Cause Of Tooth Loss Research Articles

Questionnaire-based community periodontal susceptibility screening index

Periodontal diseases are major causes of tooth loss and contribute to significant morbidity and healthcare costs. Therefore, identifying areas that deliver substantial returns with community-based preventive programs are a dire necessity. Planning and implementing preventive measures in periodontal oral care require identification of not only a population with current disease burden, but also of future susceptibility to disease. All major periodontal indices that have been used in community periodontal surveys are designed to identify either severity, prevalence, or treatment needs of periodontal diseases. No known index exists based on scientifically proven risk factors of periodontal disease to identify population susceptible to the disease, and to determine the need for preventive planning and interventions. In this article, a simple questionnaire-based index has been proposed to identify both individual and community susceptibility to periodontal disease.

Role of curcuma longa in health: A review

Turmeric is a plant that has a very long history of medicinal use, dating back nearly 4000 years. In Southeast Asia, turmeric is used not only as a principal spice but also as a component in religious ceremonies. Because of its brilliant yellow color, turmeric is also known as Indian Saffron. Periodontal disease affects approximately 75 percent of adults over age 30. The leading cause of tooth loss, periodontal disease begins with an accumulation of plaque- a sticky deposit of mucus, food particles and bacteria that adheres to the teeth. Turmeric relieves pain and inflammation linked with gingival disease. The objective of this article is to highlight uses of turmeric in the reduction of periodontal disease.

Vertical root fractures: An update review

Vertical root fractures are the most common cause of tooth loss. These fractures have a multifactorial etiology. They lead to advanced periodontal breakdown with deep periodontal pockets and vertical bone defects. Clinical signs and symptoms are often elusive in nature and may be difficult to detect. In this review, the etiology, diagnosis, prevention and management of vertical root fractures is discussed.

Role of autoimmune responses in periodontal disease.

Periodontal diseases are characterized by localized infections and inflammatory conditions that directly affect teeth supporting structures which are the major cause of tooth loss. Several studies have demonstrated the involvement of autoimmune responses in periodontal disease. Evidences of involvement of immunopathology have been reported in periodontal disease. Bacteria in the dental plaque induce antibody formation. Autoreactive T cells, natural killer cells, ANCA, heat shock proteins, autoantibodies, and genetic factors are reported to have an important role in the autoimmune component of periodontal disease. The present review describes the involvement of autoimmune responses in periodontal diseases and also the mechanisms underlying these responses. This review is an attempt to throw light on the etiopathogenesis of periodontal disease highlighting the autoimmunity aspect of the etiopathogenesis involved in the initiation and progression of the disease. However, further clinical trials are required to strengthen the role of autoimmunity as a cause of periodontal disease.

Increased Interleukin-18 in the Gingival Tissues Evokes Chronic Periodontitis after Bacterial Infection

Periodontal disease is a chronic inflammatory disease that results in the breakdown of the tooth-supporting tissues, and can ultimately lead to resorption of the alveolar bone. Recently, several studies have shown a close relationship between increased interleukin-18 (IL-18) levels and the pathogenesis of chronic periodontitis, a major cause of tooth loss. However, it has yet to be shown whether chronic periodontitis results from or causes an increase in IL-18 after bacterial infection. In the present study, we investigated how IL-18 overexpression relates to periodontal disease using IL-18 transgenic (Tg) mice. IL-18Tg and wild-type mice were inoculated intraorally with Porphyromonas (P.) gingivalis, which has been implicated in the etiology of chronic periodontitis. Seventy days after P. gingivalis infection, alveolar bone loss and gingival cytokine levels were assessed using histo-morphological analysis and enzyme-linked immuno-absorbent assay, respectively. Periodontal bone loss was evoked in IL-18Tg mice, but not in wild-type mice. Interestingly, levels of bone-resorptive cytokines, including IL-1α, IL-1β, tumor necrosis factor-α, and IL-6, were unchanged in the gingival tissues of IL-18Tg mice infected with P. gingivalis, although levels of interferon γ (a proinflammatory T-helper 1 cytokine) decreased. RT-PCR analysis showed elevated expression of mRNAs for receptor activator of nuclear factor kappa-B ligand (a key stimulator of osteoclast development and activation) and CD40 ligand (a marker of T cell activation) in the gingiva of IL-18Tg mice infected with P. gingivalis. We conclude that increased IL-18 in the gingival tissues evokes chronic periodontitis after bacterial infection, presumably via a T cell-mediated pathway.

Quercetin Inhibits Inflammatory Bone Resorption in a Mouse Periodontitis Model

Periodontitis is a disease that leads to bone destruction and represents the main cause of tooth loss in adults. The development of aggressive periodontitis has been associated with increased inflammatory response that is induced by the presence of a subgingival biofilm containing Aggregatibacter actinomycetemcomitans. The flavonoid quercetin (1) is widespread in vegetables and fruits and exhibits many biological properties for possible medical and clinical applications such as its anti-inflamatory and antioxidant effects. Thus, in the present study, the properties of 1 have been evaluated in bone loss and inflammation using a mouse periodontitis model induced by A. actinomycetemcomitans infection. Subcutaneous treatment with 1 reduced A. actinomycetemcomitans-induced bone loss and IL-1β, TNF-α, IL-17, RANKL, and ICAM-1 production in the gingival tissue without affecting bacterial counts. These results demonstrated that quercetin exhibits protective effects in A. actinomycetemcomitans-induced periodontitis in mice by modulating cytokine and ICAM-1 production.

Age and Timing of Pulp Extirpation as Major Factors Associated with Inflammatory Root Resorption in Replanted Permanent Teeth

IntroductionExternal root resorption (ERR) is a serious complication after replantation, and its progressive inflammatory and replacement forms are significant causes of tooth loss. This retrospective study aimed to evaluate the factors related to the occurrence of inflammatory ERR (IERR) and replacement ERR (RERR) shortly after permanent tooth replantation in patients treated at the Dental Trauma Clinic at the School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. MethodsCase records and radiographs of 165 patients were evaluated for the presence, type, and extension of ERR and its association with age and factors related to the management and acute treatment of the avulsed tooth by using the logistic regression model. ResultsThe patient's age at the moment of trauma had a marked effect on the ERR prevalence and extension. The patients older than 16 years at the moment of trauma had less chance of developing IERR and RERR (77% and 87%, respectively) before the pulp extirpation, regardless of the extension of the resorption. The patients older than 11 years of age at the moment of trauma showed the lowest indices of IERR (P = .02). Each day that elapsed between the replantation and the pulp extirpation increased the risk of developing IERR and RERR by 1.2% and 1.1%, respectively, and also raised the risk of severe IERR by 0.5% per day. ConclusionsThe risk of mature teeth developing severe IERR before the onset of endodontic therapy was directly affected by the timing of the pulpectomy and was inversely proportional to age. Systemic antibiotic therapy use had no effect on the occurrence and severity of IERR in mature teeth. The occurrence of RERR before the onset of endodontic treatment stimulates further investigations of the early human host response to trauma and subsequent infection.

The impact of periodontitis on oral health‐related quality of life: a review of the evidence from observational studies

Modern population based oral health management requires a complete understanding of the impact of disease in order to provide efficient and effective oral health care and guidance. Periodontitis is an important cause of tooth loss and has been shown to be associated with a number of systemic conditions. The impact of oral conditions and disorders on quality of life has been extensively studied. However, the impact of periodontitis on quality of life has received less attention. This review summarizes the literature on the impact of periodontitis on oral health-related quality of life (OHRQoL). Relevant publications were identified after searching the MEDLINE and EMBASE electronic databases. Screening of titles and abstracts and data extraction was conducted. Only observational studies were included in this review. Most of the reviewed studies reported a negative impact of periodontitis on OHRQoL. However, the reporting standards varied across studies. Moreover, most of the studies were conducted in developed countries.

Incidence of partial edentulism and its relation with age and gender

Background and objective: This study aimed to determine the incidence of various partial edentoulism according to Kennedy’s classification of edentulous arches, modification areas, types of removable partial dentures (RPDs), selection of major connectors for RPDs and patterns of tooth loss in relation to the gender and age. Methods: The study was conducted in Hawler Medical University, College of Dentistry, Dep. of Prosthodontics, Erbil/Iraq. The data were collected from 963 patients aged 17-80 years of both genders. The survey was based on visual examination for determining the incidence of Kennedy’s classification, modification areas in relation to the age and gender, determining the cause of tooth loss and types of major connectors for RPDs. Results: Kennedy’s class III in both dental arches was the most dominant pattern at a frequency of 49.84%, with class IV being the least in number. Mandibular RPDs were more common than maxillary RPDs. With an increase in age, there was an increase in the Class I and Class II dental arch and a decrease in Class III and class IV in both arches. Gender had no significant relationship with distributions of RPD classification.The majority of the constructed RPDs were acrylic resin 881(91.49%) and only 82 (8.51%) were metal. Conclusion: Kennedy’s class III is the most common RPD in both dental arches. Gender had no effect on the prevalence of various Kennedy classes, while age has a significant effect.

Predictive, preventive, personalised and participatory periodontology: 'the 5Ps age' has already started.

An impressive progress in dentistry has been recorded in the last decades. In order to reconsider guidelines in dentistry, it is required to introduce new concepts of personalised patient treatments: the wave of predictive, preventive and personalised medicine is rapidly incoming in dentistry. Worldwide dentists have to make a big cultural effort in changing the actual ‘reactive’ therapeutic point of view, belonging to the last century, into a futuristic ‘predictive’ one. The first cause of tooth loss in industrialised world is periodontitis, a Gram-negative anaerobic infection whose pathogenesis is genetically determined and characterised by complex immune reactions. Chairside diagnostic tests based on saliva, gingival crevicular fluid and cell sampling are going to be routinely used by periodontists for a new approach to the diagnosis, monitoring, prognosis and management of periodontal patients. The futuristic ‘5Ps’ (predictive, preventive, personalised and participatory periodontology) focuses on early integrated diagnosis (genetic, microbiology, host-derived biomarker detection) and on the active role of the patient in which networked patients will shift from being mere passengers to responsible drivers of their health. In this paper, we intend to propose five diagnostic levels (high-tech diagnostic tools, genetic susceptibility, bacterial infection, host response factors and tissue breakdown-derived products) to be evaluated with the intention to obtain a clear picture of the vulnerability of a single individual to periodontitis in order to organise patient stratification in different categories of risk. Lab-on-a-chip (LOC) technology may soon become an important part of efforts to improve worldwide periodontal health in developed nations as well as in the underserved communities, resource-poor areas and poor countries. The use of LOC devices for periodontal inspection will allow patients to be screened for periodontal diseases in settings other than the periodontist practice, such as at general practitioners, general dentists or dental hygienists. Personalised therapy tailored with respect to the particular medical reality of the specific stratified patient will be the ultimate target to be realised by the 5Ps approach. A long distance has to be covered to reach the above targets, but the pathway has already been clearly outlined.

SAT0083 Tooth loss is associated with swollen joints in a cohort of healthy individuals at increased risk of developing rheumatoid arthritis

BackgroundEvidence suggests an association between periodontitis/tooth loss and rheumatoid arthritis (RA). Periodontitis, a common chronic inflammatory process of the tooth supporting tissues, is a major cause of tooth loss; thus,...

FRI0074 Pre-clinical tooth loss at arthritis onset is associated with higher disease activity and worse treatment response in a large early arthritis cohort study

BackgroundGrowing evidence suggests an association between periodontitis (PD) with rheumatoid arthritis (RA). Chronic PD is a major cause of tooth loss and the number of teeth may therefore, to some...

SAT0089 The impact of periodontal disease on early inflammatory arthritis persists even after all teeth are lost

BackgroundData suggests that individuals with periodontal disease (PD) may be more likely to develop rheumatoid arthritis (RA) and have worse disease activity. PD is a common inflammatory disease characterized by...

Periodontal disease epidemiology – learned and unlearned?

The notion of periodontal disease being the major cause of tooth loss among adults was rooted in the focal infection paradigm that dominated the first half of the 20th century. This paradigm was established largely by personal opinions, and it was not until the development of periodontal indices in the mid-1950s that periodontal epidemiology gained momentum. Unfortunately, the indices used suffered from a number of flaws, whereby the interpretation of the research results took the form of circular reasoning. It was under this paradigm that therapeutic and preventive intervention for periodontal diseases became entirely devoted to oral hygiene, as poor oral hygiene and older age were understood to explain nearly all the variation in disease occurrence. In the early 1980s, studies appeared that contradicted the concepts of poor oral hygiene as the inevitable trigger of periodontitis and of linear and ubiquitous periodontitis progression, whereby periodontal epidemiology was led into a relatively short-lived high-risk era. At this time, it became evident that old scourges continue to haunt periodontology: the inability to agree in operational clinical criteria for a periodontitis diagnosis and the inability to devise both a meaningful and a useful classification of periodontal diseases based on nominalist principles. The meager outcome of the high-risk era led researchers to resurrect the focal infection paradigm, which is now dressed up as periodontal medicine. Unfortunately, these developments have left the core of periodontology somewhat disheveled and deserted.

The expression and regulation of matrix metalloproteinase-3 is critically modulated by Porphyromonas gingivalis lipopolysaccharide with heterogeneous lipid A structures in human gingival fibroblasts

BackgroundPorphyromonas gingivalis lipopolysaccharide (LPS) is a crucial virulence factor strongly associated with chronic periodontitis which is the primary cause of tooth loss in adults. It exhibits remarkable heterogeneity containing tetra-(LPS1435/1449) and penta-(LPS1690) acylated lipid A structures. Human gingival fibroblasts (HGFs) as the main resident cells of human gingiva play a key role in regulating matrix metalloproteinases (MMPs) and contribute to periodontal homeostasis. This study investigated the expression and regulation of MMPs1-3 and tissue inhibitors of MMP-1 (TIMP-1) in HGFs in response to P. gingivalis LPS1435/1449 and LPS1690 and hexa-acylated E. coli LPS as a reference. The expression of MMPs 1–3 and TIMP-1 was evaluated by real-time PCR and ELISA.ResultsThe MMP-3 mRNA and protein were highly upregulated in P. gingivalis LPS1690- and E. coli LPS-treated cells, whereas no induction was observed in P. gingivalis LPS1435/1449-treated cells. On the contrary, the expression of MMP-1 and −2 was not significantly affected by P. gingivalis LPS lipid A heterogeneity. The TIMP-1 mRNA was upregulated in P. gingivalis LPS1435/1449- and E. coli LPS-treated cells. Next, signal transduction pathways involved in P. gingivalis LPS-induced expression of MMP-3 were examined by blocking assays. Blockage of p38 MAPK and ERK significantly inhibited P. gingivalis LPS1690-induced MMP-3 expression in HGFs.ConclusionThe present findings suggest that the heterogeneous lipid A structures of P. gingivalis LPS differentially modulate the expression of MMP-3 in HGFs, which may play a role in periodontal pathogenesis.

Exploring the genetic basis of chronic periodontitis: a genome-wide association study

Chronic periodontitis (CP) is a common oral disease that confers substantial systemic inflammatory and microbial burden and is a major cause of tooth loss. Here, we present the results of a genome-wide association study of CP that was carried out in a cohort of 4504 European Americans (EA) participating in the Atherosclerosis Risk in Communities (ARIC) Study (mean age—62 years, moderate CP—43% and severe CP—17%). We detected no genome-wide significant association signals for CP; however, we found suggestive evidence of association (P < 5 × 10−6) for six loci, including NIN, NPY, WNT5A for severe CP and NCR2, EMR1, 10p15 for moderate CP. Three of these loci had concordant effect size and direction in an independent sample of 656 adult EA participants of the Health, Aging, and Body Composition (Health ABC) Study. Meta-analysis pooled estimates were severe CP (n = 958 versus health: n = 1909)—NPY, rs2521634 [G]: odds ratio [OR = 1.49 (95% confidence interval (CI = 1.28–1.73, P = 3.5 × 10−7))]; moderate CP (n = 2293)—NCR2, rs7762544 [G]: OR = 1.40 (95% CI = 1.24–1.59, P = 7.5 × 10−8), EMR1, rs3826782 [A]: OR = 2.01 (95% CI = 1.52–2.65, P = 8.2 × 10−7). Canonical pathway analysis indicated significant enrichment of nervous system signaling, cellular immune response and cytokine signaling pathways. A significant interaction of NUAK1 (rs11112872, interaction P = 2.9 × 10−9) with smoking in ARIC was not replicated in Health ABC, although estimates of heritable variance in severe CP explained by all single nucleotide polymorphisms increased from 18 to 52% with the inclusion of a genome-wide interaction term with smoking. These genome-wide association results provide information on multiple candidate regions and pathways for interrogation in future genetic studies of CP.

Nicotine favors osteoclastogenesis in human periodontal ligament cells co-cultured with CD4+ T cells by upregulating IL-1β

Periodontitis, which is the main cause of tooth loss, is one of the most common chronic oral diseases in adults. Tooth loss is mainly a result of alveolar bone resorption, which reflects an increased osteoclast formation and activation. Osteoclast formation in periodontal tissue is a multistep process driven by osteoclastogenesis supporting cells such as human periodontal ligament (PDL) cells and CD4(+) T cells. Inflammatory cytokines, such as interleukin-1β (IL-1β), can induce osteoclastogenesis by affecting the expression of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in human PDL cells. Nicotine, the major component in tobacco smoking and a specific agonist of the α7 nicotinic acetylcholine receptor (α7 nAChR), has been proven to regulate the expression of inflammatory cytokines in smoking-associated periodontitis. In this study, we investigated the mechanism(s) through which nicotine affects osteoclastogenesis in human PDL cells co-cultured/non-co-cultured with CD4(+) T cells. Human PDL cells were stimulated with nicotine (10-5 M) and/or α-bungarotoxin (α-BTX, specific antagonist of α7 nAChR, 10-8 M) before being co-cultured with CD4(+) T cells. Compared with mono-culture systems, stimulation with nicotine caused an increased secretion of IL-1β in serum of human PDL cell-CD4(+) T cell co-culture, and the expression of RANKL in human PDL cells was further upregulated co-cultured with CD4(+) T cells, while no differences were observed in the expression of OPG between the co-culture and mono-culture systems. Our data suggested that nicotine upregulated IL-1β secretion, further upregulated RANKL expression in smoking-associated periodontitis, which may aid in the better understanding of the relationship between nicotine and alveolar bone resorption.

Gingivitis – A silent disease

Gum are pinkish brown coloured soft tissue holding the teeth in bony sockets by adhering them firmly through periodontal ligaments to periosteum . Gums are called basically gingiva and their inflammatory diseases are called gingivitis in general .Gum disease is an infection of the gum tissue that surrounds and supports the teeth. It is the major cause of tooth loss in later half of life as in adult as well as in elderly. In early stages it is called gingivitis and when gingivitis is not treated properly , it may advance to periodontitis because of nonspecific signs and symptoms to be noted by patients. Main reasons for ignorance about gum diseases in my opinion are following Non-specific symptoms  Economical  Educational  psycho-social  ignorance  self-medication  Economical factors Dental treatments and dental care is supposed to be costlier affair in a dental clinic as compared to medical services in general . in government sector dental facilities are less as compared to load of population as well as shortage of dental clinics in government sector. Gingivitis Occurs mainly due to plaque accumulation and factors responsible for plaque formation and propogation are poor dental and oral hygine .It is early and reversible disease. In this disease gum become red, swollen and bleed easily while provocation like touching , brushing or sometimes even spontaneous dental/gum bleeding happens . Gingivitis is a mild form of gum disease which can be reversible by daily brushing, flossing and regular cleaning by dentist ,this procedure is called scaling along with proper medication. In gingivitis there is no tissue or bone loss .So it is essential to treat gingivitis as early as possible so that we can prevent the Periodontitis [advanced gum disease]. Periodontitis When gingivitis is not treated, it can advance to Periodontitis. Periodontal disease is considered as one of the most prevalent disease in human. It is characterised by gingival inflammation, loss of gingival attachment and bone loss. In this gum pull away from the teeth and form spaces called pockets that become infected. Bacterial toxins and body's natural response to infection start to breakdown the bone and connective tissue that hold teeth in please. If not treated, the bone, gums and tissue that support the teeth are destroyed and eventually the teeth become loose and have to be removed.

The Association between Gender and Tooth Loss in A Small Rural Population of South Africa

Periodontal disease, which attacks the gums and supporting structures of the tooth, is one of the major causes of tooth loss in adults. Few studies on general well-being have compared the differences in oral health between men and women with studies from Europe and USA reporting that there are more edentulous women than men.Among the many factors contributing to tooth loss are poverty, availability and accessibility to dental and other health care as well as cultural traditions. This study examined a population living in a high fluoride area near Cape Town. This isolated community has until recently been unexposed to the diets and habits of the western world and have inter-married for decades. The results of this study indicated that although women had better oral hygiene habits than men, tooth loss was associated with age rather than gender.

Dental diseases in the institutionalized patients with severe motor and intellectual disabilities, and the causes of tooth loss.

Dental diseases in the institutionalized patients with severe motor and intellectual disabilities, and the causes of tooth loss.