1
|
Banjara S, Berggreen E, Igland J, Åstrøm AK, Midttun Ø, Bunæs D, Sulo G. Plasma levels of immune system activation markers Neopterin and Kynurenine-to-Tryptophan Ratio, and oral health among community-dwelling adults in Norway: a population-based, cohort study. Acta Odontol Scand 2025; 84:218-225. [PMID: 40356307 DOI: 10.2340/aos.v84.43535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 03/31/2025] [Indexed: 05/15/2025]
Abstract
OBJECTIVE Periodontitis is a condition characterised by inflammation. Neopterin and kynurenine-to-tryptophan ratio (KTR) are markers of immune system activation in response to inflammation whose elevated levels are linked to higher incidence and poorer prognosis of various systemic diseases. Their potential association with oral health remains underexplored. The aim of this study was to prospectively investigate the associations between these biomarkers and periodontal health status among community-dwelling adults in Hordaland County, Norway. MATERIALS AND METHODS Neopterin and KTR were measured in 1,298 participants of the Hordaland Health Study, 1997-1999. Information on oral health indicators was obtained from the 'Hordaland-Oral Health Survey', 2020-2022. Ordinal logistic regression and negative binomial regression were used to explore the association between biomarkers and periodontitis, tooth loss, and current inflammation (extend of sites with pocket depth ≥4mm and bleeding on probing) and odds ratios (OR) and incidence rate ratios (IRR), along with respective 95% confidence intervals (CI) were reported. RESULTS No association was found between biomarker levels and periodontitis [neopterin: OR = 0.96, 95% CI: 0.69-1.33 for fourth (Q4) vs. first quartile (Q1); KTR: OR = 0.85, 95% CI: 0.61-1.18 for Q4 vs. Q1], tooth loss [neopterin: IRR = 1.00, 95% CI: 0.94-1.06 for Q4 vs. Q1; KTR: IRR = 0.97, 95% CI: 0.91-1.03 for Q4 vs. Q1) or extend of inflammation [neopterin: OR = 0.87, 95% CI: 0.70-1.09 for Q4 vs. Q1; KTR: OR = 0.98, 95% CI: 0.78-1.23 for Q4 vs. Q1]. CONCLUSION Plasma levels of neopterin and KTR were not prospectively associated with periodontal health and number of missing teeth.
Collapse
Affiliation(s)
- Sarala Banjara
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Ellen Berggreen
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway; Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | | | - Dagmar Bunæs
- Department of Clinical Odontology, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| |
Collapse
|
2
|
Wang J, Deng Q, Qi L. Integrated bioinformatics, machine learning, and molecular docking reveal crosstalk genes and potential drugs between periodontitis and systemic lupus erythematosus. Sci Rep 2025; 15:15787. [PMID: 40328806 PMCID: PMC12055969 DOI: 10.1038/s41598-025-00620-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Accepted: 04/29/2025] [Indexed: 05/08/2025] Open
Abstract
Evidence indicates a connection between periodontitis (PD) and systemic lupus erythematosus (SLE), though the underlying co-morbid mechanisms remain unclear. This study sought to identify the genetic factors and potential therapeutic agents involved in the interaction between PD and SLE. We employed multi-omics methodologies, encompassing differential expression analysis, weighted gene co-expression network analysis (WGCNA), functional enrichment (GO/KEGG), LASSO regression, diagnostic model construction, protein-protein interaction (PPI) networks, immune infiltration profiling, computational drug prediction, molecular docking, and disease subtyping, to analyze PD and SLE expression datasets from the Gene Expression Omnibus (GEO) database (GSE10334, GSE16134, GSE50772, and GSE81622). Cross-analysis identified 32 crosstalk genes (CGs) common to both PD and SLE. LASSO analysis pinpointed three key diagnostic genes (TAGLN, MMP9, TNFAIP6) for both conditions. The resulting diagnostic models demonstrated robust efficacy in both training and validation datasets. Four topological algorithms in Cytoscape highlighted four central crosstalk genes (TAGLN, MMP9, TNFAIP6, IL1B). Additionally, hesperidin, doxycycline, and cytochalasin D emerged as potential therapeutic agents. Two subtypes (C1 and C2) of PD and SLE were delineated based on CG expression profiles. The development of diagnostic models, potential drug identification, and disease subtype classification are poised to enhance diagnosis and treatment. These findings aim to deepen the understanding of PD and SLE complexities.
Collapse
Affiliation(s)
- Junjie Wang
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Qingao Deng
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Lu Qi
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
- Department of Stomatology, The Second Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, No. 38, North Second Lane, Nanhu East Road, Urumqi, 830000, China.
| |
Collapse
|
3
|
Elabdeen HRZ, Berggreen E, Jensen KH, Sulo G, Kvalheim SF, Hasselgren LC, Gerdts E, Iversen MM, Bolstad AI, Bunæs DF. Prevalence of Periodontitis in a 70-Year-Old Population in Western Norway According to the ACES 2018 Classification Framework: A Cross-Sectional Study. J Clin Periodontol 2025; 52:754-761. [PMID: 39895368 PMCID: PMC12003053 DOI: 10.1111/jcpe.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 11/29/2024] [Accepted: 01/03/2025] [Indexed: 02/04/2025]
Abstract
AIM To assess the prevalence and severity of periodontitis in an older adult population in Western Norway using the periodontitis definition by the recently published ACES 2018 Classification Framework. MATERIALS AND METHODS In the present study, 1298 70-year-old subjects answered a questionnaire and underwent a full-mouth periodontal examination. The prevalence of periodontitis, stages, extents and grades was presented according to the Framework applying the 2018 periodontal classification scheme in epidemiological survey (ACES). Descriptive analyses were used, and results were expressed as percentages of the total number of observations. RESULTS According to ACES, periodontitis was detected in 100% of the study population, and Stage II, Stage III and Stage IV were present in 21%, 75% and 4% of the individuals, respectively. The majority of periodontitis cases demonstrated generalised periodontitis and Grade B was the predominant grade in the periodontitis cases. The mean number of teeth in the study population was 25.3. CONCLUSION There is a high burden of periodontitis in the present population of old individuals, and the majority of participants were classified as Stage III periodontitis. The cut-offs for interdental clinical attachment loss in the definition of periodontitis affect the estimate of cases, stages and extent of periodontitis in older age groups.
Collapse
Affiliation(s)
| | - Ellen Berggreen
- Oral Health Centre of Expertise in Western NorwayBergenNorway
- Department of BiomedicineUniversity of BergenBergenNorway
| | | | - Gerhard Sulo
- Oral Health Centre of Expertise in Western NorwayBergenNorway
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
| | - Siri Flagestad Kvalheim
- Oral Health Centre of Expertise in Western NorwayBergenNorway
- Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenBergenNorway
| | | | - Eva Gerdts
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | | | - Anne Isine Bolstad
- Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenBergenNorway
| | - Dagmar F. Bunæs
- Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenBergenNorway
| |
Collapse
|
4
|
Xu Z, Wang Y, Li S, Li Y, Chang L, Yao Y, Peng Q. Advances of functional nanomaterials as either therapeutic agents or delivery systems in the treatment of periodontitis. BIOMATERIALS ADVANCES 2025; 175:214326. [PMID: 40300444 DOI: 10.1016/j.bioadv.2025.214326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 04/20/2025] [Accepted: 04/26/2025] [Indexed: 05/01/2025]
Abstract
Periodontitis is a common chronic inflammatory disease primarily caused by pathogenic microorganisms in the oral cavity. Without appropriate treatments, it may lead to the gradual destruction of the supporting tissues of the teeth. While current treatments can alleviate symptoms, they still have limitations, particularly in eliminating pathogenic bacteria, promoting periodontal tissue regeneration, and avoiding antibiotic resistance. In recent years, functional nanomaterials have shown great potential in the treatment of periodontitis due to their unique physicochemical and biological properties. This review summarizes various functionalization strategies of nanomaterials and explores their potential applications in periodontitis treatment, including metal-based nanoparticles, carbon nanomaterials, polymeric nanoparticles, and exosomes. The mechanisms and advances in antibacterial effects, immune regulation, reactive oxygen species (ROS) scavenging, and bone tissue regeneration are discussed in detail. In addition, the challenges and future directions of applying nanomaterials in periodontitis therapy are also discussed.
Collapse
Affiliation(s)
- Ziyi Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yue Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuoshun Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuanhong Li
- Department of Orthodontics, Shanghai Stomatological Hospital and School of Stomatology, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, China
| | - Lili Chang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Yao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Qiang Peng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
5
|
Li H, Li L, Yang S, Dai W, Guo C, Zhu G, Wang Z, Wang Z, Yan X, Liang Y. Exploring the Nonlinear Relationship Between Dietary Flavonoid Intake and Periodontitis. Int Dent J 2025; 75:716-726. [PMID: 39547843 PMCID: PMC11976537 DOI: 10.1016/j.identj.2024.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 10/02/2024] [Accepted: 10/27/2024] [Indexed: 11/17/2024] Open
Abstract
INTRODUCTION AND AIMS Flavonoids are non-nutrient bioactive substances widely found in plants, possessing antioxidant and anti-inflammatory properties. Periodontitis is a long-term inflammatory disease that impacts the tissues supporting the teeth, poses a substantial burden on public health and individuals alike. This study aims to explore the association between dietary flavonoid intake and periodontitis. METHODS This study included 3005 participants from the 2009 to 2010 National Health and Nutrition Examination Survey. We compared the weighted prevalence of periodontitis across different participant groups. Binary logistic regression analysis was conducted to evaluate the relationship between dietary flavonoid intake and periodontitis. The restricted cubic spline plot was used to explore nonlinear relationships. RESULTS The prevalence of periodontitis among participants with total flavonoid intake in quartiles Q1 to Q4 was 54.95%, 44.11%, 40.62%, and 48.28%, respectively. When compared to the Q1 group of total flavonoid intake, the OR values for Q2 to Q4 groups were 0.58 (95% CI: 0.39-0.86, P = .01), 0.50 (95% CI: 0.35-0.73, P = .001), and 0.68 (95% CI: 0.50-0.91, P = .01), respectively. A significant nonlinear association was observed between ln-transformed total flavonoid intake and the likelihood of developing periodontitis (nonlinearity P < .001). The inflection point was identified at an ln-transformed total flavonoid intake of 4.05, corresponding to a total flavonoid intake of 57.54 mg. Beyond this inflection point, as the total flavonoid intake value continues to rise, there was a diminishing protective effect against periodontitis. CONCLUSIONS Higher dietary flavonoid intake is associated with a reduced risk of periodontitis, with the greatest protective effect observed at moderate intake levels. CLINICAL RELEVANCE Understanding the association between flavonoid intake and periodontitis can guide dietary recommendations and interventions aimed at preventing periodontitis. This study supports the potential role of a flavonoid-rich diet in promoting periodontal health, suggesting that dietary modifications could be a viable strategy in periodontal disease prevention and management.
Collapse
Affiliation(s)
- Hua Li
- Department of Pain, Jiangyou People's Hospital, Mianyang, China; Department of Rehabilitation Medicine, Jiangyou People's Hospital, Mianyang, China
| | - Linlong Li
- College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
| | | | - Wei Dai
- Jiangyou People's Hospital, Mianyang, China
| | | | | | - Zhi Wang
- Jiangyou People's Hospital, Mianyang, China
| | - Zheng Wang
- Jiangyou People's Hospital, Mianyang, China
| | | | - Yun Liang
- Department of Pain, Jiangyou People's Hospital, Mianyang, China; Department of Rehabilitation Medicine, Jiangyou People's Hospital, Mianyang, China.
| |
Collapse
|
6
|
Wu ZY, Guo W, Zhou W, Ye HJ, Jiang Y, Li H, Zhou ZH. Abductive multi-instance multi-label learning for periodontal disease classification with prior domain knowledge. Med Image Anal 2025; 101:103452. [PMID: 39826436 DOI: 10.1016/j.media.2024.103452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 12/30/2024] [Accepted: 12/31/2024] [Indexed: 01/22/2025]
Abstract
Machine learning is widely used in dentistry nowadays, offering efficient solutions for diagnosing dental diseases, such as periodontitis and gingivitis. Most existing methods for diagnosing periodontal diseases follow a two-stage process. Initially, they detect and classify potential Regions of Interest (ROIs) and subsequently determine the labels of the whole images. However, unlike the recognition of natural images, the diagnosis of periodontal diseases relies significantly on pinpointing specific affected regions, which requires professional expertise that is not fully captured by existing models. To bridge this gap, we propose a novel ABductive Multi-Instance Multi-Label learning (AB-MIML) approach. In our approach, we treat entire intraoral images as "bags" and local patches as "instances". By improving current multi-instance multi-label methods, AB-MIML seeks to establish a comprehensive many-to-many relationship to model the intricate correspondence among images, patches, and corresponding labels. Moreover, to harness the power of prior domain knowledge, AB-MIML converts the expertise of doctors and the structural information of images into a knowledge base and performs abductive reasoning to assist the classification and diagnosis process. Experiments unequivocally confirm the superior performance of our proposed method in diagnosing periodontal diseases compared to state-of-the-art approaches across various metrics. Moreover, our method proves invaluable in identifying critical areas correlated with the diagnosis process, aligning closely with determinations made by human doctors.
Collapse
Affiliation(s)
- Zi-Yuan Wu
- National Key Laboratory for Novel Software Technology, Nanjing University, Nanjing, 210023, China; School of Artificial Intelligence, Nanjing University, Nanjing, 210023, China
| | - Wei Guo
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, 210008, China
| | - Wei Zhou
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, 210008, China
| | - Han-Jia Ye
- National Key Laboratory for Novel Software Technology, Nanjing University, Nanjing, 210023, China; School of Artificial Intelligence, Nanjing University, Nanjing, 210023, China.
| | - Yuan Jiang
- National Key Laboratory for Novel Software Technology, Nanjing University, Nanjing, 210023, China; School of Artificial Intelligence, Nanjing University, Nanjing, 210023, China
| | - Houxuan Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, 210008, China.
| | - Zhi-Hua Zhou
- National Key Laboratory for Novel Software Technology, Nanjing University, Nanjing, 210023, China; School of Artificial Intelligence, Nanjing University, Nanjing, 210023, China
| |
Collapse
|
7
|
Kharbot B, Riegel M, Schwendicke F, Paris S, Göstemeyer G. Accuracy and Reliability of Intraoral 3D Scans for Diagnostic Evaluations in Nursing Home Residents. Gerodontology 2025. [PMID: 40163462 DOI: 10.1111/ger.12817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 01/17/2025] [Accepted: 03/06/2025] [Indexed: 04/02/2025]
Abstract
OBJECTIVES To evaluate the accuracy and reliability of intraoral 3D scans for assessing the oral health of older patients living in nursing homes. MATERIALS AND METHODS One examiner recorded missing teeth, restorations, caries lesions and oral hygiene (Geriatric-Debris-Index Simplified [GDI-S] ≥ 1.9) in nursing home residents using visual-tactile diagnostics (reference test) and afterwards obtained intraoral scans with an intraoral scanner (TRIOS 4, 3Shape). Two other independent investigators and the clinical examiner assessed only the scans to delineate the same diagnostic outcomes. For these outcomes, we assessed accuracy, sensitivity, specificity and the Area-under-the-Receiver-Operating-Characteristics Curve (AUROC). Kappa values (κ) were calculated to evaluate inter-examiner and intra-examiner reliability after re-examination by all examiners after a minimum interval of 3 weeks. RESULTS Forty-three partially dentate patients (65-95 years of age) in need of care living in four nursing homes with a total of 486 teeth (mean [SD]: 11 [9] teeth per patient) were examined. Scans were perfectly accurate for detecting missing teeth (AUROC [sensitivity/specificity]: 1 [1/1]) and showed high accuracy for detecting restorations (0.96 [0.93/0.98]), too. Accuracy was lower to detect caries (0.77 [0.58/0.97]) and insufficient for oral hygiene (0.76 [0.54/0.99]). Agreement between examiners was perfect for missing teeth (κ: 1), very good for the detection of restorations (0.94), and good for caries or insufficient oral hygiene (0.73 and 0.72, respectively). CONCLUSIONS Scans were suitable for basic diagnostic evaluations but showed considerable shortcomings in detecting caries and poor oral hygiene. Assessing scans was relatively reliable. CLINICAL RELEVANCE Using scans may allow telemedical assessments of nursing home residents, but users should be aware of the differential accuracy for different diagnostic targets.
Collapse
Affiliation(s)
- Basel Kharbot
- Department of Operative, Preventive and Pediatric Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maike Riegel
- Department of Operative, Preventive and Pediatric Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sebastian Paris
- Department of Operative, Preventive and Pediatric Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative, Preventive and Pediatric Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
8
|
Luan X, Jin Z, Xia S, Li J, An Y, Gao J, Wang S, Xia H, Pan S, Zhang Y, Song W, Wu Y. Smoking impairs cognitive function through the mediating effect of periodontitis in older adults. BMC Psychiatry 2025; 25:292. [PMID: 40148790 PMCID: PMC11948936 DOI: 10.1186/s12888-025-06699-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 03/10/2025] [Indexed: 03/29/2025] Open
Abstract
OBJECTIVES Evidence has shown that both smoking and periodontitis were linked to cognitive impairment. This study examines whether periodontitis mediates the effects of smoking status on cognitive function in older adults. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, the study included 1728 older participants who have data on smoking, serum cotinine, periodontal examination, and cognitive function. Mediation analysis was performed to test whether extent of periodontitis mediated associations between smoking status and cognitive function, adjusted for sociodemographic and basic health factors. RESULTS Compared to never-smokers, daily smokers exhibited significantly worse global cognitive function, with periodontitis mediating this effect (effect= -0.16; 95% CI= -0.29, -0.05). Similarly, periodontitis mediated the association between serum cotinine levels and cognitive function in the total sample (effect= -0.02; 95% CI= -0.03, -0.00). CONCLUSIONS Periodontitis significantly mediates the impact of smoking on cognitive function. The findings highlight the potential roles of maintaining oral health and smoking cessation in mitigating cognitive decline.
Collapse
Affiliation(s)
- Xiaoqian Luan
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Zhou Jin
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
- Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, Zhejiang Provincial Clinical Research Center for Mental Health, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Shenhang Xia
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Jin Li
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Yao An
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Jiaqi Gao
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Shengya Wang
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Huwei Xia
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Sipei Pan
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
| | - Yao Zhang
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China
- Department of Prosthodontics, Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Weihong Song
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, The Center for Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China.
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, 325035, Zhejiang Province, China.
| | - Yili Wu
- Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, Zhejiang Provincial Clinical Research Center for Mental Health, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
| |
Collapse
|
9
|
Mlachkova A, Dosseva-Panova V, Maynalovska H, Pashova-Tasseva Z. Nanoparticles as Strategies for Modulating the Host's Response in Periodontitis Treatment. NANOMATERIALS (BASEL, SWITZERLAND) 2025; 15:476. [PMID: 40214523 PMCID: PMC11990483 DOI: 10.3390/nano15070476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Revised: 03/08/2025] [Accepted: 03/20/2025] [Indexed: 04/14/2025]
Abstract
Periodontitis is a widespread disease, associated with challenges both in its diagnosis and in selecting from various therapeutic approaches, which do not always yield the expected success. This literature review was conducted to explore diverse therapeutic approaches, especially those focused on nanotechnologies, and their potential contribution to the successful modulation of the host's response. The effects of the existing microbial diversity and the imbalance of key microbial species in contributing to the progression and worsening of the host's response in periodontitis are well known. It is essential to understand the role of a well-structured treatment plan for periodontitis, providing opportunities for new research and innovative treatment strategies aimed at reducing the impact of periodontitis on oral and overall systemic health. This will be beneficial for dental professionals, enabling them to effectively prevent and treat periodontitis, ultimately improving the overall health and well-being of patients.
Collapse
Affiliation(s)
| | | | | | - Zdravka Pashova-Tasseva
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria; (A.M.); (V.D.-P.); (H.M.)
| |
Collapse
|
10
|
Cheng X, Shen S. Identification of key genes in periodontitis. Front Genet 2025; 16:1579848. [PMID: 40176796 PMCID: PMC11961894 DOI: 10.3389/fgene.2025.1579848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Accepted: 02/28/2025] [Indexed: 04/04/2025] Open
Abstract
Periodontitis, a prevalent global oral health issue, is primarily characterized by chronic inflammation resulting from bacterial infection. Periodontitis primarily affects the tissues surrounding and supporting the teeth, encompassing the gingival tissue, periodontal attachment apparatus, and the bony socket. The disease mechanism results from intricate interactions between hereditary factors, the body's defense mechanisms, and shifts in the composition of oral microbiota, with each element playing a crucial role in the initiation and advancement of the pathological process. The early symptoms of periodontitis are often not obvious, resulting in patients often not seeking medical attention until they are seriously ill, so finding biomarkers for periodontitis is essential for timely diagnosis and treatment. In this study, we selected two datasets (GSE10334 and GSE16134) by in-depth analysis of publicly available sequencing data of affected and unaffected gum tissue in periodontitis patients in the GEO database. To identify key genes associated with periodontitis pathogenesis and explore potential therapeutic biomarkers, we employed two complementary computational approaches: Random Forest, a robust machine learning algorithm for feature selection, and Weighted Gene Co-expression Network Analysis (WGCNA), a systems biology method for identifying co-expressed gene modules. Through comprehensive analysis of these combined datasets, our objective is to elucidate the underlying molecular pathways governing periodontal disease progression, thereby identifying novel therapeutic targets that may facilitate the design of improved clinical interventions for this condition. This study establishes a substantial scientific foundation that contributes to both clinical applications and fundamental research in periodontitis. The findings not only offer valuable insights for developing early diagnostic strategies and therapeutic interventions but also provide a robust theoretical framework to guide future investigations into the molecular mechanisms underlying this complex disease.
Collapse
Affiliation(s)
- Xianyang Cheng
- School of Stomatology, Jinan University, Guangzhou, China
| | - Shan Shen
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| |
Collapse
|
11
|
Lang Y, Song X, Chen Y, Mei H, Wu C, Zhang R, Xue C. Association between the indicators of insulin resistance and periodontitis: a study using data from the National Health and Nutrition Examination Survey 2009-2014. BMC Oral Health 2025; 25:404. [PMID: 40108596 PMCID: PMC11924845 DOI: 10.1186/s12903-025-05752-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 03/04/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND The rising obesity rates are accompanied by an increasing prevalence of insulin resistance (IR) associated with obesity. To ascertain the best index for replacing IR, this study aimed to investigate the possible association between IR, which was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and the triglyceride-glucose (TyG) index and its derived indexes and periodontitis. METHODS The association between the indicators of IR and periodontitis was assessed via multivariate-adjusted logistic regression analyses using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. In addition, subgroup analyses and receiver operating characteristic curve analyses were conducted to explore possible influencing factors. RESULTS Our study encompassed 1,588 participants, and 41.0% were diagnosed with periodontitis. Based on the multivariate logistic regression analysis, a higher TyG-waist-to-height ratio (WHtR) (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.02-1.27, P = 0.0244) and HOMA-IR score (OR = 1.00, 95% CI: 1.00-1.00, P = 0.0028) were associated with an increased risk of periodontitis. Conversely, the TyG index, TyG-adjusted for body mass index, and TyG-adjusted for waist circumference (WC) were not associated with periodontitis. According to further subgroup analyses and interaction result analyses, sex affected the association between the TyG index, TyG-WC, and TyG-WHtR and periodontitis (P < 0.05 for interaction). Moreover, the influence of age regulated the association between periodontitis and both TyG and HOMA-IR score. In terms of diagnostic accuracy, the area under the receiver operating characteristic curve analysis revealed that HOMA-IR score and TyG-WHtR slightly outperformed the TyG index, TyG-body mass index, and TyG-WC. Thus, they can be robust markers for assessing IR-related periodontitis risk. CONCLUSION A consistent and positive association was found between HOMA-IR score and TyG-WHtR and the odds of periodontitis prevalence. Hence, HOMA-IR score and TyG-WHtR were significantly associated with periodontitis in this cross-sectional study. However, prospective studies are needed to determine whether higher TyG-waist-to-height ratio and HOMA-IR score can predict the occurrence of periodontitis.
Collapse
Affiliation(s)
- Yiyuan Lang
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Xin Song
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Chen
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Han Mei
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengyu Wu
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Zhang
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Changao Xue
- Department of Stomatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
- The Third Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
12
|
Saleh MHA, Roh A, Martin K, Mianecki M, Tariq Sheikh A, Singh P, Akorede K, Saunders MN, Shea LD, Decker A, Decker JT. Cargo-less Nanoparticles Prevent Bone Loss in Periodontitis and Peri-implantitis. J Dent Res 2025:220345251319256. [PMID: 40077863 DOI: 10.1177/00220345251319256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2025] Open
Abstract
Periodontal and peri-implant diseases are a significant public health problem worldwide, resulting in the destruction of the supporting bone. These bone defects can cause esthetic problems, increased relapse rate, and eventually tooth loss. The etiology of periodontal disease involves an influx of innate immune cells (neutrophils and monocytes) and upregulation of local inflammatory cytokines in the gingiva. Biodegradable polymeric nanoparticles are an inexpensive, safe, and effective means of preventing innate immune activation by bacterial biofilms. We therefore hypothesize that this technology is a potential means of managing periodontal disease. Polylactic acid (PLA) particles were fabricated using an oil-in-water emulsion and used as a therapy in ligature-induced periodontitis and peri-implantitis. Mice were treated daily with nanoparticles or saline control through intravenous injection for 5 or 7 d. Bone loss and quality were characterized using micro-computed tomography and histology, and immune cell infiltrate was characterized by flow cytometry and enzyme-linked immunosorbent assay. PLA particle therapy prevented bone loss in both periodontitis and peri-implantitis. Particle treatment was associated with decreased osteoclast activation. Flow cytometry showed particles were mainly taken up by macrophages and limited inflammatory monocyte recruitment to the ligature site. In vitro evaluation of particle therapy demonstrated the inhibition of toll-like receptor activation during particle treatment. These results extended to monocytes that had been presensitized by titania nanoparticles. Taken together, the results of these experiments demonstrated that cargo-less PLA particle therapy may be a safe, cost-effective therapy to manage inflammatory bone loss in periodontal disease.
Collapse
Affiliation(s)
- M H A Saleh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - A Roh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - K Martin
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Mianecki
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - A Tariq Sheikh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - P Singh
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - K Akorede
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M N Saunders
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - L D Shea
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - A Decker
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J T Decker
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
13
|
Chu X, Elashiry M, Carroll A, Cornelius Timothius CJ, Cutler CW, Elsayed R. The Role of Senescence in Experimental Periodontitis at the Causal Level: An in Vivo Study. Cells 2025; 14:226. [PMID: 39937017 PMCID: PMC11817363 DOI: 10.3390/cells14030226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/22/2025] [Accepted: 01/29/2025] [Indexed: 02/13/2025] Open
Abstract
The occurrence and severity of periodontitis (PD) tend to increase with age, and yet the underlying mechanisms remain unclear. Immune senescence is known to be triggered in mice and humans as they age. Experimental PD in mice has been shown to induce senescence biomarkers p16 INK4a and p21, dysfunction of antigen-presenting cells (APCs), and activation of the senescence-associated secretory phenotype (SASP). However, the causal links of senescence to experimental PD are not yet established. This study aims to elucidate the role of senescence in experimental PD at a causal level. The P16-3MR mouse model harbors the p16INK4a (Cdkn2a) promoter, driving in vivo expression of synthetic Renilla luciferase, monomeric red fluorescent protein (mRFP), and herpes simplex virus-1 thymidine kinase (HSV-TK). This facilitates in vivo identification of p16 INK4a activation at the cellular level and the consequences of selective elimination of p16INK4a-positive cells by ganciclovir (GCV) treatment. Mice were treated with/without GCV for two weeks during ligature-induced PD. In vivo bioluminescence imaging quantified p16INK4a activation, while Western blot and immunofluorescence analyses assessed key senescence and inflammatory markers (p16, p21, p53, Cyclin D1, p-H2A.X, IL17, and IL1β). Alveolar bone volume was analyzed by micro-CT and histomorphometry. Our findings demonstrate that clearance of senescent cells in mice subjected to experimental PD alleviates inflammation and mitigates bone loss. These results suggest a causal role for senescence in PD pathology, raising the future prospect of senolytic agents for therapeutic intervention in PD.
Collapse
Affiliation(s)
| | | | | | | | | | - Ranya Elsayed
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA 30912, USA; (X.C.); (M.E.); (A.C.); (C.J.C.T.); (C.W.C.)
| |
Collapse
|
14
|
Suhaimi AN, Roop Kishore YA, Shalihin MSE, Hamzah HA, Abidin S, Mohammad Aidid E, Musa R. The Detection of Porphyromonas Gingivalis in Geriatrics and Its Associated Periodontal and Clinical Factors. Cureus 2025; 17:e79522. [PMID: 40135017 PMCID: PMC11936489 DOI: 10.7759/cureus.79522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2025] [Indexed: 03/27/2025] Open
Abstract
BACKGROUND Porphyromonas gingivalis is one of the important pathogens in the initiation and progression of periodontitis. The findings regarding the bacterium and periodontal status in geriatric subjects are not widely reported. Bacterial analysis is needed to provide more insight regarding the severity of the disease. This study evaluated the presence of P. gingivalis in the oral cavity of geriatric patients and found a significant association between P. gingivalis infection and medical illness. METHODS Periodontal pocket samples were obtained from 32 geriatrics who were chosen randomly from health clinics. Clinical periodontal parameters were recorded during the oral examination. Samples were subjected to DNA extraction and polymerase chain reaction (PCR) amplification. The identification of P. gingivalis by PCR assay was determined based on the P. gingivalis 16S rRNA subunit amplification. Medical illnesses of patients were recorded. Mild cognitive impairment was diagnosed according to cognitive score assessment and daily function. RESULTS Approximately 90.63% (n=29) of geriatric patients had periodontitis. The presence of P. gingivalis was significantly associated with periodontal depth and clinical attachment loss (p = 0.037). The extension of periodontal disease, cognitive impairment status, and diabetes status are highly associated with P. gingivalis. Conclusion: Due to asymptomatic periodontal disease in the early phase, early screening of bacterial detection and oral public health awareness is crucial, especially among elderly groups who are smokers and diabetics. P. gingivalis infection is associated with worsening geriatric periodontitis. Adequate oral care and comorbidity control among geriatrics are indeed crucial to preventing disease progression. It is important to improve and modify the local diabetic checklist protocol for geriatric diabetic patients by incorporating oral health and oral microbiome assessments, as well as cognitive assessments.
Collapse
Affiliation(s)
- Aina Nabilah Suhaimi
- Department of Health Sciences, International Islamic University Malaysia, Kuantan, MYS
| | | | | | - Hairul Aini Hamzah
- Department of Basic Medical Science, International Islamic University Malaysia, Kuantan, MYS
| | - Sulhi Abidin
- Department of Prosthodontics, International Islamic University Malaysia, Kuantan, MYS
| | - Edre Mohammad Aidid
- Department of Community Medicine, International Islamic University Malaysia, Kuantan, MYS
| | - Ramli Musa
- Department of Psychiatry, International Islamic University Malaysia, Kuantan, MYS
| |
Collapse
|
15
|
Ebersole JL, Novak MJ, Cappelli D, Dawson DR, Gonzalez OA. Use of Nonhuman Primates in Periodontal Disease Research: Contribution of the Caribbean Primate Research Center and Cayo Santiago Rhesus Colony. Am J Primatol 2025; 87:e23724. [PMID: 39902755 DOI: 10.1002/ajp.23724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 12/04/2024] [Accepted: 12/16/2024] [Indexed: 02/06/2025]
Abstract
This review article provides a historical summary regarding the use, value, and validity of the nonhuman primate model of periodontal disease. The information provided cites results regarding the features of naturally occurring periodontitis in various nonhuman primate species, as well as the implementation of a model of experimental periodontitis. Clinical similarities to human disease are discussed, as well as the use of these models to document physiological and pathophysiological tissue changes in the periodontium related to the initiation and progression of the disease. Additionally, the use of these analytics in examination of the tissue characteristics of the disease, and the utility of nonhuman primates in testing and describing various therapeutic modalities are described. As periodontitis represents a disease of an oral microbiome dysbiosis, features of the altered microbiome in the disease in nonhuman primates are related to similar findings in the human condition. The review then provides a summary of the features of local and systemic host responses to a periodontal infection in an array of nonhuman primate species. This includes attributes of innate immunity, acute and chronic inflammation, and adaptive immune responses. Finally, extensive information is presented regarding the role of Macaca mulatta derived from the Cayo Santiago community in evaluating critical biologic details of disease initiation, progression, and resolution. This unique resource afforded the capacity to relate risk and expression of disease and traits of the responses to age, sex, and matriline derivation (e.g., heritability) of the animals. The Cayo Santiago colony continues to provide a critical preclinical model for assessment of molecular aspects of the disease process that can lead to both new targets for therapeutics and consideration of vaccine approaches to preventing and/or treating this global disease.
Collapse
Grants
- This study was supported by National Institute on Minority Health and Health Disparities (MD007600), National Institute of Dental and Craniofacial Research (DE05599, DE07267, DE07457), National Center for Research Resources (RR003051, RR020145, RR03640), National Institute of General Medical Sciences (GM103538), Office of Research Infrastructure Programs (OD012217, OD021458), and National Institute on Aging (AG021406).
Collapse
Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - M J Novak
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - D Cappelli
- Department of Biomedical Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - D R Dawson
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - O A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
16
|
Ma L, Cao Z. Periodontopathogen-Related Cell Autophagy-A Double-Edged Sword. Inflammation 2025; 48:1-14. [PMID: 38762837 DOI: 10.1007/s10753-024-02049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
The periodontium is a highly organized ecosystem, and the imbalance between oral microorganisms and host defense leads to periodontal diseases. The periodontal pathogens, mainly Gram-negative anaerobic bacteria, colonize the periodontal niches or enter the blood circulation, resulting in periodontal tissue destruction and distal organ damage. This phenomenon links periodontitis with various systemic conditions, including cardiovascular diseases, malignant tumors, steatohepatitis, and Alzheimer's disease. Autophagy is an evolutionarily conserved cellular self-degradation process essential for eliminating internalized pathogens. Nowadays, increasing studies have been carried out in cells derived from periodontal tissues, immune system, and distant organs to investigate the relationship between periodontal pathogen infection and autophagy-related activities. On one hand, as a vital part of innate and adaptive immunity, autophagy actively participates in host resistance to periodontal bacterial infection. On the other, certain periodontal pathogens exploit autophagic vesicles or pathways to evade immune surveillance, therefore achieving survival within host cells. This review provides an overview of the autophagy process and focuses on periodontopathogen-related autophagy and their involvements in cells of different tissue origins, so as to comprehensively understand the role of autophagy in the occurrence and development of periodontal diseases and various periodontitis-associated systemic illnesses.
Collapse
Affiliation(s)
- Li Ma
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Zhengguo Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Hongshan District, Wuhan, 430079, China.
| |
Collapse
|
17
|
Zhang S, Jiao Y, Liu S, Liu Y, Liu Y. Effects of Porphyromonas gingivalis Outer Membrane Vesicles (OMVs) on Macrophages in Periodontitis. Oral Dis 2025. [PMID: 39887837 DOI: 10.1111/odi.15264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 11/13/2024] [Accepted: 01/09/2025] [Indexed: 02/01/2025]
Abstract
OBJECTIVE To review the effect of outer membrane vesicles (OMVs) of the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) on macrophages during periodontitis development. METHOD Literature pertaining to P. gingivalis OMVs and macrophages was reviewed and discussed, with a focus on the immunomodulatory effects of P. gingivalis OMVs on macrophages. RESULTS P. gingivalis OMVs affect the recognition, phagocytosis, polarization, and apoptosis functions of macrophages. However, information on their antigen-presenting effect remains lacking, and further research is required for clinical applications. CONCLUSION P. gingivalis OMVs can influence the development of periodontitis through immune modulation of macrophages; however, further research is required to provide novel ideas for the prevention and treatment of periodontitis.
Collapse
Affiliation(s)
- Shuyi Zhang
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Yao Jiao
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Siyan Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Yitong Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Yi Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| |
Collapse
|
18
|
Li C, Huang D, Pan Q, Tao P, Pan X, Pan Y, He R, Wang T, Huang H. An analysis of the current status of geriatric oral disease treatment-a dental institutions-based perspective. Front Public Health 2025; 12:1503938. [PMID: 39877915 PMCID: PMC11772203 DOI: 10.3389/fpubh.2024.1503938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 12/30/2024] [Indexed: 01/31/2025] Open
Abstract
Background This study aimed to investigate and analyze the current status of oral disease treatment among the older adult in Guangxi Zhuang Autonomous Region, while also assessing the continuing medical education (CME) needs of dental institution personnel regarding oral diseases in this population. Methods Convenience sampling was used to investigate the oral disease treatment among older adults and to assess CME needs of dental institution personnel regarding oral diseases in this population across various oral medical and health institutions in Guangxi. Results A total of 754 valid questionnaires were collected, of which 70.3% were from non-public oral health institutions. Out-of-pocket costs for older adults were as high as 91.3%. The per capita cost of older adult patients was beyond 500 yuan in 51.6% of the oral health institutions. In terms of CME training, 32.8% of dental institution medical personnel have participated in CME courses specifically on oral diseases in the older adult. Meanwhile, 69.9% of institutions have expressed a need for CME training on oral diseases in the older adult. Conclusion Non-public oral health institutions account for a significant proportion, and the older adult primarily pay out-of-pocket for oral disease treatment in these facilities. The high cost of treatment may pose a significant barrier to the older adult seeking oral healthcare. Increasing CME programs targeted at geriatric oral diseases can help enhance the treatment capabilities of dental healthcare workers and improve oral health outcomes for the older adult population.
Collapse
Affiliation(s)
- Caili Li
- General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dongmei Huang
- Rehabilitation Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qini Pan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Pinyue Tao
- Anesthesiology Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao Pan
- Ear, Nose, Throat, Head and Neck Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yanfei Pan
- Orthopedic Trauma Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ruofei He
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Tongting Wang
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huiqiao Huang
- Party Committee Office, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| |
Collapse
|
19
|
Acharya AB, Hegde U, Acharya S. Nanosystems for modulation of immune responses in periodontal therapy: a mini-review. FRONTIERS IN DENTAL MEDICINE 2025; 5:1509775. [PMID: 39917718 PMCID: PMC11797770 DOI: 10.3389/fdmed.2024.1509775] [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: 10/11/2024] [Accepted: 12/13/2024] [Indexed: 02/09/2025] Open
Abstract
Periodontitis is one of the most common oral diseases. It is generally treated by non-surgical and/or surgical therapy with adjunctive approaches for prevention and control. The current understanding of the pathogenesis of periodontitis has unraveled the importance of the inflammatory and immune reactions to combat periodontitis whose etiology is an overlap of microbial, genetic, and environmental factors in a susceptible host. Based on this premise, many therapeutic modalities have been investigated or attempted to resolve this inflammatory disease. Amongst these, nanomedicine has been shown to have therapeutic applications in periodontitis, especially focused on immunomodulation because periodontitis is characterized by over-reactive immune response. This mini-review explores the potential of nanosystems in treating periodontitis by providing an overview of the research efforts in this field of therapeutics. The unique physicochemical and targeting properties of nanosystems seem to be potentially effective platforms for treating periodontitis.
Collapse
Affiliation(s)
- Anirudh B. Acharya
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Usha Hegde
- Department of Oral Pathology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka, India
| | - Swetha Acharya
- Department of Oral Pathology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research (JSSAHER), Mysore, Karnataka, India
| |
Collapse
|
20
|
Yu Z, Yang Y, Yu Z, Yan Z, Gao R. Causal relationship between 14 micronutrients and chronic periodontitis: a Mendelian randomization study. Aust Dent J 2025. [PMID: 39749852 DOI: 10.1111/adj.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2024] [Indexed: 01/04/2025]
Abstract
BACKGROUND Chronic periodontitis is one of the most common inflammatory diseases worldwide. Micronutrients play a significant impact on health and periodontal disease progression. However, there is still a lack of conclusive studies confirming the causal association of micronutrients with chronic periodontitis. MATERIALS AND METHODS Genome-wide association study pooled data on chronic periodontitis were collected from the FinnGen consortium, and 14 micronutrients (calcium, copper, zinc, potassium, magnesium, selenium, iron, carotenoids, vitamin B6, B12, C, D, E and folate) were obtained from the OpenGWAS and UK Biobank Study. Instrumental variables were screened by strict criteria. Five Mendelian randomization (MR) methods were used. Finally, the robustness of the findings was verified by sensitivity analyses. RESULTS We found that vitamin D reduced the risk of chronic periodontitis (OR: 0.605, 95%CI: 0.398-0.921, P = 0.019). However, we had no evidence of a significant association between other micronutrients and chronic periodontitis. Multiple sensitivity analyses confirmed the robustness of the findings. A variety of sensitivity analysis methods confirmed the reliability of the results. CONCLUSION In this study, we found a potential causal relationship between vitamin D and chronic periodontitis by MR analysis, whereas we did not find an association between 13 other micronutrients and chronic periodontitis. This result might provide new ideas for the prevention and treatment of chronic periodontitis to some extent. However, despite the rigorous analytical methods used in this study, this finding needs to be interpreted with caution. Further randomized controlled studies might provide more in-depth references to the findings of this study.
Collapse
Affiliation(s)
- Z Yu
- Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Y Yang
- Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Z Yu
- Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Z Yan
- Beijing University of Chinese Medicine, Beijing, China
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - R Gao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
21
|
Fan RY, Chen JX, Chen LL, Sun WL. Assessing periodontitis risk from specific dietary patterns: a systematic review and meta-analysis. Clin Oral Investig 2025; 29:43. [PMID: 39751926 DOI: 10.1007/s00784-024-06125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 12/21/2024] [Indexed: 01/04/2025]
Abstract
AIMS Our goal is to perform a meta-analysis to investigate the risk of periodontitis associated with specific dietary patterns. METHODS We employed the PRISMA methodology in a meta-analysis to examine the correlation between dietary patterns and the risk of periodontitis. We systematically searched three online databases from inception to November 2024 to identify relevant studies. Summary estimates with 95%CI were calculated to assess the relationship between specific dietary patterns and the risk of periodontitis. Cumulative estimates were synthesized using random-effects or fixed-effects models. Heterogeneity among studies was evaluated using Cochran's Q and I2 statistics. RESULTS In total, we included 19 articles that analyzed 5 dietary patterns The study showed that a diet high in inflammation-promoting foods significantly raised the likelihood of periodontitis (OR = 1.39, 95% CI, 1.09-1.77), in contrast, dietary patterns like the mediterranean diet (OR = 0.96, 95% CI, 0.94-0.98), plant-based diet (OR = 0.92, 95% CI, 0.86-0.98), or dairy-rich diet (OR = 0.76, 95% CI, 0.66-0.87) lowered the risk of periodontitis. The analysis revealed no statistically significant association between a western diet (OR = 1.07; 95% CI, 0.86-1.33) and the risk of periodontitis. CONCLUSIONS As dietary diversity and complexity continue to expand, there has been a concomitant increase in the prevalence of periodontal disease. This study has identified specific dietary patterns associated with the risk of periodontitis, particularly highlighting the heightened risk linked to pro-inflammatory diets. These findings emphasize the importance of implementing targeted dietary practices to reduce the incidence of this condition.
Collapse
Affiliation(s)
- Ru-Yi Fan
- Department of Periodontology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310009, P. R. China
| | - Jia-Xi Chen
- Zhejiang Chinese Medical University, Hangzhou, P. R. China
| | - Li-Li Chen
- Department of Periodontology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310009, P. R. China.
| | - Wei-Lian Sun
- Department of Periodontology, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310009, P. R. China.
| |
Collapse
|
22
|
Iijima Y, Yamada M, Takahashi T, Hino S, Sano M, Sakagami H, Horie N, Kaneko T. Persistent Gingival Bleeding Related to Periodontal Disease. Cureus 2025; 17:e77693. [PMID: 39839212 PMCID: PMC11748091 DOI: 10.7759/cureus.77693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2025] [Indexed: 01/23/2025] Open
Abstract
Objective More patients visit oral surgery outpatient clinics from evening to night to treat persistent gingival bleeding (PGB) related to periodontal disease (PD) (PD-PGB). Since there are few reports on PD-PGB, the present study performed a detailed characterisation of this disease. Materials and methods Patients who visited our oral surgery clinic between 1 January 2014 and 31 December 2022 to treat PD-PGB without trauma. Demographic data, systemic diseases and bleeding tooth characteristics were retrieved. The occurrence of systemic diseases was compared with that of the control group (patients consisting of temporomandibular joint dislocation and minor trauma). Results Among 295 patients with gingival bleeding (GB) unrelated to trauma, 193 patients (65.4%) showed postoperative bleeding, and 91 patients (30.1%) showed PD-PGB; 93.4% of patients over 60 years old showed PD-PGB. Patients in the PGB-RPD group showed a significantly higher percentage (57.1%) of taking anticoagulants and/or antiplatelets than the control group (24.2%) (P < 0.001) Significantly higher percentage of patients in the PGB-RPD group showed a significantly higher incidence of hypertension (68.1%) than the control group (34.1%) (P < 0.001). Bleeding is the most frequently observed in molars, with a depth of the pockets exceeding 4 mm. Conclusion PD-PGB accompanied by deep pockets was more common in older patients and aggravated by taking anticoagulants and/or antiplatelets and antihypertensives. PD-PGB is not rare, and periodontal maintenance, such as regular dental checks, is an important preventive measure.
Collapse
Affiliation(s)
- Yosuke Iijima
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| | - Miki Yamada
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| | - Takumi Takahashi
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| | - Shunsuke Hino
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| | - Motohiko Sano
- Division of Applied Pharmaceutical Education and Research, Hoshi University, Tokyo, JPN
| | - Hiroshi Sakagami
- Research Institute of Odontology, Meikai University, Saitama, JPN
| | - Norio Horie
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| | - Takahiro Kaneko
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, JPN
| |
Collapse
|
23
|
Mayta-Mayorga M, Guerra-Rodríguez V, Bernabe-Ortiz A. Association between type 2 diabetes and periodontitis: a population-based study in the North Peru. Wellcome Open Res 2024; 9:562. [PMID: 39588166 PMCID: PMC11586918 DOI: 10.12688/wellcomeopenres.23036.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2024] [Indexed: 11/27/2024] Open
Abstract
Background Periodontitis, one of the most common forms of periodontal disease, has been linked to several cardiovascular factors including metabolic syndrome and inflammatory processes. This study aimed to determine the association between type 2 diabetes mellitus (T2DM) and periodontitis in a representative sample of individuals in the north of Peru. Materials and methods Secondary data analysis using information of a population-based survey, enrolling subjects aged 35 to 69 years. The outcome was periodontitis, evaluated using a self-reported and validated 8-item questionnaire (≥5 points compatible with severe periodontitis compared to those without severe periodontitis), whereas the exposure was the presence of T2DM, evaluated using results of oral glucose tolerance test and categorized into two different forms: (a) normoglycemic, prediabetes, and T2DM, and (b) without T2DM, with T2DM and <5 years of diagnosis, and with T2DM and ≥5 years of diagnosis. Poisson regression models were utilized to report prevalence ratios (PR) and 95% confidence intervals (95% CI). Results Data from 1606 individuals were analyzed, with a mean age of 48.2 (SD: 10.6) years, and 50.3% were women. Of these, 272 (16.9%) had prediabetes and 176 (11.0%) had T2DM (71.6% with <5 years of disease). Overall, 97.0% presented at least one symptom compatible with periodontitis, 882 (55.0%) had mild, 643 (40.0%) had moderate, and 5% had severe periodontitis. In multivariable model, those with T2DM had a higher prevalence of severe periodontitis (PR = 1.99; 95% CI: 1.12 - 3.54). Similarly, those with <5 years of disease had a higher prevalence of severe periodontitis (PR = 2.48; 95% CI: 1.38 - 4.46). Conclusions Our research confirms the association between T2DM and severe periodontitis, especially among those with recent diagnosis (<5 years). Symptoms of periodontitis are quite common in our study population. Our results suggest a need to periodically assess oral health in patients with T2DM.
Collapse
|
24
|
Li Y, Guo X, Zhan P, Huang S, Chen J, Zhou Y, Jiang W, Chen L, Lin Z. TRPV1 Regulates Proinflammatory Properties of M1 Macrophages in Periodontitis Via NRF2. Inflammation 2024; 47:2041-2056. [PMID: 38700791 DOI: 10.1007/s10753-024-02024-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/24/2024] [Accepted: 04/11/2024] [Indexed: 11/30/2024]
Abstract
Periodontitis, characterized by progressive alveolar bone destruction, leads to the loss of attachment and stability of the affected teeth. Macrophages, especially the proinflammatory M1 subtype, are key in periodontitis pathogenesis, driving the disease's inflammatory and destructive processes. Despite existing insight into their involvement, comprehensive understanding of the underlying molecular mechanisms remains limited. TRPV1 is a non-selective cation channel protein and is known to regulate cellular function and homeostasis in macrophages. Our research objective was to investigate the impact of TRPV1 on the proinflammatory attributes of M1 macrophages in periodontal tissues, exploring potential mechanistic pathways. A mouse model of periodontitis was established using Porphyromonas gingivalis inoculation and ligature application around the maxillary second molar. Immunohistological analysis showed a significant reduction in macrophage TRPV1 expression in periodontitis-induced mice. Treatment with capsaicin, a TRPV1 agonist, was observed to effectively elevate TRPV1 expression in these macrophages. Furthermore, micro-computed tomography analysis revealed a marked decrease in alveolar bone resorption in the capsaicin -treated group, compared with vehicle and healthy control groups. Our in vitro findings show that capsaicin treatment successfully attenuated LPS-induced TNF-α and IL-6 production in macrophages, mediated through NRF2 activation, consequently reducing intracellular ROS levels. These findings suggest that TRPV1 agonists, through modulating M1 macrophage activity and up-regulating TRPV1, could be a novel therapeutic approach in periodontal disease management.
Collapse
Affiliation(s)
- Yiyang Li
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaotong Guo
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Peimeng Zhan
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Shuheng Huang
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jiayao Chen
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yujie Zhou
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wentao Jiang
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lingling Chen
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Zhengmei Lin
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| |
Collapse
|
25
|
Chairunisa F, Widita E, Thwin KM, Takehara S, Nohno K, Hanindriyo L, Miyazaki H, Ogawa H. Ten years' evaluation of periodontal status and its changes among Japanese older adults. SPECIAL CARE IN DENTISTRY 2024; 44:1731-1741. [PMID: 39030932 DOI: 10.1111/scd.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/26/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
AIMS This study aims to evaluate the periodontal status and its changes among Japanese older adults over a 10-year period. METHODS AND RESULTS A total of 206 dentate older adults aged 70 years who completely participated in 10 years of oral examination were included. The community periodontal index (CPI) was used to assess the gingival and periodontal pocket status, while the loss of attachment (LA) scoring system was used to report the extensive LA. A higher score in CPI (Code 3 and Code 4) and more extensive attachment loss were found in a majority of participants. During follow-up evaluation, mean number of sextants with CPI code 4 remained stable, while CPI code 3 significantly decreased particularly in male participants. Whereas, sextants without attachment loss significantly decreased on average. The mean number of missing sextants significantly increased from 1.1 to 1.9, and 5.8% of subjects had all sextants excluded in the follow-up. CONCLUSION This study indicated that majority of the older people experienced severe periodontal disease and this condition remained stable during 10-year period. Additionally, the incidence of tooth loss increased as individuals aged. Regular oral care and maintenance are highly recommended for older population.
Collapse
Affiliation(s)
- Fania Chairunisa
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Elastria Widita
- Department of Oral Medicine, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kaung Myat Thwin
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Sachiko Takehara
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kaname Nohno
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Lisdrianto Hanindriyo
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hideo Miyazaki
- Department of Dental Hygiene and Welfare, Meirin Junior College, Niigata, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| |
Collapse
|
26
|
Garcia MCU, de la Vega SAF, Yanga-Mabunga MST. Periodontal Status of Filipino Older Adults in the Focused Interventions for FRAIL Older Adults Research and Development Program (FITforFRAIL): A Cross-sectional Study. ACTA MEDICA PHILIPPINA 2024; 58:64-73. [PMID: 39600659 PMCID: PMC11586286 DOI: 10.47895/amp.vi0.7630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
Introduction and Objective Periodontitis is highly prevalent worldwide, and previous investigations have reported increased prevalence and severity among elderly. Regular monitoring of dental health, which includes periodontal conditions, has been recommended by the Philippine Department of Health, as basis for the development and updating of policies and laws that will address the public health problem of periodontal disease among the ageing Filipino population. Therefore, this present study aimed to determine the prevalence and severity of periodontal disease among Filipino older adults who participated in the Focused Interventions for Frail Older Adults Research and Development Program (FITforFRAIL) study. Methods This study on the periodontal status of Filipino older adults is a cross-sectional substudy of the FITforFRAIL research of the Institute on Aging, National Institutes of Health, University of the Philippines Manila. Participants aged ≥60 years were from four identified geographical regions in the Philippines. Three hundred sixteen completed oral health assessment, which included full mouth periodontal recording, and 183 participants were eligible for inclusion in the periodontal component. Periodontal diagnoses were determined using the Centers for Disease Control-American Academy of Periodontology (CDC-AAP) case definitions for surveillance of periodontitis and the 2018 European Federation of Periodontology (EFP)/AAP classification. Descriptive statistics (frequency, percentage, and mean) were used to report the sociodemographic characteristics and periodontal diagnoses of the participants. The clinical periodontal measures used to indicate the extent and severity of periodontitis were presented as mean [standard error (SE)] or percentage (SE). Results Using the CDC/AAP case definitions, majority (97.3%) were diagnosed with periodontitis, with 33.3% having severe periodontal destruction. On the other hand, based on the 2018 EFP/AAP classification, all participants had periodontitis and most (94.5%) presented with severe disease. Moreover, using the latter classification system, the percentage of severe periodontitis was observed to increase with age. Among the young-old, 93.1% had severe disease, while 94.1% of the middle-old and 100% of the oldest-old were found to have severe destruction. Conclusions Based on the results of the study, the prevalence of total and severe periodontitis is high among this sample of Filipino older adults. Future studies for regular monitoring of the oral health of Filipino older adults are recommended.
Collapse
Affiliation(s)
- Ma. Celina U. Garcia
- Department of Clinical Dental Health Sciences, College of Dentistry, University of the Philippines Manila
- Institute on Aging, National Institutes of Health, University of the Philippines Manila
| | - Shelley Ann F. de la Vega
- Institute on Aging, National Institutes of Health, University of the Philippines Manila
- Department of Medicine, College of Medicine, University of the Philippines Manila
| | | |
Collapse
|
27
|
Liu F, Yao Y, Huang Y, Luo L, Wang Q, Chen B, Hu H. Gut microbiota and metabolic profile changes unveil the deterioration of alveolar bone inflammatory resorption with aging induced by D-galactose. Sci Rep 2024; 14:26135. [PMID: 39477973 PMCID: PMC11526011 DOI: 10.1038/s41598-024-75941-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 10/09/2024] [Indexed: 11/02/2024] Open
Abstract
The global aging population has led to a rise in age-related health issues, such as malnutrition, metabolic disorders, and even immune decline. Among these concerns, periodontitis holds particular significance for the well-being of the elderly. This study aimed to investigate the impact of aging on inflammatory resorption of alveolar bone in mice with periodontitis, with a specific focus on alterations in the intestinal microenvironment. To achieve this, we established a D-galactose (D-gal)-induced aging mouse model with periodontitis and employed histopathological staining, oxidative stress, and inflammatory factors analyses to assess the severity of periodontitis and the health status. Additionally, the 16S rRNA sequencing and untargeted metabolomics analysis were employed to investigate alterations in the intestinal microbiota and metabolites. Our results showed that D-gal-induced aging mice with periodontitis experienced more pronounced alveolar bone inflammatory resorption and disruptions in the gut barrier, accompanied by an overall decline in physical condition. The microbial composition and structure of aged mice also underwent significant modifications, with a decreased Firmicutes/Bacteroidetes (F/B) ratio. Furthermore, metabolomics analysis demonstrated that D-gal-induced aging primarily influenced lipids and lipid-like molecules metabolism, and enrichment observed in the rheumatoid arthritis and histidine metabolism pathways. These findings provide further evidence that the aging process exacerbates age-related alveolar bone loss (ABL) through disturbances in intestinal homeostasis.
Collapse
Affiliation(s)
- Fangzhou Liu
- School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Yanzi Yao
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Department of Stomatology, Luoyang Maternal and Child Health Hospital, Luoyang, China
| | - Yue Huang
- School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Liangliang Luo
- School of Preclinical Medicine, Zunyi Medical University, Zunyi, China
| | - Qian Wang
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Microbial Resources and Drug Development Key Laboratory of Guizhou Tertiary Institution, Zunyi Medical University, Zunyi, China
| | - Bin Chen
- School of Stomatology, Zunyi Medical University, Zunyi, China
- Microbial Resources and Drug Development Key Laboratory of Guizhou Tertiary Institution, Zunyi Medical University, Zunyi, China
| | - Huan Hu
- School of Stomatology, Zunyi Medical University, Zunyi, China.
- Microbial Resources and Drug Development Key Laboratory of Guizhou Tertiary Institution, Zunyi Medical University, Zunyi, China.
| |
Collapse
|
28
|
Wang J, Sun Z, Zhong Y, Ye Y, Chen X, Hu X, Peng Y. Hypertensive patients with periodontitis as predictors of cardiovascular and all-cause mortality: a long-term cohort study. Clin Oral Investig 2024; 28:582. [PMID: 39382756 DOI: 10.1007/s00784-024-05986-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 10/01/2024] [Indexed: 10/10/2024]
Abstract
OBJECTIVES The aim of this study is to examine the potential correlation between periodontitis and the risk of cardiovascular mortality and all-cause mortality in individuals diagnosed with hypertension, despite the established association between periodontitis and hypertension. METHODS The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in 1999-2014 involving hypertensive individuals. Following the criteria proposed by Eke et al., periodontitis was classified. Survival estimates were calculated using Kaplan Meier analyses and a Kaplan Meier curve was generated. Weighted multivariate cox regression were employed to assess the association between periodontitis and all-cause mortality, as well as cardiovascular mortality. RESULTS Of the 21,645 individuals, 6,904 individuals were diagnosed with periodontitis. The Kaplan-Meier survival analysis revealed significantly higher rates of all-cause mortality (34.766% vs. 14.739%) and cardiovascular mortality (12.469% vs. 3.736%) in the periodontitis group compared to the non-periodontitis group. Hazard ratios (HRs) for all-cause mortality were 3.19 (95% CI 2.88-3.53) and for cardiovascular mortality were 3.80 (95% CI 3.13-4.61) in individuals with periodontitis compared to those without periodontitis. CONCLUSION Periodontitis is a risk factor for mortality in patient with hypertension, especially if it is moderate to severe. Improving periodontal health could lead to better outcomes for these patients.
Collapse
Affiliation(s)
- Junwen Wang
- 1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Ziyi Sun
- Department of Intensive Care Unit, The Seventh Affiliated Hospital, Sun Yat-sen University, Guangdong, Shenzhen, 518107, China
| | - Yi Zhong
- Department of Cardiovascular Center, The Seventh Affiliated Hospital, Sun Yat- sen University, Guangdong, Shenzhen, 518107, China
| | - Yuyang Ye
- 1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Xuefeng Chen
- 1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Xinru Hu
- 1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Yong Peng
- 1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China.
| |
Collapse
|
29
|
Akabane M, Kwong A, Imaoka Y, Esquivel CO, Kim WR, Melcher ML, Sasaki K. Beyond 75: Graft Allocation and Organ Utility Implications in Liver Transplantation. Transplant Direct 2024; 10:e1661. [PMID: 39359941 PMCID: PMC11446594 DOI: 10.1097/txd.0000000000001661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 10/04/2024] Open
Abstract
Background The global surge in aging has intensified debates on liver transplantation (LT) for candidates aged 75 y and older, given the prevalent donor scarcity. This study examined both the survival benefits and organ utility of LT for this age group. Methods A total of 178 469 adult LT candidates from the United Network for Organ Sharing database (2003-2022) were analyzed, with 112 266 undergoing LT. Post-LT survival outcomes and waitlist dropout rates were monitored across varying age brackets. Multivariable Cox regression analysis determined prognostic indicators. The 5-y survival benefit was assessed by comparing LT recipients to waitlist candidates using hazard ratios. Organ utility was evaluated through a simulation model across various donor classifications. Results Among candidates aged 75 y and older, 343 received LT. The 90-d graft and patient survival rates for these patients were comparable with those in other age categories; however, differences emerged at 1 and 3 y. Age of 75 y or older was identified as a significant negative prognostic indicator for 3-y graft survival (hazard ratio: 1.72 [1.20-2.42], P < 0.01). Dropout rates for the 75 y and older age category were 12.0%, 24.1%, and 35.1% at 90 d, 1 y, and 3 y, respectively. The survival benefit of LT for the 75 y and older cohort was clear when comparing outcomes between LT recipients and those on waitlists. However, organ utility considerations did not favor allocating livers to this age group, regardless of donor type. Comparing 3-y patient survival between LT using donors aged 60 y and younger and older than 60 y showed no significant difference (P = 0.50) in the 75 y or older cohort. Conclusions Although LT offers survival benefits to individuals aged 75 y and older, the system may need rethinking to optimize the use of scarce donor livers, perhaps by matching older donors with older recipients.
Collapse
Affiliation(s)
- Miho Akabane
- Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA
| | - Allison Kwong
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA
| | - Yuki Imaoka
- Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA
| | - Carlos O Esquivel
- Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA
| | - W Ray Kim
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA
| | - Marc L Melcher
- Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA
| | - Kazunari Sasaki
- Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, CA
| |
Collapse
|
30
|
Sánchez V, Cidoncha G, de Pedro M, Antoranz A. General health status of a sample of patients with periodontitis in a Spanish university dental clinic: A case-control study. J Clin Exp Dent 2024; 16:e1224-e1232. [PMID: 39544217 PMCID: PMC11559123 DOI: 10.4317/jced.62102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 09/06/2024] [Indexed: 11/17/2024] Open
Abstract
Background During the past years, a bidirectional relationship has been proved between periodontitis and some systemic disorders, such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). The aim of this study was to compare the general health status between patients with and without periodontitis from a Spanish university dental clinic. Material and Methods A retrospective observational case-control study was conducted to achieve the research objective. The random sampling was extracted from the patients who attended to the university dental clinic between January 2017 and December 2020. Results A total of 2,714 (44.6% males and 55.4% females, 49 [38-60] years old) were included: 1,363 cases (patients with periodontitis; 47.2% males and 52.8% females; 54.6 ± 13.4 years old) and 1,351 controls (patients without periodontitis; 41.9% males and 58.1% females; 44.2 ± 13.4 years old). Patients with periodontitis had lower oral hygiene habits than controls: the 28.9% vs 7.0% (p-value <0.001) brushed their teeth once a day, 94.9% vs 69.6% (p-value <0.001) did not use interproximal cleaning. 31.0% of periodontal patients were smokers vs 21.2% of the control group (p-value <0.001). 51.8% of patients with periodontitis were taking medication vs 31.2% of the controls (p-value <0.001). Regarding their general health status, 8.2% periodontitis patients had DM vs 3.9% of the controls (p-value <0.001) and 21.3% of the cases suffered from high blood pressure (HBP) vs 10.6% (p-value <0.001). In addition, a multivariable regression analysis was performed, where the variables with more strength were age, number of cigarettes and oral hygiene habits. Conclusions In the present research, statistically significant differences have observed between patients with and without periodontitis, regarding medication, health problems such as DM, HBP, CVD and cholesterol. Key words:Periodontitis, systemic diseases, health status, university dental clinic.
Collapse
Affiliation(s)
- Virginia Sánchez
- Department of Clinical Dentistry. Faculty of Biomedical Sciences. European University of Madrid. Spain
| | - Gema Cidoncha
- Department of Clinical Dentistry. Faculty of Biomedical Sciences. European University of Madrid. Spain
| | - Miguel de Pedro
- Department of Clinical Dentistry. Faculty of Biomedical Sciences. European University of Madrid. Spain
| | - Ana Antoranz
- Department of Clinical Dentistry. Faculty of Biomedical Sciences. European University of Madrid. Spain
| |
Collapse
|
31
|
Wang Z, Xue H, Sun Y, Wang Q, Sun W, Zhang H. Deciphering the Biological Aging Impact on Alveolar Bone Loss: Insights From α-Klotho and Renal Function Dynamics. J Gerontol A Biol Sci Med Sci 2024; 79:glae172. [PMID: 38995226 DOI: 10.1093/gerona/glae172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Indexed: 07/13/2024] Open
Abstract
Alveolar bone loss is generally considered a chronological age-related disease. As biological aging process is not absolutely determined by increasing age, whether alveolar bone loss is associated with increasing chronological age or biological aging remains unclear. Accurately distinguishing whether alveolar bone loss is chronological age-related or biological aging-related is critical for selecting appropriate clinical treatments. This study aimed to identify the relationship between alveolar bone loss and body aging. In total, 3 635 participants from the National Health and Nutrition Examination Survey and 71 living kidney transplant recipients from Gene Expression Omnibus Datasets were enrolled. Multivariate regression analysis, smooth curve fittings, and generalized additive models were used to explore the association among alveolar bone loss, age, serum α-Klotho level, renal function markers, as well as between preoperative creatinine and renal cortex-related α-Klotho gene expression level. Meanwhile, a 2-sample Mendelian randomization (MR) study was conducted to assess the causal relationship between α-Klotho and periodontal disease (4 376 individuals vs 361 194 individuals). As a biological aging-related indicator, the α-Klotho level was negatively correlated with impaired renal function and alveolar bone loss. Correspondingly, accompanied by decreasing renal function, it was manifested with a downregulated expression level of α-Klotho in the renal cortex and aggravated alveolar bone loss. The MR analysis further identified the negative association between higher genetically predicted α-Klotho concentrations with alveolar bone loss susceptibility using the IVW (odds ratio [OR] = 0.999, p = .005). However, an inversely U-shaped association was observed between chronological age and alveolar bone loss, which is especially stable in men (the optimal cutoff values were both 62 years old). For men above 62 years old, increasing age is converted to protective factor and is accompanied by alleviated alveolar bone loss. Alveolar bone loss that is directly associated with decreased renal function and α-Klotho level was related to biological aging rather than chronological age. The renal-alveolar bone axis could provide a new sight of clinical therapy in alveolar bone loss.
Collapse
Affiliation(s)
- Zifei Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Hao Xue
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuqiang Sun
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Qing Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Wansu Sun
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hengguo Zhang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| |
Collapse
|
32
|
Alharbi N, Alharbi AS. AI-Driven Innovations in Pediatric Dentistry: Enhancing Care and Improving Outcome. Cureus 2024; 16:e69250. [PMID: 39398765 PMCID: PMC11470390 DOI: 10.7759/cureus.69250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2024] [Indexed: 10/15/2024] Open
Abstract
Artificial intelligence (AI) is transforming pediatric dentistry by enhancing diagnostic accuracy, streamlining treatment planning, and improving behavior management. This review explores current AI applications in detecting dental anomalies, categorizing fissure sealants, assessing chronological age, and managing patient behavior. The review also identifies emerging trends and future directions in AI technology that promise to further revolutionize pediatric dental care. By synthesizing recent research and clinical studies, this review aimed to inform dental professionals and researchers about the potential of AI to address traditional challenges and improve oral health outcomes for children.
Collapse
Affiliation(s)
| | - Adel S Alharbi
- Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| |
Collapse
|
33
|
Tanwar H, Gnanasekaran JM, Allison D, Chuang LS, He X, Aimetti M, Baima G, Costalonga M, Cross RK, Sears C, Mehandru S, Cho J, Colombel JF, Raufman JP, Thumbigere-Math V. Unravelling the Oral-Gut Axis: Interconnection Between Periodontitis and Inflammatory Bowel Disease, Current Challenges, and Future Perspective. J Crohns Colitis 2024; 18:1319-1341. [PMID: 38417137 PMCID: PMC11324343 DOI: 10.1093/ecco-jcc/jjae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 02/27/2024] [Indexed: 03/01/2024]
Abstract
As the opposite ends of the orodigestive tract, the oral cavity and the intestine share anatomical, microbial, and immunological ties that have bidirectional health implications. A growing body of evidence suggests an interconnection between oral pathologies and inflammatory bowel disease [IBD], implying a shift from the traditional concept of independent diseases to a complex, reciprocal cycle. This review outlines the evidence supporting an 'oral-gut' axis, marked by a higher prevalence of periodontitis and other oral conditions in IBD patients and vice versa. We present an in-depth examination of the interconnection between oral pathologies and IBD, highlighting the shared microbiological and immunological pathways, and proposing a 'multi-hit' hypothesis in the pathogenesis of periodontitis-mediated intestinal inflammation. Furthermore, the review underscores the critical need for a collaborative approach between dentists and gastroenterologists to provide holistic oral-systemic healthcare.
Collapse
Affiliation(s)
- Himanshi Tanwar
- Division of Periodontology, University of Maryland School of Dentistry, Baltimore, MD, USA
| | | | - Devon Allison
- Division of Periodontology, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Ling-shiang Chuang
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xuesong He
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, USA
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Massimo Costalonga
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Raymond K Cross
- Division of Gastroenterology & Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cynthia Sears
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Saurabh Mehandru
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judy Cho
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Frederic Colombel
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Pierre Raufman
- Division of Gastroenterology & Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Vivek Thumbigere-Math
- Division of Periodontology, University of Maryland School of Dentistry, Baltimore, MD, USA
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| |
Collapse
|
34
|
Batista-Cárdenas D, Araya-Castillo A, Arias-Campos MP, Solís-Rivera AP, Jiménez-Matarrita J, Piedra-Hernández L, Madriz-Montero L, Ramírez K. Association of the severity and progression rate of periodontitis with systemic medication intake. FRONTIERS IN ORAL HEALTH 2024; 5:1447019. [PMID: 39157205 PMCID: PMC11328918 DOI: 10.3389/froh.2024.1447019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Background/purpose Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Karol Ramírez
- Faculty of Dentistry, University of Costa Rica, San José, Costa Rica
| |
Collapse
|
35
|
Yu PS, Tu CC, Wara-Aswapati N, Wang CY, Tu YK, Hou HH, Ueno T, Chen IH, Fu KL, Li HY, Chen YW. Microbiome of periodontitis and peri-implantitis before and after therapy: Long-read 16S rRNA gene amplicon sequencing. J Periodontal Res 2024; 59:657-668. [PMID: 38718089 DOI: 10.1111/jre.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 07/16/2024]
Abstract
AIMS The microbial profiles of peri-implantitis and periodontitis (PT) are inconclusive. The controversies mainly arise from the differences in sampling sites, targeted gene fragment, and microbiome analysis techniques. The objective of this study was to explore the microbiomes of peri-implantitis (PI), control implants (CI), PT and control teeth (CT), and the microbial change of PI after nonsurgical treatment (PIAT). METHODS Twenty-two patients diagnosed with both PT and peri-implantitis were recruited. Clinical periodontal parameters and radiographic bone levels were recorded. In each patient, the subgingival and submucosal plaque samples were collected from sites with PI, CI, PT, CT, and PIAT. Microbiome diversity was analyzed by high-throughput amplicon sequencing using full-length of 16S rRNA gene by next generation sequencing. RESULTS The 16S rRNA gene sequencing analysis revealed 512 OTUs in oral microbiome and 377 OTUs reached strain levels. The PI and PT groups possessed their own unique core microbiome. Treponema denticola was predominant in PI with probing depth of 8-10 mm. Interestingly, Thermovirga lienii DSM 17291 and Dialister invisus DSM 15470 were found to associate with PI. Nonsurgical treatment for peri-implantitis did not significantly alter the microbiome, except Rothia aeria. CONCLUSION Our study suggests Treponemas species may play a pivotal role in peri-implantitis. Nonsurgical treatment did not exert a major influence on the peri-implantitis microbiome in short-term follow-up. PT and peri-implantitis possess the unique microbiome profiles, and different therapeutic strategies may be suggested in the future.
Collapse
Affiliation(s)
- Pei-Shiuan Yu
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Che-Chang Tu
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Nawarat Wara-Aswapati
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chen-Ying Wang
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsin-Han Hou
- Graduate Institute of Oral Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - I-Hui Chen
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
- Division of Periodontology, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuan-Lun Fu
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| | - Huei-Ying Li
- Medical Microbiota Center of the First Core Laboratory, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Wen Chen
- Department of Dentistry, National Taiwan University Hospital and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
36
|
Qi X, Zhu Z, Wang K, Zheng Y, Li A, Wu B. Association of Gum Treatment with Cognitive Decline and Dementia Risk among Older Adults with Periodontal Symptoms: A 12-Year Prospective Cohort Study. Neuroepidemiology 2024:1-10. [PMID: 39053434 PMCID: PMC11759719 DOI: 10.1159/000540086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION This study examines the associations of gum treatment with cognitive decline and dementia risk among older adults with periodontal symptoms in the USA. METHODS A cohort of 866 adults aged ≥50 with periodontal symptoms was recruited for the 2008 Health and Retirement Study "Dental Health Experimental Module" and followed until 2020. Cognitive function was assessed with the Telephone Interview for Cognitive Status (TICS). Dementia status was ascertained with the Langa-Weir algorithm based on TICS scores and proxy assessments. Linear mixed-effects model and multivariable Cox regression models were utilized to analyze the associations of gum treatment with cognitive decline and the risk of dementia, respectively. RESULTS Of 866 participants (mean age 67.7, 61.4% women), 105 (12.1%) developed dementia with a median follow-up of 9 (IQR, 6-10) years. The dementia incidence rates were lower in the group with gum treatment (7.4 vs. 12.9 per 1,000 person-years). Compared with participants who did not have gum treatment, those with gum treatment experienced a decline in TICS score that was on average 0.025 (95% CI, 0.005-0.044) points less per year and a 38% lower incidence of dementia (hazard ratio, 0.62; 95% CI, 0.41-0.93). These associations were consistent across participants with a different severity of periodontal symptoms and sociodemographic characteristics (age, sex, race, ethnicity, and education) except for income levels. CONCLUSION Prompt gum treatment for older adults with periodontal symptoms may be beneficial for their cognitive health.
Collapse
Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Zheng Zhu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- School of Nursing, Fudan University, Shanghai, China
| | - Katherine Wang
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Yaguang Zheng
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| |
Collapse
|
37
|
Al Shammary NH. Exploring the impact of oral health on the quality of life in older patients: a cross-sectional study. BDJ Open 2024; 10:60. [PMID: 39034313 PMCID: PMC11271468 DOI: 10.1038/s41405-024-00244-1] [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: 03/26/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE To investigate the significant impact of oral health on the quality of life of older individuals in Riyadh, Saudi Arabia, across various socioeconomic and demographic contexts. METHODS A cross- sectional study was conducted, involving the distribution of a translated online questionnaire based on the OHQoL-UK® tool to evaluate oral health-related quality of life OHRQoL. This included utilizing the Oral Health Quality of Life Scale to assess overall quality of life. RESULTS A total of 586 participants were involved in the study, with the majority being over 60 years old (77.1%). The mean score of OHRQoL was 3.79. The Social Dental Scale SDS had a mean score of 0.71. The General Oral Health Assessment GOHS scored 3.51 on average. The mean score of Dental Impact Profile DIP was 3.12. The Subjective Oral Health Status Indicators SOHSIs had a mean score of 3.82. The mean score of Oral Health Benefit of Life Inventory OHBLI averaged at 4.04, and Dental Impact on Daily Living DIDL scored an average of 4.05. The mean scores of OHRQoL and Oral Impacts on Daily Performance OIDP were 3.90 and 3.89 respectively. Cronbach's Alpha values ranged from 0.854 to 0.939, with an overall questionnaire reliability of 0.977, indicating a good reliability of the study's tool. CONCLUSION Older adults exhibited lower OHRQoL compared to younger adults, particularly influenced by factors such as health insurance coverage, monthly income, and educational level. It is essential to develop health programs specifically tailored for senior adults to safeguard their overall health and quality of life. Making health and medical insurance obligatory and accessible to all individuals is crucial for enhancing their QoL and reducing the diseases.
Collapse
Affiliation(s)
- Nawaf H Al Shammary
- Department of Preventive Dentistry, College of Dentistry, University of Ha'il, P.O. Box 2440, Ha'il, 81481, Saudi Arabia.
| |
Collapse
|
38
|
Hu Q, Zhang B, Jing Y, Ma S, Hu L, Li J, Zheng Y, Xin Z, Peng J, Wang S, Cheng B, Qu J, Zhang W, Liu GH, Wang S. Single-nucleus transcriptomics uncovers a geroprotective role of YAP in primate gingival aging. Protein Cell 2024; 15:612-632. [PMID: 38577810 PMCID: PMC11259548 DOI: 10.1093/procel/pwae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
Aging has a profound impact on the gingiva and significantly increases its susceptibility to periodontitis, a worldwide prevalent inflammatory disease. However, a systematic characterization and comprehensive understanding of the regulatory mechanism underlying gingival aging is still lacking. Here, we systematically dissected the phenotypic characteristics of gingiva during aging in primates and constructed the first single-nucleus transcriptomic landscape of gingival aging, by which a panel of cell type-specific signatures were elucidated. Epithelial cells were identified as the most affected cell types by aging in the gingiva. Further analyses pinpointed the crucial role of YAP in epithelial self-renew and homeostasis, which declined during aging in epithelial cells, especially in basal cells. The decline of YAP activity during aging was confirmed in the human gingival tissues, and downregulation of YAP in human primary gingival keratinocytes recapitulated the major phenotypic defects observed in the aged primate gingiva while overexpression of YAP showed rejuvenation effects. Our work provides an in-depth understanding of gingival aging and serves as a rich resource for developing novel strategies to combat aging-associated gingival diseases, with the ultimate goal of advancing periodontal health and promoting healthy aging.
Collapse
Affiliation(s)
- Qinchao Hu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510060, China
| | - Bin Zhang
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yaobin Jing
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
- International Center for Aging and Cancer, Hainan Medical University, Haikou 571199, China
| | - Shuai Ma
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Lei Hu
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Jingyi Li
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Yandong Zheng
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zijuan Xin
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Jianmin Peng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510060, China
| | - Si Wang
- Advanced Innovation Center for Human Brain Protection and National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing 100053, China
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Bin Cheng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510060, China
| | - Jing Qu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Weiqi Zhang
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Guang-Hui Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
- Advanced Innovation Center for Human Brain Protection and National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing 100053, China
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
- Aging Biomarker Consortium, Beijing 100101, China
| | - Songlin Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| |
Collapse
|
39
|
Conceição SDS, Batista JET, da Cruz SS, Gomes-Filho IS, Hintz AM, Coelho JMF, Passos-Soares JDS, Loomer PM, Lyrio AO, Souza ES, Figueiredo ACMG, Pereira MG. Systematic review to evaluate accuracy studies of the diagnostic criteria for periodontitis in pregnant women. PLoS One 2024; 19:e0304758. [PMID: 39018288 PMCID: PMC11253960 DOI: 10.1371/journal.pone.0304758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/18/2024] [Indexed: 07/19/2024] Open
Abstract
The diversity of criteria used in the diagnosis of periodontitis in pregnant women makes it difficult to define and compare the disease. Using a systematic review, this study evaluated the accuracy of criteria for diagnosing periodontitis in pregnant women. Searches were carried out in the databases: Medline/PubMed, Embase, Scopus, Web of Science, SciELO, Lilacs, ProQuest, and CINAHL. Validation studies of the criteria used for diagnosing periodontitis met the inclusion criteria. The study steps were performed by three independent reviewers. A qualitative synthesis of the included articles was carried out and the quality methodological analysis using the QUADAS-2 instrument. The assessment of the quality of the evidence was obtained through the GRADE tool. A total of 592 records were identified, of which only 6 made up this systematic review. The included studies analyzed different criteria for diagnosing periodontitis, evaluating 3,005 pregnant women. The criteria selected as a test presented results equivalent to the performance of those recognized as the gold standard. The self-reported criteria were of lower diagnostic accuracy. A major limitation of this review was the small number of primary studies that evaluated clinical diagnosis of periodontitis in pregnant women, which was highly heterogeneous, making it impossible to carry out accuracy meta-analysis and additional analyzes. There is a lack of consensus on the criteria for the diagnosis of periodontitis, with great variability in the accuracy and prevalence of the disease in pregnant women.
Collapse
Affiliation(s)
| | | | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Cruz das Almas, Bahia, Brazil
| | | | | | | | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Department of Preventive Dentistry, Federal University Bahia, Salvador, Bahia, Brazil
| | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Amanda Oliveira Lyrio
- Faculty of Health Sciences, University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Elivan Silva Souza
- Faculty of Health Sciences, University of Brasilia, Brasília, Distrito Federal, Brazil
| | | | | |
Collapse
|
40
|
Wang D, Li Q, Xiao C, Wang H, Dong S. Nanoparticles in Periodontitis Therapy: A Review of the Current Situation. Int J Nanomedicine 2024; 19:6857-6893. [PMID: 39005956 PMCID: PMC11246087 DOI: 10.2147/ijn.s465089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/10/2024] [Indexed: 07/16/2024] Open
Abstract
Periodontitis is a disease of inflammation that affects the tissues supporting the periodontium. It is triggered by an immunological reaction of the gums to plaque, which leads to the destruction of periodontal attachment structures. Periodontitis is one of the most commonly recognized dental disorders in the world and a major factor in the loss of adult teeth. Scaling and root planing remain crucial for managing patients with persistent periodontitis. Nevertheless, exclusive reliance on mechanical interventions like periodontal surgery, extractions, and root planning is insufficient to halt the progression of periodontitis. In response to the problem of bacterial resistance, some researchers are committed to finding alternative therapies to antibiotics. In addition, some scholars focus on finding new materials to provide a powerful microenvironment for periodontal tissue regeneration and promote osteogenic repair. Nanoparticles possess distinct therapeutic qualities, including exceptional antibacterial, anti-inflammatory, and antioxidant properties, immunomodulatory capacities, and the promotion of bone regeneration ability, which made them can be used for the treatment of periodontitis. However, there are many problems that limit the clinical translation of nanoparticles, such as toxic accumulation in cells, poor correlation between in vitro and in vivo, and poor animal-to-human transmissibility. In this paper, we review the present researches on nanoparticles in periodontitis treatment from the perspective of three main categories: inorganic nanoparticles, organic nanoparticles, and nanocomposites (including nanofibers, hydrogels, and membranes). The aim of this review is to provide a comprehensive and recent update on nanoparticles-based therapies for periodontitis. The conclusion section summarizes the opportunities and challenges in the design and clinical translation of nanoparticles for the treatment of periodontitis.
Collapse
Affiliation(s)
- Di Wang
- The First Outpatient Department, Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, 130021, People’s Republic of China
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, People’s Republic of China
| | - Qiqi Li
- The First Outpatient Department, Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, 130021, People’s Republic of China
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, People’s Republic of China
| | - Chunsheng Xiao
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, People’s Republic of China
| | - Hao Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, People’s Republic of China
| | - Shujun Dong
- The First Outpatient Department, Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, 130021, People’s Republic of China
| |
Collapse
|
41
|
Yüksel B, Özveren N, Yeşil Ç. Evaluation of Dental Plaque Area with Artificial Intelligence Model. Niger J Clin Pract 2024; 27:759-765. [PMID: 38943301 DOI: 10.4103/njcp.njcp_862_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/06/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVES This study aims to assess the diagnostic accuracy of an artificial intelligence (AI) system employing deep learning for identifying dental plaque, utilizing a dataset comprising photographs of permanent teeth. MATERIALS AND METHODS In this study, photographs of 168 teeth belonging to 20 patients aged between 10 and 15 years, who met our criteria, were included. Intraoral photographs were taken of the patients in two stages, before and after the application of the plaque staining agent. To train the AI system to identify plaque on teeth with dental plaque that is not discolored, plaque and teeth were marked on photos with exposed dental plaque. One hundred forty teeth were used to construct the training group, while 28 teeth were used to create the test group. Another dentist reviewed images of teeth with dental plaque that was not discolored, and the effectiveness of AI in detecting plaque was evaluated using pertinent performance indicators. To compare the AI model and the dentist's evaluation outcomes, the mean intersection over union (IoU) values were evaluated by the Wilcoxon test. RESULTS The AI system showed higher performance in our study with a precision of 82% accuracy, 84% sensitivity, 83% F1 score, 87% accuracy, and 89% specificity in plaque detection. The area under the curve (AUC) value was found to be 0.922, and the IoU value was 76%. Subsequently, the dentist's plaque diagnosis performance was also evaluated. The IoU value was 0.71, and the AUC was 0.833. The AI model showed statistically significantly higher performance than the dentist (P < 0.05). CONCLUSIONS The AI algorithm that we developed has achieved promising results and demonstrated clinically acceptable performance in detecting dental plaque compared to a dentist.
Collapse
Affiliation(s)
- B Yüksel
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - N Özveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Ç Yeşil
- Department of Computer Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Turkey
| |
Collapse
|
42
|
Ebersole JL, Hasturk H, Huber M, Gellibolian R, Markaryan A, Zhang XD, Miller CS. Realizing the clinical utility of saliva for monitoring oral diseases. Periodontol 2000 2024; 95:203-219. [PMID: 39010260 DOI: 10.1111/prd.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/01/2024] [Accepted: 05/16/2024] [Indexed: 07/17/2024]
Abstract
In the era of personalized/precision health care, additional effort is being expended to understand the biology and molecular mechanisms of disease processes. How these mechanisms are affected by individual genetics, environmental exposures, and behavioral choices will encompass an expanding role in the future of optimally preventing and treating diseases. Considering saliva as an important biological fluid for analysis to inform oral disease detection/description continues to expand. This review provides an overview of saliva as a diagnostic fluid and the features of various biomarkers that have been reported. We emphasize the use of salivary biomarkers in periodontitis and transport the reader through extant literature, gaps in knowledge, and a structured approach toward validating and determine the utility of biomarkers in periodontitis. A summation of the findings support the likelihood that a panel of biomarkers including both host molecules and specific microorganisms will be required to most effectively identify risk for early transition to disease, ongoing disease activity, progression, and likelihood of response to standard periodontal therapy. The goals would be to develop predictive algorithms that serve as adjunctive diagnostic tools which provide the clinician and patient important information for making informed clinical decisions.
Collapse
Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Hatice Hasturk
- Immunology and Inflammation, Center for Clinical and Translational Research, The ADA Forsyth Institute, Cambridge, Massachusetts, USA
| | - Michaell Huber
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Xiaohua D Zhang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Craig S Miller
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
43
|
Pitchika V, Büttner M, Schwendicke F. Artificial intelligence and personalized diagnostics in periodontology: A narrative review. Periodontol 2000 2024; 95:220-231. [PMID: 38927004 DOI: 10.1111/prd.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/29/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
Periodontal diseases pose a significant global health burden, requiring early detection and personalized treatment approaches. Traditional diagnostic approaches in periodontology often rely on a "one size fits all" approach, which may overlook the unique variations in disease progression and response to treatment among individuals. This narrative review explores the role of artificial intelligence (AI) and personalized diagnostics in periodontology, emphasizing the potential for tailored diagnostic strategies to enhance precision medicine in periodontal care. The review begins by elucidating the limitations of conventional diagnostic techniques. Subsequently, it delves into the application of AI models in analyzing diverse data sets, such as clinical records, imaging, and molecular information, and its role in periodontal training. Furthermore, the review also discusses the role of research community and policymakers in integrating personalized diagnostics in periodontal care. Challenges and ethical considerations associated with adopting AI-based personalized diagnostic tools are also explored, emphasizing the need for transparent algorithms, data safety and privacy, ongoing multidisciplinary collaboration, and patient involvement. In conclusion, this narrative review underscores the transformative potential of AI in advancing periodontal diagnostics toward a personalized paradigm, and their integration into clinical practice holds the promise of ushering in a new era of precision medicine for periodontal care.
Collapse
Affiliation(s)
- Vinay Pitchika
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Martha Büttner
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
44
|
Blasi AM, Vonhoegen L, Herrler A, Wicht MJ, Barbe AG. Older people's preferences and expectations of preventive oral care in the home. Gerodontology 2024; 41:241-250. [PMID: 37309670 DOI: 10.1111/ger.12698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of the study was to assess older people's preferences and expectations for preventive oral care in their own home. BACKGROUND With increasing age, the use of dental services declines and oral health becomes secondary, yet good oral health contributes to quality of life and has a positive impact on general health. Thus, the healthcare system should offer a care structure in which oral health can be maintained into old age. To provide patient-centred care, patient preferences in additional preventive oral care need to be explored. MATERIALS AND METHODS In this qualitative study, semi-structured interviews were conducted with community-dwelling individuals aged ≥65 years to understand their preferences and expectations for oral care in a home-based setting. Interviews were recorded, transcribed verbatim and analysed thematically. RESULTS Fourteen dental patients were included. Three overarching themes were identified. The desire for independence was predominant when addressing their future capability to perform oral hygiene. When addressing possible future oral health support, self-determination and independence were important to them. Concerns about dependency in inpatient care facilities and the associated reduction in oral care were evident. Frequency, costs and the practice environment played a decisive role when thinking about additional preventive measures for their future. CONCLUSION The results of this study provide important information about older people's preferences and expectations for preventive oral care in the home environment and relate to three core themes of (1) changes in oral hygiene skills and perceptions, (2) support and (3) organisational factors. These must be considered when planning and implementing preventive oral care.
Collapse
Affiliation(s)
- Alicia M Blasi
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| | - Lena Vonhoegen
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| | - Angélique Herrler
- Faculty of Human Sciences and Faculty of Medicine, Graduate School GROW-Gerontological Research on Well-being, University of Cologne, Cologne, Germany
- Institute for Health Economics and Clinical Epidemiology, University Hospital Cologne, Cologne, Germany
| | - Michael J Wicht
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| | - Anna Greta Barbe
- Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| |
Collapse
|
45
|
Alves-Costa S, Nascimento GG, Peres MA, Li H, Costa SA, Ribeiro CCC, Leite FRM. Sugar-sweetened beverage consumption and periodontitis among adults: A population-based cross-sectional study. J Clin Periodontol 2024; 51:712-721. [PMID: 38454156 DOI: 10.1111/jcpe.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
AIM Investigating the association between sugar-sweetened beverages (SSBs) and periodontitis and whether the awareness of diabetes modifies this relationship. MATERIALS AND METHODS Cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES III) data involving US adults aged 30-50. Periodontitis was classified according to the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP), and SSB consumption as dichotomous (<5 or ≥5, <7 or ≥7 and <14 or ≥14 times/week), ordinal and continuous variables. Confounders included family income poverty ratio, education, race/ethnicity, sex, age, food energy intake, smoking and alcohol. Odds ratios (ORs) were obtained by logistic regressions using inverse probability weighting. Effect modification analysis was performed considering self-reported diabetes. RESULTS Among 4473 cases analysed, 198 self-reported diabetes. SSBs were associated with periodontitis when individuals consumed ≥5 (OR 1.64; 95% confidence interval [CI] = 1.30-2.06), ≥7 (OR 1.92; 95% CI = 1.50-2.46) and ≥14 (OR 2.19; 95% CI = 1.50-3.18) times/week. The combined effect of consuming SSBs (≥5 and ≥14 times/week) and self-reported diabetes had less impact than the cumulative effect. CONCLUSIONS SSB consumption was associated with higher odds of periodontitis, and the estimates were reduced among those with awareness of diabetes.
Collapse
Affiliation(s)
- Silas Alves-Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Fábio Renato Manzolli Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| |
Collapse
|
46
|
Parsegian K, Okano DK, Chandrasekaran S, Kim Y, Carter TC, Shimpi N, Fadakar S, Angelov N. The PocketPerio application significantly increases the accuracy of diagnosing periodontal conditions in didactic and chairside settings. Sci Rep 2024; 14:10189. [PMID: 38702352 PMCID: PMC11068793 DOI: 10.1038/s41598-024-59394-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/10/2024] [Indexed: 05/06/2024] Open
Abstract
The study aimed to determine the accuracy of diagnosing periodontal conditions using the developed web-based PocketPerio application and evaluate the user's perspective on the use of PocketPerio. First, 22 third-year dental students (DS3) diagnosed ten cases without PocketPerio (control) and with PocketPerio (test) during a mock examination. Then, 105 DS3, 13 fourth-year dental students (DS4), and 32 senior second-year International Standing Program students (ISP2) used PocketPerio chairside. Statistical analysis was performed using a non-parametric paired two-tailed test of significance with the Wilcoxon matched-pairs signed rank test. The null hypothesis that PocketPerio did not increase the accuracy of periodontal diagnoses was rejected at α < 0.01. Periodontal diagnoses made using PocketPerio correlated with those made by periodontics faculty ("gold standard") in all cases. During the mock examination, PocketPerio significantly increased the accuracy of periodontal diagnoses compared to the control (52.73 vs. 13.18%, respectively). Chairside, PocketPerio significantly increased the accuracy of primary (100 vs. 40.0%) and secondary (100 vs. 14.25%) periodontal diagnoses compared to the respective controls. Students regardless of their training year felt more confident in diagnosing periodontal conditions using PocketPerio than their current tools, provided positive feedback on its features, and suggested avenues for its further development.
Collapse
Affiliation(s)
- Karo Parsegian
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA.
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - David K Okano
- Section of Periodontics, School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Sangeetha Chandrasekaran
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA
| | - Yoolim Kim
- Division of Periodontics, Department of Diagnostic Sciences and Surgical Dentistry, School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13065 E 17Th Ave, Rm 130J, Aurora, CO, 80045-2532, USA
| | - Tonia C Carter
- Center for Precision Medicine Research, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Neel Shimpi
- Center for Dental Benefits, Coding and Quality, American Dental Association, Chicago, IL, USA
| | - Sadaf Fadakar
- Predoctoral Dental Student, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nikola Angelov
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
47
|
Saleh MHA, Dias DR, Kumar P. The economic and societal impact of periodontal and peri-implant diseases. Periodontol 2000 2024. [PMID: 38693603 DOI: 10.1111/prd.12568] [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: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Periodontal and peri-implant diseases result from a chronic inflammatory response to dysbiotic microbial communities and are characterized by inflammation in the soft tissue and the ensuing progressive destruction of supporting bone, resulting in tooth or implant loss. These diseases' high prevalence, multifactorial etiology, extensive treatment costs, and significant detriment to patients' quality-of-life underscore their status as a critical public health burden. This review delineates the economic and sociocultural ramifications of periodontal and peri-implant diseases on patient welfare and healthcare economics. We delve into the implications of diagnosis, treatment, supportive care, and managing destructive tissue consequences, contrasting these aspects with healthy patients.
Collapse
Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
48
|
Holtfreter B, Kuhr K, Borof K, Tonetti MS, Sanz M, Kornman K, Jepsen S, Aarabi G, Völzke H, Kocher T, Krois J, Papapanou PN. ACES: A new framework for the application of the 2018 periodontal status classification scheme to epidemiological survey data. J Clin Periodontol 2024; 51:512-521. [PMID: 38385950 DOI: 10.1111/jcpe.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
AIM To propose a framework for consistently applying the 2018 periodontal status classification scheme to epidemiological surveys (Application of the 2018 periodontal status Classification to Epidemiological Survey data, ACES). PROPOSED FRAMEWORK We specified data requirements and workflows for either completed or planned epidemiological surveys, utilizing commonly collected measures of periodontal status (clinical attachment levels [CAL], probing depths, bleeding on probing), as well as additional necessary variables for the implementation of the 2018 periodontal status classification (tooth loss due to periodontitis and complexity factors). Following detailed instructions and flowcharts, survey participants are classified as having periodontal health, gingivitis or periodontitis. Rates of edentulism must also be reported. In cases of periodontitis, instructions on how to compute the stage and extent are provided. Assessment of grade can be derived from CAL measurements (or from radiographic alveolar bone loss data) in relation to root length and the participant's age. CONCLUSIONS ACES is a framework to be used in epidemiological studies of periodontal status that (i) have been completed, and in which stage and grade according to the 2018 classification are inferred retroactively, or (ii) are being planned. Consistent use of the proposed comprehensive approach will facilitate the comparability of periodontitis prevalence estimates across studies.
Collapse
Affiliation(s)
- Birte Holtfreter
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Kuhr
- Health Care Research and Epidemiology, Institute of German Dentists (IDZ), Cologne, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Mariano Sanz
- Department of Dental Clinical Specialties, ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Kenneth Kornman
- Department of Periodontics and Oral Medicine, The University of Michigan-School of Dentistry, Ann Arbor, Michigan, USA
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| |
Collapse
|
49
|
Lee CT, Zhang K, Li W, Tang K, Ling Y, Walji MF, Jiang X. Identifying predictors of the tooth loss phenotype in a large periodontitis patient cohort using a machine learning approach. J Dent 2024; 144:104921. [PMID: 38437976 DOI: 10.1016/j.jdent.2024.104921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/17/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES This study aimed to identify predictors associated with the tooth loss phenotype in a large periodontitis patient cohort in the university setting. METHODS Information on periodontitis patients and nineteen factors identified at the initial visit was extracted from electronic health records. The primary outcome is tooth loss phenotype (presence or absence of tooth loss). Prediction models were built on significant factors (single or combinatory) selected by the RuleFit algorithm, and these factors were further adopted by regression models. Model performance was evaluated by Area Under the Receiver Operating Characteristic Curve (AUROC) and Area Under the Precision-Recall Curve (AUPRC). Associations between predictors and the tooth loss phenotype were also evaluated by classical statistical approaches to validate the performance of machine learning models. RESULTS In total, 7840 patients were included. The machine learning model predicting the tooth loss phenotype achieved AUROC of 0.71 and AUPRC of 0.66. Age, periodontal diagnosis, number of missing teeth at baseline, furcation involvement, and tooth mobility were associated with the tooth loss phenotype in both machine learning and classical statistical models. CONCLUSIONS The rule-based machine learning approach improves model explainability compared to classical statistical methods. However, the model's generalizability needs to be further validated by external datasets. CLINICAL SIGNIFICANCE Predictors identified by the current machine learning approach using the RuleFit algorithm had clinically relevant thresholds in predicting the tooth loss phenotype in a large and diverse periodontitis patient cohort. The results of this study will assist clinicians in performing risk assessment for periodontitis at the initial visit.
Collapse
Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge Street, Houston, TX 77054, USA
| | - Kai Zhang
- The University of Texas Health Science Center at Houston School of Biomedical Informatics, 7000 Fannin St, Houston, Texas 77030, USA
| | - Wen Li
- Division of Clinical and Translational Sciences, Department of Internal Medicine, the University of Texas McGovern Medical School at Houston, 6431 Fannin St, Houston, Texas, USA; Biostatistics/Epidemiology/Research Design (BERD) Component, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, Houston, Texas 77030, USA
| | - Kaichen Tang
- The University of Texas Health Science Center at Houston School of Biomedical Informatics, 7000 Fannin St, Houston, Texas 77030, USA
| | - Yaobin Ling
- The University of Texas Health Science Center at Houston School of Biomedical Informatics, 7000 Fannin St, Houston, Texas 77030, USA
| | - Muhammad F Walji
- The University of Texas Health Science Center at Houston School of Biomedical Informatics, 7000 Fannin St, Houston, Texas 77030, USA; Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, 7000 Fannin St., Houston, Texas 77030, USA
| | - Xiaoqian Jiang
- The University of Texas Health Science Center at Houston School of Biomedical Informatics, 7000 Fannin St, Houston, Texas 77030, USA.
| |
Collapse
|
50
|
Kang S, Liu ZY, Yuan HH, Wang SM, Pan GG, Wei W, Jiang Y, Hou Y. The impact of different states of type 2 diabetes when stratified by baseline HbA1c on the periodontal outcomes of non-surgical periodontal treatment: A systematic review and network meta-analysis. Int J Dent Hyg 2024; 22:401-413. [PMID: 38394099 DOI: 10.1111/idh.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/16/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) has been considered by many studies to have a bidirectional relationship with periodontitis. This systematic review and network meta-analysis aimed to investigate the impact of different states of T2DM when stratified by baseline HbA1c on the clinical outcomes of non-surgical periodontal treatment (NSPT). METHODS This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and involved an electronic literature search (from inception to the 2nd of January 2023). The study included at least two groups of patients: chronic periodontitis only (No-DM) or periodontitis and well-controlled/poorly controlled type 2 diabetes mellitus (WC/PC-T2DM). Clinical outcomes included probing depth (PD) reduction, bleeding on probing reduction, and clinical attachment level (CAL) gain. Direct and indirect comparisons between groups were assessed by network meta-analysis, thus allowing us to establish a treatment ranking. RESULTS Ten prospective cohort studies (11 data sets) were included for qualitative analysis and network meta-analysis. The data included in this study had high consistency; in addition, a funnel plot and Egger's test showed that the articles had low publication bias. Network meta-analysis showed that the effect of NSPT in the No-DM group was significantly better than the WC-T2DM group [weighted mean difference (WMD) = 0.09, 95% confidence interval (CI) (0.01, 0.18)] and the PC-T2DM group [WMD = 0.09, 95% CI (0.01, 0.18)] in terms of CAL gain and better than the PC-T2DM group [WMD = 0.15, 95% CI (0.02, 0.28)] in terms of PD reduction. According to the surface under the cumulative ranking value, the No-DM group had the highest probability of achieving the best outcome following NSPT. CONCLUSIONS Collectively, our analyses show that T2DM exerts significant effects on the outcomes of NSPT.
Collapse
Affiliation(s)
- Shuai Kang
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Zheng-Ya Liu
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Huan-Huan Yuan
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Shu-Min Wang
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Ge-Ge Pan
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Wei Wei
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Yi Jiang
- Institute of Stomatology, First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yu Hou
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| |
Collapse
|