Periodontal Disease Status Research Articles

Effectiveness of oral health interventions for schoolchildren from disadvantaged backgrounds: a systematic review protocol.

Disadvantaged schoolchildren from rural and low socioeconomic backgrounds face persistent oral health inequalities, specifically dental caries, and periodontal diseases. This protocol aims to review the effectiveness of promotive and preventive oral health interventions for improving the oral health of primary schoolchildren in these areas. We will search the PubMed, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Web of Science, Dentistry and Oral Sciences databases for studies published from 2000-2023. The review includes randomised/nonrandomised controlled trials and community trials evaluating the effectiveness of promotive and preventive oral health interventions on at least one of these outcomes: changes in dental caries status, periodontal disease status, oral hygiene status/practices, sugar consumption, or smoking behaviours. Two reviewers will independently assess the searched articles, extract the data, and assess the risk of bias in the studies using the Cochrane Risk of Bias 2 (ROB 2) for randomised controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomised controlled trials. Both narrative and quantitative analyses will be conducted. However, only narrative synthesis will be performed if the data are substantially heterogeneous. The synthesised evidence from this review can inform policymakers on evidence-based interventions to improve the oral health outcomes of schoolchildren from rural and low socioeconomic backgrounds. Systematic Review Registration PROSPERO (Registration number: CRD42022344898).

The Prevalence of Systemic Diseases and Its Association with Periodontal Disease among Patients Referred to a Government Periodontal Specialist Clinic in Melaka, Malaysia

Abstract Aim: The aim of the study was to identify the prevalence of systemic diseases among patients referred to a newly established government periodontal specialist clinic and to analyze the association between the severity (staging) and the rate of progression (grading) of periodontitis with the presence of these systemic diseases. Materials and Methods: Records of all new patients within the first 5 years of the clinic’s operation were reviewed, and their periodontitis status was classified according to the 2017 World Workshop Classification system. The association between the severity of periodontitis and the presence of systemic diseases was analyzed using the Chi-square test, whereas Fisher’s exact test was used to determine the association between the rate of progression and the presence of systemic diseases. Results: A total of 489 dental records were reviewed. We found that 40.1% of our patients suffered from systemic diseases. The two most common systemic diseases were cardiovascular disease (CVD) (11.4%) and diabetes mellitus (9.4%). No significant association was found between the severity of periodontitis and the presence of systemic diseases (P = 0.376). However, we found a significant association between the rate of progression of periodontitis and systemic diseases (P = 0.004). There was also a significant association between the rate of progression of periodontitis and CVDs (P = 0.001). Conclusion: The rate of progression of periodontitis is significantly associated with the presence of systemic diseases and CVDs. This highlights that periodontitis is not a stand-alone disease. Instead, it reaches across a spectrum of other noncommunicable diseases. The collaboration between medical and dental practitioners can further improve the management of this group of patients.

Relationship between aging and periodontal disease severity in gauge-raised cynomolgus monkeys (Macaca fascicularis).

The study aimed to evaluate the periodontal disease status in different age groups and clarify the relationship between aging and the severity of periodontal disease. The test animals were cynomolgus monkeys that were born and raised at Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition. The participants were divided into three groups: young (5-10 years old), middle (10-19 years old), and old (≥20 years old). The Plaque Index (PLI), Gingival Index (GI), Probing pocket depth (PPD), and Bleeding on probing (BOP) were used for the periodontal examination. Representative teeth were also examined. Polymerase chain reaction (PCR) was used to identify Porphyromonas macacae in dental plaque. Multiple comparisons and regression analyses were used to analyze the relationship between each age group and each oral examination index. Statistically significant differences were found between the age groups and periodontal examination index. Multiple regression analysis revealed that age was strongly correlated with each oral examination index. Based on these results, oral examinations of cynomolgus monkeys kept in the same environment confirmed an association between aging and periodontal disease severity. Monkeys at this facility are expected to serve as new experimental models for elucidating the mechanisms underlying the progression of age-related periodontal disease.

Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009–2014

This study examined the relationship between uncontrolled diabetes and periodontal disease (PD) among adults in the United States. We used data from the 2009–2014 National Health and Nutrition Examination Survey (NHANES) with a sample of 6108 adults ages 30 and over. To measure PD status, we used the Centers for Disease Control and Prevention/American Academy of Periodontology’s standards. To classify DM status (no DM, DM with HbA1c < 9%, diabetes with HbA1c ≥ 9%),we used self-reported Diabetes Mellitus (DM) diagnosis and laboratory report of HbA1c. Approximately 8.5% of the sample had controlled DM, and 1.7% had uncontrolled DM, for a total of 10.2% DM in the analysis. Multivariate logistic regression showed that compared to those without DM, PD was significantly increased with controlled DM (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) 1.01–1.73, p < 0.05) and even more with uncontrolled DM (aOR = 2.48, 95% CI 1.52–4.04, p < 0.001), after adjusting for covariates. Factors that reduced the prevalence of PD included annual dental visits, female gender, and college education. Factors that significantly increased PD prevalence were cigarette smoking, non-white race, income < 200% Federal Poverty Level, and older age (age > 50 years). In conclusion, uncontrolled DM was significantly associated with higher odds of PD among adults in the US.

Suitability of machine learning models for prediction of clinically defined Stage III/IV periodontitis from questionnaires and demographic data in Danish cohorts.

To evaluate if, and to what extent, machine learning models can capture clinically defined Stage III/IV periodontitis from self-report questionnaires and demographic data. Self-reported measures of periodontitis, demographic data and clinically established Stage III/IV periodontitis status were extracted from two Danish population-based cohorts (The Copenhagen Aging and Midlife Biobank [CAMB] and The Danish Health Examination Survey [DANHES]) and used to develop cross-validated machine learning models for the prediction of clinically established Stage III/IV periodontitis. Models were trained using 10-fold cross-validations repeated three times on the CAMB dataset (n = 1476), and the resulting models were validated in the DANHES dataset (n = 3585). The prevalence of Stage III/IV periodontitis was 23.2% (n = 342) in the CAMB dataset and 9.3% (n = 335) in the DANHES dataset. For the prediction of clinically established Stage III/IV periodontitis in the CAMB cohort, models reached area under the receiver operating characteristics (AUROCs) of 0.67-0.69, sensitivities of 0.58-0.64 and specificities of 0.71-0.80. In the DANHES cohort, models derived from the CAMB cohort achieved AUROCs of 0.64-0.70, sensitivities of 0.44-0.63 and specificities of 0.75-0.84. Applying cross-validated machine learning algorithms to demographic data and self-reported measures of periodontitis resulted in models with modest capabilities for the prediction of Stage III/IV periodontitis in two Danish cohorts.

Association between the presence and genotype of Helicobacterpylori and periodontitis.

Whether Helicobacter pylori (H. pylori) infection is associated with periodontitis has been contested for decades. The relationship between H. pylori genotypes and periodontitis has not been clarified either. The present study provides a novel perspective to better understand the role of H. pylori in the pathogenesis of periodontitis. A total of 53 volunteers were recruited and divided into 3 groups in this cross-sectional study, namely the periodontally healthy group (15 participants), the stage I/II periodontitis group (20 participants) and the stage III/IV periodontitis group (18 participants). DNA from the subgingival plaque of all participants was extracted and PCR was performed using specific primers for the urease C gene and cytotoxin-associated gene A (cagA)/vacuolating cytotoxin gene A (vacA) to detect the presence and genotype of H. pylori. A χ2 test and one-way ANOVA were performed on the data. There was no significant difference in sex, age or body mass index between the groups. The detection rate of H. pylori was 39.62% in the total population and increased with the deepening of probing depth and clinical attachment loss. There were significant differences in the detection rate of H. pylori among the three groups, with 13.33, 40.00 and 61.11% in the periodontally healthy, stage I/II periodontitis and stage III/IV periodontitis groups, respectively (χ2=8.760, P<0.001). The cagA-/vacAs2m2 genotype was most commonly detected in the periodontally healthy group (100%). In the periodontitis group, cagA+/vacAs1m2 was the most commonly detected genotype in the stage I/II periodontitis group (37.5%) and cagA+/vacAs1m1 in the stage III/IV periodontitis group (36.3%). The results of the present study suggest that the detection rates and genotypes of H. pylori in the subgingival plaque are associated with the status of periodontitis. cagA+/vacAs1m1 and cagA+/vacAs1m2 may be considered virulence markers of periodontitis. However, given the small sample size and lack of correlation analysis of the study, further larger scale and high-quality clinical trials are required to confirm these findings.

Research on the Association Between Periodontitis and COPD.

Periodontitis is a common chronic bacteria-initiated inflammatory disease that is closely associated with various systemic diseases, including chronic obstructive pulmonary disease (COPD). Periodontitis and COPD share similar risk factors, pathology and microorganisms. Epidemiological and clinical research have shown positive correlation between the two diseases. Individuals with severe periodontitis had a higher risk of developing COPD. Moreover, the relative risk of COPD in severe periodontitis was much higher compared to people without periodontal disease and patients with mild to moderate periodontitis. COPD patients with periodontitis had a higher frequency of COPD exacerbation and periodontal treatment demonstrated some control of COPD. However, the nature of periodontitis affecting COPD still needs further exploration. Periodontitis caused microbial and immune imbalances of the lung through several aspects: (I) under periodontitis status, periodontal pathogens directly caused the lung inflammatory reaction after inhalation and colonization on the lung, (II) periodontitis status promoted the oral colonization of pneumonia-associated pathogens, (III) periodontitis status affected the respiratory epithelium structure and (IV) periodontitis status caused imbalances in neutrophils, macrophages and inflammatory cytokines. In this review, we conclude the association between periodontitis and COPD through several aspects and further discuss the potential mechanism by which periodontitis affects COPD.

Current status and factors of periodontal disease among Japanese high school students: a cross-sectional study

IntroductionThis study aimed to investigate the prevalence of periodontal disease and the factors of the disease among high school students.MethodThe participants were all students aged 15–18 years (n = 1202) at a high school in Japan. The data on oral health perceptions and behaviours were collected by a questionnaire survey. The prevalence of periodontal disease among them was investigated with the partial community periodontal index (PCPI). A logistic regression analysis was used to identify the factors associated with the PCPI.ResultsA total of 1069 students (88.9%) participated in this study. The prevalence of gingival bleeding, calculus, pocket depth of 4–5 mm, and pocket depth of 6 mm or more were 44.2%, 42.2%, 11.4%, and 1.6%, respectively. Approximately one-third of the students had a fear of dental treatment, and only 28.4% used dental floss. The results of logistic regression analysis, adjusted for sex and school year, showed that not visiting dentists regularly, not using dental floss, brushing teeth for less than 5 min, fear of dental treatment, and drinking sports drinks frequently were positively associated with periodontal conditions.ConclusionThis study identified a high prevalence of periodontal disease among Japanese high school students aged 15–18 years and its risk factors, such as poor oral health behaviours and fear of dental treatment.

Association between periodontal disease status and risk of atrial fibrillation: a nationwide population-based cohort study

BackgroundPeriodontal disease can activate an immune process linked to systemic diseases, including atrial fibrillation. However, the relationship between periodontal disease and atrial fibrillation remains unclear.AimThis study aimed to investigate whether changes in periodontal disease status are associated with the risk of atrial fibrillation.MethodsUsing the National Health Insurance Database Korea, participants who underwent the first oral health examination in 2003 and a second examination in 2005–2006 without a history of atrial fibrillation were included. Participants were grouped according to changes in periodontal disease status during two oral examinations: periodontal disease-free, periodontal disease-recovered, periodontal disease-developed, and periodontal disease-chronic. The outcome was the incidence of atrial fibrillation.ResultsThe study included 1,254,515 participants, with a median follow-up of 14.3 years and 25,402 (2.02%) cases of atrial fibrillation occurred. During follow-up, the risk of atrial fibrillation was highest in the periodontal disease-chronic group, followed by the periodontal disease-developed, periodontal disease-recovered, and periodontal disease-free groups (p for trend < 0.001). Moreover, recovery from periodontal disease was associated with a reduced risk of atrial fibrillation compared to a chronic periodontal disease status (Hazard ratio: 0.97, 95% Confidence interval: 0.94—0.99, p = 0.045). The development of periodontal disease was associated with an increased risk of atrial fibrillation compared to being periodontal disease-free (Hazard ratio: 1.04, 95% Confidence interval: 1.01—1.08, p = 0.035).ConclusionOur findings suggest that changes in periodontal disease status impact the risk of atrial fibrillation. Management of periodontal disease may help prevent atrial fibrillation.

1337-P: Association of Uncontrolled Diabetes with Periodontal Disease in U.S. Adults

Objectives: The purpose of this study was to analyze the relationship between uncontrolled diabetes with periodontal disease (PD) among adults in the US. Methods: The study sample from the 2009-2014 National Health and Nutrition Examination Survey data included 10,071 US participants aged ≥ 30 years in a probability weighted sample. We used the Centers for Disease Control and Prevention/American Academy of Periodontology’s standard to measure PD status by using means of a full-month oral examination at 6 sites per tooth for periodontal probing depth and clinical attachment loss. We used self-reported response to the diabetes questionnaire and laboratory report of HbA1c to assess the participant’s diabetes status (no diabetes, diabetes with HbA1c &amp;lt; 9%, diabetes with HbA1c ≥ 9%). Multiple logistic regression analysis was performed to examine the relationship between diabetes status with PD. Results: Multiple logistic regression showed that PD was significantly associated with controlled diabetes (adjusted odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.01 - 1.73, p &amp;lt;0.05) and uncontrolled diabetes (OR = 2.48, 95% CI: 1.52 - 4.04, p &amp;lt;0.001) after adjusting for covariates. PD’s protective factors of PD included annual dental visit, female gender, and college education. PD’s risk factors were smoking status, racial minorities, income &amp;lt;200% Federal Poverty Guidelines, and older age. Conclusions: Uncontrolled diabetes was significantly associated with a higher risk of periodontal disease among adults in the US. Physicians should work with dentists to strongly recommend patients with diabetes to check their glycemic level and have an annual dental visit. Disclosure G.Vu: None. B.B.Little: None. C.King: None. V.P.Gurupur: None. S.Shakib: None.

Prevalence of periodontal disease in preschool-age children in Hue city

Background: Determining the status of periodontal disease will help us have an appropriate prevention strategy from an early age. The objective of the study was to investigate the status of periodontal disease in preschool children in Hue city in 2020. Subjects and methods: A cross-sectional descriptive study of 464 children in some kindergartens of Hue city. Clinical examination of gingivitis and dental plaque for all study subjects. Results: The rate of gingivitis is 54.3%, plaque is 55.2%. The percentage of children with gingivitis and dental plaque in the center of Hue city was significantly higher than in the suburbs of Hue city, this difference was statistically significant (p &lt; 0.01, p &lt; 0.001). The rate of gingivitis increased with age (p &lt; 0.05). Conclusion: The prevalence of periodontal disease in preschool children in Hue city is still quite high. Therefore, it is necessary to have comprehensive disease prevention programs in order to improve oral health and take care of reasonable nutrition for preschool children. Key words: Gingivitis, dental plaque, preschool-age children.

Periodontal Disease in Young Adults as a Risk Factor for Subclinical Atherosclerosis: A Clinical, Biochemical and Immunological Study.

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.

Candidate loci shared among periodontal disease, diabetes and bone density.

While periodontal disease (PD) has been associated with type 2 diabetes (T2D) and osteoporosis, the underlying genetic mechanisms for these associations remain largely unknown. The aim of this study is to apply cross-trait genetic analyses to investigate the potentially shared biology among PD, T2D, and bone mineral density (BMD) by assessing pairwise genetic correlations and searching for shared polymorphisms. We applied cross-trait genetic analyses leveraging genome-wide association study (GWAS) summary statistics for: Periodontitis/loose teeth from the UKBB/GLIDE consortium (PerioLT, N=506594), T2D from the DIAGRAM consortium (Neff=228825), and BMD from the GEFOS consortium (N=426824). Among all three, pair-wise genetic correlations were estimated with linkage disequilibrium (LD) score regression. Multi-trait meta-analysis of GWAS (MTAG) and colocalization analyses were performed to discover shared genome-wide significant variants (pMTAG <5x10-8). For replication, we conducted independent genetic analyses in the Women's Genome Health Study (WGHS), a prospective cohort study of middle-aged women of whom 14711 provided self-reported periodontal disease diagnosis, oral health measures, and periodontal risk factor data including incident T2D. Significant genetic correlations were identified between PerioLT/T2D (Rg=0.23; SE=0.04; p=7.4e-09) and T2D/BMD (Rg=0.09; SE=0.02; p=9.8e-06). Twenty-one independent pleiotropic variants were identified via MTAG (pMTAG<5x10-8 across all traits). Of these variants, genetic signals for PerioLT and T2D colocalized at one candidate variant (rs17522122; ProbH4 = 0.58), a 3'UTR variant of AKAP6. Colocalization between T2D/BMD and the original PerioLT GWAS p-values suggested 14 additional loci. In the independent WGHS sample, which includes responses to a validated oral health questionnaire for PD surveillance, the primary shared candidate (rs17522122) was associated with less frequent dental flossing [OR(95%CI)= 0.92 (0.87-0.98), p=0.007], a response that is correlated with worse PD status. Moreover, 4 additional candidate variants were indirectly supported by associations with less frequent dental flossing [rs75933965, 1.17(1.04-1.31), p=0.008], less frequent dental visits [rs77464186, 0.82(0.75-0.91), p=0.0002], less frequent dental prophylaxis [rs67111375, 0.91(0.83-0.99), p=0.03; rs77464186, 0.80(0.72-0.89), p=3.8e-05], or having bone loss around teeth [rs8047395, 1.09(1.03-1.15), p=0.005]. This integrative approach identified one colocalized locus and 14 additional candidate loci that are shared between T2D and PD/oral health by comparing effects across PD, T2D and BMD. Future research is needed to independently validate our findings.

HUBUNGAN KEBIASAAN MEROKOK DAN MENGUNYAH SATU SISI TERHADAP TINGKAT KEPARAHAN PERIODONTITIS

Introduction : Periodontitis is an inflammatory condition of the supporting tissues of the teeth caused by one or a group of specific microorganisms that cause progressive periodontal destruction characterized by an increase in probing depth, recession, or both. One of the risk factors for periodontal disease is habitual factors, such as smoking and unilateral chewing. The purpose of this study was to examine the relationship between smoking and unilateral chewing on the severity of periodontitis. Methods : This study was cross-sectional with a retrospective analytical design. The sample used is 67 people. Data was obtained from periodontitis status in 2017-2019 at the Periodontics Clinic of the USU Dental Hospital. Data were analyzed using the Chi-square test with a 95% confidence interval and a 5% significance level (p&lt;0.05). The severity of periodontitis was assessed based on a staging system published by the Academy of Periodontology (AAP) in 2017. Results : The results showed a significant relationship between smoking habits and the severity of periodontitis (p=0.012), as well as a significant relationship between unilateral chewing habits and the severity of periodontitis (p=0.019). Conclusion : The result of this study concluded that is a significant relationship between smoking and unilateral chewing habits on the severity of periodontitis.

The influence of periodontitis case definition on the association between periodontal disease and glycaemic status.

The association between periodontitis and glycaemic control is complex, and often described as 'bidirectional'. Although epidemiological studies have examined this relationship extensively, a disagreement on periodontitis case definition still exists. This study aimed to assess the influence of case definition on the association between periodontal disease and glycaemic status. The study is a secondary analysis of data from the United States National Health and Nutrition Examination Survey (NHANES), 2009-2014 cycles. The association between periodontitis and glycated haemoglobin (HbA1c) was assessed using different periodontitis case definitions: the definition by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP), Community Periodontal Index (CPI), ≥1 site with ≥3 mm clinical attachment loss (CAL) and ≥4 mm probing depth (PD), ≥1 site with ≥4 mm CAL and ≥4 mm PD, the 5th European Workshop definitions, Machtei et al. 'established periodontitis', the 2017 World Workshop classification, and self-reported periodontitis. The associations between periodontitis and HbA1c were compared across the case definitions. There was substantial variability in prevalence estimates of periodontitis, and in the strength of association between periodontitis and HbA1c when different case definitions were applied. The CDC/AAP and stage III/IV periodontitis were consistently significantly associated with elevated HbA1c. For stage III/IV, the adjusted odds ratios of prediabetes and diabetes HbA1c were 1.19 and 1.76, respectively. Comprehensive periodontitis case definitions that account for CAL and PD, such as the CDC/AAP and the 2017 classification, seem to better detect the association between periodontal disease and HbA1c.

Association of periodontal disease and diabetic retinopathy

The main problem of type II diabetes is that excessive levels of glucose in the blood damage the vascular endothelium causing complications, such as periodontal disease (PD) that, in people with diabetes, can compromise the patient's ability to maintain normal function. adequate metabolic control. Therefore, it is important to analyse the effect of PD status on complications in patients with type II diabetes; Previous studies have reported that there is a bidirectional relationship between PD and diabetic complications, but it has not been clarified whether PD affects the presence of complications such as diabetic retinopathy (DR). DR is a microvascular complication and is considered the main cause of visual loss worldwide, similarly, periodontitis is a microvascular chronic inflammatory condition that compromises the dental support tissues. This article was prepared as an update for health professionals and also to analyse PE and how it is related to the presence of DR. Based on the literature, we can conclude that the number of teeth is an independent risk factor for DR, greater bleeding on probing could affect the presence of DR, and that patients with DR seem to show greater susceptibility to PD. The bibliography also mentions that more studies should be carried out with large samples, adequate models that adjust confounding variables such as obesity, hypertension, other chronic-degenerative diseases, use of substances such as alcohol or cigarettes, also carrying out prospective analyses of the conditions of periodontitis and DR.

Periodontal disease severity is associated to pathogenic consortia comprising putative and candidate periodontal pathogens

Based on a holistic concept of polymicrobial etiology, we have hypothesized that putative and candidate periodontal pathogens are more frequently detected in consortia than alone in advanced forms of periodontal diseases (PD). To correlate specific consortia of periodontal pathogens with clinical periodontal status and severity of periodontitis. Subgingival biofilm was obtained from individuals with periodontal health (113, PH), gingivitis (91, G), and periodontitis (209, P). Genomic DNA was purified and the species Aggregatibacter actinomycetemcomitans (Aa), Aa JP2-like strain, Porphyromonas gingivalis (Pg), Dialister pneumosintes (Dp), and Filifactor alocis (Fa) were detected by PCR. Configural frequency and logistic regression analyses were performed to correlate microbial consortia and PD. Aa + Pg in the presence of Dp (phi=0.240; χ2=11.9, p<0.01), as well as Aa JP2 + Dp + Fa (phi=0.186, χ2=4.6, p<0.05) were significantly more associated in advanced stages of P. The consortium Aa + Fa + Dp was strongly associated with deep pocketing and inflammation (p<0.001). The best predictors of disease severity (80% accuracy) included older age (OR 1.11 [95% CI 1.07 - 1.15], p<0.001), Black/African-American ancestry (OR 1.89 [95% CI 1.19 - 2.99], p=0.007), and high frequency of Aa + Pg + Dp (OR 3.04 [95% CI 1.49 - 6.22], p=0.002). Specific microbial consortia of putative and novel periodontal pathogens, associated with demographic parameters, correlate with severe periodontitis, supporting the multifactorial nature of PD.

Profiling of bile acids and activated receptor S1PR2 in gingival tissues of periodontitis patients.

Bile acids, as a group of cholesterol metabolites, play important roles in inflammation and bone metabolism. However, the possible link between bile acids and periodontitis is still unclear. This study aimed to clarify the alterations of the bile acid profile and corresponding receptor expression levels in periodontitis patients, and evaluate their association with periodontitis severity. The concentrations of 15 bile acids in gingival tissues from 16 periodontitis patients and 16 healthy individuals were tested by metabolomics. Sphingosine-1-phosphate receptor 2 (S1PR2) expression was determined by real-time PCR and immunohistochemistry, which was also validated in two datasets, GSE16134 and GSE10334. The correlation between bile acids, S1PR2, and clinical parameters was analyzed by Spearman's correlation analysis, and receiver-operator characteristic (ROC) curves were examined to access the ability of bile acids and S1PR2 for defining local periodontitis status. In the periodontitis group, concentrations of total bile acids were elevated by increases of all bile acid forms, and five conjugated bile acids were significantly increased. Meanwhile, the expression of their receptor, S1PR2, was also upregulated in the periodontitis group. Positive correlations were further observed between glycocholic acid (GCA), taurochenodeoxycholic acid (TCDCA), taurocholic acid (TCA), S1PR2, and periodontal clinical parameters. ROC analysis also showed combinations of two bile acids (GCA and TCDCA) with S1PR2 as novel signatures for indicating local periodontitis status. Our findings demonstrated the alterations of the bile acid profile and receptor S1PR2 expression in periodontitis patients, and provided evidence of association between bile acids and periodontitis status.

Analysis of subgingival micro-organisms based on multi-omics and Treg/Th17 balance in type 2 diabetes with/without periodontitis.

Type 2 diabetes mellitus (T2DM) and periodontitis are common and interrelated diseases, resulting in altered host response microbiota. The subgingival micro-organisms play a key role in periodontitis pathogenesis. To assess the shift of subgingival microbiome and metabolome in T2DM, we performed an analysis of the subgingival microbiome in patients with T2DM (n = 20) compared with non-diabetes (ND) subjects (n = 21). Furthermore, patients were subdivided into 10 T2DM with periodontitis (DP), 10 T2DM without periodontitis (DNP), 10 periodontitis (P), and 11 healthy control (H) groups. 16SrRNA gene sequencing combined with ultra high-performance liquid chromatography-mass spectrometry (UHPLC-MS) based metabolomics was performed in all participants. T lymphocyte immunity was analyzed by flow cytometry. Furthermore, the network relationship among subgingival micro-organisms, metabolites, blood glucose level, and T lymphocyte immunity were analyzed. The results showed that the difference of the subgingival microbiome from healthy to periodontitis status was less prominent in T2DM compared with ND, though the clinical signs of disease were similar. The bacteria Eubacterium nodatum group, Filifactor, Fretibacterium, Peptostreptococcus, and Desulfovibrio, amongst others, may be important in the pathopoiesia of periodontitis in the T2DM state. In addition, some dominant bacteria showed network relationships. The Treg/Th17 ratio was lower in the DP and DNP groups than in the P and H groups-though that of P was lower than for H. The percentage of CD4+/CD8+ PD1 and CD8+ PDL1 was higher in the DP and DNP groups than in the H group; the percentage of CD8+ PDL1 was higher in the DP than P groups. Subgingival micro-organisms in periodontitis had a significant metabolic shift in terms of their signature metabolites. Butyrate metabolism and phenylalanine metabolism may play a role in the pathogenesis of periodontitis with/without T2DM. Specifically, biphenyl degradation, tryptophan metabolism, and the two-component system may play important roles in periodontitis with T2DM. Lastly, the network relationship among subgingival micro-organisms, metabolites, blood glucose level, and T lymphocyte immunity were unbalanced. This study identified the changes in the subgingival microbiome associated with periodontitis in T2DM, as well as the associated network between bacterial flora, metabolism dysbiosis, and immune regulation.

Effects of Laser Therapy on Periodontal Status in Adult Patients Undergoing Orthodontic Treatment.

Orthodontic treatment with fixed devices should only be indicated in case of a stable, non-active periodontal disease status. Throughout orthodontic treatment, a careful assessment of the periodontal status is advised. Due to its anti-inflammatory and antimicrobial effects, laser therapy is frequently used as an adjunct to classic periodontal therapy. The aim of this study was to evaluate the advantages and limitations of the use of laser therapy on periodontal status during orthodontic treatment. Throughout the 9 months during which this placebo-controlled, single-blind clinical trial was conducted, 32 patients were included in the study, divided into two groups: microscope "+" (patients who observed the bacteria within the dental plaque-sample examination on the screen of a dark-field microscope in real time) and microscope "-" (patients who did not see the oral pathogens using a dark-field microscope). For all patients, using the split-mouth study design, laser therapy was applied to one hemiarch (HL), whereas the other hemiarch received treatment without active light (HC). After one month, by analyzing the main indicators of periodontal health status, we found that the plaque index (PI) and bleeding on probing (BOP) values were significantly decreased after receiving treatment (for PI: HL-p = 0.0005, HC-p = 0.0297; for BOP: HL-p = 0.0121, HC-p = 0.0236), whereas the probing-depth (PD) values remained almost the same as before treatment (HL-p = 1.5143; HC-p = 1.4762). Conclusions: The use of the dark-field microscope proved to be beneficial in sensitizing patients to the presence of bacteria in the oral cavity and motivated them to strictly follow the rules of oral hygiene. Laser treatment can be a valuable aid in periodontal therapy, but only in adjunction with mechanical therapy.