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Journal of Clinical Periodontology Apr 2024To explore the association between polycyclic aromatic hydrocarbons (PAHs) (measured using urinary metabolites) and periodontitis using data from the National Health and...
AIM
To explore the association between polycyclic aromatic hydrocarbons (PAHs) (measured using urinary metabolites) and periodontitis using data from the National Health and Nutrition Examination Survey 2009-2014.
MATERIALS AND METHODS
Weighted binary logistic regression, Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression were used to evaluate independent and joint associations between the six urinary monohydroxylated metabolites of PAHs (OH-PAHs) and periodontitis.
RESULTS
In all, 3413 participants were included in this study. All six urinary OH-PAHs were present at higher levels in the periodontitis group compared with the non-periodontitis group (p < .001). Fully adjusted multivariable logistic regressions showed positive associations between the six urinary OH-PAHs and periodontitis (p < .05). Higher concentrations of OH-PAHs were also positively associated with attachment loss, periodontal pocket depth (PPD) and the number of tooth loss. BKMR and WQS regression yielded similar positive associations between OH-PAH mixtures and periodontitis.
CONCLUSIONS
PAHs and their mixture are positively associated with periodontitis, which may provide novel insights into periodontitis prevention from an environmental exposure perspective.
Topics: Humans; Bayes Theorem; Nutrition Surveys; Periodontitis; Periodontal Pocket; Polycyclic Aromatic Hydrocarbons
PubMed: 38158854
DOI: 10.1111/jcpe.13919 -
Periodontology 2000 Jun 2024This narrative review addresses conventional diagnostic criteria used in clinical practice to discriminate between periodontal health, gingivitis, and periodontitis.... (Review)
Review
This narrative review addresses conventional diagnostic criteria used in clinical practice to discriminate between periodontal health, gingivitis, and periodontitis. Visual examination of the color and texture of the periodontal tissues, assessment of plaque deposits, periodontal probing assessments, and diagnostic imaging enable the collation of information to make a periodontal diagnosis, followed by an appropriate treatment plan. The periodontal probe is an essential diagnostic tool to assess probing pocket depth, clinical attachment level, bleeding on probing, and the degree of furcation involvement at multirooted teeth. When clinical signs and symptoms of periodontitis are identified, diagnostic imaging enables evaluation of the level and extent of bone destruction and bone defect morphology. The diagnostic process requires clinicians who are trained to evaluate, record, and interpret these measures. This narrative review focuses on conventional clinical diagnostic parameters which, despite their limitations, are considered the current standard of care.
PubMed: 38831568
DOI: 10.1111/prd.12579 -
Journal of Indian Society of... 2023Pentraxin 3 (PTX3) is a biomarker, associated with the pathogenesis of Periodontitis and coronary artery disease (CAD) individually, but their role in patients with both...
OBJECTIVES
Pentraxin 3 (PTX3) is a biomarker, associated with the pathogenesis of Periodontitis and coronary artery disease (CAD) individually, but their role in patients with both diseases remains unclear. The current study aims to evaluate the association of PTX in patients with concomitant periodontitis and CAD.
MATERIALS AND METHODS
In a case-control study, 240 participants were selected and divided into four groups. Nonperiodontitis + noncardiac = 60 patients, periodontitis + noncardiac (P + NC) = 60 patients, nonperiodontitis + cardiac (NP + C) = 60 patients, periodontitis + cardiac (P + C) = 60 patients. Demographic variables, cardiac and periodontal parameters were recorded. PTX was evaluated in the subgingival plaque and atheromatous plaque samples using real-time quantitative polymerase chain reaction and compared between the groups. The results were statistically analyzed.
RESULTS
Among the demographic variables, age showed a significant difference between the groups. Systolic and diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP + C and + C groups ( ≤ 0.05). The plaque index, probing pocket depth, and clinical attachment loss were significantly higher in + NC and + C groups ( ≤ 0.05). PTX was significantly elevated in + C group ( = 0.000). Pearson's correlation revealed a significant correlation between the periodontal parameters and PTX in both the cardiac and oral samples.
CONCLUSION
PTX3 levels were elevated in CAD patients with periodontitis suggesting the influence of periodontal inflammation in the progression of CAD. PTX3 may serve as a diagnostic and prognostic tool for both periodontitis and CAD. This study could provide an understanding and awareness about the potential role of PTX3 in both periodontitis and CAD.
PubMed: 38434506
DOI: 10.4103/jisp.jisp_487_22 -
Journal of Periodontology Apr 2024Studies on the impact of intermittent fasting on periodontal health are still scarce. Thus, this study evaluated the effects of long-term intermittent fasting on...
BACKGROUND
Studies on the impact of intermittent fasting on periodontal health are still scarce. Thus, this study evaluated the effects of long-term intermittent fasting on periodontal health and the subgingival microbiota.
METHODS
This pilot study was part of a nonrandomized controlled trial. Overweight/obese participants (n = 14) entered an intermittent fasting program, specifically the 5:2 diet, in which they restricted caloric intake to about a quarter of the normal total daily caloric expenditure for two nonconsecutive days/week. Subjects underwent a thorough clinical and laboratory examination, including an assessment of their periodontal condition, at baseline and 6 months after starting the diet. Additionally, subgingival microbiota was assessed by 16S rRNA gene sequencing.
RESULTS
After 6 months of intermittent fasting, weight, body mass index, C-reactive protein, hemoglobin A1c (HbA1c), and the cholesterol profile improved significantly (p < 0.05). Moreover, significant reductions were observed in bleeding on probing (p = 0.01) and the presence of shallow periodontal pockets after fasting (p < 0.001), while no significant change was seen in plaque index (p = 0.14). While we did not observe significant changes in α- or β-diversity of the subgingival microbiota related to dietary intervention (p > 0.05), significant differences were seen in the abundances of several taxa among individuals exhibiting ≥60% reduction (good responders) in probing pocket depth of 4-5 mm compared to those with <60% reduction (bad responders).
CONCLUSION
Intermittent fasting decreased systemic and periodontal inflammation. Although the subgingival microbiota was unaltered by this intervention, apparent taxonomic variability was observed between good and bad responders.
PubMed: 38655661
DOI: 10.1002/JPER.23-0676 -
Journal of Periodontology Apr 2024To examine the relationship between the systemic immune-inflammation index (SII) and periodontitis and to investigate possible effect modifiers.
BACKGROUND
To examine the relationship between the systemic immune-inflammation index (SII) and periodontitis and to investigate possible effect modifiers.
METHODS
Data used in the present cross-sectional study are from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 (N = 10,301). The SII was calculated using the following formula: (neutrophils count × platelet count)/lymphocytes count. The category of periodontitis was defined by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP) classification. We employed natural cubic spline and multivariable logistic regression analyses to evaluate the associations of the SII with periodontitis.
RESULTS
The associations between SII and periodontal health followed a J-shape (p < 0.001). The risk of periodontitis tended to reduce with the increment of log(SII) in participants with log(SII) ≤ 8.66 (odds radio [OR] = 0.83; 95% CI: 0.69-0.999), especially among non-Hispanic Whites (OR = 0.70; 95% CI: 0.52-0.95), and increased with the increment of log(SII) in participants with log(SII) > 8.66 (OR = 1.19; 95% CI: 1.02-1.38). A similar trend was also observed between the SII and the number of sites with probing pocket depth (PPD) ≥4 mm and clinical attachment loss (CAL) ≥ 3 or 5 mm. Furthermore, we found a significantly stronger correlation between lymphocytes and either neutrophils or platelets in individuals with log(SII) > 8.66, as opposed to those with log(SII) ≤ 8.66.
CONCLUSIONS
There is a J-shaped association between SII and periodontitis in US adults, with an inflection point of log(SII) at 8.66, which may provide potential adjunctive treatment strategies for periodontitis with different immune response states. Further prospective trials are still required to confirm our findings.
Topics: Humans; Male; Female; Nutrition Surveys; Periodontitis; Cross-Sectional Studies; Middle Aged; Adult; United States; Neutrophils; Platelet Count; Inflammation; Aged; Lymphocyte Count; Periodontal Index; Risk Factors
PubMed: 37713193
DOI: 10.1002/JPER.23-0260 -
Journal of Indian Society of... 2023Periodontal disease and chronic obstructive pulmonary disease (COPD) share a pathogenic mechanism that involves activating and using inflammatory cytokines and...
BACKGROUND
Periodontal disease and chronic obstructive pulmonary disease (COPD) share a pathogenic mechanism that involves activating and using inflammatory cytokines and neutrophils, which generate pathological changes in various tissues with a chronic degenerative outcome.
AIM
the aim of this study was to assess and compare the periodontal health status among COPD patients with age- and gender-matched controls.
MATERIALS AND METHODS
All the patients aged >30 years who were diagnosed with COPD by the physician were included as cases, while people who are apparently healthy and age and gender matched with cases were included as controls. Data on demographic details, socioeconomic status (Kuppuswamy scale), deleterious oral habits, and oral hygiene practices were obtained. The Simplified Oral Hygiene Index (OHI-S) and the WHO basic oral health survey proforma (1997) were used to obtain the data on oral hygiene and periodontal status respectively.
RESULTS
Most cases had moderate COPD severity (58.25%). The overall mean OHI-S, CPI, and LOA were higher among cases (3.92 ± 0.95, 3.68 ± 0.60, and 2.33 ± 1.10, respectively) in comparison to controls. Further, among cases, the mean oral hygiene and periodontitis increased with increased severity of COPD. Although among both cases and controls, gender, tobacco use, and alcohol consumption influenced their periodontal status, significant odds of higher risk were seen only among cases. Further, subjects with COPD had higher odds of having poor oral hygiene, deeper pocket depths, and LOA.
CONCLUSION
A strong association between COPD and periodontitis was observed. The oral hygiene and periodontal disease worsened with the severity of COPD.
PubMed: 37781331
DOI: 10.4103/jisp.jisp_479_22 -
Journal of Periodontology Jun 2024Periodontal disease is a biofilm-dependent chronic inflammatory condition triggered by a host response. Several factors impact systemic inflammation and could lead to...
BACKGROUND
Periodontal disease is a biofilm-dependent chronic inflammatory condition triggered by a host response. Several factors impact systemic inflammation and could lead to changes in disease pathogenesis. Recently, studies have assessed the influence of nutritional patterns on the development of periodontitis. In the present cross-sectional study, we evaluated the dietary inflammatory profile on periodontal conditions, focusing on clinical, subgingival microbial, and cytokine assessment of individuals with periodontal health or gingivitis.
METHODS
One hundred patients with periodontal health or gingivitis were included. Plaque index (PI), Bleeding on probing (BoP), the probing depth (PD), and the clinical attachment level (CAL) for each patient were assessed. Nutritional data and the Dietary Inflammatory Index (DII) were recorded by two 24-h food recalls on non-consecutive days. Biofilm and gingival crevicular fluid (GCF) to assess the microbiome profile and inflammatory biomarkers were collected. Multiple regressions focused on the DII, age, and sex as predictors of periodontal conditions were done.
RESULTS
Age and moderate DII scores increased the risk of gingivitis by 1.64 and 3.94 times, respectively. Males with an elevated DII score had 27.15 times higher odds of being diagnosed with gingivitis and BoP (β = 6.54; p = 0.03). Elderly patients with a moderate or high DII score were less prone to gingivitis and increased BoP (p < 0.04) compared with younger subjects. Considering the DII, there were no differences in microbial alpha and beta diversity; however, distinct species abundance and a higher concentration of monocyte-chemoattractant protein-1 and interleukin 33 were seen in patients with a higher DII.
CONCLUSION
A pro-inflammatory diet significantly contributes to periodontal inflammation, modulating inflammatory biomarkers and affecting the subgingival microbial community in healthy individuals.
Topics: Humans; Male; Female; Gingivitis; Cross-Sectional Studies; Adult; Middle Aged; Biofilms; Periodontal Index; Gingival Crevicular Fluid; Diet; Age Factors; Dental Plaque Index; Microbiota; Cytokines; Periodontal Attachment Loss; Sex Factors; Periodontal Pocket; Biomarkers; Inflammation; Aged; Young Adult
PubMed: 38152036
DOI: 10.1002/JPER.23-0292 -
AAPS PharmSciTech May 2024Periodontal disease is a multifactorial pathogenic condition involving microbial infection, inflammation, and various systemic complications. Here, a systematic and... (Review)
Review
Periodontal disease is a multifactorial pathogenic condition involving microbial infection, inflammation, and various systemic complications. Here, a systematic and comprehensive review discussing key-points such as the pros and cons of conventional methods, new advancements, challenges, patents and products, and future prospects is presented. A systematic review process was adopted here by using the following keywords: periodontal diseases, pathogenesis, models, patents, challenges, recent developments, and 3-D printing scaffolds. Search engines used were "google scholar", "web of science", "scopus", and "pubmed", along with textbooks published over the last few decades. A thorough study of the published data rendered an accurate and deep understanding of periodontal diseases, the gap of research so far, and future opportunities. Formulation scientists and doctors need to be interconnected for a better understanding of the disease to prescribe a quality product. Moreover, prime challenges (such as a lack of a vital testing model, scarcity of clinical and preclinical data, products allowing for high drug access to deeper tissue regions for prolonged residence, lack of an international monitoring body, lack of 4D or time controlled scaffolds, and lack of successful AI based tools) exist that must be addressed for designing new quality products. Generally, several products have been commercialized to treat periodontal diseases with certain limitations. Various strategic approaches have been attempted to target certain delivery regions, maximize residence time, improve efficacy, and reduce toxicity. Conclusively, the current review summarizes valuable information for researchers and healthcare professional to treat a wide range of periodontal diseases.
Topics: Humans; Patents as Topic; Periodontal Diseases; Periodontal Pocket; Animals; Printing, Three-Dimensional
PubMed: 38816555
DOI: 10.1208/s12249-024-02842-6 -
Cureus Mar 2024Furcation-involved teeth, commonly seen in dental practice, have a higher likelihood of needing extraction as the severity of periodontal furcation involvement... (Review)
Review
Furcation-involved teeth, commonly seen in dental practice, have a higher likelihood of needing extraction as the severity of periodontal furcation involvement increases. Studies consistently show that periodontitis in teeth with multiple roots significantly increases the risk of tooth loss, especially in the area where the furcation is involved. These furcation defects pose a major problem for dentists because of their location, accessibility issues, and the unpredictable healing process. The biggest hurdle in treating furcation defects is their irregular shape, which makes it hard to achieve complete debridement. While various treatments have been explored, non-surgical methods have not shown much success. This article comprehensively provides a review and discussion on the classification, assessment, and treatment options, including surgical and non-surgical management of furcation-involved molar teeth. Properly understanding the severity of the disease and its confounding factors and managing and treating the lesions appropriately have been shown to impart satisfactory survival rates for these teeth. Enhancing the understanding of managing these teeth can also lead to better outcomes for patients.
PubMed: 38601385
DOI: 10.7759/cureus.55924 -
F1000Research 2023Periodontitis is the chronic inflammation of tooth-supporting tissues that leads to loss of tooth support if untreated. Conventional therapy for periodontitis... (Review)
Review
Periodontitis is the chronic inflammation of tooth-supporting tissues that leads to loss of tooth support if untreated. Conventional therapy for periodontitis (mechanical removal of microbial biofilm and oral hygiene enforcement) is augmented by anti-microbial and anti-inflammatory drugs. These drugs are frequently delivered locally into the periodontal pocket for maximum efficiency and minimum adverse effects. The potential of oleogels for periodontal drug delivery has been discussed and further, the future scope of oleogel-based drug delivery systems in dentistry. An oleogel-based local drug delivery system offers several advantages over other systems. Superior mechanical properties (firmness and compressibility), muco-adhesion, shear thinning, thixotropy, controlled drug release and the ability to incorporate water-insoluble drugs clearly distinguish and highlight the potential of oleogels as periodontal local drug delivery systems. Bigels can combine the qualities of both hydrogels and oleogels to provide a more promising option for drug delivery. However, there is limited evidence concerning oleogels as local drug delivery agents in periodontics. Further studies are needed to discern the clinical efficacy of oleogel-based drug delivery systems.
Topics: Periodontitis; Humans; Drug Delivery Systems; Organic Chemicals; Animals; Anti-Inflammatory Agents
PubMed: 38690138
DOI: 10.12688/f1000research.140173.1