Periodontitis: Current Status and the Future

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (25 August 2022) | Viewed by 35264

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Guest Editor
Department of Operative Dentistry and Periodontology, Martin Luther University, Halle-Wittenberg, Germany
Interests: periodontitis and systemic diseases; genetic end epigenetic risk markers; complex oral microbiome

Special Issue Information

Dear Colleagues,

Periodontitis is a common inflammatory disease in which the composition of the oral biofilm as wells as the individual immune response have significant impacts. Severe periodontitis was amongst the most prevalent condition in the world in accordance to the Global Burden of Disease Study (2016), leading to periodontitis being a public health problem.

It is widely accepted that periodontitis may be a modifiable risk factor/modulator for several systemic diseases including diabetes, cardiovascular disease, adverse pregnancy outcomes, rheumatoid arthritis, chronic obstructive pulmonary disease, and chronic kidney disease. It seems to have an influence not only on the manifestation and progression but also on the prognosis of several systemic diseases. The biological plausibility linking periodontitis and various systemic diseases could, among other things, be due to bacteremia and the associated systemic inflammatory consequences. This raises the question of whether individualized periodontal therapy could possibly reduce the risk of the development of systemic diseases or positively influence their outcome.

Dr. Susanne Schulz
Guest Editor

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Keywords

  • periodontitis and global health
  • current pathophysiological understanding of periodontitis
  • bidirectional interactions of periodontitis and systemic diseases
  • impact of periodontitis on the prognosis of systemic diseases
  • risk factors and modulators linking periodontitis and systemic diseases
  • intervention studies: effect of periodontal therapy
  • perspectives of an individualized periodontal therapy

Published Papers (15 papers)

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Research

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12 pages, 1247 KiB  
Article
The Correlation between Periodontal Parameters and Cell-Free DNA in the Gingival Crevicular Fluid, Saliva, and Plasma in Chinese Patients: A Cross-Sectional Study
by Xuanzhi Zhu, Chao-Jung Chu, Weiyi Pan, Yan Li, Hanyao Huang and Lei Zhao
J. Clin. Med. 2022, 11(23), 6902; https://doi.org/10.3390/jcm11236902 - 23 Nov 2022
Cited by 9 | Viewed by 1351
Abstract
Purpose: To investigate the correlation between periodontal parameters and cell-free DNA (cfDNA) concentrations in gingival crevicular fluid (GCF), saliva, and plasma. Methods: Full mouth periodontal parameters, including probing depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded from 25 healthy [...] Read more.
Purpose: To investigate the correlation between periodontal parameters and cell-free DNA (cfDNA) concentrations in gingival crevicular fluid (GCF), saliva, and plasma. Methods: Full mouth periodontal parameters, including probing depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded from 25 healthy volunteers, 31 patients with untreated gingivitis, and 25 patients with untreated periodontitis. GCF, saliva, and plasma samples were collected from all subjects. Extraction and quantification assays were undertaken to determine cfDNA concentrations of each sample. Results: GCF and salivary cfDNA levels were increased with aggravation of periodontal inflammation (GCF p < 0.0001; saliva p < 0.001). Plasma cfDNA concentrations in patients with periodontitis were significantly higher than those in healthy volunteers and patients with gingivitis. GCF and salivary cfDNA were positively correlated with mean PD, max PD, BOP, and mean PI (p < 0.0001), whereas plasma cfDNA was not correlated with BOP (p = 0.099). Conclusion: GCF, saliva, and plasma concentrations of cfDNA were significantly elevated in patients with periodontal disease. There were also positive correlations between cfDNA levels in GCF and saliva and periodontal parameters. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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13 pages, 1292 KiB  
Article
Lipid Peroxidation Levels in Saliva and Plasma of Patients Suffering from Periodontitis
by Tanja Veljovic, Milanko Djuric, Jelena Mirnic, Ivana Gusic, Aleksandra Maletin, Bojana Ramic, Isidora Neskovic, Karolina Vukoje and Snezana Brkic
J. Clin. Med. 2022, 11(13), 3617; https://doi.org/10.3390/jcm11133617 - 23 Jun 2022
Cited by 16 | Viewed by 1864
Abstract
Lipid peroxidation (LPO) participates in the development of various diseases, including periodontitis, and malondialdehyde (MDA) is its terminal product. Therefore, in the present study, salivary and plasma MDA levels in 30 periodontitis patients were compared to those in 20 healthy controls, as well [...] Read more.
Lipid peroxidation (LPO) participates in the development of various diseases, including periodontitis, and malondialdehyde (MDA) is its terminal product. Therefore, in the present study, salivary and plasma MDA levels in 30 periodontitis patients were compared to those in 20 healthy controls, as well as in relation to periodontal therapy in order to assess its effectiveness. Periodontal status was assessed via plaque index, gingival index, papilla bleeding index, probing depth and clinical attachment level, while salivary and plasma MDA levels were determined by the ELISA method. The periodontitis group had a significantly greater salivary (2.99 pmol/µL) and plasma (0.50 pmol/µL) MDA levels relative to the healthy controls (1.33 pmol/µL and 0.40 pmol/µL, respectively). Three months after the periodontal therapy completion, although salivary MDA levels were significantly lower than those measured at the baseline (p < 0.001), the reduction in plasma MDA was not statistically significant (p > 0.05). These findings indicate that, while inflammatory processes in periodontium may increase local and systemic lipid peroxidation, periodontal therapy can result in a significant decrease in salivary, but not plasma, MDA levels. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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11 pages, 253 KiB  
Article
Effect of Subgingival Instrumentation on Neutrophil Elastase and C-Reactive Protein in Grade B and C Periodontitis: Exploratory Analysis of a Prospective Cohort Study
by Peter Eickholz, Anne Asendorf, Mario Schröder, Beate Schacher, Gerhard M. Oremek, Ralf Schubert, Martin Wohlfeil and Otto Zuhr
J. Clin. Med. 2022, 11(11), 3189; https://doi.org/10.3390/jcm11113189 - 2 Jun 2022
Cited by 1 | Viewed by 1430
Abstract
Background: Assessment of the effect of subgingival instrumentation (SI) on systemic inflammation in periodontitis grades B (BP) and C (CP). Methods: In this prospective cohort study, eight BP and 46 CP patients received SI. Data were collected prior to and 12 weeks after [...] Read more.
Background: Assessment of the effect of subgingival instrumentation (SI) on systemic inflammation in periodontitis grades B (BP) and C (CP). Methods: In this prospective cohort study, eight BP and 46 CP patients received SI. Data were collected prior to and 12 weeks after SI. Blood was sampled prior to, one day, 6, and 12 weeks after SI. Neutrophil elastase (NE), C-reactive protein (CRP), leukocyte count, lipopolysaccharide binding protein, interleukin 6 (IL-6) and IL-8 were assessed. Results: Both groups showed significant clinical improvement. NE was lower in BP than CP at baseline and 1 day after SI, while CRP was lower in BP than CP at baseline (p < 0.05). NE and CRP had a peak 1 day after SI (p < 0.05). Between-subjects effects due to CP (p = 0.042) and PISA (p = 0.005) occurred. Within-subjects NE change was confirmed and modulated by grade (p = 0.017), smoking (p = 0.029), number of teeth (p = 0.033), and PISA (p = 0.002). For CRP between-subjects effects due to BMI (p = 0.008) were seen. Within-subjects PISA modulated the change of CRP over time (p = 0.017). Conclusions: In untreated CP, NE and CRP were higher than in BP. SI results in better PPD and PISA reduction in BP than CP. Trial registration: Deutsches Register Klinischer Studien DRKS00026952 28 October 2021 registered retrospectively. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
12 pages, 4213 KiB  
Article
Heterogeneity of Blood Vessels and Assessment of Microvessel Density-MVD in Gingivitis
by Ciprian Roi, Pușa Nela Gaje, Raluca Amalia Ceaușu, Alexandra Roi, Laura Cristina Rusu, Eugen Radu Boia, Simina Boia, Ruxandra Elena Luca and Mircea Riviș
J. Clin. Med. 2022, 11(10), 2758; https://doi.org/10.3390/jcm11102758 - 13 May 2022
Cited by 4 | Viewed by 1590
Abstract
Gingivitis is a very common oral disease highly prevalent in adults that, if left untreated, can progress to periodontitis. It involves a complex and slow interaction between the host response and the oral microbiome represented by the dental plaque. The inflammation of the [...] Read more.
Gingivitis is a very common oral disease highly prevalent in adults that, if left untreated, can progress to periodontitis. It involves a complex and slow interaction between the host response and the oral microbiome represented by the dental plaque. The inflammation of the gingiva is associated with the activation of pathological angiogenesis and the existence of a high number of newly formed blood vessels quantified as microvessel density (MVD). The present study includes a number of 51 gingival biopsies from patients with different gingival indexes (GI): GI = 0, n = 12; GI = 1, n = 15; GI = 2, n = 16; and GI = 3, n = 8, processed and stained with the routine hematoxylin–eosin method. The inflammatory infiltrate was scored, the blood vessels were detected with anti-CD34 antibody, and MVD was determined. Inflammatory changes were observed in 39 of the 51 cases included in our study. CD34 + vessels with normal morphological appearance were observed in all 12 cases of health gingiva. In cases of inflammatory lesions, the morphology of the blood vessels showed changes with the evolution of gingival lesions. In severe inflammation, a particular aspect was observed in the vessels, such as the presence of the phenomenon of intussusception. MVD increases with the severity of gingival lesions, with the highest density being observed in severe inflammation. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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12 pages, 261 KiB  
Article
Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care
by Ewa Dolińska, Robert Milewski, Maria Julia Pietruska, Katarzyna Gumińska, Natalia Prysak, Tomasz Tarasewicz, Maciej Janica and Małgorzata Pietruska
J. Clin. Med. 2022, 11(6), 1517; https://doi.org/10.3390/jcm11061517 - 10 Mar 2022
Cited by 8 | Viewed by 3010
Abstract
Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: [...] Read more.
Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: A written questionnaire was carried out to assess the knowledge of patients of the Outpatient Clinic of Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland. The questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the connection between periodontal disease and general health status. To analyze the population, patients were divided according to gender, age and if they were first-time or regular outpatients. Results: Written questionnaires were completed by a total of 302 patients. In the studied population, we noted knowledge deficits, particularly related to weaker periodontal disease risk factors (stress, diabetes, osteoporosis, obesity) and the genetic factor, which is the determinant of periodontitis. The patients’ awareness of the role of plaque bacteria and the effect of smoking on the periodontium was at a relatively high level. The respondents were also aware of the impact of periodontal disease on general health as well as the role of oral hygiene in preventing the disease. At the same time, few of them (26%) used interdental brushes or an irrigator (8%). Conclusions: We demonstrated that patients have an insufficient level of knowledge related to risk factors as well as the prevention of periodontal disease. Awareness of the extent of oral health literacy among patients will help to identify key issues connected with health education interventions Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
13 pages, 1450 KiB  
Article
Comparison of the Treatment Efficacy of Endo−Perio Lesions Using a Standard Treatment Protocol and Extended by Using a Diode Laser (940 nm)
by Elżbieta Dembowska, Aleksandra Jaroń, Aleksandra Homik-Rodzińska, Ewa Gabrysz-Trybek, Joanna Bladowska and Grzegorz Trybek
J. Clin. Med. 2022, 11(3), 811; https://doi.org/10.3390/jcm11030811 - 3 Feb 2022
Cited by 7 | Viewed by 2551
Abstract
Marginal and periapical periodontal diseases cause massive destruction of tooth tissues and surrounding tissues, such as alveolar bone and maxillary sinus floor, visible on radiographs. Lesions involving the apical and marginal periodontium are endo−perio (EPL) lesions. This study aimed to compare the treatment [...] Read more.
Marginal and periapical periodontal diseases cause massive destruction of tooth tissues and surrounding tissues, such as alveolar bone and maxillary sinus floor, visible on radiographs. Lesions involving the apical and marginal periodontium are endo−perio (EPL) lesions. This study aimed to compare the treatment efficacy of endo−perio lesions using a standard treatment protocol and a standard diode laser-assisted treatment protocol. The 12 patients were divided into the study (a) and control (b) group. Periodontal indices, tooth vitality and mobility, occlusal status, and radiographic diagnosis were evaluated. Standard EPL treatment was then performed—without (a) and with (b) the use of diode laser (940 nm). Again, after six months, the above-mentioned parameters were evaluated and compared. The treatment of endo−perio lesions is a significant challenge for modern dentistry. Diode lasers are increasingly used in addition to traditional treatment methods. The conventional use of a 940 nm diode laser with an average power of 0.8 W in pulsed mode allows for the depth of periodontal pockets to be reduced. In addition, the use of a diode laser has a significant effect on tooth mobility and reduces bone loss. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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10 pages, 592 KiB  
Article
Association between Oral Health Status and Relative Handgrip Strength in 11,337 Korean
by Ji-Eun Kim, Na-Yeong Kim, Choong-Ho Choi and Ki-Ho Chung
J. Clin. Med. 2021, 10(22), 5425; https://doi.org/10.3390/jcm10225425 - 20 Nov 2021
Cited by 4 | Viewed by 1538
Abstract
Grip strength is a simple indicator of physical strength and is closely associated with systemic health. Conversely, oral health has also been reported to have an important association with systemic health. The present study aimed to assess the effect of oral health status [...] Read more.
Grip strength is a simple indicator of physical strength and is closely associated with systemic health. Conversely, oral health has also been reported to have an important association with systemic health. The present study aimed to assess the effect of oral health status on relative handgrip strength. The data pertaining to 11,337 participants were obtained by means of the seventh Korea National Health and Nutrition Survey (2016 to 2018). Oral health status was evaluated on the basis of the presence of periodontitis and number of remaining teeth (PT, present teeth). Relative handgrip strength was evaluated by means of a digital dynamometer and the value pertaining to the lower 25% of measurements was used as the quartile by gender. The association between oral health status and relative handgrip strength was evaluated by means of multiple regression analysis and multiple logistic regression analysis with covariate correction. Analysis of the crude model revealed a significant association in the group of patients with periodontal disease (odds ratio = 1.69, 95% confidence interval: 1.51–1.89). However, analysis with adjusted covariates revealed that the association was not statistically significant. Moreover, statistical analysis after adjustment for covariates revealed a consistent correlation between PT and relative handgrip strength as categorical and continuous variables. Hence, the present study observed a significant association between oral health status and relative handgrip strength among the Korean adult population. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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15 pages, 273 KiB  
Article
Evaluation of the Effect of Surgical Extraction of an Impacted Mandibular Third Molar on the Periodontal Status of the Second Molar—Prospective Study
by Magda Aniko-Włodarczyk, Aleksandra Jaroń, Olga Preuss, Anna Grzywacz and Grzegorz Trybek
J. Clin. Med. 2021, 10(12), 2655; https://doi.org/10.3390/jcm10122655 - 16 Jun 2021
Cited by 12 | Viewed by 2854
Abstract
Dental injury to the second molar (SM) caused by the surgical extraction of the impacted third molar tends to be underestimated. The necessity of assessment of the impact of the removal of the wisdom tooth in the mandible on the second molar arose. [...] Read more.
Dental injury to the second molar (SM) caused by the surgical extraction of the impacted third molar tends to be underestimated. The necessity of assessment of the impact of the removal of the wisdom tooth in the mandible on the second molar arose. The study group (n = 60) was the one with the second molar on the surgical side, and the control group (n = 60) was the one with the tooth on the opposite side of the alveolar arch. Before the surgery, the difficulty level was assessed according to the Pederson scale. The periodontal status of the SM was assessed by probing depth (PD), gingival index (GI), tooth mobility (TM) examination by the percussion method and resonance frequency. Measurements were taken before and after the surgery, 7 days and 8 weeks after the surgery. The study demonstrated the significant impact of the surgical removal of the wisdom tooth on the PD, GI and TM of the SM. The predicted degree of difficulty of the very difficult surgery had an influence on the increase in PD on the distal buccal and lingual surface of the SM, and on the GI in the proximity of the examined tooth. The results of the presented research confirm the necessity of the clinical assessment of the lower SM before and after the surgical removal of the impacted wisdom tooth in the mandible. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
14 pages, 602 KiB  
Article
Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population
by Federica Romano, Stefano Perotto, Sara Elamin Osman Mohamed, Sara Bernardi, Marta Giraudi, Paola Caropreso, Giulio Mengozzi, Giacomo Baima, Filippo Citterio, Giovanni Nicolao Berta, Marilena Durazzo, Gabriella Gruden and Mario Aimetti
J. Clin. Med. 2021, 10(8), 1787; https://doi.org/10.3390/jcm10081787 - 20 Apr 2021
Cited by 23 | Viewed by 2646
Abstract
This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 [...] Read more.
This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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16 pages, 728 KiB  
Article
Quantification of Bacteria in Mouth-Rinsing Solution for the Diagnosis of Periodontal Disease
by Jeong-Hwa Kim, Jae-Woon Oh, Young Lee, Jeong-Ho Yun, Seong-Ho Choi and Dong-Woon Lee
J. Clin. Med. 2021, 10(4), 891; https://doi.org/10.3390/jcm10040891 - 22 Feb 2021
Cited by 3 | Viewed by 2380
Abstract
This study aimed to evaluate the feasibility of diagnosing periodontitis via the identification of 18 bacterial species in mouth-rinse samples. Patients (n = 110) who underwent dental examinations in the Department of Periodontology at the Veterans Health Service Medical Center between 2018 and [...] Read more.
This study aimed to evaluate the feasibility of diagnosing periodontitis via the identification of 18 bacterial species in mouth-rinse samples. Patients (n = 110) who underwent dental examinations in the Department of Periodontology at the Veterans Health Service Medical Center between 2018 and 2019 were included. They were divided into healthy and periodontitis groups. The overall number of bacteria, and those of 18 specific bacteria, were determined via real-time polymerase chain reaction in 92 mouth-rinse samples. Differences between groups were evaluated through logistic regression after adjusting for sex, age, and smoking history. There was a significant difference in the prevalence (healthy vs. periodontitis group) of Aggregatibacter actinomycetemcomitans (2.9% vs. 13.5%), Treponema denticola (42.9% vs. 69.2%), and Prevotella nigrescens (80% vs. 2.7%). Levels of Treponema denticola, Prevotella nigrescens, and Streptococcus mitis were significantly associated with severe periodontitis. We demonstrated the feasibility of detecting periopathogenic bacteria in mouth-rinse samples obtained from patients with periodontitis. As we did not comprehensively assess all periopathogenic bacteria, further studies are required to assess the potential of oral-rinsing solutions to indicate oral infection risk and the need to improve oral hygiene, and to serve as a complementary method for periodontal disease diagnosis. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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19 pages, 1242 KiB  
Article
Phenotypic and Functional Alterations of Immune Effectors in Periodontitis; A Multifactorial and Complex Oral Disease
by Kawaljit Kaur, Shahram Vaziri, Marcela Romero-Reyes, Avina Paranjpe and Anahid Jewett
J. Clin. Med. 2021, 10(4), 875; https://doi.org/10.3390/jcm10040875 - 20 Feb 2021
Cited by 1 | Viewed by 2169
Abstract
Survival and function of immune subsets in the oral blood, peripheral blood and gingival tissues of patients with periodontal disease and healthy controls were assessed. NK and CD8 + T cells within the oral blood mononuclear cells (OBMCs) expressed significantly higher levels of [...] Read more.
Survival and function of immune subsets in the oral blood, peripheral blood and gingival tissues of patients with periodontal disease and healthy controls were assessed. NK and CD8 + T cells within the oral blood mononuclear cells (OBMCs) expressed significantly higher levels of CD69 in patients with periodontal disease compared to those from healthy controls. Similarly, TNF-α release was higher from oral blood of patients with periodontal disease when compared to healthy controls. Increased activation induced cell death of peripheral blood mononuclear cells (PBMCs) but not OBMCs from patients with periodontal disease was observed when compared to those from healthy individuals. Unlike those from healthy individuals, OBMC-derived supernatants from periodontitis patients exhibited decreased ability to induce secretion of IFN-γ by allogeneic healthy PBMCs treated with IL-2, while they triggered significant levels of TNF-α, IL-1β and IL-6 by untreated PBMCs. Interaction of PBMCs, or NK cells with intact or NFκB knock down oral epithelial cells in the presence of a periodontal pathogen, F. nucleatum, significantly induced a number of pro-inflammatory cytokines including IFN-γ. These studies indicated that the relative numbers of immune subsets obtained from peripheral blood may not represent the composition of the immune cells in the oral environment, and that orally-derived immune effectors may differ in survival and function from those of peripheral blood. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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12 pages, 560 KiB  
Article
Is Periodontitis a Predictor for an Adverse Outcome in Patients Undergoing Coronary Artery Bypass Grafting? A Pilot Study
by Stefan Reichert, Susanne Schulz, Lisa Friebe, Michael Kohnert, Julia Grollmitz, Hans-Günter Schaller and Britt Hofmann
J. Clin. Med. 2021, 10(4), 818; https://doi.org/10.3390/jcm10040818 - 17 Feb 2021
Cited by 4 | Viewed by 1931
Abstract
Periodontitis is a risk factor for atherosclerosis and coronary vascular disease (CVD). This research evaluated the relationship between periodontal conditions and postoperative outcome in patients who underwent coronary artery bypass grafting (CABG). A total of 101 patients with CVD (age 69 years, 88.1% [...] Read more.
Periodontitis is a risk factor for atherosclerosis and coronary vascular disease (CVD). This research evaluated the relationship between periodontal conditions and postoperative outcome in patients who underwent coronary artery bypass grafting (CABG). A total of 101 patients with CVD (age 69 years, 88.1% males) and the necessity of CABG surgery were included. Periodontal diagnosis was made according to the guidelines of the Centers for Disease Control and Prevention (CDC, 2007). Additionally, periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) were determined. Multivariate survival analyses were carried out after a one-year follow-up period with Cox regression. All study subjects suffered from periodontitis (28.7% moderate, 71.3% severe). During the follow-up period, 14 patients (13.9%) experienced a new cardiovascular event (11 with angina pectoris, 2 with cardiac decompensation, and 1 with cardiac death). Severe periodontitis was not significant associated with the incidence of new events (adjusted hazard ratio, HR = 2.6; p = 0.199). Other risk factors for new events were pre-existing peripheral arterial disease (adjusted HR = 4.8, p = 0.030) and a history of myocardial infarction (HR = 6.1, p = 0.002). Periodontitis was not found to be an independent risk factor for the incidence of new cardiovascular events after CABG surgery. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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Review

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15 pages, 1087 KiB  
Review
Compromised Teeth Preserve or Extract: A Review of the Literature
by Valentina Cárcamo-España, Nataly Cuesta Reyes, Paul Flores Saldivar, Eduardo Chimenos-Küstner, Alberto Estrugo Devesa and José López-López
J. Clin. Med. 2022, 11(18), 5301; https://doi.org/10.3390/jcm11185301 - 8 Sep 2022
Cited by 4 | Viewed by 3849
Abstract
Multiple systems and associated factors have been described in the literature to assess the prognosis of teeth with periodontal disease. Nowadays there is a tendency among clinicians to consider implants as the best solution after tooth extraction, in cases of teeth with a [...] Read more.
Multiple systems and associated factors have been described in the literature to assess the prognosis of teeth with periodontal disease. Nowadays there is a tendency among clinicians to consider implants as the best solution after tooth extraction, in cases of teeth with a questionable prognosis. However, the value of the natural tooth must be considered, as the proprioception of the periodontal ligament is preserved, and it adapts to stress during functional loads. We first review the literature focusing on analyzing the factors that should guide decision-making to maintain or extract a tooth with a compromised periodontium. Then, we propose a schematic diagram of prognostic indicators to reflect the main factors to consider and the survival rate that each one represents when preserving or extracting a tooth. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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12 pages, 223 KiB  
Review
Systemic Lupus Erythematosus and Periodontal Disease: A Complex Clinical and Biological Interplay
by Bouchra Sojod, Cibele Pidorodeski Nagano, Glenda Melissa Garcia Lopez, Antoine Zalcberg, Sophie Myriam Dridi and Fani Anagnostou
J. Clin. Med. 2021, 10(9), 1957; https://doi.org/10.3390/jcm10091957 - 2 May 2021
Cited by 13 | Viewed by 2620
Abstract
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing [...] Read more.
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing to systemic inflammation. SLE is a multi-system chronic inflammatory autoimmune disease that has a wide range of clinical presentations, touching multiple organ systems. Many epidemiological studies have investigated the two-way relationship between PD and SLE, though their results are heterogeneous. SLE and PD are multifactorial conditions and many biological-based hypotheses suggest common physiopathological pathways between the two diseases, including genetics, microbiology, immunity, and environmental common risk factors. By focusing on recent clinical and translational research, this review aimed to discuss and give an overview of the relationship of SLE with PD, as well as looking at the similarities in the immune-pathological aspects and the possible mechanisms connecting the development and progression of both diseases. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)

Other

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10 pages, 1078 KiB  
Case Report
Long-Term Results after Placing Dental Implants in Patients with Papillon-Lefèvre Syndrome: Results 2.5–20 Years after Implant Insertion
by Katrin Nickles, Mischa Krebs, Beate Schacher, Hari Petsos and Peter Eickholz
J. Clin. Med. 2022, 11(9), 2438; https://doi.org/10.3390/jcm11092438 - 26 Apr 2022
Cited by 2 | Viewed by 2068
Abstract
Aim: A retrospective evaluation of patients with Papillon-Lefèvre syndrome (PLS) treated with dental implants to identify factors that may influence treatment outcomes. Methods: All PLS patients with dental implants currently registered at the Department of Periodontology, Goethe-University Frankfurt (20–38 years; mean: 29.6 years), [...] Read more.
Aim: A retrospective evaluation of patients with Papillon-Lefèvre syndrome (PLS) treated with dental implants to identify factors that may influence treatment outcomes. Methods: All PLS patients with dental implants currently registered at the Department of Periodontology, Goethe-University Frankfurt (20–38 years; mean: 29.6 years), were recruited. Five patients from three families (two pairs of siblings) with a total of 48 dental implants (inserted in different dental institutions) were included with a follow-up time of 2.5–20 years (mean: 10.4 years). Results: Implant failure occurred in three patients (at least 15 implants). Nearly all patients demonstrated peri-implantitis in more or less advanced stages; 60% of patients demonstrated bone loss ≥50% around the implants. Two patients did not follow any supportive therapy. Conclusions: Implants in PLS patients who did not follow any maintenance programme had a high risk of peri-implantitis and implant loss. Full article
(This article belongs to the Special Issue Periodontitis: Current Status and the Future)
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