Evidence Of Periodontal Disease Research Articles

Teeth and gums in diabetes

Teeth and gums in diabetes

Salivary Gene Expression of RANK, RANKL, and OPG in Type 1 Diabetes Mellitus and Periodontal Disease Patients.

The relationship between type 1 diabetes mellitus (T1DM) and periodontal disease may exhibit by the alteration of bone metabolism. However, evidence for this relationship is scarce and inconclusive. Thus, the aims of the present study were to investigate salivary receptor activator of nuclear factor kappa-β (RANK), receptor activator of nuclear factor kappa-β ligand (RANKL), osteoprotegerin (OPG) gene expression and the RANKL:OPG ratio in T1DM and non-T1DM. Secondary objective was to determine the relationships of RANK, RANKL and OPG gene expression to clinical parameters of T1DM and periodontal disease. Twenty patients with T1DM and twenty age-matched non-T1DM were recruited. Clinical periodontal parameters were measured. Total RNA was isolated from non-stimulated saliva, and the relative gene expressions of RANK, RANKL, OPG and RANKL:OPG ratio were determined by quantitative real-time polymerase chain reaction. The T1DM group had significantly higher mean periodontal parameters than the non-T1DM group, while the mean plaque scores of both groups were not significantly different. There was a trend of higher relative gene expression of RANK, RANKL, and the RANKL:OPG ratio and lower expression of OPG in T1DM group but no statistic significant different when compared to non-T1DM. In the T1DM group, RANKL:OPG correlated with the percentage of bleeding sites, whereas RANK, RANKL, and HbA1c levels correlated with pocket depth. Bone metabolisms demonstrating by decreased OPG gene expression and upregulated of RANK, RANKL, RANKL:OPG with higher pocket depth and bleeding in T1DM may play an important role in periodontal destruction in T1DM.

Levels of Cadmium in Human Mandibular Bone.

Cadmium (Cd) is an environmental toxicant that accumulates in bone and alters bone turnover and metabolism. Periodontal disease is characterized by tooth loss and tissue destruction, specifically, loss of supporting bone around the teeth. We have previously shown that Cd causes loss of dental alveolar (tooth supporting) bone in a rodent model of long-term Cd poisoning. The overall goal of this study was to determine the possible association between levels of Cd in alveolar bone and evidence of periodontal disease in human cadavers. The extent of Cd accumulation in human mandible samples was analyzed. Levels of Cd in mandibular alveolar bone were compared to those in basal bone as well as the renal cortex in samples obtained from the cadavers. Alveolar bone contained significantly higher levels of Cd when compared to basal bone (p < 0.01). Cd levels in mandibular bone were significantly higher in female compared to male cadavers (p < 0.05). The kidney cortex had greater than 15-fold higher Cd levels compared to mandible bone. Additional analyses showed a possible association between levels of Cd in basal bone and the presence of periodontal disease in cadavers from which the samples were obtained. This study shows that Cd accumulates to relatively high levels within alveolar bone as compared to basal bone in the mandible and thus may have a significant and direct effect in the progression of changes in bone associated with periodontal disease.

Prevalence of chronic periodontitis and its risk determinants among female patients in the Aseer Region of KSA.

ObjectivesTo determine the prevalence of chronic periodontitis and its determinants among patients in the Aseer Region of KSA.MethodsA total of 1000 consecutive new female patients between 25- to 75-years of age were screened for the presence of any periodontal disease. The various demographic characteristics of the study participants included age, educational level, occupation, presence of diabetes mellitus, family history of periodontal disease, and oral hygiene practices per subject were recorded. The parameters addressing periodontal prevalence and severity were also recorded.ResultsOf these patients, 457 were found to have evidence of periodontal disease. These patients were considered for a further detailed periodontal examination. The chi-square test for goodness of fit showed that 46.6% have localized chronic gingivitis while 2.2% have generalized chronic gingivitis. Localized chronic periodontitis ranged from 4.2% to 12%, whereas generalized chronic periodontitis varied from 3.1 to 14.7%. The non-parametric Kruskal–Wallis chi-square statistics showed that factors such as age, education, occupation, infrequent last dental visit, presence of diabetes mellitus and bleeding on probing were significant risk determinants for periodontal disease in the selected cohort.ConclusionThe majority of the population showed the presence of localized chronic gingivitis. Age, education, occupation, infrequent dental visits and presence of diabetes mellitus are significant risk determinants for the occurrence of chronic periodontitis. Information concerning individual risk for developing periodontal disease should be carefully evaluated for proper patient management and for better overall general health.

Determining the association between oral malodor and periodontal disease: A case control study.

Aim:To assess the role of periodontal health in oral malodor causation and compare the two methods (organoleptic and Halimeter) of malodor measurement.Materials and Methods:A total of 240 subjects (60 subjects without any evidence of periodontal disease and 180 patients with gingivitis and periodontitis) were evaluated for periodontal and oral malodor parameters. Periodontal parameters included Plaque Index (PI), Gingival Index (GI), mSBI, calculus component of OHIS, pocket depth (PD), and clinical attachment level (CAL), and oral malodor was assessed by organoleptic scores, Halimeter readings, and Tongue Coating Index (TCI).Results:80% of the sample when assessed organoleptically (i.e. 192 subjects) and 74.6% when assessed with Halimeter (i.e. 179 subjects) presented with varying degrees of halitosis. All the clinical parameters were significantly associated with oral malodor (P < 0.001). The amount of tongue coating and bleeding on probing played the most important role in increasing VSC concentration, followed by periodontal status, plaque indices, and calculus component.Conclusion:There was a high prevalence of halitosis in the present study population. All the clinical parameters were significantly related to oral malodor in this study, and the results indicate that determining VSC levels with Halimeter is a useful means of diagnosing halitosis objectively.

Allotransplant to replace avulsed mandibular central incisors using mesiodens

Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented in this article. Teeth from two different donors was implanted into the socket of the mandibular central incisors. Follow-up of 1-year indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options in children.

Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.

Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions. To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates. Statistically significant reductions in both outcomes (p<0.05) were found for T2D, CVD, CAD, and pregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts. These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions.

AB0042 Human Host Defense Peptide Cathelicidin (LL37) Serum Levels Are Increased in Anti-Cyclical Citrullinated Peptide Positive Patients with Recent Onset Inflammatory Arthritis

BackgroundDisruption of normal innate immune responses to pathogens and toxins may contribute to Rheumatoid Arthritis (RA) pathogenesis. The host defense peptide cathelicidin (LL37) is produced as part of the innate...

Allotransplantation of Tooth: A Case Report

Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented. A mandibular first premolar from the donor was implanted into the socket of maxillary central incisor Follow up after 12 months indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options.

Periodontal Disease as a Risk Factor for Rheumatoid Arthritis: A Systematic Review.

Types of participants This review will consider for inclusion, studies that include patients with diagnosed rheumatoid arthritis with or without a clinical diagnosis of chronic periodontitis. Participants will be at least 45 years of age and both genders will be considered. The lower age limit was selected in order to be as inclusive as possible, however, studies specifically focussing aggressive forms of periodontitis will not be included as the aetiology is likely to be different. Studies were the focus is patients with co-morbidities that may impact on periodontal disease and/or rheumatoid arthritis will not be considered as they are outside the scope of this review. Diagnosis of periodontal disease should be based on the clinical and radiographic criteria described by the 1999 Consensus Classification of Periodontal Diseases. 19 Focus of the review The focus of this systematic review is the epidemiological association between periodontal disease and rheumatoid arthritis. Types of outcomes This review will consider studies that aim to establish periodontal disease as a risk factor for rheumatoid arthritis. Outcomes measures considered will include, but are not limited to: Primary Outcomes Studies that include either or both clinical and laboratory measurements that describe rheumatoid arthritis using criteria by the American College of Rheumatology 3 will be considered for inclusion. Outcomes measures such as DAS-28, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), citrullinated proteins (CCP) and rheumatoid factor (RF) will be considered. Secondary Outcomes A secondary outcome of interest in the tooth loss in rheumatoid arthritis sufferers as a result of periodontal disease.

Oral Examination Results in Rescued Ferrets: Clinical Findings

Ferrets have increased in popularity as pets, and a growing number are seen in companion animal practice. Domestic ferrets are commonly used as animal models for research of human oral conditions. The present study evaluated the prevalence of oral pathology in rescued ferrets which - to the authors' knowledge - has not yet been described in the scientific literature. Conscious oral examination was performed on 63 ferrets, of which 49 underwent general anesthesia for further examination. The most common clinical findings included malocclusion of mandibular second incisor teeth (95.2%); extrusion of canine teeth (93.7%); and abrasion and attrition of teeth (76.2%). Tooth fractures were exclusively associated with canine teeth and found in 31.7% of ferrets. Pulp exposure was confirmed in 60.0% of fractured teeth. The normal gingival sulcus depth measured < 0.5-mm in 87.8% of anesthetized ferrets. Clinical evidence of periodontal disease was present in 65.3% of anesthetized ferrets (gingivitis or probing depths > 0.5-mm), however advanced periodontal disease (i.e. periodontal pockets > 2-mm or stage 3 furcation exposure) was not found upon clinical examination. There was no evidence of tooth resorption, dental caries, stomatitis, or oral tumors in the examined group of ferrets.

The People of Wairau Bar: a Re-examination

A new study of macroscopic evidence of health in Wairau Bar human skeletal remains (koiwi tangata), prior to their reburial in April 2009, generally supports the views of Houghton (1975), but reports new evidence of childhood stress, the presence of specific infectious diseases, and revises dental evidence of diet. Assessment of health parameters between spatially separated groups within the cemetery (uruupa) found differences in the demography, with more old females in Group 3 (Burials 12–44) or the ‘southern uruupa’. The oral health of the burial groups was also different where individuals of Group 1 (Burials 1–7) had more evidence of periodontal disease and less extreme wear suggesting a diet different to that of Group 3. Differential health between the sexes and groups at Wairau Bar is implied. Overall parameters of health and disease indicate that the Wairau Bar people survived the observed stress during childhood and lived active, mostly healthy, lives.

Periodontal Disease Status in Gullah African Americans With Type 2 Diabetes Living in South Carolina

African Americans have a disproportionate burden of diabetes. Gullah African Americans are the most genetically homogeneous population of African descent in the United States, with an estimated European admixture of only 3.5%. This study assessed the previously unknown prevalence of periodontal disease among a sample of Gullah African Americans with diabetes and investigated the association between diabetes control and the presence of periodontal disease. Two hundred thirty-five Gullah African Americans with type 2 diabetes were included. Diabetes control was assessed by percentage of glycosylated hemoglobin (HbA1c) and divided into three categories: well controlled, <7%; moderately controlled, 7% to 8.5%; and poorly controlled, >8.5%. Participants were categorized as healthy (no clinical attachment loss [AL] or bleeding on probing) or as having early periodontitis (clinical AL > or =1 mm in at least two teeth), moderate periodontitis (three sites with clinical AL > or =4 mm and at least two sites with probing depth [PD] > or =3 mm), or severe periodontitis (clinical AL > or =6 mm in at least two teeth and PD > or =5 mm in at least one site). Observed prevalences of periodontitis were compared to rates reported for the National Health and Nutrition Examination Survey (NHANES) studies. All subjects had evidence of periodontal disease: 70.6% had moderate periodontitis and 28.5% had severe disease. Diabetes control was not associated with periodontal disease. The periodontal disease proportions were significantly higher than the reported national prevalence of 10.6% among African Americans without diabetes. Our sample of Gullah African Americans with type 2 diabetes exhibited a higher prevalence of periodontal disease compared to African Americans, with and without diabetes, as reported in NHANES III and NHANES 1999-2000.

Studies suggest an association between maternal periodontal disease and pre-eclampsia

In this systematic review, several types of infections are identified and investigated: urinary tract infection, periodontal disease, Chlamydia pneumoniae infection, HIV infection, malaria and other persistent bacterial and viral infections. Separate analyses were conducted for each of them. This summary review will only focus on the link between pre-eclampsia and periodontitis, which was just a part of the original systematic review. MEDLINE, EMBASE, POPLINE, CINAHL, LILACS (all from inception to June 30, 2007), proceedings of international meetings on pre-eclampsia, bibliography of the retrieved articles, reviews, chapters in standard textbooks on hypertension in pregnancy, and contact with investigators involved in the field were used to identify relevant studies. No language restrictions were imposed. Cohort, case-control or cross-sectional studies with original data that evaluated the association between maternal periodontal disease and pre-eclampsia were included. Cases were defined as women suffering from hypertension plus proteinuria, after 20 weeks' gestation. Data were extracted from each study according to design, geographic location, sample size, gestational age when periodontal disease was diagnosed, definition and severity of pre-eclampsia, confounding factors controlled for, temporality of the association, and report of dose-response gradient. Studies included in the systematic review were also included in the meta-analysis if they reported Odds Ratio (OR) or Relative Risk (RR) estimates with their 95% Confidence Intervals (CIs), or provided the information necessary to calculate them. Results from different reports were combined to produce a pooled OR according to the Mantel-Haenszel method, using both fixed- and random-effects models. Heterogeneity was quantified with I(2) statistics. Studies were also quality assessed. Seven case-control studies and 2 cohort studies evaluated the association between periodontal disease and pre-eclampsia. Six studies, representing a total of 3420 women (493 pre-eclamptic and 2927 non-pre-eclamptic control women) were pooled for meta-analysis. Women with evidence of periodontal disease during pregnancy had a 1.76 fold higher risk of pre-eclampsia compared with women without periodontal disease (OR, 1.76, 95% CI: 1.43-2.18). Periodontal disease during pregnancy is associated with an increased risk of pre-eclampsia. More studies are required to verify this as well as to explore whether or not such relationship is causal and, if so, the mechanisms involved.

Age as a Risk Factor for Third Molar Surgery Complications

The purpose of this study was to estimate the frequency of complications after third molar (M3) surgery, with age as the primary risk factor. This was a prospective cohort study of a sample of subjects having at least 1 M3 extracted as part of the American Association of Oral and Maxillofacial Surgeons' Age-Related Third Molar Study. The predictor variables were categorized as demographic, health status, anatomic, and pathological. The outcome variable was overall complications, including both intraoperative and postoperative complications. Appropriate univariate and bivariate statistics were computed. A multiple logistic regression model was used to evaluate the simultaneous effects of multiple covariates. The study sample was comprised of 4,004 subjects having a total of 8,748 M3s removed. The mean age was 39.8 +/- 13.6 years, with 245 subjects (6.1%) age 25 and younger. Approximately half of the subjects were female. The overall complication rate was 19%. In bivariate analyses, age above 25 years, gender, American Society of Anesthesiologists classification, number of preoperatively identified risk factors for complication, impaction level of M3, evidence of periodontal disease, preoperative infection, and evidence of any pathology associated with M3 were associated with complications (P <or= .15). In the multiple regression model, age above 25 years was associated with an increased risk of complications (odds ratio = 1.5; P = .05). The results of these analyses suggest that increased age (>25 years) appears to be associated with a higher complication rate for M3 extractions.

THE BIOARCHAEOLOGY OF THE VAT KOMNOU CEMETERY, ANGKOR BOREI, CAMBODIA

Approximately 60 inhumation burials, of varying states of completeness and preservation, dated between 200 BC and AD 400 (or the early historic period in the Mekong delta) were excavated at the Vat Komnou cemetery located in Angkor Borei, Cambodia, by the University of Hawaii and the Royal University of Fine Arts in 1999 and 2000. The cemetery contained the remains of all age groups from infants to old adults. Over 40% of the burials are subadults. Adult males outnumber females 2 to 1 and most of the adults died as young adults. Osteological analyses are beginning to provide us with our first glimpses of these protohistoric people, associated with early Khmer culture, including evidence of health, disease, physiological stress, injury, physical activity, subsistence, length of life, and cultural modification of bone and teeth. Among the findings are tooth caries, moderate to extreme tooth attrition, and evidence of periodontal disease. Many of the teeth show evidence of betel staining. Healed fractures of the cranium and the infracranial skeleton, although rare, were also observed. Comparisons with other skeletal series from Southeast Asia provide regional context for these preliminary observations.

A Collaborative Cardiovascular Health Program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray Region: Development and Risk Factor Screening at Indigenous Community Organisations

The Heart Health Project was developed in partnership between Aboriginal health and social organisations in the Goulburn-Murray region and university departments. The aims included screening for cardiovascular disease (CVD) risk factors, and evaluating community-directed interventions. We describe the development of the Heart Health Project and the results of risk factor screening among employees (n=66) of Aboriginal organisations during 2003-04. Screening identified few new cases of overt hypertension, diabetes or hypercholesterolaemia, but did find a large proportion of the survey sample who smoked, had evidence of periodontal disease or who had "high normal" levels of risk factors at a relatively young age, placing them at risk of developing overt disease. Barriers to diet and exercise behaviours thought to protect against CVD were documented. While appropriate planning made clinical follow-up relatively straightforward, effective referral of at-risk people to primary prevention programs was more difficult. The barriers to making diet and exercise changes need consideration in designing interventions for primary prevention of CVD, as does the importance of promoting heart health in a culturally relevant way. This can be achieved through community direction but long-term support for partnerships and intervention programs is required.

Program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray Region: Development and Risk Factor Screening at Indigenous Community Organisations

The Heart Health Project was developed in partnership between Aboriginal health and social organisations in the Goulburn-Murray region and university departments. The aims included screening for cardiovascular disease (CVD) risk factors, and evaluating community-directed interventions. We describe the development of the Heart Health Project and the results of risk factor screening among employees (n=66) of Aboriginal organisations during 2003-04. Screening identified few new cases of overt hypertension, diabetes or hypercholesterolaemia, but did find a large proportion of the survey sample who smoked, had evidence of periodontal disease or who had ?high normal? levels of risk factors at a relatively young age, placing them at risk of developing overt disease. Barriers to diet and exercise behaviours thought to protect against CVD were documented. While appropriate planning made clinical follow-up relatively straightforward, effective referral of at-risk people to primary prevention programs was more difficult. The barriers to making diet and exercise changes need consideration in designing interventions for primary prevention of CVD, as does the importance of promoting heart health in a culturally relevant way. This can be achieved through community direction but long-term support for partnerships and intervention programs is required.

Radioimmunoassay quantification of adrenomedullin in human gingival crevicular fluid

To investigate whether adrenomedullin (ADM), a multifunctional peptide with key roles in host antimicrobial defence and inflammation, was present and quantifiable in human gingival crevicular fluid (GCF) and to study its relationship with periodontal health and disease. GCF samples (30s) were collected using perio-paper strips from one diseased site in 21 subjects with periodontal disease and one healthy site from 19 control subjects with no evidence of periodontal disease. Samples were analysed by radioimmunoassay using a specific anti-human ADM antibody. Measurable adrenomedullin-like immunoreactivity (ADM-LI) was present in all the GCF samples collected. ADM-LI was significantly higher in periodontitis sites (mean 493.6 pg) than in control healthy sites (mean 248.5 pg), p = 0.0016. It is concluded that ADM is present in GCF at levels at which it could have an antibacterial role in the gingival crevice and modulate the pathophysiology of periodontal inflammation.

Periapical tooth root infections in llamas and alpacas

Head and neck abscesses are a common complaint in llamas and alpacas in North America representing 3% of clinical cases presented at the Veterinary Teaching Hospital at Ohio State University (OSU-VTH). Approximately 20% of infected teeth have infection of the pulp cavity most often associated with a patent infundibulum, approximately 60% have evidence of periodontal disease and compromised periodontal ligament, and 20% are of unknown cause. Differential diagnosis includes tooth root abscess, osteomyelitis, soft tissue abscess ( Corynebacterium pseudotuberculosis), foreign body, parotid duct lesion, facial bone fracture, retained food bolus, and malocclusion. The aim of this paper is to review available information and provide clinical observation on etiology, diagnosis, and treatment option for tooth root infection in llamas and alpacas.