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Journal of Dental Research Mar 2024Colorectal cancer (CRC) and periodontitis have recently been related due to the higher incidence of CRC in periodontal patients and the involvement of periodontal...
Colorectal cancer (CRC) and periodontitis have recently been related due to the higher incidence of CRC in periodontal patients and the involvement of periodontal pathogens in carcinogenesis, suggesting that leakage from the oral cavity to the gut occurs. However, the magnitude of this pass-through in healthy individuals is controversial, and the effect that periodontitis could play in it is understudied. To evaluate the rate of bacterial leakage from the oral cavity to the gut, we analyzed the microbial composition of saliva, subgingival plaque, and fecal samples in healthy individuals without gastrointestinal disorders, including 20 periodontitis patients and 20 oral healthy controls, using PacBio full-length 16S rRNA gene sequencing. As expected, we observed a higher abundance of periodontal pathogens in the subgingival plaque and saliva of periodontal patients. In contrast, no significant differences were found between the fecal samples of both groups, implying that gut samples from periodontal patients were not enriched in periodontal pathogens. , a biomarker of CRC, was not found in the fecal samples of any participant. Our study does show a small leakage of some oral bacteria (mainly streptococci) to the gut, regardless of periodontal health status. Future studies should test whether other host factors and/or the preexistence of a gut disorder must be present in addition to periodontitis to promote the colonization of the gut by oral pathogens. The absence of periodontal pathogens in feces supports the idea that these bacteria could be used as biomarkers of intestinal disorders, including CRC.
Topics: Humans; RNA, Ribosomal, 16S; Periodontitis; Bacteria; Dental Plaque; Fusobacterium nucleatum
PubMed: 38193290
DOI: 10.1177/00220345231221709 -
Journal of Clinical Periodontology Oct 2023To identify (i) the prevalence of meeting the endpoints of 'stable periodontitis' (probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, no BoP... (Meta-Analysis)
Meta-Analysis Review
Prevalence of stable and successfully treated periodontitis subjects and incidence of subsequent tooth loss within supportive periodontal care: A systematic review with meta-analyses.
AIM
To identify (i) the prevalence of meeting the endpoints of 'stable periodontitis' (probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, no BoP at 4 mm sites), 'endpoints of therapy' (no PPD > 4 mm with BoP, no PPD ≥ 6 mm), 'controlled periodontitis' (≤4 sites with PPD ≥ 5 mm), 'PPD < 5 mm' and 'PPD < 6 mm' at the start of supportive periodontal care [SPC]) and (ii) the incidence of tooth loss in relation to not meeting these endpoints within a minimum of 5 years of SPC.
MATERIALS AND METHODS
Systematic electronic and manual searches were conducted to identify studies where subjects, upon completion of active periodontal therapy, entered into SPC. Duplicate screening was performed to find relevant articles. Corresponding authors were contacted to confirm inclusion and retrieve required clinical data for further analyses to assess the prevalence of reaching endpoints and incidence of subsequent tooth loss, if available, within at least 5 years of SPC. Meta-analyses were carried out to evaluate risk ratios for tooth loss in relation to not reaching the various endpoints.
RESULTS
Fifteen studies including 12,884 patients and 323,111 teeth were retrieved. Achievement of endpoints at baseline SPC was rare (1.35%, 11.00% and 34.62%, respectively, for 'stable periodontitis', 'endpoints of therapy' and 'controlled periodontitis'). Less than a third of the 1190 subjects with 5 years of SPC data lost teeth-a total of 3.14% of all teeth were lost. Statistically significant associations with tooth loss, at the subject-level, were found for not achieving 'controlled periodontitis' (relative risk [RR] = 2.57), PPD < 5 mm (RR = 1.59) and PPD < 6 mm (RR = 1.98).
CONCLUSIONS
An overwhelming majority of subjects and teeth do not achieve the proposed endpoints for periodontal stability, yet most periodontal patients preserve most of their teeth during an average of 10-13 years in SPC.
Topics: Humans; Tooth Loss; Incidence; Prevalence; Retrospective Studies; Periodontitis
PubMed: 37402624
DOI: 10.1111/jcpe.13835 -
Frontiers in Public Health 2024The etiopathogenesis of periodontitis is closely associated with environmental conditions. However, the relationship between ethylene oxide exposure and periodontitis...
BACKGROUND
The etiopathogenesis of periodontitis is closely associated with environmental conditions. However, the relationship between ethylene oxide exposure and periodontitis risk remains unclear.
METHODS
We selected qualified participants from National Health and Nutrition Examination Survey (NHANES) 2013-2014. Periodontitis was identified according to the criteria of the Community Periodontal Index (CPI), Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) definition. Ethylene oxide exposure was quantified by hemoglobin adducts of ethylene oxide (HbEO) levels. Log2-transformation was used to normalize HbEO levels. We designed three logistic regression models to explore potential relationship between HbEO and periodontitis. Restricted cubic spline (RCS) and subgroup analysis were also conducted with all covariates adjusted. We performed multivariable linear regression to appraise the association between the risk of periodontitis and different indicators of inflammation, including white blood cells, neutrophils, lymphocytes, and monocytes. Mediation analysis was subsequently performed to examine whether ethylene oxide exposure contributed to periodontitis development through systemic body inflammation.
RESULTS
A total of 1,065 participants aged more than 30 were incorporated in this study. We identified that participants with higher HbEO levels showed increased risk of periodontitis after adjusting for all covariates (OR = 1.49, 95% CI: 1.14, 1.95, = 0.0014). The results of subgroup analysis remained stable. The restricted cubic spline (RCS) curve also revealed a non-linear correlation between log2-transformed HbEO levels with the risk of periodontitis ( for nonlinear < 0.001). Mediation analysis indicated that HbEO level was significantly associated with four inflammatory mediators, with the mediated proportions of 14.44% ( < 0.001) for white blood cell, 9.62% ( < 0.001) for neutrophil, 6.17% ( = 0.006) for lymphocyte, and 6.72% ( < 0.001) for monocyte.
CONCLUSION
Participants with higher ethylene oxide exposure showed higher risk of periodontitis, which was partially mediated by systemic body inflammation. More well-designed longitudinal studies should be carried out to validate this relationship.
Topics: Humans; Ethylene Oxide; Nutrition Surveys; Periodontitis; Inflammation; Hemoglobins
PubMed: 38384884
DOI: 10.3389/fpubh.2024.1338319 -
Evidence-based Dentistry Sep 2023This was an analytical 'case-control' study.
DESIGN
This was an analytical 'case-control' study.
CASE/CONTROL SELECTION
Patients diagnosed with inflammatory bowel diseases (IBD), that is either ulcerative colitis or Crohn's disease, were selected from the Medical Hospital of University of Turin and were referred as cases. Equal number of patients, not having IBD, were selected from the Dental school of the same University and called as controls. The cases and controls were matched for age, sex, and ethnicity. Data for all patients regarding their socio-demographic features was collected using a questionnaire. In addition, data regarding periodontal health, which included clinical attachment loss, bleeding on probing, recession, presence, and severity of periodontitis etc. was also evaluated for all the included patients.
DATA ANALYSIS
Data analysis involved descriptive statistics to compare cases and control. This was done by comparing the proportions (using χ test), comparing continuous measures (using median values). In addition, two logistic regression models were created to explore the impact/association of different variables with the causation of the disease; one model explored the variables associated with periodontitis while the second model explored the variables which can be risk indicators for IBD.
RESULTS
Non-significant differences were observed on comparing various socio-demographic features while significant differences were observed in the prevalence of severe periodontitis (85.6% vs. 65.6%) amongst cases and controls. Fragmenting the periodontitis-prevalence data as per age, patients in age groups 36-50 and 51-65 exhibited significant differences on comparing cases and controls, with p values of 0.002 and 0.022, respectively, while comparison of periodontitis prevalence amongst cases/controls in 18-35 age group or >65 age group non-significant differences were observed. The logistic regression models revealed strong associations between IBD and periodontitis and vice versa. Role of other risk factors was also explored in these regression models.
CONCLUSIONS
Associations between periodontitis and IBD were found; and these connotations were bi-directional.
Topics: Humans; Inflammatory Bowel Diseases; Periodontitis; Colitis, Ulcerative; Crohn Disease; Case-Control Studies
PubMed: 37474731
DOI: 10.1038/s41432-023-00917-0 -
Journal of Clinical Periodontology Oct 2023Adult women experience several changes in physiological status, such as pregnancy and childbirth, during their life cycle. This study analyses the association between...
AIM
Adult women experience several changes in physiological status, such as pregnancy and childbirth, during their life cycle. This study analyses the association between birth-related factors (the number of childbirths, abortions and miscarriages) and periodontitis using data from the Korea National Health and Nutrition Examination Survey, which represents Korean adults.
MATERIALS AND METHODS
The study used data from Korea National Health and Nutrition Examination Survey VI and VII (2013-2018) and included 10,072 women 19 years or older, with no missing data on the variables assessed. Periodontitis was defined according to the Community Periodontal Index (CPI) criteria. Multiple logistic regression analysis, adjusting for age, household income, education, alcohol consumption, smoking, stress, body mass index, waist circumference, hypertension, diabetes mellitus, an oral examination within 1 year, daily tooth brushing frequency, hygiene products and self-perceived oral health as identified via logistic regression analyses, was performed to determine the association between birth-related variables and periodontitis.
RESULTS
In the crude model, the odds ratio (OR) showed a significantly increased risk of periodontitis (CPI ≥ 3) and severe periodontitis (CPI = 4) based on the number of childbirths, abortions and miscarriages (p < .05). After covariate adjustment, periodontitis (CPI ≥ 3) was associated with the number of childbirths (1: OR = 1.92; 95% confidence interval [CI]: 1.47-2.50; 2: OR = 2.03; 95% CI: 1.57-2.61; ≥3: OR = 2.11; 95% CI: 1.60-2.78). Furthermore, severe periodontitis (CPI = 4) was also associated with the number of childbirths (1: OR = 2.33; 95% CI: 1.24-4.38; 2: OR = 2.99; 95% CI: 1.62-5.52; ≥3: OR = 3.34; 95% CI: 1.79-6.21).
CONCLUSIONS
The findings of this large-scale, nationally representative study suggest that the number of childbirths is associated with the severity of periodontitis. However, the relationship between the number of abortions and miscarriages and periodontitis (CPI ≥ 3) or severe periodontitis (CPI = 4) is not significant.
Topics: Adult; Pregnancy; Humans; Female; Nutrition Surveys; Abortion, Spontaneous; Periodontitis; Diabetes Mellitus; Republic of Korea
PubMed: 37407503
DOI: 10.1111/jcpe.13845 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2023Studies try to explain the hypothesis that maternal periodontitis may be associated with preterm birth.
BACKGROUND
Studies try to explain the hypothesis that maternal periodontitis may be associated with preterm birth.
MATERIAL AND METHODS
This is a case-control study with 120, 40 cases (gestational age <37 weeks) and 80 controls (gestational age ≥37 weeks), that were submitted to the clinical periodontal examination and subgingival biofilm collection. Bacterial DNA of subgingival biofilm was performed and processed by qPCR.
RESULTS
Periodontitis was statistically significant in the Case group (35%) when compared to the Control group (11.2%) and Gingival Bleeding Index (GBI), sites with PS ≥ 4mm and sites with CAL ≥ 5mm were statistically higher in the Case group (p < 0.05). The proportions of Pi (p = 0.026) and Fn (p = 0.041) of subgingival biofilm were higher in the Case group. A greater number of sites with PS ≥ 4mm (r = -0.202; p = 0.026) and CAL ≥ 5mm (r = -0.322; p < 0.001) were correlated to lower gestational age.
CONCLUSIONS
Periodontitis, preterm delivery, and/or low birth weight may have a possible relationship based on clinical parameters and the ratio of Pi and Fn at periodontal sites.
Topics: Infant, Newborn; Humans; Female; Infant; Fusobacterium nucleatum; Prevotella; Case-Control Studies; Premature Birth; Periodontitis
PubMed: 37622431
DOI: 10.4317/medoral.25874 -
International Journal of Medical... Oct 2023In recent years, periodontitis, and dental caries have become common in humans and need to be diagnosed in the early stage to prevent severe complications and tooth... (Review)
Review
OBJECTIVES
In recent years, periodontitis, and dental caries have become common in humans and need to be diagnosed in the early stage to prevent severe complications and tooth loss. These dental issues are diagnosed by visual inspection, measuring pocket probing depth, and radiographs findings from experienced dentists. Though a glut of machine learning (ML) algorithms has been proposed for the automated detection of periodontitis, and dental caries, determining which ML techniques are suitable for clinical practice remains under debate. This review aims to identify the research challenges by analyzing the limitations of current methods and how to address these to obtain robust systems suitable for clinical use or point-of-care testing.
METHODS
An extensive search of the literature published from 2015 to 2022 written in English, related to the subject of study was sought by searching the electronic databases: PubMed, Institute of Electrical and Electronics Engineers (IEEE) Xplore, and ScienceDirect.
RESULTS
The initial electronic search yielded 1743 titles, and 55 studies were eventually included based on the selection criteria adopted in this review. Studies selected were on ML applications for the automatic detection of periodontitis and dental caries and related dental issues: Apical lessons, Periodontal bone loss, and Vertical root fracture.
CONCLUSION
While most of the ML-based studies use radiograph images for the detection of periodontitis and dental caries, few pieces of the literature revealed that good diagnostic accuracy could be achieved by training the ML model even with mobile photos representing the images of dental issues. Nowadays smartphones are used in every sector for different applications. Training the ML model with as many images of dental issues captured by the smartphone can achieve good accuracy, reduce the cost of clinical diagnosis, and provide user interaction.
Topics: Humans; Dental Caries; Periodontitis
PubMed: 37595373
DOI: 10.1016/j.ijmedinf.2023.105170 -
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 -
BMC Public Health Jan 2024Exposure to ethylene oxide (EO) induces inflammation and oxidative stress, which are the main mechanisms of periodontitis. However, the effect of EO on periodontal...
BACKGROUND
Exposure to ethylene oxide (EO) induces inflammation and oxidative stress, which are the main mechanisms of periodontitis. However, the effect of EO on periodontal health is not unclear. In this study, we aimed to explore the relationship between EO exposure and the risk of periodontitis in general US adults.
METHODS
Data used in our study from the National Health and Nutritional Examination Survey (NHANES) 2013-2014. The EO biomarker, hemoglobin adduct of EO (HbEO), was measured in blood samples utilizing high-performance liquid chromatography-tandem mass spectrometry. Periodontitis category was defined by the CDC/AAP according to clinical periodontal parameters. Natural cubic spline, weight multivariable logistic regression analyses and subgroup analysis were used to explore the association between EO exposure and the risk of periodontitis.
RESULTS
A total of 1497 participants over the age of 30 were included in our study. A non-linear positive association with periodontitis was identified for HbEO levels. Participants in the highest tertile of HbEO levels were more likely to have poorer periodontal health compared to the lowest tertile (OR = 2.80, 95% CI: 1.85-4.24). Similar results were also found in different subgroups.
CONCLUSIONS
HbEO levels are positively associated with poor periodontal health in US adults. Additional longitudinal studies are necessary to further enhance our comprehension of the impact of exposure to EO on periodontal status.
Topics: Adult; Humans; Ethylene Oxide; Cross-Sectional Studies; Nutrition Surveys; Periodontitis; Longitudinal Studies
PubMed: 38229065
DOI: 10.1186/s12889-024-17735-3 -
Journal of Periodontal Research Apr 2024To estimate whether genetically proxied periodontitis causally impacts the brain cortical structure using Mendelian randomization (MR). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To estimate whether genetically proxied periodontitis causally impacts the brain cortical structure using Mendelian randomization (MR).
BACKGROUND
Periodontitis is one of the most prevalent inflammatory conditions globally, and emerging evidence has indicated its influences on distal organs, including the brain, whose disorders are always accompanied by magnetic resonance imaging (MRI)-identified brain cortical changes. However, to date, no available evidence has revealed the association between periodontitis and brain cortical structures.
METHODS
The instrumental variables (IVs) were adopted from previous genome-wide association study (GWAS) studies and meta-analyses of GWAS studies of periodontitis from 1844 to 5266 cases and 8255 to 12 515 controls. IVs were linked to GWAS summary data of 51 665 patients from the ENIGMA Consortium, assessing the impacts of genetically proxied periodontitis on the surficial area (SA) or the cortical thickness (TH) of the global and 34 MRI-identified functional regions of the brain. Inverse-variance weighted was used as the primary estimate; the MR pleiotropy residual sum and outlier (MR-PRESSO), the MR-Egger intercept test, and leave-one-out analyses were used to examine the potential horizontal pleiotropy.
RESULTS
Genetically proxied periodontitis affects the SA of the medial orbitofrontal cortex, the lateral orbitofrontal cortex, the inferior temporal cortex, the entorhinal cortex, and the temporal pole, as well as the TH of the entorhinal. No pleiotropy was detected.
CONCLUSIONS
Periodontitis causally influences the brain cortical structures, implying the existence of a periodontal tissue-brain axis.
Topics: Humans; Brain; Genome-Wide Association Study; Mendelian Randomization Analysis; Periodontitis; Periodontium
PubMed: 38059384
DOI: 10.1111/jre.13222