Severe Periodontitis Research Articles

Passive Smoking - Effects of Second-Hand Smoke on Oral Health

Worldwide, smoking poses a serious threat to public health. Numerous research has examined how active smoking affects health, and the overall harmful effects of active smoking are widely acknowledged. In contrast, it's unclear how passive smoking affects your health. A number of disorders, including female breast cancer, allergic rhinitis, allergic dermatitis, and food allergies, have been linked to smoking, both actively and passively. The typical oral and nasopharyngeal flora are altered by passive smoking, which increases the risk of upper airway infection. In addition to producing severe periodontitis, implant failure, gingival pigmentation in children and adults, primary and permanent tooth decay, and tooth loss, it can impair alveolar bone density. But research on the effects of passive smoking on health has not been fully compiled and is still mainly inconclusive. Consequently, the total systemic and oral negative consequences of passive smoking exposure are the focus of this review.

Replantation After Dental Avulsion: A Scoping Review and Proposal of a Flow Chart.

Dental avulsion, the complete displacement of a tooth from its socket, is a severe dental trauma with a prevalence of 0.5% to 16% of all dental injuries. Replantation of avulsed teeth is common, yet recent studies show high failure rates and unpredictable long-term outcomes. This review examines clinical variables influencing intentional dental replantation decisions and proposes a treatment flow chart. A comprehensive literature search was conducted in PubMed-Medline, Scopus, WoS, and Cochrane databases using the keywords "tooth avulsion," "tooth replantation," and "tooth ankylosis." Inclusion criteria encompassed studies from January 2018 to February 2024. From 752 identified articles, 9 systematic reviews including 3 meta-analyses were selected for this scoping review. Immediate replantation is the gold standard for avulsed teeth, yet delayed replantation is more common in practice, impacting survival rates. Adherence to guidelines from the International Association on Dental Traumatology improves outcomes, especially in paediatric patients. Factors such as multiple caries, severe periodontal disease, advanced age, psychological conditions, immunodeficiency, and lack of cooperation are contraindications for replantation. Despite the high failure rate, replantation remains recommended in literature due to its potential advantages over prosthetic implants. This review highlights the complexities in decision-making for dental replantation, emphasising the need for a comprehensive approach considering individual clinical cases. A proposed treatment flow chart aims to support clinicians in predicting prognosis and making informed decisions. The review also underscores the link between dental trauma, poor oral health, and potential neglect in children, highlighting the importance of preventive measures and parental awareness.

Role of Melatonin in Periodontal Diseases: A Structured Review.

Melatonin is produced by the pineal gland and plays a role in regulating circadian rhythm. It influences the physiologic processes, such as the activation of the immune system and the antioxidant function. Melatonin has been reported in the samples of patients with periodontitis. Therefore, the role of melatonin in periodontal diseases must be appraised. Using the strategy of electronic search of various databases, we included studies, published until December 2021, measuring the expression of melatonin in patient samples and evaluating the effect of periodontal therapy on melatonin expression. This review also included studies evaluating the effect of melatonin supplementation on periodontal parameters. In total, 15 articles fulfilled the study inclusion criteria. The results revealed that melatonin is negatively correlated with the severity of periodontal diseases, and melatonin supplementation reduces the levels of periodontal inflammatory parameters. Hence, melatonin has a role in periodontal diseases, but additional studies are warranted to substantiate its use as a biomarker and host modulatory agent.

Periodontal health in patients with type 1 diabetes mellitus: relationship and risk factors of periodontitis progression

The article presents the results of literary sources review, namely clinical and experimental studies, meta-analyses and systematic analyzes regarding the effect of type 1 diabetes (T1D) on the periodontal tissues. According to them, the prevalence of periodontitis in patients with T1D is probably higher compared to healthy people. However, there are conflicting data on the cause-and-effect relationship between T1D and periodontitis. The article analyzes the impact of metabolic control in patients with T1D on the severity of periodontal diseases and the clinical attachment loss. Most studies show that the level of metabolic control of diabetes is associated with a high risk of developing periodontitis. The authors provide data from the analysis of the literature on possible mechanisms of periodontitis development, such as pro-inflammatory reactions and microcirculation disorders, changes in the microbial biofilm. Pathophysiological changes in bone tissue in patients with T1D, which are associated with insulin deficiency and its anabolic effect on bone tissue, worsen the biomechanical and adaptive properties of bones and may contribute to the severity of periodontitis. The conducted analysis indicates the importance of further research to assess the oral health in children with T1D.

Effect of minimally invasive treatment for intrabony defects using Bio-Oss® collagen.

The potential of Bio-Oss® collagen xenograft for treating intrabony defects using minimally invasive surgical methods is of interest. Hence, 30 defect sites in individuals with mild to severe chronic periodontitis were investigated. Participants were randomly divided into two groups of 15 each. Group A underwent regenerative MIST (minimally invasive surgical technique) with a bovine-derived xenograft, while Group B received only MIST. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment levels, and intrabony defect fill, were evaluated at three and six-month intervals. Significant improvements in periodontal parameters were observed in both groups, with Group A showing significantly better results.

Association of periodontitis with cardiometabolic and haemostatic parameters

ObjectiveTo investigate the association between periodontitis and cardiometabolic and haemostatic parameters.Materials and methodsBetween 2014 and 2019, 54 individuals needing full mouth extraction, and 50 control individuals, were recruited for a combined cross-sectional (individuals versus controls) and longitudinal (individuals before and after extraction) study. Periodontitis severity was measured using the periodontal inflamed surface area (PISA). Blood was drawn to measure the haemostatic (Factor VIII, von Willebrand factor [VWF], endogenous thrombin potential, d-dimer, clot lysis time) and cardiovascular risk (C-reactive protein [CRP], lipid profile) parameters, prior to and 12 weeks post-extraction. The results were analysed group-wise.ResultsThe mean VWF and CRP levels were higher and the high-density lipoprotein levels were lower in the individuals prior to extraction compared to the controls. The VWF was significantly correlated with the PISA (a 21% unit increase in VWF per 1000 mm2 increase in PISA, 95%CI: 6–36%, p = 0.01). The other analyses were comparable between the individuals and controls, and did not change in the individuals after the extraction.ConclusionVWF levels are associated with periodontitis severity; they do not improve after full-mouth extraction. Severe periodontitis in control individuals does not induce substantial changes in their haemostatic or inflammatory systems.Clinical relevanceTreatment of periodontitis has been shown to improve the cardiometabolic blood profile of patients with established cardiometabolic disease. However, whether periodontitis treatment improves cardiometabolic and haemostatic profiles in people without cardiometabolic disease is uncertain.

Association between brominated flame retardants (BFRs) and periodontitis: Results from a large population-based study

BackgroundBrominated flame retardants (BFRs) are widely utilized to mitigate the flammability of various materials. Previous studies have revealed the impact of BFRs exposure on hormonal disruption and bone metabolism which are closely related to periodontitis. However, it remains unknown the potential relationship between BFRs and periodontitis. This study aimed to explore the association between BFRs exposure and periodontitis in US adults.MethodsThe data analyzed in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. Twelve serum BFRs were quantified using isotope dilution gas chromatography high-resolution mass spectrometry. Univariable and multivariable logistic regression was employed to evaluate the association between serum BFRs and periodontitis. Bayesian kernel machine regression (BKMR) analyses were utilized to assess the association between mixtures of BFRs and periodontitis.ResultsA total of 3311 eligible participants were included. Serum BFRs (PBDE-47, PBDE-99, and PBDE-154) were significantly associated with periodontitis, and the odds ratios (ORs) and corresponding 95% confidence intervals(CIs) were 1.15(1.01,1.29), 1.10(1.01,1.20), and 1.12(1.01,1.25), respectively. Notably, these three BFRs were also significantly associated with the severity of periodontitis. Additionally, the BKMR model revealed a significant association between the mixture of all twelve BFRs and periodontitis.ConclusionsThis preliminary study suggests a significant association between specific serum BFRs (PBDE-47, PBDE-99, and PBDE-154) and periodontitis and its severity. Further prospective and experimental studies are warranted to validate our findings.

AMMP-8 POCT vs. Other Potential Biomarkers in Chair-Side Diagnostics and Treatment Monitoring of Severe Periodontitis.

This study aimed to compare several potential mouthrinse biomarkers for periodontitis including active matrix-metalloproteinase-8 (aMMP-8), total MMP-8, and other inflammatory biomarkers in diagnosing and monitoring the effects of nonsurgical periodontal therapy. Thirteen patients with stage III/IV periodontitis were recruited, along with thirteen periodontally and systemically healthy controls. These 13 patients were representative of the number of outpatients visiting any dentist in a single day. Full-mouth clinical periodontal parameters and biomarkers (the aMMP-8 point-of-care-test [POCT], total MMP-8, tissue inhibitor of MMPs (TIMP)-1, the aMMP-8 RFU activity assay, Myeloperoxidase, PMN elastase, calprotectin, and interleukin-6) were recorded at baseline and after nonsurgical therapy at 6 weeks. The aMMP-8 POCT was the most efficient and precise discriminator, with a cut-off of 20 ng/mL found to be optimal. Myeloperoxidase, MMP-8's oxidative activator, was also efficient. Following closely in precision was the aMMP-8 RFU activity assay and PMN elastase. In contrast, the total MMP-8 assay and the other biomarkers were less efficient and precise in distinguishing patients with periodontitis from healthy controls. aMMP-8, MPO, and PMN elastase may form a proteolytic and pro-oxidative tissue destruction cascade in periodontitis, potentially representing a therapeutic target. The aMMP-8 chair-side test with a cut-off of 20 ng/mL was the most efficient and precise discriminator between periodontal health and disease. The aMMP-8 POC test can be effectively used by dental professionals in their dental practices in online and real-time diagnoses as well as in monitoring periodontal disease and educating and encouraging good oral practices among patients.

The Role of Bone and Root Resorption on the Biomechanical Behavior of Mandibular Anterior Teeth Subjected to Orthodontic Forces: A Finite Element Approach.

This study was conducted to systematically evaluate the biomechanical impact of varying degrees of root and bone resorption resulting from periodontitis and orthodontic tooth movement (OTM) on the mandibular anterior teeth. The objective was to determine whether these distinct resorption patterns exert a specific influence on tooth displacement and strain patterns. A finite element (FE) model of an idealized anterior mandible from the first premolar in the third to the fourth quadrant was developed without bone or root resorption and a constant periodontal ligament (PDL) thickness of 0.2 mm. Variations included three root resorption levels (0%, 20%, 50%) and three bone resorption types (circular 50%, circular 80%, vestibular 80%). Models ranged from 200,000 to 440,000 elements and 55,000 to 130,000 nodes. Orthodontic forces, namely root torque (5 Nmm), intrusion (0.2 N), and distalization (0.5 N) were applied for subsequent crown displacement and PDL strain analysis. A total of 180 simulations were performed. Simulations showed that displacement was similar across different bone resorption conditions, irrespective of modeled root resorptions. Circumferential bone resorption increased tooth displacement, regardless of root resorption status. Vestibular bone resorption exhibited less increase in tooth displacement. However, when accompanied by root resorption, the combination exacerbated tooth displacement. Strains in the PDL clearly increased with a circumferential bone resorption of 80%. This study highlights the critical role of bone resorption in tooth displacement during OTM, particularly the challenges associated with circumferential resorption. Clinicians must consider both bone and root resorption for personalized medicine treatment of patients with severe periodontitis, in favor of low-force application strategies to optimize outcomes and minimize complications linked to excessive tooth displacement.

Smoking's impact on pocket closure after nonsurgical periodontal treatment in relation to bleeding on probing.

Our aim was to investigate the impact of smoking on pocket closure at six months after treatment of severe periodontitis, in relation to residual clinical inflammation. The clinical records of deep pockets (probing depth≥6 mm, n&#61;984) in 46 individuals with periodontitis were analyzed. Following baseline clinical assessments (plaque index, probing depth, clinical attachment level, and bleeding on probing), non-surgical periodontal treatment was performed. Clinical assessments were repeated at 2 and 24 weeks after periodontal therapy. A logistic regression model using generalised estimation equations (GEE) adapting the cluster robust standard errors was performed to investigate potential associations between bleeding on probing and pocket closure at post-treatment 24 weeks. Absence of bleeding at two weeks after non-surgical treatment related to pocket closure after six-months. Pockets that do not bleed neither at baseline nor two weeks (OR&#61;2.7; P <.005) and pockets of non-smokers (OR&#61;6.32; P <.001) and females (OR&#61;1.79; P &#61;.022) associated with pocket closure at six months. Pocket closure is associated with being a non-smoker and the absence of inflammation after non-surgical periodontal treatment, which indicates the importance of smoking cessation and inflammation control in achieving optimal clinical outcomes.

Role of circulating microparticles and cytokines in periodontitis associated with diabetes.

Periodontitis is a chronic inflammatory condition that affects the supporting tissues of the teeth, and can lead to serious complications such as tooth loss and systemic health problems, including diabetes, which have a bidirectional relationship with periodontitis. Circulating microparticles originate from different cell types after stimuli such as activation or apoptosis. Interleukins are related to processes in the regulation of the immune response, inflammation, and cell growth. This study aimed to evaluate circulating microparticles as well as interleukins in the plasma, at baseline and 1 month after the end of the non-surgical periodontal treatment. Samples were collected from 45 patients, with moderate to severe periodontitis with diabetes (N = 25) and without diabetes (N = 20). Microparticles were evaluated in the platelet-poor plasma by flow cytometer. Cytokine levels were evaluated by the enzyme immunoabsorption assay (ELISA). Higher levels of the pro-inflammatory cytokines were found in the group with diabetes compared to the non-diabetic group both at baseline and 1 month after the end of the treatment. A higher IL-6/IL-10 ratio was found in patients with diabetes compared to the group without diabetes at T0 and T1, whereas an increased IFN-γ/IL-10 ratio was only found at T1 in patients with diabetes in comparison to the group without diabetes. In the group with diabetes, it was verified positive correlations between IL-10 and IL-6 or IFN-γ and a negative correlation between IL-6 and PMP, at T0; in contrast, in the T1, negative correlations were found between TNF-α and IL-10 or PMP. Besides, at T0, it was evidenced positive correlations both between circulating TNF-α and IL-6, and IL-10 and EMP, as well as a negative correlation between IL-10 and PMP in the group with diabetes. In addition, it was observed in T1 positive correlations between levels of TNF-α and IL-6, IFN-γ, or IL-10, and between PMP and IFN-γ, and between EMP and IL-6, TNF-α and IFN-γ in this group. The results suggest a modulatory effect of the periodontitis associated with diabetes, as well as the periodontal treatment, in the systemic inflammatory status of the participants of the study.

Association of tooth loss and periodontal disease with all-cause mortality in cancer survivors: A cohort study based on NHANES

BackgroundIncreasing evidence supports the association between impaired oral health and elevated mortality. However, there is currently a lack of research on the impact of tooth loss and periodontal disease on survival outcomes in cancer survivors. This study aims to clarify the effect of tooth loss and periodontitis on all-cause mortality on cancer survivors. MethodsThe clinical data of cancer survivors were collected from National Health and Nutrition Examination Survey (NHANES) 1999–2018. Mortality data were obtained by linking to records in the National Death Index until December 31, 2019. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal threshold for discriminating mortality based on the number of teeth lost. Kaplan–Meier survival curves and Cox regression analysis were performed to calculate hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for tooth loss and periodontitis. ResultsA total of 3271 cancer survivors were assessed for tooth loss status, while 1267 patients were evaluated for periodontitis status. The prevalence of any tooth loss and CDC-AAP periodontitis was 83.5 % and 47.2 %, respectively. The ROC curve showed the cut-off point of tooth loss for predicting mortality is > 5. Cancer survivors with tooth loss>5 had significantly lower bone density (1.06 vs. 1.13 g/cm2, P < 0.001), elevated C-reactive protein level (0.3 vs. 0.18 mg/dL, P < 0.001), and a trend of lower lean body mass (46.9 vs. 47.6 kg, P = 0.093). Besides, cancer survivors with severe periodontitis also exhibited elevated C-reactive protein level (0.34 vs. 0.21 mg/dL, P = 0.033). All-cause mortality significantly increased in cancer survivors with either tooth loss>5 (HR = 1.290, P = 0.001) or severe CDC-AAP periodontitis (HR = 1.682, P = 0.016) in the multivariate Cox regression analysis. ConclusionTooth loss and periodontitis are strong risk factors for reduced overall survival in cancer survivors. Cancer survivors should emphasize diligent oral hygiene and consistent dental check-ups to optimize long-term oral health. The causal relationship between oral health and survival rates in cancer survivors requires further validation through randomized controlled trials.

Clinical Application of Basic Treatment Combined with Periodontal Maintenance in the Treatment of Chronic Periodontitis

Objective: To analyze the clinical effect of basic treatment combined with periodontal maintenance treatment on chronic periodontitis patients and its impact on periodontal index. Method: 100 patients with severe and chronic periodontitis who voluntarily participated were collected as participants and divided into a control group (50 cases, receiving basic treatment) and an observation group (50 cases, receiving basic treatment combined with periodontal maintenance). The admission time of patients was within the range of April 2022 to April 2023 to analyze and compare the clinical efficacy of the two groups of patients after treatment, analyze the changes in periodontal index after treatment and compare between groups, and analyze and compare the annual number of missing teeth and the recurrence rate of periodontitis between the two groups of patients after treatment. Result: Compared with 76.00% of the clinical effect in the control group, the observation group had a higher clinical effect of 94.00%; Compared with before treatment, PD, BI, PET, CAL and other indicators all decreased after treatment, and the observed group showed a more significant downward trend; The annual number of missing teeth in the control group was (1.32 ± 0.27), which was higher than that in the observation group (0.63 ± 0.18); The recurrence rate of the control group was 42.11% (16/38), which was higher than the observation group's 17.02% (8/47), and the difference was statistically significant (P&lt;0.05). Conclusion: The combination of basic treatment and periodontal maintenance therapy for patients with chronic periodontitis has good clinical application effects, improve their periodontal indicators, and reduce the recurrence rate of periodontitis and the probability of tooth loss.

Association of periodontitis with cardiovascular and all-cause mortality in hypertensive individuals: insights from a NHANES cohort study

BackgroundThe objective of this research is to clarify the impact of periodontitis on overall and cardiovascular-related death rates among hypertensive individuals.MethodA total of 5665 individuals with hypertension were included from the National Health and Nutrition Examination Survey (NHANES) data spanning 2001–2004 and 2009–2014. These individuals were divided into two groups based on the presence or absence of periodontitis and further stratified by the severity of periodontitis. We employed weighted multivariate Cox proportional hazards regression and Kaplan-Meier curves (log-rank test) to evaluate the impact of periodontitis on all-cause and cardiovascular mortality. Additional analyses, including adjustments for various covariates, subgroups, and sensitivity analyses, were conducted to ensure the robustness and reliability of our results.ResultOver an average follow-up duration of 10.22 years, there were 1,122 all-cause and 297 cardiovascular deaths. Individuals with periodontitis exhibited an elevated risk of all-cause mortality (HR = 1.33, 95% CI 1.18–1.51; p < 0.0001) and cardiovascular mortality (HR = 1.48, 95% CI 1.15–1.89; p = 0.002). Moreover, we observed a progressive increase in both all-cause mortality and cardiovascular mortality (p for trend are both lower than 0.001) and correlating with the severity of periodontitis. These associations remained consistent across various subgroup and sensitivity analyses.ConclusionOur findings suggest a significant association between periodontitis and increased risks of all-cause and cardiovascular mortality among hypertensive individuals. Notably, the severity of periodontitis appears to be a critical factor, with moderate to severe cases exerting a more pronounced impact on all-cause mortality. Additionally, cardiovascular disease mortality significantlly increases in individuals with varying degrees of periodontitis.

Deep Convolutional Neural Network for Automated Staging of Periodontal Bone Loss Severity on Bite-wing Radiographs: An Eigen-CAM Explainability Mapping Approach.

Periodontal disease is a significant global oral health problem. Radiographic staging is critical in determining periodontitis severity and treatment requirements. This study aims to automatically stage periodontal bone loss using a deep learning approach using bite-wing images. A total of 1752 bite-wing images were used for the study. Radiological examinations were classified into 4 groups. Healthy (normal), no bone loss; stage I (mild destruction), bone loss in the coronal third (< 15%); stage II (moderate destruction), bone loss is in the coronal third and from 15 to 33% (15-33%); stage III-IV (severe destruction), bone loss extending from the middle third to the apical third with furcation destruction (> 33%). All images were converted to 512 × 400 dimensions using bilinear interpolation. The data was divided into 80% training validation and 20% testing. The classification module of the YOLOv8 deep learning model was used for the artificial intelligence-based classification of the images. Based on four class results, it was trained using fivefold cross-validation after transfer learning and fine tuning. After the training, 20% of test data, which the system had never seen, were analyzed using the artificial intelligence weights obtained in each cross-validation. Training and test results were calculated with average accuracy, precision, recall, and F1-score performance metrics. Test images were analyzed with Eigen-CAM explainability heat maps. In the classification of bite-wing images as healthy, mild destruction, moderate destruction, and severe destruction, training performance results were 86.100% accuracy, 84.790% precision, 82.350% recall, and 84.411% F1-score, and test performance results were 83.446% accuracy, 81.742% precision, 80.883% recall, and 81.090% F1-score. The deep learning model gave successful results in staging periodontal bone loss in bite-wing images. Classification scores were relatively high for normal (no bone loss) and severe bone loss in bite-wing images, as they are more clearly visible than mild and moderate damage.

Estimating disease prevalence from partially-sampled clusters using the conditional linear family for multivariate Bernoulli data

In periodontal disease surveillance in human populations, full-mouth clinical examinations to classify the disease status of individuals are the gold standard for estimating periodontitis prevalence. However, conducting full-mouth exams is resource intensive, time consuming, and costly, especially in studies involving thousands of participants. Partial-recording protocols have been utilized in oral health surveys worldwide to gather correlated binary outcomes of periodontal disease on selected teeth in lieu of full-mouth exams. Since the use of partial-recording protocols tends to underestimate disease prevalence, a statistical distributional approach considering the pattern of tooth-level disease in the mouth was proposed to substantially reduce bias for the estimation of periodontitis prevalence. This approach employed multivariate Bernoulli distributions for observation (tooth)-level disease indicators to define formulae for the prevalence of disease (periodontitis) at the cluster (person)-level for various full-mouth case definitions. In turn, prevalence estimators were based on plug- in estimates of parameters from a conditional linear family for binary data gathered under partial recording protocols. Work in this article extended existing prevalence estimators for simple case definitions based on single clinical measures of tooth-level periodontal disease to a definition of severe periodontitis using two measures as defined by the Centers for Disease Control and Prevention and the American Academy of Periodontology, and later adopted by the 2017 World Workshop in Periodontology. Simulations evaluated the finite-sample performance of the proposed estimators and their confidence intervals for three established partial-recording protocols. In general, the prevalence estimators performed well relative to bias and coverage when tooth-level probabilities of disease and within-mouth correlation structures were correctly specified and even when the pattern of tooth-pair correlations was misspecified. Journal of Statistical Research 2024, Vol. 58, No. 1, pp. 3-31.

Effect of Laser Combined with Periodontal Flap Surgery on Severe Periodontitis

Objective: To explore the clinical effect of laser combined periodontal flap surgery in patients with severe periodontitis. Methods: Eighty patients with severe periodontitis from March 2023 to March 2024 were selected as study samples and randomly divided into two groups. The control group (a total of 40 patients) received only traditional periodontal flap surgery as a treatment option. In contrast, the observation group (which also included 40 patients) combined Er: YAG laser technology with periodontal flap surgery during treatment. The periodontal health of the two groups was compared before treatment and 3 months after treatment. Compare pain and sleep patterns; The treatment efficiency of the two groups was compared. Results: After treatment, the indexes of PD, PLI, GI, SBI, VAS score and PSQI score of 2 groups were lower than before treatment, and the decrease rate of observation group was higher than control group (P &lt; 0.05). The effective rate of observation group was significantly higher than that of control group (P &lt; 0.05). Conclusion: Laser combined periodontal flap surgery has significant clinical effect on patients with severe periodontitis, which can improve the periodontal condition and sleep status, and reduce the postoperative pain of patients.

Healthy lifestyles ameliorate an increased risk of periodontitis associated with polycyclic aromatic hydrocarbons

The risk of chronic inflammatory diseases has been linked to exposure to polycyclic aromatic hydrocarbons (PAHs). However, limited data are available regarding their impact on periodontitis. This study aims to explore the association between PAHs and periodontitis while also evaluating the potential modifying effects of healthy lifestyles. We included 17,031 participants from the US National Health and Nutrition Examination Survey (NHANES, 2001–2004 and 2009–2014). A meta-analysis-based environment-wide association study (EWAS) was adopted to identify environmental chemicals for the mean probing pocket depth (PPD) and the mean attachment loss (AL). PAHs were further evaluated concerning the cross-sectional association with Mod/Sev periodontitis using multivariable logistic regression models. Moreover, healthy lifestyle scores were estimated to assess their modifying effect on the PAH–periodontitis association. EWAS analysis identified several urinary PAH metabolites as significant risk factors for the mean PPD and AL (false discovery rate <0.05, Q > 0.05). Periodontitis severity was positively associated with eight individual and total PAH concentrations. Stratifying the participants in terms of healthy lifestyle scores did not reveal any association in the healthy group. Moreover, the association weakened in never-smokers and individuals with sufficient physical activity and normal weight. PAH exposure was a risk factor for periodontitis. A healthier lifestyle was observed to offset the risk potentials of PAHs for periodontitis. Smoking cessation, physical activity, and weight loss might be recommended as a healthy lifestyle strategy for ameliorating PAH-related periodontitis.

Effect of photobiomodulation with different wavelengths on periodontal repair in non-hyperglycemic and hyperglycemicrats.

Hyperglycemic conditions is associated with more severe periodontitis and poorer outcomes after nonsurgical periodontal treatment (NPT). Then, these patients are candidates for adjunctive therapy associated with NPT. This study evaluates the effect of photobiomodulation (PBMT) at different wavelengths on periodontal repair in non-hyperglycemic/hyperglycemic animals. Sixty-four rats were submitted to induction of periodontitis by ligatures. Hyperglycemia was induced in half of these animals, whereas the other half remained non-hyperglycemic. The animals were subdivided into 4 groups according to the PBMT protocol applied at the time of ligature removal (n = 8): CTR: Without PBMT; IRL: PBMT with infrared laser (808 nm); RL: PBMT with red laser (660 nm); and RL-IRL: PBMT with red (660 nm) and infrared laser (808 nm). After a period of 7 days, the animals were euthanized. The parameters assessed by microtomography were the bone volume relative to total tissue volume (BV/TV%), distance from the cemento-enamel junction to the top of the bone crest (CEJ-CB), trabecular thickness, space between trabeculae, and number of trabeculae. Additionally, the percentage of inflammatory cells, blood vessels, and connective tissue matrix were assessed by histomorphometric analysis. PBMT reduced bone loss and increased trabecular density in hyperglycemic animals (p < .05), with RL being more effective in reducing linear bone loss (CEJ-CB), whereas RL-IRL was more effective in maintaining BV/TV%. PBMT reduced blood vessels and increased the connective tissue component in hyperglycemic animals (p < .05). RL-IRL reduced inflammatory cells regardless of the systemic condition of the animal (p < .05). PBMT (RL, RL-IRL) improves the repair of periodontal tissues in hyperglycemic animals.

Association between proton pump inhibitors use and the severity of periodontal disease and peri-implantitis: a systematic review.

This systematic review investigates the probable effect of proton pump inhibitor (PPI) use on the severity of periodontal disease and peri-implantitis and implant survival. We conducted a literature search in PubMed, Scopus, and Cochrane Central Library up to April 2024. Two review authors independently screened the title and abstracts and then the full texts of retrieved studies. Observational and clinical trial studies that assessed the association between PPIs use and periodontal disease severity and peri-implantitis or implant survival were included. Data extraction from the included studies was done by two reviews independently. Of 940 studies initially retrieved from online searching, 7 research met the inclusion criteria. Three studies examined periodontitis, while four focused on peri-implantitis and implant longevity. On the contrary, evidence regarding the impact of PPIs use on peri-implantits and implant survival is conflicting. Therefore, more well-designed RCTs are warranted to come to a definite conclusion. Since proton pump inhibitors alter the gut microbiome, and affect bone, plus the pathogenesis and etiology of periodontal disease are affected by bacteria within the periodontal pocket, it is hypothesized that they may affect periodontal pathogenesis.