitis Bone Resorption. ACS APPLIED MATERIALS & INTERFACES 2024; 16:45929-45947. [PMID: 39183483 DOI: 10.1021/acsami.4c07210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Treatments to reduce periodontal inflammation and rescue periodontitis bone resorption have been of interest to researchers. Bone tissue engineering materials have been gradually used in the treatment of bone defects, but periodontal bone tissue regeneration still faces challenges. Considering the biocompatibility factor, constructing bionic scaffolds with natural extracellular matrix properties is an ideal therapeutic pathway. Based on the pathological mechanism of periodontitis, in this study, short peptide and nanometer inorganic particles were comingled to construct NapKFF-nano CaF2 supramolecular composite hydrogels with different ratios. Material characterization experiments confirmed that the composite hydrogel had suitable mechanical properties and a three-dimensional structure that can function in the resorption region of the alveolar bone and provide spaces for cell proliferation and adhesion. The release of low concentrations of fluoride and calcium ions has been shown to have positive biological effects in both in vivo and in vitro experiments. Vitro experiments confirmed that the composite hydrogel had good biocompatibility and promoted osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Microbiological experiments confirmed that the composite hydrogel inhibited the activity of periodontal pathogenic bacteria. In animal studies, composite hydrogel applied to periodontitis rats in vivo can effectively repair alveolar bone resorption. This composite hydrogel has a simple preparation method and is inexpensive to produce, yet it has antibacterial and osteogenesis-promoting incremental effects, which makes it well suited for the treatment of periodontitis bone resorption, providing a new strategy for periodontal bone tissue engineering.
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Affiliation(s)
- Guanning Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
| | - Mei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
| | - Qingchen Feng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
| | - Ruohan Wang
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, Sichuan, China
| | - Hongxiang Mei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
| | - Ke Xing
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Third Section, Renmin South Rd, Chengdu 610041, Sichuan, China
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Wu KCH, Liu L, Xu A, Chan YH, Cheung BMY. Shared genetic architecture between periodontal disease and type 2 diabetes: a large scale genome-wide cross-trait analysis. Endocrine 2024; 85:685-694. [PMID: 38460073 PMCID: PMC11291565 DOI: 10.1007/s12020-024-03766-8] [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: 12/21/2023] [Accepted: 02/27/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE To investigate the relationship between abnormal glucose metabolism, type 2 diabetes (T2D), and periodontal disease (PER) independent of Body Mass Index (BMI), we employed a genome-wide cross-trait approach to clarify the association. METHODS Our study utilized the most extensive genome-wide association studies conducted for populations of European ancestry, including PER, T2D, fasting glucose, fasting insulin, 2-hour glucose after an oral glucose challenge, HOMA-β, HOMA-IR (unadjusted or adjusted for BMI) and HbA1c. RESULTS With this approach, we were able to identify pleiotropic loci, establish expression-trait associations, and quantify global and local genetic correlations. There was a significant positive global genetic correlation between T2D (rg = 0.261, p = 2.65 × 10-13), HbA1c (rg = 0.182, p = 4.14 × 10-6) and PER, as well as for T2D independent of BMI (rg = 0.158, p = 2.34 × 10-6). A significant local genetic correlation was also observed between PER and glycemic traits or T2D. We also identified 62 independent pleiotropic loci that impact both PER and glycemic traits, including T2D. Nine significant pathways were identified between the shared genes between T2D, glycemic traits and PER. Genetically liability of HOMA-βadjBMI was causally associated with the risk of PER. CONCLUSION Our research has revealed a genetic link between T2D, glycemic traits, and PER that is influenced by biological pleiotropy. Notably, some of these links are not related to BMI. Our research highlights an underlying link between patients with T2D and PER, regardless of their BMI.
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Affiliation(s)
- Kevin Chun Hei Wu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Lin Liu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Aimin Xu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yap Hang Chan
- Division of Cardiology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Bernard Man Yung Cheung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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Ravidà A, Saleh MHA, Ghassib IH, Qazi M, Kumar PS, Wang HL, Eke PI, Borgnakke WS. Impact of smoking on cost-effectiveness of 10-48 years of periodontal care. Periodontol 2000 2024. [PMID: 39054672 DOI: 10.1111/prd.12585] [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: 02/23/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024]
Abstract
The study aims were (1) to explore whether "periodontal treatment" consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long-term periodontal maintenance treatment, is cost-effective in terms of preventing periodontitis-attributable tooth extraction and replacement by implant-supported crowns ("extraction/replacement"); (2) to assess the effect of cigarette smoking on this cost-effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow-up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost-effectiveness. Cigarette smoking adversely impacted this cost-effectiveness, with current heavy smokers experiencing no cost-effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost-effectiveness for Grade B periodontitis. Assessed by mean annual costs of "extraction/replacement," periodontal treatment was cost-effective, which decreased in a dose-response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost-effective analyses of periodontal treatment. Smoking cessation should be encouraged.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Iya H Ghassib
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics, The Virginia Commonwealth University, Richmond, Virginia, USA
| | - Musa Qazi
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Purnima S Kumar
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Liang L, Chen CY, Aris IM. Association of the Life's Essential 8 cardiovascular health score with periodontitis among US adults. J Clin Periodontol 2024. [PMID: 38964852 DOI: 10.1111/jcpe.14042] [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: 01/17/2024] [Revised: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
AIM To investigate whether cardiovascular health (CVH) is associated with periodontitis. MATERIALS AND METHODS We used data from the 2009 to 2014 National Health and Nutrition Examination Survey. We quantified CVH using Life's Essential 8, which includes four health behaviours (diet, smoking, physical activity and sleep) and four health factors (body mass index, blood cholesterol, glucose and pressure). We categorized scores as low (0-49), moderate (50-79) and high (80-100). We calculated subscores of health behaviours and factors and categorized them as low, moderate and high. We used logistic regression to assess the association of CVH with periodontitis, adjusting for age, gender, race/ethnicity, education, poverty index, marital status and health insurance. We computed odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS This study included 9296 adults ≥30 years old. Multivariable-adjusted models showed that subjects with moderate (OR, 0.62; 95% CI: 0.52-0.74) or high (OR, 0.43; 95% CI: 0.33-0.57) CVH had significantly lower odds of periodontitis compared to those with low CVH. These results were consistent in the health behaviours model, but the estimates in the health factors model were not significant. CONCLUSIONS Improving CVH may help prevent periodontitis. Longitudinal studies are needed to confirm our findings.
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Affiliation(s)
- Lang Liang
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Chia-Yu Chen
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Lyra P, Botelho J, Rota S, Poplawska-Domaszewicz K, Machado V, Guerreiro D, Proença L, Barroso H, Mendes JJ, Chaudhuri KR. Non-Surgical Periodontal Therapy's Influence on Alpha-Synuclein and Inflammatory Marker Levels: A Pilot Study. J Clin Med 2024; 13:3586. [PMID: 38930115 PMCID: PMC11204787 DOI: 10.3390/jcm13123586] [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: 05/22/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Microbial dysbiosis may contribute to alpha-synuclein (α-Syn) homeostasis disruption, yet the burden of inflammatory periodontal infection and its treatment have never been studied in this regard. We aimed to compare the cytokine and α-Syn levels in the saliva and blood of patients with periodontitis who underwent non-surgical periodontal therapy (NSPT) and those of their healthy counterparts. Methods: Periodontal examination and saliva and blood sample collection were carried out in incoming patients at a university clinic. The periodontitis group (PG) received NSPT. The sample collection and periodontal observation were repeated 30 days after. IL-6, IL1-β and total α-Syn were quantified using immunoassay methods. The periodontal inflamed surface area (PISA) was calculated as a proxy for periodontal inflammation. Results: Eleven participants formed the PG, and there were fifteen healthy controls (HC). At baseline, no correlation between salivary and plasma α-Syn was found. The salivary α-Syn levels revealed a tendency to decrease 30 days after, particularly in the PD cases. The variation in PISA and α-Syn showed significant correlation. Salivary α-Syn correlated negatively with salivary IL-6 levels at both timepoints in the total sample (rho = -0.394 and rho = -0.451) and in the HC (rho = -0.632 and rho = -0.561). Variations in plasma IL-6 and α-Syn were negatively correlated (rho = -0.518) in the healthy participants. Baseline plasma IL1-β negatively correlated with plasmatic α-Syn at 30 days in the HC (rho = -0.581). Conclusions: Salivary and plasma α-Syn bioavailability operate independently, and periodontal diagnosis was not a confounding factor. Salivary α-Syn levels were significantly affected by NSPT, contrary to plasma levels. These results should be confirmed in future larger and prospective studies.
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Affiliation(s)
- Patrícia Lyra
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - João Botelho
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Silvia Rota
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (S.R.); (K.R.C.)
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
| | - Karolina Poplawska-Domaszewicz
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
- Department of Neurology, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Vanessa Machado
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Daniela Guerreiro
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Luís Proença
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - José João Mendes
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Kallol Ray Chaudhuri
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (S.R.); (K.R.C.)
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
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8
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Ebersole JL, Hasturk H, Huber M, Gellibolian R, Markaryan A, Zhang XD, Miller CS. Realizing the clinical utility of saliva for monitoring oral diseases. Periodontol 2000 2024; 95:203-219. [PMID: 39010260 DOI: 10.1111/prd.12581] [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: 03/18/2024] [Revised: 05/01/2024] [Accepted: 05/16/2024] [Indexed: 07/17/2024]
Abstract
In the era of personalized/precision health care, additional effort is being expended to understand the biology and molecular mechanisms of disease processes. How these mechanisms are affected by individual genetics, environmental exposures, and behavioral choices will encompass an expanding role in the future of optimally preventing and treating diseases. Considering saliva as an important biological fluid for analysis to inform oral disease detection/description continues to expand. This review provides an overview of saliva as a diagnostic fluid and the features of various biomarkers that have been reported. We emphasize the use of salivary biomarkers in periodontitis and transport the reader through extant literature, gaps in knowledge, and a structured approach toward validating and determine the utility of biomarkers in periodontitis. A summation of the findings support the likelihood that a panel of biomarkers including both host molecules and specific microorganisms will be required to most effectively identify risk for early transition to disease, ongoing disease activity, progression, and likelihood of response to standard periodontal therapy. The goals would be to develop predictive algorithms that serve as adjunctive diagnostic tools which provide the clinician and patient important information for making informed clinical decisions.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Hatice Hasturk
- Immunology and Inflammation, Center for Clinical and Translational Research, The ADA Forsyth Institute, Cambridge, Massachusetts, USA
| | - Michaell Huber
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Xiaohua D Zhang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Craig S Miller
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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9
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Xiong B, Wang Y, He J, Wang L, He R, Zhu M, Wang J, Li Y, Liu B, Xiao K, She Q. Association of domain-specific physical activity with albuminuria among prediabetes and diabetes: a large cross-sectional study. J Transl Med 2024; 22:252. [PMID: 38459493 PMCID: PMC10921818 DOI: 10.1186/s12967-024-05061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Albuminuria, the presence of excess of protein in urine, is a well-known risk factor for early kidney damage among diabetic/prediabetic patients. There is a complex interaction between physical activity (PA) and albuminuria. However, the relationship of specific-domain PA and albuminuria remained obscure. METHODS Albuminuria was defined as urinary albumin/creatinine ratio (ACR) > 30 mg/g. PA was self-reported by participants and classified into transportation-related PA (TPA), occupation-related PA (OPA), and leisure-time PA (LTPA). Weighted logistic regression was conducted to compute the odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) was used to evaluate the dose-response of PA domains with the risk of albuminuria. RESULTS A total of 6739 diabetic/prediabetic patients (mean age: 56.52 ± 0.29 years) were enrolled in our study, including 3181 (47.20%) females and 3558 (52.80%) males. Of them, 1578 (23.42%) were identified with albuminuria, and 5161(76.58%) were without albuminuria. Diabetic/prediabetic patients who adhered the PA guidelines for total PA had a 22% decreased risk of albuminuria (OR = 0.78, 95%CI 0.64-0.95), and those met the PA guidelines for LTPA had a 28% decreased of albuminuria (OR = 0.72, 95%CI 0.57-0.92). However, OPA and TPA were both not associated with decreased risk of albuminuria. RCS showed linear relationship between the risk of albuminuria with LTPA. CONCLUSIONS Meeting the PA guideline for LTPA, but not OPA and TPA, was inversely related to the risk of albuminuria among diabetic/prediabetic patients. Additionally, achieving more than 300 min/week of LTPA conferred the positive effects in reducing albuminuria among diabetic/prediabetic patients.
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Affiliation(s)
- Bingquan Xiong
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Yufan Wang
- Department of Cardiovascular Medicine Intensive Care Unit, The Second Affiliated Hospital of Hainan Medical University, Hainan, China
| | - Juan He
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Lisha Wang
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Rui He
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Min Zhu
- Department of Geriatrics, The First People's Hospital of Neijiang, No. 41 Tuozhong Lane, Jiaotong Road, Neijiang, 641000, Sichuan, China
| | - Jiaxing Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang Pu Avenue West, Guangzhou, Guangdong, China
| | - Yingrui Li
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Bin Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Kaihu Xiao
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Qiang She
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China.
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Matayoshi S, Tojo F, Suehiro Y, Okuda M, Takagi M, Ochiai M, Kadono M, Mikasa Y, Okawa R, Nomura R, Itoh Y, Itoh N, Nakano K. Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus. Sci Rep 2024; 14:2777. [PMID: 38307981 PMCID: PMC10837110 DOI: 10.1038/s41598-024-53213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
Periodontitis is known to be associated with type 2 diabetes mellitus (T2DM), and gargling with mouthwash is known to reduce the incidence of periodontitis by inhibiting periodontal pathogens. However, the effects of mouthwash on oral and systemic conditions in patients with T2DM remain unknown. In this study, we investigated the effects of gargling with mouthwash on the number of red complex species, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, and HbA1c levels in patients with T2DM. Patients were instructed to gargle with water for 6 months, followed by gargling with mouthwash containing chlorhexidine gluconate for the subsequent 6 months. At each clinic visit, saliva was collected and bacterial DNA was extracted to detect red complex species using the polymerase chain reaction technique. The HbA1c level was determined using a blood sample. The number of red complex species significantly decreased in younger or male patients who gargled with mouthwash. Furthermore, HbA1c levels significantly decreased in younger patients or patients with higher HbA1c levels who gargled with mouthwash. These results suggest that gargling with mouthwash reduces the number of red complex species and improves the hyperglycemic status in patients with T2DM, especially younger patients.
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Affiliation(s)
- Saaya Matayoshi
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan.
| | - Fumikazu Tojo
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Makoto Okuda
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Misato Takagi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Marin Ochiai
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Maika Kadono
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yusuke Mikasa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Rena Okawa
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshito Itoh
- Itoh Internal Medicine Clinic, Osaka, Japan
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan
| | - Naoto Itoh
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Itoh Internal Medicine Clinic, Osaka, Japan
| | - Kazuhiko Nakano
- Joint Research Laboratory of Science for Oral and Systemic Connection, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
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11
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Albandar JM. Disparities and social determinants of periodontal diseases. Periodontol 2000 2024. [PMID: 38217495 DOI: 10.1111/prd.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/15/2024]
Abstract
Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.
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Affiliation(s)
- Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
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12
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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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13
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Ebersole JL, Kirakodu SS, Nguyen LM, Gonzalez OA. Periodontitis-resistant and -susceptible matriline regulation of gingival transcriptome in nonhuman primates. J Periodontal Res 2023; 58:1171-1187. [PMID: 37638662 DOI: 10.1111/jre.13162] [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: 05/04/2023] [Revised: 06/20/2023] [Accepted: 07/07/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE This report identified if gingival gene expression transcriptomes demonstrated unique profiles that discriminated periodontitis-susceptible (PDS) and periodontitis-resistant (PDR) animals in health and disease. BACKGROUND Nonhuman primates generally organize their social groups based upon matriline origin. We have used a multi-generational colony of rhesus macaques to identify matrilines presenting with significant differences in periodontitis (e.g., earlier age onset, greater prevalence, and severity). METHODS Animals from 12 to 23 years of age (n = 17; 8 - PDR, 9 - PDS) were entered into a ligature-induced periodontitis trial. Gingival biopsies were taken at baseline and 0.5, 1, 3, and 5 months post-ligation, and microarray analysis was used to quantify gene expression in samples at each time point. RESULTS Over 1000 genes showed significant (p < .01) differences in the PDR versus PDS animals at baseline. The frequency of differences generally decreased during the disease process, and increased with resolution (i.e., 5 months). A nearly 2:1 ratio of elevated gene levels was noted in baseline PDR samples that included up-regulated MMPs, Fc receptors, chemokines, interleukins, and innate immune receptors, and down-regulated genes particularly related to epithelial biology. Most dramatically, there was a skewed differential expression of adaptive immune response genes in the PDR and epithelial cell structure/function genes in PDS samples. CONCLUSIONS The results demonstrate substantive differences in gingival tissue response capacity/programming in PDR and PDS samples that may contribute to the differences in clinical outcomes related to the heritability of disease risk through matrilines.
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Affiliation(s)
- J L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - S S Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - L M Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - O A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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14
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Vu GT, Shakib S, King C, Gurupur V, Little BB. Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009-2014. Sci Rep 2023; 13:16694. [PMID: 37794165 PMCID: PMC10550940 DOI: 10.1038/s41598-023-43827-y] [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: 05/30/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023] Open
Abstract
This study examined the relationship between uncontrolled diabetes and periodontal disease (PD) among adults in the United States. We used data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES) with a sample of 6108 adults ages 30 and over. To measure PD status, we used the Centers for Disease Control and Prevention/American Academy of Periodontology's standards. To classify DM status (no DM, DM with HbA1c < 9%, diabetes with HbA1c ≥ 9%),we used self-reported Diabetes Mellitus (DM) diagnosis and laboratory report of HbA1c. Approximately 8.5% of the sample had controlled DM, and 1.7% had uncontrolled DM, for a total of 10.2% DM in the analysis. Multivariate logistic regression showed that compared to those without DM, PD was significantly increased with controlled DM (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) 1.01-1.73, p < 0.05) and even more with uncontrolled DM (aOR = 2.48, 95% CI 1.52-4.04, p < 0.001), after adjusting for covariates. Factors that reduced the prevalence of PD included annual dental visits, female gender, and college education. Factors that significantly increased PD prevalence were cigarette smoking, non-white race, income < 200% Federal Poverty Level, and older age (age > 50 years). In conclusion, uncontrolled DM was significantly associated with higher odds of PD among adults in the US.
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Affiliation(s)
- Giang T Vu
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA.
| | - Shaminul Shakib
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY, USA
| | - Christian King
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA
| | - Varadraj Gurupur
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA
| | - Bert B Little
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY, USA
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15
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Andrews M, Gao H, Datta S, Katz J. Increased odds for COVID-19 infection among individuals with periodontal disease. Clin Oral Investig 2023; 27:5925-5933. [PMID: 37606722 DOI: 10.1007/s00784-023-05204-x] [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: 04/27/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Periodontal disease has been linked to multiple systemic conditions, but the relationship with COVID-19 still needs to be elucidated. We hypothesized that periodontal disease may be associated with COVID-19 infection. MATERIALS AND METHODS This study utilized cross-sectional data to establish the strength of the association between periodontal disease and COVID-19 infection. The University of Florida Health Center's i2b2 patient's registry was used to generate patient counts through ICD-10 diagnostic codes. Univariate descriptive statistics of the patient population and logistic regression to estimate odds ratios of associations between periodontal disease and COVID-19 infection were used for analysis. RESULTS Patients with periodontal disease were 4.4 times more likely to be positively diagnosed with COVID-19 than patients without PD. Associations remained similar and robust (P value < 0.0001) after adjustment for age (OR = 4.34; 95% CI, 3.68-5.09), gender (OR = 4.46; 95% CI, 3.79-5.23), and smoking status (OR = 4.77; 95% CI, 4.04-5.59). Associations were smaller but remained robust (P value < 0.0001) after adjusting for race (OR = 2.83; 95% CI, 2.40-3.32), obesity (OR = 2.53; 95% CI, 2.14-2.98), diabetes (OR = 3.32; 95% CI, 2.81-3.90), and cardiovascular disease (OR = 2.68; 95% CI, 2.27-3.14). CONCLUSIONS Periodontal disease is significantly associated with increased odds for COVID-19 infection. CLINICAL RELEVANCE With the caveat of a cross-sectional study design, these results suggest that periodontal disease may increase the odds for COVID-19 infection.
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Affiliation(s)
- Michael Andrews
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanzhi Gao
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Santanu Datta
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Joseph Katz
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
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16
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Kzar WA, Abbas RF, Hussein HM. The Antimicrobial Peptide LL-37 as a Predictor Biomarker for Periodontitis with the Presence and Absence of Smoking: A Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:5581267. [PMID: 37711877 PMCID: PMC10499532 DOI: 10.1155/2023/5581267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023]
Abstract
Background A major issue is finding a valid biomarker able to diagnose periodontal disease with the presence and absence of risk factors. Indeed, the association between smoking and periodontal diseases and its impact on the manifestation of antimicrobial peptides has been delineated in clinical and epidemiological investigations. The antimicrobial peptide cathelicidin (LL-37) is pivotal in preserving periodontal health. Objectives This investigation examines and contrasts the levels of cathelicidin in the saliva of smokers and nonsmokers of periodontitis. The study also seeks to establish this biomarker's diagnostic ability to differentiate between periodontal health and disease. Materials and Methods The study involved the collection of unstimulated saliva samples from 160 participants, comprising 80 patients diagnosed with periodontitis (40 of whom were smokers and 40 were nonsmokers) and 80 periodontitis-free individuals (40 smokers and 40 nonsmokers). The clinical periodontal parameters were assessed, including recording the probing pocket depth, the level of clinical attachment, and the percentage of bleeding on probing. Subsequently, enzyme-linked immunosorbent assays were conducted to quantify the protein levels of LL-37 in the saliva samples obtained from the subjects mentioned above. Results The highest level of salivary LL-37 was found in the nonsmoker periodontitis (NSP) patients, followed by the group of smoker periodontitis (SP) and then nonsmoker healthy (NSH) group, while the lowest level was found in the healthy smoker (HS) group. At the same time, the LL-37 seems to be a very good biomarker in differentiating periodontal health from disease with the presence and absence of smoking. Conclusion Periodontitis results in a significant elevation of salivary LL-37 levels in smoker and nonsmoker patients compared to healthy individuals. These levels are positively correlated with the periodontal parameter and can serve as a valuable diagnostic tool to predict periodontitis, whereas smoking significantly reduces these levels.
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Affiliation(s)
- Wael Abdulazeez Kzar
- Department of Periodontology, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Raghad Fadhil Abbas
- Department of Periodontology, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Hashim Mueen Hussein
- Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
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17
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Ebersole JL, Kirakodu SS, Nguyen LM, Gonzalez OA. Sex effects on gingival transcriptomic patterns during initiation, progression, and resolution of periodontitis. J Periodontol 2023; 94:1018-1031. [PMID: 36853808 DOI: 10.1002/jper.23-0042] [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: 01/19/2023] [Revised: 01/12/2023] [Accepted: 02/22/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The prevalence and severity of periodontitis demonstrates altered population distribution with age, sex, and race and ethnicity. While males exhibit greater frequency of disease, particularly with aging, the underlying basis for this observation remains obscure. OBJECTIVE This study used a nonhuman primate (Macaca mulatta) model of experimental ligature-induced periodontitis in adult animals to evaluate gingival transcriptomic differences stratified based upon sex of the animal. METHODS The 18 animals represented humans ages 40-80 years, with gingival tissue samples obtained at baseline, 0.5 months (initiation), 1 and 3 months (progression), and at 5 months that were 60 days after ligature removal for clinical disease resolution. Microarray analysis was used to quantify gene expression profiles in the gingival tissues. RESULTS The results demonstrated clear gene expression differences in healthy (baseline) tissues between the sexes, with elevations in females associated with immune responses and elevation in males related to tissue structural genes. With disease initiation, fewer genes differed between the sexes, while these differences were significantly increased in progressing disease and resolution, particularly in male animals. Overexpressed biological processes showed tissue structural/functional genes at initiation, with host response pathways altered during disease progression. Resolution samples generally demonstrated biological processes of cellular metabolism that differed from baseline healthy samples. CONCLUSION The transcriptomic findings support sex as a biological variable in periodontitis using a nonhuman primate model of experimental periodontitis.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Sreenatha S Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Linh M Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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18
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Ebersole J, Kirakodu S, Nguyen L, Gonzalez O. Sex and Age Effects on Healthy Gingival Transcriptomic Patterns. J Dent Res 2023; 102:947-956. [PMID: 37232535 PMCID: PMC10399078 DOI: 10.1177/00220345231166310] [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] [Indexed: 05/27/2023] Open
Abstract
Many chronic inflammatory diseases demonstrate demographic associations such as sex, age, and race-ethnicity. Periodontitis has been found to be increased with age and in males. This study used nonhuman primates representing a human-like model for periodontitis and examined the gingival transcriptome stratified on sex and age. Thirty-six Macaca mulatta in 4 age groups-young (<3 y), adolescent (3-7 y), adult (12-15 y), and aged (>17 y)-with a healthy periodontium were used to characterize gene expression in healthy gingival tissues. Gene expression was compared to clinical measures of bleeding on probing (BOP) and probing pocket depth (PPD). The results demonstrated sex differences in number of up- and downregulated genes that increased with age. Female animals generally showed elevated expression of genes related to host immunoinflammatory responses, and males showed increased expression of tissue structural genes. Gene expression correlations with BOP and/or PPD showed minimal overlap between the sexes, while male animals demonstrated substantial overlap in genes that correlated with both BOP and PPD clinical features. A cluster analysis of genes significantly different between sexes showed a clear sex and age discrimination in the young and adolescent animals. In the older groups, the genes clustered predominately by sex, irrespective of age group. A pathway analysis identified that significant gene expression patterns were quite similar in adolescent and adult animals, while the young and aged samples were quite distinct. The results confirmed substantial sex related variations in gingival tissue biology that were affected by age and observed even in adolescent animals. This suggests that "programming" of the gingival tissues related to sex can occur rather early in life and presage variations in future risk for periodontitis.
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Affiliation(s)
- J.L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - S.S. Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - L.M. Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - O.A. Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Henshaw MM, Karpas S. Oral Health Disparities and Inequities in Older Adults. Clin Geriatr Med 2023; 39:207-223. [PMID: 37045529 DOI: 10.1016/j.cger.2023.01.007] [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: 04/14/2023]
Abstract
The number of individuals 65 and older living in the United States is increasing substantially and becoming more racially and ethnically diverse. This shift will affect the demographics of the patient population seeking dental care. It will also impact the future treatment needs of older adults. In older adults, similar to the general adult population, oral health disparities continue to exist related to race, ethnicity, gender, and socioeconomic level. Dental practitioners must understand these changes in order to meet the challenges of providing oral health care to the increasing numbers of diverse, medically compromised, and cognitively impaired older adults.
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Affiliation(s)
- Michelle M Henshaw
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, Suite 301, Boston, MA 02118, USA.
| | - Steven Karpas
- Department of General Dentistry, Boston University Henry M. Goldman School of Dental Medicine, 635 Albany Street, Boston, MA 02118, USA
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Alghamdi B, Jeon HH, Ni J, Qiu D, Liu A, Hong JJ, Ali M, Wang A, Troka M, Graves DT. Osteoimmunology in Periodontitis and Orthodontic Tooth Movement. Curr Osteoporos Rep 2023; 21:128-146. [PMID: 36862360 PMCID: PMC10696608 DOI: 10.1007/s11914-023-00774-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW To review the role of the immune cells and their interaction with cells found in gingiva, periodontal ligament, and bone that leads to net bone loss in periodontitis or bone remodeling in orthodontic tooth movement. RECENT FINDINGS Periodontal disease is one of the most common oral diseases causing inflammation in the soft and hard tissues of the periodontium and is initiated by bacteria that induce a host response. Although the innate and adaptive immune response function cooperatively to prevent bacterial dissemination, they also play a major role in gingival inflammation and destruction of the connective tissue, periodontal ligament, and alveolar bone characteristic of periodontitis. The inflammatory response is triggered by bacteria or their products that bind to pattern recognition receptors that induce transcription factor activity to stimulate cytokine and chemokine expression. Epithelial, fibroblast/stromal, and resident leukocytes play a key role in initiating the host response and contribute to periodontal disease. Single-cell RNA-seq (scRNA-seq) experiments have added new insight into the roles of various cell types in the response to bacterial challenge. This response is modified by systemic conditions such as diabetes and smoking. In contrast to periodontitis, orthodontic tooth movement (OTM) is a sterile inflammatory response induced by mechanical force. Orthodontic force application stimulates acute inflammatory responses in the periodontal ligament and alveolar bone stimulated by cytokines and chemokines that produce bone resorption on the compression side. On the tension side, orthodontic forces induce the production of osteogenic factors, stimulating new bone formation. A number of different cell types, cytokines, and signaling/pathways are involved in this complex process. Inflammatory and mechanical force-induced bone remodeling involves bone resorption and bone formation. The interaction of leukocytes with host stromal cells and osteoblastic cells plays a key role in both initiating the inflammatory events as well as inducing a cellular cascade that results in remodeling in orthodontic tooth movement or in tissue destruction in periodontitis.
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Affiliation(s)
- Bushra Alghamdi
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
- Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Medina, 42353, Kingdom of Saudi Arabia
| | - Hyeran Helen Jeon
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jia Ni
- Department of Periodontics, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Dongxu Qiu
- Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Alyssia Liu
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
| | - Julie J Hong
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
| | - Mamoon Ali
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
| | - Albert Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
| | - Michael Troka
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA
| | - Dana T Graves
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, 19104, Philadelphia, USA.
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Tamashiro R, Strange L, Schnackenberg K, Santos J, Gadalla H, Zhao L, Li EC, Hill E, Hill B, Sidhu GS, Kirst M, Walker C, Wang GP. Smoking-induced subgingival dysbiosis precedes clinical signs of periodontal disease. Sci Rep 2023; 13:3755. [PMID: 36882425 PMCID: PMC9992395 DOI: 10.1038/s41598-023-30203-z] [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: 06/28/2022] [Accepted: 02/17/2023] [Indexed: 03/09/2023] Open
Abstract
Smoking accelerates periodontal disease and alters the subgingival microbiome. However, the relationship between smoking-associated subgingival dysbiosis and progression of periodontal disease is not well understood. Here, we sampled 233 subgingival sites longitudinally from 8 smokers and 9 non-smokers over 6-12 months, analyzing 804 subgingival plaque samples using 16 rRNA sequencing. At equal probing depths, the microbial richness and diversity of the subgingival microbiome was higher in smokers compared to non-smokers, but these differences decreased as probing depths increased. The overall subgingival microbiome of smokers differed significantly from non-smokers at equal probing depths, which was characterized by colonization of novel minority microbes and a shift in abundant members of the microbiome to resemble periodontally diseased communities enriched with pathogenic bacteria. Temporal analysis showed that microbiome in shallow sites were less stable than deeper sites, but temporal stability of the microbiome was not significantly affected by smoking status or scaling and root planing. We identified 7 taxa-Olsenella sp., Streptococcus cristatus, Streptococcus pneumoniae, Streptococcus parasanguinis, Prevotella sp., Alloprevotella sp., and a Bacteroidales sp. that were significantly associated with progression of periodontal disease. Taken together, these results suggest that subgingival dysbiosis in smokers precedes clinical signs of periodontal disease, and support the hypothesis that smoking accelerates subgingival dysbiosis to facilitate periodontal disease progression.
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Affiliation(s)
- Ryan Tamashiro
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Leah Strange
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Kristin Schnackenberg
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Janelle Santos
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Hana Gadalla
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Lisa Zhao
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Eric C Li
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Emilie Hill
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Brett Hill
- Department of Endotontics, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Gurjit S Sidhu
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mariana Kirst
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Clay Walker
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Gary P Wang
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
- Medical Service, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
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22
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Thakkar-Samtani M, Heaton LJ, Kelly AL, Taylor SD, Vidone L, Tranby EP. Periodontal treatment associated with decreased diabetes mellitus-related treatment costs: An analysis of dental and medical claims data. J Am Dent Assoc 2023; 154:283-292.e1. [PMID: 36841690 DOI: 10.1016/j.adaj.2022.12.011] [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: 04/18/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 02/26/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) and periodontal disease have a suggested bidirectional relationship. Researchers have reported decreases in DM-related health care costs after periodontal treatment. The authors examined the relationship between periodontal disease treatment and DM health care costs in commercial insurance and Medicaid claims data. METHODS This study of IBM MarketScan commercial insurance and Medicaid databases included overall outpatient, inpatient, and drug costs for patients with DM. The authors examined associations between overall health care costs per patient in 2019 according to use of periodontal services from 2017 through 2018 using generalized linear modeling. The average treatment effect on treated was calculated by means of propensity score matching using a logistic model for periodontal treatment on covariates. RESULTS For commercial insurance enrollees, periodontal treatment was associated with reduced overall health care costs of 12% compared with no treatment ($13,915 vs $15,739; average treatment effect on treated, -$2,498.20; 95% CI, -$3,057.21 to -$1,939.19; P < .001). In the Medicaid cohort, periodontal treatment was associated with a 14% decrease in costs compared with patients with DM without treatment ($14,796 vs $17,181; average treatment effect on treated, -$2,917.84; 95% CI, -$3,354.48 to -$2,480.76; P < .001). There were no significant differences in inpatient costs (commercial insurance) or drug costs (Medicaid). CONCLUSIONS Undergoing periodontal treatment is associated with reduced overall and outpatient health care costs for patients with DM in Medicaid and commercial insurance claims data. There were no significant differences in inpatient costs for commercial insurance enrollees or in drug costs for Medicaid beneficiaries. PRACTICAL IMPLICATIONS A healthy mouth can play a key role in DM management. Expanding Medicaid benefits to include comprehensive periodontal treatment has the potential to reduce health care costs for patients with DM.
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23
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Ju X, Mejia G, Chrisopoulos S, Luzzi L, Jamieson LM. A longitudinal assessment of chronic periodontitis in Australian adults. J Clin Periodontol 2023; 50:276-285. [PMID: 36330664 PMCID: PMC10947095 DOI: 10.1111/jcpe.13741] [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: 05/03/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
AIM The study aimed to estimate the incidence/progression and reversal of chronic periodontitis and to identify factors associated with chronic periodontitis in Australian adults over a 12-year period. MATERIALS AND METHODS Data were obtained from the longitudinal component of the National Study of Adult Oral Health (NSAOH) in 2004-2006, and repeated data, among the same adults, in 2017-2018. NSAOH 2004-2006 was a population-based study of Australian adults aged 15+ years. The American Academy of Periodontology/European Federation of Periodontology case definitions were used, and then compared with two other case definitions. Multivariable Poisson regression models were used to estimate incidence rate ratios (IRRs) and reversal rate ratio (RRRs) of periodontitis. RESULTS A total of 775 dentate Australian adults had dental examinations at both times. The proportion of incidence/progression and reversal among Australian adults was 56.4% and 11.0%, respectively. Tobacco smokers presented with more than three times higher incidence (IRR: 3.32, 95% CI: 1.50-7.60) and lower reversals (RRR: 0.94, 95% CI: 0.39-0.98) than those who had never smoked. Cessation of smoking was positively associated with periodontitis reversal. The total incidence/progression was 471.7/10,000 person-years, with reversal being 107.5/10,000 person-years. The average number of teeth lost due to periodontal disease was 1.9 in 2017-2018. Being male and not having periodontal treatment were significant risk markers for the incidence/progression of periodontitis. CONCLUSION Smoking is a risk factor for periodontitis. Cessation of smoking is an effective means of reducing the incidence and progression of chronic periodontitis, to reduce the risk of tooth loss, and to improve overall periodontal health.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Gloria Mejia
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH)Adelaide Dental School, University of AdelaideAdelaideSouth AustraliaAustralia
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24
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Yamamoto A, Kambara Y, Fujiwara H. Impact of oral microbiota on pathophysiology of GVHD. Front Immunol 2023; 14:1132983. [PMID: 36969182 PMCID: PMC10033631 DOI: 10.3389/fimmu.2023.1132983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/23/2023] [Indexed: 03/29/2023] Open
Abstract
Allogeneic transplantation of hematopoietic cells is the only curative therapy for several hematopoietic disease in which patients receive cytotoxic conditioning regimens followed by infusion of hematopoietic stem cells. Although the outcomes have improved over the past decades, graft-versus-host-disease (GVHD), the most common life-threatening complication, remains a major cause of non-relapse morbidity and mortality. Pathophysiology of acute GVHD characterized by host antigen-presenting cells after tissue damage and donor T-cells is well studied, and additionally the importance of recipient microbiota in the intestine is elucidated in the GVHD setting. Oral microbiota is the second most abundant bacterial flora in the body after the intestinal tract, and it is related to chronic inflammation and carcinogenesis. Recently, composition of the oral microbiome in GVHD related to transplantation has been characterized and several common patterns, dysbiosis and enrichment of the specific bacterial groups, have been reported. This review focuses on the role of the oral microbiota in the context of GVHD.
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Affiliation(s)
- Akira Yamamoto
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yui Kambara
- Department of Hematology and Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
- *Correspondence: Hideaki Fujiwara,
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25
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Yu Y, Kim HJ, Song JM, Kang J, Lee H, Park HR, Kim YH. Differential microbiota network in gingival tissues between periodontitis and periodontitis with diabetes. Front Cell Infect Microbiol 2022; 12:1061125. [PMID: 36530437 PMCID: PMC9755495 DOI: 10.3389/fcimb.2022.1061125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Periodontitis and diabetes mellitus (DM) have a bidirectional relationship. Periodontitis is initiated by dysbiosis of oral microorganisms, and in particular, the characteristics of the microorganisms that have penetrated the tissue are directly related to the disease; therefore, we investigated the effect of DM on intragingival microbial profiling of patients with periodontitis. A total of 39 subjects were recruited and divided into three groups in this case control study as follows: healthy (NA, 10), periodontitis only (PD, 18), and periodontitis with DM (PD_DM, 11). Gingival tissue was collected, DNA was extracted, and whole-genome sequencing was performed. PD and PD_DM showed different characteristics from NA in diversity and composition of the microbial community; however, no difference was found between the PD nad PD_DM. PD_DM showed discriminatory characteristics for PD in the network analysis. PD showed a network structure in which six species were connected, including three red complex species, and PD_DM's network was more closely connected and expanded, with six additional species added to the PD network. Although DM did not significantly affect α- and β-diversity or abundance of phyla and genera of microbiota that invaded the gingival tissue of patients with periodontitis, DM will affect the progression of periodontitis by strengthening the bacterial network in the gingival tissue.
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Affiliation(s)
- Yeuni Yu
- Biomedical Research Institute, School of Medicine, Pusan National University, Yangsan, South Korea
| | - Hyun-Joo Kim
- Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, South Korea
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Jae-Min Song
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Junho Kang
- Biomedical Research Institute, School of Medicine, Pusan National University, Yangsan, South Korea
| | - Hansong Lee
- Convergence Medical Sciences, Pusan National University, Yangsan, South Korea
| | - Hae Ryoun Park
- Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, South Korea
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, South Korea
- Department of Oral Pathology, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Yun Hak Kim
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, South Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, South Korea
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, South Korea
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26
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Peng L, Chen H, Wang Z, He Y, Zhang X. Identification and validation of a classifier based on hub aging-related genes and aging subtypes correlation with immune microenvironment for periodontitis. Front Immunol 2022; 13:1042484. [PMID: 36389665 PMCID: PMC9663931 DOI: 10.3389/fimmu.2022.1042484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Periodontitis (PD), an age-related disease, is characterized by inflammatory periodontal tissue loss, and with the general aging of the global population, the burden of PD is becoming a major health concern. Nevertheless, the mechanism underlying this phenomenon remains indistinct. We aimed to develop a classification model for PD and explore the relationship between aging subtypes and the immune microenvironment for PD based on bioinformatics analysis. MATERIALS AND METHODS The PD-related datasets were acquired from the Gene Expression Omnibus (GEO) database, and aging-related genes (ARGs) were obtained from the Human Aging Genomic Resources (HAGR). Four machine learning algorithms were applied to screen out the hub ARGs. Then, an artificial neural network (ANN) model was constructed and the accuracy of the model was validated by receiver operating characteristic (ROC) curve analysis. The clinical effect of the model was evaluated by decision curve analysis (DCA). Consensus clustering was employed to determine the aging expression subtypes. A series of bioinformatics analyses were performed to explore the PD immune microenvironment and its subtypes. The hub aging-related modules were defined using weighted correlation network analysis (WGCNA). RESULTS Twenty-seven differentially expressed ARGs were dysregulated and a classifier based on four hub ARGs (BLM, FOS, IGFBP3, and PDGFRB) was constructed to diagnose PD with excellent accuracy. Subsequently, the mRNA levels of the hub ARGs were validated by quantitative real-time PCR (qRT-PCR). Based on differentially expressed ARGs, two aging-related subtypes were identified. Distinct biological functions and immune characteristics including infiltrating immunocytes, immunological reaction gene sets, the human leukocyte antigen (HLA) gene, and immune checkpoints were revealed between the subtypes. Additionally, the black module correlated with subtype-1 was manifested as the hub aging-related module and its latent functions were identified. CONCLUSION Our findings highlight the critical implications of aging-related genes in modulating the immune microenvironment. Four hub ARGs (BLM, FOS, IGFBP3, and PDGFRB) formed a classification model, and accompanied findings revealed the essential role of aging in the immune microenvironment for PD, providing fresh inspiration for PD etiopathogenesis and potential immunotherapy.
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Affiliation(s)
- Limin Peng
- College of Stomatology, Chongqing Medical University, Chongqing, China,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Hang Chen
- College of Stomatology, Chongqing Medical University, Chongqing, China,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Zhenxiang Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yujuan He
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine (Ministry of Education), Chongqing Medical University, Chongqing, China
| | - Xiaonan Zhang
- College of Stomatology, Chongqing Medical University, Chongqing, China,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China,*Correspondence: Xiaonan Zhang,
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Bhuyan R, Bhuyan SK, Mohanty JN, Das S, Juliana N, Abu IF. Periodontitis and Its Inflammatory Changes Linked to Various Systemic Diseases: A Review of Its Underlying Mechanisms. Biomedicines 2022; 10:biomedicines10102659. [PMID: 36289921 PMCID: PMC9599402 DOI: 10.3390/biomedicines10102659] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease of the gums. The incidence of periodontitis is increasing all over the world. In patients with periodontitis, there is gradual destruction of the periodontal ligament and the alveolar bone, and later, in advanced stages, there is tooth loss. Different microorganisms, the host’s immune response, and various environmental factors interact in the progression of this chronic inflammatory disease. In the present review, we discuss the epidemiology, clinical features, diagnosis, and complications of periodontitis. We also discuss the association of chronic inflammation found in periodontitis with various other systemic diseases, which include cardiovascular, respiratory, diabetes, Alzheimer’s, cancer, adverse pregnancy, and multiple myeloma, and also highlight microbial carcinogenesis and the microRNAs involved. The latest updates on the molecular mechanism, possible biomarkers, and treatment procedures may be beneficial for diagnostic and therapeutic purposes.
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Affiliation(s)
- Ruchi Bhuyan
- Department of Oral Pathology & Microbiology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan University (Deemed to be), Bhubaneswar 751003, India
- Department of Medical Research, IMS and SUM Hospital, Siksha ‘O’ Anusandhan University (Deemed to be), Bhubaneswar 751003, India
| | - Sanat Kumar Bhuyan
- Institute of Dental Sciences, Siksha ‘O’ Anusandhan University (Deemed to be), Bhubaneswar 751003, India
| | - Jatindra Nath Mohanty
- Department of Medical Research, IMS and SUM Hospital, Siksha ‘O’ Anusandhan University (Deemed to be), Bhubaneswar 751003, India
| | - Srijit Das
- School of Applied Sciences, Centurion University of Technology and Management, Jatni, Bhubaneswar 752050, India
- Correspondence:
| | - Norsham Juliana
- Department of Human and Clinical Anatomy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Izuddin Fahmy Abu
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
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Antônio Raulino do Nascimento T, Vilton Costa J, Oliveira Guerra R. Periodontal Disease in the Brazilian Population: A Retrospective Analysis on the 2013 National Health Survey to Identifying Risk Profiles. Int J Dent 2022; 2022:5430473. [PMID: 36249730 PMCID: PMC9568304 DOI: 10.1155/2022/5430473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/27/2022] [Indexed: 11/18/2022] Open
Abstract
Periodontal disease (PD) is a global public health problem with prevalence varying according to social and economic contexts; however, few studies have investigated the distribution of PD worldwide. PD is the host response to an infection or progression of a clinical condition, and the identification of modifiable risk factors for adequate clinical management of patients should be a priority in health policies directed to vulnerable population groups. In this context, we investigated the characteristics and risk factors for PD using the Brazilian National Health Survey 2013 (PNS-2013). A cluster analysis using the interdependence technique was applied to explore data on the risk of periodontitis. The presence or absence of a risk factor was analyzed using five variables (ten categories), while ordinal regression assessed risk profiles based on sociodemographic aspects of the Brazilian population. Individuals were classified as low (26.33%), medium (23.34%), or high risk (50.32%) for PD. Age, educational level, ethnicity, and Brazilian regions (except the North region) were significantly associated with risk for PD in the adjusted final regression model. Individual and social contexts were factors related to the high risk of PD in the Brazilian population. Our results highlight the need for public policies on healthy habits to prevent systemic diseases affecting oral health.
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Affiliation(s)
- Thiago Antônio Raulino do Nascimento
- Federal Institute of Education Science and Technology of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Subcoordination of Sanitary Surveillance of State of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Vilton Costa
- Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Efficacy and Safety of Traditional Chinese Medicine Based on the Method of “Nourishing Kidney and Clearing Heat” as Adjuvant in the Treatment of Diabetes Mellitus Patients with Periodontitis: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3853303. [PMID: 36065270 PMCID: PMC9440795 DOI: 10.1155/2022/3853303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Objective The aim of this systematic review and meta-analysis was to assess the efficacy and safety of traditional Chinese medicine based on the method of “nourishing kidney and clearing heat” as an adjuvant in the treatment of diabetes mellitus patients with periodontitis. Methods An electronic literature search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Scientific Journals Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, EMBASE, Web of Science, and Cochrane Library databases for articles published until October 2021. The primary outcomes were probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PLI), and sulcular bleeding index (SBI), while the secondary outcomes were tooth mobility (TM), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total effective rate, and adverse effects. Results Eleven randomized controlled trials (RCT) were included in the meta-analysis. The pooled results showed PPD (WMD = 1.07, 95%CI: (0.82, 1.33), P < 0.00001, I2 = 89%), CAL (WMD = 0.78, 95%CI: (0.62, 0.93), P < 0.00001, I2 = 58%), PLI (WMD = 0.44, 95%CI: (0.09, 0.79), P=0.01, I2 = 97%), SBI (WMD = 0.87, 95%CI: (0.79, 0.95), P < 0.00001, I2 = 37%), TM (WMD = 0.26, 95%CI: (0.21, 0.30), P < 0.00001, I2 = 31%), HbA1c (WMD = 0.48, 95%CI: (0.28, 0.67), P < 0.00001, I2 = 26%), FBG (WMD = 1.34, 95%CI: (0.96, 1.72), P < 0.00001, I2 = 52%), total effective rate (RR = 1.24, 95%CI: (1.14, 1.34), P < 0.00001, I2 = 0%), and adverse effects (RR = 0.78, 95%CI: (0.20, 3.03), P=0.72, I2 = 0%) in the traditional Chinese medicine based on the method of “nourishing kidney and clearing heat” + routine western medicine treatment (periodontal basic treatment, PBT, with or without antibiotic) group were significantly improved compared to control group, but no significant difference was observed for PLI at 2–3 months and 6 months. Conclusions This review supports traditional Chinese medicine based on the method of “nourishing kidney and clearing heat” as an adjuvant to routine western medicine treatment in the management of diabetes mellitus patients with periodontitis. Within the limits of the evidence, the well-designed, long-term efficacy, and high-quality multicenter RCTs need to be further confirmed.
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30
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Tagger-Green N, Nemcovsky C, Fridenberg N, Green O, Chaushu L, Kolerman R. Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)-A Cross-Sectional Study. J Clin Med 2022; 11:3249. [PMID: 35683634 PMCID: PMC9181801 DOI: 10.3390/jcm11113249] [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: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 non-PTSD periodontal patients (Control group). The study group was further divided into two subgroups of individuals who received psychiatric medications (40 patients) or did not (60 patients). All patients underwent complete dental, oral, and periodontal examinations, including assessing signs of parafunction. Results: All PTSD patients had poor oral hygiene. The plaque index (PI) was higher in the PTSD group compared to the control group (0.72 ± 0.28 vs. 0.45 ± 0.29, respectively, p < 0.001). The decayed, missing, and filled teeth score (DMFt) was higher in the PTSD population than in the controls (19.97 ± 8.07 vs. 13.05 ± 6.23 p < 0.05). Severe periodontal disease was more common among the PTSD subgroup taking medications (med -group) (62.5%) compared to the nonmedicated group (non-med group) (30.0%) and the controls (27.2%) (p = 0.001). Heavy smoking was more prevalent in the medicated PTSD patients than in other groups. Conclusions: The present study shows higher morbidities in combat-induced PTSD patients, including oral, dental, and periodontal manifestations, especially in medicated patients.
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Affiliation(s)
- Nirit Tagger-Green
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (C.N.); (L.C.); (R.K.)
| | - Carlos Nemcovsky
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (C.N.); (L.C.); (R.K.)
| | - Naama Fridenberg
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Orr Green
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Liat Chaushu
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (C.N.); (L.C.); (R.K.)
| | - Roni Kolerman
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (C.N.); (L.C.); (R.K.)
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31
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Cardiovascular Diseases and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:261-280. [PMID: 35612803 DOI: 10.1007/978-3-030-96881-6_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the tooth-supporting connective tissue and alveolar bone that is initiated by a bacterial biofilm in periodontal pockets. It affects about half of adults in the Western world, and is associated with a range of systemic comorbidities, e.g., cardiovascular disease (CVD), diabetes and rheumatoid arthritis, and these diseases share overlapping systemic and target tissue inflammatory mechanisms. Indeed, mounting evidence has indicated that their association is causal and built on the presence of systemic low-grade inflammation (LGI). Prior research linking periodontitis to CVD has mainly been derived from experimental studies, observational data, and small interventional trials with surrogate markers of CVD, e.g., endothelial dysfunction. However, recent data from randomised studies have demonstrated that intensive treatment of periodontitis can reduce blood pressure in patients with hypertension in conjunction with reduction of systemic inflammatory markers. Furthermore, targeted anti-inflammatory therapy has been shown to reduce recurrent events in patients with established CVD and LGI. Along this line, the concept of residual inflammatory risk has emerged as an independent new risk factor for atherothrombotic CVD. The present review summarizes translational evidence indicating that periodontitis is a risk factor for CVD dependent on LGI, and we conclude that treatment of periodontitis is likely to contribute importantly to reduction of residual inflammatory risk.
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Obesity in young women is positively associated with periodontitis. Clin Oral Investig 2022; 26:6139-6149. [PMID: 35624385 DOI: 10.1007/s00784-022-04563-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/21/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This cross-sectional study was performed to investigate the association between excess body weight and periodontitis in adults, stratified by sex and age, and using different criteria for obesity. MATERIAL AND METHODS Enrolled in the study were 345 individuals with a minimum age of 18 years who had attended the Public Health Service in the city of Salvador, Bahia, Brazil. All individuals underwent a complete periodontal examination and anthropometric measurements and answered a questionnaire regarding their socioeconomic, demographic, health, and lifestyle conditions. Excess body weight (exposure factor) was defined using body mass index (BMI) and waist circumference (WC). Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were obtained by Poisson regression analysis with robust variance. RESULTS Periodontitis was found in 74.2% of study participants, with the disease being more prevalent among those individuals with increased WC. The occurrence of overweight was 44.4% and that of obesity ranged from 29.9 to 70.8%, dependent upon the specific definition of obesity that was used. There was a positive association between obesity (WC > 88 cm) and periodontitis only among women, after adjustment for age, smoking habit, education level, diabetes, and family income (PRadjusted: 1.20; 95%CI: [1.01-1.44]). The magnitude of this positive association was higher among women aged 18 to 49 years when the outcome was severe periodontitis, and the exposure was obesity defined by WC. CONCLUSIONS The findings draw attention to the high frequency of the diseases investigated: overweight, obesity and periodontitis. Moreover, obesity was positively associated with periodontitis in women and younger individuals, demonstrating that among those with obesity, there is a higher probability of having periodontitis. The smaller number study of men in the may have influenced the non-statistically significant association found in that group. CLINICAL RELEVANCE Obese females and younger people are more likely to also have periodontitis. Periodontal evaluation and clinical management of individuals with obesity is recommended.
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Gonzalez OA, Kirakodu S, Nguyen LM, Orraca L, Novak MJ, Gonzalez-Martinez J, Ebersole JL. Comparative Analysis of Gene Expression Patterns for Oral Epithelial Cell Functions in Periodontitis. FRONTIERS IN ORAL HEALTH 2022; 3:863231. [PMID: 35677025 PMCID: PMC9169451 DOI: 10.3389/froh.2022.863231] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
The structure and function of epithelial cells are critical for the construction and maintenance of intact epithelial surfaces throughout the body. Beyond the mechanical barrier functions, epithelial cells have been identified as active participants in providing warning signals to the host immune and inflammatory cells and in communicating various detailed information on the noxious challenge to help drive specificity in the characteristics of the host response related to health or pathologic inflammation. Rhesus monkeys were used in these studies to evaluate the gingival transcriptome for naturally occurring disease samples (GeneChip® Rhesus Macaque Genome Array) or for ligature-induced disease (GeneChip® Rhesus Gene 1.0 ST Array) to explore up to 452 annotated genes related to epithelial cell structure and functions. Animals were distributed by age into four groups: ≤ 3 years (young), 3–7 years (adolescent), 12–16 years (adult), and 18–23 years (aged). For naturally occurring disease, adult and aged periodontitis animals were used, which comprised 34 animals (14 females and 20 males). Groups of nine animals in similar age groups were included in a ligature-induced periodontitis experiment. A buccal gingival sample from either healthy or periodontitis-affected tissues were collected, and microarray analysis performed. The overall results of this investigation suggested a substantial alteration in epithelial cell functions that occurs rapidly with disease initiation. Many of these changes were prolonged throughout disease progression and generally reflect a disruption of normal cellular functions that would presage the resulting tissue destruction and clinical disease measures. Finally, clinical resolution may not signify biological resolution and represent a continued risk for disease that may require considerations for additional biologically specific interventions to best manage further disease.
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Affiliation(s)
- Octavio A. Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, United States
| | - Sreenatha Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States
| | - Linh M. Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Luis Orraca
- School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico
| | - Michael J. Novak
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, United States
| | - Janis Gonzalez-Martinez
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Jeffrey L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV, United States
- *Correspondence: Jeffrey L. Ebersole
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Ebersole JL, Nguyen LM, Gonzalez OA. Gingival tissue antibody gene utilization in aging and periodontitis. J Periodontal Res 2022; 57:780-798. [PMID: 35582846 DOI: 10.1111/jre.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/20/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study used a nonhuman primate model of ligature-induced periodontitis to document the characteristics of immunoglobulin (Ig) gene usage in gingival tissues with disease and affected by age. BACKGROUND Adaptive immune responses to an array of oral bacteria are routinely detected in local gingival tissues and the systemic circulation across the human population. The level and diversity of antibody increases with periodontitis, reflecting the increased quantity of B cells and plasmacytes in the tissues at sites of periodontal lesions. METHODS Macaca mulatta (n = 36) in four groups (young - ≤3 years; adolescent >3-7 years; adult - 12-15 years; aged - 17-23 years) were used in this study. Gingival tissues were sampled at baseline (health), 2 weeks (initiation), 1 and 3 months (progression), and 5 months (resolution) of the lesion development and transcriptomic analysis included 78 Ig-related genes. RESULTS The results demonstrated extensive variation in Ig gene usage patterns and changes with the disease process that was substantially affected by the age of the animal. Of note was that the aged animals generally demonstrated elevated expression on multiple Ig genes even in the baseline/healthy gingival tissues. The expression levels revealed 5 aggregates of Ig gene change profiles across the age groups. The number of gene changes were greatly increased in adult animals with the initiation of disease, while the young and adolescent animals showed extensive changes with disease progression. Elevated Ig gene transcripts remained with disease resolution except in the aged animals. The response profiles demonstrated selective heavy/light change gene transcripts that differed with age and clustering of the transcript expression was dominated by the age of the animals. CONCLUSIONS The results suggested potential critical variations in the molecular aspects of Ig gene expression in gingival tissues that can contribute to understanding the kinetics of periodontal lesions, as well as the variation in episodes, rapidity of progression, and role in resolution that are impacted by age.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Linh M Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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Emergency Room Visits with a Non-Traumatic Dental-Related Diagnosis in Hawaii, 2016-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053073. [PMID: 35270765 PMCID: PMC8910124 DOI: 10.3390/ijerph19053073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to characterize the frequencies and patterns of emergency room (ER) visits with a non-traumatic dental-related diagnosis among adults (≥21 years old) in Hawaii, United States. This descriptive cross-sectional study used state-level inpatient and outpatient data recorded in Hawaii from 2016 to 2020. We identified dental-related ER visits using the diagnosis codes for non-traumatic dental-related conditions and summarized the frequency, rates, and cumulative total charges of the ER visits. The results show that approximately 30 thousand ER visits between 2016 and 2020 had a dental-related diagnosis. Sixty-seven percent of them had it as a principal diagnosis, amounting to USD 38.7 million total charges over the five years. A high proportion of these visits was found among those aged 21−44 years old (62%), Medicaid beneficiaries (49%), and Native Hawaiians/Part Native Hawaiians (26%). Compared to the proportions of ER visits with a secondary diagnosis, these groups had a higher proportion of ER visits with a principal diagnosis (ps < 0.001). A higher visit rate was found for those aged 21−44 years old and from less-populated counties. These results suggest that oral health disparities in age, socioeconomic status, and race/ethnicity exist in Hawaii. Our findings could provide insight in developing a framework to reduce oral health disparities, particularly among Medicaid beneficiaries and Native Hawaiians. Dental coverage with effective education in multiple dimensions is necessary to reduce non-traumatic dental-related ER visits.
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A Cross-Sectional Study for Association between Periodontitis and Benign Prostatic Hyperplasia Using the Korean Genome and Epidemiology Study Data. COATINGS 2022. [DOI: 10.3390/coatings12020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recently, several studies have suggested the relationship between periodontitis and prostatic disease. However, epidemiological studies on the association between periodontitis and benign prostatic hyperplasia (BPH) are scarce. Hence, we aimed to identify the association between the two diseases using data from the Korean Genome and Epidemiology Study. Among the 173,209 participants, 3297 men with periodontitis and 35,292 controls (without periodontitis) were selected. The history of BPH in participants with periodontitis and the controls were also investigated. Two-tailed analyses, independent t-tests, and chi-square tests were used for statistical analysis. The adjusted odds ratio (OR) for BPH was 1.50 (95% confidence interval, 1.35–1.68; p < 0.001) after adjusting for past medical histories. The adjusted OR for BPH was 1.57 (95% confidence interval, 1.41–1.76; p < 0.001) after adjusting for anthropometric and laboratory data. Collectively, this study provides evidence that periodontitis is associated with BPH. This finding supports the use of regular dental checkups and periodontal treatments to reduce the prevalence and progression of BPH.
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Alawaji YN, Alshammari A, Mostafa N, Carvalho RM, Aleksejuniene J. Periodontal disease prevalence, extent, and risk associations in untreated individuals. Clin Exp Dent Res 2022; 8:380-394. [PMID: 35015383 PMCID: PMC8874091 DOI: 10.1002/cre2.526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives to examine the prevalence, extent, and risk associations of untreated periodontitis. Materials and Methods A purposive sample of subjects who were never treated for periodontal conditions was clinically examined after collecting information about their sociodemographic characteristics, medical conditions, oral health behaviors, perceived stress, and perceived social support. Results A total of 431 subjects were recruited (response rate, 97.0%), and their mean age (SD) was 35.4 (13.3) years. Overall, high plaque levels were observed in all untreated individuals. The prevalence of periodontitis and severe (stage III/IV) periodontitis using the American Academy of Periodontology and European Federation of Periodontology (AAP/EFP) classification were 85.4% and 48.5%, respectively. The prevalence of moderate‐severe and severe periodontitis using the definitions of the Centers for Disease Control and Prevention (CDC) and AAP were 78.4% and 31.1%, respectively. The extent of periodontitis expressed as mean% of clinical attachment loss (CAL) ≥ 3 mm and CAL ≥ 5 mm were 34.9% and 14.4%, respectively, while the mean% of a periodontal probing depth (PPD) ≥4 mm and PPD ≥6 mm were 22.0% and 9.2%, respectively. Risk determinants associated with AAP/EFP periodontitis after the adjustment for other variables were age ≥35 years (odds ratio [OR] = 11.5) and lower income (OR = 2.5). Adjusted risk associations with stage II/IV periodontitis included age ≥35 years (OR = 8.2), males (OR = 2.5), lower income (OR = 2.3), and lower perceived stress (OR = 2.0). Adjusted risk associations with CDC/AAP moderate‐severe periodontitis included age ≥35 years (OR = 12.0), lower income (OR = 2.1), and current cigarette smoking (OR = 4.2). Adjusted risk associations with CDC/AAP severe periodontitis included age ≥35 years (OR = 4.5), males (OR = 1.9), lower education (OR = 2.0), lower income (OR = 1.7), uncontrolled diabetes mellitus (OR = 2.0), and current cigarette smoking (OR = 2.3). Conclusions The prevalence and extent of periodontitis were high in untreated subjects. Risk associations with untreated periodontitis included age ≥35 years, males, lower income, lower education, current cigarette smoking, uncontrolled diabetes mellitus, and lower perceived stress.
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Affiliation(s)
- Yasmine N Alawaji
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia.,Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Abdulsalam Alshammari
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nesrine Mostafa
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ricardo M Carvalho
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jolanta Aleksejuniene
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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Sheth AN, Adimora AA, Golub ET, Kassaye SG, Rana A, Westreich D, Cyriaque JW, Parish C, Konkle-Parker D, Jones DL, Kempf MC, Ofotokun I, Kanthula RM, Donohue J, Raccamarich P, Tisdale T, Ramirez C, Warren-Jeanpiere L, Tien PC, Alcaide ML. Study of Treatment and Reproductive Outcomes Among Reproductive-Age Women With HIV Infection in the Southern United States: Protocol for a Longitudinal Cohort Study. JMIR Res Protoc 2021; 10:e30398. [PMID: 34932006 PMCID: PMC8726043 DOI: 10.2196/30398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/30/2021] [Accepted: 07/16/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Nearly a quarter of the 1.1 million individuals with HIV in the United States are women. Racial and ethnic minority women in the Southern United States are disproportionately impacted. Reproductive-age women with HIV are prone to poor HIV outcomes but remain underrepresented in HIV research. We will answer contemporary questions related to the health outcomes in this population by enrolling a prospective cohort of reproductive-age women with and without HIV in the Southern United States. OBJECTIVE The Study of Treatment and Reproductive Outcomes (STAR) will enroll and retain 2000 reproductive-age women with and without HIV. The STAR will leverage the infrastructure of the US-based Multicenter AIDS Cohort Study (MACS)/Women's Interagency HIV Study (WIHS) Combined Cohort Study, comprising the WIHS (a cohort of women with and at risk for HIV, which began in 1993), and the MACS (a cohort of gay and bisexual men with and at risk for HIV, which began in 1984). Although the advancing age of the participants enrolled in the MACS/WIHS Combined Cohort Study provides an opportunity to address the questions related to HIV and aging, the research questions pertinent to the reproductive years must also be addressed. The STAR will conduct high-priority scientific research in key areas with the overall aim of addressing the unique needs of reproductive-age women with HIV. METHODS The STAR is a prospective, observational cohort study that will be conducted at 6 sites in the United States-Atlanta, Georgia; Birmingham, Alabama; Jackson, Mississippi; Chapel Hill, North Carolina; Miami, Florida; and Washington, District of Columbia. Visits will occur semiannually for 2 years, with additional visits for up to 5 years. At each visit, the participating women will complete a structured interview for collecting key demographic, psychosocial, and clinical variables, and undergo biospecimen collection for laboratory testing and repositing (blood, urine, hair, vaginal, anal, and oral specimens). Pregnant women and infants will undergo additional study assessments. The initial scientific focus of the STAR is to understand the roles of key social determinants of health, depression, reproductive health, and oral health on HIV and pregnancy outcomes across the reproductive life span. RESULTS Enrollment in the STAR commenced in February 2021 and is ongoing. CONCLUSIONS Through in-depth, longitudinal data and biospecimen collection, the newly initiated STAR cohort will create a platform to answer scientific questions regarding reproductive-age women with and without HIV. STAR will be uniquely positioned to enable investigators to conduct high-impact research relevant to this population. Building on the legacy of the MACS and WIHS cohorts, the STAR is designed to foster multidisciplinary collaborations to galvanize scientific discoveries to improve the health of reproductive-age women with HIV and ameliorate the effects of the HIV epidemic in this population in the United States.
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Affiliation(s)
- Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Infectious Diseases Program, Grady Health System, Atlanta, GA, United States
| | - Adaora A Adimora
- Division of Infectious Diseases, Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Elizabeth Topper Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Seble G Kassaye
- Department of Medicine, Georgetown University, Washington, DC, United States
| | - Aadia Rana
- Division of Infectious Diseases, Department of Medicine, University of Alabama-Birmingham Heersink School of Medicine, Birmingham, AL, United States
| | - Daniel Westreich
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Jennifer Webster Cyriaque
- Division of Oral and Craniofacial Sciences, Department of Microbiology and Immunology, University of North Carolina - Chapel Hill, Chapel Hill, NC, United States
| | - Carrigan Parish
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY, United States
| | - Deborah Konkle-Parker
- Schools of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Mirjam-Colette Kempf
- Division of Infectious Diseases, Department of Medicine, University of Alabama-Birmingham Heersink School of Medicine, Birmingham, AL, United States
- Departments of Epidemiology and Health Behavior, University of Alabama-Birmingham Ryals School of Public Health, Birmingham, AL, United States
- Department of Nursing Family, Community & Health Systems, University of Alabama-Birmingham School of Nursing, Birmingham, AL, United States
| | - Igho Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Infectious Diseases Program, Grady Health System, Atlanta, GA, United States
| | - Ruth M Kanthula
- Department of Pediatrics, Georgetown University, Washington, DC, United States
| | - Jessica Donohue
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Patricia Raccamarich
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Tina Tisdale
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Catalina Ramirez
- Division of Infectious Diseases, Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | | | - Phyllis C Tien
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Veteran Affairs Medical Center, San Francisco, CA, United States
| | - Maria L Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, United States
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Zemedikun DT, Chandan JS, Raindi D, Rajgor AD, Gokhale KM, Thomas T, Falahee M, De Pablo P, Lord JM, Raza K, Nirantharakumar K. Burden of chronic diseases associated with periodontal diseases: a retrospective cohort study using UK primary care data. BMJ Open 2021; 11:e048296. [PMID: 34924359 PMCID: PMC8689170 DOI: 10.1136/bmjopen-2020-048296] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To identify the association between periodontal diseases (gingivitis and periodontitis) and chronic diseases including cardiovascular disease, cardiometabolic disease, autoimmune disease and mental ill health. DESIGN Retrospective cohort. SETTING IQVIA Medical Research Data-UK between 1 January 1995 and 1 January 2019. PARTICIPANTS 64 379 adult patients with a general practitioner recorded diagnosis of periodontal disease (exposed patients) were matched to 251 161 unexposed patients by age, sex, deprivation and registration date. MAIN OUTCOME MEASURES Logistic regression models accounting for covariates of clinical importance were undertaken to estimate the adjusted OR (aOR) of having chronic diseases at baseline in the exposed compared with the unexposed group. Incidence rates for each outcome of interest were then provided followed by the calculation of adjusted HRs using cox regression modelling to describe the risk of outcome development in each group. RESULTS The average age at cohort entry was 45 years and the median follow-up was 3.4 years. At study entry, the exposed cohort had an increased likelihood of having a diagnosis of cardiovascular disease (aOR 1.43; 95% CI 1.38 to 1.48), cardiometabolic disease (aOR 1.16; 95% CI 1.13 to 1.19), autoimmune disease (aOR 1.33; 95% CI 1.28 to 1.37) and mental ill health (aOR 1.79; 95% CI 1.75 to 1.83) compared with the unexposed group. During the follow-up of individuals without pre-existing outcomes of interest, the exposed group had an increased risk of developing cardiovascular disease (HR 1.18; 95% CI 1.13 to 1.23), cardiometabolic disease (HR 1.07; 95% CI 1.03 to 1.10), autoimmune disease (HR 1.33; 95% CI 1.26 to 1.40) and mental ill health (HR 1.37; 95% CI 1.33 to 1.42) compared with the unexposed group. CONCLUSIONS In this cohort, periodontal diseases appeared to be associated with an increased risk of developing cardiovascular, cardiometabolic, autoimmune diseases and mental ill health. Periodontal diseases are very common; therefore, an increased risk of other chronic diseases represent a substantial public health burden.
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Affiliation(s)
- Dawit T Zemedikun
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | - Amarkumar Dhirajlal Rajgor
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Population Health Sciences, Newcastle University, Newcastle, UK
| | - Krishna Margadhmane Gokhale
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Tom Thomas
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Marie Falahee
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Paola De Pablo
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Janet M Lord
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Karim Raza
- Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Sandwell and West Birmingham NHS Trust, Birmingham, UK
- Research into Inflammatory Arthritis Centre Versus Arthritis and MRC- Versus Arthritis Centre for Musculoskeletal Ageing Research, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
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Shah PD, Badner VM, Moss KL. Association between asthma and periodontitis in the US adult population: A population-based observational epidemiological study. J Clin Periodontol 2021; 49:230-239. [PMID: 34866232 DOI: 10.1111/jcpe.13579] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine the association between asthma and periodontitis in a nationally representative sample of adults in the United States. MATERIALS AND METHODS Data obtained from 10,710 adult men and women who participated in National Health and Nutritional Examination Survey from 2009 to 2014 were analysed. Asthma was measured based on self-reported physician diagnosis. Periodontitis was the outcome of interest. It was classified into mild, moderate, and severe periodontitis according to the updated CDC/AAP case definitions. Multivariable models were developed to examine the association of asthma with periodontitis while controlling for age, race/ethnicity, gender, education, income, body mass index, diabetes, and smoking. Odds ratio (OR) and respective 95% confidence interval (CI) were calculated. Replication was performed by differently classifying the outcome using another system called periodontal profile class (PPC). RESULTS Current asthmatics, in reference to never asthmatics, had lower odds of severe periodontitis [(adjusted OR = 0.51, 95% CI = 0.30-0.87) and (adjusted OR = 0.58, 95% CI = 0.35-0.97) as classified using CDC/AAP case definitions and PPC system, respectively]. However, there was no statistically significant association between asthma and any other forms of periodontitis (p value >.05). CONCLUSIONS In the United States, current-asthmatic adults were less likely to have severe periodontitis as compared with never-asthmatic adults. Further research is required to fully understand this association.
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Affiliation(s)
- Parth D Shah
- Division of Population Health & Community Dentistry, Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Victor M Badner
- Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kevin L Moss
- Department of Dental Ecology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Kouanda B, Sattar Z, Geraghty P. Periodontal Diseases: Major Exacerbators of Pulmonary Diseases? Pulm Med 2021; 2021:4712406. [PMID: 34765263 PMCID: PMC8577952 DOI: 10.1155/2021/4712406] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/16/2021] [Indexed: 12/13/2022] Open
Abstract
Periodontal diseases are a range of polymicrobial infectious disorders, such as gingivitis and periodontitis, which affect tooth-supporting tissues and are linked to playing a role in the exacerbation of several pulmonary diseases. Pulmonary diseases, such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, tuberculosis, COVID-19, and bronchiectasis, significantly contribute to poor quality of life and mortality. The association between periodontal disease and pulmonary outcomes is an important topic and requires further attention. Numerous resident microorganisms coexist in the oral cavity and lungs. However, changes in the normal microflora due to oral disease, old age, lifestyle habits, or dental intervention may contribute to altered aspiration of oral periodontopathic bacteria into the lungs and changing inflammatory responses. Equally, periodontal diseases are associated with the longitudinal decline in spirometry lung volume. Several studies suggest a possible beneficial effect of periodontal therapy in improving lung function with a decreased frequency of exacerbations and reduced risk of adverse respiratory events and morbidity. Here, we review the current literature outlining the link between the oral cavity and pulmonary outcomes and focus on the microflora of the oral cavity, environmental and genetic factors, and preexisting conditions that can impact oral and pulmonary outcomes.
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Affiliation(s)
- Bakey Kouanda
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Zeeshan Sattar
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Patrick Geraghty
- Department of Medicine, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
- Department of Cell Biology, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
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Ahmed N, Arshad S, Basheer SN, Karobari MI, Marya A, Marya CM, Taneja P, Messina P, Yean CY, Scardina GA. Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111003. [PMID: 34769523 PMCID: PMC8582668 DOI: 10.3390/ijerph182111003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022]
Abstract
Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.
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Affiliation(s)
- Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Sohaib Arshad
- Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Syed Nahid Basheer
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Mohmed Isaqali Karobari
- Conservative Dentistry Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, India
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
| | - Anand Marya
- Department of Orthodontics, University of Puthisastra, Phnom Penh 12211, Cambodia;
- Department of Orthodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, India
| | - Charu Mohan Marya
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, India; (C.M.M.); (P.T.)
| | - Pratibha Taneja
- Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, India; (C.M.M.); (P.T.)
| | - Pietro Messina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
| | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy;
- Correspondence: (M.I.K.); (C.Y.Y.); (G.A.S.)
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Association between root taper and root proximity of single-rooted teeth with periodontitis: a cone-beam computed tomography based study. Odontology 2021; 110:356-364. [PMID: 34637093 DOI: 10.1007/s10266-021-00665-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/04/2021] [Indexed: 12/12/2022]
Abstract
This study aimed to determine the association between the root taper and proximity of single-rooted teeth with periodontitis using cone-beam computed tomography (CBCT). CBCT images of 362 single-rooted teeth from 37 patients were evaluated. This case-control study analyzed 17 participants with stage II and III periodontitis, (n = 161 teeth, periodontitis group) and 20 participants with healthy periodontium (n = 201 teeth, control group). Multiplanar reconstructions were used for proximity measurements, and cross-sectional images for calculating the angle of the root tapers. Root proximity, root length, and root taper were measured. Multivariate binary logistic regression analysis was used to determine association with periodontitis. In the periodontitis group, the upper lateral root-taper was 18.33° ± 3.25° and was significantly higher when compared to the control group (p = 0.001). The root taper of the lateral incisor was associated with the diagnosis of periodontitis (p = 0.01) with an odds ratio of 1.541 according to regression analysis. Root length was also identified as a potential protective parameter. The risk of being diagnosed with periodontitis decreases when root length increases by 0.785 times (p = 0.043). Upper canines in the periodontitis group presented shorter root lengths (p = 0.039) and higher root tapers (p = 0.01). Also, mandibular canines were closer form adjacent teeth in the periodontitis group (p = 0.042). This study indicated that short-root and increased root-taper at specific teeth could be considered as risk indicators for periodontitis.
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Morales A, Strauss FJ, Hämmerle CHF, Romandini M, Cavalla F, Baeza M, Sanz M, Gamonal J. Performance of the 2017 AAP/EFP case definition compared to the CDC/AAP definition in population-based studies. J Periodontol 2021; 93:1003-1013. [PMID: 34625960 DOI: 10.1002/jper.21-0276] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/08/2021] [Accepted: 09/26/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Classification of the periodontal conditions is indispensable for epidemiological data in order to guide situational awareness and therapeutic strategies. The new classification of periodontal diseases and conditions introduced by the American Academy of Periodontology and the European Federation of Periodontology (AAP/EFP), however, has not yet been applied to population-based studies. The aim of the present study was to compare the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification system and to evaluate the accuracy of the new AAP/EFP classification system against the CDC/AAP case definition for population-based studies. METHODS Epidemiological data from two cross-sectional studies were obtained. One of them was a population-based study on Chilean adults (1.456 individuals; 35-44 years; 65-74 years) and the other one a sample of adolescents (1.070 individuals; 15-19 years) from 5 countries; Argentina, Chile, Colombia, Ecuador and Uruguay. All participants had undergone full-mouth periodontal examination by calibrated examiners. Epidemiological datasets were analyzed according to the AAP/EFP and the CDC/AAP case definitions. The accuracy of the AAP/EFP definition was examined by assessing the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating curve (ROC) using the CDC/AAP case definition as the reference standard. RESULTS According to the AAP/EFP, the prevalence of periodontitis in adolescents was 75.6%. The majority of the adolescents were classified either as stage I (39.2%) or stage II (28.2%). By using the CDC/AAP classification the prevalence of periodontitis in adolescents was 27.2%. The most common form of periodontitis with the CDC/AAP classification was moderate periodontitis (15.3%) followed by mild periodontitis (11.4%). The AAP/EFP revealed high sensitivity in moderate (95.7%) and severe periodontitis (100%) as well as a moderate (75%) to high specificity (92%) in moderate and severe periodontitis, respectively. The PPV was 41.6% in moderate and 5.7% in severe periodontitis while the NPV was high in both categories (moderate = 99%; severe = 100%). The AUC was 0.912 (95% CI = 0.89 - 0.93). In adults, the prevalence of periodontitis was 99% according to the AAP/EFP. The majority of adults were classified as stage IV (81.3%) whereas stage III amounted to 12.8%. By using the CDC/AAP classification, the prevalence of periodontitis in adults was 88.3% and the most common form of periodontitis was moderate periodontitis (57.2%) followed by severe periodontitis (29.7%). In adults, the AAP/EFP revealed high sensitivity in moderate (99.7%) and severe periodontitis (100%) but low specificity in both categories (moderate = 6.8%; severe = 8.3%). The PPV was 88.7% in moderate and 31.7% in severe periodontitis. The NPV was high in both categories (moderate = 76.5%; severe = 100%). The AUC was 0.573 (95% CI = 0.53 - 0.62). CONCLUSIONS This study revealed a clear discrepancy in the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification when using epidemiological data. The 2017 AAP/EFP classification system performs well compared to the CDC/AAP case definition in identifying adolescents with periodontitis. The AAP/EFP system seems less accurate in adults with high prevalence of periodontitis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Alicia Morales
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Franz J Strauss
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mario Romandini
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Franco Cavalla
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Mauricio Baeza
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Jorge Gamonal
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
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Popa GV, Costache A, Badea O, Cojocaru MO, Mitroi G, Lazăr AC, Olimid DA, Mogoantă L. Histopathological and immunohistochemical study of periodontal changes in chronic smokers. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 62:209-217. [PMID: 34609423 PMCID: PMC8597366 DOI: 10.47162/rjme.62.1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Periodontal disease is a chronic inflammatory, multifactorial condition, that, in the absence of an early and adequate treatment, may lead to a progressive damaging of the alveolar tissues that support the teeth (periodontal ligament, cement and alveolar bone) followed by teeth mobility and, subsequently, their loss. Periodontal disease is one of the most common inflammatory disease affecting adult individuals all over the world, being considered a real worldwide pandemic. This disease may influence the progression of certain systemic diseases: diabetes mellitus, cardiovascular diseases, ischemic cardiomyopathy, myocardial infarction, stroke, neurodegenerative diseases, chronic kidney diseases, cancer, etc. The association between smoking and periodontal disease was described in numerous clinical and epidemiological studies, suggesting that products derived from tobacco burning may change the clinical aspects and the disease progression. The present study analyzed microscopically and immunohistochemically 58 periodontal fragments, from 50 patients, chronic smokers, clinically diagnosed with severe periodontitis. There were highlighted major changes in the gingival epithelium (epithelium thickening, acanthosis, intraepithelial edema, infiltrates of neutrophils or lymphocytes, epithelial necrosis), in the periodontal conjunctive tissue (more or less intense inflammatory infiltrates, microhemorrhages, vascular congestion, intense immunohistochemical expression for some matrix metalloproteinases). The periodontal changes may be the expression of both toxic factors present in tobacco smoke and due to the changes caused by tobacco in the microbial flora of the oral cavity.
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Affiliation(s)
- Gabriel Valeriu Popa
- Department of Histology, University of Medicine and Pharmacy of Craiova, Romania;
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Chaffee BW, Couch ET, Vora MV, Holliday RS. Oral and periodontal implications of tobacco and nicotine products. Periodontol 2000 2021; 87:241-253. [PMID: 34463989 PMCID: PMC8444622 DOI: 10.1111/prd.12395] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tobacco use contributes to more mortality and morbidity globally than any other behavioral risk factor. Adverse effects do not spare the oral cavity, with many oral diseases more common, and treatments less successful, in the tobacco-using patient. Many of the oral health effects of cigarette smoking are well established, but other forms of tobacco, including cigars and smokeless tobacco, merit dental professionals' attention. Recently, an expanding variety of new or emerging tobacco and/or nicotine products has been brought to market, most prominently electronic cigarettes, but also including heated tobacco and other noncombustible nicotine products. The use of cannabis (marijuana) is increasing and also has risks for oral health and dental treatment. For the practicing periodontist, and all dental professionals, providing sound patient recommendations requires knowledge of the general and oral health implications associated with this wide range of tobacco and nicotine products and cannabis. This review provides an overview of selected tobacco and nicotine products with an emphasis on their implications for periodontal disease risk and clinical management. Also presented are strategies for tobacco use counselling and cessation support that dental professionals can implement in practice.
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Affiliation(s)
- Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Manali V. Vora
- Division of Periodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Richard S. Holliday
- NIHR Clinical Lecturer in Restorative Dentistry, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Ghafouri-Fard S, Gholami L, Badrlou E, Sadeghpour S, Nazer N, Shadnoush M, Sayad A, Taheri M. Dysregulation of lncRNAs in circulation of patients with periodontitis: results of a pilot study. BMC Oral Health 2021; 21:471. [PMID: 34563175 PMCID: PMC8466695 DOI: 10.1186/s12903-021-01851-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background Periodontitis is a chronic inflammatory disorder with a complex etiology. Long non-coding RNAs (lncRNAs) have been shown to affect pathoetiology of periodontitis. We aimed at identification of expression of five lncRNAs, namely Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 in the circulation and gingival tissues of these patients compared with healthy controls. Methods In a pilot case–control study, we compared expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 lncRNAs between blood and tissue samples of patients with periodontitis and healthy controls using real time quantitative PCR technique. The present work was performed on samples got from 26 patients with periodontitis and 28 controls. Female/male ratio was 16/10 and 12/16 in cases and controls, respectively. Results There was no significant difference in the expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 genes between affected and unaffected tissues. However, expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 genes were significantly lower in the blood samples of patients when compared with control samples (Ratio of mean expression = 0.16, 0.14, 0.13, 0.10 and 0.14, respectively). Subsequently, we compared expressions of these lncRNAs between patients and controls in a sex-based manner. Expressions of Linc00667, FENDRR and DIRC3 genes were significantly lower in female patients compared with female controls (RME = 0.09, 0.07 and 0.10, respectively). Yet, there was no significant difference in expression of any of mentioned lncRNAs among male subgroups. Consistent with the similar levels of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 in tissue samples of patients and controls, none of them could separate these two sets of samples. However, AUC values for of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 expression levels in blood samples were 0.66, 0.72, 0.70, 0.72, 0.70 and 0.68, respectively with FENDRR having the best sensitivity value. Conclusion Taken together, lncRNAs might be involved in the pathologic events in the circulation of patients with periodontitis.
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Affiliation(s)
- Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Gholami
- Department of Periodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham Badrlou
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Pediatric Cell and Gene Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Sadeghpour
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naghme Nazer
- Department of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mahdi Shadnoush
- Department of Clinical Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezou Sayad
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Dental Research Center, Research Institute for Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Taheri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Huang N, Dong H, Luo Y, Shao B. Th17 Cells in Periodontitis and Its Regulation by A20. Front Immunol 2021; 12:742925. [PMID: 34557201 PMCID: PMC8453085 DOI: 10.3389/fimmu.2021.742925] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is a prevalent chronic disease that results in loss of periodontal ligament and bone resorption. Triggered by pathogens and prolonged inflammation, periodontitis is modulated by the immune system, especially pro-inflammatory cells, such as T helper (Th) 17 cells. Originated from CD4+ Th cells, Th17 cells play a central role for they drive and regulate periodontal inflammation. Cytokines secreted by Th17 cells are also major players in the pathogenesis of periodontitis. Given the importance of Th17 cells, modulators of Th17 cells are of great clinical potential and worth of discussion. This review aims to provide an overview of the current understanding of the effect of Th17 cells on periodontitis, as well as a brief discussion of current and potential therapies targeting Th17 cells. Lastly, we highlight this article by summarizing the causal relationship between A20 (encoded by TNFAIP3), an anti-inflammatory molecule, and Th17 cell differentiation.
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Affiliation(s)
- Ning Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hao Dong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqi Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Shao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Characterization of the Subgingival Cultivable Microbiota in Patients with Different Stages of Periodontitis in Spain and Colombia. A Cross-Sectional Study. Microorganisms 2021; 9:microorganisms9091940. [PMID: 34576835 PMCID: PMC8469102 DOI: 10.3390/microorganisms9091940] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/31/2021] [Accepted: 09/11/2021] [Indexed: 02/04/2023] Open
Abstract
The objective was to characterize and compare the subgingival microbiota in patients diagnosed according to the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions 2018. For this cross-sectional study, Spanish and Colombian subjects (characterized as health/gingivitis, periodontitis in stages I-II or stages III-IV) were clinically assessed, and subgingival samples were taken and processed by culture. The comparisons among patients with periodontal status (and between countries) was made using Mann–Whitney, Kruskal–Wallis, ANOVA and chi-square tests. The final sample consisted of 167 subjects. Eikenella corrodens and Parvimonas micra were more frequently detected in health/gingivitis and Porphyromonas gingivalis in periodontitis (p < 0.05). Higher total counts were observed in Colombia (p = 0.036). In Spain, significantly higher levels of P. gingivalis and Campylobacter rectus were observed, and of Tannerella forsythia, P. micra, Prevotella intermedia, Fusobacterium nucleatum, Actinomyces odontolyticus and Capnocytophaga spp. in Colombia (p < 0.001). P. micra was more prevalent in health/gingivitis and stage I-II periodontitis in Colombia, and P. gingivalis in all periodontitis groups in Spain (p < 0.05). As conclusions, significant differences were detected in the microbiota between health/gingivitis and periodontitis, with minor differences between stages of periodontitis. Differences were also relevant between countries, with Colombia showing larger counts and variability of bacterial species.
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50
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Nguyen T, Brody H, Radaic A, Kapila Y. Probiotics for periodontal health-Current molecular findings. Periodontol 2000 2021; 87:254-267. [PMID: 34463979 PMCID: PMC8448672 DOI: 10.1111/prd.12382] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dysbiosis of the oral microbiome is associated with a variety of oral and systemic diseases, including periodontal disease. Oral dysbiosis in periodontal disease leads to an exacerbated host immune response that induces progressive periodontal tissue destruction and ultimately tooth loss. To counter the disease‐associated dysbiosis of the oral cavity, strategies have been proposed to reestablish a “healthy” microbiome via the use of probiotics. This study reviews the literature on the use of probiotics for modifying the oral microbial composition toward a beneficial state that might alleviate disease progression. Four in vitro and 10 preclinical studies were included in the analysis, and these studies explored the effects of probiotics on cultured biofilm growth and bacterial gene expressions, as well as modulation of the host response to inflammation. The current molecular findings on probiotics provide fundamental evidence for further clinical research for the use of probiotics in periodontal therapy. They also point out an important caveat: Changing the biofilm composition might alter the normal oral flora that is beneficial and/or critical for oral health.
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Affiliation(s)
- Trang Nguyen
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Hanna Brody
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Alan Radaic
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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