Periodontal Examination Research Articles

Improving the use of Nabers probes for furcation detection during periodontal assessment in dental curricula

INTRODUCTION Detection of furcation involvement (FI) is an integral part of full periodontal examination. The aims of this study were to: 1) investigate the extent to which furcation assessment was performed and recorded by undergraduate and postgraduate students on clinic; 2) evaluate the perceptions of teachers about possible problems in relation to furcation assessment among students; and 3) assess the impact of the dental school’s educational interventions on the improvement in furcation assessment among students. METHODS Students were interviewed after their periodontal assessment. This occurred in three different settings: undergraduate and postgraduate treatment clinics, and new patient assessment clinics. Teachers were also interviewed about their perceptions of the students’ quality of furcation assessment. Students were re-surveyed following educational interventions to improve their furcation detection. RESULTS The baseline questionnaire showed that only 44% of the undergraduate students checked for FI; this compared with 83% of postgraduate students. Of those undergraduate students who assessed FI, only 13% used a Nabers probe and 63% did not record their finding in the patient’s notes. Following educational interventions, 56% of the undergraduates performed furcation assessment, with 78% of these using a Nabers probe. CONCLUSIONS Furcation assessment is often missed during the full periodontal examination carried out by undergraduate dental students and Nabers probes are rarely used. However, teaching interventions have the potential to improve the students’ learning experience and therefore also patient care.

Association between carotenoid intake and periodontitis in diabetic patients.

This study aimed to evaluate the association between dietary carotenoid intake and periodontitis in diabetic patients. Data on diabetic patients were collected from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 for this cross-sectional study. Dietary intake of carotenoids was assessed through the first 24-hour dietary recall interview. Full-mouth periodontal examinations were conducted by trained dental examiners. Subgroup analysis was conducted in terms of age, gender, the number of missing teeth, cardiovascular disease, smoking, and anti-diabetic drugs. Totally 1914 diabetic patients were included, with 1281 (66.93%) in the periodontitis group. After adjusting for age, gender, race, education, smoking, dental implants, hepatitis, and the number of missing teeth, α-carotene intake ≥55.82 mcg was associated with lower odds of periodontitis than α-carotene intake <55.82 mcg [OR = 0.70, 95% CI: 0.53-0.91, P = 0.010]; lutein and zeaxanthin intake ≥795.95 mcg was associated with decreased odds of periodontitis than lutein and zeaxanthin intake <795.95 mcg (OR = 0.75, 95%CI: 0.57-0.98, P = 0.039). The association between carotenoid intake and periodontitis varied across different subpopulations. In diabetes, dietary intake of α-carotene and lutein and zeaxanthin was inversely associated with the odds of periodontitis, which may facilitate clinical periodontitis management.

Convergence of inflammatory response: Salivary cytokine dynamics in coronavirus disease 2019 and periodontal disease.

Periodontal disease is associated with immune dysregulation, and cytokines released can add on to the coronavirus disease 2019 (COVID-19)-associated cytokine storm, further worsening the related adverse outcomes. Specific studies investigating cytokine levels in COVID-19 patients with periodontal disease are lacking. Examining the correlation between these conditions could aid in categorizing risk categories, determining referrals, and strengthening oral hygiene protocols. The current study sought to evaluate cytokine levels in the saliva of COVID-19-positive patients with and without periodontal disease. Twenty-six COVID-19-positive patients were subjected to periodontal examination, saliva collection, and assessment of cytokine levels through cytokine bead-based multiplex assay, using fluorescence-encoded beads with flow cytometry (BD FACS LSRFortessa). Eleven cytokines were assessed (interleukin [IL] 2, 4, 6, 10, 17A, and interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-α), chemokine ligand 2 (CCL2/monocyte chemoattractant protein-1), C-X-C motif chemokine ligand (CXCL) 8/IL 8, CXCL 9/monokine-induced gamma interferon [MIG]), and CXCL 10 (chemokine IFN-gamma inducible protein 10 kDa). The cytokine levels of the recruited subjects were also compared graphically with the salivary cytokine levels reported in the literature for health, COVID-19, and periodontal disease alone. Out of 26 COVID-19-positive patients, 17 had periodontal disease. Levels of all cytokines were raised in patients with both diseases when compared to values reported in literature for health, periodontal disease alone, or COVID-19 alone. However, there was no statistical difference among the recruited subjects for IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-gamma, TNF-α, CCL2, CXCL 8, and CXCL 10. MIG levels were found to be higher in periodontally healthy, COVID-19-positive subjects (P = 0.01). Periodontal disease might contribute to the COVID-19-induced cytokine storm, potentially amplifying its impact.

Impact of Non-surgical Periodontal Therapy on Oral Health-related Quality of Life amongst Primary Dental Care Patients: A Prospective Cohort Study

Abstract Aim: The aim of this study was to determine the impact of non-surgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) of a selected group of the Malaysian population at the primary dental care setting. Participants and Methods: This study was conducted from year 2021 to 2022. Patients attending four government dental clinics in Kinta district were included in the study after basic periodontal examination was conducted. The sample size was calculated using the NCSS PASS 11 power analysis and sample size, and a final sample size of 94 was used. A short version of the Malaysian Oral Health Impact Profile (S-OHIP[M]) questionnaire was given as a baseline before the intervention. NSPT was provided in a single session or by a quadrant approach. Patients were then called for review after 6 weeks during when they were required to complete the S-OHIP(M) questionnaire again. All data were then entered and analysed using SPSS version 26.0. Results: The prevalence of impact decreased significantly post-treatment (n [%] pre vs. post: 91 [96.8%] vs. 70 [74.5%]; P &lt; 0.001). A significant decrease was observed in the severity of impact (additive score) (median [interquartile range (IQR)] pre vs. post: 8.5 [5.0–15.0] vs. 2.0 [0.0–6.0]; P &lt; 0.001) and extend of impact (simple count score) (median [IQR] pre vs. post: 0.5 [0.0–2.0] vs. 0.0 [0.0–0.0]; P &lt; 0.001) post-treatment compared to pre-treatment too. Conclusion: The OHRQoL status amongst gingivitis and mild-to-moderate periodontitis patients in primary care has improved after treatment.

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).

Decreased bone mineral density is associated with an increased number of teeth with periodontitis progression: a 5-year retrospective cohort study

ObjectiveLongitudinal studies on the systemic bone loss-periodontitis relationship are limited with disparate results. The aim of this study was to investigate the association between bone mineral density (BMD) and periodontitis progression, controlling for other covariables in a Thai population.Materials and methodsIn 2,418 participants, BMD values of the lumbar spine, femoral neck, and total hip were measured with dual-energy X-ray absorptiometry at baseline. Each participant’s BMD status was classified as normal, osteopenia, or osteoporosis. Full mouth periodontal examinations on 6 sites/tooth were performed at baseline and 5-year follow-up visits. Periodontitis progression was defined as a tooth presenting an additional proximal CAL loss of ≥ 3 mm or an additional lost tooth with a baseline CAL ≥ 5 mm. The risk effects of BMD status on the number of teeth with periodontitis progression were analyzed using multivariate Poisson regression.ResultsBaseline BMD status of osteoporosis was associated with an increased number of teeth with periodontitis progression in the subgroups of postmenopausal women, non-smokers, and participants with periodontitis stage III/IV with adjusted risk ratios of 1.31 (95% CI = 1.09–1.58), 1.19 (95% CI = 1.04–1.36), and 1.13 (95% CI = 1.00–1.28), respectively.ConclusionBaseline BMD in the osteoporosis range increased the risk of having a greater number of teeth with periodontitis progression in specific participant subgroups.Clinical RelevanceDecreased BMD is a potential factor affecting periodontitis progression risk in some individuals. Multidisciplinary approaches in educating and maintaining patients’ bone-oral health may help improve their quality of life.

Evaluation of Periodontal Status and Serum C-Reactive Protein Levels in Adult Cigarette Smokers

Background: This study aimed to evaluate the periodontal status of adult smokers and assess their serum C-reactive protein (CRP) levels, hypothesizing an association between periodontal inflammation, smoking, and elevated serum CRP, a marker for cardiovascular diseases. The primary objective is to contribute to the assessment and prevention of potential cardiovascular diseases in adult smokers. Methods: This cross-sectional study was conducted at HIT Hospital and Dental Hospital HITEC-IMS Taxila Cantt over five months from October 20, 2021, to March 31, 2022, the study included 60 healthy male adult smokers and 20 healthy male non-smokers as a control. Basic periodontal examination involved the use of a periodontal probe, assessing parameters such as gingival index, bleeding on probing, oral pigmentation, presence of periodontal pockets, and gingival recession. Blood samples were collected to evaluate serum CRP levels. Results: Smokers exhibited higher rates of gingival recession (38.3%), gingival pigmentation (43.3%), and periodontal pocket formation (33.3%) compared to the nonsmokers control group, with significant p-values of 0.040 in gingival recession and 0.035 in the presence of periodontal pockets. Serum CRP levels were significantly elevated in adult smokers, with a significant p-value of 0.024. Conclusion: The study concluded that adult smokers show signs of periodontitis, and their serum CRP levels are elevated. Assessing periodontal status and serum CRP in adult smokers may aid in risk assessment and reducing the likelihood of developing future cardiovascular diseases.

Diagnostic performance of a point-of-care test device for periodontitis using human saliva: a single-center, single-blinded, confirmatory study.

Recently, matrix metalloproteinase-8 (MMP-8) has been used to diagnose periodontal disease in a point-of-care (POC) test in order to save time and cost relative to the traditional diagnostic workflow. This study aimed to investigate the diagnostic performance of INCLIX TRF MMP-8, a POC testing device for periodontitis using the area under the receiver operating characteristic curve, sensitivity, specificity, and predictive values. Full-mouth periodontal examination and radiographic analysis were used for evaluating periodontal condition based on the 2018 classification of periodontal disease. A dichotomous diagnosis of clinical periodontal condition was performed using the POC device. The relationships among periodontal condition and the concentration of MMP-8, tooth loss (TL), gingival index (GI), plaque index (PI), and alveolar bone loss (ABL) were assessed by the Spearman rank correlations (rs). In all, 108 cases of non-periodontitis (NP) and 191 cases of periodontitis (P), including 38 cases of periodontitis stage I, 42 cases of periodontitis stage II, 99 cases of periodontitis stage III, and 11 cases of periodontitis stage IV, were enrolled in this study. Diagnostic accuracy in assessing periodontal condition with the POC device improved when it was used with participants aged ≥ 40 years. There were weak positive correlations between periodontal condition and MMP-8 and between periodontal condition and GI (rs2 = 0.1124 and rs2 = 0.0906, respectively), whereas a strong positive correlation between periodontal condition and alveolar bone loss (rs2 = 0.6877) was observed. The POC device investigated in this study is a potential tool to distinguish between NP and P in individuals ≥ 40 years of age.

Dental Plaque Accumulation and Periodontal Treatment Needs of Smokers

Organic deposits such as food residue, pellicle, dental plaque, and calculus can easily stick to the surface of smokers' teeth due to the tar content that sticks to the teeth, causing the tooth surface to become rough. This study aims to describe periodontal conditions through plaque accumulation and the need for periodontal treatment in smokers. Cross-sectional study at the Dental and Oral Hospital, University of North Sumatra, with a sample of 60 smokers. Plaque accumulation examination uses the Loe and Silness index and periodontal status needs use the Community Periodontal Index of Treatment Needs (CPITN) index. The results of the periodontal status of smokers showed that 36.7% of smokers had a periodontal status score of 0 (healthy periodontium), 33.3% had a periodontal status score of 2 (supragingival calculus), 28.3% had a score of 1 (spontaneous bleeding) and 1.7 % had periodontal status with a score of 3 (pockets 4-5 mm). The results showed that 36.7% did not need treatment (TN 0), 35% of smokers needed better dental care at home/improved oral hygiene and tartar cleaning (TN II), and 28.3% of smokers only needed adequate dental care. better (TN I). The conclusion of this study is that the periodontal treatment needs of smokers at RSGM USU are based on the number of cigarettes and duration of smoking, which is most often found in periodontal status and treatment with scores of 0 and 2.

PERIODONTAL STATUS IN INDIVIDUALS WITH MEDITERRANEAN DIET (LITERATURE REVIEW)

Introduction: The condition of the periodontal tissues can usually be checked by conducting a periodontal screening or examination of the periodontal tissues. From this examination, the health status of the periodontal tissue will be obtained, which can facilitate findings related to periodontal disease. Diet has been reported to be significantly associated with periodontal health. A diet that is known to have a beneficial effect on treating inflammation in the oral cavity is the Mediterranean diet. Aim: This literature review discusses the conclusive results of periodontal status in patients or individuals with a Mediterranean diet obtained from several studies. Review: The clinical parameters measured on examination of the periodontal tissue to obtain periodontal health status were plaque and calculus scores, bleeding on probing (BOP), probing pocket depth (PPD), gingival recession (GR), and clinical attachment level or clinical attachment loss (CAL). Nutritional factors are known to act as sources of interference and modulation. A diet that lacks micronutrients (vitamins and minerals) can exacerbate the inflammatory response of the periodontal tissues. The Mediterranean diet is known to be low in saturated fat and rich in polyphenols, oleocanthal, lycopene, minerals, fiber, vitamins, and omega-3 fatty acids. This diet can provide antioxidant and anti-inflammatory effects that can affect the periodontal tissue. Although not very numerous, there are studies examining periodontal tissue and periodontal disease in individuals with a Mediterranean diet. These studies require the health status of the periodontal tissues. Conclusion: Periodontal health status in individuals with a Mediterranean diet based on several studies shows quite good results, where there is a decrease in scores on bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), and low plaque index.

Induction of Collagenolytic MMP-8 and -9 Tissue Destruction Cascade in Mouth by Head and Neck Cancer Radiotherapy: A Cohort Study.

The effect of head and neck cancer (HNC) radiotherapy (RT) on biomarkers is not known but there is a lot of potential for gaining more precise cancer treatments and less side effects. This cohort study investigated the levels and molecular forms of the matrix metalloproteinase (MMP) -8 and -9, tissue inhibitor of metalloproteinase (TIMP)-1, myeloperoxidase (MPO) and interleukin (IL)-6 in mouth-rinse samples as well as the clinical periodontal status in HNC patients (n = 21) receiving RT. Complete periodontal examinations were performed pre-RT and one month after RT. Mouth-rinse samples (pre-RT, after six weeks of RT and one month after RT) were assayed using a point-of-care-kit (PerioSafe®/ORALyzer® (Dentognostics GmbH, Jena, Germany)) for active MMP-8 and ELISA analysis for total MMP-8 and -9, MPO, TIMP-1, and IL-6 levels. Molecular forms of MMP-9 were assessed by gelatinolytic zymography and MMP-8 by western immunoblot. Significant changes were observed between the three time points in the mean levels of active and total MMP-8, active MMP-9, and IL-6. Their levels increased during the RT and decreased after the RT period. The aMMP-8 levels stayed elevated even one month after RT compared to the pre-RT. Clinical attachment loss, probing depths, and bleeding on probing were increased between pre- and post-calculations in periodontal status. Elevated inflammatory biomarker levels together with clinical recordings strongly suggest that RT eventually increases the risk to the periodontal tissue destruction by inducing the active proteolytical MMP-cascade, and especially by prolonged activity of collagenolytic aMMP-8. Eventually, the aMMP-8 point-of-care mouth-rinse test could be an easy, early detection tool for estimating the risk for periodontal damage by the destructive MMP-cascade in HNC patients with RT treatment.

Comparison of red blood cell parameters in patients with and without periodontitis – A hospital based observational study

Dental plaque bio film aggregate around dentition is the primary etiology of periodontitis. The host inflammation mounted in response to bacterial biofilm determines the extent and severity of periodontitis. The low grade inflammation results increase in pro inflammatory cytokine levels, and this links periodontitis with other systemic diseases. Epidemiologic studies have revealed a possible association of periodontitis with some systemic diseases. There are conflicting results regarding the association of periodontitis and anemia. The aim of the study was to compare the red blood cell parameters in subjects with and without periodontitis in our population.A single calibrated examiner was entrusted to do the periodontal examination, and 48 subjects with periodontitis (Group I) and 50 age matched subjects without periodontitis (Group II) with a mean age of 33.45 yrs. +/- 7.86 were recruited for the study. Gingival index and full mouth periodontal charting were done and 2ml blood samples were collected for estimation of blood parameters.Group I showed a statistically insignificant difference in hemoglobin levels compared to group II (P value-0.065) where as MCH and MCHC showed a statistically significant difference between the groups (P value-0.012, 0.002 respectively).The inflammatory burden increases with the severity of Periodontitis and this may lead to the development of anemia.

A Short-term Comparative Evaluation of Efficacy of Hydroalcoholic Herbal Phytonutrient Mouthrinse as an Adjunct with Scaling &amp; Root Planning in Old Age Home Inmates with Chronic Periodontitis: a Randomized Control Clinical Trial

AIM: The aim of this study is to compare &amp; evaluate clinical efficacy of a herbal phytonutrients mouthrinse with Hedychium coronarium, Echinacea, Calendula-officinalis and Ocimum sanctum extracts in patients with gingivitis &amp; chronic periodontitis in adjunct with scaling &amp; root planning. MATERIAL &amp; METHODS: 30 subjects diagnosed with chronic periodontitis based on periodontal examination and microbiological evaluation, were selected from an Old Age Home. The study population was randomly divided into 3 groups of 10 subjects each: Group I - Phytonutrient herbal mouthrinse, Group II - 0.2% chlorhexidine gluconate and Group III – Distilled water. RESULTS: ANOVA test showed significant difference in the mean values of FMPI, FMBI and PPD variables– PHT: (FMBI-P value- .005); (FMPI- P value- .002); (PPD- P value- &lt;0.001), CHX: (FMBI-P value- .003); (FMPI- P value- .441); (PPD- P value- 0.049), DW: (FMBI-P value- .089); (FMPI- P value-.081); (PPD- P value- 0.104). There was statistically significant difference in the efficacy of PHT when compared with CHX and DW mouthrinse on plaque accumulation, gingival health and oral hygiene status. CONCLUSION: Herbal phytonutrient rich-mouthrinse can prove to be effective alternatives to CHX with minimal side effects.

Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study

Background Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases. Aim To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively &amp; post-operatively. Materials and methods The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel’s index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment. Results The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell’s index. Conclusion As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.

Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases.

The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM. This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires. Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001). The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.

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.

Association of oral care with periodontitis and glycemic control among US adults with diabetes

BackgroundStudies indicate that treating periodontitis may benefit glycemic control among people with diabetes. It is unclear whether oral self-care such as flossing may reduce risk for periodontitis and improve glycemic control among people with diabetes. The purpose of this study was to examine associations between oral care, specifically, flossing and preventive dental care, with periodontitis and glycemic control, among US dentate adults with diabetes.MethodsWe analyzed data from the National Health and Nutrition Examination Survey 2011–2014 for 892 participants aged 30 years and older with diabetes who completed the periodontal examination and lab test for hemoglobin A1c (HbA1c). Sampling weights were applied. Multivariable logistic regression and multivariable linear modeling were performed to examine the associations of flossing and preventive dental services on periodontal health and HbA1c levels, respectively, controlling for sociodemographic characteristics, health behaviors, and other risk factors.ResultsAmong U.S. dentate adults with diabetes, 52.1% of flossers and 72.1% of non-flossers had periodontitis (p < 0.001). Flossers were 39% less likely to have periodontitis (Adj. OR 0.61, 95% CI 0.43–0.88) compared to non-flossers. Flossers had an average HbA1c reading 0.30% (95% CI 0.02%—0.58%) lower than non-flossers, adjusted for covariates (p = 0.037). Preventive dental visits were associated with reduced risk for periodontitis (Adj. OR 0.54, 95%CI, 0.38–0.75) but not glycemic control.ConclusionFlossing was associated with periodontal health and glycemic control among US adults with diabetes. Although further research is needed, the findings support that oral self-care may be particularly beneficial for adults with diabetes.

Association between periodontitis and disc structural failures in patients with cervical degenerative disorders

ObjectiveRecent studies have shown that the mouth–gut–disc axis may play a key role in the process of disc structural failures (including intervertebral disc degeneration (IDD) and endplate change) in the cervical spine and neck pain. However, the potential mechanisms underlying the mouth–gut–disc axis remain elusive. Therefore, we explored whether periodontal disease is associated with disc structural failures in patients with cervical degeneration disorders and clinical outcomes.MethodsAdults (aged > 18 years) who met open surgery criteria for cervical spine were enrolled in this prospective cohort study. Participants were allocated into two groups based on periodontal examinations before surgery: no/mild periodontitis group and moderate/severe periodontitis group. Data were evaluated using an independent t test and Pearson’s correlation analysis.ResultsA total of 108 patients were enrolled, including 68 patients in the no/mild periodontitis group and 40 patients in the moderate/severe periodontitis group. The number of common causes of missing teeth (P = 0.005), plaque index (PLI) (P = 0.003), bleeding index (BI) (P = 0.000), and probing depth (PD) (P = 0.000) significantly differed between the two groups. The incidence rate of endplate change (P = 0.005) was higher in the moderate/severe periodontitis group than in the no/mild periodontitis group. A moderate negative association was found between the neck disability index (NDI) score and periodontal parameters (PLI: r = − 0.337, P = 0.013; BI: r = − 0.426, P = 0.001; PD: r = − 0.346, r = − 0.010).ConclusionsThis is the first study to provide evidence that severe periodontitis is associated with a higher occurrence rate of disc structural failures and poor clinical outcomes in patients with cervical degenerative disorders.

Long-term radiographic and periodontal evaluations of the bone-grafted alveolar cleft region in young adults born with a UCLP.

Studies addressing the periodontal health of the teeth surrounding the bone-grafted cleft in patients born with unilateral cleft lip and palate disagree on whether periodontal health is compromised. To determine periodontal health differences between the cleft and the non-cleft sides nearly a decade after secondary alveolar bone grafting. This prospective, controlled (split-mouth design) study comprised an intraoral apical radiographic and a periodontal examination of 40 consecutive patients from one centre (n = 26 males) who had undergone bone grafting at mean age of 10.2 years (±1.6). Probing pocket depth, gingival index, gingival recession, and radiographic bone support were assessed. No significant difference occurred in probing pocket depth between teeth at cleft and non-cleft sites (OR 1.8, P = .488). Gingival recession was present at 6.6% of all examined sites on the cleft side and at 1.7% on the non-cleft side (OR 17.3, P < .001). Gingival recession occurred most often on the buccal and disto-buccal surfaces of the central incisor on the cleft side. The gingival index was significantly higher on the cleft side (OR 8.0, P < .001). The Bergland index was I or II in most patients (87%). Recruitment of eligible patients was lengthy. The teeth on the cleft side had high levels of gingival inflammation. Few pathological gingival pockets, however, were found. Shallow gingival recessions frequently occurred around the central incisor on the cleft side. Teeth in the bone-grafted cleft region generally had good bone support.