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Chen IH, Lin CH, Lee MK, Chen TE, Lan TH, Chang CM, Tseng TY, Wang T, Du JK. Convolutional-neural-network-based radiographs evaluation assisting in early diagnosis of the periodontal bone loss via periapical radiograph. J Dent Sci 2024; 19:550-559. [PMID: 38303886 PMCID: PMC10829720 DOI: 10.1016/j.jds.2023.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/30/2023] [Indexed: 02/03/2024] Open
Abstract
Background/Purpose The preciseness of detecting periodontal bone loss is examiners dependent, and this leads to low reliability. The need for automated assistance systems on dental radiographic images has been increased. To the best of our knowledge, no studies have quantitatively and automatically staged periodontitis using dental periapical radiographs. The purpose of this study was to evaluate periodontal bone loss and periodontitis stage on dental periapical radiographs using deep convolutional neural networks (CNNs). Materials and methods 336 periapical radiographic images (teeth: 390) between January 2017 and December 2019 were collected and de-identified. All periapical radiographic image datasets were divided into training dataset (n = 82, teeth: 123) and test dataset (n = 336, teeth: 390). For creating an optimal deep CNN algorithm model, the training datasets were directly used for the segmentation and individual tooth detection. To evaluate the diagnostic power, we calculated the degree of alveolar bone loss deviation between our proposed method and ground truth, the Pearson correlation coefficients (PCC), and the diagnostic accuracy of the proposed method in the test datasets. Results The periodontal bone loss degree deviation between our proposed method and the ground truth drawn by the three periodontists was 6.5 %. In addition, the overall PCC value of our proposed system and the periodontists' diagnoses was 0.828 (P < 0.01). The total diagnostic accuracy of our proposed method was 72.8 %. The diagnostic accuracy was highest for stage III (97.0 %). Conclusion This tool helps with diagnosis and prevents omission, and this may be especially helpful for inexperienced younger doctors and doctors in underdeveloped countries. It could also dramatically reduce the workload of clinicians and timely access to periodontist care for people requiring advanced periodontal treatment.
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Affiliation(s)
- I-Hui Chen
- Division of Periodontology, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Hua Lin
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Min-Kang Lee
- Division of Family Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tsung-En Chen
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Ting-Hsun Lan
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Ming Chang
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Tsai-Yu Tseng
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Tsaipei Wang
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Je-Kang Du
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Ortíz de Urbina Comerón P, Zubizarreta-Macho Á, Lobo Galindo AB, Montiel-Company JM, Lorenzo-Gómez MF, Flores Fraile J. Relationship between Prostate Inflammation and Periodontal Disease-A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6070. [PMID: 37763009 PMCID: PMC10531617 DOI: 10.3390/jcm12186070] [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: 08/07/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this systematic review and meta-analysis was to analyze the association between periodontal disease and prostate inflammation with a null hypothesis stating that periodontal disease does not increase the incidence of prostate inflammation. MATERIALS AND METHODS A systematic literature review and meta-analysis of longitudinal observational cohort and case-control studies that evaluated the odds ratio or hazard ratio and confidence interval was undertaken based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (2020). A total of four databases were consulted in the literature search: PubMed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and quantitative analyses. RESULTS Four observational cohort studies and three observational cohort case-control studies were included in the meta-analysis. The four observational cohort studies were combined using the random effects model to estimate a hazard ratio of 1.32 with a confidence interval of 95% between 0.87 and 1.77. The meta-analysis presented high heterogeneity (Q test = 56.1; p value < 0.001; I2 = 94.9%). Moreover, the three observational case-control studies were combined using the random effects model to estimate an odds ratio of 1.62 with a confidence interval of 95% between 1.41 and 1.84. The meta-analysis presented high heterogeneity (Q test = 1.07; p value = 0.782; I2 = 0%). CONCLUSIONS The incidence of periodontal disease does not increase the risk of the incidence of prostate inflammation.
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Affiliation(s)
- Pablo Ortíz de Urbina Comerón
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - Ana Belén Lobo Galindo
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - María-Fernanda Lorenzo-Gómez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
- Servicio de Urología del Hospital, Universitario de Salamanca, 37007 Salamanca, Spain
| | - Javier Flores Fraile
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (P.O.d.U.C.); (M.-F.L.-G.); (J.F.F.)
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Nearing JT, DeClercq V, Langille MGI. Investigating the oral microbiome in retrospective and prospective cases of prostate, colon, and breast cancer. NPJ Biofilms Microbiomes 2023; 9:23. [PMID: 37127667 PMCID: PMC10151362 DOI: 10.1038/s41522-023-00391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023] Open
Abstract
The human microbiome has been proposed as a potentially useful biomarker for several cancers. To examine this, we made use of salivary samples from the Atlantic Partnership for Tomorrow's Health (PATH) project and Alberta's Tomorrow Project (ATP). Sample selection was divided into both a retrospective and prospective case control design examining prostate, breast, and colon cancer. In total 89 retrospective and 260 prospective cancer cases were matched to non-cancer controls and saliva samples were sequenced using 16S rRNA gene sequencing. We found no significant differences in alpha diversity. All beta diversity measures were insignificant except for unweighted UniFrac profiles in retrospective breast cancer cases and weighted UniFrac, Bray-Curtis and Robust Atchinson's distances in colon cancer after testing with age and sex adjusted MiRKAT models. Differential abundance (DA) analysis showed several taxa that were associated with previous cancer in all three groupings. Only one genus (Clostridia UCG-014) in breast cancer and one ASV (Fusobacterium periodonticum) in colon cancer was identified by more than one DA tool. In prospective cases three ASVs were associated with colon cancer, one ASV with breast cancer, and one ASV with prostate cancer. Random Forest classification showed low levels of signal in both study designs in breast and prostate cancer. Contrastingly, colon cancer did show signal in our retrospective analysis (AUC: 0.737) and in one of two prospective cohorts (AUC: 0.717). Our results indicate that it is unlikely that reliable microbial oral biomarkers for breast and prostate cancer exist.. However, further research into the oral microbiome and colon cancer could be fruitful.
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Affiliation(s)
- Jacob T Nearing
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada.
| | - Vanessa DeClercq
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Morgan G I Langille
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
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4
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Wang K, Zhang Z, Wang Z. Assessment of the association between periodontal disease and total cancer incidence and mortality: a meta-analysis. PeerJ 2022; 10:e14320. [PMID: 36389427 PMCID: PMC9648345 DOI: 10.7717/peerj.14320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background Periodontal disease (PD) is a chronic inflammatory disease that leads to alveolar bone resorption and tooth loss. Many studies have reported the association between periodontal disease and various cancers including oral cancer, lung cancer, breast cancer and so on. However, there is still no specialized meta-analysis that assesses the association between periodontal disease and cancer incidence and mortality in-deepth. Thus, we conducted this meta-analysis. Methods This meta-analysis was registered with PROSPERO: CRD42020183497. We searched five online databases for observational studies about the association between periodontal disease and breast, prostate, lung and bronchial, colorectal, and total cancers by July 2020. Then we evaluated quality of the included studies by the Newcastle-Ottawa scale. Risk ratios (HRs) and their 95% confidence intervals (CIs) were pooled to evaluate the strength of the association between periodontal disease and four cancers, total cancer incidence and mortality. In addition, we analyzed heterogeneity by subgroup analysis and sensitivity analysis. Finally, we inspected publication bias by Begg's and Egger's tests. Results None of the studies included in this meta-analysis were of poor quality. PD is not only related to breast cancer incidence (HR = 1.26,95%CI [1.11-1.43], I 2 = 75.8%, P = 0.000), but also connected with total cancer mortality (HR = 1.40,95%CI [1.24-1.58], I 2 = 0.0%, P = 0.718). Subgroup analyses showed that study population, study design, dental status, follow-up period, adjustment for smoking partially explained the heterogeneity between studies. The results of Begg's test and Egger's test were consistent and indicated that there is no publication bias in this study. Conclusion In conclusion, this meta-analysis revealed a positive relationship between periodontal disease and breast cancer incidence and total cancer mortality. Further well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusion of this meta-analysis. However, longer follow-up period, multi-center trials and even multinational studies are required to corroborate the results.
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Affiliation(s)
- Kaili Wang
- Department of Stomatology, Beijing You ’an Hospital, Capital Medical University, Beijing, China
| | - Zheng Zhang
- Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China,Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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5
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Li TJ, Hao YH, Tang YL, Liang XH. Periodontal Pathogens: A Crucial Link Between Periodontal Diseases and Oral Cancer. Front Microbiol 2022; 13:919633. [PMID: 35847109 PMCID: PMC9279119 DOI: 10.3389/fmicb.2022.919633] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/20/2022] [Indexed: 12/24/2022] Open
Abstract
Emerging evidence shows a striking link between periodontal diseases and various human cancers including oral cancer. And periodontal pathogens, leading to periodontal diseases development, may serve a crucial role in oral cancer. This review elucidated the molecular mechanisms of periodontal pathogens in oral cancer. The pathogens directly engage in their own unique molecular dialogue with the host epithelium to acquire cancer phenotypes, and indirectly induce a proinflammatory environment and carcinogenic substance in favor of cancer development. And functional, rather than compositional, properties of oral microbial community correlated with cancer development are discussed. The effect of periodontal pathogens on periodontal diseases and oral cancer will further detail the pathogenesis of oral cancer and intensify the need of maintaining oral hygiene for the prevention of oral diseases including oral cancer.
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Affiliation(s)
- Tian-Jiao Li
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi-hang Hao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ya-ling Tang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin-hua Liang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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6
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Groeger S, Wu F, Wagenlehner F, Dansranjav T, Ruf S, Denter F, Meyle J. PD-L1 Up-Regulation in Prostate Cancer Cells by Porphyromonas gingivalis. Front Cell Infect Microbiol 2022; 12:935806. [PMID: 35846769 PMCID: PMC9277116 DOI: 10.3389/fcimb.2022.935806] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Chronic inflammation is known to contribute to various human cancers. Porphyromonas gingivalis (P. gingivalis), is a gram-negative oral keystone pathogen that may cause severe periodontitis and expresses several virulence factors to affect the host immune system. Periodontitis is a chronic infectious disease that while progression, may cause loss of attachment and destruction of the tooth supporting tissues. Prostate cancer is one of the most common malignancies in men. Increasing evidence links periodontitis with prostate cancer, however the mechanisms explaining this relationship remain unclear. The aim of this study was to investigate the expression and signaling pathway of programmed death ligand 1 (PD-L1) in a prostate cancer cell line after infection with P. gingivalis and stimulation with P. gingivalis components to reveal the mechanism of tumor-induced immune evasion associated with bacterial infection in the tumor environment. Prostate cancer cells were infected with different concentrations of viable P. gingivalis and treated with different concentrations of heat-killed P. gingivalis and P. gingivalis cell components, including the total membrane fraction, inner membrane fraction, outer membrane fraction, cytosolic fraction and peptidoglycan (PGN). Chemical inhibitors were used to block different important molecules of signaling pathways to assess the participating signal transduction mechanisms. PD-L1 expression was detected by Western blot after 24 h of infection. PD-L1 was demonstrated to be upregulated in prostate cancer cells after infection with viable and with heat-killed P. gingivalis membrane fractions. Also isolated PGN induced PD-L1 up-regulation. The upregulation was mediated by the NOD1/NOD2 signaling pathway. No upregulation could be detected after treatment of the cells with P. gingivalis lipopolysaccharide (LPS). These results indicate, that chronic inflammatory disease can contribute to tumor immune evasion by modifying the tumor microenvironment. Thus, chronic infection possibly plays an essential role in the immune response and may promote the development and progression of prostate cancer.
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Affiliation(s)
- Sabine Groeger
- Dept. of Periodontology, Justus-Liebig University, Giessen, Germany
- Dept. of Orthodontics, Justus-Liebig University, Giessen, Germany
- *Correspondence: Sabine Groeger,
| | - Fan Wu
- Dept. of Periodontology, Justus-Liebig University, Giessen, Germany
| | | | | | - Sabine Ruf
- Dept. of Orthodontics, Justus-Liebig University, Giessen, Germany
| | - Fabian Denter
- Dept. of Periodontology, Justus-Liebig University, Giessen, Germany
| | - Joerg Meyle
- Dept. of Periodontology, Justus-Liebig University, Giessen, Germany
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7
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Mao M, Zhu H, Xie Y, Ni D, Zhu F, Chen Q. Correlation between periodontitis and prostate-specific antigen levels in the elderly Chinese male population. BMC Oral Health 2022; 22:163. [PMID: 35524291 PMCID: PMC9074280 DOI: 10.1186/s12903-022-02171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background The comparison of prostate-specific antigen (PSA) levels among older individuals with different periodontal statuses has not been fully investigated. Here we aimed to explore the correlation between the staging and grading of periodontitis and PSA levels in an elderly Chinese male population, which may lead to a biopsy recommendation and prevent prostate cancer as early as possible. Methods The study included 996 individuals aged ≥ 55 years who participated in routine postretirement physical examinations. Periodontal data included probing depth and gingival recession on four sites/tooth and on two diagonal quadrants (1–3 or 2–4) while excluding third molars, and clinical attachment loss was calculated. Periodontal status was classified as none, mild-moderate or severe periodontitis according to the Centers for Disease Control and Prevention and the American Academy of Periodontology case definition. Blood samples, oral health status and sociodemographic characteristics were collected by using general and oral examinations and questionnaires. Linear and logistic regressions were used to estimate the correlation between periodontitis severity and PSA levels, respectively. Results A total of 479 men had mild-moderate periodontitis and 355 had severe periodontitis; 162 men were periodontally healthy individuals. After adjusting for potential confounders, PSA levels were significantly lower in the individuals without periodontitis than in those with mild-moderate (P = 0.04) or severe (P = 0.03) periodontitis. However, PSA levels did not significantly correlate with periodontitis severity (P = 0.06). Although the ORs of elevated PSA were not significant, individuals with PSA ≥ 4.0 ng/mL were more likely to have periodontitis. Conclusions In a sample of an elderly Chinese male population, after adjusting for possible confounders, serum PSA levels in individuals with periodontitis were significantly higher than those in individuals without periodontitis, but serum PSA did not significantly correlate with periodontitis severity.
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Affiliation(s)
- Mengyun Mao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Haihua Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Yanyi Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Da Ni
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Fudong Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
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8
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Zarei A, Javid H, Sanjarian S, Senemar S, Zarei H. Metagenomics studies for the diagnosis and treatment of prostate cancer. Prostate 2022; 82:289-297. [PMID: 34855234 DOI: 10.1002/pros.24276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 12/19/2022]
Abstract
AIM Mutation occurs in the prostate cell genes, leading to abnormal prostate proliferation and ultimately cancer. Prostate cancer (PC) is one of the most common cancers amongst men, and its prevalence worldwide increases relative to men's age. About 16% of the world's cancers are the result of microbes in the human body. Impaired population balance of symbiosis microbes in the human reproductive system is linked to PC development. DISCUSSION With the advent of metagenomics science, the genome sequence of the microbiota of the human body has been unveiled. Therefore, it is now possible to identify a higher range of microbiome changes in PC tissue via the Next Generation Technique, which will have positive consequences in personalized medicine. In this review, we intend to question the role of metagenomics studies in the diagnosis and treatment of PC. CONCLUSION The microbial imbalance in the men's genital tract might have an effect on prostate health. Based on next-generation sequencing-generated data, Proteobacteria, Firmicutes, Actinobacteria, and Bacteriodetes are the nine frequent phyla detected in a PC sample, which might be involved in inducing mutation in the prostate cells that cause cancer.
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Affiliation(s)
- Ali Zarei
- Department of Human Genetics, Iranian Academic Center for Education, Culture and Research (ACECR)-Fars Branch Institute for Human Genetics Research, Shiraz, Iran
| | - Hossein Javid
- Department of Human Genetics, Iranian Academic Center for Education, Culture and Research (ACECR)-Fars Branch Institute for Human Genetics Research, Shiraz, Iran
| | - Sara Sanjarian
- Department of Human Genetics, Iranian Academic Center for Education, Culture and Research (ACECR)-Fars Branch Institute for Human Genetics Research, Shiraz, Iran
| | - Sara Senemar
- Department of Human Genetics, Iranian Academic Center for Education, Culture and Research (ACECR)-Fars Branch Institute for Human Genetics Research, Shiraz, Iran
| | - Hanieh Zarei
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Yuan S, Fang C, Leng WD, Wu L, Li BH, Wang XH, Hu H, Zeng XT. Oral microbiota in the oral-genitourinary axis: identifying periodontitis as a potential risk of genitourinary cancers. Mil Med Res 2021; 8:54. [PMID: 34588004 PMCID: PMC8480014 DOI: 10.1186/s40779-021-00344-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022] Open
Abstract
Periodontitis has been proposed as a novel risk factor of genitourinary cancers: although periodontitis and genitourinary cancers are two totally distinct types of disorders, epidemiological and clinical studies, have established associations between them. Dysbiosis of oral microbiota has already been established as a major factor contributing to periodontitis. Recent emerging epidemiological evidence and the detection of oral microbiota in genitourinary organs indicate the presence of an oral-genitourinary axis and oral microbiota may be involved in the pathogenesis of genitourinary cancers. Therefore, oral microbiota provides the bridge between periodontitis and genitourinary cancers. We have carried out this narrative review which summarizes epidemiological studies exploring the association between periodontitis and genitourinary cancers. We have also highlighted the current evidence demonstrating the capacity of oral microbiota to regulate almost all hallmarks of cancer, and proposed the potential mechanisms of oral microbiota in the development of genitourinary cancers.
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Affiliation(s)
- Shuai Yuan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Cheng Fang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Lan Wu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Bing-Hui Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. .,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
| | - Hailiang Hu
- Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, USA. .,School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China.
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China. .,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
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Wei Y, Zhong Y, Wang Y, Huang R. Association between periodontal disease and prostate cancer: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2021; 26:e459-e465. [PMID: 33247563 PMCID: PMC8254894 DOI: 10.4317/medoral.24308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/16/2020] [Indexed: 02/05/2023] Open
Abstract
Background Periodontal disease is a chronic infectious disease caused by bacterial infection which may lead to various systematic diseases. Recently, increasing studies have explored the correlation of periodontal disease with the risk of prostate cancer. However, the findings were inconsistent. Hence, this study aims to investigate the association between periodontal disease and the risk of prostate cancer by a meta-analysis.
Material and Methods PubMed, EMBASE, and Cochrane were searched for publications up to July 17, 2020. Cohort and case-control studies evaluating the risk of prostate cancer in patients with periodontal disease were included. A fixed or random-effect model was used to calculate the summary relative risk (RR) along with 95% confidence interval (CI). All analyses were conducted using Stata 12.0 software.
Results Seven studies were included in the final analysis. The pooled estimates showed that periodontal disease was significantly associated with the risk of prostate cancer (RR = 1.17; 95% CI = 1.07-1.27; P = 0.001). Findings of sensitivity analyses proved that the overall results were robust.
Conclusions Periodontal disease may be considered as a potential risk factor for prostate cancer. Although it’s a possibility, males should be more aware of their oral health and implement effective measures to prevent and treat periodontal disease. Key words:Periodontal disease, periodontitis, prostate cancer, meta-analysis
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Affiliation(s)
- Y Wei
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases Dept. of Pediatric Dentistry, West China Hospital of Stomatology Sichuan University, Chengdu, P. R. China
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11
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Periodontal Disease and Tooth Loss Are Associated with Lung Cancer Risk. BIOMED RESEARCH INTERNATIONAL 2021; 2020:5107696. [PMID: 32802852 PMCID: PMC7403933 DOI: 10.1155/2020/5107696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 01/11/2023]
Abstract
Background The associations between periodontal disease, tooth loss, and lung cancer risk remain debatable. Therefore, the purpose of the present study is to evaluate whether periodontal disease and tooth loss are associated with lung cancer risk. Methods A literature search was performed for relevant studies using PubMed and Embase databases. Risk ratio (RR) with 95% confidence interval (CI) was applied as effect size to summarize the associations between periodontal disease, tooth loss, and lung cancer risk. A further dose-response analysis was also performed. Results A total of twelve studies comprising 263,238 participants were included. The results indicated that periodontal disease was positively associated with lung cancer risk (RR = 1.37, 95%CI = 1.16‐1.63). There was a positive association between tooth loss and lung cancer risk (RR = 1.69, 95%CI = 1.46‐1.96). Moreover, there was a significantly linear dose-response relationship between tooth loss and lung cancer risk, and every 5 increment in tooth loss was associated with 10% increased lung cancer risk. Similar results were obtained in subgroup analysis. Conclusions Periodontal disease and tooth loss are increased risk factors for lung cancer. Prevention and treatment of periodontal disease may be effective potential prevention strategies for lung cancer.
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12
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Guo Z, Gu C, Li S, Gan S, Li Y, Xiang S, Gong L, Wang S. Periodontal disease and the risk of prostate cancer: a meta-analysis of cohort studies. Int Braz J Urol 2021; 47:1120-1130. [PMID: 33650836 PMCID: PMC8486441 DOI: 10.1590/s1677-5538.ibju.2020.0333] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/19/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Periodontal disease is reportedly associated with the risk of various systemic diseases, including pancreatic and lung cancers. However, its association with prostate cancer remains inconclusive. Herein, we explored the association of periodontal disease with the risk of prostate cancer through a meta-analysis. Materials and Methods: MEDLINE, Embase, Web of Sciences and Cochrane Library databases were searched for eligible publications up to April 2020. Multivariate adjusted risk estimates with corresponding 95% confidence intervals (CIs) were extracted and calculated using random- or fixed-effect models. Results: Nine cohort studies involving 3.353 prostate cancer cases with 440.911 participants were identified and included in the meta-analysis. We found that periodontal disease significantly increased the risk of prostate cancer by 1.40-fold (hazard ratio [HR]=1.40, 95% CI: 1.16-1.70; P=0.001; I2=76.1%) compared with normal condition. Interestingly, the risk of developing prostate cancer was not significant in patients treated with periodontal therapy (HR=1.22, 95% CI: 0.86-1.73; P=0.272; I2=65.2%). The results of subgroup analyses were also consistent and significant when stratified by study design and follow-up period, whereas conflicting results were observed in periodontal disease ascertainment stratification. These findings were robust as indicated by sensitivity analyses. Conclusions: Periodontal disease was associated with the increased risk of prostate cancer, whereas no significant association was observed in patients treated with periodontal therapy. Hence, the awareness and importance for maintaining oral health should be improved, and the underlying mechanisms linking periodontal disease and prostate cancer should be fully explored in future research.
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Affiliation(s)
- Zhenlang Guo
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chiming Gu
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Siyi Li
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shu Gan
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan Li
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Songtao Xiang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Leiliang Gong
- Department of mechanical engineering, National University of Singapore, Kent Ridge, Singapore
| | - Shusheng Wang
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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13
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Falz R, Thieme R, Tegtbur U, Bischoff C, Leps C, Hillemanns P, Kohlhaw K, Klempnauer J, Lordick F, Stolzenburg JU, Aktas B, Weitz J, Bork U, Wimberger P, Thomas C, Biemann R, Jansen-Winkeln B, Schulze A, Gockel I, Busse M. CRBP-TS - evaluation of a home-based training and health care program for colorectal, breast, and prostate cancer using telemonitoring and self-management: study protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:15. [PMID: 33622370 PMCID: PMC7901214 DOI: 10.1186/s13102-021-00244-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/07/2021] [Indexed: 01/19/2023]
Abstract
Background Physical training is recommended in various national and international guidelines for patients with cancer. Observational studies have shown that physical activity leads to reduced recurrence and mortality rates by 20–40% in colorectal, breast, and prostate cancer. Despite existing evidence, a systematic care structure is still lacking. The primary aim of this study is to implement and evaluate an online training platform to strengthen physical performance and patient empowerment after cancer surgery. Methods The evaluation will be conducted as a prospective multicenter randomized controlled trial with three subgroups (colorectal-, breast-, and prostate cancer). Each group will include 100 patients (total 300 patients including dropouts; clinical stages T1–3 and/or N+; M0 after surgery intervention) and the primary endpoint (13% increase in the maximal oxygen consumption during exercise) will be examined. The intervention group will receive a 6-month home-based online training (2–3 times per week strength-endurance training using video presentations), bidirectional activity feedback information, online communication, and online counseling. The control group (usual care) will be advised lifestyle improvement. In-hospital testing will be performed before, during, and after the intervention. In addition to cardiopulmonary capacity, tumor specific diagnostics (liquid biopsy, depression and fatigue assessment, metabolic and endothelial screening) will be applied. Discussion Due to the increasing incidence of cancer, associated with considerable mortality, morbidity and impaired quality of life, there is an imperative requirement for improved cancer care, of which structured physical training may become an integral component. Trial registration DRKS-ID: DRKS00020499; Registered 17 March 2020.
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Institute of Sport Medicine, Hannover Medical School, Hannover, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Christian Leps
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Kay Kohlhaw
- Department of Surgery, Sana Hospitals "Leipziger Land", Borna, Germany
| | - Jürgen Klempnauer
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Florian Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany.,University Cancer Center Leipzig, University Hospital Leipzig, Leipzig, Germany
| | | | - Bahriye Aktas
- Department of Gynaecology, University Hospital Leipzig, Leipzig, Germany
| | - Jürgen Weitz
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Ulrich Bork
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Pauline Wimberger
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Thomas
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Boris Jansen-Winkeln
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
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14
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Badewy R, Singh H, Quiñonez C, Singhal S. Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review. Health Serv Insights 2021; 14:1178632921989734. [PMID: 33597810 PMCID: PMC7841244 DOI: 10.1177/1178632921989734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.
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Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
| | | | - Carlos Quiñonez
- Faculty of Dentistry, Director of
Graduate Program in Dental Public Health, University of Toronto, Toronto, ON,
Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON,
Canada
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15
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Fang C, Wu L, Zhu C, Xie WZ, Hu H, Zeng XT. A potential therapeutic strategy for prostatic disease by targeting the oral microbiome. Med Res Rev 2020; 41:1812-1834. [PMID: 33377531 PMCID: PMC8246803 DOI: 10.1002/med.21778] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/22/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022]
Abstract
Nowadays, human microbiome research is rapidly growing and emerging evidence has witnessed the critical role that oral microbiome plays in the process of human health and disease. Oral microbial dysbiosis has been confirmed as a contributory cause for diseases in multiple body systems, ranging from the oral cavity to the gastrointestinal, endocrine, immune, cardiovascular, and even nervous system. As research progressing, oral microbiome‐based diagnosis and therapy are proposed and applied, which may represent potential drug targets in systemic diseases. Recent studies have uncovered the possible association between periodontal disease and prostatic disease, suggesting new prevention and therapeutic treatment for the disease by targeting periodontal pathogens. Thus, we performed this review to first explore the association between the oral microbiome and prostatic disease, according to current knowledge based on published articles, and then mainly focus on the underlying molecular and cellular mechanisms and the potential prevention and treatment derived from these mechanistic studies.
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Affiliation(s)
- Cheng Fang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Lan Wu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Cong Zhu
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wen-Zhong Xie
- Department of Stomatology, Kaifeng University Health Science Center, Kaifeng, Henan, China
| | - Hailiang Hu
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA.,School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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16
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Larvin H, Wilmott S, Wu J, Kang J. The Impact of Periodontal Disease on Hospital Admission and Mortality During COVID-19 Pandemic. Front Med (Lausanne) 2020; 7:604980. [PMID: 33330570 PMCID: PMC7719810 DOI: 10.3389/fmed.2020.604980] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: COVID-19 has had a huge impact on society and healthcare and it has been suggested that people with periodontal disease are at risk of having worse outcomes from the disease. The aim of this study was to quantify the impact of periodontal disease on hospital admission and mortality during the COVID-19 pandemic. Materials and Methods: The study extracted UK Biobank participants who had taken a COVID-19 test between March and June 2020 (n = 13,253), of which 1,616 were COVID-19 positive (12%) and 11,637 were COVID-19 negative (88%). Self-reported oral health indicators of painful or bleeding gums and loose teeth were used as surrogates for periodontal disease, participants who did not report any of the aforementioned indicators were used as controls. Multivariable logistic regressions were used to obtain crude and adjusted odds ratios of COVID-19 infection, subsequent hospital admission and mortality adjusted for demographics, BMI, biomarkers, lifestyle and co-morbidities. Results: Painful gums, bleeding gums and loose teeth were reported in 2.7, 11.2 and 3.3% of participants with COVID-19 infection, respectively. Risk of COVID-19 infection in participants with painful or bleeding gums and loose teeth compared to controls was not increased (odds ratio [OR]: 1.10, 95% CI: 0.72–1.69; OR: 1.15, 95% CI: 0.84–1.59). COVID-19 positive participants with painful or bleeding gums had a higher risk of mortality (OR: 1.71, 95% CI: 1.05–2.72) but not hospital admission (OR: 0.90, 95% CI: 0.59–1.37). Participants with loose teeth did not show higher risk of hospital admission or mortality compared to the control group (OR = 1.55, 95% CI: 0.87–2.77; OR: 1.85; 95% CI: 0.92–2.72). Conclusion: There was insufficient evidence to link periodontal disease with an increased risk of COVID-19 infection. However, amongst the COVID-19 positive, there was significantly higher mortality for participants with periodontal disease. Utilization of linked dental and hospital patient records would improve the understanding of the impact of periodontal disease on COVID-19 related outcomes.
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Affiliation(s)
- Harriet Larvin
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Sheryl Wilmott
- Leeds Dental Institute, Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, United Kingdom.,Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom
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17
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Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses 2020; 144:109969. [PMID: 32592918 PMCID: PMC7303044 DOI: 10.1016/j.mehy.2020.109969] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations.
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Affiliation(s)
- Viviana Pitones-Rubio
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - E G Chávez-Cortez
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Angélica Hurtado-Camarena
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Anna González-Rascón
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico
| | - Nicolás Serafín-Higuera
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California 21040, Mexico.
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18
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Fu E, Cheng CM, Chung CH, Lee WC, Chen WL, Sun GH, Chien WC. Association of chronic periodontitis with prostatic hyperplasia and prostatitis: A population-based cohort study in Taiwan. J Periodontol 2020; 92:72-86. [PMID: 32627845 DOI: 10.1002/jper.19-0706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/30/2020] [Accepted: 05/05/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Association between periodontitis and prostate diseases of benign prostatic hyperplasia (BPH) and prostatitis is uncertain. METHODS From the National Health Insurance Research Database of Taiwan, 5,510 patients with newly diagnosed chronic periodontitis and participated in therapies were selected from 2000 to 2015 as cohort 1. Matched with age and index year, 5,510 patients with periodontitis diagnosis without therapy were selected as cohort 2, and 5,510 participants without diagnosis were used as control. Cox proportional hazard and survival analysis were performed to compare the risks and the survival probabilities among cohorts. RESULTS In two periodontitis cohorts, 636 and 638 participants compared with 550 in control (1,174 and 1,187 versus 989 per 100,000 person-years) had prostate disorder. Difference was identified for prostatitis (n = 68, 70 versus 34; rate = 125, 130 versus 61 /100,000 person-years; P <0.001) but not for BPH (n = 577, 575, versus 529; rate = 1,065, 1,070 versus 951 /100,000 person-years, respectively). Different survival probabilities for prostate disorder and prostatitis, but not for BPH, were observed among cohorts. Periodontitis patients were more likely to develop prostate disorder after adjustment (adjusted hazard ratio [aHR] of 2.590 to 2.641 by competing model). With stratification, risks between two periodontitis cohorts exhibited no difference. When BPH cases were excluded, the aHRs for prostatitis were 4.611 to 4.798. CONCLUSIONS Despite treatment, the patients with periodontitis had higher risk of developing prostatitis than patients without periodontitis.
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Affiliation(s)
- Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Xindian, Taiwan, ROC.,Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chia-Mao Cheng
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Xindian, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, ROC
| | - Wei-Cheng Lee
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wei-Liang Chen
- Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.,School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Guang-Huan Sun
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, ROC.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
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19
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Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000 2020; 83:213-233. [PMID: 32385885 PMCID: PMC7328760 DOI: 10.1111/prd.12329] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Epidemiologic and cancer control studies on the association of periodontal disease and cancer risk mostly suggest a positive association with overall cancer risk and certain specific types of cancer. These findings are generally consistent among cross‐sectional and longitudinal studies. In this paper, we review epidemiologic studies and current knowledge on periodontal disease and cancer, with a focus on those studies conducted in the years following the Joint European Federation of Periodontology/American Academy of Periodontology Workshop on “Periodontitis and Systemic Diseases” in November 2012. This review also explores the role of chronic inflammation as a biologically plausible mechanistic link between periodontal disease and risk of cancer. Furthermore, it highlights studies that have examined the potential importance of certain periodontal pathogens in this association.
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Affiliation(s)
- Ngozi Nwizu
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, USA.,School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA.,Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, USA
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA
| | - Robert J Genco
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, USA
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20
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Kim DH, Jeong SN, Lee JH. Chronic Periodontal Disease increases risk for Prostate Cancer in Elderly individuals in South Korea: a Retrospective Nationwide Population-based Cohort Study. J Cancer 2020; 11:4716-4723. [PMID: 32626518 PMCID: PMC7330688 DOI: 10.7150/jca.45369] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/17/2020] [Indexed: 12/25/2022] Open
Abstract
Objectives: The association between prostate cancer (PC) and chronic periodontal disease (PD) has been evaluated in previous studies, but results have been inconsistent. This study aimed to determine whether the presence of chronic PD in old age increases the risk of PC using data in the large-scale elderly cohort. Materials and Methods: This nationwide population-based cohort study examined data of 121,240 South Korean individuals aged ≥ 60 years from the National Health Insurance Service-Elderly Cohort database who completed a national program between 2002 and 2015. For a maximum 10 years' observation period, patients with incident PC with chronic PD compared with those without chronic PD were retrospectively tracked, and Cox proportional hazard ratios and 95% confidence intervals (CIs) were calculated, adjusted for potential confounding factors, including age, household income, insurance status, Charlson Comorbidity Index, hypertension, diabetes mellitus, cerebral infarction, angina pectoris, myocardial infarction, prostatitis, smoking status, daily smoking, alcohol intake habits, one-time alcohol intake, and regular exercise. Results: The overall incidence of PC with chronic PD in 10 years was 3.0% (n = 2,063). In the multivariate Cox analysis with adjustment for confounding factors, chronic PD was associated with a 24% higher risk of PC (95% CI = 1.16-1.32, P < 0.001). Conclusion: Our results suggest that chronic PD is significantly and positively associated with PC. Larger and better-controlled studies are needed to strengthen this evidence of association and explain the underlying biological mechanisms.
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Affiliation(s)
- Do-Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
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21
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Kim DH, Jeong SN, Lee JH. Severe periodontitis with tooth loss as a modifiable risk factor for the development of Alzheimer, vascular, and mixed dementia: National Health Insurance Service-National Health Screening Retrospective Cohort 2002-2015. J Periodontal Implant Sci 2020; 50:303-312. [PMID: 33124208 PMCID: PMC7606895 DOI: 10.5051/jpis.2000600030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/14/2020] [Accepted: 05/08/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose The purpose of this study was to evaluate severe periodontitis with tooth loss as a modifiable risk factor for Alzheimer dementia (AD), vascular dementia (VaD), and mixed dementia (MD) using the National Health Insurance Service-National Health Screening Retrospective Cohort database with long-term follow-up over 14 years. Methods Multivariate Cox hazards regression analysis was applied to a longitudinal retrospective database, which was updated in 2018, to evaluate the association between severe periodontitis with few remaining teeth and dementia after adjusting for potential risk factors, including sociodemographic factors and comorbid diseases. Results Among 514,866 individuals in South Korea, 237,940 (46.2%) participants satisfying the inclusion criteria were selected. A total of 10,115 age- and sex-matched participants with severe periodontitis and 10,115 periodontally healthy participants were randomly selected and evenly assigned. The results showed that the risks of AD (hazard ratio [HR], 1.08), VaD (HR, 1.24), and MD (HR, 1.16) were significantly higher in patients with severe periodontitis with 1–9 remaining teeth after adjustment for sociodemographic factors, anthropomorphic measurements, lifestyle factors, and comorbidities. Conclusions Severe periodontitis with few remaining teeth (1–9) may be considered a modifiable risk factor for the development of AD, VaD, and MD in Korean adults.
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Affiliation(s)
- Do Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jae Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea.
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Ma H, Zheng J, Li X. Potential risk of certain cancers among patients with Periodontitis: a supplementary meta-analysis of a large-scale population. Int J Med Sci 2020; 17:2531-2543. [PMID: 33029095 PMCID: PMC7532473 DOI: 10.7150/ijms.46812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Some studies have reported biological linkages between periodontitis and esophageal cancer, prostate cancer, kidney cancer, hematological malignancy, and melanoma of the skin. This meta-analysis aimed to assess the relationship between periodontitis and the aforementioned five cancers. Methods: Eligible studies on the association between periodontitis and the aforementioned five kinds of cancers were retrieved. The statistical analysis was conducted using Stata 12.0. Results: Ten articles (more than 100,000 samples for most cancers) were included. With statistical significance, participants with periodontitis might have enhanced risks of esophageal cancer (HR = 1.79, 95% CI: 1.15-2.79), prostate cancer (HR = 1.20, 95% CI: 1.09-1.31), hematological malignancy (HR = 1.19, 95% CI: 1.09-1.29), and melanoma of skin (HR = 1.21, 95% CI: 1.03-1.42), compared with those without periodontitis. However, the evidence regarding the correlation between periodontitis and the susceptibility to kidney cancer was lacking (HR=1.30, 95% CI: 0.96-1.76). Conclusions: The present meta-analysis revealed a potential link between periodontitis and esophageal cancer, prostate cancer, hematological malignancy, and melanoma of the skin. However, multi-center studies with large sample sizes and multivariable adjustments are still needed to support the conclusion.
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Affiliation(s)
- Haozhen Ma
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, 510055 Guangzhou/PR. China.,Guanghua School of Stomatology, Sun Yat-sen University, 510055 Guangzhou/PR. China
| | - Jianmao Zheng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, 510055 Guangzhou/PR. China.,Guanghua School of Stomatology, Sun Yat-sen University, 510055 Guangzhou/PR. China
| | - Xiaolan Li
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, 510055 Guangzhou/PR. China.,Guanghua School of Stomatology, Sun Yat-sen University, 510055 Guangzhou/PR. China
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Lorenzo‐Pouso AI, Pérez‐Sayáns M, Chamorro‐Petronacci C, Gándara‐Vila P, López‐Jornet P, Carballo J, García‐García A. Association between periodontitis and medication‐related osteonecrosis of the jaw: A systematic review and meta‐analysis. J Oral Pathol Med 2019; 49:190-200. [DOI: 10.1111/jop.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/14/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Alejandro I. Lorenzo‐Pouso
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Mario Pérez‐Sayáns
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Cintia Chamorro‐Petronacci
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Pilar Gándara‐Vila
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Pía López‐Jornet
- Faculty of Medicine Department of Oral Medicine Regional Campus of International Excellence "Campus Mare Nostrum" University of Murcia Espinardo Murcia Spain
| | - Javier Carballo
- Faculty of Sciences Department of Food Technology University of Vigo‐Ourense Campus Ourense Spain
| | - Abel García‐García
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
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Huang Y, Michaud DS, Lu J, Carter HB, Platz EA. The association between clinically determined periodontal disease and prostate-specific antigen concentration in men without prostate cancer: the 2009-2010 National Health and Nutrition Examination Survey. Cancer Causes Control 2019; 30:1293-1300. [PMID: 31637561 DOI: 10.1007/s10552-019-01238-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE We evaluated the association between clinically assessed periodontal disease and serum prostate-specific antigen (PSA) concentration in men without a prostate cancer diagnosis in a US nationally representative sample of non-institutionalized men. METHODS Included were 1263 men aged ≥ 40 years who participated in the National Health and Nutrition Examination Survey in 2009-2010. Measurements of periodontal health and tooth count were used to define periodontal disease severity (no, mild, moderate, severe) and edentulism. Linear and logistic regressions were used to estimate the association of periodontal disease severity and edentulism with PSA concentration and elevated PSA, respectively. RESULTS Adjusting for age and other factors including race, body mass index, and education, the natural logarithm of PSA concentration did not change with increasing severity (mild - 0.20, 95% confidence interval [CI] - 0.34 to - 0.05; moderate - 0.12, 95% CI - 0.26 to 0.01; severe - 0.16, 95% CI - 0.43 to 0.12; edentulism - 0.16, 95% CI - 0.35 to 0.04; P-trend 0.13) compared with dentate men without periodontal disease. Although the multivariable-adjusted ORs of elevated PSA were not statistically significant, participants with more severe periodontal disease were less likely to have PSA > 2.0 and > 2.5 ng/mL, but more likely to have PSA > 4.0 ng/mL, compared to dentate men without periodontal disease. Similar non-significant associations with PSA were observed when comparing edentulous men to dentate men without periodontal disease. CONCLUSIONS In this US nationally representative sample, men with periodontal disease did not have higher serum PSA and were not more likely to have clinically elevated PSA after taking into account age and other factors, contrary to the hypothesis. This study suggests that periodontal disease does not notably affect the specificity of PSA for prostate cancer screening.
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Affiliation(s)
- Yuhan Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6132, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, USA
| | - Jiayun Lu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6132, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - H Ballentine Carter
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6132, 615 N Wolfe St, Baltimore, MD, 21205, USA. .,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
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25
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Kim YJ. Oral health of high-cost patients and evaluation of oral health measures as predictors for high-cost patients in South Korea: a population-based cohort study. BMJ Open 2019; 9:e032446. [PMID: 31515435 PMCID: PMC6747678 DOI: 10.1136/bmjopen-2019-032446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To examine the oral health conditions and oral health behaviour of high-cost patients and evaluate oral health measures as predictors of future high-cost patients. DESIGN A retrospective, population-based cohort study using administrative healthcare records. SETTING The National Health Insurance Service (NHIS) medical check-up database (a.k.a. NHIS-national health screening cohort database) in South Korea. PARTICIPANTS 131 549 individuals who received biennial health check-ups including dental check-ups in 2011 or 2012, aged 49-88. PRIMARY OUTCOME MEASURES Current and subsequent year high-cost patient status. RESULTS High-cost patients, on average, incur higher dental costs, suffer more from periodontal disease, brush their teeth less and use secondary oral hygiene products less. Some of the self-reported oral health behaviours and oral symptom variables show statistically significant associations with subsequent year high-cost patient indicators, even after adjusting for demographic, socioeconomic, medical conditions, and prior healthcare cost and utilisation. CONCLUSIONS We demonstrate that oral health measures are associated with an increased risk of becoming a high-cost patient.
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Affiliation(s)
- Yeonkook Joseph Kim
- College of Business, Chungbuk National University, Cheongju, Republic of Korea
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26
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Blaschke K, Seitz MW, Schubert I, Listl S. Methodological approaches for investigating links between dental and chronic diseases with claims data: A scoping study. J Public Health Dent 2019; 79:334-342. [PMID: 31418874 DOI: 10.1111/jphd.12335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The purpose of this study was to provide an overview of methodological approaches to assess the relationship between dental diseases and other noncommunicable diseases on the basis of claims data. METHODS Based on the methodological framework of Arksey and O'Malley, a scoping study was conducted. By searching electronic databases (PubMed, Web of Science, and LILACS), appropriate articles were identified. After extracting relevant information and entering it into a data-charting form, the study characteristics and the methodological approaches were summarized descriptively. RESULTS Fifty-one articles were identified for inclusion in the analysis. Most of the selected studies (78 percent) originated from Taiwan and employed a cohort design. The majority of studies considered dental diseases, particularly periodontal disease (PD) measures, but no common standard was identified for the definition of PD. Unmeasured confounding, misclassification, and surveillance bias were reported to be the main limitations of the claims data analyses. CONCLUSIONS Claims data provide a very useful information source to further delineate the relationship between PDs and other noncommunicable diseases. If diagnostic codes are available, they seem to be the most suitable tool to assess PD in claims-based studies. In databases that do not contain dental diagnostic codes, e.g., databases in Germany and the United States, the identification of PD is a particular challenge. The inclusion of dental diagnostic codes in all claims databases is strongly recommended. Due to the public health relevance of PD, there is a need for more comprehensive documentation of dental parameters within claims data.
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Affiliation(s)
- Katja Blaschke
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Max W Seitz
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Ingrid Schubert
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefan Listl
- Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.,Department of Dentistry - Quality and Safety of Oral Healthcare, Radboudumc (RIHS), Radboud University, Nijmegen, The Netherlands
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Kim YT, Choi JK, Kim DH, Jeong SN, Lee JH. Association between health status and tooth loss in Korean adults: longitudinal results from the National Health Insurance Service-Health Examinee Cohort, 2002-2015. J Periodontal Implant Sci 2019; 49:158-170. [PMID: 31285940 PMCID: PMC6599754 DOI: 10.5051/jpis.2019.49.3.158] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/09/2019] [Accepted: 06/10/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose This study investigated the association between health status and tooth loss based on data from the National Health Insurance Service-Health Examinee Cohort in 2002–2015. Methods Multivariate Cox proportional hazards regression analyses were applied to a longitudinal retrospective database, which was updated and newly released in 2018, to assess the association between health status and tooth loss while adjusting for potential confounders among sociodemographic and economic factors (sex, age, household income, insurance, and presence of disability), general and oral health status (body mass index [BMI], smoking and drinking status, periodic dental visits and scaling, and brushing before sleep), and comorbid disease (hypertension, diabetes mellitus [DM], and Charlson comorbidity index [CCI]). Results Among 514,866 participants from a South Korean population, 234,247 (45.5%) participants satisfying the inclusion criteria were analyzed. In the adjusted multivariate analysis, sex, age, household income, insurance, presence of disability, BMI, smoking and drinking status, periodic scaling, tooth brushing before sleep, DM, and CCI showed statistically significant associations with the loss of at least 1 tooth. The risk of experiencing a loss of ≥4 teeth was associated with an increase in age (in those 50–59 years of age: hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.93–2.03; in those 60–69 years of age: HR, 2.93; 95% CI, 2.85–3.02; and in those 70–79 years of age: HR, 2.93; 95%, CI 2.81–3.05), smoking (HR, 1.69; 95% CI, 1.65–1.73), and DM (HR, 1.43; 95% CI, 1.38–1.48). Conclusions The results of this study showed that the risk of experiencing tooth loss was related to multiple determinants. DM and smoking were especially significantly associated with tooth loss.
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Affiliation(s)
- Yeon-Tae Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, Korea
| | - Do-Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
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28
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Güven DC, Dizdar Ö, Akman AC, Berker E, Yekedüz E, Ceylan F, Başpınar B, Akbıyık İ, Aktaş BY, Yüce D, Erman M, Hayran M. Evaluation of cancer risk in patients with periodontal diseases. Turk J Med Sci 2019; 49:826-831. [PMID: 31195790 PMCID: PMC7018248 DOI: 10.3906/sag-1812-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background/aim In this study, we aimed to assess the cancer risk among patients with periodontal disease. Materials and methods Patients diagnosed with periodontal diseases at Hacettepe University between 2007 and 2012 were included and data on the diagnosis of any cancer after periodontal disease were collected from patient files. The age- and sex-standardized incidence rates (SIRs) were calculated using Turkish National Cancer Registry 2013 data. Results A total of 5199 patients were included. Median follow-up was 7.2 years. Patients with periodontal diseases had 17% increased risk of cancer compared with the expected counts for the corresponding age and sex groups (SIR: 1.17; 95% CI: 1.04–1.3, P = 0.006). The increased cancer risk was statistically significant in women (SIR: 1.24; 95% CI: 1.05–1.45, P = 0.008) but not in men. Among women with periodontal disease, the risks of breast cancer (SIR: 2.19) and head and neck cancer (SIR: 4.71) were significantly increased. Among men, the risks of prostate cancer (SIR: 1.84), head and neck cancer (SIR: 3.55), and hematological cancers (SIR: 1.76) were significantly increased. Conclusion This study showed that periodontal diseases were associated with increased risk of several cancers. Besides other well-known benefits for health, the provision of oral/dental health should be considered and employed as a cancer prevention measure.
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Affiliation(s)
- Deniz Can Güven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ömer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Abdullah Cevdet Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ezel Berker
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Emre Yekedüz
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Furkan Ceylan
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Batuhan Başpınar
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İlgın Akbıyık
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burak Yasin Aktaş
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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da Silva APB, Alluri LSC, Bissada NF, Gupta S. Association between oral pathogens and prostate cancer: building the relationship. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2019; 7:1-10. [PMID: 30906801 PMCID: PMC6420702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Chronic inflammation and infections are associated with increased risk of prostate cancer development. There is considerable evidence that proves the interrelationship between bacterial/viral infections and carcinogenesis. Periodontitis is a chronic inflammatory disease triggered by gram-negative anaerobic bacteria. In this narrative review, we investigate the relationship between periodontal disease and prostate cancer by reviewing previous studies of the association and possible mechanisms that may explain this link. METHODS A comprehensive search for articles published was performed using the key words, "periodontal disease", "prostate disease", "prostate cancer", "prostatic inflammation". Thorough reviews of each study were conducted and assessed for eligibility, and data was summarized. RESULTS The role of inflammatory responses in the prostate as drivers of malignancy appears to be predisposed by periodontal pathogens and/or periodontitis inflammatory mediators. CONCLUSION Periodontal diseases might be associated with prostate cancer. However, the mechanism(s) explaining this relationship remains unclear and requires further elucidation.
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Affiliation(s)
- Andre Paes B da Silva
- Department of Periodontics, Case Western Reserve University, School of Dental MedicineCleveland 44106, Ohio
| | - Leela Subhashini C Alluri
- Department of Periodontics, Case Western Reserve University, School of Dental MedicineCleveland 44106, Ohio
| | - Nabil F Bissada
- Department of Periodontics, Case Western Reserve University, School of Dental MedicineCleveland 44106, Ohio
| | - Sanjay Gupta
- Department of Urology, Case Western Reserve University, School of Dental MedicineCleveland 44106, Ohio
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Dysregulated Phosphate Metabolism, Periodontal Disease, and Cancer: Possible Global Health Implications. Dent J (Basel) 2019; 7:dj7010018. [PMID: 30754693 PMCID: PMC6473307 DOI: 10.3390/dj7010018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/31/2019] [Accepted: 02/06/2019] [Indexed: 01/08/2023] Open
Abstract
An association between periodontal disease and cancer has been established in recent studies, but no common etiology has been identified in the hopes of reducing the global burden of these non-communicable diseases. This perspective article hypothesizes that the determinant mediating the association of periodontal disease with cancer is dysregulated phosphate metabolism. Phosphate, an essential dietary micronutrient, is dysregulated in chronic kidney disease, and both cancer and periodontal disease are associated with chronic kidney disease. Reviewed evidence includes the association between phosphate toxicity and cancer development, and the association between periodontal disease and chronic kidney disease-mineral and bone disorder includes conditions such as ectopic calcification and bone resorption, which may be indirectly related to periodontal disease. Dental calculus in periodontal disease contains calcium phosphate crystals that are deposited from excess calcium and phosphate in saliva. Alveolar bone resorption may be linked systemically to release of parathyroid hormone in response to hypocalcemia induced by hyperphosphatemia. More research is needed to examine the role of dysregulated phosphate metabolism in periodontal disease.
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Lee JH, Jeong SN, Choi SH. Predictive data mining for diagnosing periodontal disease: the Korea National Health and Nutrition Examination Surveys (KNHANES V and VI) from 2010 to 2015. J Public Health Dent 2018; 79:44-52. [PMID: 30468241 DOI: 10.1111/jphd.12293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/17/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study aimed to identify patients with the highest risk of periodontal disease (PD), and to provide recommendations for the effective use and application of data mining (DM) techniques when establishing evidence-based dental-care policies for vulnerable groups at a high risk of PD. METHODS This study used the SEMMA (Sample, Explore, Modify, Model, and Assess) methodology to construct DM models based on data acquired from the fifth and sixth Korea National Health and Nutrition Examination Surveys (2000-2015). We analyzed the sociodemographic and comorbidity variables that influence PD by applying the popular DM techniques of decision-tree, neural-network, and regression models, and also attempted to improve the predictive power and reliability by comparing the results obtained by these three models. RESULTS Our comparisons of the three DM algorithms confirmed that the average squared error, misclassification rate, receiver operating characteristic index, Gini coefficient, and Kolmogorov-Smirnov test results were the most appropriate for the decision-tree model. The analysis of the decision-tree model revealed that age and smoking status exert major effects on the risk of PD, and that stress and education level exert effects in rural areas, whereas education level, sex, hyperlipidemia, and alcohol intake exert effects in urban areas. CONCLUSIONS We demonstrated that the decision-tree model is an effective DM technique for identifying the complex risk factors for PD. These results are expected to be helpful in improving the equality and efficacy of dental-care policies for vulnerable groups at a high risk of PD.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Lee JH, Kim DH, Jeong SN, Choi SH. Diagnosis and prediction of periodontally compromised teeth using a deep learning-based convolutional neural network algorithm. J Periodontal Implant Sci 2018; 48:114-123. [PMID: 29770240 PMCID: PMC5944222 DOI: 10.5051/jpis.2018.48.2.114] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/23/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose The aim of the current study was to develop a computer-assisted detection system based on a deep convolutional neural network (CNN) algorithm and to evaluate the potential usefulness and accuracy of this system for the diagnosis and prediction of periodontally compromised teeth (PCT). Methods Combining pretrained deep CNN architecture and a self-trained network, periapical radiographic images were used to determine the optimal CNN algorithm and weights. The diagnostic and predictive accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve, area under the ROC curve, confusion matrix, and 95% confidence intervals (CIs) were calculated using our deep CNN algorithm, based on a Keras framework in Python. Results The periapical radiographic dataset was split into training (n=1,044), validation (n=348), and test (n=348) datasets. With the deep learning algorithm, the diagnostic accuracy for PCT was 81.0% for premolars and 76.7% for molars. Using 64 premolars and 64 molars that were clinically diagnosed as severe PCT, the accuracy of predicting extraction was 82.8% (95% CI, 70.1%–91.2%) for premolars and 73.4% (95% CI, 59.9%–84.0%) for molars. Conclusions We demonstrated that the deep CNN algorithm was useful for assessing the diagnosis and predictability of PCT. Therefore, with further optimization of the PCT dataset and improvements in the algorithm, a computer-aided detection system can be expected to become an effective and efficient method of diagnosing and predicting PCT.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Do-Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Lee JH, Choi JK, Jeong SN, Choi SH. Charlson comorbidity index as a predictor of periodontal disease in elderly participants. J Periodontal Implant Sci 2018; 48:92-102. [PMID: 29770238 PMCID: PMC5944227 DOI: 10.5051/jpis.2018.48.2.92] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods Nationwide representative samples of 149,785 adults aged ≥60 years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ≥2: HR, 1.12, P<0.001). Conclusions We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Boyapati R, Swarna C, Devulapalli N, Sanivarapu S, Katuri KK, Kolaparthy L. Unveiling the Link between Prostatitis and Periodontitis. Contemp Clin Dent 2018; 9:524-529. [PMID: 31772457 PMCID: PMC6868634 DOI: 10.4103/ccd.ccd_746_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: One of the important tumor markers having critically important applications in every aspect of treating men with prostatic illness is prostate-specific antigen (PSA), formed by prostate acini's epithelial cells. Where prostate is affected by inflammation or malignancy, the PSA levels rise to/and above 4 ng/ml. This study analyzes the interlink between different severity of periodontitis and prostatitis by assessment of PSA antigen levels and periodontal clinical parameters. Materials and Methods: In this study, 100 chronic prostatitis patients diagnosed to also have periodontal diseases were divided into four batches on the basis of the nature of prostatitis and levels of periodontal clinical attachment. The grouping was as: group 1A – clinical attachment level (CAL) <3 mm and mild prostatitis, Group 2A – CAL ≥3 mm and mild prostatitis, and Group 1B – CAL <3 mm and moderate-to-severe prostatitis, Group 2B – CAL ≥3 mm and moderate-to-severe prostatitis. Readings of CAL, probing pocket depth, bleeding on probing, plaque index, and gingival index (PI and GI) were recorded, followed by calculation and assessment of PSA values and correlation of periodontal parameters, respectively. Results: An important and affirmative correlation (r = 0.5549, P < 0.05) was seen between PSA and CAL scores at significance level of 5%, and also between PSA and probing depths (PD) scores at 5% (r = 0.5315, P < 0.05), indicating that PSA and CAL scores, as also PSA and PD scores are mutually dependent. The similar positive correlation was seen between PSA with PI (r = 0.3231, P < 0.05) and GI (r = 0.3567, P < 0.05) scores, respectively, at 5% level of significance, which shows PSA is also mutually dependent on PI and GI scores. Conclusion: Patients with of grades, moderate-to-severe prostatitis as well as periodontitis were found having higher PSA levels. The clinical readings of periodontal parameters were significantly higher in patients with moderate-to-severe prostatitis which shows a pathological link between the above two.
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Affiliation(s)
- Ramanarayana Boyapati
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Chakrapani Swarna
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | | | - Sahitya Sanivarapu
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Kishore Kumar Katuri
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Lakshmikanth Kolaparthy
- Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Lee JH, Oh JY, Choi JK, Kim YT, Park YS, Jeong SN, Choi SH. Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea. J Periodontal Implant Sci 2017; 47:264-272. [PMID: 29093985 PMCID: PMC5663665 DOI: 10.5051/jpis.2017.47.5.264] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/17/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002–2013. Methods A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Wonkwang University Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jin-Young Oh
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, Korea
| | - Yeon-Tae Kim
- Department of Periodontology, Wonkwang University Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Ye-Sol Park
- Department of Periodontology, Wonkwang University Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Wonkwang University Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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