Osteoporosis,the risk of vertebral fracture,and periodontal disease in an elderly group in Mexico City

doi: 10.1111/j.1741‐2358.2009.00342.x
Osteoporosis, the risk of vertebral fracture, and periodontal disease in an elderly group in Mexico City Objectives: The aims of this study were to identify the possible association of osteoporosis, fracture risk and periodontitis, and consider the role of pharmacological treatment of osteoporosis and the periodontal condition. Methods: Patients aged 60 and older from the Mexican National Medical Science and Nutrition Institute Salvador Zubirán participated in the study. DXA was used to assess osteoporosis and risk of vertebral fracture. A modified version of the extent and severity index (ESI) was applied to evaluate periodontitis (cut‐off point for attachment loss ≥ 4 mm) and all teeth were examined. Results: One hundred and sixty‐six patients were examined, 88.6% were females, 47.0% had osteoporosis and 38.6% showed a high risk of fracture. The modified ESI was 5.13 mm (SD 1.4), 57.8% (SD 29.7). The model for periodontitis severity showed an association with oral hygiene (OR = 1.85) and use of osteoporosis medication (OR = 0.43). The model for the extent of periodontitis identified an association with smoking (OR = 2.37), osteoporosis (OR = 1.82) and osteoporosis medication (OR = 0.36). The model for tooth loss detected an association with fracture risk (OR = 3.02) and osteoporosis medication (OR = 0.33). Conclusion: Periodontitis extent was associated with osteoporosis, and tooth loss with fracture risk.     

Periodontal disease in Norwegian old-age pensioners

doi: 10.1111/j.1741‐2358.2010.00380.x Periodontal disease in Norwegian old‐age pensioners Purpose: To identify factors of importance for periodontal health and disease on an old‐age Norwegian population. Materials and methods: From a random sample of 1152 urban and rural elderly Norwegians, aged 67 years or older, 582 individuals were agreed to participate in the study. After exclusion of edentulous individuals, 394 individuals were remained. A standardised clinical examination was performed by the same examiner. In conjunction with the clinical examination, a questionnaire was filled out regarding demographic and social status, educational level, tobacco habits and general condition. Results: In the examined population, 33% of the subjects had periodontal disease. Out of those, 12% had severe periodontitis, that is, ≥3 periodontal pockets ≥6 mm. All variables were tested separately in a logistic regression model with periodontal pockets 6 mm and above, as the outcome variable. After univariate testing the following variables were included in a multivariate logistic regression model: daily smoking, higher plaque score, rural living and lower education. Only daily smoking remained significantly correlated to periodontal disease in the multivariate model. Conclusions: This study has shown a prevalence of periodontal disease in 33% of the study population. Out of those approximately 12% had more severe periodontitis. Daily tobacco use was the only factor significantly correlated to presence of periodontal disease.     

牙周组织再生术联合无托槽隐形矫治对牙周炎患者龈沟液炎症因子的影响

目的 探讨牙周组织再生术(PTR)联合无托槽隐形矫治对牙周炎患者龈沟液炎症因子的影响,为该类患者的治疗提供参考.方法 选取2017年3月至2019年3月我院收治的120例牙周炎患者为研究对象,依据随机数字表分为再隐组和再直组,每组60例.再隐组患者给予PTR联合无托槽隐形矫治,再直组患者给予PTR联合直丝弓矫治.比较两...     

HnRNPL inhibits the osteogenic differentiation of PDLCs stimulated by SrCl2 through repressing Setd2

Osteoporosis has been shown to intensify bone loss caused by periodontitis and both share common risk factors. One strategy utilized to manage the disease has been via the release of Sr ions by Strontium Ranelate having a direct effect on preventing osteoclast activation and promoting osteoblast differentiation. Previously we have developed and characterized porous Sr‐mesoporous bioactive glass (Sr‐MBG) scaffolds and demonstrated their ability to promote periodontal regeneration when compared to MBG alone. Our group further discovered a splicing factor, heterogeneous nuclear ribonucleoprotein L (hnRNPL), was drastically down‐regulated in periodontal ligament stem cells (PDLCs) stimulated by Sr through the activation of AKT pathway. Furthermore, hnRNPL restrained the osteogenic differentiation of PDLCs through down‐regulating H3K36me3‐specific methyltransferase Setd2. The goal of the present study was to investigate the mechanism of periodontal regeneration stimulated by Sr It was first found that the epigenetic mechanism of splicing factor hnRNPL participated in the osteogenesis processing of PDLCs stimulated by SrCl₂. Meanwhile, the different role of hnRNPL and SET domain containing 2 (Setd2) may provide some implication of the treatment of periodontitis patients simultaneously suffering from osteoporosis.     

Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study

Background and Objective

Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT.

Materials and Methods

A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression.

Results

Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT.

Conclusions

Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.     

Protective effects of crocin on biochemistry and histopathology of experimental periodontitis in rats

ABSTRACT

We investigated the effectiveness of crocin for preventing oxidative damage in experimentally produced periodontitis. We used three groups of 10 female Wistar rats divided into: control (C); experimental periodontitis (EP), experimental periodontitis + crocin (Cr-EP). Malondialdehyde (MDA), glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS) and superoxide dismutase (SOD) and catalase (CAT) enzyme activities were measured. We examined histopathology and inflammatory cell infiltration in gingiva and periodontal ligament. MDA and TOS levels, and SOD and CAT activities increased significantly in rats with induced periodontitis compared to the control group, while GSH and TAS levels were decreased significantly compared to the control group. Histopathologic examination revealed inflammatory cell infiltration in gingiva epithelium and subepithelial connective tissue in the EP group. Histological damage was reduced significantly after crocin treatment compared to the EP group. Crocin supplementation may help reduce oxidative damage to periodontal tissues.     

Periodontal health of older men: the MrOS dental study

Objective: The purpose of this study was to evaluate the prevalence and severity of periodontitis in men of 65+ years and identify demographic and lifestyle factors associated with its presence. Methods: Participants were recruited from the Osteoporotic Fractures in Men Study, a longitudinal study of risk factors for fractures in older men. Dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque and bleeding on a random half‐mouth, plus a questionnaire regarding access to care, symptoms and previous diagnosis. Results: 1210 dentate men completed the dental visit. Average age was 75 years, 39% reported some graduate school education, 32% smoked 20 + pack years and 88% reported their overall health as excellent/good. In terms of periodontal health, 38% had sub‐gingival calculus, 53% gingival bleeding, 82% CAL ≥5 mm and 34% PD ≥6 mm. The prevalence of severe periodontitis was 38%. Significant demographic and lifestyle factors associated with severe periodontitis in multivariate analyses included age ≥75 (OR 1.4, 95% CI 1.1–1.7) non‐white race (OR 1.9, 95% CI 1.3–2.8), less than an annual dental visit (OR 1.5, 95% CI 1.1–2.0), and 20 + pack years (OR 2.1, 95% CI 1.6–2.7). Conclusion: A high proportion of healthy older men have evidence of periodontal destruction which could, given the growing ageing population, have a significant impact on the dental profession’s ability to provide preventive and therapeutic care. The population at highest risk of periodontitis in MrOS is older minority men who smoke and do not have annual dental visits.     

云南白药与丁香油牙周塞治剂辅助治疗牙周炎的临床效果比较

目的:为探讨和比较云南白药牙周塞治剂与丁香油牙周塞治剂辅助牙周手术治疗的临床效果差异,进而为复杂慢性牙周炎的临床治疗提供借鉴和参考依据。方法:选择2012年8月至2014年8月期间我院临床收治的慢性牙周炎患者88例为研究对象,根据患者临床治疗方法的不同将患者分成了研究组和对照组,各44例,分别给予云南白药牙周塞治剂与丁香油牙周塞治剂辅助术后治疗,对两组患者治疗后菌斑指数、牙龈指数、出血指数和松动度等指标进行观察和比较。结果:研究组患者的止血有效率显著高于对照组,且差异有统计学意义;研究组患者的愈合有效率显著高于对照组,且差异有统计学意义;研究组患者的菌斑指数、牙龈指数、出血指数和松动度均明显优于对照组,且组间比较差异有统计学意义。结论:在临床针对手术牙周炎患者实施治疗的实践过程中,采用云南白药牙周塞治剂的临床比较优势明显,可以显著提升患者术后疗效,很好的包含牙龈,有效的控制牙龈出血,是临床实践过程中的理想选择。     

Periodontal therapy increases neutrophil extracellular trap degradation

In periodontitis, polymorphonuclear leucocytes (PMNs) are activated. They entrap and eliminate pathogens by releasing neutrophil extracellular traps (NETs). Abnormal NET degradation is part of a pro-inflammatory status, affecting co-morbidities such as cardiovascular disease. We aimed to investigate the ex vivo NET degradation capacity of plasma from periodontitis patients compared to controls (part 1) and to quantify NET degradation before and after periodontal therapy (part 2). Fresh NETs were obtained by stimulating blood-derived PMNs with phorbol 12-myristate 13-acetate. Plasma samples from untreated periodontitis patients and controls were incubated for 3 h onto freshly generated NETs (part 1). Similarly, for part 2, NET degradation was studied for 91 patients before and 3, 6 and 12 mo after non-surgical periodontal therapy with and without adjunctive systemic antibiotics. Finally, NET degradation was fluorospectrometrically quantified. NET degradation levels did not differ between periodontitis patients and controls, irrespective of subject-related background characteristics. NET degradation significantly increased from 65.6 ± 1.7% before periodontal treatment to 75.7 ± 1.2% at 3 mo post periodontal therapy, and this improvement was maintained at 6 and 12 mo, irrespective of systemic usage of antibiotics. Improved NET degradation after periodontitis treatment is another systemic biomarker reflecting a decreased pro-inflammatory status, which also contributes to an improved cardiovascular condition.     

Role of Periodontal Bacteria,Viruses, and Placental mir155 in Chronic Periodontitis and Preeclampsia—A Genetic Microbiological Study

Previous studies assessed the involvement and impact of periodontal bacteria in preeclamptic women with chronic periodontitis. To explore further, the current study aimed to associate periodontal viruses and bacteria with mir155 levels in placental tissues of preeclamptic women with generalized chronic periodontitis. Four-hundred 45 pregnant women, 18–35 years of age, were selected and divided into four groups (controls, A, B, and C) where the Controls included 145 systemically and periodontally healthy pregnant women Group A-100 systemically healthy pregnant women with chronic periodontitis, Group B- 100 preeclamptic women with chronic periodontitis, Group C- 100 preeclamptic women without chronic periodontitis. Age, BMI, SES, and periodontal parameters such as PI, BOP, PPD, and CAL were noted. Periodontal pathogens such as Tf, Td, Pg, Pi, Fn, HSV, EBV, and HCMV were tested in subgingival plaque, placental tissues, and mir155. We observed that PI, BOP, PPD, CAL, Tf, and EBV were highly significant in Group B. We found a higher number of periodontal bacteria, viruses, and mir 155 in Group B showing a higher risk of preeclampsia. More genetic studies in this field are advised to ascertain the role of periodontopathogens and mir 155 in preeclampsia and periodontal inflammation. What is already known on this subject? Periodontal diseases pose an increased risk of developing preeclampsia and delivering preterm and/or low-birth-weight babies. What do the results of this study add? Periodontal variables such as PI, pocket depth, BOP, and clinical attachment levels, were found to be increased in the preeclamptic women with chronic periodontitis. The significant difference was seen in the relative fold expression of mir155 with higher gene expression of mir155 in groups B and A as compared to group C and controls. What are the implications of these findings for clinical practice and/or further research? In our study, mir155 correlation with the periodontal parameters and periodontal pathogens further strengthen the evidence of periodontal inflammation as a risk of preeclampsia in pregnant women especially when associated with chronic periodontitis. mir155 can be considered to be one of the genetic biomarkers and can be used as a diagnostic tool for the early detection of PE.     

Oral microcirculation in post-menopause: a possible correlation with periodontitis

doi: 10.1111/j.1741‐2358.2011.00608.x Oral microcirculation in post‐menopause: a possible correlation with periodontitis Objectives: The reduction in the level of oestrogen, typical in menopause, has some effect on the health of the oral cavity. In fact, post‐menopausal women present more severe periodontal disease than pre‐menopausal women. Numerous factors can be held to be responsible for this increase, among which are the effects of oestrogens on the oral epithelium, on the salivary glands, on bone tissue and on the endothelium. Our double blind study aims to evaluate the possible variations in oral microcirculation in post‐menopausal women. Methods: Twenty‐seven women in post‐menopause (age: Mean ± SD: 57.3 ± 8.73) and 27 women in pre‐menopause (age: Mean ± SD: 27.77 ± 3.56) were examined. Oral microcirculation was investigated using oral videocapillaroscopy. Results: The study showed significant differences between cases and controls for the following parameters: decrease in diameter of loops (mean ± SD: 0.038 ± 0.008; 0.045 ± 0.005), increase in tortuosity (mean ± SD: 3.83 ± 1.13; 1.83 ± 1.06) in labial mucosa and decrease in density in periodontal mucosa (Mean ± SD: 28.86 ± 10.92; 89.62 ± 17.83). Conclusion: The decrease in periodontal density may compromise the epithelium tropism, making it prone to inflammation. The tortuosity may indicate a greater permanence of inflammatory factors, increased in post‐menopausal women.     

益生菌联合牙周基础治疗对慢性牙周炎患者口腔致病菌的影响

目的 探讨益生菌联合牙周基础治疗对慢性牙周炎患者的治疗效果及其对口腔致病菌的影响。 方法 选取2017年10月至2019年4月我院收治的120例慢性牙周炎患者为研究对象,采用随机数字法将其分为对照组(n=60)及观察组(n=60),对照组采取牙周基础治疗,包括对牙垢面进行清洁、处理咬合创伤、采用生理盐水漱口等及口服阿莫西林胶囊、甲硝唑片,观察组在对照组的基础上口服双歧杆菌三联活菌胶囊,2粒/次,2次/d。治疗4周后,比较2组研究对象探诊深度(probing depth,PD)、牙菌斑指数(dental plaque index,PLI)及牙龈出血指数(bleeding index,BI),评估治疗效果;采用细菌培养的方式观察龈沟液中主要致病菌群变化情况,并记录不良反应发生情况。 结果 治疗后,观察组研究对象PD、PLI及BI均低于对照组(t=2.614,P=0.010;t=2.523,P=0.013;t=5.330,P2=6.775,P=0.009);治疗后,2组研究对象唾液中福赛坦菌、中间普氏菌、牙龈卟啉单胞菌以及伴放线放线杆菌检出率均低于对照组(t=4.174,P=0.041;t=5.783,P=0.016;t=6.009,P=0.014;t=10.231,P=0.001);2组研究对象不良反应发生率差异无统计学意义(χ2=0.086,P=0.769)。 结论 在牙周基础治疗上口服双歧杆菌三联活菌胶囊有利于减轻慢性牙周炎患者牙周症状、抑制口腔致病菌、提高治疗效果。     

Effects of systemic sitafloxacin on periodontal infection control in elderly patients

doi: 10.1111/j.1741‐2358.2011.00605.x
Effects of systemic sitafloxacin on periodontal infection control in elderly patients Objective: To evaluate the microbiological and clinical effects of the systemic administration of sitafloxacin (STFX) on periodontal pockets in elderly patients receiving supportive periodontal therapy (SPT). Background: Periodontitis is a risk factor for atherosclerosis. Better periodontal health contributes to reduce atherosclerosis‐related diseases in elderly population. Materials and methods: Forty‐four patients undergoing SPT were randomly assigned to two groups: a test group took 100 mg/day of STFX for five consecutive days, or a control group received scaling and root planing (SRP) under local anaesthesia. Microbiological and clinical parameters were examined at baseline and at 1 and 3 months after therapy. Results: The presence of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia was significantly reduced at 1 month after treatment in both groups. The median reductions of the bacteria between the baseline and 1 month were 3.08 and 2.54% in the STFX‐ and SRP‐treated groups, respectively. Both treatments significantly decreased the probing depth at 1 and 3 months compared to the baseline. Conclusion: The systemic administration of STFX is effective at improving periodontal health during SPT and could be an alternative to SRP for elderly patients who cannot undergo anaesthesia or are at risk of tissue injury.     

Oral health of the elderly living in residential homes in Slovenia

doi: 10.1111/j.1741‐2358.2011.00497.x
Oral health of the elderly living in residential homes in Slovenia Objectives:  To evaluate oral health status of the elderly, living in eight randomly selected residential homes for senior citizens across the country. Background: The percentage of the elderly is growing worldwide. With ageing, risks of various oral diseases, including dental caries and periodontal disease, are growing. Methods: Altogether 296 elderly people (88 men, 208 women) of average age 79.89 ± 7.4 years were questioned about their medical condition and oral health practice and examined orally. Evaluation of clinical examination was carried out by DMFT, plaque index ( 10 ) and Community Periodontal Index of Treatment Need (CPITN). Results: Of 296 participants, 106 (35.8%) were edentulous, 95 (32.1%) had one to nine teeth and 95 persons (32.1%) had 10 or more teeth. The average number of teeth in an individual was small: 6.76 ± 7.47. The average number of teeth with caries lesions was 3.59 ± 4.70, filled teeth 1.94 ± 3.63 and teeth without caries or fillings 1.19 ± 2.41. The average DMFT value was 30.75. In 69.5% of participants, dental plaque was visible with the naked eye. Of 171 subjects, in whom CPITN index was appraised, 81.9% would need oral hygiene education, 56.7% would need scaling and root planning and 21.6% would need periodontal surgical treatment. Conclusions: The results of this study indicate poor oral health of the elderly living in residential homes situated in different towns in Slovenia. It is of utmost importance to highlight the necessity of improving oral health care of this population.     

Linking periodontal disease with obesity and blood glucose

It is of interest to evaluate the association of obesity and blood glucose level with periodontitis. Patients (150 with age range 26-68 years) were included based on WHO obesity criteria, undiagnosed for periodontitis, with Body Mass Index (BMI) ≥ 30 and systemically healthy. These patients underwent periodontal examination followed by blood analysis for lipid profile and blood sugar level. The periodontal status was determined using parameters such as Plaque index (PI), gingival index (GI), Probing depth (PPD) and Clinical attachment loss (CAL). 103 (68.7%) patients had >190 of triglyceride values. Data shows that periodontitis has no statistical significance with total cholesterol, HDL, LDL and moderate significance with VLDL, triglycerides. Glycemic control of the patients is assessed using postprandial blood sugar (PPBS) and Fasting Blood Sugar (FBS). Data shows that 129(86.6%) had FBS (mg/dl) <100 and 21 (14.0%) had FBS (mg/dl) >100. So the number of patients with FBS (mg/dl) < 100 were more i.e., 129 (86.6%). The PPBS values were in 136 (90.7%) had PPBS (mg/dl) <140 and only 14(9.3%) had PPBS (mg/dl) >140 group of patients were said have glucose intolerance. Thus, there is no change in lipid profile with established periodontitis in obese individuals. However, altered glycemic control is observed.     

水激光与超声洁治对中度慢性牙周炎的疗效对比

目的:探讨水激光与超声洁治对中度慢性牙周炎的疗效。方法:选取81例中度慢性牙周炎患者,年龄27-62岁,随机分为两组:激光组(41例)采用水激光治疗,超声组(40例)采用超声洁治法治疗。通过患者治疗后1个月,3个月的菌斑指数(plaque index,PLI),牙龈指数(gingival index,GI),牙周袋深度(probing depth,PD),牙周附着水平(clinical attachment level,CAL),治疗过程中的VAS评分等观察指标,对水激光与超声洁治进行疗效对比。结果:与基线各项牙周指数相比,激光组和超声组治疗后1个月,3个月的各项牙周指数均明显降低(P0.05)。与超声组相比,激光组治疗后1个月的GI值明显低于超声组,治疗后1个月和3个月的PD值和CAL值均低于超声组(P0.05)。治疗前,两组VAS评分相比,差异没有统计学意义(P0.05),治疗后,激光组的VAS评分明显低于超声组(P0.05)。结论:水激光治疗中度慢性牙周炎,治疗过程痛觉感受轻微,能轻易清除引起炎症的牙石及菌斑,促进牙周组织愈合。     

慢性牙周炎与原发性肝硬化的相关性分析

目的:探究慢性牙周炎与原发性肝硬化之间的相关性。方法:选择2017年1月至2019年1月于我院接受治疗的60例原发性肝硬化患者为研究组,选择同期于我院接受体格检查的100例健康个体为对照组,对两组患者分别实施牙周检查,对比两组患者牙周炎发生率,分析吸烟、饮酒对牙周炎发生率影响,按照Child-改良分级法对肝硬化患者进行评分并分级,对比各级原发性肝硬化患者慢性牙周亚发生率,并就慢性牙周炎与肝硬化相关性进行分析。结果:(1)对照组慢性牙周炎发生率显著低于研究组慢性牙周炎发病率(44.00%vs. 71.67%,P0.05);(2)研究组和对照组中吸烟者的慢性牙周炎患病率显著高于不吸烟者(P0.05),研究组中吸烟者发生慢性牙周炎患病率高于对照组,对比无统计学意义(P0.05);研究组和对照组饮酒者的慢性牙周炎患病率显著高于不饮酒者(P0.05),研究组中饮酒者发生慢性牙周炎患病率显著高于对照组(P0.05);(3)随着原发性肝硬化患者评分的升高,患者牙周炎患病率也随之上升,牙周附着丧失程度也出现加剧(P0.05)。结论:原发性肝硬化患者慢性牙周炎患病率高于健康个体,随着肝硬化患者病情的加剧,患者慢性牙周炎发生率也随之上升;另外,吸烟及饮酒会增加健康个体慢性牙周炎患病率。     

Detection rates of periodontal bacteria and herpesviruses in different forms of periodontal disease

The aim was to investigate the detection rates of periodontal bacteria (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans) and herpesviruses (herpes simplex virus-1 [HSV-1], cytomegalovirus [CMV], and Epstein-Barr virus [EBV]) in different forms and severity of periodontal disease, and to compare them with those in periodontally healthy subjects. One hundred and twenty-nine patients participated in the study: 39 diagnosed with periodontal abscess (PA), 33 with necrotizing ulcerative periodontitis (NUP), 27 with chronic periodontitis (CP), and 30 participants with healthy periodontal tissue represented a healthy control group. All patients with periodontal disease (PA, NUP, and CP) were also divided into two groups according to the severity of their disease: moderate and severe periodontitis. The subgingival samples were collected from the periodontitis active sites and the detection of microorganisms was performed by end-point polymerase chain reaction analyses. The results revealed significantly higher detection rates of P. gingivalis, T. forsythia, and P. intermedia in all three groups of patients with periodontitis than in healthy participants. The highest detection rate of A. actinomycetemcomitans was noticed in CP, which was significantly higher than that in PA, NUP, and healthy control. The occurrence of EBV was significantly higher in NUP than in CP and healthy participants. CMV was detected significantly more frequently in PA and NUP than in CP and healthy participants. Comparisons among healthy participants and patients with moderate and severe periodontitis showed significantly higher detection rates of EBV and CMV in patients with severe forms of periodontitis than in healthy participants and those with moderate periodontitis.