Severe Forms Of Periodontitis Research Articles

On the problem of improving dental care for professional athletes

Aim. Assessment of organs and tissues of oral cavity of professional athletes who use protective mouth guards. 
 Methods. Dental examination of 340 professional athletes of Olympic reserve at the age of 18 to 32 years with a duration of sport experience of 9-13 years was performed. We investigated the effect of mouth guards on the condition of the marginal periodontium and microbial contamination. Changes in periodontal tissues were diagnosed by means of traditional methods of inspection, probing of the periodontal grooves, recesses, as well as determining tooth mobility. The control group included 20 athletes not using athletic mouth guards during training. 
 Results. High prevalence of caries (in average, in all examined athletes the rate of carious teeth reaches 32.90%) and fairly high prevalence of severe forms of periodontal diseases in those patients were revealed. Evaluation of the structure of the index of teeth with decay and fillings and removed teeth showed major defects in timely dental care organization for professional boxers: their ratio of filled teeth does not exceed 40.36% in average. A significant number of extracted teeth (more than 23%) indicates that the examined patients require dental orthopaedic care. 30 examined athletes wearing protective mouth guards had the strains of P. gingivalis, A. Actinomycetemcomitans and P. oralis revealed. 
 Conclusion. The study of dental status of professional athletes using protective mouth guards, showed high prevalence of inflammatory periodontal diseases and low level of hygienic state of oral cavity.

Subgingival microbiota dysbiosis in systemic lupus erythematosus: association with periodontal status

BackgroundPeriodontitis results from the interaction between a subgingival biofilm and host immune response. Changes in biofilm composition are thought to disrupt homeostasis between the host and subgingival bacteria resulting in periodontal damage. Chronic systemic inflammatory disorders have been shown to affect the subgingival microbiota and clinical periodontal status. However, this relationship has not been examined in subjects with systemic lupus erythematosus (SLE). The objective of our study was to investigate the influence of SLE on the subgingival microbiota and its connection with periodontal disease and SLE activity.MethodsWe evaluated 52 patients with SLE compared to 52 subjects without SLE (control group). Subjects were classified as without periodontitis and with periodontitis. Oral microbiota composition was assessed by amplifying the V4 region of 16S rRNA gene from subgingival dental plaque DNA extracts. These amplicons were examined by Illumina MiSeq sequencing.ResultsSLE patients exhibited higher prevalence of periodontitis which occurred at a younger age compared to subjects of the control group. More severe forms of periodontitis were found in SLE subjects that had higher bacterial loads and decreased microbial diversity. Bacterial species frequently detected in periodontal disease were observed in higher proportions in SLE patients, even in periodontal healthy sites such as Fretibacterium, Prevotella nigrescens, and Selenomonas. Changes in the oral microbiota were linked to increased local inflammation, as demonstrated by higher concentrations of IL-6, IL-17, and IL-33 in SLE patients with periodontitis.ConclusionsSLE is associated with differences in the composition of the microbiota, independently of periodontal status.

Is Periodontal Disease Associated with Alzheimer's Disease? A Systematic Review with Meta-Analysis

Background: In the last decade, several observational studies have suggested that there exists an association between periodontal disease (PD) and Alzheimer's disease (AD). The aim of this systematic review was to investigate whether or not this link exists. Summary: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline for systematic review was used and registered at PROSPERO (CRD42016035377). The search strategy included using electronic databases and by hand searching articles published up to January 2016. MEDLINE via PubMed, EMBASE and Web of Science were searched by 2 independent reviewers. Observational studies including patients meeting criteria for both AD and PD were eligible to be included in the analysis. Quality assessment of selected studies was performed by the Newcastle-Ottawa Scale. From a total of 550 titles and abstracts, 5 studies were included (2 cross-sectional, 2 case-control and one cohort study) in the review. A fixed effects meta-analysis showed that the presence of PD is associated with the presence of AD (OR 1.69, 95% CI 1.21-2.35). When only severe forms of PD were evaluated, a significant association was also observed (OR 2.98, 95% CI 1.58-5.62). Key Messages: In the present review, a significant association was observed between PD and AD. Further studies should be carried out in order to investigate the direction of the association and factors that may confound it.

Non-Surgical Management of Aggressive Periodontitis: Report of Two Cases

The term ‘aggressive’ literally means ‘ready or likely to attack’. As the name suggests, aggressive peridontitis is a severe form of periodontal disease with a rapid course of progression in younger individuals. It is more prevalent in younger age groups, especially in females. It requires a complex treatment approach and its stabilization often requires surgical management. Here,we are presenting report of two cases of generalized aggressive periodontitis, successfully managed by only non-surgical periodontal treatment and long term follow up at frequent interval.

Streptococcus mitis and Gemella haemolysans were simultaneously found in atherosclerotic and oral plaques of elderly without periodontitis-a pilot study.

Local infections may contribute to the initiation and progression of several clinical diseases in humans. Atherosclerotic plaques of subjects suffering from periodontitis are colonized by periopathogens; however, the presence of bacteria in atherosclerotic plaques in patients without severe forms of periodontitis is of high relevance for the general population. Patients who were electively treated for atherosclerotic lesions of the carotid artery and without clinical signs of periodontitis were eligible for the study. Oral and atherosclerotic plaques were sampled, processed, and analyzed for their microbial composition by 454-sequencing. Seventeen patients were included in the analyses, and 76% of all atherosclerotic plaque specimens were positive for bacterial DNA. In the oral plaques, 76,532 sequences were identified representing 1 phylum, 17 classes, 112 families, and 263 genera. In atherosclerotic plaques, 6112 sequences representing 1 phylum, 4 classes, 8 families, and 36 genera were found. The bacterial DNAs of the species Gemella haemolysans and Streptococcus mitis were simultaneously found in atherosclerotic as well as oral plaque samples of 3 patients. These results indicated that in subjects without periodontitis, the transmission of oral bacteria to atherosclerotic plaques of the carotid artery is a feasible event. The prevention of transient bacteremia from the oral cavity requires high levels of oral health.

Assessment of Streptococcus mutans in healthy versus gingivitis and chronic periodontitis: A clinico-microbiological study.

Background:Dental caries and periodontal disease are most common oral diseases. Streptococcus mutans are considered to be the major pathogens in initiation of dental caries. Evidence shows that periodontal disease and caries share a number of contributory factors. Thus in view of these findings it would be worthwhile to examine whether Streptococcus mutans persist within the saliva and subgingival environment of the periodontitis patients and to determine whether there is any association between Streptococcus mutans colonization, pH of saliva and sub-gingival plaque pH in periodontal diseases before therapy.Methods:The study comprises of 75 subjects aged between 20-70 years, reporting to department of Periodontology, KLEs Institute of Dental Sciences, Bangalore. Subjects were divided into 3 groups of 25 each. Group 1 – Healthy controls, Group 2 – Gingivitis Group, 3 – Chronic periodontitis. Unstimulated saliva was collected in sterile container and immediately pH was evaluated. Subgingival plaque samples were collected from four deepest periodontal pockets in chronic periodontitis and from first molars in healthy subjects using 4 sterile paper points. In gingivitis subjects samples were collected from areas showing maximum signs of inflammation. All paper points and saliva samples were cultured on mitis salivarius agar culture media with bacitracin for quantification of the Streptococcus mutans colonies.Results:Increased colonization of Streptococcus mutans was seen in chronic periodontitis subjects both in saliva and sub-gingival plaque samples. There was also a positive correlation seen with the periodontal parameters.Conclusion:More severe forms of periodontal disease may create different ecological niches for the proliferation of Streptococcus mutans.

Efficacy of subgingival air polishing in patients with aggressive periodontitis

Background: Aggressive periodontitis is one of the most severe forms of periodontal disease, resulting in the destruction of junctional epithelium and alveolar bone around teeth in a very short period of time. The early diagnosis of aggressive periodontitis and timely therapy is of outmost importance in controlling the progress of the disease. Application of the techniques of subgingival air polishing of periodontal pockets (pflow) with glycine powder has contributed to reduce damage to the root surface of the teeth and surrounding soft tissue. Aim: The goal of this paper was to determine the effectiveness of two different types of subgingival air polishing therapy for the periodontal tissue status at the patients with aggressive periodontitis Methods and materials: the study included 46 patients of both sexes diagnosed with aggressive peridontitis. The patients were divided into two groups: test group (PFLOW), and control group (sonic SRP). The size of the destruction of periodontal tissue was estimated by CAL and assessment of oral hygiene and gingival inflammation was performed using FMPS and FMBS. Results: Monitored indexes values in both groups were reduced. Conclusion: Subgingival air polishing showed equally good results as the SRP, while pflow was more advantageous with respect to patients acceptability, time usability and safety for the soft tissue.

A systematic review of implant outcomes in treated periodontitis patients.

To investigate the effect of treated periodontitis on implant outcomes in partially edentulous individuals compared with periodontally healthy patients. Longitudinal studies reporting on implant survival, success, incidence of peri-implantitis, bone loss and periodontal status, and on partially dentate patients with a history of treated periodontitis were included. The search yielded 14,917 citations. Twenty-seven publications met the inclusion criteria for qualitative data synthesis. Implant success and survival were higher in periodontally healthy patients, whilst bone loss and incidence of peri-implantitis was increased in patients with history of treated periodontitis. There was a higher tendency for implant loss and biological complications in patients previously presenting with severe forms of periodontitis. The strength of the evidence was limited by the heterogeneity of the included studies in terms of study design, population, therapy, unit of analysis, inconsistent definition of baselines and outcomes, as well as by the inadequate reporting of statistical analysis and accounting for confounding factors; thus, meta-analysis could not be performed. Implants placed in patients treated for periodontal disease are associated with higher incidence of biological complications and lower success and survival rates than those placed in periodontally healthy patients. Severe forms of periodontal disease are associated with higher rates of implant loss. However, it is critical to develop well-designed, long-term prospective studies to provide further substantive evidence on the association of these outcomes.

Few studies addressing toothbrushing frequency and periodontitis.

PubMed and seven other databases. English-language articles evaluating the association between the frequency of tooth brushing and periodontitis were considered. Two reviewers independently conducted study selection with study quality being assessed using the Health Evidence Bulletin (HEB) Wales checklist. Relevant study characteristics were extracted and where necessary, effect measures and corresponding confidence intervals (CIs) were recalculated from the reported papers. Random and fixed effects meta-analyses were conducted. Fourteen studies were included (12 cross-sectional, two case-controlled). Sample sizes ranged from 44 - 9203. A fixed effects meta-analysis (12 cross sectional studies) found a significant overall odds ratio (OR) 1.41 (95%CI: 1.25-1.58, P <0.0001). A random effects meta-analysis (all 14 studies) found OR =1.44 (95%CI: 1.21-1.71, P < <0.0001) a slight indication for heterogeneity (I(2) = 48%, P = 0.02). There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects.

Bacterial profile of aggressive periodontitis in Morocco: a cross-sectional study.

BackgroundAggressive periodontitis (AgP) is one of the most severe forms of periodontal diseases. In Morocco, Aggregatibacter actinomycetemcomitans has been strongly associated with AgP, however limited knowledge is available about the implication of other periodontal pathogens in this entity. Therefore, the main aim of this study was to evaluate the composition of the subgingival microbiota in Moroccan patients with AgP.MethodsSubgingival plaque samples were collected from 50 aggressive, 13 localized and 37 generalized periodontitis patients. Samples from 20 chronic periodontitis (ChP) patients were taken as controls. Samples collected from the four deepest periodontal pockets in each patient were pooled in pre-reduced transport fluid and examined by culture.ResultsA. actinomycetemcomitans was significantly more frequent (p = 0.004) in generalised AgP compared to ChP, and Porphyromonas gingivalis was less prevalent in localized AgP, when compared with generalized AgP (p = 0.040) or ChP (p = 0.016). Prevotella intermedia, Fusobacterium nucleatum and Tannerella forsythia were also frequently detected in all groups. Mean proportions of A. actinomycetemcomitans were significantly higher in AgP groups, when compared to ChP, and generalized AgP patients harbored significantly higher proportions of P. gingivalis and T. forsythia, when compared to localized AgP or ChP.ConclusionsA. actinomycetemcomitans, P. gingivalis, T. forsythia, P. intermedia and F. nucleatum were frequently detected in this Moroccan population with AgP. Differences in frequency of detection, counts and proportions of A. actinomycetemcomitans, P. gingivalis and T. forsythia suggests the presence of distinct microbiological profiles for localized AgP, generalized AgP and ChP patients.

Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis.

The epidemiology of periodontitis regarding oral-hygiene practices particularly the frequency of tooth brushing has been the subject of relatively few dedicated studies. This paper provides a systematic review of available relevant epidemiological studies and a meta-analysis of the effect of tooth brushing frequency on periodontitis. To review and to quantify the risk for periodontitis associated with frequency of tooth brushing. Systematic literature search was conducted in nine online resources (PUBMED, ISI and 7 additional databases). Related and cross-referencing publications were reviewed. Papers published until end of March 2013 reporting associations between tooth brushing frequency and periodontitis were considered. A meta-analysis was performed to quantify this association. Fourteen studies were identified. The test of heterogeneity for cross-sectional studies was not significant (P = 0.31). A fixed-effects model yielded a significant overall odds ratio estimate of 1.41 (95%CI: 1.25-1.58, P < 0.0001) for infrequent compared to frequent tooth brushing. For all fourteen studies, there was a slight indication for heterogeneity (I² = 48%, P = 0.02) and the corresponding result with a random-effects model was 1.44 (95%CI: 1.21-1.71, P < 0.0001). There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects.

The novel role of HtrA1 in gingivitis, chronic and aggressive periodontitis.

Proteolytic tissue degradation is a typical phenomenon in inflammatory periodontal diseases. HtrA1 (High temperature requirement A 1) has a serine protease activity and is able to degrade fibronectin whose fragments induce the expression and secretion of several matrix metalloproteinases (MMPs). The aim of this study was to investigate for the first time if HtrA1 has a role in gingivitis and in generalized forms of chronic and aggressive periodontitis. Expression of HtrA1 was investigated in 16 clinically healthy gingiva, 16 gingivitis, 14 generalized chronic periodontitis and 10 generalized aggressive periodontitis by immunohistochemistry and real-time PCR. Statistical comparisons were performed by the Kruskall-Wallis test. Significantly higher levels of HtrA1 mRNA and protein expression were observed in pathological respect to healthy tissues. In particular, we detected an increase of plasma cell HtrA1 immunostaining from gingivitis to chronic and aggressive periodontitis, with the higher intensity in aggressive disease. In addition, we observed the presence of HtrA1 in normal and pathological epithelium, with an increased expression, particularly in its superficial layer, associated with increasingly severe forms of periodontal disease. We can affirm that HtrA1 expression in plasma cells could be correlated with the destruction of pathological periodontal tissue, probably due to its ability to trigger the overproduction of MMPs and to increase the inflammatory mediators TNF-α and IL-1β by inhibition of TGF-β. Moreover, epithelial HtrA1 immunostaining suggests a participation of the molecule in the host inflammatory immune responses necessary for the control of periodontal infection.

Index of oral health literacy as the instrument for development of personalized prevention programs of stomatologic diseases

According to World Health Organization (WHO), dental caries is common among 60-90% of school children and nearly among 100% of adults. Further, severe form of periodontal disease is found in 15-20% of 35-44 years old patients. WHO experts emphasize that timely prevention of dental diseases will not only contribute importantly to mainitaining oral health but would also significantly reduce cost of care and treatment of oral diseases. An important component in the prevention of oral diseases is informing of patients about the possibility of maintaining oral health with the help of available oral hygiene products. For adequate and efficient planning of activities to raise oral health awareness it is necessary to estimate level of oral health literacy of the community. In different countries there are certain questionnaires which are primarily used during scientific research. Many of these questionnaires and tests are not well-suited for use in patients with different culture and language. We suggest that standardization of oral health literacy assessment would be conducive to more effective evaluation of oral health care needs of a given population. Thus, we have developed an index of oral health literacy which has the following characteristics: - questions are universal and reflect current trends of prevention of oral diseases; - questions have no cultural contexts and attachments; - questions can be translated into any language; - questions have some variants for answers; - quantitative assessment of oral health literacy. Pilot studies showed that the developed index of oral health literacy can reliably predict the level of knowledge in young patients and the state of the oral health. In conclusion, the use of the developed index should will allow assessment of oral health literacy of patients regarding aspects of oral health preservation irrespective of nationality and language should facilitate the development of personalized approaches to prevention of dental diseases.

Type 2 diabetes mellitus and periodontal disease severity.

The aim of this cross-sectional study was to determine whether type 2 diabetes is coupled with increased severity of periodontal destruction. A total of 80 subjects with type 2 diabetes and 78 healthy control subjects underwent a fullmouth periodontal examination. The study included dentate subjects with a minimum of 7 remaining teeth in each dental arch. Plaque score, bleeding on probing and clinical attachment loss were assessed. Diabetic patients showed a significantly lower percent of plaque-positive surfaces (P = 0.02) with a significant increase in the number and the percent of sites with clinical attachment loss ≥ 3 mm compared to controls. In the logistic regression analysis, age and diabetes were found to be associated with having > 15% sites with clinical attachment loss > 5 mm. There was a significant correlation between diabetes duration and the severity of periodontal attachment loss. Patients with type 2 diabetes were at higher risk of having severe forms of periodontal disease compared with non-diabetic subjects. The results highlight the need for frequent supportive periodontal care for patients diagnosed with type 2 diabetes mellitus.

Cytokine gene polymorphisms associate with microbiogical agents in periodontal disease: our experience.

Periodontics has evolved from a simplistic model to a more complex interplay between infection and host response. Genetic factors have been a new addition to the list of risk factors for periodontal diseases. The processes leading to destruction and regeneration of the destroyed tissues are of great interest to both researchers and clinicians.The selective susceptibility of subjects for periodontitis has remained an enigma and wide varieties of risk factors have been implicated for the manifestation and progression of periodontitis. Emerging pathway models suggest that gene-environment interactions are etiologically important in disease pathogenesis. The current practical utility of genetic knowledge in periodontitis is limited.Allelic variants at multiple gene loci probably influence periodontitis susceptibility. The pro-inflammatory cytokine interleukin-1 (IL-1) is a key modulator of host responses to microbial infection and a major modulator of extracellular matrix catabolism and bone resorption, and polymorphisms in the IL-1 gene cluster have been associated with an increased risk of developing severe adult periodontitis.The aim of this study was to test if polymorphisms of genes of IL-1α+4845 and IL-1β +3954 were linked with periodontitis, in a case-control study population, delimited to a specific geographic area, in association with microbiological findings.The polymorphisms observed in IL-1α+4845 and IL-1β+3954 single nucleotide polymorphisms (SNPs), was significantly different among the study groups (healthy controls, mild, moderate and severe periodontitis with p<0.05, d.f.=1.We found a significant correlation between the severe form of periodontitis and the presence of composite genotype (p < 0.05, d.f.=1, calculated among healthy vs. severe). Furthermore a statistically significant association between the presence of bacteria and periodontitis was detected (p<0.05, d.f.=1). In the current investigation findings were concordant with literature observations.

Association of Obesity with Periodontitis, Tooth Loss and Oral Hygiene in Non-smoking Adults

Periodontitis was found to be significantly related to obesity as well as the number of missing teeth and oral hygiene. However, the studies addressing these relationships often included smokers and diabetics, and none was performed in Eastern European patients. The aim of this cross-sectional study was to investigate associations between obesity and periodontitis, oral hygiene, and tooth loss in a sample of non-smoking Croatian subjects aged 31-75 years. A total of 320 patients were recruited by convenient sampling at the Dental Clinic, Clinical Hospital Centre in Rijeka, Croatia. Periodontal examination and data on tooth loss were completed in 292 subjects and each participant completed a structured written questionnaire with questions regarding oral hygiene, education, height, and weight. Periodontitis was categorized as early, moderate and advanced. In multiple regression analysis, periodontitis was used as predictor variable, and BMI, oral hygiene, tooth loss, and education level were used as dependent variables. Use of interdental brushes/flossing and number of missing teeth correlated significantly with BMI, but the same could not be proven for periodontitis and frequency of tooth brushing. However, logistic regression proved that the subset of obese, poorly educated women aged 36-55 years were 5-6 times more likely to develop severe forms of periodontal disease. Obesity was associated with tooth loss, oral hygiene, and education level in the investigated group. BMI could not be correlated with severity of periodontal disease, except in poorly educated women aged 36-55 years.

Transcription factor STAT1 gene polymorphism is associated with the development of severe forms of periodontal disease

Periodontal disease (PD) is one of the most common inflammatory diseases, affecting about 10% of the world population. The establishment of PD is influenced by polymorphisms in genes involved with the inflammatory response. Signal Transducer and Activator of Transcription (STAT)-1 is a transcription factor that plays a key role in the intracellular signaling triggered by cytokines and, thus, its activation is critical in inflammatory diseases. We aim to evaluate the occurrence of association between STAT-1 (rs3771300) polymorphism and distinct clinical forms and severity of PD; we genotyped 180 subjects using realtime PCR. We observed that the presence of the G allele for STAT-1 was associated with twice as high of a chance to develop aggressive periodontitis, and the most severe form of the disease.

Coaggregation between Prevotella oris and Porphyromonas gingivalis

The coaggregation of bacteria has been defined as one of the most important processes in the oral infection such as periodontitis. Prevotella oris and Porphyromonas gingivalis, which are two of the periodontopathogens, are frequently detected in severe forms of periodontal diseases. However, the interaction between P. oris and P. gingivalis is still unknown. In this study, the coaggregation of P. oris with nine oral bacterial species including P. gingivalis was examined. All bacteria used in this study were cultured anaerobically and suspended in coaggregation buffer. Each cell suspension was mixed in a test tube and subjected to shaking at room temperature for 1 hour. Subsequently, the coaggregation values were scored. Furthermore, the effects of various chemical reagents, and heat, proteinase K, and serum treatment were examined. In this study, P. oris coaggregated only with P. gingivalis. A heat-stable, nonproteinous component of P. oris and a heat-labile, proteinous component of P. gingivalis play important roles in this coaggregation. In addition, this coaggregation was inhibited by l-arginine, l-lysine, and Nα-p-tosyl-l-lysine. Therefore, it was considered that a cell surface protein on P. gingivalis, such as gingipain, may be involved in the coaggregation. Furthermore, the coaggregation was not inhibited by serum treatment. This is the first report to describe the coaggregation of P. oris and P. gingivalis. Our study proposes the possibility that P. oris may promote the colonization of P. gingivalis in an early stage of biofilm formation. Furthermore, this coaggregation may contribute to the initiation and progression of periodontitis.

OxyR Activation in Porphyromonas gingivalis in Response to a Hemin-Limited Environment

Porphyromonas gingivalis is a Gram-negative obligately anaerobic bacterium associated with several forms of periodontal disease, most closely with chronic periodontitis. Previous studies demonstrated that OxyR plays an important role in the aerotolerance of P. gingivalis by upregulating the expression of oxidative-stress genes. Increases in oxygen tension and in H(2)O(2) both induce activation of OxyR. It is also known that P. gingivalis requires hemin as an iron source for its growth. In this study, we found that a hemin-limited growth environment significantly enhanced OxyR activity in P. gingivalis. As a result, expression of sod, dps, and ahpC was also upregulated. Using a chromatin immunoprecipitation quantitative PCR (qPCR) analysis, DNA binding of activated OxyR to the promoter of the sod gene was enhanced in P. gingivalis grown under hemin-limited conditions compared to excess-hemin conditions. Cellular tolerance of H(2)O(2) was also enhanced when hemin was limited in the growth medium of P. gingivalis. Our work supports a model in which hemin serves as a signal for the regulation of OxyR activity and indicates that P. gingivalis coordinately regulates expression of oxidative-stress-related genes by this hemin concentration-dependent pathway.

Association between Human Body Composition and Periodontal Disease

Obesity in humans might increase the risk of periodontitis. The aim of the present study was to examine the relationship between body composition of males and their periodontal status. AS total of 150 males (aged 30–60) were selected: 31 were periodontally healthy, 45 had gingivitis, 39 had initial periodontitis, and 35 suffered from established periodontitis. BMI (body mass index), WC (waist circumference), and body composition parameters (consisting of body water, body fat, and skeletal muscle and bone mass) were measured. After adjusting for age, history of diabetes, smoking, physical activity status, and socioeconomic status, statistically significant correlations were found between periodontitis and BMI, WC, and body composition. There was only a statistically significant difference between the periodontal health and established periodontitis; that is, periodontal disease in mild forms (gingivitis) and initial periodontitis do not influence these variables (BMI, WC, and body composition parameters) and only the severe form of the disease influences the variables. These data suggest that there is a considerable association between severe forms of periodontal disease in males and their body composition, but this preliminary finding needs to be confirmed in more extensive studies.