Clinical Periodontal Examination Research Articles

The Prevalence of Gingival Recession According to the Cairo Classification in a Population from the North of Portugal

Background/Objectives: Gingival recession (GR) has a multifactorial etiology, resulting from the interaction of various factors. It affects aesthetics and comfort, and has negative consequences for quality of life. The main objective of this study is to investigate the prevalence of gingival recession in a sample of the population in northern Portugal, according to the classification system proposed by Cairo. The secondary objective is to investigate possible risk factors for the prevalence of gingival recession. Methods: This observational study analyzed 50 patients who met all our inclusion criteria. Participants underwent a clinical periodontal examination and completed a questionnaire. Results: On the lingual/palatine side, recession type 2 (RT2) was the most prevalent (39.1%), and on the buccal side, recession type 3 (RT3) was the most prevalent (37.7%). Statistically significant differences were found in the occurrence of RT3 on both sides, buccal and lingual/palatine, which was higher in patients over 65. Buccal side RT2 and buccal and lingual/palatine side RT3 were more prevalent in males. Buccal side RT2 was more prevalent in ex-smokers compared to nonsmokers. RT3 was more prevalent in ex-smokers compared to smokers and nonsmokers. Most patients have gingival recession with loss of interproximal attachment. Conclusions: Older age, male gender, high plaque levels, and smoking habits are considered risk factors.

GINGIVAL STATUS AND ORAL HYGIENE HABITS IN CHILDREN BETWEEN 10-12 YEARS

Introduction: Children's adolescence is characterized by dynamically changing indicators of periodontal and oral health, related mainly to the eruption of the permanent dentition and stabilization of the periodontal space. This age period is also characterized by an increased incidence of gingival diseases, with the dental biofilm being the main risk factor for the inflammatory process. Aim: The aim of this study is to assess the relationship between gingival status, oral hygiene habits and knowledge on topics related to oral health in children aged 11-13. Material and methods: The subject of the study was 106 children aged 11-13 years. All children overwent a clinical periodontal examination and periodontal risk assessment at 4 levels. An electronic periodontal probe PA ON (Orangedental) with specially designed software was used to assess periodontal and oral hygiene status. The study included a survey method for assessing children's knowledge on topics related to oral health with periodontal focus. The survey consists of 38 questions divided into eight topics. Results: All the children aged 11-13 years had an initial form of gingival inflammation, against the background of plaque accumulation affecting more than 69% of tooth surfaces, unstable and irregular oral hygiene habits, as well as insufficient knowledge of oral/periodontal health. Through appropriate preventive programs, this age is best suited to create consciously motivated behavior for proper oral hygiene and oral health.

Clinical and Microbiological Periodontal Biofilm Evaluation of Patients with Type I Diabetes.

Background/Objectives: The purpose of this study was to assess the microbial composition and density of subgingival plaque samples for periodontal pathogens while correlating the values with glycemic control levels via glycated hemoglobin (HbA1c), a type of hemoglobin that has chemically linked glucose, in type I diabetes individuals who will undergo complex oral rehabilitation through orthodontic treatment and implant surgery. Methods: A cohort of 42 adults with type I diabetes were included in this study. The subjects sustained a comprehensive periodontal clinical examination as well as microbiological assessments of their subgingival plaque samples through quantitative real-time PCR. The samples were collected from the two deepest pockets of each subject. Results: The highest number of periodontopathogenic bacteria was observed in the pockets of 5-7 mm. T. forsythia showed the highest prevalence (20.48%), with decreasing numbers as follows: T. denticola (13.31%), P. gingivalis (11.26%), A. actinomycetemcomitans (7%), and P. intermedia (4.9%). T. denticola and T. forsythia were significantly more commonly observed in individuals with elevated HbA1c serum levels. No correlation was observed between P. gingivalis, A. actinomycetemcomitans, P. intermedia presence, and the HbA1c value. Conclusions: Periodontopathogenic agents' presence in subgingival biofilm samples varied in accordance with the pocket probing depth and metabolic control of the diabetic individuals. In our study, the appearance of these periodontopathogenic agents was linked to lowered metabolic control in patients with type I diabetes mellitus.

Oral Yeasts Carriage in Prediabetic Smokers and Nonsmokers

Habitual smoking and prediabetes are independent risk factors for increased oral yeasts carriage (OYC); however, no studies have compared OYC amongst cigarette smokers and nonsmokers with and without prediabetes. The aim was to fill this research gap. Ninety-two participants were included and categorised into 4 groups: group 1, prediabetic (haemoglobin A1c [HbA1c] levels, 5.7%-6.4%) cigarette smokers; group 2, cigarette smokers without prediabetes; group 3, prediabetic nonsmokers; and group 4, nonsmokers without prediabetes. Patient demographics and HbA1c levels were recorded. Data on duration of smoking habit (pack-years) and family history of smoking were collected. Information on daily toothbrushing and flossing and most recent visit to a dentist/dental hygienist was gathered. Clinical and radiographic periodontal examination was performed and unstimulated whole salivary flow rate (UWSFR) was determined. OYC was assessed using the oral rinse sampling method. Power analysis was done, and group comparisons were performed. Logistic regression analysis was performed and P values <5% reflected statistical significance. Respectively, 23, 24, 22, and 23 individuals with comparable mean ages were included in groups 1, 2, 3, and 4. In groups 1 and 2, participants had a smoking history of (mean ± SD) 24.7 ± 3.2 and 10.6 ± 2.5 pack-years. Plaque index, clinical attachment loss, and probing depth were higher in groups 1 (P < .05), 2 (P < .05), and 3 (P < .05) than in group 4. Number of missing teeth was significantly higher in group 1 compared with groups 2 (P < .05), 3 (P < .05), and 4 (P < .05). There was no difference in UWSFR amongst the groups. OYC was greater in group 1 than in groups 2 (P < .05), 3 (P < .05), and 4 (P < .05). OYC was greater in groups 2 (P < .05) and 3 (P < .05) than in group 4. In prediabetic cigarette smokers, OYC appears to be influenced by hyperglycaemia, whilst in nondiabetic smokers, the severity of periodontal inflammation appears to be the determining factor in OYC.

Evaluation of correlation between sleep quality and chronic periodontitis – A case–control study

ABSTRACT Background: Periodontitis poses a significant public health challenge globally due to its substantial contribution to tooth loss and its links to numerous systemic diseases. Sleep, being a complex biological process crucial for overall mental and physical well-being, intersects with this concern. However, recent studies have yielded conflicting findings on the potential connection between chronic periodontitis and sleep quality, likely due to the shared inflammation characteristic in both conditions. Aim: The study aims to examine the correlation between the quality of sleep and chronic periodontitis. Materials and Methods: This study involved 100 participants who underwent a thorough clinical periodontal examination. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Univariate and multivariate logistic regression analyses were conducted to assess the impact of various factors in the presence of periodontitis. Statistical analysis was performed, with statistical significance at P ≤ 0.05. Results: In the current study, 29% of the participants exhibited poor sleep quality, and 75.8% were in the periodontitis group. Poor sleep quality was associated with periodontitis in univariate (crude odds ratio = 1.83, 95% confidence interval = 0.655–0.847; P = 0.004) analyzed. Patients’ age showed a positive correlation with periodontitis. Other variables do not show a statistically significant level. Conclusion: The present study shows that there lies a significant correlation between chronic periodontitis and poor sleep quality. Among the measured covariables, only age showed a significant relationship with periodontitis.

Oral and Intestinal Bacterial Flora in Patients with Increased Periodontal Inflamed Surface Area: A Cross-Sectional Study.

Background/Objectives: Periodontitis is caused by bacterial plaque. The oral microflora may interact with the intestinal microflora and play a role in the development of periodontitis. The periodontal inflamed surface area (PISA) has been shown to be a useful indicator of periodontal disease related to systemic diseases; however, few studies have shown an association between PISA and the bacterial flora. This study aimed to determine the association between PISA and oral and intestinal bacteria. Methods: Participants were recruited between 2018 and 2021 at the Medical and Dental Collaboration Center of Kanagawa Dental University Hospital. A periodontal clinical examination was performed, and the PISA was calculated. Salivary tests were conducted, and leukocyte scores in the saliva were calculated. Moreover, 16S rRNA amplicon sequencing was performed using saliva and stool samples to analyze oral and intestinal bacteria, respectively. Results: Higher PISA levels resulted in an increased presence of Bacteroides and a decreased presence of Proteobacteria and Actinobacteria in the saliva. An increase in Bacteroides was detected in the saliva of patients with high leukocyte scores. No correlation was observed between PISA and intestinal bacteria. Conclusions: Bacteroides was highly abundant in the saliva of patients with worsened periodontal conditions, as indicated by PISA. No association was found between PISA and intestinal bacteria.

MMP-8 in Periodontal Sites of Postpartum and without-Any-Pregnancy Women.

The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case-control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women.

All-cause and cause-specific mortality in US adults with periodontal diseases: A prospective cohort study.

This prospective cohort study investigated the association between periodontal diseases (PDs) and all-cause and cause-specific mortality. We utilized adult participants recruited from six National Health and Nutrition Examination Survey cycles (1999-2014) and linked mortality data from the National Death Index up to December 2019. Baseline clinical periodontal examinations were performed by trained and calibrated examiners. All-cause and cause-specific mortality was modelled through multivariable Cox proportional hazards and Fine-Gray models to account for competing risks. All models were adjusted for demographic and lifestyle variables, clinical measurements and comorbidities. Overall, 15,030 participants were included, with a median length of follow-up of 9 years. Risk of all-cause mortality was 22% greater in people with PD than the control group (adjusted hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.12-1.31). Risks of mortality by cardiovascular diseases (CVD), respiratory disease and diabetes were highest in participants with severe PD (CVD-sub-distribution HR [SHR]: 1.38, 95% CI: 1.16-1.64; respiratory-SHR: 1.62, 95% CI: 1.07-2.45; diabetes-SHR: 1.68, 95% CI: 1.12-2.53). Severe PD is associated with all-cause and cause-specific mortality among US adults after multivariable adjustment.

Changes in Dickkopf-1, but Not Sclerostin, in Gingival Crevicular Fluid Are Associated with Peroral Statin Treatment in Patients with Periodontitis.

Background and Objectives: Periodontitis is marked by the destruction of alveolar bone. Sclerostin (SOST) and dickkopf-1 (DKK-1) act as inhibitors of the Wingless-type (Wnt) signaling pathway, a key regulator of bone metabolism. Recent studies have suggested that statins play a role in bone resorption and formation by influencing Wnt signaling. The aim of this study was to determine the levels of SOST and DKK-1 in periodontal patients with and without peroral statins treatment in their therapy. Materials and Methods: A total of 79 patients with diagnosed periodontitis were divided into two groups: 39 patients on statin therapy (SP group) and 40 patients without statin therapy as a control group (P group). The periodontal clinical examination probing (pocket) depth (PD) and gingival recession (GR) were measured, and approximal plaque was detected, while vertical and horizontal bone resorption was measured using a panoramic radiograph image. Clinical attachment loss (CAL) values were calculated using PD and GR values. Gingival crevicular fluid (GCF) was collected and used for measuring SOST and DKK-1 levels. A questionnaire was used to assess lifestyle habits and statin intake. Patients' medical records were used to obtain biochemical parameters. Results: There was no significant difference in sclerostin concentration between the SP and P group. DKK-1 values were significantly higher in the SP group compared to the control group (p = 0.04). Also, PD (p = 0.001) and GR (p = 0.03) were significantly higher in the SP group. The level of DKK-1 had a positive relationship with the PD, the greater the PD, the higher the level of DKK-1 (Rho = 0.350), while there was no significant association with other parameters. Conclusions: Peroral statins in periodontal patients are associated with GCF levels of DKK-1 but not with sclerostin levels.

Periodontal Health in Children with Juvenile idiopathic arthritis.

To investigate gingival inflammation and prevalence of four specific periodontal associated pathogens in Juvenile idiopathic arthritis (JIA) in relation to orofacial pain, jaw function and systemic inflammatory activity in JIA. Forty-five children with JIA and 16 healthy children as controls, were enrolled. Subjects were examined and classified according to the diagnostic criteria for temporomandibular disorders (DC/TMD). Pain, pain-related disability and jaw function were also assessed. A clinical periodontal examination was performed. Subgingival plaque samples were collected and analyzed for semiquantitative levels of the following periodontal pathogens; Aggregatibacter actinomycetemcomintans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. This study suggests that the periodontal disease-associated bacteria P. gingivalis and T. forsythia do not contribute to neither periodontal disease, systemic inflammatory activity nor orofacial pain and jaw dysfunction, including TMJ arthritis, in JIA patients in Sweden.

The Comparison of Mood Factors in Individuals having Different Periodontal Status Using Depression Anxiety and Stress Scale-21 (DASS-21)

Objectives: The purpose of this study was the evaluation and comparison of depression, anxiety, and stress levels in individuals who are periodontally healthy and who have gingivitis and periodontitis. Material and Methods: This study involves 114 individuals in total, including 48 periodontally healthy patients, 48 patients who have gingivitis and 48 patients who have periodontitis. Clinical and radiological periodontal examinations of the individuals were conducted. Scores of gingival index (GI), plaque index (PI), pocket depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) were recorded during intraoral examinations. Depression Anxiety and Stress Scale-21 (DASS-21) was used to determine levels of depression, anxiety, and stress. Results: Depression, anxiety, and stress levels were meaningfully and statistically lowest in individuals who are periodontally healthy (p

A COMPARATIVE STUDY OF FULL MOUTH BLEEDING SCORE (FMBS) AND GINGIVAL INDEX LOE AND SILNESS (GILS) IN ASSESSING GINGIVAL STATUS OF CHILDREN AGED 10-14 YEARS

Aim: Comparative analysis of two gingival indices with different diagnostic thresholds and methods of application in recording the gingival status of the whole dentition in children aged 10-14 years. Materials and methods: The subjects of the current study were 457 children. The clinical periodontal examination is performed in 4 levels. Gingival status is objectified by inspection and probing using (1) provoked gingival bleeding by the full mouth bleeding score (FMBS) with a diagnostic threshold above 10% bleeding gingival units and (2) gingival index according to Loe and Silness (GILS), with a diagnostic threshold above 0. Results: Gingival inflammation could be detected in 64.3% of the children studied, with a mild form of plaque-induced gingivitis in 40% of them, concentrated mainly on the vestibular surfaces in the frontal regions of both jaws. In 87% of the same children studied, we recorded an initial degree of gingival inflammation with a gingival GILS index value above 0, also concentrated in the frontal areas of both dental arches.

Association Between Periodontal Pathogens and Severity of Periodontal Diseases Among Adolescents in Kunming City: China

Objective: To investigate the association between periodontal pathogens and periodontal status among adolescents in Kunming City.Material and Methods: A total of 560 adolescents from five high schools within five urban districts in Kunming participated in this study. Clinical periodontal examination was assessed, and the levels of Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Prevotella intermedia (P. intermedia), and Fusobacterium nucleatum (F. nucleatum) in saliva samples were examined using a real-time polymerase chain reaction (PCR). The relationship between periodontal pathogens and the severity of periodontal disease was investigated using multivariate logistic regression analysis. Results: The presence of P. gingivalis, A. actinomycetemcomitans, and P. intermedia was positively correlated with the extent of probing depth, clinical attachment level (CAL), and bleeding on probing. P. gingivalis and A. actinomycetemcomitans were detected at approximately 55-58% among adolescents with healthy periodontal status. P. gingivalis and A. actinomycetemcomitans were detected in all adolescents diagnosed with periodontitis (stage I or II), which was an increased number compared to healthy adolescents. It was found that P. gingivalis (odd ratio (OR)=7.03, 95% confidence interval (CI) 3.77-13.11) and A. actinomycetemcomitans (OR=5.37, 95% CI 2.73-10.57) were strongly associated with stage II periodontitis. F. nucleatum had no significant relationship with the occurrence of gingivitis and periodontitis.Conclusion: P. gingivalis, A. actinomycetemcomitans, and P. intermedia are important microbiological risk factors for periodontal diseases in adolescents.

Association Between Periodontal Pathogens and Severity of Periodontal Diseases Among Adolescents in Kunming City: China

Objective: To investigate the association between periodontal pathogens and periodontal status among adolescents in Kunming City.Material and Methods: A total of 560 adolescents from five high schools within five urban districts in Kunming participated in this study. Clinical periodontal examination was assessed, and the levels of Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Prevotella intermedia (P. intermedia), and Fusobacterium nucleatum (F. nucleatum) in saliva samples were examined using a real-time polymerase chain reaction (PCR). The relationship between periodontal pathogens and the severity of periodontal disease was investigated using multivariate logistic regression analysis. Results: The presence of P. gingivalis, A. actinomycetemcomitans, and P. intermedia was positively correlated with the extent of probing depth, clinical attachment level (CAL), and bleeding on probing. P. gingivalis and A. actinomycetemcomitans were detected at approximately 55-58% among adolescents with healthy periodontal status. P. gingivalis and A. actinomycetemcomitans were detected in all adolescents diagnosed with periodontitis (stage I or II), which was an increased number compared to healthy adolescents. It was found that P. gingivalis (odd ratio (OR)=7.03, 95% confidence interval (CI) 3.77-13.11) and A. actinomycetemcomitans (OR=5.37, 95% CI 2.73-10.57) were strongly associated with stage II periodontitis. F. nucleatum had no significant relationship with the occurrence of gingivitis and periodontitis.Conclusion: P. gingivalis, A. actinomycetemcomitans, and P. intermedia are important microbiological risk factors for periodontal diseases in adolescents.

Facial, dental, periodontal, and tomographic characteristics of the etiology of excessive gingival display: a cross-sectional clinical study.

In this study, we examined the facial, dental, periodontal, and tomographic features associated with excessive gingival display (EGD) when smiling in young adults self-reporting a "gummy smile," categorized by potential etiology. The study included 25 healthy adults (18-42 years old; 23 women and 2 men) who self-reported EGD. Participants completed a health questionnaire and underwent a periodontal examination assessing probing depth, clinical attachment level, keratinized gingival width, and gingival thickness (GT). Extraoral and intraoral photographs were taken for smile analysis and to determine facial and dental characteristics. Cone-beam computed tomography (CBCT), performed with a lip retractor in place, was used to measure the distance from the gingival margin (GM) to the cementoenamel junction (CEJ), the distance from the CEJ to the alveolar crest, buccal bone thickness, and GT. The extent of EGD when smiling was quantified as the distance from the GM at the upper central incisor to the upper lip edge when smiling fully. The smile was categorized into 4 types based on gingival exposure characteristics observed during full smile. Most participants were female (92%), with a mean age of 28.77±6.56 years. The average EGD was 4.2±2.44 mm, extending bilaterally from the anterior to the posterior maxilla. Two primary etiological factors were identified, alone or in combination: vertical maxillary excess (VME), predominantly indicated by an anterior maxillary height greater than 29 mm and a large interlabial gap; and altered passive/active eruption (APE), primarily characterized by square teeth (64%), upper central incisor width-to-height ratio (CIW:CIH) exceeding 87.5%, and GM-CEJ distance on CBCT exceeding 2 mm. These findings suggest a multifactorial etiology of EGD, primarily associated with VME and APE. Clinical periodontal examination, CBCT conducted with a lip retractor, CIW:CIH, and soft tissue facial cephalometric analysis may aid in identifying the etiological factors of EGD.

Socioeconomic status in life course is associated with dental appearance dissatisfaction.

The present study aimed to investigate the prevalence of dissatisfaction with dental appearance among 24-year-old Brazilian adults and the associated factors in life course. A subsample (n = 720) of the 1982 Pelotas Birth Cohort in southern Brazil was investigated at the ages of 15 and 24 years using clinical (caries and periodontal) examinations and interviews. The outcome was dissatisfaction with dental appearance at the age of 24 years. Covariate variables included socioeconomic factors, oral health, and dissatisfaction with general appearance collected during different periods of life. Poisson regression models with robust variance were applied. The prevalence of dissatisfaction with dental appearance was 43.5% (95%CI: 39.8-47.1). Individuals with downward income mobility (PR = 1.22, 95%CI: 1.07-1.79) and those always poor (PR = 1.21, 95%CI: 1.00-1.57) presented a higher prevalence of dissatisfaction with their dental appearance even after oral health variables and dissatisfaction with general appearance were controlled for. Moderate/severe malocclusion at 15 years (PR = 1.34, 95%CI: 1.13-1.59), highest experience of untreated dental caries at 24 years (PR = 1.82, 95%CI: 1.46-2.27), and dental pain experience at 24 years (PR = 1.29, 95%CI: 1.22-1.75) were associated with the outcome. Also, the prevalence of dissatisfaction with dental appearance was 20% higher (PR = 1.20, 95%CI: 1.01-1.43) among those dissatisfied with their general appearance. Our findings demonstrated a high prevalence of dissatisfaction with dental appearance among young adults. Lifetime economic disadvantage and dental problems (malocclusion at 15 years, untreated dental caries at 24 years, and dental pain at 24 years) were associated with dissatisfaction with dental appearance among young adults.

Investigating the potential clinical impact of periodontitis on the progression of Alzheimer's disease: a prospective cohort study.

This study aimed to investigate the effect of periodontitis and current occlusal relationship on the progression rate of Alzheimer's disease (AD). Ninety Alzheimer's patients, who were divided into three groups as Stage I (n=42), Stage II (n=29), and Stage III (n=19), based on the Clinical Dementia Rating Scale, were included in the study. Cognitive status of the patients was evaluated with Standardized Mini-Mental Test (SMMT) at baseline and repeated 6 months later. Clinical periodontal examinations were recorded and occlusal relationship status was classified according to the Eichner Index. Of 90 Alzheimer's patients, 65 were toothed individuals with periodontitis and 25 were edentulous individuals without active periodontal disease. Stage II and Stage III toothed Alzheimer's patients had higher percentage of bleeding on probing (BOP%) and clinical attachment level (CAL) values than Stage I patients (p<0.05). Stage III Alzheimer's patients had significantly higher probing pocket depth (PPD) values than Stage I individuals (p<0.05). ΔSMMT values showed positive correlation with BOP% (r=0.308, p=0.013) and PPD (r=0.275, p=0.027). Among the evaluated parameters, being in the AD Stage II-Stage III, having periodontitis and age variable had significant effects on ΔSMMT levels (p<0.05). Within the limits of our study, it can be concluded that periodontitis may increase the severity and also accelerate the progression rate of AD. These results are precious to show the necessity of proper oral hygiene activities and regular dental visits in patients with toothed AD. This study was registered and approved by clinical trials (NCT05807100).

Assessment of Periodontal Health Status and Serum Level of Vascular Endothelial Growth Factor in Women with Breast Cancer

Periodontal diseases are inflammatory diseases that affect the periodontium which lead to alveolar bone and attachment loss. Breast cancer is the most common cancer in women worldwide. Expression of (VEG F) is elevated in both diseases and it is the marker of angiogenesis related to cancer development. 1. To determine the periodontal health status and the serum levels of (VEGF) in women with breast cancer in comparison to women without breast cancer. 2. To correlate between serum levels of VEGF with clinical periodontal parameters (PLI, GI, BOP, PPD, and CAL) in women with breast cancer in comparison to women without breast cancer. Eighty women with age ranged from (30-60) years old, 40 women with breast cancer and another 40 women without. Periodontal health status were taken for all participants and then they were subdivided into four groups: the (BC +CP) group which included participants with breast cancer and chronic periodontitis (n=20), the (BC+ G) group included participants with breast cancer and gingivitis (n=20), the (CP) group which included participants with chronic periodontitis only (n=20) and the (G) group which included participants with gingivitis only (n=20). Other than breast cancer, all subjects were systemically healthy females. Periodontal health status was determined by clinical periodontal examination of (PLI, GI, BOP, PPD and CAL). Blood samples were collected from each participant, serum levels of VEGF were determined by enzyme -linked immune-sorbent assay (ELISA). The results of this study showed that the median values of PLI and GI were slightly increased in BC+G group in comparison to other groups with non-significant differences, the percentages of BOP showed highly significant differences among the groups (P &lt;0.01). The median values of PPD showed slight increase in BC+CP group than CP group with non-significant differences. Median values of CAL were increased in CP group than BC+CP group with non-significant differences. VEGF serum levels were elevated in BC+CP group than other groups with non-significant differences. Also by using Spearman’s rank Correlation Coefficient, serum levels of VEGF were correlated positively with all clinical periodontal parameters. VEGF serum level could be associated with progression of both periodontal diseases and breast cancer.

Association between sequelae of COVID-19 with periodontal disease and obesity: A cross-sectional study.

To assess the sequelae of coronavirus disease 2019 (COVID-19) and associated factors, such as obesity and periodontitis in adults. The study included 128 individuals aged ≥35 years with a history of a diagnosis of COVID-19 through real-time polymerase chain reaction (RT-PCR), from Pelotas, Brazil. Self-report sequelae from COVID-19 were defined as the primary outcome. A questionnaire containing sociodemographic, medical, behavioral and self-report of sequelae of COVID-19 was applied. A complete periodontal clinical examination was performed. Weight and height were assessed. Uni-, bi- and multivariate analyses were performed using Poisson regression with robust variance. Additional analyses were performed considering obesity as a subgroup. When considering the whole sample, no statistically significant associations between sequelae of COVID-19 with periodontitis (prevalence ratio [PR]:1.14;95% confidence interval [95%CI]: 0.80-1.61) and obesity (0.93 [0.68-1.26]) were identified. In the subgroup analysis, considering only individuals with obesity, those diagnosed with generalized periodontitis had 86% higher probability to have sequelae of COVID-19 when compared to individuals with periodontal health or localized periodontitis. However, when only those without obesity were considered, no significant association with periodontal status was detected (0.82 [0.55-1.23). No significant association with periodontal status were observed when the severity of sequelae (no sequelae, 1 sequela, and >1 sequela) were considered (p>0.05). Individuals diagnosed with obesity and periodontitis have a higher PR of reporting sequelae from COVID-19 compared to individuals with only obesity.

A Case Control Study Evaluating the Relationship between Vitamin K2 Serum Level and Periodontitis.

Vitamin K2 (VK2) is an essential co-factor for bone metabolism. There is still very little data regarding possible VK2 relation to periodontitis. This study aimed to investigate any potential link between VK2 serum level and the severity of periodontitis in comparison to a control group of healthy individuals. The trial was performed on 100 patients among whom 50 were diagnosed with periodontitis. The patients underwent full clinical periodontal and radiological examination. The VK2 serum level was assessed using the ELISA kit (Gla-type osteocalcin EIA Kit, Takara, Kusatsu). Patients with periodontitis had mean serum levels of VK2 significantly lower (0.27 ± 0.06 nmol/L; p < 0.001) than the control group (0.43 ± 0.09 nmol/L; p < 0.001) regardless of the patient's age or sex. The VK2 serum level decreased with the severity of periodontitis with the lowest level in stage IV of the disease (0.19 ± 0.01 nmol/L; p < 0.001). Also, a significant drop was noticed between the grades of periodontitis. Individuals with localized forms of the disease had significantly lower VK2 levels (0.26 ± 0.006 nmol/L; p < 0.001) in comparison to subjects with generalized periodontitis (0.30 ± 0.01 nmol/L; p < 0.001). The VK2 serum levels were also associated with most of the clinical parameters such as bleeding on probing (-0.805, 95% CI: -0.894 to -0.654, p < 0.001), attachment loss (-0.752, 95% CI: -0.862 to -0.574, p < 0.001), and bone loss (-0.656, 95% CI: -0.801 to -0.439, p < 0.001). In the present study, the VK2 serum level was correlated to periodontitis, and its severity, complexity, extension, and grade. The range of VK2 was decreasing together with the worsening of all clinical parameters of periodontitis.