Adult Periodontitis Research Articles

C-reactive protein levels are associated with periodontitis and periodontal inflamed surface area in adults with end-stage renal disease.

Several studies have shown the relationship between periodontal disease and chronic kidney disease, but there is little evidence to assess the impact of the amount of inflamed periodontal tissue on the levels of systemic inflammatory markers. So the aim of this study is determine the association between high-sensitivity C-reactive protein (hsCRP) and both periodontitis and periodontal inflamed surface area (PISA) in adults with end-stage renal disease (ESRD). Cross-sectional study was conducted with 176 adults with ESRD on regular hemodialysis. The participants were submitted to a full-mouth periodontal examination to determine the occurrence of periodontitis and PISA. Regression analysis was performed to test the independent association between periodontal conditions and serum hsCRP levels. A total of 98.9% of the participants had periodontitis, with stages III and IV found in 26.1% and 52.9%, respectively. Mean hsCRP and PISA was 6.57 (SD: 6.03) mg/L and 217.15 (SD: 271.50), respectively. In the adjusted analysis, mean serum hsCRP levels were significantly higher in patients with stage III and IV generalized periodontitis compared with no/localized/generalized stages I-II (7.67mg/L versus 5.72mg/L, P=0.028). After adjustments for confounding variables, individuals with PISA>490.56mm2 (85th percentile) had a 3.26-fold greater chance of having hsCRP above 5mg/L than their counterparts (OR=3.26; 95% CI: 1.25 to 8.49). The inflammatory burden imposed by periodontitis can increase serum hsCRP levels in adults with end-stage renal disease.

Platelet plug formation in whole blood is enhanced in the presence of Porphyromonas gingivalis.

Porphyromonas gingivalis is a gram-negative anaerobic bacterium and an etiologic agent of adult periodontitis. By inducing a dysbiotic state within the host microbiota it contributes to a chronic inflammatory environment in the oral cavity. Under some circumstances, the oral bacteria may gain access to systemic circulation. While the most widely recognized function of platelets is to reduce hemorrhage in case of vascular damage, it is known that platelets are also involved in the hematologic responses to bacterial infections. Some pathogenic bacteria can interact with platelets, triggering their activation and aggregation. The aim of this study was to assess platelet responses to the presence of P. gingivalis in whole blood. Human whole blood was pretreated with P. gingivalis and then platelet plug formation was measured under high shear conditions using the PFA-100. In the presence of P. gingivalis, time for a platelet plug to occlude the aperture in the collagen/ADP cartridge was shortened in a manner dependent on bacterial concentration and the duration of bacterial preincubation of blood. P. gingivalis enhances thrombus forming potential of platelets in whole blood.

Association between obesity and periodontitis in Australian adults: A single mediation analysis.

Obesity and periodontitis are conditions with high burden and cost. This study aims to unfold the proposed pathways through which the effect of obesity in the presence of health behaviors (dental visiting behavior and diabetes) increases the risk of periodontitis? The effect decomposition analysis using potential outcome approach was used to determine obesity-related periodontitis risk using the Australian National Survey of Adult Oral Health 2004 to 2006. A single mediation analysis for exposure, "physical-inactivity induced obesity," mediator "dental visiting behavior (a de facto measure of healthy behaviors)," outcome "periodontitis," and confounders "age, sex, household income, level of education, self-reported diabetes, alcohol-intake and smoking," was constructed for subset of 3,715 participants, aged ≥30 years. Proposed pathways were set independently for each risk factor and in synergy. The STATA 15 Paramed library was used for analysis. Sensitivity analysis was conducted to detect unmeasured confounding using non-parametric approach. The average treatment effect of physical inactivity induced obesity to periodontitis is 14%. Pathway effect analysis using potential outcomes illustrated that the effect of obesity on periodontitis that was not mediated through poor dental visiting behavior was 10%. Indirect effect of obesity-mediated through poor dental visiting behavior on periodontitis was 3%. The direct effect of physical inactivity induced obesity on periodontitis was higher than the indirect effect of obesity on periodontitis through dental visiting behavior. Establishing a pathway of causal relationship for obesity and periodontitis could help in developing management strategies that focuses on mediators.

Socio-hygienic aspects of the dental caries in adults and its prevention

Relevance . A significant group is occupied by risk factors that completely depend directly on the socio-hygienic aspects of the patient's lifestyle. Purpose. To study the impact of the nature of nutrition and oral hygiene on the dental health of adults in modern conditions. Materials and methods. To identify and assess the risk factors for dental caries, a questionnaire was developed and 121 patients from dental clinics in Kazan were interviewed. A discriminant analysis of a group of risk factors for dental caries was performed. We also conducted a comparative analysis of oral hygiene in 36 people using a manual toothbrush and the new device (toothbrush) for cleaning all surfaces of the teeth. Results. The majority of the respondents (95,0%) brush their teeth 2 times a day with a cleaning time of 2 minutes (64,5%), and equally use both electric and manual toothbrushes. However, the frequency of brushing does not correspond to the mode and frequency of consumption of foods with easily fermentable carbohydrates in the diet, sugar-containing beverages, which has a direct impact on the occurrence of dental caries and periodontal diseases. The nature of nutrition significantly affects the development of caries of all teeth, except for the incisors of the maxilla. Brushing your teeth with a frequency of less than 2 times a day also contributes to the development of caries (except for premolars and molars of the maxilla). To improve the level of dental health of the population and prevent the development of dental caries and periodontal diseases in adults a new device (toothbrush) for cleaning all surfaces of teeth has been proposed. Conclusion. The results of the study emphasize the practical importance of analyzing the risk factors for the development of dental caries in the adult population with the possibility of conducting reasonable, targeted correction methods to minimize the risk of further disease progression.

Dental Pulp Mesenchymal Stem Cells as a Treatment for Periodontal Disease in Older Adults.

Periodontal disease (PD) is one of the main causes of tooth loss and is related to oxidative stress and chronic inflammation. Although different treatments have been proposed in the past, the vast majority do not regenerate lost tissues. In this sense, the use of dental pulp mesenchymal stem cells (DPMSCs) seems to be an alternative for the regeneration of periodontal bone tissue. A quasi-experimental study was conducted in a sample of 22 adults between 55 and 64 years of age with PD, without uncontrolled systemic chronic diseases. Two groups were formed randomly: (i) experimental group (EG) n = 11, with a treatment based on DPMSCs; and a (ii) control group (CG) n = 11, without a treatment of DPMSCs. Every participant underwent clinical and radiological evaluations and measurement of bone mineral density (BMD) by tomography. Saliva samples were taken as well, to determine the total concentration of antioxidants, superoxide dismutase (SOD), lipoperoxides, and interleukins (IL), before and 6 months after treatment. All subjects underwent curettage and periodontal surgery, the EG had a collagen scaffold treated with DPMSCs, while the CG only had the collagen scaffold placed. The EG with DPMSCs showed an increase in the BMD of the alveolar bone with a borderline statistical significance (baseline 638.82 ± 181.7 vs. posttreatment 781.26 ± 162.2 HU, p = 0.09). Regarding oxidative stress and inflammation markers, salivary SOD levels were significantly higher in EG (baseline 1.49 ± 0.96 vs. 2.14 ± 1.12 U/L posttreatment, p < 0.05) meanwhile IL1β levels had a decrease (baseline 1001.91 ± 675.5vs. posttreatment 722.3 ± 349.4 pg/ml, p < 0.05). Our findings suggest that a DPMSCs treatment based on DPMSCs has both an effect on bone regeneration linked to an increased SOD and decreased levels of IL1β in aging subjects with PD.

Halitosis and its influence on the quality of life

Objectives: To describe the patients' perception of their own breath and verify that halitosis can lead to loss of quality of life of patients with this condition. Methods: A consecutive sample was formed from patients who sought treatment at the Dentistry Screening Service of FSG Centro Universitário, between the months of August 2015 and September 2015, where they answered a questionnaire with objective questions about their perception of breath, and attitudes related to social situations where the breath can be influential. Results: Participated in this survey a total of 102 patients. Of these, 27 (26.5%) were male and 75 (73.5%) were female. When asked about the importance and concern for their breath, 95 (94.1%) participants reported that the smell of breath has great importance in their lives and 96 of these patients (95%) have a high concern for the own breath. Conclusion: On patients' perceptions, halitosis affects the quality of life of people. However, other studies should be conducted in order to evaluate the influence of halitosis in the quality of life of patients with this condition.Descriptors: Halitosis; Quality of Life; Health Education.ReferencesPham TA, Ueno M, Zaitsu T, Takehara S, Shinada K, Lam P.H, Kawahuchi Y. Clinical trial of oral malodor treatment in patients with periodontal diseases. J Periodontal Res. 2011;46(6):722-29.Moreno T, Hass NA, Castro GD, Winter R, Oppermann RV, Rosing CK. Tratamento da periodontite agressiva e alterações nos compostos sulfurados voláteis. Rev Odonto Ciência. 2005; 20(49):217-21.Domingos PAS, Abreu AC, Dantas AAR, Oliveira ALBM. Halitose: limitando a qualidade de vida. Rev. Odontol. Univ. São Paulo. 2011;23(2):171-81.Zalewska A. et al. Halitosis-a common medical and social problem. Acta Gastroenterol Belg. 2012; 75(3):300-9.Rosenberg M. Clinical Assessment of bad breath: current concepts. J Am Dent Assoc.1996;127:475-82.Morita M, Wang HL. Association between oral malodor and adult periodontitis: a review. J Clin Periodontol. 2001;28(9):813-19.Figueiredo LC, Rosetti EP, Marcantonio E JR, Marcantonio RA, Salvador SL. The relationship of oral malodor in patients with or without periodontal disease. J Periodontol. 2002;73(11):1338-42.Gorender M, Kolbe A. Correlação entre halitose e esquiva social. Rev Bras Neurol Psiquiat. 2004; 8(2):68.Scully C, Greenman J. Halitology: Breath odour: a etiopathogenesis and management. Oral Dis. 2012;18(4):333-45.Calil C, Tarzia O, Marcondes F. Qual a origem do mau hálito? Rev Odontol UNESP. 2006;35(2):185-90.Cartaxo RO, Ferreira DAH, Padilha WWN. Influência social da qualidade do hálito. Rev Inic Cien Odontol.2008;6(2).Associação Brasileira de Halitose (ABHA/ABPO). 2008.Elias MS, Ferriani MD. Historical and social aspects of halitosis. Rev Lat Am Enfermagem. 2006;14(5):821-23.Nadanovsky P, Carvalho LB, Ponce de Leon A. Oral malodour and its association with age and sex in a general population in Brazil. Oral Dis. 2007;13(1):105-9.Almas K, Albaker A, Felembam N. Knowledge of dental health and disease among dental patients: a multicenter study in Saudi Arabia. Indian J Dent Res.2000;11(4):145-55.Sopapornamorn P, Ueno M, Shinada K, Vachirarojpisan T, Kawaguchi Y. Clinical application of a VSCs monitor for oral malodour assessment. Oral Health Prev Dent. 2006;4(2):91-7.Eli I, Baht R, Koriat H, Rosenberg M. Self-perception of breath odor. J Am Dent Assoc. 2001;132(5):621-26.Manual da Organização Mundial da Saúde, 1998. Who. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9.

Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study.

This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.

Global Prevalence of Periodontal Disease and Lack of Its Surveillance.

Background Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. Objective To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. Methods This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. Results Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. Conclusions Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.

Prevalence of Periodontal Disease among Obese Young Adult Population in Saudi Arabia-A Cross-Sectional Study.

Background and objectives: We aimed to assess the prevalence of periodontal disease among obese young adults in Saudi Arabia and to analyze the association between different body mass indexes and the severity of periodontal disease. Materials and methods: This descriptive cross-sectional study consisted of 307 obese patients aged 18–39 years, with body mass index (BMI) ≥30. Demographic variables for periodontal disease, anthropometric parameters such as BMI along with clinical parameters such as oral hygiene index-simplified, community periodontal index (CPI) score and loss of attachment (LOA), were assessed. Multivariate binary logistic regression analysis was used to identify the predictors for chronic periodontitis in obese young adults between 18–40 years of age. Results: The majority of the participants (71.3%) had periodontal disease. Obese and extremely obese patients together showed a statistically significant difference in the age group of 21-30 years in terms of CPI score for inflammation (p < 0.05) and LOA (p < 0.001). Logistic regression analysis showed age (OR: 3.180; 95%CL: 1.337–7.561; p <.001), occasional dental visit (OR: 5.965; 95%CL: 3.130–11.368; p < 0.001), smoking >10 cigarettes (OR: 11.868; 95%CL: 3.588–39.254; p < 0.001) and poor oral hygiene status (OR: 17.250; 95%CL: 6.958–42.764; p < 0.001) were associated with a significantly higher risk of having periodontal disease. Conclusions: This study showed a high prevalence of periodontal disease in obese patients among the Saudi Arabian population.

The effect of periodontal bacteria infection on incidence and prognosis of cancer: A systematic review and meta-analysis.

Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in cancer is controversial. The aim of this study was to evaluate the effect of periodontal bacteria infection on incidence and prognosis of cancer. A systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library databases was performed to obtain 39 studies comprising 7184 participants. The incidence of cancer was evaluated as odd ratios (OR) with a 95% confidence interval (95% CI) using Review Manager 5.2 software. Overall survival, cancer-specific survival and disease-free survival, which were measured as hazard ratios (HR) with a 95% CI using Review Manager 5.2 software. Our results indicated that periodontal bacteria infection increased the incidence of cancer (OR = 1.25; 95%CI: 1.03-1.52) and was associated with poor overall survival (HR = 1.75; 95% CI: 1.40-2.20), disease-free survival (HR = 2.18; 95%CI: 1.24-3.84) and cancer-specific survival (HR = 1.85, 95%CI: 1.44-2.39). Subgroup analysis indicted that the risk of cancer was associated with Porphyromonas gingivalis (Pg) infection (OR = 2.16; 95%CI: 1.34-3.47) and Prevotella intermedia (Pi) infection (OR = 1.28; 95%CI: 1.01-1.63) but not Tannerella forsythia (Tf) (OR = 1.06; 95%CI: 0.8-1.41), Treponema denticola (Td) (OR = 1.30; 95%CI: 0.99-1.72), Aggregatibacter actinomycetemcomitans (Aa) (OR = 1.00; 95%CI: 0.48-2.08) and Fusobacterium nucleatum (Fn) (OR = 0.61; 95%CI: 0.32-1.16). This meta-analysis revealed periodontal bacteria infection increased the incidence of cancer and predicted poor prognosis of cancer.

Molecular Dynamic Simulations for Mammalian Target of Rapamycin (mTOR) Variants to Characterize Potential Disruption of Porphyromonas gingivalis Induced Degradation

Gingipains are a protease secreted by Porphyromonas gingivalis, a major cause of adult periodontitis. P. gingivalis infections are associated with suppressed adaptive immunity and increased neuroinflammation among individuals with Alzheimer’s disease. Gingipains promote neuronal damage and are associated with immunoreactivity. The mammalian target of rapamycin (mTOR) is one protein potentially influenced by gingipain function. mTOR, a protein kinase, controls rates of protein synthesis and degradation, and may also play a significant role in the Alzheimer’s phenotype. Recent evidence suggests that P. gingivalis may inhibit mTOR signaling Alzheimer’s patients. We sought to investigate the role mTOR variants may play in the interaction with gingipains and Alzheimer’s disease. The objectives were to investigate the effect mTOR variants had on structure, function and interaction with gingipains. It was hypothesized that wild type mTOR may confer gingipain induced protection from Alzheimer’s disease, while variant phenotypes may contribute to disease progression. Molecular dynamic simulations were performed to measure hydrophobic collapse and the average movement in 10ns for each structure and compared to wild type. Results suggest structural alterations among the variants which may influence interactions with gingipains. These structural changes may lend evidence to suggest subsequent in vivo analyses investigating how P. gingivalis infection may influence mTOR signaling plays in the Alzheimer’s phenotype.

Factors affecting puberty gingivitis in Polish girls with adolescent idiopathic scoliosis

Age at menarche and hormonal disturbances have been linked to the occurrence and severity of adolescent idiopathic scoliosis (AIS). Concomitantly, an increase in the production of sex hormones during puberty may result in steroid hormones-related gingivitis. Thus, the study aimed to assess the prevalence and factors affecting puberty gingivitis, including menarcheal status, in female patients with AIS and control subjects. The study group was comprised of 59 girls aged 12-16 years with AIS and 50 healthy controls. Dental examination included the assessment of oral hygiene, gingivitis, and dental caries intensity. Data were statistically analyzed with a significance taken as p < 0.05. There wasn't any statistically significant difference in the age at menarche and menarcheal status of both groups. During regression analysis, three predictors significantly affected gingival status of girls: oral hygiene, orthopedic condition, and laterality of the curve. Scoliosis and left convex of the curve significantly increased the index of gingival inflammation. The results indicate that gingivitis is frequent among female adolescents with AIS, due to poor oral hygiene and higher susceptibility to inflammation. It emphasizes a need for a development of preventive strategy for scoliotic patients, since incipient periodontal problems in children may turn into irreversible advanced periodontal diseases in adults.

Periodontitis en individuos con psoriasis en Chile

IntroductionAlthough psoriasis has recently been associated with periodontitis, the evidence is limited, with no studies in Chilean population. This study evaluated the potential association between psoriasis and periodontitis in Chilean adults. MethodA case-control study was conducted that included 39 patients with psoriasis and 47 systemically healthy subjects (>18 years) recruited from the San José Hospital and the Dental Clinic of Andrés Bello University. The presence and severity of psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI), the Dermatology Life Quality Index (DLQI), and the physician's global assessment and body surface area (PGA and BSA) index. All patients were examined for the presence of oral lesions, and a full periodontal examination was carried out. ResultsThose with psoriasis were older, had worse periodontal parameters and worst hygiene habits than controls (P<.05). A higher frequency of severe periodontitis was found in psoriatic patients (P<.05). Psoriatic patients had an increased risk of severe periodontitis (OR: 7.05; 95% CI: 1.22-40.52, P<.029). ConclusionsThis study shows an association between psoriasis and the presence of severe periodontitis in Chilean adults. Periodic periodontal evaluations of a preventive nature should be carried in psoriatic patients.

Current status of periodontal disease in adults in Takahagi, Japan: a cross-sectional study

BackgroundTo date, a few studies have documented the detailed periodontal conditions of a Japanese population. It is important to know if the awareness of Japanese nationals and dentists regarding oral hygiene and prevention of periodontal disease have improved when compared with the past in Japan for the development of future scenarios regarding prevention. The aim of this study was to investigate the severity, prevalence, and extent of periodontal disease in the adult population of the city of Takahagi, Japan. Results were also compared with those of an epidemiological study performed in Japan in the 1980s.MethodsA total of 582 (aged 20 to 89 years) randomly sampled Takahagi residents answered a comprehensive questionnaire and participated in clinical examinations.ResultsThe mean percentages of tooth surfaces harboring plaque and exhibiting BOP were 59.5 ± 20.9% and 31.1 ± 21.1%, respectively. The mean PPD and CAL were 2.5 ± 0.5 mm and 2.9 ± 1.0 mm, respectively. Compared with results of the 1980s survey, the mean percentages of plaque and bleeding on probing were lower in the current population. The mean CAL and prevalence of attachment loss of ≥5 mm in some age groups were higher in the present study than in the 1980s study. There were no statistically significant differences with respect to mean probing depth between the 1980s and current age groups.ConclusionsPeriodontal disease was still prevalent in the current Japanese population, even though some improvement occurred. Proper public health programs therefore need to be established.

Rheumatoid arthritis and periodontitis in adults: Using the Korean National Health Insurance Service-National Sample Cohort.

Using the database of the National Health Insurance Service-National Sample Cohort (NHIS-NSC), we aimed to assess the relationship between the prevalence of rheumatoid arthritis (RA) and periodontitis. Participants aged ≥19 years with a previous health check-up at the NHIS between 2009 and 2015 were selected. In total, 559,280 participants were included after implementing appropriate exclusion criteria. The Chi-squared test was used to compare the general and health-related characteristics of participants with and without RA or periodontitis. Univariate and multivariate logistic regression analyses with consecutive adjustment for confounders, were used to assess the association between the prevalence of rheumatoid arthritis and periodontitis. The prevalence of rheumatoid arthritis in patients with and without periodontitis was 6.2% and 5.2%, respectively. The prevalence of periodontitis in patients with and without rheumatoid arthritis was 19.6% and 16.6%, respectively. The possibility of having rheumatoid arthritis was greater in patients with periodontitis than in individuals without periodontitis (odds ratio [OR]; 1.22, P<0.001), and remained high (OR; 1.07, P<0.001) after adjusting for confounders. Our results revealed a significant association between the prevalence of rheumatoid arthritis and periodontitis.

Obesity and periodontitis in Australian adults: A population-based cross-sectional study

Obesity and periodontitis are public health issues in Australia. This study aimed to determine the association between overweight/obesity and periodontitis in Australian adults. The cross-sectional National Survey of Adult Oral Health 2004-2006 data were analysed. Body mass index was calculated, and a self-reported questionnaire was used to measure the estimated daily intake of added sugar. The mean number of sites with probing depth (PD) ≥ 4mm and clinical attachment loss (CAL) ≥ 4mm and presence of periodontitis were used as outcome measures. CDC/AAP periodontitis case definition was adopted. Bivariate analyses and multiple variable regression models were constructed. The study sample was 4,170 participants. The proportion of people that were overweight/obese was 51.9% [95% confidence interval (CI): 48.1%, 54.1%]. Overall 21.3% (95% CI: 19.3%, 23.5%) people experienced periodontitis. The mean number of sites with PD ≥ 4mm and CAL ≥ 4mm were recorded as 0.7 (95% CI: 0.5, 0.9) and 2.4 (95% CI: 2.1, 2.6), respectively. Multiple variable analysis suggested that periodontal parameters [sites with PD ≥ 4mm (0.13, 95% CI: -0.86, 0.35) and sites with CAL ≥ 4 mm (0.11, 95% CI: -0.58, 0.35) and presence of periodontitis (1.23, 95% CI: 0.96, 1.57)] were not associated with overweight/obesity when controlled for putative confounders. A positive association was found between overweight/obesity and periodontitis (PD and CAL). However, the statistical significance disappeared in the multiple variable regression analysis, where age, sex, smoking and dental visiting behaviour were found to be key determinants of periodontitis.

Molecular identification of Capnocytophaga species from the oral cavity of patients with chronic periodontitis and healthy individuals.

Introduction:Capnocytophaga species are recognized as part of human oral microbiota and implicated as periodontal pathogens associated with various periodontal diseases. The three original Capnocytophaga species - Capnocytophaga ochracea, Capnocytophaga sputigena and Capnocytophaga gingivalis were initially isolated from periodontitis in adults, but subsequent studies demonstrated their presence also at periodontally healthy sites in both children and adults. Their association with periodontal disease is a matter of controversy. Considering the differing virulence features of the respective isolate, it is crucial to identify these isolates to species level.Aims:The aim of this study is to investigate the prevalence of Capnocytophaga species by polymerase chain reaction (PCR) through restriction fragment length polymorphism in healthy individuals and patients with periodontal disease.Material and Methods:The study included a total of 300 individuals, 100 each with Gingivitis, Chronic periodontitis, and Healthy individuals. The plaque samples were collected using sterile curette in reduced transport fluid. DNA extraction was carried out for PCR analysis.Results:Of 300 individuals, Capnocytophaga species were identified from 237 (79%) participants in all groups. The prevalence was statistically analyzed using Chi-square test. The prevalence was more in males in gingivitis and healthy individuals (42% and 49% respectively), and females in periodontitis (40%). C. ochracea was observed in a higher proportion (36.33%), followed by C. granulosa (32.66%) and C. gingivalis (10%). They were identified more in the age group of 30–40 years in gingivitis and periodontitis, (30 and 21 individuals, respectively) and 39 individuals in 18–29 years in healthy individuals. They were present in 87% in healthy individuals, 77% in gingivitis and 73% in periodontitis.Conclusion:Capnocytophaga species are commonly present in healthy individuals and may be associated with periodontal disease. There is a need for further study to know the prevalence of other species of Capnocytophaga in health and disease.

Uloga oksidativnog stresa i sistema antioksidativne zaštite u parodontopatiji

The prevalence of periodontal disease is very high in the adult population. According to research results, as much as 46% of the total population was affected by periodontal disease in the period from 2010 to 2012, which would mean that 64.7 million people had periodontitis, of which 8% had a severe form of this disease. Having in mind the clinical and socioeconomic significance of periodontitis, this review aims to present in a comprehensive way the pathogenetic aspects of periodontitis with a special emphasis on oxidative stress and antioxidant protection mechanisms as possible molecular mechanisms for the development of periodontitis in adults. Oxidation stress is involved in the progression of periodontitis as a chronic inflammatory disease of periodontium, which occurs as a result of imbalance between host response and bacterial infection. At the same time there is a decreased antioxidant activity and salivary gland capacity, which contributes to the further development of this disease. MDA is the most common lipid peroxidation derivative that occurs in periodontitis. All of the mentioned literature data suggest that the elevated MDA values may be due to both local and systemic oxidative stress as a response to inflammatory periodontal disease alone or in combination with other systemic disorders and smoking. The harmful effects of ROS during oxidative stress occur through lipid peroxidation processes and irreversible protein modification to cell apoptosis and programmed cell death. In addition to the two most important signal pathways, caspase pathway and NADPH oxidase-4 pathway, several other signaling pathways mediate in oxidative cell damage: PERK/NRF2 signal path, JNK / mitogen-activating pathway (MAP). When a clinically visible inflammatory process occurs in periodontium, this usually presents a condition that is more or less irreversible. In parodontology, therefore, the idea of introducing biochemical analyzes to diagnose the inflammatory process in parodontium is still open before it can be seen at the clinical level. For this reason, the significance of the role of oxidative stress, the antioxidant protection of the organism and the molecular mechanisms by which damage occurs is an indisputable importance. Assessment and measurement of biomarkers of oxidative stress and antioxidant enzymes can play a central role in monitoring biochemical indicators of parodontium state and even assist with various methods of treatment of periodontal disease.

Effectiveness of cognitive-behavioral therapy compared with basic health education for tobacco cessation among smokers: A randomized controlled trial

Background: Tobacco is a risk factor for oral cancer, adult periodontal diseases, and cleft lip and palate in children. Tobacco cessation counseling has been shown to improve the likelihood of achieving success for quitting the habits. Aim: This study aimed to assess the effectiveness of cognitive-behavioral therapy (CBT) compared with basic health education (BHE) for tobacco cessation among smokers in Bengaluru city. Materials and Methods: A randomized controlled trial was conducted over a period of 6 months among smokers attending a tobacco cessation center in a dental college in Bengaluru city. The participants were assigned to either CBT or BHE groups with 1:1 allocation sequence ratio. Randomization and allocation concealment were done by an investigator who had no clinical involvement in the trial. Nicotine dependence was assessed using the Fagerstrom's Addiction Scale for smokers, while motivational levels were assessed using Transtheoretical model. The groups were followed up for 4 and 12 weeks. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS 22.0, IBM, Armonk, NY, USA). Paired and unpaired “t“-tests, Chi-square test, Fisher's exact test, and analysis of variance test were applied. Statistical significance was considered atP < 0.05. Results: Majority of the study participants started smoking at an early age and had long duration and cigarette smoking years. Among CBT group, the mean Fagerstrom's addiction score at baseline (4.8 ± 7.3) significantly reduced (3.8 ± 3.1) at the 1st follow-up and at the 2nd follow-up (3.5 ± 8.9) (P < 0.001). The proportion of smokers with frequency more than ten cigarettes per day reduced from baseline (P = 0.16) to the 2nd follow-up (P = 0.07) in CBT group compared to BHE group. Conclusion: CBT is effective in reducing tobacco habits and addiction levels when compared to BHE among smokers. Tobacco cessation counseling using CBT has been found to reduce smoking habits, thereby improving the possibility of quitting the habits.

Oral human cytomegalovirus prevalence and its relationships with periodontitis and Porphyromonas gingivalis in Japanese adults: a cross-sectional study.

Objective This study aimed to clarify the association between oral human cytomegalovirus (HCMV) and periodontitis in Japanese adults.Methodology In total, 190 patients (75 men and 115 women; mean age, 70.2 years) who visited Hiroshima University Hospital between March 2018 and May 2020 were included. Oral rinse samples were taken to examine the presence of HCMV DNA using real-time polymerase chain reaction (PCR). P. gingivalis was detected by semi-quantitative PCR analysis.Results HCMV DNA was present in nine of 190 patients (4.7%). There were significant associations between HCMV presence and the presence of ≥4-mm-deep periodontal pockets with bleeding on probing (BOP) (P<0.01) and ≥6-mm-deep periodontal pockets with BOP (P=0.01). However, no significant relationship was observed between HCMV presence and periodontal epithelial surface area scores. Logistic regression analysis revealed that the presence of ≥4-mm-deep periodontal pockets with BOP was significantly associated with HCMV (odds ratio, 14.4; P=0.01). Propensity score matching was performed between patients presenting ≥4-mm-deep periodontal pockets with BOP (i.e., active periodontitis) and patients without ≥4-mm-deep periodontal pockets with BOP; 62 matched pairs were generated. Patients who had ≥4-mm-deep periodontal pockets with BOP showed a higher rate of HCMV presence (9.7%) than those who lacked ≥4-mm-deep periodontal pockets with BOP (0.0%). There was a significant relationship between HCMV presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03). A significant relationship was found between HCMV/P. gingivalis DNA presence and ≥4-mm-deep periodontal pockets with BOP (P=0.03).Conclusions Coinfection of oral HCMV and P. gingivalis was significantly associated with active periodontitis. Moreover, interactions between oral HCMV and P. gingivalis may be related to the severity of periodontal disease.