Risk Factor For Aggressive Periodontitis Research Articles

Identification of genetic risk factors of aggressive periodontitis using genomewide association studies in association with those of chronic periodontitis.

To identify the genetic risk factors for aggressive periodontitis (AgP), it is important to understand the progression and pathogenesis of AgP. The purpose of this review was to summarize the genetic risk factors for AgP identified through a case-control genomewide association study (GWAS) and replication study. The initial studies to identify novel AgP risk factors were potentially biased because they relied on previous studies. To overcome this kind of issue, an unbiased GWAS strategy was introduced to identify genetic risk factors for various diseases. Currently, three genes glycosyltransferase 6 domain containing 1 (GLT6D1), defensin α1 and α3 (DEFA1A3), and sialic acid-binding Ig-like lectin 5 (SIGLEC5) that reach the threshold for genomewide significance have been identified as genetic risk factors for AgP through a case-control GWAS.

Comparison of various risk indicators among patients with chronic and aggressive periodontitis in davangere population.

Background:The aim of the present study was to compare various risk indicators of chronic periodontitis (CP) and aggressive periodontitis (AP) among patients of Davangere population.Materials and Methods:Totally, 89 CP and 90 AP patients were selected from outpatient Department of Periodontics, College of Dental Sciences, Davangere. Various clinical parameters proven to be risk indicators were determined for each patient such as age, gender, occupation, oral hygiene habits, personal habits, income, level of education, place of residence, frequency of dental visits, various oral hygiene indices, gingival status, wasting diseases, malocclusion, laboratory investigations, and the results were subjected to statistical analysis.Results:This study demonstrated that AP is manifested early in life in susceptible individuals. Proven risk indicators for AP and CP in the present study population included young age, place of residence, income and education levels, frequency of dental visits. Patients with AP had better oral hygiene habits and oral hygiene index results than patients with CP. Paan chewing and smoking could be considered as risk factors, both in CP and AP cases. The similar association of plaque scores but higher bleeding tendency in AP patients supported the fact of higher susceptibility of AP patients to periodontal breakdown. Malocclusion being present in the majority of cases could also be put forth as a risk factor for AP and CP.Conclusion:This study identifies the different risk indicators for CP and AP and demonstrates the need for constructing nationwide oral health promotion programs to improve the level of oral health awareness and standards in Indian population.

Association of mitochondrial DNA displacement loop polymorphisms and aggressive periodontitis in a Chinese population: a pilot study

To examine whether certain mitochondrial DNA (mtDNA) haplogroups and/or alterations affect susceptibility to aggressive periodontitis (AgP), we analyzed the mtDNA D-Loop region in a Han Chinese population. The mtDNA haplogroups were analyzed in 58 patients with AgP and 50 periodontally healthy controls. The frequency of haplogroups A in AgP group was significantly higher than that in the control group (p = 0.007). Furthermore, the frequency of haplogroup D was higher in the control group than that in AgP group (p = 0.007). The frequencies of D-Loop polymorphisms m.16126T > C, m.16290C > T and m.152 T > C were significantly higher in patients with AgP compared with controls (p = 0.029, 0.014 and 0.022, respectively). Additionally, the frequencies of three other D-Loop polymorphisms, m.16223C > T m.489 T > C and m.515CA deletion (del) were significantly lower in patients with AgP compared with controls (p = 0.042, 0.003 and 0.026, respectively). Our study showed for the first time, an association between AgP and mtDNA haplogroups. Haplogroups A was implicated as a risk factor for AgP, while haplogroups D exhibited a protective effect in this disease. These observations may provide a new perspective on the study of the pathogenesis of periodontitis.

Four tumor necrosis factor alpha genes polymorphisms and periodontitis risk in a Chinese population

BackgroundTumour necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of generalized aggressive periodontitis (AgP) and chronic periodontitis (CP). The objective of the present study was to evaluate the association of four TNF-alpha gene polymorphisms (−1031T/C, −857C/T, −308G/A and −238G/A) with susceptibility to AgP and CP in a Chinese population. MethodsA hospital-based case-control study was conducted in in patients with CP (n=180), AgP (n=180) and healthy controls (n=180). Gene promoter polymorphisms were analyzed by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) assay. Genotype and allele frequencies were analyzed using the chi-square test and logistic regression analysis. ResultsTNF-alpha −1031CC genotype was significantly higher [odds ratio (OR)=2.36, 95% confidence interval (CI)=1.03, 5.43; P=0.04] in patients with CP compared with healthy controls. TNF-alpha −308AA genotype was significantly higher (OR=2.71, 95% CI=1.09, 6.73; P=0.03) in patients with AgP compared with healthy controls. No association was found of TNF-alpha −857C/T and −238G/A polymorphisms with susceptibility to AgP or CP. ConclusionsOur data demonstrated that TNF-alpha −1031CC genotype was a risk factor for CP, and that TNF-alpha −308AA genotype was a risk factor for AgP. But there is a lack of association of TNF-alpha −857C/T and −238G/A polymorphisms with susceptibility to AgP or CP in a Chinese population.

Analysis of periodontal attachment loss in relation to root form abnormalities

PurposeThe aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis.MethodsFrom January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification.ResultsThe periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01).ConclusionsConsidering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.

Prevalence of aggressive periodontitis among Yemeni students from schools in the city of Thamar

Introduction and objective: Aggressive periodontitis (AgP) is a type of periodontitis that causes rapid destruction of alveolar bone, especially in young ages. In Yemen, there is no previous study about aggressive periodontitis, so the aim of this study was to assess the prevalence and related risk factors for aggressive periodontitis among school students in the city of Thamar. Material and methods: In this study, a two-stage sampling method was used. At first stage, a random sample of eight public schools was selected from the schools of the city of Thamar by simple random sampling. In the second stage, a sample of 807 students (458 female and 349 male) was drawn from the chosen schools by simple random sampling. People aged from 10 to 22, with mean age of 17. The classification considered in the current paper was based on the American Academy of Periodontology classification of 1999. A questionnaire was applied and included questions that would give information about the risk factors that might be considered causal factors for aggressive periodontitis. Results: The number of affected students with AgP was 29 among 807 students, that is, 3.6% of the sample. The percentages of localized aggressive periodontitis (LAgP) and generalized aggressive periodontitis (GAgP) were, respectively, 2.6% (21 students) and 1.0% (8 students). The following teeth were found to be affected: first molars, second molars, incisors, first premolars and second premolars. In GAgP, 20 first molars, 22 incisors, 6 first premolars, 3 second molars and 2 second premolars showed clinical attachment loss. But in LAgP, 18 first molars, 19 incisors, 6 first premolars, 3 second molars and 2 second premolars showed clinical attachment loss. With regards to the risk factors – socioeconomic level, age, poor oral hygiene status, plaque index and gingival bleeding –, the statistical results indicated that each of these factors showed highly significant relationships with AgP. Conclusion: The prevalence of AgP among Yemeni schools students was relatively high: 3.6%. This might be related to the low socioeconomic level and poor oral hygiene status of most of the Yemeni students.

Ethnic Disparities in the Prevalence of Periodontitis Among High School Students in Sudan

There are limited data on the epidemiology and risk factors of periodontitis in young populations in developing nations. This study assesses the prevalence of periodontal attachment loss and aggressive periodontitis and the association with ethnicity among high school students in Sudan. The study sample consisted of 1,200 students, 13 to 19 years old, selected from 38 public and private high schools using a multistage, stratified sampling design. The subjects were interviewed and examined clinically. Periodontal parameters were assessed at six sites per tooth. Subjects with aggressive periodontitis were identified. A total of 3.4% of the subjects had aggressive periodontitis, and 16.3% and 8.2% of the subjects had at least one tooth with > or = 4 and > or = 5 mm attachment loss, respectively. A significantly higher percentage of subjects of African tribal ethnicity had attachment loss > or = 4 and > or = 5 mm compared to Afro-Arab tribes (19.8% versus 14.7%, P = 0.02; and 12% versus 6.4%, P = 0.004, respectively), and had a higher prevalence of aggressive periodontitis (6% versus 2.3%; P = 0.01) and higher risk of being diagnosed with this disease (odds ratio = 2.7; P <0.0001). African ethnicity was also associated with a significantly higher number of teeth with attachment loss than in Afro-Arabs (P <0.01). Comparison by gender showed a significantly higher percentage of males with aggressive periodontitis (4.9% versus 2%; P <0.01) and a higher risk for this disease (odds ratio = 2.5; P = 0.01) than in females. However, the prevalence of subjects with attachment loss > or = 4 and > or = 5 mm was comparable in the two gender groups. Our results show that aggressive periodontitis is highly prevalent in this population. African ethnicity (versus Afro-Arab) and male gender were risk factors for aggressive periodontitis.

Genetic Variants Associated With Neutrophil Function in Aggressive Periodontitis and Healthy Controls

Genetic polymorphisms that influence neutrophil function were proposed as possible risk factors for aggressive periodontitis (AgP). The aim of this study is to test whether a clinical diagnosis and specific genetic variants are associated with neutrophil activity in subjects with AgP and healthy subjects. This study describes the results of neutrophil analyses performed in 40 subjects (20 subjects with AgP and 20 healthy control subjects). Neutrophils were extracted from peripheral blood and analyzed in a masked manner for phagocytosis and oxidative burst by flow cytometry in response to Escherichia coli, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Porphyromonas gingivalis. Genomic DNA was extracted and genotyped for the nicotinamide adenine dinucleotide phosphate p22 phagocytic oxidase subunit (p22(phox)) cytochrome b alpha gene (CYBA) C242T, crystallizable gamma fragment (Fcgamma)IIa H/R, and FcgammaIIIb neutrophil antigen (NA)1/NA2 polymorphisms. Analyses in pairs of white subjects (n = 24) revealed that patients with AgP exhibited a higher oxidative burst in response to E. coli (P = 0.002) and P. gingivalis (P = 0.002) compared to healthy control subjects. The p22(phox) CYBA 242 T allele was associated with an oxidative burst in response to the challenge by two strains of A. actinomycetemcomitans (P = 0.018 and P = 0.046). The FcgammaIIa polymorphism was associated with the phagocytic index of E. coli (P = 0.024). This study confirms previous reports of a higher oxidative burst associated with AgP and presented preliminary evidence that genetic factors may influence neutrophil function in patients with AgP and healthy individuals.

The interleukin‐10 promoter haplotype ATA is a putative risk factor for aggressive periodontitis

Interleukin-10 has been described as an anti-inflammatory cytokine and a B-cell proliferation factor. Promoter polymorphisms of the interleukin-10 gene have been associated with altered interleukin-10 expression. Therefore, the aim of this study was to evaluate three polymorphisms at positions -1082G>A, -819C>T and -590C>A in patients with generalized chronic periodontitis (n = 27) and generalized aggressive periodontitis (n = 32) in comparison with periodontitis-free controls (n = 34). Interleukin-10 promoter polymorphisms were analyzed by polymerase chain reaction with sequence-specific primers (PCR-SSP). Distributions of single alleles, genotypes and haplotypes were calculated by the chi-square test. Risk factor analyses were carried out by logistic regression. Subgingival bacteria were subjected to molecular biological analyses using the micro-Ident test. The combination ATA/ATA was found only in patients with aggressive periodontitis (15.6 vs. 0.0%, p = 0.023). Taking into account age, gender, smoking and plaque level, an increased odds ratio (3.7, p = 0.04) for aggressive periodontitis was shown for subjects with the haplotype ATA. Prevotella intermedia was found to be decreased in ACC- positive (41.3 vs. 66.7%, p = 0.022), ATA-positive (33.3 vs. 57.1%, p = 0.032) and ACC/ATA-positive (20.0 vs. 55.9%, p = 0.002) individuals. In GCC/GCC-positive subjects, P. intermedia occurred more frequently (86.7 vs. 42.3%, p = 0.002). The haplotype ATA, which is known as a 'low interleukin-10 producer' is a putative risk indicator for generalized aggressive periodontitis.

NADPH oxidase (CYBA) and FcγR polymorphisms as risk factors for aggressive periodontitis: A case–control association study

Neutrophils (PMN) in aggressive periodontitis (AgP) patients have been reported to be hyperactive especially with regards to superoxide production. Polymorphisms in genes influencing PMN function have been proposed as candidate risk factors for AgP. The aim of this study was to test the association of specific gene polymorphisms affecting PMN functions with AgP. Two hundred and twenty-four patients with confirmed diagnosis of AgP and 231 subjects with healthy periodontium took part in the study. A blood sample was collected from subjects and genotypes for p22phox (CYBA) NADPH oxidase, FP, Fcalpha and Fcgamma receptors were analysed in a blind fashion. The C242T p22phox NADPH oxidase T allele was significantly associated with AgP in a multiple logistic regression model adjusting for confounders, and this was observed for all subjects [p = 0.002, odds ratio (OR) = 1.87, 95% confidence interval (CI) = 1.27-2.83] and Caucasians (p = 0.009, OR=2.07, 95% CI = 1.20-3.59). Concomitant presence of C242T p22phox NADPH oxidase T allele and FcgammaRIIIb NA1 homozygosity was associated with the generalized AgP phenotype in Caucasians (p = 0.001, OR = 30.35, 95% CI = 3.81-241.97). C242T p22phox NADPH oxidase and FcgammaR polymorphisms may predispose to AgP through a modulation of neutrophil superoxide production.

The Fcγ receptor III genotype as a risk factor for aggressive periodontitis in Korean patients

Aggressive periodontitis (AgP) represents an inflammatory disease with pathogenic features, such as onset in the juvenile or early adults years and severe and rapid destruction of periodontal tissue. It is now recognized that microbial factors can not solely be held responsible for AgP, although these are important in the initiation of periodontitis. 1 Genetically determined variance in host immune response bacteria has been identified in individuals with AgP. Many AgP (especially those with localized form) patients display defective neutrophil chemotaxis due to changes in chemotactic receptors or activation pathways. 2,31) It was after only the Kormann’s study4 on the genetic polymorphism of interleukin (IL) that many researchers were really being interested in the genetic factors and trying to find the scientific evidences of genetic factors that affect the pathogenesis of periodontitis. Since then, the wide spectrum of genes that might affect the progression of the peridontal disease, such as IL, tumor necrosis factor-α (TNF-α), Fcγ receptor (Fcγ R), vitamine D receptor, Nformyl receptor, matrix metalloproteinase (MMP) promoter, Toll-like receptor 2 (TLR2) and TLR4 have been studied for their role in the various types of periodontitis. Leukocyte receptors for the constant (or Fc-) part of immunoglobulins (FcR) link cellular and humoral branches of the immune systems, which are considered essential for host defense against periodontopathic bacteria. FcR for IgG (FcγR) may play a crucial role in the host defense against periodontopathic bacteria. 6-7 Three receptor

Aggressive Periodontitis in an Urban Population in Southern Brazil

There are limited data about the epidemiology and risk factors for aggressive periodontitis (AgP) in Latin American and Brazilian populations. The aim of this study was to assess the prevalence of AgP and the risk associated with demographic variables, smoking behavior, and other periodontal variables in a young urban population in southern Brazil. A representative sample of 612 subjects aged 14 to 29 years were sampled using a multistage probability method. A full-mouth clinical examination of six sites per tooth and an interview were performed in a mobile examination center. Subjects in the age groups 14 to 19 years and 20 to 29 years were classified with AgP if they had four or more teeth with attachment loss > or =4 mm or > or =5 mm, respectively. AgP was found in 5.5% of the subjects. The disease occurred equally among males and females, but was twice as prevalent among non-whites than whites. In the age groups 20 to 24 years and 25 to 29 years, the AgP subjects had a significantly higher prevalence of tooth loss (90.2% versus 40.4% and 86.1% versus 43.4%, P <0.01) and mean number of missing teeth (2.6 versus 0.9 and 3.4 versus 1.5, P <0.05) than subjects without attachment loss. The AgP subjects also had significantly higher percentages of sites with dental plaque (P <0.0001), gingival bleeding (P <0.05), and supragingival calculus (P <0.0001) than normal subjects. The risk for AgP was higher in the 25- to 29-year than the 14- to 19-year age groups (odds ratio [OR] = 6.2), in the low than middle or high socioeconomic status (OR = 4.5), in moderate or heavy smokers than nonsmokers (OR = 3.1), and in subjects with > or =10% versus <10% sites with supragingival calculus (OR = 3.6). Socioeconomic status, smoking, and dental calculus were significant risk indicators of aggressive periodontitis in this population. Suitable periodontal prevention programs implementing these risk indicators may prevent or reduce the prevalence of aggressive periodontitis in this and similar populations.