Cases Of Periodontitis Research Articles

Long-Term Oral Health Effects of Traumatic Events Among World Trade Center Health Registry Enrolees, 2003-2020.

Posttraumatic stress disorder (PTSD) is a disabling mental health condition arising from experiencing serious traumatic events. This study investigated if PTSD secondary to the World Trade Center terrorist attack on 11 September 2001 (9/11) is associated with self-reported doctor's diagnosis of periodontitis and count of missing teeth. Data from the World Trade Center Health Registry, 2003-2020 (n = 20 826) were used to prospectively examine the rate of periodontitis and cross-sectionally the odds of missing teeth among enrolees with/without PTSD post-9/11 using a modified Poisson regression and generalised logit model, respectively, adjusted for covariates. Approximately 17% reported a doctor's diagnosis of PTSD post-9/11 and 7.4% a doctor's diagnosis of periodontitis. There were 355 new cases of periodontitis (incidence rate = 7.6 per 1000 person-years) among those with PTSD and a rate of 4.3 per 1000 person-years among those without PTSD. The covariate-adjusted rate ratio for periodontitis comparing those with and without PTSD = 1.52 (95% CI: 1.33, 1.74). The adjusted odds ratio (OR) (95% CI) comparing those with and without PTSD were, respectively, OR = 1.15 (95% CI: 1.05, 1.25) and OR = 1.41 (95% CI: 1.09, 1.83) for missing 1-5 teeth and all teeth missing, respectively, as compared to no missing teeth. PTSD post-9/11 appears to be associated with poorer oral health outcomes, underscoring the far-reaching consequences of traumatic events on oral health.

Evaluating salivary MMP-8 as a biomarker for periodontal diseases: A systematic review and meta-analysis

ObjectivePeriodontitis is the irreversible destructive process of the periodontium and is the major cause of tooth loss in adults worldwide. Diagnosis of early-stage periodontal disease is crucial for improving outcomes, and to this end, the application of indicator biomarkers is gaining interest. One such method involves measuring the level of matrix metalloproteinase-8 (MMP-8). This systematic review and meta-analysis aims to evaluate the salivary MMP-8 level of periodontitis and gingivitis cases compared to healthy controls. DataWe evaluated all studies that compared different laboratory techniques for measuring salivary MMP-8 levels in periodontitis and gingivitis patients, alongside healthy controls. SourcesThe systematic search was performed on 10 October 2022 in three electronic databases. Study selection resultsPooled mean differences (MD) were calculated with 95 % confidence intervals (CIs) between the researched groups. In addition, the correlation coefficient results between MMP-8 values and other clinical parameters were narratively summarized.Based on 20 eligible studies (n = 1725), patients with periodontitis presented significantly higher MMP-8 levels (MD = 273.26 ng/ml, CI: 194.42; 352.10). Similarly, patients with gingivitis presented significantly higher salivary MMP-8 levels than healthy individuals (MD = 122.82 ng/ml, CI: 64.19; 181.45) based on the results of 10 eligible studies (n = 704). Additionally, we found higher MMP-8 levels in periodontitis compared to gingivitis (MD = 112.04 ng/ml, CI: 56.15; 167.92). The correlation results suggest that salivary MMP-8 is associated with different clinical periodontal parameters. ConclusionSalivary MMP-8 level measurement may be a reliable method to distinguish between periodontal health and periodontal disease and also to distinguish between gingivitis and periodontitis. Clinical significanceThe measurement of salivary MMP-8 levels may have the potential to differentiate between periodontal health and disease reliably. Accordingly, it can be considered for integration into routine dental examinations as a quick and convenient method for the early detection and prevention of periodontitis, pending further validation.

Are antibiotics overprescribed for apical periodontitis in dental practice?

There is a discrepancy in the databases and data sources mentioned by the authors. The abstract references four databases, which differ from those listed in the materials and methods section. According to the methods, the literature search was conducted across three databases: PubMed-MEDLINE, EMBASE, and Scielo. However, the abstract mentions four databases, including MEDLINE/PubMed, Wiley Online Database, Web of Science, and Scopus. All relevant articles were searched using specific keywords derived from Medical Subject Headings (MeSH) terms and text words (TW) related to the topic. Following the screening of titles and abstracts, the full texts of the selected studies were reviewed, and inclusion and exclusion criteria were applied. Any disagreements regarding study inclusion were resolved by consensus. Studies that reported data on antibiotic prescription patterns by dentists for the treatment of apical disease were included. Data extraction was carried out by three independent reviewers, with a fourth author resolving any disagreements. Extracted data included publication details (authors, year of publication), number of respondents, response rate, survey location, and prescriber type (general practitioner, endodontist, or dental surgeon). The primary outcome measured was the percentage of dentists prescribing antibiotics for each form of periapical endodontic disease. The search strategy identified a total of 96 studies, of which 39 cross-sectional studies met the inclusion criteria. Dentists prescribed antibiotics in 25.8% of cases of symptomatic apical periodontitis (AP) and in 31.5% of asymptomatic AP cases. In instances of acute symptomatic apical abscess with swelling and moderate to severe symptoms, approximately 89% of dentists prescribed antibiotics, compared to nearly 100% of endodontists. Endodontists demonstrate more appropriate antibiotic-prescribing practices than general practitioners. Globally, dentists tend to over-prescribe antibiotics for managing apical disease. Therefore, there is a pressing need to enhance antibiotic prescribing practices in the treatment of endodontic infections.

The Management of Periodontally Diseased Individuals-A Registry-Based Study on a Swedish Population.

This registry-based study aimed to describe cross-sectional dental and demographic data with focus on diagnosis and treatment of periodontal disease. A second aim was to analyse the extent and content of performed periodontal treatment in patients with varying degrees of periodontitis and if treatment was provided on equal terms. An additional aim was to identify if possible differences in treatments were related to type of dental insurance system. A study population, 225,913 individuals ≥ 20 years living in the Region of Västra Götaland, was identified by the Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa). Registry data were retrieved for the period 2010-2012. Logistic regression models were used to predict the probability of receiving periodontal interventions and access to fixed annual fees. Among the study population, 17% had periodontal disease (≥ 4 teeth with periodontal pockets ≥ 4 mm) and constituted the final study sample. The probability of periodontal intervention increased with severity of periodontitis, in moderate (OR = 2.3) and severe cases (OR = 5.2) compared to the group with minor disease (p < 0.001). Severe periodontitis was associated with male gender, increasing age and smoking. About 30% of the individuals remained untreated over the 3-year period. Individuals with fee-for-service were more likely to receive periodontal intervention than individuals with fixed annual fees (OR = 1.7; p < 0.001). Severe periodontitis and being in the fee-for-service system were associated with more periodontal interventions. However, one-third of the study subjects remained untreated. These findings indicate the need for improved care on equal terms for patients with periodontal disease.

Prognostic Impact of Microbiome Dysbiosis: A Prospective Study.

To determine the relationship between microbiome dysbiosis indices and biofilm immunogenicity and their prognostic implications on periodontal treatment response. Thirty periodontally healthy controls and 30 periodontitis cases (stage III) were recruited. Cases received non-surgical periodontal therapy (NSPT), and their treatment response at 6 months was evaluated using a treat-to-target endpoint (≤ 4 sites with probing depths ≥ 5 mm). Pooled subgingival biofilm samples were obtained from controls and cases. The V3-4 hypervariable region of the 16S rRNA gene was sequenced and two compositional indices (subgingival microbiome dysbiosis index, SMDI, and dysbiosis ratio, DR) were calculated. Nuclear factor kappa-B (NF-κB) activation elicited by biofilm samples in monocytic reporter cells was quantified to assess biofilm immunogenicity. SMDI, DR and biofilm immunogenicity were highly diagnostic for periodontitis (area under curves [AUC] > 0.90, p < 0.001). Among periodontitis cases, all three microbial parameters were significantly reduced after NSPT (p < 0.001). Cases achieving the treat-to-target endpoint had lower pre-treatment SMDI and biofilm immunogenicity (p < 0.05) and different microbial recolonization patterns from poor responders. Both measures predicted treatment response (AUC of 0.767 and 0.835, respectively, p < 0.05). Subgingival biofilm dysbiosis quantified using SMDI and biofilm immunogenicity was diagnostic of periodontitis and predictive of NSPT outcomes.

Using genetics to explore complement C5 as a druggable protein in periodontitis.

An excessively activated or dysregulated complement system has been proven to be a vital contributor to the pathogenesis of periodontitis. It has been previously hypothesized that inhibiting the activity of complement component C5 by targeting the C5a receptor is a powerful candidate for treating periodontitis. Here, we apply the drug target instrumental variable (IV) approach to investigate the therapeutic effect of genetically proxied inhibition of C5 on periodontitis. In our primary analysis, we used 26 independent 'cis' single nucleotide polymorphisms as IVs from the vicinity of the encoding locus of C5 that are associated with plasma C5 levels. In a secondary analysis, we assess the validity of our primary findings, exploring the involvement of alternative downstream biomarkers, interleukin 17 (IL-17), interleukin 1β (IL-1β), and tumor necrosis factor (TNF). Summary statistics of plasma levels (C5, IL-17, IL-1β, and TNF) were obtained from a genome-wide association study (GWAS) of 35,559 European descent individuals. We extracted association statistics from a GWAS of 17,353 clinical periodontitis cases and 28,210 European controls. Wald ratios were combined using inverse-variance weighted meta-analysis. In our primary approach, inhibiting C5 reduced the risk of periodontitis (Odds ratio 0.89 per 1 standard deviation reduction in C5; 95% confidence Interval 0.80-0.98, p value=0.022). Our secondary analysis suggests an involvement of IL-17 within the potential causal pathway, but was inconclusive for other biomarkers. The findings from our study suggest that C5 inhibition may reduce the risk of periodontitis, prioritizing C5 inhibitors as a potential adjunctive therapeutic intervention in this disease.

Microbiome to dictate the occurrence of neurological disorders

Neuropsychiatric disorders have been the constant burden impacting healthcare since 1990, and more than 3 billion people worldwide are living with neurological conditions. Mental health conditions with cognitive decline were also observed in people who contracted SARSCoV-2 and later presented the PACS related disease after the resolution of primary infection. Long term dysbiosis, inflammatory bowel disease (IBD), and neurological inflammations signify the establishment of major depressive disorders (MDD), Alzheimer’s disease (AD), Schizophrenia, Parkinson’s disease (PD), lateral sclerosis etc. More than 4% of cases of periodontitis are likely to develop brain related abnormalities. Conversely, cellular and molecular alterations keep restoring Amyloid beta peptides (Aβ), tau protein, and 2-synuclein protein with plaque formation allow the disease associate microglia (DAM TREM) phenotype to transfer the aberrant signals through post synaptic neurons. Brain related inflammations are accompanied by various agonist molecules, Lipopolysaccharides (LPS), increased C-reactive protein, tumor necrosis factor alpha (TNF-α), and mitochondrial dysfunctions. Firmicutes with Lactobacillus spp., Ruminococcus spp., Lachnospira spp. are the known short-chain fatty acids (SCFAs) producers, those meant to involve in regulating the immunological and physiological functions from Gut-Brain-Gut building homeostasis. Aβ stimulation of glial cells produces anti-inflammatory effects, while controlling the ERK/MAPK/JAK/NFkβ pathways-based inflammations. Serotonin, dopamine, gamma aminobutyric acid (GABA), kynurenic acid are the regulatory neurotransmitters that contribute to the prognosis of neurodegenerative diseases and also reduce the stress related corticosterone. Impaired molecular signals disrupt the endothelial layer of gut and blood brain barrier (BBB) impacting the serotonin production in brain. It is imperative to utilize pre, pro, and postbiotics to modulate the depleted microbiota, could reverse the aberrant signals instigating a better disease prognosis.

Assessment of Periodontitis Risk Factors in Endodontically Treated Teeth: A Cross-Sectional Study.

The aim of the study was to collect data about the prevalence and risk factors of apical periodontitis in a population of endodontically treated patients. The study group included 151 patients (52 males, 99 females; mean age 48.36 ± 15.708 yrs.) with 391 endodontically treated teeth (mean follow-up of 5.25 ± 1.759 yrs.). According to the initial tooth diagnosis, root-filled teeth were divided into Group A, root-filled teeth treated for pulpitis or for the purpose of prosthetic pulpectomies (vital pulp group), and Group B, root-filled teeth with non-vital pulp (necrotic pulp). Clinical and radiographic evaluation of the root and its periapical area were performed to establish the success/failure of endodontic therapy, the quality of the root canal fillings (length, density, taper), and coronal restoration. The presence of recurrent caries, periodontal pathology, or endo-periodontal lesions were also recorded. Univariate and multivariate analyses were used to determine the risk factors for apical periodontitis and calculate their odds ratios (ORs). For the root-filled vital pulp tooth group, the highest risks for apical periodontitis are associated with inadequate homogeneity (OR 30.938), periodontitis (OR 9.226), and over-filling (OR 8.800). For the root-filled non-vital pulp tooth group, the highest risks are associated with periodontitis (OR 4.235) and age over 60 yrs. (OR 4.875). For the necrotic pulp tooth group, multivariate analysis identified an age > 60 yrs., filled molars, intracanal posts, poor coronal restoration quality, under-filling, and periodontitis as significant combined risk factors. Inadequate root canal filling and periodontitis in both groups were risk factors associated with most cases of apical periodontitis. Other risk factors include age > 60 yrs., poor coronal restoration quality, and the presence of intracanal posts in root-filled teeth with necrotic pulp.

Applying current European periodontitis clinical practice guidelines is not feasible even for the richest countries in the world.

Clinical practice guidelines aim to enhance the quality, equality and consistency of care but often demand more time than is available, rendering adherence impractical and exceeding feasible resources. The 2017 introduction of a new periodontal classification system by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) sought to refine clinical and epidemiological practices by serving as the basis for clinical practice guidelines and epidemiological investigations around the world. Following this classification, the EFP recommends supportive periodontal care visits every 3-12 months for all periodontitis cases. Given that in Norway, approximately 72% of the adult population are identified as periodontitis cases under the current AAP/EFP case definition, this poses a significant demand on healthcare resources. We calculated that between 60% and 70% of all estimated available working hours available for adult dental care provided by dentists and dental hygienists in Norway in 2017 would be spent on supportive periodontal care visits alone if the recommendations were to be met. This situation calls for a reevaluation of disease definitions and clinical practice guidelines to ensure they are practical, financially feasible and patient-outcome relevant.

The PerioGene North Study Uncovers Serum Proteins Related to Periodontitis

The sequalae of periodontitis include irreversible degradation of tooth-supporting structures and circulatory spread of inflammatory mediators. However, the serum protein profile in periodontitis is not well described, which is partly attributable to the limited number of studies based on large and well-characterized periodontitis cohorts. This study aims to identify novel, circulating inflammation-related proteins associated with periodontitis within the PerioGene North case-control study, which includes 478 cases with severe periodontitis and 509 periodontally healthy controls. The serum concentrations of high-sensitivity C-reactive protein (hs-CRP) and a panel of 45 inflammation-related proteins were analyzed using targeted proteomics. A distinguishable serum protein profile was evident in periodontitis cases. The protein pattern could separate cases from controls with a sensitivity of 0.81 and specificity of 0.81 (area under the curve = 0.87). Adjusted levels for hs-CRP and 24 of the 45 proteins were different between cases and controls. High levels of hs-CRP and matrix metalloproteinase–12, and low levels of epidermal growth factor (EGF) and oxidized low-density lipoprotein receptor 1 (OLR-1) were detected among the cases. Furthermore, the levels of C-C motif chemokine–19, granulocyte colony-stimulating factor–3 (CSF-3), interleukin-7 (IL-7), and hs-CRP were significantly higher in cases with a high degree of gingival inflammation. The levels of CSF-3 and tumor necrosis factor ligand superfamily member–10 TNFSF-10 were higher in cases with many deep periodontal pockets. The PerioGene North study includes detailed clinical periodontal data and uncovers a distinct serum protein profile in periodontitis. The findings of lower EGF and OLR-1 among the cases are highlighted, as this has not been presented before. The role of EGF and OLR-1 in periodontitis pathogenesis and as possible future biomarkers should be further explored.

Utility of gingival crevicular fluid components for periodontal diagnosis.

Periodontal diseases are highly prevalent chronic diseases, and severe periodontitis creates functional and esthetic problems and decreases self-esteem for a large percentage of the older population worldwide. In many cases of periodontitis, there is no distinct tell-tale pain that motivates a patient to seek treatment, rather the signs become clinically detectable late, and typically when the disease has progressed to a problematic level for the life of the dentition. Early periodontal screening and diagnostics tools will provide early recognition of periodontal diseases and facilitate timely management of the disease to reduce tooth loss. To this goal, gingival crevicular fluid is easily sampled, can be repeatedly and non-invasively collected, and can be tested for potential biomarkers. Moreover, the site specificity of periodontal diseases enhances the usefulness of gingival crevicular fluid sampled from specific sites as a biofluid for diagnosis and longitudinal monitoring of periodontal diseases. The present review aimed to provide up-to-date information on potential diagnostic biomarkers with utility that can be assayed from gingival crevicular fluid samples, focusing on what is new and useful and providing only general historic background textually and in a tabulated format.

Frequency of Fimbrial Gene Types I, Ib, and II in Clinical Strains of Porphyromonas gingivalis Characterized From Periodontitis Patients.

Objective Porphyromonas gingivalis (P. gingivalis) is considered the predominant pathogen in association with different stages of periodontitis, and fim genes play a vital role in adherence and colonization. This study is thus aimed to detect the prevalence of P. gingivalis and the frequency of fim gene types among the clinical strains isolated from periodontitis patients. Methods Plaque samples (N = 45) were collected from patients with three different stages of periodontitis (n = 15 in each group). All the samples were inoculated onto sterile anaerobic blood agar and were processed anaerobically using a GasPak system at 37°C for five to sevendays. Standard microbiological techniques were used to identify P. gingivalis. Genomic DNA was extracted, and polymerase chain reaction (PCR) was carried out to detect the frequency of three fim gene types, using specific primers. Results P. gingivalis was more prevalent in Group III (93.3%), followed by 26.7% in Group II, and 13.3% in Group I. Maximum isolates were seen in the age group of 40-50, with no significance within the genders. fim type I was frequent in Group III (78.5% (n = 11)), followed by 0.25% (n = 1) under Group II, with no other fim types in the other groups. Conclusion Prevalence of P. gingivalis and frequency of fim genes, in association with its virulence, were observed. Periodical monitoring of such virulence genes would aid in the theranostic approach to combat the complications caused by P. gingivalis in periodontitis cases.

Association between nonalcoholic fatty liver disease scores and chronic periodontitis: A retrospective cohort study.

Although several studies have demonstrated a bidirectional relationship between nonalcoholic fatty liver disease (NAFLD) and chronic periodontitis, few studies have reported that NAFLD causes chronic periodontitis, especially in the Asian population. This study was conducted on 129,087 individuals, and the NAFLD score was assessed using the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Framingham Steatosis Index (FSI). The incidence of chronic periodontitis was defined as a diagnostic code with dental procedures. Multi-variable adjusted Cox proportional hazard regression analysis was performed with hazard ratio (HR) and 95% confidence intervals (CIs). Nine thousand one hundred and twenty-eight chronic periodontitis cases (7.1%) were identified during a mean 7.4years follow-up period. Each NAFLD score was related to chronic periodontitis. In the FLI score, HR and 95% CIs for the incidence of chronic periodontitis compared with a low FLI group were as follows: indeterminate FLI: 1.19 (1.12-1.26), high FLI: 1.32 (1.18-1.47). In the HSI and FSI scores, HR and 95% CIs for the incidence of chronic periodontitis were 1.13 (1.05-1.22) and 1.23 (1.05-1.31), respectively. All NAFLD scores were associated with chronic periodontitis in the Korean population. As chronic periodontitis can aggravate the liver status, patients with NAFLD may need regular dental visits.

Association between virus infection and periodontitis: Evidence from the National Health and Nutrition Examination Survey 2009-2014.

Periodontitis is a cumulative inflammatory disease associated with multiple health conditions and various systemic diseases. As a common disease, virus infection along with its consequences has become a serious health burden. The study aims to evaluate the relationship between common viruses including hepatitis virus, human immunodeficiency virus (HIV), herpes simplex virus (HSV), human papillomavirus (HPV), and periodontitis. The data from the US National Health and Nutrition Examination Survey (NHANES) 2009-2014 was adopted and screened through, including 10 714 participants. Generalized linear regression was conducted to verify the relationships between the virus infections and periodontitis. Moreover, we also performed analyses in age and gender subgroups. The results suggested that the infection of HCV, HSV-1, and HSV-2 was significantly associated with the prevalence of periodontitis (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.26-1.70; OR 1.09, 95% CI 1.05-1.13; OR 1.06, 95% CI 1.01 - 1.11, respectively) and risk of developing moderate or severe periodontitis (OR 1.51, 95% CI 1.29-1.77; OR 1.08, 95% CI 1.04-1.12; OR 1.05, 95% CI 1.01-1.10, respectively) after adjusting all relevant co-factors. Subgroup analyses revealed a steady association between periodontitis and hepatitis C virus (HCV) or HSV-1 infection, while the relationship between HSV-2 and HPV infection can also be found in some subgroups. The presence of HCV and HSV infection was found to be significantly associated with the prevalence of periodontitis, including moderate or severe cases. Moreover, the association of periodontitis and HPV infection can also be observed in people < 35 years.

The adjunctive effect of frankincense extract gel to nonsurgical treatment of chronic periodontitis: a randomized clinical study

Abstract Aim This study was aimed at assessing the impact of applying the frankincense extract gel subgingivally in addition to scaling and root planing (SRP) of nonsurgically treated moderate chronic periodontitis patients. Patients and methods Twenty cases were randomly chosen and undergo an equal division into two groups: group I underwent only SRP, group II underwent SRP as well as frankincense extract gel. Applying frankincense extract gel subgingivally was carried out after initial SRP (day 1), 7, and 14 days. Clinical measurements involved probing depth, bleeding on probing, as well as clinical attachment level. qRT-PCR was performed to identify the treatment’s effect on Porphyromonas gingivalis. Clinical measurements along with plaque samples for PCR were documented at baseline (prior to the therapy), 1, and 3 months following treatment. Results Group II (frankincense extract gel) exhibited statistically significant enhancement in all clinical parameters involving probing depth, clinical attachment level, as well as bleeding on probing. In addition, P. gingivalis revealed a significant reduction in its load as revealed from qRT-PCR as opposed to the control group. Conclusion Applying frankincense extract gel subgingivally has exhibited potent antibacterial properties. As it is biologically accepted by most cases when applied in periodontal pockets, it is advised to be utilized in addition to SRP for managing moderate chronic periodontitis cases as well as others under the periodontal maintenance phase.

Immune-mediated inflammatory diseases and periodontal disease: a bidirectional two-sample mendelian randomization study

BackgroundPrevious observational studies have shown a bidirectional association between immune-mediated inflammatory disorders (IMID) and periodontal disease. However, evidence regarding the causal role of IMID and periodontal disease is still lacking. Therefore, we conducted a bidirectional two-sample Mendelian randomization (MR) study to uncover the potential genetic causal effects between IMID and periodontal disease.MethodsBidirectional two-sample MR analysis was employed. Data for ten IMIDs were sourced from genome-wide association studies (GWAS) conducted by the FinnGen Consortium (range from 1023 to 36321 cases) and UK Biobank (UKB) (range from 150 to 17574 cases). Furthermore, GWAS data for periodontal disease were obtained from the FinnGen Consortium (87497 cases), UKB (458 cases), and Gene Lifestyle Interactions in Dental Endpoints (GLIDE) consortium (17,353 periodontitis cases). Subsequently, the causal relationships were analyzed by random effects inverse variance weighting, weighted median, and MR-Egger. Sensitivity analyses were performed using the Cochrane Q test, funnel plot, and Mr-Egger intercept test to ensure robustness. Eventually, replication analysis and meta-analysis across different databases were carried out.ResultsSystemic lupus erythematosus (SLE) [IVW: OR = 1.079 (95% CI: 1.032–1.128) and P < 0.001], Sjogren syndrome [IVW: OR = 1.082 (95% CI: 1.012–1.157) and P = 0.022] and hypothyroidism [IVW: OR = 1.52 (95% CI: 1.13–2.04) and P = 0.005] may increase the risk of periodontal disease. In addition, periodontal disease may reduce the risk of SLE [IVW: OR = 0.8079 (95% CI: 0.6764–0.9650) and P = 0.019] and hyperthyroidism [IVW: OR = 5.59*10–9 (95% CI: 1.43*10–15-2.18*10–2) and P = 0.014]. Meta-analysis indicated a causal correlation between SLE and an increased risk of periodontal disease: [OR = 1.08 (95% CI: 1.03–1.13), P = 0.0009]. No significant evidence suggests bilateral causal relationships between other IMIDs and periodontal disease. No significant estimation of heterogeneity or pleiotropy is detected.ConclusionsOur study has confirmed a genetic causal relationship between IMIDs and periodontal disease, thereby unveiling novel potential mechanisms underlying IMIDs and periodontal disease. This discovery is promising in fostering interdisciplinary collaboration between clinicians and stomatologists to facilitate appropriate and precise screening, prevention, and early treatment of IMIDs and periodontal disease.

Occurrence of periodontal diseases according to the ACES 2018 Classification Framework and the CDC/AAP definition: A cross-sectional study in a major Brazilian city.

The occurrence of periodontal diseases is still to be determined in large samples of major Brazilian cities. This study aimed to assess the periodontal status of adults from Curitiba, Paraná, Brazil, using periodontitis definitions by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) and the recently published ACES 2018 Classification Framework. A multi-stage probability sampling technique was applied to draw individuals aged 18 or older. A total of 566 individuals underwent a full-mouth periodontal examination. Periodontitis cases were defined according to the CDC/AAP and the ACES 2018 Classification Framework. Non-periodontitis cases were classified as healthy or gingivitis. The agreement between the two definitions was calculated. Periodontal health was present in 33.6% and 13.8% of individuals, and gingivitis was found in 11.7% and 7.5%, according to CDC/AAP and ACES, respectively. Mild, moderate and severe periodontitis (CDC/AAP) were present in 2.1%, 33.4% and 19.1% of individuals, respectively. Using ACES, 34.3% had Stages I/II and 43.3% had Stages III/IV. The occurrence of periodontitis was higher when a subgroup of individuals aged 30+ were analysed, ranging from 69.6% (CDC/AAP) to 90.1% (ACES). CDC/AAP and ACES agreement for health, gingivitis and periodontitis accounted for 68.8% of the observations. Periodontal diseases affect more than 66% of the population aged 18+ years. Classic definition by the CDC/AAP and the recently published ACES Framework yielded moderate agreement.

Major aspects of minimally invasive endodontic surgery using microsurgery: a systematic review

Introduction: Knowledge about endodontic infections has increased significantly over the last 50 years and, although many issues still require elucidation, endodontics has become the dental science that has the most improved approaches and technologies to increase the success and longevity of treatments dental organs. Endodontic microsurgery has produced highly successful results in preserving teeth with persistent or recurrent cases of periapical periodontitis that could not be successfully treated by non-surgical endodontic approaches. Objective: It was to list the main clinical considerations of minimally invasive endodontic surgery using apical microsurgery, as well as point out the success rate of this technique. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to March 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 117 articles were found, 50 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=58.5%&lt;50%. It was concluded that the success of apical endodontic surgery in terms of healing existing periapical pathology, together with a good long-term prognosis, depends on correct diagnosis and planning, as well as the association of surgical techniques, well-executed protocols, and biocompatible materials. The apical endodontic microsurgery approach is predictable and has a high success rate, which resulted from the introduction of cone beam computed tomography, microscope, ultrasonic instruments, and materials such as mineral trioxide aggregate (MTA) and bioceramics for retro-fillings.

The prevalence of periodontitis in an Iraqi population using the 2017 classification

Background: To determine the prevalence and severity of periodontitis in an Iraqi population using the 2017 classification. Methods: Data on the periodontal status of patients were retrospectively collected from healthcare records. The information included demographics, clinical parameters including bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL). Descriptive and inferential statistical analyses were performed using SPSS (version 26, IBM, USA) software. Results: Out of 1578 records, the periodontal health, gingivitis, and periodontitis represented 26.4%, 37.1%, and 36.5%, respectively with males more affected by periodontal disease compared with females. Periodontitis cases were dominated by stage 3 and 4 which combined accounted for 77.3%, followed by stage 2 (21.3%), and stage 1 (1.4%). When looking at disease grade and levels of stability, localized pattern, Grade C, and unstable status were the most prevalent domains. Regression analysis suggested age, BOP, male, and positive family history as predictors for increasing extent and severity of CAL both in periodontal health and disease. Conclusion: The prevalence of periodontal disease (periodontitis, and gingivitis) was almost equally expressed. Severe periodontitis was the most dominant group whilst milder forms of disease were least prevalent. The data indicated that demographic variables and clinical parameters could predict severity of attachment loss.

Clinico-immunological evaluation of use of omega-3 fatty acids as nutraceutical approach in management of patients with chronic periodontitis: A randomized clinical trial

BackgroundSubgingival bacterial colonization and biofilm formation are known to be the main etiology of periodontal disease progression. This biofilm elicits host response and the interaction between host defence mechanisms with plaque microorganisms and their products results in periodontal disease. Host modulatory therapy (HMT) is a form of treatment of periodontitis that focuses on treatment of the host in the host–bacteria interaction. Omega-3 fatty acids have emerged as a potential HMT agent to treat inflammation associated with periodontal disease. MethodsA total of 60 cases of chronic periodontitis were allocated into two groups; the test group (n = 30) were treated with scaling and root planing (SRP) and given a dietary supplementation of omega-3 fatty acid while the control group were treated with SRP alone. Clinical parameters carried out were plaque index (PI), gingival bleeding index (GBI), pocket probing depth (PPD) and clinical attachment level (CAL) and immunological parameter included interleukin-1β level in saliva at baseline, 3 months and 6 months after therapy. ResultsAt 6 months, both the groups showed significant improvements with regards to all clinical and immunological parameters compared to baseline (all p < 0.05). However, test group presented with more favourable statistically significant results. ConclusionThe use of omega-3 fatty acid as nutraceutical agent to conventional method acted as beneficial therapeutic measures and effective in patients with chronic periodontitis when compared with SRP alone.