Furcation Research Articles

Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study.

The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.

Management of large furcal defect -1.5 year follow up: A case report

In about 2 -12 % perforation may occur while doing a root canal or post placement. Perforation can be pathological or mechanical. Treatment outcome will depend on several factors size, position, time lapse, sealing ability of the material used. In this case report patient came with furcation defect which was managed with MTA and patient was kept on follow for 1.5 year.

Orthodontic treatment in patients with periodontitis - anarrative literature review.

Patients with periodontitis often require an inter-disciplinary approach, including orthodontic treatment, for effective rehabilitation of masticatory function, aesthetics and quality of life. The aim of this narrative review was to comprehensively discuss literature focusing on the biology, indications and inter-disciplinary connections related to the orthodontic approach in patients with periodontitis and to present clinical concepts in accordance with valid guidelines. The outcomes of the experimental studies indicate that orthodontic tooth movement (OTM) can be performed safely for teeth with reduced periodontium, provided infection and inflammation are controlled. Orthodontic treatment can correct pathological tooth migration, is not associated with deterioration of clinical periodontal parameters and improves aesthetics. Intrusion is safe when performed with light forces and under a strict oral hygiene regimen. Teeth can be moved either towards or away from the intrabony defect previously subjected to regenerative procedures, and research suggests that OTM has the potential to enhance bone formation after regenerative therapy. The data on orthodontic movement of teeth with furcation involvement are very scarce. The improvement in furcation involvement following either combined periodontal and orthodontic treatment was only documented in animal model studies. Due to bone and tooth loss, special consideration should be given to orthodontic treatment mechanics. © 2023 Australian Dental Association.

Correlation of clinical and radiographic severity of periodontitis with furcation involvement: Evaluation of periapical radiographs and Cone-beam Computed Tomography

Objectives: To analyze the correlation of clinical and radiographic features in periodontitis with furcation involvement.
 Materials and Methods: Cross-sectional analytic study of 30 mandibular molars from 13 patients (8 males and 5 females), who had periodontitis with furcation involvement, with purposive sampling. Clinical, periapical and CBCT examination were then carried out . Assessment for clinical dan CBCT based on modified Glickman classification. Correlation test was performed with Kendall's Tau_b.
 Results: There was a significant difference between subjects of non CBCT group (clinical (p=0,01) and periapical (p=0,026)), with subjects examined by CBCT. However there was no difference between the clinical and periapical group. There is a correlation between furcation involvement on CBCT and periapical group (r=0,528; p=0,003).
 Conclusion: There was no correlation between furcation involvement on clinical examination with periapical radiographs and CBCT. The correlation is only seen between periapical radiographs and CBCT.

Utilizing a Film Holder to Enhance Radiographic Imaging in Maxillary Molar Trifurcation

Background: The parallel technique stands as a prominent method for radiographic examinations aiming to identify furcation involvement. Nevertheless, an inherent limitation lies in the frequent superimposition of the trifurcation region with tooth roots, potentially leading to inaccurate diagnoses. The Same Lingual Opposite Buccal (SLOB) technique was devised to yield radiographic images that alleviate superimposition at the trifurcation of the maxillary first molar. Purpose: to observe and compare the radiographic images of the trifurcation region of the maxillary first molar generated through the SLOB technique with the film holder modification set at a mesial and distal angulation of 20˚ with the parallel technique. Methods: This observational analytic research encompassed a sample size of 24 instances. Each individual sample underwent three separate exposures: the SLOB technique with a horizontal angulation of 20˚ towards both mesial and distal directions, and the parallel technique (serving as the control). Results: a significant difference in radiographic images of the trifurcation region of the maxillary first molar obtained through the SLOB technique, employing the film holder modification with a mesial angulation of 20˚ and a distal angulation of 20˚, as opposed to the parallel technique (control). Conclusion: A radiographic image capturing the trifurcation of the maxillary first molar, devoid of superimposition, was successfully generated through the SLOB technique incorporating a horizontal angulation of 20˚ towards the distal direction.

Clinical success of guided tissue regeneration for treating vertical bone and furcation defects in dogs.

This study evaluated the clinical success rate of guided tissue regeneration (GTR) for treating advanced periodontal disease in a large canine cohort. A total of 112 GTR procedures performed from 2003-2021 were retrospectively evaluated, including pre- and post-treatment (3-12 months) periodontal probing depths of 104 treated teeth, dental radiographs of 73 treated teeth, and both diagnostic modalities in 64 treated teeth. Probing depth, radiographically apparent bone height, bone graft material, barrier membrane material, and tooth extraction adjacent to the GTR site were investigated as factors affecting success. Vertical bone defects were evaluated separately from furcation defects. GTR was clinically successful, defined as objective improvement in probing depth, objective decrease in radiographic vertical bone defect, and subjective radiographic gain in bone height in 90.3% of vertical bone defects. Success was significantly associated with the magnitude of initial probing depth and the type of barrier membrane used. GTR was clinically successful, defined as objective improvement in furcation probing and subjective radiographic improvement of the bone in the furcation in 22.2% of furcation defects. When F3 lesions were excluded, GTR was successful in 64.3% of furcation defects. GTR is an appropriate treatment to maintain teeth in the oral cavity of dogs with proper client counseling and patient selection, but it is most likely to be successful in vertical defects.

Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects.

Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.

Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study

IntroductionCarbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). MethodsA single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. ResultsThe postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. ConclusionsThe clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.

Clinicoradiographic comparative evaluation of 1% melatonin gel plus platelet-rich fibrin over platelet-rich fibrin alone in treatment of Grade II furcation defects: A randomized controlled double-blind clinical trial.

The present study aims to evaluate and compare the effects of 1% melatonin gel plus platelet-rich fibrin (PRF) and PRF alone in treatment of furcation defects, clinically and radiographically using cone-beam computed tomography. This split-mouth clinical trial included 23 patients with 46 bilateral Grade II furcation defects in first or second maxillary or mandibular molars. Control group was treated with PRF alone while the test group was treated with 1% melatonin gel and PRF. Clinical attachment level (CAL) and horizontal probing depth (HPD) were primary outcome parameters while secondary outcome parameters were pocket probing depth (PPD) and defect volume (DV) assessed at 3 and 6 months postoperatively. Significantly greater mean reduction of PPD, HPD, and CAL gain was observed in test group (2.23±0.41, 2.36±0.68, and 2.97±0.62mm, respectively) in comparison with control group (2.83±0.78, 2.85±0.67, and 3.21±0.86mm, respectively) at 6 months. A significant reduction in the mean DV was exhibited radiographically in test group (1.06±0.5 mm3) as compared with control group (3.94±1.32 mm3) at the end of 6 months. Both the groups showed improvements in assessed parameters. In Grade II furcation defects the combination therapy of 1% melatonin + PRF shows a statistically significant degree of bone fill within the periodontal tissues and also better results in terms of decrease in PPD, HPD, and a greater CAL gain.

Retrospective evaluation of the prevalence of endodontic-periodontal lesions on panoramic images in the latest classification of periodontal and peri-implant diseases

Aims: This study aimed to determine the prevalence of endodontic-periodontal lesions (EPLs) and EPL grades 1–3 without root damage in patients with and without periodontitis according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases.&#x0D; Methods: This study included 500 panoramic radiographs from the Faculty of Dentistry at the University of İstanbul Medipol. Each radiograph was evaluated by a calibrated investigator for diagnostic signs. Patients’ age, sex, total number of teeth, total number of implants, number of filled teeth, number of missing teeth, number of caries, presence of fixed prosthesis, full mouth periodontal diagnosis and determination of the region with the highest radiographic bone loss without EPL were recorded in all patients. For patients with EPL, the presence of EPL and its grading according to the 2017 World Workshop on Classification of Periodontal and Peri-Implant Diseases, the presence of furcation involvement, degree of furcation involvement, the presence of caries in the related tooth, and restoration in the relevant tooth material were also evaluated.&#x0D; Results: The mean age was higher for patients with EPL teeth than without EPL teeth (p

Probing pocket depth reduction after non-surgical periodontal therapy: Tooth-related factors.

To investigate tooth-related factors that influence the reduction of probing pocket depths (PPD) after non-surgical periodontal therapy (NST). Seven hundred forty-six patients with a total of 16,825 teeth were included and retrospectively analyzed. PPD reduction after NST was correlated with the tooth-related factors; tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration; using logistic multilevel regression for statistical analysis. NST was able to reduce probing depth overall stratified probing depths (1.20±1.51mm, p≤0.001). The reduction was significantly higher at teeth with higher probing depths at baseline. At pockets with PPD ≥6mm, PPD remains high after NST. Tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration are significantly and independently associated with the rate of pocket closure. The tooth-related factors: tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration had a significant and clinically relevant influence on phase I and II therapy. Considering these factors in advance may enhance the prediction of sites not responding adequately and the potential need for additional treatment, such as re-instrumentation or periodontal surgery, to ultimately achieve the therapy end points.

A Novel Piezoelectric-Assisted Non-Surgical Periodontal Treatment: A Prospective Case Series.

The purpose of this study was to evaluate the clinical efficacy of a non-surgical periodontal treatment using a piezoelectric power-driven device with a novel insert. Plaque index (PlI), bleeding on probing (BoP), probing depth (PD), recession depth (Rec) and clinical attachment level (CAL) were assessed at 6 weeks, 3 months and 6 months. Furthermore, tooth mobility and furcation involvement were recorded and chewing discomfort and dental hypersensitivity were evaluated. Eighteen stage I to IV periodontitis patients providing 437 teeth and 2622 sites in total were analyzed. At six weeks, CAL gain (0.4; p < 0.0001), PD reduction (0.4; p < 0.0001) and Rec increase (0.1; p = 0.0029) were statistically significant. Similarly, the mean number of sites with PD > 4 mm and absence of BoP significantly decreased between baseline and 6 weeks (-12.7; p < 0.0001). At this time point, the patient's chewing discomfort was also significantly diminished (1.4; p = 0.0172). Conversely, no statistically significant changes were observed between 6 weeks and 3 months and between 3 months and 6 months for any of the clinical variables evaluated. In conclusion, within the limitation of this study, mechanical piezo-assisted non-surgical periodontal treatment in conjunction with an innovative tip resulted significantly efficacious to reduce pathological periodontal pockets, to gain clinical attachment and to reduce gingival inflammation.

Clinical periodontal diagnosis.

Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.

Evaluation of hyaluronic acid gel with or without acellular dermal matrix allograft in the treatment of class II furcation defects in dogs: A histologic and histomorphometric study

AimTo evaluate the histologic and histomorphometric effects of hyaluronic acid (HA) gel with or without acellular dermal matrix allograft (ADMA) on periodontal regeneration in Class II furcation defects in dogs. Materials and methodsClass II furcation defects were surgically created in the mandibular first and second premolars bilaterally in eight beagle dogs. The Class II furcation defects were assigned randomly, using the split-mouth design, into the test and control sides. The teeth on the test sides were equally and randomly divided into the HA/ADMA group (n = 8) treated with 0.8% HA gel followed by ADMA, and the HA-only group (n = 8) treated with 0.8% HA only. The furcation defects of the control sides (n = 16) were subjected to open flap debridement (OFD group). The animals were euthanized for histologic and histomorphometric analyses after one month (n = 4) and three months (n = 4). ResultsAt one month, the newly formed bone area (NFBA) was larger in the HA/ADMA (6.23 ± 1.41 mm2) and HA-only (5.90 ± 1.43 mm2) groups than in the OFD group (2.42 ± 1.62 mm2) (p < 0.05). The newly formed cementum (NFAC) and periodontal ligament (NFPL) were similar in the HA/ADMA and HA-only groups but significantly lesser in the OFD group (p < 0.05.) At three months, the NFBA, NFAC, and NFPL were greater in the HA/ADMA group than in the HA-only group (p < 0.05). New regenerative tissue was significantly greater in both the test groups than in the OFD group (p < 0.05), while epithelial downgrowth predominated the healing in the latter. ConclusionsThese results suggest that HA with ADMA positively affects the periodontal regeneration and wound healing in Class II furcation defects.

Deep Learning for Dental Diagnosis: A Novel Approach to Furcation Involvement Detection on Periapical Radiographs.

Furcation defects pose a significant challenge in the diagnosis and treatment planning of periodontal diseases. The accurate detection of furcation involvements (FI) on periapical radiographs (PAs) is crucial for the success of periodontal therapy. This research proposes a deep learning-based approach to furcation defect detection using convolutional neural networks (CNN) with an accuracy rate of 95%. This research has undergone a rigorous review by the Institutional Review Board (IRB) and has received accreditation under number 202002030B0C505. A dataset of 300 periapical radiographs of teeth with and without FI were collected and preprocessed to enhance the quality of the images. The efficient and innovative image masking technique used in this research better enhances the contrast between FI symptoms and other areas. Moreover, this technology highlights the region of interest (ROI) for the subsequent CNN models training with a combination of transfer learning and fine-tuning techniques. The proposed segmentation algorithm demonstrates exceptional performance with an overall accuracy up to 94.97%, surpassing other conventional methods. Moreover, in comparison with existing CNN technology for identifying dental problems, this research proposes an improved adaptive threshold preprocessing technique that produces clearer distinctions between teeth and interdental molars. The proposed model achieves impressive results in detecting FI with identification rates ranging from 92.96% to a remarkable 94.97%. These findings suggest that our deep learning approach holds significant potential for improving the accuracy and efficiency of dental diagnosis. Such AI-assisted dental diagnosis has the potential to improve periodontal diagnosis, treatment planning, and patient outcomes. This research demonstrates the feasibility and effectiveness of using deep learning algorithms for furcation defect detection on periapical radiographs and highlights the potential for AI-assisted dental diagnosis. With the improvement of dental abnormality detection, earlier intervention could be enabled and could ultimately lead to improved patient outcomes.

Periodontal regeneration risk assessment in the treatment of intrabony defects.

Regenerative approaches performed in periodontics seems to be efficient in treating intrabony defects. There are, however, many factors that may affect the predictability of the regenerative procedures. The present article aimed to propose a new risk assessment tool for treating periodontal intrabony defects by regenerative therapy. Different variables that could affect the success of a regenerative procedure were considered based on their impact on (i) the wound healing potential, promoting wound stability, cells, and angiogenesis, or (ii) the ability to clean the root surface and maintain an optimal plaque control or (iii) aesthetics (risk for gingival recession). The risk assessment variables were divided into a patient, tooth, defect, and operator level. Patient-related factors included medical conditions such as diabetes, smoking habit, plaque control, compliance with supportive care, and expectations. Tooth-related factors included prognosis, traumatic occlusal forces or mobility, endodontic status, root surface topography, soft tissue anatomy, and gingival phenotype. Defect-associated factors included local anatomy (number of residual bone walls, width, and depth), furcation involvement, cleansability, and number of sides of the root involved. Operator-related factors should not be neglected and included the clinician's level of experience, the presence of environmental stress factors, and the use of checklists in the daily routine. Using a risk assessment comprised of patient-, tooth-, defect- and operator-level factors can aid the clinician in identifying challenging characteristics and in the treatment decision process.

Treatment of furcation defects using various bone grafts and guided tissue regeneration membranes: A review on single-center institutional studies

Abstract Bone formation in class II furcation is least due to the morphology of the root in case of multirooted teeth performed by conventional procedure. Hence, various bone grafts with membranes have been tried in the current study to evaluate its efficacy by comparing test and control groups. This collection of research from a single center presents a bone graft and guided tissue regeneration (GTR) membrane-based furcation therapy. Bio-Oss and Bio-Gide, PerioGlas and Atrisorb, Periobone G and Resolut XT, as well as PepGen P-15 and Atrisorb, were among the bone graft materials used, both with and without the GTR barrier. Patients were divided into four groups based on the periodontal regenerative materials used. A periodontal flap procedure was performed where periodontal intraosseous defect along with furcation defects were present. The results show that the bone formation in the furcation area was more with Group C (Periobone G and Resolut XT) as compared to the least amount of bone formation in Group A (Bio-Oss and Bio-Gide) in the test group, and this same group shows least bone formation in control. To conclude, clinical outcomes observed with the combined use of Atrisorb as a GTR barrier and PerioGlas as a bone graft material improved the clinical measurements of furcation defect depth compared to the use of PerioGlas alone.

Estimation of Salivary Thiocyanate Levels in Light and Heavy Smokers with Chronic Periodontitis

Introduction: Periodontitis is a common chronic inflammatory disease reported in adults with multifactorial origins that affects the periodontium. In addition to the direct etiological impact of the microorganisms involved, cigarette smoking and tobacco chewing are considered to be the most important environmental risk factors. Periodontitis is common and severe in smokers, characterized by deep periodontal pockets, attachment loss, and furcation defects. Human saliva has been recently investigated as an alternative to serum for diagnostic purposes due to its non-invasiveness and lower risk of infection. To estimate and compare salivary thiocyanate levels in light and heavy smokers with chronic periodontitis and non-smokers with chronic periodontitis and healthy control. Materials and Methods: Total of 60 saliva samples were collected between the age group of 20 and 50 years males and grouped as: Group 1: normal control (n = 15); Group 2: light smokers with chronic periodontitis (n = 15); Group 3: heavy smokers with chronic periodontitis (n = 15); Group 4: non-smokers with chronic periodontitis (n = 15). Whole saliva sample were collected and centrifuged and total salivary thiocyanate (SCN) levels were analyzed using Spectrophometer at 450 nm. Results: The mean salivary total SCN levels show that they are higher in heavy smokers with chronic periodontitis when compared to light smokers and non-smokers with chronic periodontitis. Conclusion: Salivary SCN level stands out as a useful marker of periodontal tissue destruction, proving to be a promising diagnostic marker, and it is a biochemical indicator of cigarette smokers.

Comparative Analysis of Various Forms of Local Drug Delivery Systems on a Class 2 Furcation - A Systematic Review.

Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar bone remaining intact. There may be involvement of vertical bone loss. Local drug deliveries such as Boric acid, alendronate gel, and other drugs exhibited anti-inflammatory, antibacterial & osteoblastic differentiation activity. The present systematic review compares the drugs based on their outcomes and pharmacological action. To analzse & compare various forms of local drug delivery systems on a class II furcation. A search was conducted using PubMed, Google scholar, science direct, and Pub Med central using MeSH terms - local drug delivery in periodontics, boric acid in the management of class II mandibular furcation, simvastatin in the treatment of furcation. A total of 560 articles were screened; 58 out of 560 were full-text articles accessed for eligibility, and five articles were included in the systematic review. PRISMA guidelines were used for reporting this review. In addition, five randomized controlled trials were enclosed and used in this systematic review. The various local drugs used in treating class II mandibular furcation defects are effective in the prevention of bleeding on probing, bone resorption, gingival bleeding index and increase in the bone fill, and microbial deposit removal. The managing of class II mandibular furcation defect with the drugs mentioned in this review can be effective by reducing several clinical parameters such as bleeding on probing, gingival indices, osteoblastic differentiation, bone fill, etc., Considering the results of the studies, it can be concluded that it can be used as a therapeutic therapy against class II furcation defects with positive outcomes.

Periodontitis in obese adults with and without metabolic syndrome: a cross-sectional study

BackgroundEpidemiological studies support an association between obesity, metabolic syndrome (MetS), and periodontitis. Still, understanding of the effects of low-grade inflammation in obese subjects on periodontitis and influence of MetS remains incomplete. The aims of this cross-sectional study were to explore the association between obesity related variables and periodontitis, and assess if MetS is a risk indicator for periodontitis in a sample of obese adults.MethodsThe study sample comprised 52 adults with a body mass index (BMI) of ≥ 30 kg/m2 referred for obesity therapy at the Obesity Centre at Haukeland University Hospital (HUH), Bergen, Norway. The subjects had prior to enrolment completed a 5-month lifestyle intervention course as part of a 2-year managing program. According to the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) classification of MetS, 38 subjects were recruited to the MetS group and 14 subjects to the non-MetS group. Medical data including peripheral blood samples were obtained from records at HUH at the time of enrolment. Probing depth, clinical attachment level, tooth mobility, furcation involvement, bleeding on probing (BoP) were recorded and intraoral bitewings evaluated at a full-mouth periodontal examination. Associations between risk variables for obesity/MetS and periodontitis were explored using linear and logistic regression models.ResultsIn the present sample 79% of the subjects were diagnosed with periodontitis. The prevalence of stage III/IV periodontitis was 42.9% in the non-MetS group vs. 36.8% in the MetS group (p = 0.200). In the non-MetS group 29.8% of the sites displayed BoP vs. 23.5% in the MetS group (p = 0.048). For stage III/IV periodontitis, the effect of age appeared to be significant for obesity related variables and MetS (p = 0.006, p = 0.002, respectively). None of the other analyses showed significant association with the outcome variables.ConclusionIn the present sample of obese subjects, periodontitis occurred independently of MetS. Reaching a certain BMI level, suggested association between MetS and periodontitis might be non-significant due to the dominating impact of obesity related variables undermining the effect of other systemic factors.Trial registrationThe principal clinical trial, entitled “Obesity and Oral Diseases”, was prospectively registered in ClinicalTrials.gov with registration NCT04602572 (20.10.2020).