Serum levels of oncostatin M (a gp 130 cytokine): an inflammatory biomarker in periodontal disease

Objective: Periodontitis is considered to be a risk factor for systemic diseases such as atherosclerosis, diabetes, etc., and cytokines play a key role. The present study was carried out to measure the level of serum oncostatin M (OSM) in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the serum OSM concentration.

Materials and methods: Sixty subjects were divided into three groups (each group n?=?20) based on the gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL): group I healthy; group II gingivitis; and group III chronic periodontitis. Group III patients were followed for 8 weeks after non-surgical periodontal therapy as the after-treatment group (group IV). Estimation of serum OSM was done using an enzyme-linked immunosorbent assay.

Results: The mean OSM concentrations in serum were highest in the chronic periodontitis group (mean 68.05 pg ml^?1) and decreased following treatment (39.65 pg ml^?1) while OSM was undetectable in healthy subjects or in patients with gingivitis.

Conclusion: Increased serum OSM concentration in patients with chronic periodontitis and its positive correlation with PPD and CAL, suggest its role as an inflammatory biomarker in periodontal disease and it may exaggerate other systemic conditions such as atherosclerosis and rheumatoid arthritis.     

Effect of Nadir CD4+ T Cell Count on Clinical Measures of Periodontal Disease in HIV+ Adults before and during Immune Reconstitution on HAART

Background

The contribution of HIV-infection to periodontal disease (PD) is poorly understood.  We proposed that immunological markers would be associated with improved clinical measures of PD.

Methods

We performed a longitudinal cohort study of HIV-infected adults who had started highly active antiretroviral therapy (HAART) <2 years. PD was characterized clinically as the percent of teeth with ≥1 site with periodontal probing depth (PPD) ≥5.0mm, recession (REC) >0mm, clinical attachment level (CAL) ≥4.0mm, and bleeding on probing (BOP) at ≥4 sites/tooth and microbiologically as specific periodontopathogen concentration. Linear mixed-effects models were used to assess the associations between immune function and PD.

Results

Forty (40) subjects with median 2.7 months on HAART and median nadir CD4+ T-cell count of 212 cells/μl completed a median 3 visits. Over 24 months, CD4+ T-cell count increased by a mean 173 cells/µl (p<0.001) and HIV RNA decreased by 0.5 log₁₀ copies/ml (p<0.001); concurrently, PPD, CAL and BOP decreased by a mean 11.7%, 12.1%, and 14.7% respectively (all p<0.001). Lower nadir CD4+ T-cell count was associated with worse baseline REC (-6.72%; p=0.04) and CAL (9.06%; p<0.001). Further, lower nadir CD4+ T-cell count was associated with a greater relative longitudinal improvement in PPD in subjects with higher baseline levels of Porphyromonas gingivalis (p=0.027), and BOP in subjects with higher baseline levels of Porphyromonas gingivalis or Treponema denticola (p=0.001 and p=0.006 respectively). Longitudinal changes from baseline in CD4+ T-cell count and level of HIV RNA were not independently associated with longitudinal changes in any clinical markers of PD.

Conclusion

Degree of immunosuppression was associated with baseline gingival recession. After HAART initiation, measures of active PD improved most in those with lower nadir CD4+ T-cell counts and higher baseline levels of specific periodontopathogens. Nadir CD4+ T-cell count differentially influences periodontal disease both before and after HAART in HIV-infected adults.     

甲硝唑药膜联合盐酸米诺环素软膏治疗牙周病的临床疗效分析

目的:研究甲硝唑药膜联合盐酸米诺环素软膏治疗牙周病的临床疗效。方法:选择2014年1月~2016年1月在我院进行诊治的牙周病患者80例,随机分为两组。观察组采用甲硝唑药膜联合盐酸米诺环素软膏治疗治疗,对照组采用甲硝唑药膜治疗。观察并比较两组的疗效,牙周附着指数、牙菌斑指数、牙龈指数、牙齿松动度和白介素-6、白介素-8和肿瘤坏死因子的水平。结果:治疗4周后,观察组的治疗有效率为95.0%,明显高于对照组的90.0%(P0.05);治疗后两组的牙周附着指数、牙菌斑指数、牙龈指数和牙齿松动度均较治疗前明显降低(P0.05),且观察组的降低程度明显优于对照组(P0.05);治疗后两组的肿瘤坏死因子、白介素-6和白介素-8均较治疗前明显降低(P0.05),且观察组的降低程度明显优于对照组(P0.05);两组间丘疹、恶心、胃肠道反应和失眠的发生情况相比无明显差异(P0.05);观察组的复发率为2.5%,明显低于对照组的7.5%(P0.05)。结论:甲硝唑药膜联合盐酸米诺环素软膏能增强对牙周病各种致病菌的抑制作用,提高临床疗效,改善牙周状况和炎症状态,不良反应少,且复发率低,值得推广应用。     

The evaluation of chorionic membrane in guided tissue regeneration for periodontal pocket therapy: a clinical and radiographic study

Periodontal regenerative therapy is aimed at reconstruction and to restore the architecture and function of lost or injured tissues. Melcher (J Periodontol 47(5):256–260, 1976) introduced the concept of guided tissue regeneration (GTR) for osseous reconstructive surgery. The aim of the present innovative clinical and radiographic study was to evaluate the effect of chorionic membrane (CM) in GTR in periodontal pocket therapy. Ten patients with moderate to severe periodontitis were selected in the single blind randomized controlled clinical trial. Patients were treated with periodontal pocket therapy along with CM in study sites and the control sites were treated with periodontal pocket therapy alone. The clinical parameters were recorded at baseline and 12 months. The radiographic parameters were recorded at baseline, 6 and 12 months. Clinical parameters included gingival index (GI), plaque index (PI), pocket probing depth (PPD) and relative attachment level (RAL). Digital images were analysed for bone gain (BG) and density. Data were evaluated using t test. Statistical significant differences were found in both sites at 12 months for GI, PI, PPD and RAL. Highly significant reduction was seen in GI 0.40 ± 0.08 (p = 0.0001), PI (0.41 ± 0.18), PPD 2.50 ± 0.53 mm (p = 0.0431) and increased BG 0.86 ± 0.18 (p < 0.0001) were observed in study sites. This shows that CM when used with pocket therapy can have influence on clinical parameters. Radiographic findings from this study demonstrated significant BG and density in sites treated with CM as compared to control sites.     

Dietary ratio of n-6 to n-3 polyunsaturated fatty acids and periodontal disease in community-based older Japanese: a 3-year follow-up study

The longitudinal relationship between dietary n-6 to n-3 PUFAs ratio and periodontal disease in 235 Japanese subjects for whom data were available for the years 2003-2006 was investigated. PUFAs intake was assessed at baseline with a brief-type self-administered diet history questionnaire. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and once a year for 3 years. The number of teeth with a change in the loss of CAL ≥3 mm at any site over a year was calculated as ‘periodontal disease events’. Poisson regression analysis was conducted, with dietary n-6 to n-3 PUFAs ratio as the main predictor, to estimate its influence on periodontal disease events.A high dietary n-6 to n-3 PUFAs ratio was significantly associated with greater number of periodontal disease events. The findings suggest the dietary n-6 to n-3 PUFAs ratio is associated with periodontal disease among older Japanese.     

Oral status in home-dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease

doi: 10.1111/j.1741‐2358.2011.00507.x Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease Objectives: The aim of this study was to compare the prevalence of edentulous subjects, caries and periodontal disease among the home‐dwelling elderly with moderate and substantial needs of support for daily living. Materials and method: A sample of 302 randomly selected elderly with moderate or substantial needs of supportive care were examined in Sweden. Several oral clinical variables were registered: number of teeth, dentures, caries, probing pocket depth, gingival bleeding and Eichner’s index. Results: Both in general and in oral health, the differences were small when comparing elderly with moderate and substantial care needs for daily living. Those with substantial needs had more caries lesions (p < 0.01) and more gingival bleeding (p < 0.05), while the number of teeth and prevalence of edentulous subjects did not differ in relation to the need of daily support. The elderly had, on average, 9.8–11.7 teeth, one‐third of whom had no natural teeth. According to Eichner’s index, half of the elderly in both groups had no opposing tooth contacts. Fifty‐five per cent used dentures. Conclusions: Elderly people with needs of supportive care have lost many teeth before they become dependent. Health promotion should be a priority in early ageing populations to prevent oral diseases and tooth loss.     

牙周骨再生过程中BMP-1表达变化的临床意义

目的:观察在牙周骨再生过程中骨形态发生蛋白-1(BMP-1)的表达的变化情况及临床意义。方法:以我院收治的牙周骨缺损患者196例作为研究对象,采用常规的基础牙周治疗(龈上洁治彻底,龈下刮治,整平根面)处理后,通过引导组织再生术(GTR)技术对骨缺损进行修复的同时,植入Bio-oss人工骨材料和Bio-gide胶原膜。在治疗前和治疗后,分别测定患者血清BMP-1水平,分析BMP-1表达水平与牙周骨缺损修复的关系。结果:与治疗前相比,患者治疗后的牙周骨缺损均有所修复,所有患者在术后所有时间点的PPD和骨密度值与治疗前相比均显著改善(P0.05)。治疗6个月后,牙周骨密度出现小幅度下降,但显著高于治疗前,差异具有统计学意义(P0.05)。与治疗前相比,所有患者治疗后1 d、2 d、5 d、10 d、1个月、3个月、6个月血清BMP-1的水平均显著升高,差异具有统计学意义(P0.05),且治疗后BMP-1水平的变化与PPD呈显著负相关(P0.05),但与骨密度的相关性不显著(P0.05)。结论:血清BMP-1在牙周骨修复过程存在动态变化与患者牙周骨术后恢复相关。     

牙周夹板联合正畸治疗对牙周炎所致前牙扇形移位患者咀嚼功能和龈沟液PGE2、sICAM-1、PAK5的影响

目的:探讨牙周夹板联合正畸治疗对牙周炎所致前牙扇形移位患者咀嚼功能和龈沟液中前列素E2(PGE2)、可溶性细胞间黏附分子-1(s ICAM-1)、p2l活化激酶5(PAK5)的影响。方法:采用随机数字表法,将我院2018年2月~2020年2月间接收的93例牙周炎所致前牙扇形移位患者分为对照组(46例,牙周基础治疗、牙周夹板治疗)和研究组(47例,牙周基础治疗、牙周夹板治疗联合正畸治疗),观察两组疗效,对比两组治疗前后的牙周情况,咀嚼功能、美观度,龈沟液PGE2、s ICAM-1、PAK5水平。结果:研究组的临床总有效率高于对照组(P<0.05)。研究组治疗后牙周菌斑指数(PLI)、探诊深度(PD)、牙龈指数(GI)、附着丧失(AL)、龈沟出血指数(SBI)低于对照组(P<0.05)。研究组治疗后探诊出血率、前牙咬合低于对照组,咀嚼功能评分高于对照组(P<0.05)。研究组治疗后牙周袋深度、前牙覆盖度、牙槽骨高度低于对照组(P<0.05)。研究组治疗后龈沟液PGE2、s ICAM-1、PAK5水平低于对照组(P<0.05)。结论:牙周夹板联合正畸治疗可有效恢复牙周炎所致前牙扇形移位患者牙周功能和咀嚼功能,且美观效果好,还可减轻对龈沟液PGE2、s ICAM-1、PAK5水平的影响。     

龈沟液中骨硬化蛋白对慢性牙周炎患者疗效评价的临床价值

目的:探讨龈沟液中骨硬化蛋白对慢性牙周炎疗效评价的临床价值。方法:选择2013年1月-2017年12月我院收治的81例慢性牙周炎患者作为观察组及同期79例牙周健康者为对照组,观察组患者给予基础治疗。观察和比较对照组和观察组治疗前及治疗后1个月、2个月的牙周临床指标、龈沟液中的骨硬化蛋白水平,并分析牙周临床指标与龈沟液骨硬化蛋白水平的相关性。结果:治疗前,观察组的菌斑指数、出血指数、牙周探诊深度、附着丧失水平及龈沟液中骨硬化蛋白水平明显高于对照组;治疗后1个月、2个月,观察组以上指标均明显低于治疗前,且治疗后2个月,观察组以上指标明显低于治疗后1个月,但附着丧失水平仍高于对照组(P均0.05),而两组的菌斑指数、出血指数、牙周探诊深度对比差异无统计学意义(P0.05)。龈沟液中骨硬化蛋白水平与菌斑指数、出血指数、牙周探诊深度、附着丧失水平呈高度正相关(r1=0.876,P10.001;r2=0.842,P10.00;r3=0.913,P10.001;r4=0.903,P10.001)。结论:慢性牙周炎患者龈沟液中骨硬化蛋白水平明显上调,并与与菌斑指数、出血指数、牙周探诊深度、附着丧失水平呈高度正相关,可作为慢性牙周炎疗效评价的参考指标。     

固定矫治器戴入前后牙周可疑病原菌和牙周临床指数的变化

目的:固定矫治器戴入前后的不同时间进行龈缘菌斑的微生物学检查和牙周状况的临床检查,以探讨固定矫治器戴入前后牙周可疑病原菌和牙周状况的动态变化过程.方法:选择18名固定正畸患者,于矫治器戴入前和戴入后1、3、6月分别检查16、41牙位的菌斑指数、牙龈指数、探诊深度、探诊出血,并在近中颊侧颊轴角处采集龈缘菌斑样本,采用细菌培养鉴定方法测定牙周可疑病原菌的检出量(CFU/g)和检出率.结果:与基线相比,观察期内龈缘菌斑的G￣产黑色素厌氧杆菌检出量和检出率在两个牙位均升高(P＜0.05),41的优杆菌、弯曲杆菌、拟杆菌、普氏菌亦有升高(P＜0.05).临床指标中16的牙龈指数(颊侧)和探诊深度(颊、舌侧)升高;41的菌斑指数(舌侧)降低(P＜0.05).结论:固定矫治器戴入后虽然可通过严格的口腔卫生指导有效控制牙面菌斑,但仍可引起牙周可疑病原菌增加.     

纤维桩、纳米复合树脂结合氧化锆烤瓷冠对根管治疗后后牙楔状缺损患者美学效果及牙周组织的影响

摘要 目的：探讨纤维桩、纳米复合树脂结合氧化锆烤瓷冠对根管治疗后后牙楔状缺损患者美学效果及牙周组织的影响。方法：选取2018年1月至2019年3月期间我院收治的103例患者作为研究对象,按修复材料的不同分为对照组（n=52,患牙62颗）和研究组（n=51,患牙63颗）。对照组给予金属桩核、金属烤瓷冠修复,研究组给予纤维桩、纳米复合树脂结合氧化锆烤瓷冠修复。修复1年后,评价两组的修复成功率和修复效果。比较两组修复前及修复后1年的牙龈指数、菌斑指数、牙周探诊深度、龈沟液量及龈沟液中碱性磷酸酶（ALP）、天门冬氨酸转氨酶（AST）水平。结果：研究组的修复成功率比对照组高（P<0.05）。研究组修复体的表面光滑率、边缘密合性、固定良好率及颜色匹配率均明显高于对照组（P<0.05）。两组治疗后牙龈指数、菌斑指数及牙周探诊深度均明显低于治疗前（P<0.05）,龈沟液量及龈沟液中ALP、AST水平均明显低于治疗前（P<0.05）,同时研究组治疗后牙龈指数、菌斑指数及牙周探诊深度均低于对照组（P<0.05）,但两组治疗后龈沟液量及龈沟液中ALP、AST水平比较无差异（P>0.05）。结论：纤维桩、纳米复合树脂结合氧化锆烤瓷冠对根管治疗后后牙楔状缺损的修复成功率高,修复后美学效果佳,对牙周组织影响小。     

The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women

doi: 10.1111/j.1741‐2358.2011.00481.x
The association between renal function and tooth loss in Japanese community‐dwelling postmenopausal women Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community‐dwelling elderly Japanese. Background data: Many elderly individuals display both low renal function and tooth loss. Materials and Methods: Subjects comprised 405 randomly selected women (55–74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross‐linked N‐telopeptide of type I collagen level; body mass index and smoking habits. Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was ?0.11 (p = 0.018). Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.     

A longitudinal study of the relationship between diet intake and dental caries and periodontal disease in elderly Japanese subjects

Objective: We hypothesise that a difference in nutrition influences dental caries and periodontal disease. There are few previous studies especially longitudinal ones which have evaluated this hypothesis. This study investigated the relationship between nutritional intake, including milk and milk products (MMP), and dental disease, controlling for several confounding factors. Material and methods: A group of 600 subjects aged 70, randomly selected for this study, included approximately the same number of male and female subjects. The number of teeth on which root caries had occurred or where there was a periodontal event over a 6‐year period was measured. To determine quantitative food intake at baseline, a semi‐quantitative food frequency questionnaire was used during face‐to‐face interviews by dieticians. The stepwise method of multiple linear regression analysis was used to identify independent predictors of the number of root caries or periodontal disease events during the 6 years. Intake of the six food groups includes (i) fish, shellfish, meat, beans and eggs; (ii) MMP; (iii) dark green and yellow vegetables (DYV); (iv) other vegetables and fruits; (v) cereals, nuts and seeds, sugar and sweeteners, confectioneries (CNSC) and (vi) fats and oils. The alcohol, gender and anthropometric evaluation including measurements of weight and height for the calculation of body mass index, educational level, the number of family members and the number of remaining teeth were used as independent variables. Results: According to stepwise multiple regression analysis, two variables (quantity of MMP, and gender) were negatively associated with the number of root caries events during the 6 years. The standardised coefficients were ?0.14 (p = 0.035) and ?0.17 (p = 0.007) respectively. In addition, DYV were negatively, and three other variables (CNSC; alcohol; and the number of remaining teeth at baseline) were positively associated with the number of periodontal disease events during the 6 years. The standardised coefficients were ?0.16 (p = 0.001), 0.11 (p = 0.042), 0.10 (p = 0.041) and 0.58 (p < 0.001) respectively. Conclusion: Our results suggest that the intake of MMP in this elderly population correlated with root caries events. In addition, intake of vegetables negatively correlated, and intake of ‘CNSC’ positively correlated with periodontal disease events.     

A Cohort Study of the Impact of Tooth Loss and Periodontal Disease on Respiratory Events among COPD Subjects: Modulatory Role of Systemic Biomarkers of Inflammation

Background

In COPD patients, fatal and non-fatal respiratory-related events are influenced by age, severity of respiratory disease, and comorbidities.

Objectives

Analyze the effects of edentulism, periodontal disease and systemic biomarkers of inflammation on the occurrence of serious fatal and non-fatal respiratory-related events among subjects with COPD.

Methods

Cases were identified from Dental Atherosclerosis Risk in Communities study. Edentulism was defined as study participants without any natural teeth or implants. Participants with one or more natural teeth (comprising 11,378 subjects) were studied as dentate subjects. Periodontal disease status among dentate individuals was determined using the consensus definitions published by the joint Center for Disease Control/American Association of Periodontology working group). Adjusted Hazard Models are developed to evaluate the relationship between edentulism/periodontal disease and COPD Related Events. Models were then stratified by GOLD Stage I, II and III/IV. Serum biomarkers were also evaluated to explore the effect of systemic inflammation.

Results

A statistically significant association was found between oral health status and COPD-related events, even adjusting for conditions such as hypertension, smoking and diabetes. Edentulous individuals who had been diagnosed with COPD had a higher incidence and were at greater risk of having a COPD related event (hospitalization and death) than individuals who had teeth and whose mouths had healthy periodontal status. However, being edentulous did not convey excess risk for COPD-related events for those study participants who were classified as GOLD III/IV at baseline. Finally, we showed that individuals who had levels of serum IL-6 in the highest two quartiles were at even higher risk for COPD-related events.

Conclusions

These findings suggest that the risk for COPD-related events after adjusting for potential confounders may be attributable to both edentulism and elevated serum IL-6 levels.     

Periodontal Disease in Type 1 Diabetes Mellitus: Influence of Pubertal Stage and Glycemic Control

ObjectiveThough gingivitis is common in children with type 1 diabetes mellitus (T1DM), the overall periodontal health in T1DM during the pubertal stage is less well-characterized. The study was undertaken to explore the possible influence of puberty and metabolic derangement on periodontal health in T1DM.MethodsIn this cross-sectional study, 110 subjects between 10-18 years with T1DM and 52 healthy siblings of similar age were evaluated for pubertal stage, glycosylated hemoglobin (HbA1c), and periodontal health. Simplified oral hygiene index (OHIS), gingival index (GI), plaque index (PI), bleeding on probing (BOP), and probing depth (PPD) were evaluated at 4 sites per tooth as per 6 Ramfjord index teeth used to assess periodontal disease (PD).ResultsPD not merely gingivitis was significantly higher in T1DM (84/110, 76.36%) than the control group (28/52, 53.8%) (P = .004). Irrespective of pubertal status, children with T1DM had worse GI, PI, BOP, and PPD than nondiabetic subjects, although OHIS was better in diabetes. In both T1DM and nondiabetic subjects, pubertal subjects showed significantly worse OHIS, PPD, BOP, and GI than prepubertal subjects. PD was correlated with pubertal stage, age, and HbA1c, although less strongly with the duration of diabetes. In logistic regression, pubertal stage was a stronger predictor of PD (OR = 14.26) than age (OR = 2.22), and HbA1c (OR = 1.5) rather than the presence of diabetes and its duration.ConclusionsThough pubertal status, age, and poor glycemic control rather than the presence of diabetes and its duration are associated with gingivitis and other forms of PD, puberty had a more profound effect in the pathogenesis of PD in T1DM.     

Allele frequencies in the VRN-A1, VRN-B1 and VRN-D1 vernalization response and PPD-B1 and PPD-D1 photoperiod sensitivity genes,and their effects on heading in a diverse set of wheat cultivars (Triticum aestivum L.)

Heading of cereals is determined by complex genetic and environmental factors in which genes responsible for vernalization and photoperiod sensitivity play a decisive role. Our aim was to use diagnostic molecular markers to determine the main allele types in VRN-A1, VRN-B1, VRN-D1, PPD-B1 and PPD-D1 in a worldwide wheat collection of 683 genotypes and to investigate the effect of these alleles on heading in the field. The dominant VRN-A1, VRN-B1 and VRN-D1 alleles were present at a low frequency. The PPD-D1a photoperiod-insensitive allele was carried by 57 % of the cultivars and was most frequent in Asian and European cultivars. The PPD-B1 photoperiod-insensitive allele was carried by 22 % of the genotypes from Asia, America and Europe. Nine versions of the PPD-B1-insensitive allele were identified based on gene copy number and intercopy structure. The allele compositions in PPD-D1, PPD-B1 and VRN-D1 significantly influenced heading and together explained 37.5 % of the phenotypic variance. The role of gene model increased to 39.1 % when PPD-B1 intercopy structure was taken into account instead of overall PPD-B1 type (sensitive vs. insensitive). As a single component, PPD-D1 had the most important role (28.0 % of the phenotypic variance), followed by PPD-B1 (12.3 % for PPD-B1_overall, and 15.1 % for PPD-B1_intercopy) and VRN-D1 (2.2 %). Significant gene interactions were identified between the marker alleles within PPD-B1 and between VRN-D1 and the two PPD1 genes. The earliest heading genotypes were those with the photoperiod-insensitive allele in PPD-D1 and PPD-B1, and with the spring allele for VRN-D1 and the winter alleles for VRN-A1 and VRN-B1. This combination could only be detected in genotypes from Southern Europe and Asia. Late-heading genotypes had the sensitivity alleles for both PPD1 genes, regardless of the allelic composition of the VRN1 genes. There was a 10-day difference in heading between the earliest and latest groups under field conditions.     

The relationship between seven health practices and oral health status in community‐dwelling elderly Thai

Gerodontology 2012; doi: 10.1111/j.1741‐2358.2012.00672.x The relationship between seven health practices and oral health status in community‐dwelling elderly Thai Objective: This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. Materials and methods: The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self‐reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Results: Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between‐meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Conclusion: Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health habits are suggested to lead to better oral health for the elderly, and vice versa.     

Periodontitis Is Associated with Endothelial Dysfunction in a General Population: A Cross-Sectional Study

A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated the association between periodontal disease and flow-mediated dilation of the brachial artery (FMD) as a measure of endothelial dysfunction in a general population, and also addressed a possible mediation via inflammation. The study population comprised 1,234 subjects (50.5% men) aged 25–85 years from the 5-year follow-up of the Study of Health in Pomerania, a population-based cohort study. Clinical attachment loss (CAL) and pocket probing depth (PPD) as measures of periodontal disease were assessed half-mouth at four sites per tooth. Subjects were classified according to the periodontitis case definition proposed by Tonetti and Claffey (2005). Measurements of FMD and nitroglycerin-mediated dilation (NMD) were performed using standardized ultrasound techniques. High-sensitive C-reactive protein, fibrinogen and leukocyte count were measured. Fully adjusted multivariate linear regression analyses revealed significant associations of the percentage of sites with PPD ≥6 mm with FMD (p_trend=0.048), with subjects within the highest category having a 0.74% higher FMD compared to subjects within the lowest category (p<0.05). Consistently, FMD values increased significantly across categories of the percentage of sites with CAL ≥6 mm (p_trend=0.01) and the periodontitis case definition (p_trend=0.006). Restrictions to subjects without antihypertensive or statin medication or current non-smokers confirmed previous results. Systemic inflammation did not seem to mediate the relation. Both PPD and CAL were not consistently associated with NMD. In contrast to previous studies, high levels of periodontal disease were significantly associated with high FMD values. This association was not mediated via systemic inflammation. This study revives the discussion on whether and how periodontitis contributes to endothelial dysfunction.     

Cervitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响

目的:探讨Cervitec凝胶局部应用结合洁刮治术对牙周炎龈下菌群的影响效果。方法:选取我院口腔科已确诊为牙周炎患者60例,根据治疗方案不同分为实验组与对照组,对照组进行传统洁刮术治疗,实验组在对照组基础上将Cervitec凝胶涂抹于牙齿及牙周袋周围,比较两组患者的口腔健康指数、探诊及龈沟液水平、菌群抑制效果及主要细菌杀灭水平变化情况,其数据结果应用统计学软件SPSS 17.0处理。结果:与对照组相比较,实验组患者口腔指数、牙龈水平及菌群杀灭抑制效果明显,表现为:菌斑指数、牙龈指数、出血指数明显降低(P0.05);探诊深度、附着水平、龈沟液含量明显下降(P0.05);总菌群、G-及G+菌群抑制程度提高(P0.05);高登链球菌、缓症链球菌、变黑普氏菌、牙龈卟啉单胞菌杀灭程度明显提高(P0.05)。其结果均有统计学意义。结论:Cervitec凝胶局部应用联合洁刮治术对牙周炎牙龈下菌群有良好抑制效果,并维持长久疗效,降低刺激程度及过敏情况,提高临床有效率,保护牙龈健康,对牙体产生较小的副作用。     

Marginal analysis of multiple outcomes with informative cluster size

In surveillance studies of periodontal disease, the relationship between disease and other health and socioeconomic conditions is of key interest. To determine whether a patient has periodontal disease, multiple clinical measurements (eg, clinical attachment loss, alveolar bone loss, and tooth mobility) are taken at the tooth‐level. Researchers often create a composite outcome from these measurements or analyze each outcome separately. Moreover, patients have varying number of teeth, with those who are more prone to the disease having fewer teeth compared to those with good oral health. Such dependence between the outcome of interest and cluster size (number of teeth) is called informative cluster size and results obtained from fitting conventional marginal models can be biased. We propose a novel method to jointly analyze multiple correlated binary outcomes for clustered data with informative cluster size using the class of generalized estimating equations (GEE) with cluster‐specific weights. We compare our proposed multivariate outcome cluster‐weighted GEE results to those from the convectional GEE using the baseline data from Veterans Affairs Dental Longitudinal Study. In an extensive simulation study, we show that our proposed method yields estimates with minimal relative biases and excellent coverage probabilities.