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Clinical Oral Implants Research Nov 2023To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri-implantitis (E) and peri-implant... (Meta-Analysis)
Meta-Analysis Review
AIM
To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri-implantitis (E) and peri-implant health/mucositis (C) in terms of bacterial presence/count (O)?"
MATERIALS AND METHODS
Cross-sectional studies fulfilling specific inclusion criteria established to answer the PECO question were included. Two review authors independently searched for studies, screened the titles and abstracts, did full-text analysis, extracted the data from the included reports, and performed the risk of bias assessment through an adaptation of the Newcastle/Ottawa tool for cross-sectional studies and of the JBI critical appraisal checklist. In case of disagreement, a third reviewer author took the final decision. Study results were summarized using random effects meta-analyses.
RESULTS
A total of 12 studies were included, involving 1233 participants and 1513 implants. Peri-implantitis was associated with the presence of S. epidermidis (Odds ratio, OR = 10.28 [95% Confidence interval, CI: 1.26-83.98]), F. nucleatum (OR = 7.83 [95% CI: 2.24-27.36]), T. denticola (OR = 6.11 [95% CI: 2.72-13.76]), T. forsythia (OR = 4.25 [95% CI: 1.71-10.57]), P. intermedia (OR = 3.79 [95% CI: 1.07-13.35]), and P. gingivalis (OR = 2.46 [95% CI: 1.21-5.00]). Conversely, the presence of A. actinomycetemcomitans (OR = 3.82 [95% CI: 0.59-24.68]), S. aureus (OR = 1.05 [95% CI: 0.06-17.08]), and C. rectus (OR = 1.48 [95% CI: 0.69-3.17]) was not associated with peri-implantitis.
CONCLUSIONS
Peri-implantitis is associated with the presence of S. epidermidis and specific periodontopathogens (P. gingivalis, T. forsythia, T. denticola, F. nucleatum, and P. intermedia). (CRD42021254589).
Topics: Humans; Peri-Implantitis; Staphylococcus aureus; Cross-Sectional Studies; Porphyromonas gingivalis; Microbiota; Dental Implants
PubMed: 37523470
DOI: 10.1111/clr.14153 -
Frontiers in Cellular and Infection... 2023is a Gram-negative oral anaerobic bacterium that plays a key role in the pathogenesis of periodontitis. expresses a variety of virulence factors that disrupt innate... (Review)
Review
is a Gram-negative oral anaerobic bacterium that plays a key role in the pathogenesis of periodontitis. expresses a variety of virulence factors that disrupt innate and adaptive immunity, allowing to survive and multiply in the host and destroy periodontal tissue. In addition to periodontal disease, is also associated with systemic diseases, of which insulin resistance is an important pathological basis. causes a systemic inflammatory response, disrupts insulin signaling pathways, induces pancreatic β-cell hypofunction and reduced numbers, and causes decreased insulin sensitivity leading to insulin resistance (IR). In this paper, we systematically review the studies on the mechanism of insulin resistance induced by , discuss the association between and systemic diseases based on insulin resistance, and finally propose relevant therapeutic approaches. Overall, through a systematic review of the mechanisms related to systemic diseases caused by through insulin resistance, we hope to provide new insights for future basic research and clinical interventions for related systemic diseases.
Topics: Humans; Porphyromonas gingivalis; Insulin Resistance; Base Composition; RNA, Ribosomal, 16S; Phylogeny; Sequence Analysis, DNA; Insulin
PubMed: 37520442
DOI: 10.3389/fcimb.2023.1209381 -
Pharmaceutics Jul 2023() is a Gram-negative anaerobic bacterium that plays an important role in the development and progression of periodontitis. Hyaluronic acid (HA) is a naturally... (Review)
Review
() is a Gram-negative anaerobic bacterium that plays an important role in the development and progression of periodontitis. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan that has previously demonstrated antibacterial potential in vitro against multiple bacterial species, including . The purpose of this systematic review is to evaluate the effectiveness of HA as an adjunctive topical antibacterial agent to non-surgical mechanical therapy of periodontitis in reducing the prevalence of in subgingival biofilms. Five clinical studies were identified that satisfied the eligibility criteria. Only three trials were suitable for the meta-analysis as they provided data at three and six months. Data on the prevalence of in each study were collected. The odds ratio (OR) for measuring the effect size with a 95% confidence interval (CI) was applied to the available data. The results did not favor the use of HA during non-surgical mechanical therapy to reduce the prevalence of in subgingival biofilm (odd ratio = 0.95 and 1.11 at three and six months, consecutively). Within their limitations, the current data do not indicate an advantage for using HA during mechanical periodontal therapy to reduce the prevalence of .
PubMed: 37514069
DOI: 10.3390/pharmaceutics15071883 -
BMC Oral Health Jul 2023The current literature suggests the significant role of foam cells in the initiation of atherosclerosis through the formation of a necrotic core in atherosclerotic...
BACKGROUND
The current literature suggests the significant role of foam cells in the initiation of atherosclerosis through the formation of a necrotic core in atherosclerotic plaques. Moreover, an important periodontal pathogen called Porphyromonas gingivalis (P. gingivalis) is indicated to play a significant role in this regard. Thus, the aim of this systematic review was to comprehensively study the pathways by which P. gingivalis as a prominent bacterial species in periodontal disease, can induce foam cells that would initiate the process of atherosclerosis formation.
METHODS
An electronic search was undertaken in three databases (Pubmed, Scopus, and Web of Science) to identify the studies published from January 2000 until March 2023. The risk of bias in each study was also assessed using the QUIN risk of bias assessment tool.
RESULTS
After the completion of the screening process, 11 in-vitro studies met the inclusion criteria and were included for further assessments. Nine of these studies represented a medium risk of bias, while the other two had a high risk of bias. All of the studies have reported that P. gingivalis can significantly induce foam cell formation by infecting the macrophages and induction of oxidized low-density lipoprotein (oxLDL) uptake. This process is activated through various mediators and pathways. The most important factors in this regard are the lipopolysaccharide of P. gingivalis and its outer membrane vesicles, as well as the changes in the expression rate of transmembrane lipid transportation channels, including transient receptor potential channel of the vanilloid subfamily 4 (TRPV4), lysosomal integral protein 2 (LIMP2), CD36, etc. The identified molecular pathways involved in this process include but are not limited to NF-κB, ERK1/2, p65.
CONCLUSION
Based on the results of this study, it can be concluded that P. gingivalis can effectively promote foam cell formation through various pathogenic elements and this bacterial species can affect the expression rate of various genes and the function of specific receptors in the cellular and lysosomal membranes. However, due to the moderate to high level of risk of bias among the studies, further studies are required in this regard.
Topics: Humans; Foam Cells; Porphyromonas gingivalis; Macrophages; Atherosclerosis; Periodontitis
PubMed: 37442956
DOI: 10.1186/s12903-023-03183-9 -
Evidence-based Dentistry Sep 2023To summarize the data on association between periodontal diseases and cognitive impairment in adults this systematic review scrutinized various observational studies...
DESIGN
To summarize the data on association between periodontal diseases and cognitive impairment in adults this systematic review scrutinized various observational studies till September 2021. This review was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) guidelines. The authors used PECO framework question,: population-Adults (18 years or older), exposure-adults suffering from periodontitis, comparator-adult group without periodontitis, outcome-adults at high risk for cognitive impairment.
CASE/CONTROL SELECTION
Search for the literature was conducted on PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Search was limited to human studies with no limitation to year of publication prior to September 2021. Search terms used were related to gingiva, oral bacteria like Porphyromonas gingivalis, gum inflammation, periodontitis, dementia, neuroinflammation, cognitive impairment, Alzheimer's disease, Parkinson disease. Following research, all the studies providing association between periodontal diseases and neurodegenerative diseases with quantitative measures were included in the study. Non-human studies, studies on patients below 18 year old, studies related to influence of treatment and in subjects already suffering from neurological disease were excluded. After removing duplicates, eligible studies were identified and data extracted by two reviewers to make ensure inter examiner reliability and to prevent data entry errors. Data from the studies were tabulated as study design, sample characteristics, diagnosis, exposure biomarkers/measures, outcomes and results.
DATA ANALYSIS
Methodological quality of studies was assessed by adapted Newcastle-Ottawa scale. Selection of study groups, comparability and exposure/outcome were used as parameters. Case-control and cohort studies were considered as high-quality studies if six or more stars were awarded out of nine maximum stars and four or more stars for cross-sectional studies out of six stars. Comparability among the groups was studied by taking into account primary factors for Alzheimer's disease such as age and sex and secondary factors like hypertension, osteoarthritis, depression, diabetes mellitus, and cerebrovascular disease. For cohort studies, 10 year follow up and dropout of <10% was considered to be successful.
RESULTS
A total of 3693 studies were identified by two independent reviewers and finally 11 studies were included in the final analysis. Six cohort studies, three cross-sectional and two case-control studies were included after excluding remaining studies. Bias in studies was assessed by adapted Newcastle-Ottawa Scale. All included studies were of high methodological quality. Association between periodontitis and cognitive impairment was determined by using different criteria like International classification of disease, clinical measurement of periodontitis subjects, inflammatory biomarkers, microbes and antibodies. It was suggested that subjects with chronic periodontitis since 8 years or more, are at a higher risk of having dementia. Clinical measures of periodontal disease like probing depth, clinical attachment loss, alveolar bone loss were found to be positively associated with cognitive impairment. Inflammatory biomarkers and pre-existing elevated levels of serum IgG specific to periodontopathogens was reported to be associated with cognitive impairment. Within the limitations of the study, the authors concluded that though the patients with long-standing periodontitis are at greater risk for developing cognitive impairment by neurodegenerative diseases, the mechanism by which periodontitis can lead to cognitive impairment is still vague.
CONCLUSIONS
Evidence suggests a strong association between periodontitis and cognitive impairment. Still further studies should be done to explore the mechanism involved.
Topics: Adult; Humans; Alzheimer Disease; Cross-Sectional Studies; Reproducibility of Results; Chronic Periodontitis; Cognitive Dysfunction; Biomarkers
PubMed: 37433922
DOI: 10.1038/s41432-023-00915-2 -
Clinical Laboratory May 2023No systematic review/meta-analysis has been conducted on the microbiological profile associated with the occurrence of periodontitis in patients with HIV. The aim of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
No systematic review/meta-analysis has been conducted on the microbiological profile associated with the occurrence of periodontitis in patients with HIV. The aim of this study was to evaluate the prevalence of identified bacteria in HIV-infected patients with periodontal disease.
METHODS
Three English electronic databases (MEDLINE (via PubMed), SCOPUS, and Web of Science) were searched systematically from the beginning to February 13, 2021. The frequency of each identified bacteria in HIV-infected patients with periodontal disease was extracted. All meta-analysis methods were performed using STATA software.
RESULTS
Twenty-two articles met inclusion criteria and were enrolled into the systematic review. This review analyzed a total of 965 HIV-infected patients with periodontitis. The prevalence of periodontitis was higher in HIV-infected male patients (83% (CI 95%: 76 - 88%)) compared to females (28% (CI 95%: 17 - 39%)). In our study, the pooled prevalence of necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis in patients with HIV infection was 67% (CI 95%: 52 - 82%) and 60% (CI 95%: 45 - 74%), while a lower prevalence of linear gingivitis erythema was reported (11% (CI 95%: 5 - 18%)). More than 140 bacterial species were identified from HIV-infected patients with periodontal disease. High prevalence of Tannerella forsythia (51% (CI 95%: 5 - 96%)), Fusobacterium nucleatum (50% (CI 95%: 21 - 78%)), Prevotella intermedia (50% (CI 95%: 32 - 68%)), Peptostreptococcus micros (44% (CI 95%: 25 - 65%)), Campylobacter rectus (35% (CI 95%: 25 - 45%)), and Fusobacterium spp. (35% (CI 95%: 3 - 78%)) in HIV-infected patients with periodontal disease was found.
CONCLUSIONS
Our study demonstrated that the prevalence of the red and orange complex of bacteria in HIV patients with periodontal disease is relatively high.
Topics: Female; Humans; Male; HIV Infections; Porphyromonas gingivalis; Periodontal Diseases; Periodontitis; Gingivitis
PubMed: 37145081
DOI: 10.7754/Clin.Lab.2022.220738 -
Clinical and Experimental Dental... Apr 2023This review was conducted to assess the effectiveness of xylitol against Porphyromonas gingivalis anaerobic species, a key microbe contributing to periodontal disease... (Review)
Review
OBJECTIVE
This review was conducted to assess the effectiveness of xylitol against Porphyromonas gingivalis anaerobic species, a key microbe contributing to periodontal disease pathogenesis.
MATERIAL AND METHODS
Relevant studies published on seven online databases (Cochrane, Ovid, Pubmed, Pubmed Central, Scopus, Google Scholar, and Web of Science) were included in accordance with the PRISMA guidelines. Inclusion criteria allowed all study designs involving xylitol and P. gingivalis, literature published since the year 2000, and all xylitol delivery forms.
RESULTS
The initial search yielded 186 papers. After the removal of duplicates, five reviewers screened every article for eligibility and seven articles were selected for data extraction. Four out of seven included studies assessed the dose-dependent effect of xylitol on P. gingivalis growth, two studies assessed the effect of xylitol on P. gingivalis-induced cytokine expression, and one study assessed both domains.
CONCLUSIONS
From the in vitro studies included in this systematic review, there is some evidence of xylitol's inhibitory effect on P. gingivalis. However, more evidence derived from in vivo studies is required to confirm its effectiveness warranting their routine use.
Topics: Humans; Porphyromonas gingivalis; Xylitol; Periodontal Diseases; Cytokines
PubMed: 36894516
DOI: 10.1002/cre2.724 -
Cureus Jan 2023The oral cavity has the second largest and most diverse microflora. A wide variety of bacteria, viruses, and fungi are present in the oral cavity. A significant number... (Review)
Review
The oral cavity has the second largest and most diverse microflora. A wide variety of bacteria, viruses, and fungi are present in the oral cavity. A significant number of studies have shown the important role of oral microflora in the initiation and pathogenesis of oral squamous cell carcinoma (OSCC). Microorganisms like , , , , , , Herpes Simplex Virus I (HSV-1), Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV), plays an important role in OSCC. Increased microbial load affects tumor initiation and progression through direct effects on the tumor cells and indirectly through manipulation of the immune system. But the mechanisms describing the steps of oral microflora initiating the OSCC remain an enigma. This systematic review aims to understand the potential carcinogenic effect of oral microflora on OSCC. A systematic literature search was done in PubMed and Google Scholar databases, and six studies were obtained, comprising 1267 participants. The incidence was evaluated as an odds ratio (OR) with a 95% confidence interval (95% CI) using review manager 5.2 software. Oral microflora increased 2.10-fold risk of oral squamous cell carcinoma (OR=2.10, 95% CI: 0.76, 5.84, P= 0.15, I=86%, P<0.00001). In our subgroup analysis, there is a significant relation between Fusobacterium and oral squamous cell carcinoma (OR= 4.86, 95% CI: 0.99, 23.82, P=0.05, I=0%, P= 0.84). Individuals with Epstein-Barr Virus infection exhibit increased incidence of oral squamous cell carcinoma (OR= 3.72, 95% CI: 1.97, 7.04, P=<0.0001, I=0%, P= 0.82). The meta-analysis revealed that oral microflora increases the risk of oral squamous cell carcinoma.
PubMed: 36779115
DOI: 10.7759/cureus.33560 -
The Japanese Dental Science Review Dec 2023The mechanisms modulated by periodontal pathogens in atherosclerosis are not fully understood. Aim: to perform an integrative analysis of gene and protein expression... (Review)
Review
UNLABELLED
The mechanisms modulated by periodontal pathogens in atherosclerosis are not fully understood. Aim: to perform an integrative analysis of gene and protein expression modulated by periodontal pathogens in cells and animal models for atherosclerosis.
METHODS
Cochrane, PRISMA and AMSTAR2 guidelines for systematic reviews were followed. Data search was conducted in Pub-med, LILACS and Science Direct databases. Gene and protein expression data were collected from the included papers to perform an overrepresentation analysis using the Reactome Pathway Analysis tool and the KEGG database.
RESULTS
Thirty-two papers were included in the review, they analyzed the effect of , , , , , and or/and their virulent factors on gene and protein expression in human cells and animal models of atherosclerosis. Some of the modulated pathways include the immune system, programmed cell death, cellular responses to external stimuli, transport of small molecules, and signal transduction (p < 0.05). Those pathways are known to be involved in different stages of atherosclerosis progression.
CONCLUSION
Based on the performed analysis, it is possible to state that periodontal pathogens have the potential to be a contributing factor for atherosclerosis even in absence of a high-fat diet or high shear stress.
PubMed: 36654677
DOI: 10.1016/j.jdsr.2022.12.001 -
Journal of Periodontal Research Apr 2023The objective of this systematic review and meta-analysis was to evaluate the effect of periodontal surgery on the subgingival microbiome. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this systematic review and meta-analysis was to evaluate the effect of periodontal surgery on the subgingival microbiome.
BACKGROUND
Periodontitis is a chronic inflammation of the tooth supporting tissues caused by the dysbiosis of the subgingival biofilm. It is managed through different non-surgical and surgical treatment modalities. Recent EFP S3 guidelines recommended performing periodontal surgery as part of Step 3 periodontitis treatment after Step 1 and Step 2 periodontal therapy, with the aim to achieve pocket closure of persisting sites. Changes in the sub-gingival microbiome may explain the treatment outcomes observed at different time points. Various microbiological detection techniques for disease-associated pathogens have been evolved over time and have been described in the literature. However, the impact of different types of periodontal surgery on the subgingival microbiome remains unclear.
METHODS
A systematic literature search was conducted in Medline, Embase, LILACS and Cochrane Library supplemented by manual search (23DEC2019, updated 21APR2022).
RESULTS
From an initial search of 3046 studies, 28 were included according to our specific inclusion criteria. Seven microbiological detection techniques were used to analyse disease-associated species in subgingival plaque samples: optical microscope, culture, polymerase chain reaction (PCR), checkerboard, enzymatic reactions, immunofluorescence and 16S gene sequencing. The included studies exhibited differences in various aspects of their methodologies such as subgingival plaque sample collection or treatment modalities. Clinical data showed a significant decrease in probing pocket depths (PPD) and clinical attachment loss (CAL) after periodontal surgery. Microbiological findings were overall heterogeneous. Meta-analysis was performed on a sub-cohort of studies all using checkerboard as a microbiological detection technique. Random effect models for Treponema denticola (T. denticola), Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) did not show a significant effect on mean counts 3 months after periodontal surgery. Notably, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) showed a significant increase 3 months after periodontal surgery. 16S gene sequencing was used in one included study and reported a decrease in disease-associated species with an increase in health-associated species after periodontal surgery at 3 and 6 months.
CONCLUSION
This systematic review has shown that the effect of periodontal surgery on the changes in subgingival microbiome is heterogeneous and may not always be associated with a decrease in disease-associated species. The variability could be attributed to the microbiological techniques employed for the analysis. Therefore, there is a need for well-designed and adequately powered studies to understand how periodontal surgery influences the subgingival microbiome and how the individual's microbiome affects treatment outcomes after periodontal surgery.
Topics: Humans; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Tannerella forsythia; Microbiota; Aggregatibacter actinomycetemcomitans; Treponema denticola
PubMed: 36597817
DOI: 10.1111/jre.13092