Mean Clinical Attachment Loss Research Articles

Comparison Between the Conventional and Electronic Smoking Effects on Periodontal Health—A Cross-Sectional Study

ABSTRACT Objectives: To compare the adverse effect of e-cigarettes and conventional cigarette smoking on periodontal health. Materials and Methods: Sixty participants were split into two groups of 30 each (Group A—traditional cigarettes and Group B—e-cigarette smokers). Socio-demographic data, smoking, and oral health status were gathered using a self-administered questionnaire. Gingival index (GI), Russell’s periodontal index, and clinical attachment loss (CAL) were recorded in patients of both the groups. Results: The mean GI (1.79), periodontal index (5.92), and CAL (3.44) were higher in patients using traditional cigarettes than e-cigarettes. The questionnaire revealed that patients using traditional cigarettes had bleeding gums (32.22%), pus in the gums (39.22%), extracted teeth due to mobility (59.65%), discolored tooth (89.66%), and tongue (71.76%), which was more than e-cigarette smokers. Conclusion: E-cigarette smokers have similar adverse effects on the periodontal tissues but are less as compared to normal cigarette smokers.

The relationship of dietary flavonoids and periodontitis in US population: a cross-sectional NHANES analysis.

We investigated the association between dietary flavonoids intake and periodontitis. This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey 2009-2010 on 3025 participants aged between 30 and 80 years who had full-mouth periodontal examination and dietary flavonoids intake data. This study used periodontal pocket depth (PPD) and clinical attachment loss (CAL) as periodontitis markers. Data were analyzed using multivariate linear regression. After adjusting confounders, the middle tertile of total dietary flavonoids was associated with decreased mean PPD (0.06mm, P = 0.016) and mean CAL (0.13mm, P = 0.001) and the top tertile of total dietary flavonoids was significantly associated with decreases in mean PPD (0.05mm, P = 0.029) and mean CAL (0.11mm, P = 0.010). Both the middle and top tertiles of total flavonoids intake were significantly related with decreased mean CAL in females, those flossing 0 days/week, overweight and non-diabetic population but not in males, smokers, those flossing 1-6 days/week and diabetic population. Higher anthocyanidins, flavones and flavonols intake was significantly associated with decreased mean PPD and mean CAL while higher flavanones intake was only significantly associated with decreased mean CAL. Higher anthocyanidins intake was particularly related with greatest decreases in mean CAL (top tertile: 0.22mm, middle tertile: 0.17mm, both P < 0.010). However, no significant associations were found between isoflavones and flavan_3_ols intake and mean CAL. Higher dietary flavonoids intake may be beneficial for periodontal health. Additional anthocyanidins, flavanones, flavones and flavonols intake was associated with improved periodontal health.

Six-Month Follow-Up of Periodontal Condition in Rheumatoid Arthritis and Ankylosing Spondylitis Arthritis Patients Undergoing Anti-Tumour Necrosis Factor-α Therapy.

In our present study, we aimed to assess the effects of anti-TNF therapy on periodontal condition in a mixed cohort of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Moreover, we wished to determine whether the baseline dental condition of these patients would affect response to biological therapy. A cohort of 24 arthritis patients was consecutively recruited before starting anti-TNFα therapy. After the dropout of six patients, we evaluated the dental status of 18 subjects at baseline and after 6 months of biological therapy. Clinical responder (R) and non-responder (NR) status was determined after 6 months of anti-TNF treatment. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), PPDmax, clinical attachment loss (CAL), and CALmax were determined. During the 6-month treatment period, six patients (3 RA and 3 AS) terminated the study prematurely as they did not respond to treatment (NR). Therefore, 18 patients were included in the full analysis. There were no major differences in PI, BOP, PPD, PPD max, CAL, and CALmax, among R and NR patients. TNF inhibition resulted in increased GI (0.65 ± 0.34 vs. 0.88 ± 0.30; p < 0.05), as well as decreased PPDmax (4 ± 1.94 vs. 2.72 ± 1.36; p < 0.05) and CALmax (5.22 ± 2.56 vs. 2.72 ± 1.36; p < 0.05) after 6 months. Eight patients had incomplete canal fillings or dead pulps and/or apical periodontitis; six in the R and two in the NR group. In our present study, anti-TNF therapy seemed to worsen the extent of gingival inflammation (GI); however our results also do not support the reduction of mean CPD and CAL as reported by others.

Comparative evaluation of propolis mouthwash with 0.2% chlorhexidine mouthwash as an adjunct to mechanical therapy in improving the periodontitis among perimenopausal women: a randomized controlled trial

ObjectiveTo evaluate the efficacy of Propolis mouthwash compared to chlorhexidine mouthwash as an adjunct to mechanical therapy in improving clinical parameters in perimenopausal women with chronic periodontitis.MethodologyA double-blind, randomized, controlled clinical trial was conducted by recruiting 144 subjects with mild to moderate chronic periodontitis. After scaling and root planning, subjects were allocated to two treatment groups: 0.2% chlorhexidine mouthwash and 20% propolis mouthwash twice daily for six weeks. Clinical parameters such as pocket probing depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP) were analysed at baseline, six weeks, and 12 weeks.ResultThe mean value of PPD in the propolis group was 4.67 at baseline, reduced to 4.01 at six weeks and 3.59 at 12 weeks. While in the chlorhexidine group, the baseline value of 4.65 reduced to 4.44 and 4.25 at six weeks and 12 weeks, respectively. The baseline value of the mean CAL in the propolis group was 4.45. This value was reduced to 4.15 at six weeks and 3.77 at 12 weeks. For the chlorhexidine group, the baseline value of CAL was 4.80, which was reduced to 4.50 and 4.19 at six weeks and 12 weeks. The mean value of bleeding on probing in the propolis group was 77.20, which decreased to 46.30 at six weeks and 14.60 at the final visit. In the chlorhexidine group, the mean value of 77.30 was reduced to 49.60 and 22.80 at subsequent visits.ConclusionThis study concludes that both propolis and chlorhexidine mouthwash positively improve clinical parameters; however, propolis is significantly more effective in improving BOP.Trial registrationID: NCT05870059, Date of Registration: 02/02/2022. (https://beta.clinicaltrials.gov/study/NCT05870059).

Clinical evaluation of chitosan/polycaprolactone nanofibrous scaffolds releasing tetracycline hydrochloride in periodontal pockets of patients with chronic periodontitis.

The role of bacteria in the initiation and progression of periodontitis has led to a great interest in using antibiotics to suppress pathogenic microbiota. Considering the drawbacks of systemic antibiotics' application, local delivery systems directly in the periodontal pocket can be helpful. Therefore, the effect of an efficient tetracycline-loaded delivery system was investigated on the clinical parameters of periodontitis. In this clinical trial with a split-mouth design, 10 patients with periodontitis with pocket depths≥5 mm were included. After scaling and root planing (SRP) for all the patients, one side of the mouth was randomly considered as the control group, and on the other side, chitosan/polycaprolactone (PCL) nanofibrous films containing tetracycline (5%) were placed in pockets of 5 mm and deeper. Clinical measurements of pocket probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) indices were made at the beginning and after 8 weeks of intervention. PPD, CAL, and BOP parameters were compared between the control and test groups before and after the intervention with paired t tests using SPSS 24. The significance level of the tests was considered at P<0.05. The mean PPD, CAL, and BOP in both the control (SRP) and test (LDDs) groups decreased after 8 weeks. A significant difference was detected in reducing PPD, BOP, and CAL after 8 weeks in 5-mm pockets, and the mean values were higher in the test group than in the control (P<0.05). The local drug delivery system using chitosan/PCL nanofibrous films containing tetracycline can effectively control periodontal diseases by reducing pocket depth and inflammation and improving CAL without offering side effects, although further evaluations are needed.

Association of periodontal condition with cognitive impairment and the mediating role of accelerated biological aging among US older adults

AbstractBackgroundIncreasing evidence has shown the associations between periodontitis and cognitive impairment or dementia; however, few studies have explored the role of accelerated biological aging that affects this association. Biological aging is the gradual and progressive decline in system integrity that occurs with advancing age. In this study, we examined the mediating effect of biological aging on the association between periodontal conditions and cognitive impairment in US older adults.MethodWe analyzed data from 2,186 participants aged 60 and older from the US National Health and Nutrition Examination Survey 2011‐2014. Data included sociodemographic, behavioral, and health‐related characteristics, periodontal status (measured by mean clinical attachment loss and pocket depth), blood‐chemistry measures of biological age (using KDM‐biological age and PhenoAge algorithms), and cognitive functioning (measured by Digit Symbol Substitution Test). We created an accelerated biological aging measure using residuals from regressing each blood‐chemistry measure on chronological age. The biological ages’ residual discrepancies with chronological age were defined as the biological age accelerations (BAA). Mediation analysis, weighted for complex survey design, assessed the effect of BAA on the association between periodontal conditions and cognitive functioning.ResultAfter adjusting for covariates, participants with periodontitis exhibited greater KDM BAA (β [SE] = ‐0.40 [0.17]), PhenoAge BAA (β [SE] = ‐0.57 [0.21]), and lower level of cognitive function (β [SE] = ‐1.50 [0.33]) than those without periodontitis. Both KDM and PhenoAge BAA were significantly associated with lower cognitive functioning (β [SE] = ‐0.27 [0.10] and β [SE] = ‐0.29 [0.07]), mediating 11.0% and 9.7% of the total effects of periodontitis on cognitive functioning, respectively. Furthermore, KDM and PhenoAge BAA mediated 11.7% and 5.8% of the association between mean pocket depth and DSST, respectively.ConclusionOur findings suggest that periodontitis is partially associated with worse cognitive functioning through accelerating the biological aging process. Efforts to improve oral health or slow biological aging have the potential to help reserve cognitive health in later life.

Periodontal health in adequately controlled and inadequately controlled type 2 diabetes: A cross-sectional study.

Objective: To compare health status in term of clinical attachment loss and pocket depth adequately-controlled vs. inadequately-controlled type 2 diabetes. Study Design: Cross-Sectional study. Setting: Department of Periodontology, Khyber College of Dentistry, Peshawar. Period: 1st May 2021 to 30th January 2022. Material &amp; Methods: A total of 142 participants with Type 2 diabetes mellitus (DM), aged between 35 and 65 years, and with a DM duration exceeding 3 years, along with a minimum of seven teeth per arch determined through clinical examination, were included. Participants with type 1 diabetes mellitus, smokers, pregnant women, those on medications inducing gingival enlargement, those who underwent periodontal therapy in the last six months, and patients undergoing orthodontic treatment were excluded. Pocket depth and clinical attachment loss at six points on each reference tooth (including upper and lower first molars, first premolars, and central incisors) were measured using a Michigan 'O' Probe featuring William markings on a periodontal pocket chart. The arithmetic mean value was then calculated. To compare the two groups (adequately controlled diabetics and inadequately controlled diabetics), the mean pocket depth and mean clinical attachment loss were analyzed separately using an independent samples t-test. Results: The mean duration of DM, age, periodontal pocket depth, clinical attachment were 6.42 ±2.76 years, 50.77 ±9.50 years, 4.03 ±0.74mm, and 4.74 ±0.74mm. The males were 80(56%) and females were 62(44%). The mean PPD was less in well controlled (3.45±0.36mm) than poorly controlled diabetes (4.76±0.36mm) statistically significantly (p&lt;0.001). Similarly mean CAL was less in adequately controlled (4.16±0.36mm) than inadequately controlled diabetes (5.47±0.36mm) statistically significantly (p&lt;0.001). Conclusion: Inadequately controlled diabetes mellitus is associated with adverse periodontal health status.

Association between Mediterranean diet and periodontitis among US adults: The mediating roles of obesity indicators.

This study aimed to assess the association between the Mediterranean diet (MedDiet) and periodontitis in US adults and to further explore the mediating roles of obesity indicators in this association. The relationship between MedDiet and periodontitis is controversial. And it is unclear whether obesity indicators are potential mediators of this relationship. Using data derived from the National Health and Nutrition Examination Survey (2009-2014). Weighted binary logistic regression and restricted cubic spline were used to assess the association between MedDiet and periodontitis. Weighted ordinal logistic regression was performed to evaluate the relationship between MedDiet and periodontitis severity. The mediating roles of body mass index (BMI) and waist circumference in the relationship between the MedDiet and periodontitis were explored. Association analyses were further performed using mean clinical attachment loss (CAL) or mean periodontal probing depth (PPD) as dependent variables. The false discovery rate method was used to correct the p-values in the regression analyses. A total of 8290 eligible participants (4159 participants with periodontitis and 4131 without periodontitis) were included. A negative association between the MedDiet adherence score and periodontitis was observed in the binary logistic regression model (adjusted odds ratio = 0.94, 95% confidence interval: 0.90-0.97, p = .001). Restricted cubic spline regression revealed a dose-response relationship between the MedDiet adherence score and periodontitis. BMI and waist circumference significantly mediate this association, with mediation proportions of 9.7% (p = .032) and 9.3% (p = .012), respectively. Multivariable ordinal logistic regression showed that the MedDiet adherence score was negatively associated with the severity of periodontitis (all p < .05). Additionally, the MedDiet adherence score was negatively associated with mean PPD or mean CAL (all p < .05). This study suggests a significant negative association between adherence to the MedDiet and periodontitis and a possible mediating role of obesity indicators in this association. Furthermore, studies are still warranted to confirm our findings.

Associations of periodontitis with risk of all-cause and cause-specific mortality among us adults with chronic kidney disease

ObjectivesTo investigate the associations of periodontitis with risk of all-cause and cause-specific mortality in a nationally representative sample of adults with chronic kidney disease (CKD) in the United States. MethodsThis prospective cohort study included 4,271 individuals aged ≥30 years at baseline with CKD participants in the National Health and Nutrition Examination Survey (NHANES) during 1988–1994, 1999–2004, and 2009–2014. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 and/or urinary albumin/creatinine ratio (uACR) ≥30 mg/g. Multivariate cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of all-cause and cause-specific mortality in participants with CKD according to periodontitis. The associations of the quartiles of mean clinical attachment loss (CAL) and mean periodontal probing depth (PPD) levels with mortality were examined using the first quartile as the reference group. ResultsDuring a median of 8.67 years of follow-up, 2,146 deaths were documented. After multivariate adjustments, moderate/severe periodontitis was significantly associated with all-cause (HR:1.28; 95 % CI:1.11–1.47; P = 0.001) and cardiovascular disease (CVD)-related mortality (HR:1.44; 95 % CI:1.14–1.81; P = 0.002) in participants with CKD. Compared with the reference group of mean CAL and mean PPD levels, all-cause (CAL: HR, 1.58; 95 % CI, 1.32–1.89, P <0.001; PPD: HR, 1.35, 95 % CI, 1.09–1.67, P = 0.011) and CVD-related mortality (CAL: HR, 1.70, 95 % CI, 1.21–2.40, P = 0.001) were increased for participants in the highest quartile. ConclusionsThis study suggests that moderate/severe periodontitis and high levels of mean CAL and mean PPD are associated with an increased risk of all-cause mortality, and moderate/severe periodontitis and mean CAL associated with CVD-related mortality among adults with CKD in the US. Clinical SignificanceThis study details the association between periodontitis and the increased risk of all-cause mortality and CVD-related mortality in a large, representative sample of adults with CKD.

Association of anxiety, age and oral health-related quality of life with periodontitis: A case-control study.

This case-control study evaluated the association of sociodemographic profile, mental health disorders and oral health-related quality of life (OHRQoL) with periodontitis. Patients with periodontitis (PP, n = 50) and control patients (CP, n = 50) were allocated into 2 groups after a complete periodontal examination. Data collection included age, sex, marital status, education and application of 2 questionnaires: Hospital Anxiety and Depression Scale for the diagnosis of anxiety/depression and Impact Profile on Oral Health (OHIP-14) for classification of well-being. An adjusted multiple binary logistic regression analysis was performed to assess the effect of all studied covariates on periodontitis. The results show that mean clinical attachment loss and periodontal probing depth were 5.92 (SD = 0.42) and 5.46 (SD = 0.78) in PP and 0.00 (SD = 0.00) and 2.85 (SD = 0.23) in CP, respectively (p < 0.001). The regression analysis demonstrated a significant effect on periodontitis for age (OR = 1.13; p < 0.0001; 95% CI: 1.07-1.20), with the PP having more people aged 50 years or older than CP, anxiety (OR = 1.25; p = 0.020; 95% CI: 1.04-1.50) and OHIP-14 (OR = 1.17; p < 0.0001; 95% CI: 1.08-1.226). The findings showed a positive association between anxiety, OHRQoL and age with periodontitis.

Periodontitis Burden in Diffuse Versus Limited Systemic Sclerosis Subtypes: A Pilot Study.

This study aimed to evaluate the periodontal status of a group of Romanian systemic sclerosis (SSc) patients and to investigate the relationships between periodontitis and SSc subtypes. This observational study included patients diagnosed with limited SSc (lcSSc) and diffuse SSc (dcSSc). Demographic data were collected from medical records. Each participant underwent a full-mouth periodontal examination including Bleeding on Probing (BoP) index, Oral Hygiene (OH) index, Probing Depth (PD), Gingival Recession (GR), and Clinical Attachment Loss (CAL). The periodontal status was defined according to presently recognised case definition system. The study included 30 patients with lcSSc and 30 patients with dcSSc with a mean age of 52.45±11.75 years. The overall periodontitis frequence in our SSc group was 95%. The frequency of stage III/IV periodontitis was higher in the dcSSc group (90%) than in the lcSSc group (60%). Within the group of SSc patients, significant positive correlations were observed between age, BoP index, OH index, the number of missing teeth, mean PD, mean CAL on one side and periodontitis diagnosis on the other side (r=0.588, p=0.001; r=0.399, p=0.002; r=0.388, p=0.002; r=0.574, p=0.001; r=0.444, p=0.001; r=0.571, p=0.001). A significant positive correlation existed between the diagnostic of periodontitis and SSc subtypes (r=0.327, p <0.001). Periodontitis was highly prevalent in both lcSSc and dcSSc groups. More stage III/IV periodontitis cases were detected dcSSc group of patients.

The elevation of fibroblast growth factor 21 is associated with generalized periodontitis in patients with treated metabolic syndrome

BackgroundFibroblast growth factor 21 (FGF21) is closely associated with metabolic syndrome (MetS). An alteration of FGF21 is possibly affected by periodontitis. The present study aimed to investigate the levels of serum FGF21 in MetS patients with generalized periodontitis and its association with periodontal and metabolic parameters.MethodsOne hundred forty-six MetS patients were recruited from the CORE (Cohort Of patients at a high Risk for Cardiovascular Events) Thailand registry. All participants received general data interviewing, periodontal examination and blood collection for measurement of FGF21 levels and biochemistry parameters. Periodontitis was defined according to the new classification and divided into two groups of localized periodontitis and generalized periodontitis.ResultsFGF21 was significantly higher in generalized periodontitis group when compared with localized periodontitis group (p < 0.05). The significant correlation was observed between FGF21 and variables including number of remaining teeth, mean clinical attachment loss, hypertriglyceridemia and low high-density lipoprotein cholesterol. The elevation of serum FGF21 was associated with presence of generalized periodontitis after adjusting of covariate factors (OR = 27.12, p = 0.012).ConclusionsThe elevation of serum FGF21 might be a potential biomarker for MetS patients who have risk of generalized periodontitis.

Comparison of serum levels of vitamin D in periodontitis patients with and without type 2 diabetes and healthy subjects.

The purpose of this study is to find out the levels of serum vitamin D in periodontitis patients with and without type 2 diabetes and to compare them with healthy subjects. In this study, 48 periodontitis patients with type 2 diabetes mellitus (PDM), 53 periodontitis patients (P), and 42 controls who were in the age ranges of 30-50 years and had the entry requirements were selected. Plaque index, calculus index, modified gingival index, pocket depth, clinical attachment loss (CAL), and tooth loss were measured. Serum 25(OH)D level was estimated by electrochemiluminescence immunoassay, and fasting blood sugar and glycosylated hemoglobin were estimated by biochemical colorimetric assays. The mean serum 25(OH)D level was 17.06 ± 10.73, 15.12 ± 7.74, and 14.17 ± 11.04 ηg/ml for PDM, P, and control groups, respectively, showing no statisticaldifference. The mean CAL was significantly high in diabetic patients as compared to other groups. Prediabetes prevalence was significantly high in periodontitis patients as compared to controls. The prevalence of vitamin D insufficiency was high in the population studied. Serum levels of 25(OH)D showed no significant difference between groups. Periodontitis patients showed an elevated risk for diabetes.

Clinical attachment loss in the use of adjunctive antimicrobial photodynamic therapy in Stages II-IV Grade C molar-incisor periodontitis: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.

Association between levels of blood trace minerals and periodontitis among United States adults.

AimEvidence linking trace minerals and periodontitis is limited. To investigate the relationship between trace minerals (selenium, manganese, lead, cadmium, and mercury) and periodontitis, data from the National Health and Nutrition Examination Survey (NHANES) were analyzed after accounting for potential confounding factors. No known studies have explored the relationship between these five trace minerals and periodontitis.Materials and methodsA total of 4,964 participants who had undergone a full-mouth periodontal examination and laboratory tests for five trace minerals were studied in a cross-sectional study. Clinical attachment loss (CAL) and periodontitis grading were used to measure periodontitis severity. Linear and logistic regression models were used to evaluate the association between trace minerals and periodontitis. Further subgroup analyses were performed.ResultsBlood lead and cadmium levels were positively associated with mean CAL, and blood selenium was negatively associated with mean CAL; however, blood mercury, blood manganese, and mean CAL were not significantly associated. The association between trace minerals and mean CAL was more significant in males, the elderly, and patients with diabetes. There was a threshold effect between blood cadmium levels and mean CAL. Among the Black population, the relationship between blood cadmium levels and mean CAL followed an inverted U-shaped curve. There was a saturation effect in the study of blood lead in people aged 45–59 years old.ConclusionOur study highlighted that blood selenium, lead, and cadmium levels were significantly associated with periodontitis in a nationally representative sample of United States adults.

An Insight into the Role of Periodontitis as a Potential Risk Factor for Development of Erectile Dysfunction

Erectile dysfunction (ED) is one of the common sexual disorders affecting many men worldwide. Owing to shared common risk factors, periodontitis is related to ED. However, the prevalence of periodontitis among Malaysian patients with ED is currently unknown. This study aimed to investigate the prevalence of periodontitis in patients with ED in Malaysia and the factors associated with this relationship. Forty-one subjects aged 27–59 years old were recruited to participate in this study. The International Index of Erectile Function (IIEF-5) was used in assessing the presence of ED. Their periodontal health was assessed through comprehensive periodontal examination including plaque index, bleeding on probing and clinical attachment level. The subjects were categorised according to the severity of their periodontal health and ED. A questionnaire on general health and oral habits was administered. The prevalence of periodontitis (95.5%) among subjects with ED was significantly higher than those without ED (52.6%). Subjects with ED had the worst periodontal health, as indicated by the mean clinical attachment loss and percentage of sites with bleeding on probing. No differences in oral hygiene habits were found between subjects with and without ED. The prevalence of periodontal disease among Malaysian patients with ED was high. Periodontitis was positively associated with the severity of ED, supporting a dose-dependent association between the two diseases. Oral hygiene habits were not significantly related to any periodontitis parameters nor were significantly different between subjects with and without ED.

Chloro-aluminum phthalocyanine-mediated photodynamic therapy in the treatment of stage-II chronic periodontitis among smokers.

To assess the clinical periodontal, bacterial, and immunological outcomes of chloro-aluminum phthalocyanine-mediated photodynamic therapy (PDT) as an adjunct to dental scaling (DS) versus DS alone among cigarette smokers (CS) and never-smokers (NS). A total of 26 patients (13 CS and 13 NS) with clinical and radiographic diagnosis of stage-II chronic periodontitis were recruited. Each patient from both groups were subjected with two parallel therapies (split-mouth): PDT + DS (test side) and DS alone (control side). Periodontal parameters were investigated by evaluating plaque scores (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL). Subgingival plaque was collected to detect and quantify Porphyromonas gingivalis and Tannerella forsythia using real-time quantitative polymerase chain reaction (RT-qPCR) assay. Gingival crevicular fluid was sampled for the quantification of interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α) using enzyme linked immunosorbent assay. All assessments were performed at baseline, 3 months, and 6 months. Bleeding on probing was significantly reduced at 6 months after PDT + DS in CS groups (p < .05). Mean PD and CAL significantly reduced after both PDT + DS and DS subgroups and among NS and CS groups (p < .05). At 6 months follow-up, the copy number of both P.gingivalis and T.forsythia remained significantly high in CS group (p < .01). Only PDT + DS subgroup in CS significantly reduced the counts of P. gingivalis and T. forsythia at 3 months and 6 months (p < .05). Only at 6 months did PDT + DS showed statistically significantly reduced IL-1β levels in the NS group (p < .01). TNF-α levels significantly reduced in CS group with PDT + DS and DS alone at both 3 months and 6 months follow-up (p < .01). Chloro-aluminum phthalocyanine-mediated PDT helped to improve the non-surgical periodontal therapy outcomes among stage-II chronic periodontitis patients among smokers and never-smokers.

Prevalence and risk indicators for severe periodontitis in Côte d'Ivoire.

Background The present study evaluated the prevalence of severe periodontitis (SP) and determined the possible relevant risk factors among patients referred to the Periodontology Department at the Dental Care Center of the Odontostomatology Training and Research Unit of Abidjan, in Côte d’Ivoire. Methods This retrospective observational study was based on 1087 patients data aged 18‒80 years, who were treated in the periodontology department from December 2008 to December 2018. Severe periodontitis (stages III or IV) was defined as interdental clinical attachment loss (CAL)>5 mm at two non-adjacent teeth. Two groups were considered: patients with severe periodontitis (test) or without severe periodontitis (control). Differences between the two groups were tested using the chi-squared test and ANOVA. Furthermore, logistic regression analysis was used to model the relationship between the severity of periodontitis and covariables as potential risk indicators. Results 43.4% of patients had severe periodontitis with a mean CAL of 6.89 mm. SP was associated with age (P=0.004), socioeconomic status (P=0.005), smoking habits (P=0.000), brushing frequency (P=0.000), the number of mobile teeth (P<0.001), and the number of lost teeth (P<0.001). Logistic regression analysis showed that having at least five mobile teeth (OR= 4.11, 95% CI: 2.95‒5.73) and/or five missing teeth (OR=2.60, 95% CI: 1.85‒3.66) were independent risk indicators for severe periodontal disease. Conclusion This Ivorian sample presented a high prevalence of severe periodontal diseases. Therefore, proper public health measures would allow early detection, with targeted and effective treatment of the Ivorian population.

Association between bone turnover markers and periodontitis: A population-based cross-sectional study.

To examine the associations between bone turnover markers and periodontitis in two cross-sectional population-based studies. We used data from two independent adult samples (N= 4993), collected within the Study of Health in Pomerania project, to analyse cross-sectional associations of N-procollagen type 1 amino-terminal propeptide (P1NP), C-terminal cross-linking telopeptide, osteocalcin, bone-specific alkaline phosphatase (BAP), fibroblast growth factor 23, wingless-type mouse mammary tumour virus integration site family member 5a (WNT5A), and sclerostin values with periodontitis. Confounder-adjusted gamma and fractional response regression models were applied. Positive associations were found for P1NP with mean pocket probing depth (PPD; ; 95% confidence interval [CI]: 1.001-1.015), mean clinical attachment loss (mean CAL; ; 95% CI: 1.011-1.044), and proportion of sites with bleeding on probing (%BOP; ; 95% CI: 1.005-1.109). Similar associations were seen for BAP with %BOP ( ; 95% CI: 1.042-1.205), proportion of sites with PPD ≥4 mm (%PPD4) ( ; 95% CI: 1.005-1.161), and sclerostin with %BOP ( ; 95% CI: 1.005-1.704). WNT5A was inversely associated with mean PPD ( ; 95% CI: 0.920-0.993) and %PPD4 ( ; 95% CI: 0.642-0.982). This study revealed scattered associations of P1NP, BAP, WNT5A, and sclerostin with periodontitis, but the results are contradictory in the overall context. Associations reported in previous studies could not be confirmed.

Lipid Profile and the Severity of Periodontitis among Tertiary Hospital Patients in a Semi-Urban Population in Southwestern Nigeria

The prevalence of hyperlipidemia among Nigerians is established, while the relationship between it and periodontitis has been studied globally. This study aimed to investigate the relationship between lipid profile and severity of periodontitis among Nigerians. 195 patients were drawn from the family medicine clinic of the Obafemi Awolowo University Teaching Hospital Ile-Ife Osun state Nigeria. Sociodemographic data was obtained using a closed-ended questionnaire, simplified oral hygiene index (OHI), periodontal disease index (PDI), clinical attachment loss (CAL), and periodontal pocket depth (PPD) were also estimated. A full mouth mean CAL ≥0.6mm was considered as periodontitis. Lipid profile was carried out at the chemical pathology department of the same institution by spectrophotometry. Appropriate parameters were determined for descriptive variables. A two-way t-test was done for the mean values of the intraoral and the lipid parameters. Data was exposed to logistic regression to eliminate confounders. Male to female ratio was 1:1.6 with a mean age of 37.42±12.95. High-density lipoproteins (HDL) and triglycerides have a statistically significant relationship with CAL and PPD (p&lt;0.05). Logistic regression showed statistical significance for total cholesterol (p&lt;0.05) in females only. Following the trend with other associated chronic diseases, HDL was higher in the periodontally healthy subjects and those with mild chronic periodontitis, while it was lower in those with moderate and severe chronic periodontitis. This relationship was inverse for low-density lipoproteins (LDL). Increase in LDL/HDL had a linear relationship with the severity of chronic periodontitis from mild to severe. This emphasises the need for oral health education in the community and regular lipid investigations.