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Influence of Risk Factors on Periodontitis and Periodontal Treatment

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 26937

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Prof. Dr. Olivier Huck

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Department of Periodontics, University of Strasbourg, 67000 Strasbourg, France
Interests: periodontology; implant dentistry; dental implantology; oral diseases; oral surgery; immunology
Special Issues, Collections and Topics in MDPI journals

Dr. Hélène Rangé

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Assistant Guest Editor

Dental Faculty, Université de Paris, 75006 Paris, France
Interests: periodontology; implantology; oral microbiota; epidemiology

Dr. Ulkü Baser

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Assistant Guest Editor

Faculty of Dentistry, Istanbul University, 34134 Istanbul, Turkey
Interests: periodontology; implantology; periodontitis-systemic disease interactions; inflammation

Dr. Alexandra Stähli

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Assistant Guest Editor

Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
Interests: periodontology; periodontal regeneration; cell biology

Special Issue Information

Dear Colleagues,

On behalf of IJERPH, we are organizing a Special Issue focusing on risk and influencing factors associated with periodontitis and periodontal treatment. Periodontitis is a highly prevalent inflammatory disease affecting more than 50% of the population worldwide. Diagnosis and management of periodontitis are challenging as several risk factors have already been identified, such as smoking, diet, and systemic diseases (diabetes, chronic inflammatory diseases). However, the profile of at-risk patient needs to be clearly determined through consideration of new potential risk factors.

Studies involving the following topics are welcome for this Special issue in IJERPH:

Assessment of risk factors on periodontitis incidence;
Evaluation of risk factors on periodontal treatment outcomes;
Biomarkers associated to periodontitis diagnosis and prognosis;
Development of prognosis assessment tools.

Dr. Olivier Huck
Dr. Hélène Rangé
Dr. Ulkü Baser
Dr. Alexandra Stähli
Guest Editors

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Keywords

periodontitis
inflammation
oral microbiota
smoking
risk assessment

Published Papers (9 papers)

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11 pages, 873 KiB

Open AccessArticle

No Obvious Role for Suspicious Oral Pathogens in Arthritis Development

by Poerwati S. Rahajoe, Menke J. de Smit, Elisabeth Raveling-Eelsing, Marines du Teil Espina, Tim Stobernack, Paola Lisotto, Hermie J. M. Harmsen, Jan Maarten van Dijl, Nyoman Kertia, Arjan Vissink and Johanna Westra

Int. J. Environ. Res. Public Health 2021, 18(18), 9560; https://doi.org/10.3390/ijerph18189560 - 10 Sep 2021

Cited by 4 | Viewed by 2456

Abstract

A particular role for Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) has been suggested in periodontitis and rheumatoid arthritis (RA), as these bacteria could initiate the formation of rheumatoid factor (RF) and anticitrullinated protein autoantibodies (ACPA). We assessed whether serum antibodies against Pg and Aa in RA patients and non-RA controls reflect the subgingival presence of Pg and Aa, and evaluated the relationship of these antibodies to the severity of periodontal inflammation and RA-specific serum autoantibodies. In 70 Indonesian RA patients and 70 non-RA controls, the subgingival presence of Pg and Aa was assessed by bacterial 16S rRNA gene sequencing, and serum IgG levels specific for Pg and Aa were determined. In parallel, serum levels of ACPA (ACPA:IgG,IgA) and RF (RF:IgM,IgA) were measured. The extent of periodontal inflammation was assessed by the periodontal inflamed surface area. In both RA patients and the controls, the presence of subgingival Pg and Aa was comparable, anti-Pg and anti-Aa antibody levels were associated with the subgingival presence of Pg and Aa, and anti-Pg did not correlate with ACPA or RF levels. The subgingival Pg and Aa were not related to RA. No noteworthy correlation was detected between the antibodies against Pg and Aa, and RA-specific autoantibodies. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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10 pages, 770 KiB

Open AccessArticle

Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study

by Catherine Petit, Victor Anadon-Rosinach, Nicolas Tuzin, Jean-Luc Davideau and Olivier Huck

Int. J. Environ. Res. Public Health 2021, 18(17), 9394; https://doi.org/10.3390/ijerph18179394 - 06 Sep 2021

Cited by 4 | Viewed by 2291

Abstract

Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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9 pages, 345 KiB

Open AccessArticle

Impact of Smoking on Neutrophil Enzyme Levels in Gingivitis: A Case-Control Study

by Rumeysa Omer-Cihangir, Ulku Baser, Canan Kucukgergin, Gokce Aykol-Sahin, Olivier Huck and Funda Yalcin

Int. J. Environ. Res. Public Health 2021, 18(15), 8075; https://doi.org/10.3390/ijerph18158075 - 30 Jul 2021

Cited by 2 | Viewed by 2623

Abstract

Background: The determination of the impact of risk factors such as smoking in periodontal disease development is of importance to better characterize the disease. However, its impact on host response remains unclear. This study aimed to evaluate the effects of tobacco smoking on GCF levels of neutrophil enzymes (myeloperoxidase (MPO), beta-glucuronidase (BGD), neutrophil elastase (NE) and periodontal parameters in healthy young adults with dental plaque biofilm-induced gingivitis. Methods: The study population consisted of 60 systemically healthy young adults (39 smokers (Sm) and 21 non-smokers (n-Sm)) diagnosed with plaque-induced gingivitis. The periodontal examination consisted of a plaque index (PI); gingival index (GI); probing depth (PD); bleeding on probing (BoP), and clinical attachment level (CAL). GCF MPO, BGD, and NE levels were determined by means of an enzyme-linked immunosorbent assay (ELISA). Results: PI, GI, and BoP were significantly increased in the Sm group (p < 0.05). PD and CAL showed no significant difference between Sm and n-Sm groups (p > 0.05). In GCF, MPO, BGD, and NE levels were significantly increased in Sm group (p < 0.05). NE levels showed a significant correlation with GI and BoP (p < 0.05 for both). Moreover, a positive correlation between BGD and NE levels (p < 0.05) was measured. Conclusions: It may be concluded that, even in young patients, tobacco consumption affects the host’s immune response related to gingival inflammation. It is, therefore, mandatory to inform young patients about the risk related to tobacco consumption for their gingival health. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

9 pages, 337 KiB

Open AccessArticle

Risk Factors for Oral Health in Anorexia Nervosa: Comparison of a Self-Report Questionnaire and a Face-to-Face Interview

by Hélène Rangé, Alice Pallier, Aminata Ali, Caroline Huas, Pierre Colon and Nathalie Godart

Int. J. Environ. Res. Public Health 2021, 18(8), 4212; https://doi.org/10.3390/ijerph18084212 - 16 Apr 2021

Cited by 2 | Viewed by 2415

Abstract

Behavioral, nutritional, and local risk factors for oral health are frequent in people with anorexia nervosa. However no self-report questionnaire is available for screening in clinical practice or for research purposes. The objective of this study was to design a questionnaire to identify risk factors and symptoms of oral diseases and to test its reliability as a self-report form among people with anorexia nervosa. A 26-item questionnaire was designed based on a sound literature review performed by a group of dentists, psychiatrists, and epidemiologists specialized in the field of eating disorders. Sixty-nine anorexia nervosa inpatients (mean age 18.72 ± 5.1) were included from four specialized units. The questionnaire was first self-reported by the patients, then the same questionnaire was administrated by a dentist during a structured face-to-face interview as the gold standard. The concordance between the two forms was evaluated globally and item per item using Cohen’s kappa statistical tests. The overall concordance between the self-report questionnaire and the face-to-face structured interview was 55%. Of the 26 items, 19 showed significant concordance. Items relating to water intake, extracted teeth, gingival status, and oral hygiene had the best concordance (all kappa coefficients > 0.4). A questionnaire that identifies risk factors and symptoms of oral diseases in anorexia nervosa was developed and tested. The 26-item form of the questionnaire (long version) is moderately reliable as a self-reported form. A short version of the questionnaire, including the 10 most reliable items, is recommended for oral risk assessment in patients with anorexia nervosa. The clinical value of the self-administered questionnaire remains to be evaluated. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

8 pages, 322 KiB

Open AccessArticle

Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification

by Meliha Germen, Ulku Baser, Cagdas Caglar Lacin, Erhan Fıratlı, Halim İşsever and Funda Yalcin

Int. J. Environ. Res. Public Health 2021, 18(7), 3459; https://doi.org/10.3390/ijerph18073459 - 26 Mar 2021

Cited by 43 | Viewed by 4182

Abstract

Background: This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. Methods: We included 488 participants aged 35–74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). Results: The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III–IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. Conclusion: It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

12 pages, 1997 KiB

Open AccessArticle

Potential Suppressive Effect of Nicotine on the Inflammatory Response in Oral Epithelial Cells: An In Vitro Study

by Na An, Jasmin Holl, Xuekui Wang, Marco Aoqi Rausch, Oleh Andrukhov and Xiaohui Rausch-Fan

Int. J. Environ. Res. Public Health 2021, 18(2), 483; https://doi.org/10.3390/ijerph18020483 - 09 Jan 2021

Cited by 12 | Viewed by 3202

Abstract

Smoking is a well-recognized risk factor for oral mucosal and periodontal diseases. Nicotine is an important component of cigarette smoke. This study aims to investigate the impact of nicotine on the viability and inflammatory mediator production of an oral epithelial cell line in the presence of various inflammatory stimuli. Oral epithelial HSC-2 cells were challenged with nicotine (10⁻⁸–10⁻² M) for 24 h in the presence or absence of Porphyromonas gingivalis lipopolysaccharide (LPS, 1 µg/mL) or tumor necrosis factor (TNF)-α (10⁻⁷ M) for 24 h. The cell proliferation/viability was determined by MTT assay. Gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, and β-defensin was assayed by qPCR. The production of IL-8 protein and cell surface expression of ICAM-1 was assessed by ELISA and flow cytometry, respectively. Proliferation/viability of HSC-2 cells was unaffected by nicotine at concentrations up to 10⁻³ M and inhibited at 10⁻² M. Nicotine had no significant effect on the basal expression of IL-8, ICAM-1, and β-defensin. At the same time, it significantly diminished P. gingivalis LPS or the TNF-α-induced expression levels of these factors. Within the limitations of this study, the first evidence was provided in vitro that nicotine probably exerts a suppressive effect on the production of inflammatory mediators and antimicrobial peptides in human oral epithelial cells. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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10 pages, 576 KiB

Open AccessArticle

Analyzing the Association between Hyperuricemia and Periodontitis: A Cross-Sectional Study Using KoGES HEXA Data

by Soo-Hwan Byun, Dae-Myoung Yoo, Jung-Woo Lee and Hyo-Geun Choi

Int. J. Environ. Res. Public Health 2020, 17(13), 4777; https://doi.org/10.3390/ijerph17134777 - 02 Jul 2020

Cited by 16 | Viewed by 3260

Abstract

Hyperuricemia arises from the buildup of excessive uric acid in the blood, and it is implicated in the development of periodontitis. The objective of this study was to investigate the association between hyperuricemia and periodontitis using a cross-sectional study design and Korean Genome and Epidemiology Study Health Examinee (KoGES HEXA) data. This prospective cohort study used epidemiological data from the KoGES from 2004 to 2016. Among 173,209 participants, 8809 with hyperuricemia and 126,465 controls (non-hyperuricemia) were selected. This study defined hyperuricemia as >7.0 mg/dL of uric acid in men and >6.0 mg/dL in women. This study analyzed the history of periodontitis among hyperuricemia and control participants. Participants’ age, gender, income, obesity, smoking, alcohol consumption, and nutritional intake were all examined. Chi-square tests, independent t-tests, and two-tailed analyses were used for statistical analysis. The adjusted OR (aOR) of hyperuricemia for periodontitis was 0.89 (95% confidence interval (CI) = 0.81–0.96, p = 0.005). This study demonstrated that hyperuricemia was associated with periodontitis. This finding meant that elevated uric acid levels could have a positive effect on periodontitis. However, further studies should be performed to determine the range of uric acid levels beneficial to periodontal health. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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11 pages, 703 KiB

Open AccessArticle

Impact of Molar Furcations on Photodynamic Therapy Outcomes: A 6-Month Split-Mouth Randomized Clinical Trial

by Aymeric Courval, Laetitia Harmouche, Anne Mathieu, Catherine Petit, Olivier Huck, François Séverac and Jean-Luc Davideau

Int. J. Environ. Res. Public Health 2020, 17(11), 4162; https://doi.org/10.3390/ijerph17114162 - 11 Jun 2020

Cited by 4 | Viewed by 2867

Abstract

The effectiveness of adjunctive photodynamic treatment (PDT) to non-surgical periodontal therapy has been shown to depend on initial periodontal status. As molar furcation involvement impairs healing response to non-surgical periodontal therapy, the aim of this study was to evaluate the impact of furcation involvement on PDT outcomes. Thirty-six patients suffering from severe chronic periodontitis were included in a 6-month split-mouth randomized clinical trial. PDT applications used the toluidine blue O and a light-emitting diode (LED) with a red spectrum. Repeated PDT applications were performed in addition to non-surgical periodontal treatment at baseline and at 3-months. Pocket probing depth (PPD), plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, and again at 3- and 6-months. Furcation sites of molars were compared to other sites of molars and non-molars. Multilevel analysis showed no PDT effect in molar furcation sites while an additional significant reduction (odds ratio = 0.67) of pockets with PPD > 5 mm in other sites at 3-months was measured. PPD reduction appeared delayed in molar furcation sites treated with PDT. There is no additional apparent benefit to use PDT in molar furcation sites for the reduction of pockets with PPD > 5 mm contrary to other sites. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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10 pages, 2396 KiB

Open AccessCase Report

Dental and Periodontal Care at the Bedside Using a Portable Dental Unit in Hospitalized Special Needs Patients: The Experience of an Italian Pediatric Hospital

by Angela Galeotti, Massimiliano Ciribè, Giorgio Matarazzo, Giancarlo Antonielli, Paola Festa, Alessandro Inserra, Annelyse Garret-Bernardin, Michele Callea and Massimiliano Raponi

Int. J. Environ. Res. Public Health 2021, 18(15), 7987; https://doi.org/10.3390/ijerph18157987 - 28 Jul 2021

Cited by 1 | Viewed by 2387

Abstract

Patients with special needs (SNPs) include individuals who are disabled due to physical limitations, medical complications, developmental problems, and cognitive impairments. SNPs may be at an increased risk of oral diseases throughout their lifetime. These patients have difficulties in accessing traditional dental studios or clinics. Moreover, orodental problems may cause local and generalized infections, leading to worrisome complications when not properly treated. In this paper, we describe the preliminary experience of treating dental problems in a series of nine hospitalized patients with special needs. This innovative protocol at the Bambino Gesù Children’s Hospital (Rome, Italy) provides an introduction to a portable dental unit in order to perform oral care for hospitalized patients at the bedside. A multidisciplinary team composed of pediatric dentists, dental hygienists, nursing staff, and the patient’s case manager was involved in the operative protocol. The SNPs described were affected by congenital heart or oncohematological diseases and neurodisabilities, and they were all hospitalized for different reasons: Open heart surgery, chemotherapy, organ transplantation, and rehabilitation. The oral evaluation was mandatory for ruling out or treating problems that could cause complications. Dental extractions, caries and fracture fillings, sealing, and oral hygiene procedures were performed at the bedside of the patients in the reference unit of their pediatric hospital. The results of this protocol confirm the feasibility of dental procedures at patients’ bedside with portable dental units, encourage implementation of their use, and may represent an actionable model for oral care management in hospitalized SNPs. Full article

(This article belongs to the Special Issue Influence of Risk Factors on Periodontitis and Periodontal Treatment)

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