Mechanisms of Connection between Periodontitis and Non-communicable Chronic Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry".

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 16696

Special Issue Editors

Department of Internal Medicine and Medical Specialties (DIMIS), Università degli Studi di Palermo UNIPA, 90100 Palermo, Italy
Interests: cardiovascular risk; lipids; diabetes; prevention; therapy; metabolic syndrome; metabolism; lipoproteins; incretins; nutraceuticals
Special Issues, Collections and Topics in MDPI journals
King's College London Dental Institute, Guy's Hospital, Great Maze Pond, London, UK
Interests: minimally-invasive periodontal treatment; periodontitis; genetics; chronic non-communicable diseases
School of Dentistry, University of Granada, E-18071 Granada, Spain
Interests: periodontology; periodontal pathology; periodontal medicine; implant dentistry and regenerative therapies in dentistry

Special Issue Information

Dear Colleagues, 

Periodontitis is a very common microbially driven inflammatory condition of the supporting apparatus of the teeth, leading to early tooth loss and reduced quality of life. A considerable amount of research in recent decades has shown how periodontal inflammation is not just limited to the mouth but may have systemic consequences through systemic spread of bacteria and increased inflammatory burden.

The aim of this issue is to expand on the associations between periodontitis and chronic non-communicable diseases. In particular, mechanisms of associations as well as modalities to reduce the systemic impact of periodontitis will be discussed.

This is a rapidly emerging topic in the dental–medical literature. A better understanding of associations between periodontitis and systemic conditions will be needed for clinical practice and future research.

Papers reporting mechanisms of association between periodontitis and systemic non-communicable diseases and discussing methods to reduce the systemic inflammatory burden of periodontal disease are welcomed to be submitted.

Dr. Manfredi Rizzo
Prof. Dr. Luigi Nibali
Prof. Dr. Francisco Mesa
Guest Editors

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Keywords

  • periodontitis
  • inflammation
  • systemic

Published Papers (4 papers)

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Research

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11 pages, 340 KiB  
Article
Comparative Evaluation of Gingival Crevicular Fluid Interleukin-17, 18 and 21 in Different Stages of Periodontal Health and Disease
by Vineet Nair, Vishakha Grover, Suraj Arora, Gotam Das, Irfan Ahmad, Anchal Ohri, Shan Sainudeen, Priyanka Saluja and Arindam Saha
Medicina 2022, 58(8), 1042; https://doi.org/10.3390/medicina58081042 - 03 Aug 2022
Cited by 8 | Viewed by 1846
Abstract
Background and Objectives: The elicitation of a host’s immune–inflammatory responses to overcome oral bacterial biofilm challenges is mediated by numerous cytokines. We explored the role of three such cytokines, viz. interleukin (IL)-17, 18 and 21, by measuring their levels in the gingival crevicular [...] Read more.
Background and Objectives: The elicitation of a host’s immune–inflammatory responses to overcome oral bacterial biofilm challenges is mediated by numerous cytokines. We explored the role of three such cytokines, viz. interleukin (IL)-17, 18 and 21, by measuring their levels in the gingival crevicular fluid (GCF) of Indian individuals with healthy gingiva, chronic gingivitis, or chronic periodontitis. Materials and Method: Ninety systemically healthy individuals were enrolled in the study on the basis of predefined criteria and were categorized into three groups of 30 participants each. Groups A, B and C were composed of a control group with healthy gingiva, subjects with chronic gingivitis and subjects with chronic periodontitis, respectively. The periodontal disease status was assessed on the basis of a subject’s gingival index, probing pocket depth, clinical attachment loss and radiographic evidence of bone loss. After the complete history-taking and identification of gingival sulcus/pocket depth areas for GCF collection, a sample was collected from each subject in all groups for an estimation of the cytokine levels using ELISA. Statistical analysis was performed using SPSS v 21.0. Intergroup comparisons were conducted using a post hoc Tukey’s test. A value of p < 0.05 was considered to be statistically significant. Results: The mean IL-17, 18 and 21 concentrations in pg/mL was the greatest for Group C (99.67 ± 18.85, 144.61 ± 20.83 and 69.67 ± 12.46, respectively), followed by Group B (19.27 ± 2.78, 22.27 ± 2.43 and 22.74 ± 1.43, respectively) and finally by Group A (healthy control; 11.56 ± 0.99, 17.94 ± 1.24 and 12.83 ± 1.21 respectively). A statistically significant difference in the mean concentrations of two interleukins (IL-17 and IL-18) was observed between Groups A and C and also between Groups B and C. A statistically significant difference in the mean concentrations of IL-21 was observed between Groups B and C. Conclusions: Within the limitations of the present study, the findings revealed that the GCF levels of IL-17, IL-18 and IL-21 rose and correlated well with the severity of the disease. Thus, these cytokines present in GCF have the potential to be considered as biomarkers for periodontal tissue destruction. IL-21 in particular appears to be a promising biomarker for differentiating between gingivitis and periodontitis. Full article

Review

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24 pages, 2591 KiB  
Review
Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review
by Sadia Ambreen Niazi and Abdulaziz Bakhsh
Medicina 2022, 58(7), 931; https://doi.org/10.3390/medicina58070931 - 14 Jul 2022
Cited by 19 | Viewed by 7180
Abstract
The ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote [...] Read more.
The ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body parts, resulting in many types of degenerative systemic diseases. This theory was eventually refuted due to anecdotal evidence. However, lately there has been increased interest in investigating whether endodontic disease could have an impact on general health. There are reviews that have previously been carried out on this subject, but as new data have emerged since then, this review aims to appraise the available literature investigating the dynamic associations between apical periodontitis, endodontic treatment, and systemic health. The available evidence regarding focal infection theory, bacteraemia and inflammatory markers was appraised. The review also collated the available research arguing the associations of apical periodontitis with cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome and autoimmune disorders, along with the effect of statins and immunomodulators on apical periodontitis prevalence and endodontic treatment prognosis. There is emerging evidence that bacteraemia and low-grade systemic inflammation associated with apical periodontitis may negatively impact systemic health, e.g., development of cardiovascular diseases, adverse pregnancy outcomes, and diabetic metabolic dyscontrol. However, there is limited information supporting the effect of diabetes mellitus or autoimmune disorders on the prevalence and prognosis post endodontic treatment. Furthermore, convincing evidence supports that successful root canal treatment has a beneficial impact on systemic health by reducing the inflammatory burden, thereby dismissing the misconceptions of focal infection theory. Although compelling evidence regarding the association between apical periodontitis and systemic health is present, further high-quality research is required to support and establish the benefits of endodontic treatment on systemic health. Full article
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14 pages, 700 KiB  
Review
Managing the Systemic Impact of Periodontitis
by Giuseppe Mainas, Mark Ide, Manfredi Rizzo, Antonio Magan-Fernandez, Francisco Mesa and Luigi Nibali
Medicina 2022, 58(5), 621; https://doi.org/10.3390/medicina58050621 - 29 Apr 2022
Cited by 11 | Viewed by 3290
Abstract
Periodontitis is a microbially driven host-mediated disease that leads to loss of periodontal attachment and bone. It is associated with elevation of systemic inflammatory markers and with the presence of systemic co-morbidities. Furthermore, periodontal treatment leads to a 24–48 h-long acute local and [...] Read more.
Periodontitis is a microbially driven host-mediated disease that leads to loss of periodontal attachment and bone. It is associated with elevation of systemic inflammatory markers and with the presence of systemic co-morbidities. Furthermore, periodontal treatment leads to a 24–48 h-long acute local and systemic inflammatory response. This systemic response might increase the burden of patients with compromised medical history and/or uncontrolled systemic diseases. The correlation between periodontitis and systemic diseases, the impact of periodontitis on the quality of life and public health, the effects of periodontal treatment on systemic health and disease, and the available methods to manage systemic inflammation after periodontal therapy are discussed. The main focus then shifts to a description of the existing evidence regarding the impact of periodontitis and periodontal treatment on systemic health and to the identification of approaches aiming to reduce the effect of periodontitis on systemic inflammation. Full article
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12 pages, 1315 KiB  
Review
A New Comorbidity in Periodontitis: Fusobacterium nucleatum and Colorectal Cancer
by Francisco Mesa, Maria José Mesa-López, Juan Egea-Valenzuela, Cristina Benavides-Reyes, Luigi Nibali, Mark Ide, Giuseppe Mainas, Manfredi Rizzo and Antonio Magan-Fernandez
Medicina 2022, 58(4), 546; https://doi.org/10.3390/medicina58040546 - 15 Apr 2022
Cited by 10 | Viewed by 3559
Abstract
There is very recent and strong evidence relating Fusobacterium nucleatum to colorectal cancer. In this narrative review, we update the knowledge about gingival dysbiosis and the characteristics of Fusobacterium nucleatum as one of the main bacteria related to periodontitis. We provide data on [...] Read more.
There is very recent and strong evidence relating Fusobacterium nucleatum to colorectal cancer. In this narrative review, we update the knowledge about gingival dysbiosis and the characteristics of Fusobacterium nucleatum as one of the main bacteria related to periodontitis. We provide data on microbiome, epidemiology, risk factors, prognosis, and treatment of colorectal cancer, one of the most frequent tumours diagnosed and whose incidence increases every year. We describe, from its recent origin, the relationship between this bacterium and this type of cancer and the knowledge and emerging mechanisms that scientific evidence reveals in an updated way. A diagram provided synthesizes the pathogenic mechanisms of this relationship in a comprehensive manner. Finally, the main questions and further research perspectives are presented. Full article
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