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Ma KSK, Thota E, Huang JY, Huang YF, Wei JCC. Onset of oral lichen planus following dental treatments: A nested case-control study. Oral Dis 2023; 29:1269-1281. [PMID: 34953110 DOI: 10.1111/odi.14115] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/30/2021] [Accepted: 12/18/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The exposure to amalgam restorations has been reported to bring about altered immunity followed by inflammation and infection. AIMS This study aimed at identifying whether patients who received restorative or endodontic treatments, or tooth extraction, would have altered odds of developing oral lichen planus (OLP). MATERIAL AND METHODS In this population-based nested case-control study, 421 cases of OLP and 1,684 controls were included after propensity score matching. Logistic regression was used to estimate the adjusted odds ratio (aOR) of OLP in individuals who had received amalgam and composite resin restorations, root canal therapy, and tooth extraction over a follow-up duration of five years. RESULTS There were no significantly different odds of OLP for those who underwent either amalgam (aOR = 0.948, 95% CI = 0.853-1.053, p = 0.3170) or resin restorations (aOR = 1.007, 95% CI = 0.978-1.037, p = 0.6557) in both anterior and posterior teeth in an observational period of five years after restorations. Root canal therapy was associated with significantly lower odds of OLP, with each additional root canal therapy attenuating the risk of OLP at an aOR of 0.771 (95% CI = 0.680-0.874, p = 0.0001) for both anterior (aOR = 0.786, 95% CI = 0.626-0.986, p = 0.0372) and posterior teeth (aOR = 0.762, 95% CI = 0.650-0.893, p = 0.0008). Likewise, each tooth extraction reduced the risk of OLP, with an aOR of 0.846 (95% CI = 0.772-0.927, p = 0.0003), especially for anterior teeth (aOR = 0.733, 95% CI = 0.595-0.904, p = 0.0037). CONCLUSIONS We reported no significant association between dental restorations and consequent OLP, and significantly lower odds of OLP following both root canal therapy and tooth extraction.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
| | - Eshwar Thota
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Feng Huang
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
- College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Huang HH, Ma KSK, Wu MY, Hung YM, Tsao CH, Wei JCC, Wen WS, Wang YH, Hung SY, Chao MM. Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study. Clin Oral Investig 2023; 27:183-192. [PMID: 36129542 DOI: 10.1007/s00784-022-04707-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/30/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD). MATERIALS AND METHODS Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD. RESULTS Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08-3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33-6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05-5.47). CONCLUSIONS Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA. CLINICAL RELEVANCE Timely interventions for OSA may prevent OSA-associated FD.
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Affiliation(s)
- Hsin-Hsin Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan
| | - Min-You Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yao-Min Hung
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Chien-Han Tsao
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan. .,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - James Cheng-Chung Wei
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan. .,Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan. .,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
| | - Wei-Sheng Wen
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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Chen HH, Ma KSK, Dong C, Chang WJ, Gao KR, Perng WT, Huang JY, Wei JCC. Risk of primary Sjogren’s Syndrome following human papillomavirus infections: a nationwide population-based cohort study. Front Immunol 2022; 13:967040. [PMID: 36052092 PMCID: PMC9424920 DOI: 10.3389/fimmu.2022.967040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
IntroductionViral infection is an exogeneous factor for primary Sjogren’s syndrome (pSS). This study investigated the association between human papillomavirus (HPV) infections and pSS through a nationwide population based cohort study.MethodsPatients with HPV infections between January, 1999 and December, 2013 were included. The incidence of new-onset pSS in patients with HPV infections and non-HPV controls were derived. The multiple Cox regression model derived the risk of pSS in patients with HPV infections. Subgroup analysis and sensitivity analysis were performed to validate the association.ResultsDuring a follow-up period of 12 years, the adjusted hazard ratio (aHR) of pSS in patients with HPV infections was significantly higher than that in non-HPV controls (aHR=1.64, 95% CI=1.47-1.83, P<0.001). The risk of pSS increased with age and the risk increased by 2.64-fold (95% CI= 2.37-2.93) for those older than 45 years. The significant association between HPV infections and the risk of pSS persisted in the sensitivity analysis restricted in HPV infections that lasted over 12 months (aHR=1.63, 95%CI=1.45-1.83, P<0.0001). Subgroup analyses revealed that both male (aHR=1.83, 95%CI=1.47-2.28, P<0.0001) and female (aHR=1.58, 95%CI=1.40-1.79, P<0.0001) patients with HPV infections and HPV-infected patients aged between 16 and 45 years (aHR=1.60, 95%CI=1.34-1.91, P<0.0001) and over 45 years (aHR=1.67, 95%CI=1.46-1.91, P<0.0001) were associated with a significantly greater risk of pSS.ConclusionPatients with HPV infections presented with a significantly higher risk of pSS, regardless of age and sex.
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Affiliation(s)
- Huang-Hsi Chen
- Division of Allergy, Immunology, and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Chen Dong
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wen-Jung Chang
- Department of Obstetrics and Gynecology, Dajia Lees General Hospital, Taichung, Taiwan
| | - Kuan-Rong Gao
- Department of Obstetrics and Gynecology, Yuanli Lees General Hospital, Miaoli, Taiwan
- *Correspondence: Kuan-Rong Gao, ; Wuu-Tsun Perng, ; Jing-Yang Huang, ; James Cheng-Chung Wei,
| | - Wuu-Tsun Perng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Center for Health Data Science, Chung Shan Medical University Hospital, Taichung, Taiwan
- *Correspondence: Kuan-Rong Gao, ; Wuu-Tsun Perng, ; Jing-Yang Huang, ; James Cheng-Chung Wei,
| | - Jing-Yang Huang
- Center for Health Data Science, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
- *Correspondence: Kuan-Rong Gao, ; Wuu-Tsun Perng, ; Jing-Yang Huang, ; James Cheng-Chung Wei,
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology, and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Center for Health Data Science, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Kuan-Rong Gao, ; Wuu-Tsun Perng, ; Jing-Yang Huang, ; James Cheng-Chung Wei,
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Ma KSK, Lai JN, Thota E, Yip HT, Chin NC, Wei JCC, Van Dyke TE. Bidirectional Relationship Between Osteoarthritis and Periodontitis: A Population-Based Cohort Study Over a 15-year Follow-Up. Front Immunol 2022; 13:909783. [PMID: 35958545 PMCID: PMC9358960 DOI: 10.3389/fimmu.2022.909783] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To identify the relationship between osteoarthritis and periodontitis. Methods 144,788 periodontitis patients and 144,788 propensity score-matched controls without history of periodontitis were enrolled in this cohort study. A Cox proportional hazard model was used to estimate the risk of osteoarthritis. Survival analysis was utilized to assess the time-dependent effect of periodontitis on osteoarthritis. Age and gender were stratified to identify subgroups at risk. A symmetrical case-control analysis was designed to determine the relationship between present periodontitis and history of osteoarthritis. Results Patients with periodontitis had higher risk of osteoarthritis (hazard ratio, HR =1.15, 95% CI =1.12–1.17, p < 0.001) and severe osteoarthritis that led to total knee replacement or total hip replacement (TKR/THR) (HR =1.12, 95% CI =1.03–1.21, p < 0.01) than controls, which was time-dependent (log-rank test p < 0.01). The effect of periodontitis on osteoarthritis was significant in both genders and age subgroups over 30 years-old (all p < 0.001). Among them, females (HR=1.27, 95% CI = 1.13–1.42, p < 0.001) and patients aged over 51 (HR= 1.21, 95% CI =1.10-1.33, p < 0.001) with periodontitis were predisposed to severe osteoarthritis. In addition, periodontitis patients were more likely to have a history of osteoarthritis (odds ratio = 1.11, 95% CI = 1.06 - 1.17, p < 0.001). Conclusions These findings suggest an association between periodontitis and a higher risk of osteoarthritis, including severe osteoarthritis that led to TKR/THR. Likewise, periodontitis is more likely to develop following osteoarthritis. A bidirectional relationship between osteoarthritis and periodontitis was observed.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Jung-Nien Lai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Eshwar Thota
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Hei-Tung Yip
- Management office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Ning-Chien Chin
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Orthopedics, Antai Tian-Sheng Memorial Hospital, Pingtung, Taiwan
- *Correspondence: Ning-Chien Chin, ; James Cheng-Chung Wei, ; Thomas E. Van Dyke,
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Ning-Chien Chin, ; James Cheng-Chung Wei, ; Thomas E. Van Dyke,
| | - Thomas E. Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, MA, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
- *Correspondence: Ning-Chien Chin, ; James Cheng-Chung Wei, ; Thomas E. Van Dyke,
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Lo SC, Ma KS, Li YR, Li ZY, Lin CH, Lin HC, Yang SF. Nutritional support for successful weaning in patients undergoing prolonged mechanical ventilation. Sci Rep 2022; 12:12044. [PMID: 35835785 DOI: 10.1038/s41598-022-15917-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Successful weaning from ventilators not only improves the quality of life of patients, but also reduces medical expenses. The aim of this study was to explore the association between nutritional provision and successful ventilator weaning. In this retrospective study data from the Respiratory Care Center of Chung Shan Medical University Hospital between October, 2017 and July, 2019 on patient characteristics, amount of nutrition delivered, and clinical outcomes were retrieved. A total of 280 ventilated patients were enrolled and divided into successful extubation and failed weaning groups. There were 178 males (63.6%) and 102 females (36.4%) with a mean age of 67.3 ± 16.9 years. The successful extubation group consisted of patients who tended towards ideal body weight during the weaning process (BMI 23.9 ± 5.0 versus 22.7 ± 4.8 kg/m2, p < 0.001). Patients from both groups initially received the same nutritional intervention, while patients of successful extubation received significantly more calories and protein after weaning (23.8 ± 7.8 kcal versus 27.8 ± 9.1 kcal, p < 0.001 and 0.97 ± 0.36 g versus 1.14 ± 0.42 g, p < 0.001). Successful weaning was associated with higher survival rate (p = 0.016), shortened hospital stay (p = 0.001), and reduced medical costs (p < 0.001). Overall, nutritional support with high calories and protein was associated with the probability of successful ventilator weaning in patients undergoing prolonged mechanical ventilation. Adequate nutrition is a determinant of successful ventilator weaning.
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Thota E, Veeravalli JJ, Manchala SK, Lakkepuram BP, Kodapaneni J, Chen YW, Wang LT, Ma KSK. Age-dependent oral manifestations of neurofibromatosis type 1: a case-control study. Orphanet J Rare Dis 2022; 17:93. [PMID: 35236379 PMCID: PMC8889631 DOI: 10.1186/s13023-022-02223-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Most craniofacial manifestations of neurofibromatosis type 1 (NF1) are considered as a result of tumor compression. We sought to determine salivary changes, caries, and periodontal complications in NF1 patients without tumors in the oral cavity.
Objective and methods Eleven NF1 patients without tumors in the oral cavity and 29 matched controls without NF1 were enrolled in this case–control study. Demographic information, medical history, and data of intraoral examinations, including the Decayed, Missing, and Filled Teeth (DMFT) scores and Russel’s periodontal index (PI), were recorded. The functional salivary analysis was performed for sialometry, salivary pH values, and amylase activity. Ingenuity Systems Pathway Analysis (IPA) was conducted to identify mutually activated pathways for NF1-associated oral complications.
Results NF1 patients were associated with periodontitis (OR = 1.40, 95% CI = 1.06–1.73, P = 0.04), gingivitis (OR = 1.55, 95% CI = 1.09–2.01, P = 0.0002), and decreased salivary flow rates (OR = 1.40, 95% CI = 1.05–1.76, P = 0.005). Periodontal destruction, salivary changes, and dental caries in NF1 patients were age-dependent. Subgroup analyses based on age stratification suggested that salivary flow rates and salivary amylase activities were significantly low in NF1 patients aged over 20 years and that salivary pH values, PI and DMFT scores were significantly high among NF1- controls aged over 20. All oral complications were not significantly presented in NF1 patients aged below 20 years. IPA analyses suggested that cellular mechanisms underlying NF1-associated oral complications involved chronic inflammatory pathways and fibrosis signaling pathway.
Conclusion NF1 patients without tumors in the oral cavity presented a comparatively high prevalence of age-dependent oral complications, including periodontal destruction and salivary gland dysfunction, which were associated with chronic inflammatory pathogenesis.
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Affiliation(s)
- Eshwar Thota
- Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.,SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - John Jims Veeravalli
- Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.,SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - Sai Krishna Manchala
- Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Jayasurya Kodapaneni
- Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Yi-Wen Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC. .,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan, ROC.
| | - Li-Tzu Wang
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan, ROC.
| | - Kevin Sheng-Kai Ma
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC. .,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan, ROC. .,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan, ROC. .,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Ma KSK, Wu MC, Thota E, Wang YH, Alqaderi H, Wei JCC. Tonsillectomy as a risk factor of periodontitis: a population-based cohort study. J Periodontol 2021; 93:721-731. [PMID: 34710237 DOI: 10.1002/jper.21-0215] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/28/2021] [Accepted: 10/19/2021] [Indexed: 11/07/2022]
Abstract
AIM To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis. METHODS Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population-based cohort study consisting of cases of newly-onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. 1,482 tonsillectomy cases and 14,796 non-tonsillectomy controls were selected. Propensity score matching between the tonsillectomy group and the non-tonsillectomy group was conducted to exclude the confounding effect resulting from indications of tonsillectomy. Cox proportional hazard model and subgroup analyses were conducted to identify subpopulations at risk of tonsillectomy-associated periodontitis, and a sub-outcome analysis was applied to identify the subtype of tonsillectomy-associated periodontitis. RESULTS A total of 648 patients who had undergone tonsillectomy and 648 out of 6,509 propensity score-matched controls were retrieved, among which 230 cases in the tonsillectomy group were associated with post-surgical periodontitis (adjusted HR = 1.31, 95% CI = 1.08-1.59). The association persisted in a subpopulation of patients with periodontitis who received mechanical and surgical treatments for periodontitis (adjusted HR = 1.33, 95% CI = 1.09-1.63). The incidence of periodontitis was significantly high in the individuals who underwent tonsillectomy and was particularly high in those that were below 12 years of age (HR = 1.58, 95% CI = 1.10-2.27). The risk of periodontitis increased 4 years after tonsillectomy (HR = 1.82; 95% CI = 1.29-2.59). The majority of post-tonsillectomy periodontitis was aggressive and acute periodontitis (HR = 1.37; 95% CI = 1.10 - 1.71). CONCLUSIONS Tonsillectomy performed in paediatric patients of less than 12 years old, increased the risk of developing periodontitis. Aggressive and acute periodontitis as a long-term, postoperative adverse event took place at 4 years or longer after tonsillectomy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, Chung Shan Medical University and Chung Shan Medical, University Hospital, Taichung, Taiwan
| | - Meng-Che Wu
- Division of Gastroenterology, Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Eshwar Thota
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical, University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hend Alqaderi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.,The Forsyth Institute, Cambridge, MA, USA.,Dasman Diabetes Institute, Kuwait
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine Chung Shan Medical University Hospital, Taichung, Taiwan.,Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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