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Periodontitis associated with brain function impairment in middle-aged and elderly individuals with normal cognition. 牙周炎与认知能力正常的中老年人脑功能损伤有关。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-20 DOI: 10.1002/JPER.24-0264
Wei Ye, Yufei Tao, Wenrui Wang, Yongqiang Yu, Xiaoshu Li

Background: The present study aimed to investigate changes in intranetwork functional connectivity (FC) and internetwork FC in middle-aged and elderly individuals with normal cognition (NC) and varying degrees of periodontitis to determine the effects of periodontitis on brain function.

Methods: Periodontal findings and resting-state functional magnetic resonance imaging data were acquired from 51 subjects with NC. Independent component analysis and correlation analysis were used for the statistical analysis of the data.

Results: Differences in intranetwork FC were observed among groups in the anterior default-mode network (aDMN), dorsal attention network and dorsal sensorimotor network (dSMN). Compared with the nonperiodontitis (NP) group or the mild-periodontitis group, the analysis of internetwork FC showed increased FC between the auditory network and the ventral attention network (VAN), between the aDMN and the salience network (SN), and between the SN and the VAN and decreased FC between the posterior default-mode network and the right frontoparietal network in the moderate-to-severe periodontitis group. Additionally, internetwork FC between the dSMN and the VAN was also increased in the moderate-to-severe periodontitis group compared to the NP group. The altered intra- and internetwork FC were significantly correlated with the periodontal clinical index.

Conclusion: Our results confirmed that periodontitis was associated with both intra- and internetwork FC changes even in NC. The present study indicates that periodontitis might be a potential risk factor for brain damage and provides a theoretical clue and a new treatment target for the early prevention of Alzheimer disease.

Plain language summary: Recent research has proposed that periodontitis is a potential risk factor for Alzheimer disease (AD). However, the relationship between periodontitis and the brain function of middle-aged and elderly individuals with normal cognition (NC) remains unclear. Analyzing the effect of periodontitis on brain function in the NC stage can provide clues to AD development and help achieve early prevention of dementia. The present study aimed to investigate changes in brain functional connectivity (FC) in NC with different severity of periodontitis to determine the effects of periodontitis on brain function. Both changed intranetwork FC and internetwork FC were found in the moderate-to-severe periodontitis group, and periodontitis was associated with brain network function impairment in NC. The present study indicates that periodontitis might be a potential risk factor for brain damage even in NC stage, and provides a theoretical clue and a new treatment target for the early prevention of AD.

研究背景本研究旨在调查具有正常认知能力(NC)和不同程度牙周炎的中老年人的网络内功能连接(FC)和网络功能连接的变化,以确定牙周炎对大脑功能的影响:方法:研究人员采集了51名NC患者的牙周检查结果和静息态功能磁共振成像数据。独立成分分析和相关分析用于数据的统计分析:结果:在前默认模式网络(aDMN)、背侧注意网络和背侧感觉运动网络(dsmN)中观察到了不同组间网络内FC的差异。与非牙周炎(NP)组或轻度牙周炎组相比,网络FC分析表明,中重度牙周炎组的听觉网络与腹侧注意网络(VAN)之间、aDMN与显著性网络(SN)之间、SN与VAN之间的网络FC增加,而后默认模式网络与右侧额顶网络之间的网络FC减少。此外,与 NP 组相比,中重度牙周炎组中 dSMN 与 VAN 之间的网络 FC 也有所增加。网络内和网络间FC的改变与牙周临床指数显著相关:我们的研究结果证实,即使在 NC 中,牙周炎也与网络内和网络 FC 的变化有关。本研究表明,牙周炎可能是脑损伤的潜在危险因素,为早期预防阿尔茨海默病提供了理论线索和新的治疗靶点:最新研究提出,牙周炎是阿尔茨海默病(AD)的潜在危险因素。然而,牙周炎与认知正常(NC)的中老年人大脑功能之间的关系仍不清楚。分析牙周炎对NC阶段脑功能的影响可以为AD的发展提供线索,有助于实现痴呆症的早期预防。本研究旨在调查不同程度牙周炎的NC患者大脑功能连接(FC)的变化,以确定牙周炎对大脑功能的影响。结果发现,中度至重度牙周炎组的脑内网络功能连接(intranetwork FC)和脑网络功能连接(internetwork FC)均发生了变化,牙周炎与数控系统的脑网络功能损伤有关。本研究表明,即使在NC阶段,牙周炎也可能是脑损伤的潜在危险因素,为早期预防AD提供了理论线索和新的治疗靶点。
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引用次数: 0
Impact of nonsurgical periodontal treatment on arterial stiffness outcomes related to endothelial dysfunction: A systematic review and meta-analysis. 非手术牙周治疗对与内皮功能障碍有关的动脉僵化结果的影响:系统回顾和荟萃分析。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-16 DOI: 10.1002/JPER.24-0422
Alessandro Polizzi, Luigi Nibali, Gianluca Martino Tartaglia, Gaetano Isola
<p><strong>Background: </strong>To assess the available evidence on whether nonsurgical periodontal treatment (NSPT) improves arterial stiffness outcomes in patients with periodontitis (PD).</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and population, intervention, comparison, outcomes, and study design (PICOS) question, electronic databases were screened for clinical interventional studies addressing the impact of NSPT on pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and flow-mediated dilatation (FMD) outcomes in PD patients. Furthermore, the research strategy was implemented using a hand search. Studies were selected, and data were extracted by two independent reviewers. Random effects models were applied to perform a meta-analysis, and methodological index for nonrandomized studies (MINORS) and Cochrane Rob2 tools were used to assess the risk of bias.</p><p><strong>Results: </strong>Fifteen articles were finally included for qualitative synthesis. Among them, eight single-arm cohort studies met the final inclusion criteria for meta-analysis. The Rob2 analysis evidenced that one randomized clinical trial (RCT) had a low risk, three RCTs raised some concerns, and three RCTs had a high risk of bias, while the MINORS scores ranged from 9 to 14. The meta-analysis showed that NSPT significantly impacted FMD (p < 0.001) and CIMT (p = 0.004), while changes in PWV were not statistically significant. However, there was high heterogeneity among studies (I<sup>2</sup> = 78% for FMD and I<sup>2</sup> = 62% for CIMT).</p><p><strong>Conclusion: </strong>Despite some beneficial effects on FMD and CIMT, due to study limitations, high heterogeneity, and risk of bias, it cannot be concluded that NSPT is effective in improving arterial stiffness. Therefore, further studies are necessary to achieve high-quality evidence on the effect of NSPT on arterial stiffness outcomes in PD patients.</p><p><strong>Trial registration: </strong>PROSPERO ID CRD42024501399.</p><p><strong>Plain language summary: </strong>Periodontitis (PD) has been associated with alterations in arterial stiffness outcomes related to early endothelial dysfunction. Based on noninterventional studies, this meta-analysis indicates that nonsurgical periodontal treatment (NSPT) may reduce cardiovascular disease risk in patients with PD. The moderate evidence derived from the studies that were finally included showed that NSPT had beneficial effects on flow-mediated dilatation and carotid intima-media thickness, while this trend was not observed for pulse wave velocity. Moreover, the findings of the present meta-analysis were characterized by high heterogeneity and risk of bias and were derived from uncontrolled clinical trials or randomized clinical trials with limitations. Therefore, more studies with standardized protocols and homogeneous arterial stiffness outcomes are needed to elevate the qua
背景:评估非手术牙周治疗(NSPT)是否能改善牙周炎(PD)患者的动脉僵化结果:目的:评估非手术牙周治疗(NSPT)是否能改善牙周炎(PD)患者动脉僵化结果的现有证据:方法:按照系统综述和荟萃分析首选报告项目(PRISMA)指南和人群、干预、比较、结果和研究设计(PICOS)问题,在电子数据库中筛选了有关非手术牙周治疗对牙周炎患者脉搏波速度(PWV)、颈动脉内膜中层厚度(CIMT)和血流介导扩张(FMD)结果影响的临床干预研究。此外,研究策略采用人工搜索。由两名独立审稿人筛选出研究并提取数据。采用随机效应模型进行荟萃分析,并使用非随机研究方法指数(MINORS)和Cochrane Rob2工具评估偏倚风险:最终纳入 15 篇文章进行定性综合。其中,8 项单臂队列研究符合荟萃分析的最终纳入标准。Rob2 分析表明,一项随机临床试验(RCT)的偏倚风险较低,三项随机临床试验存在一些问题,三项随机临床试验的偏倚风险较高,而 MINORS 的评分在 9 到 14 分之间。荟萃分析表明,NSPT 对 FMD 有显著影响(FMD 的 p 2 = 78%,CIMT 的 I2 = 62%):结论:尽管 NSPT 对 FMD 和 CIMT 有一些有益的影响,但由于研究的局限性、高度异质性和偏倚风险,还不能得出 NSPT 能有效改善动脉僵化的结论。因此,有必要开展进一步研究,以获得 NSPT 对帕金森病患者动脉僵化效果的高质量证据:PROSPERO ID CRD42024501399.纯文字摘要:牙周炎(PD)与早期内皮功能障碍相关的动脉僵化结果改变有关。基于非介入性研究,该荟萃分析表明非手术牙周治疗(NSPT)可降低牙周炎患者的心血管疾病风险。从最终纳入的研究中得出的中度证据显示,非手术牙周治疗对血流介导的扩张和颈动脉内膜中层厚度有有益影响,而脉搏波速度则未观察到这一趋势。此外,本荟萃分析的研究结果存在高度异质性和偏倚风险,且均来自非对照临床试验或随机临床试验,存在局限性。因此,需要进行更多具有标准化方案和同质化动脉僵化结果的研究,以提高现有证据的质量。
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引用次数: 0
Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients. 人工智能对牙周炎患者治疗效果和生活质量的影响。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-16 DOI: 10.1002/JPER.24-0082
Fu-Tzu You, Pei-Chen Lin, Chiung-Lin Huang, Ju-Hui Wu, Yuji Kabasawa, Chih-Chang Chen, Hsiao-Ling Huang

Background: To evaluate the effects of artificial intelligence (AI)-assisted dental monitoring (DM) with and without health counseling on the treatment outcomes and oral health-related quality of life (OHRQoL) of patients with periodontitis.

Methods: Patients with periodontitis were randomly assigned to either an AI group (AI group, n = 28), an AI and health counseling group (AIHC group, n = 27), or a control group (n = 27). All patients underwent nonsurgical periodontal treatment. Patients in the AI and AIHC groups underwent additional AI-assisted DM and AI-assisted DM with oral health counseling, respectively, for 6 months. Data on OHRQoL and periodontal measures were collected at baseline and follow-ups.

Results: At 3 months of follow-up, the AI and AIHC groups exhibited a significantly greater reduction in probing pocket depth (mean diff: -0.5 and -0.7) and clinical attachment level (mean diff: -0.5 and -0.6) compared with the control group. At 6 months of follow-up, the AI and AIHC groups exhibited a significantly greater improvement in OHRQoL (mean diff: -4.5 and -4.7) compared with the control group. At 3-month follow-up, the AIHC group exhibited a greater improvement in plaque index (mean diff: -0.2) and OHRQoL (mean diff: -4.3) compared with the AI group.

Conclusion: AI-assisted DM can be used to remind patients with periodontitis of their oral hygiene at home and effectively improve their periodontal measures and long-term OHRQoL.

Plain language summary: Gum disease is a common problem, but new technology could help. In this study, researchers looked at how AI affects gum health and quality of life (QoL). The researchers divided participants into 3 groups. One group used an AI system to monitor their gums at home. Another used AI plus got health advice. The third did not use any special technology. After 3 and 6 months, the AI groups had healthier gums, with less deep pockets and better gum attachment, compared to the group without AI. The group that also got health advice saw even greater improvements, like cleaner teeth and a bigger boost to their QoL. This is exciting because gum disease is tricky to manage alone. The AI system seems to help by reminding people to care for their teeth and gums. With expert guidance, the AI becomes an even more powerful tool for improving long-term oral health and well-being. This study shows how new technologies like AI could transform how we approach common health problems. By providing personalized support, AI can empower people to better manage their own health, leading to better outcomes.

背景:评估人工智能(AI)辅助牙科监测(DM)与健康咨询(DM)对牙周炎患者治疗效果和口腔健康相关生活质量(OHRQoL)的影响:牙周炎患者被随机分配到人工智能组(AI 组,n = 28)、人工智能和健康咨询组(AIHC 组,n = 27)或对照组(n = 27)。所有患者均接受非手术牙周治疗。AI组和AIHC组患者分别接受了为期6个月的额外AI辅助DM和AI辅助DM加口腔健康咨询。在基线和随访期间收集了有关 OHRQoL 和牙周测量的数据:随访 3 个月时,与对照组相比,人工智能组和人工口腔健康咨询组的探诊袋深度(平均差值:-0.5 和 -0.7)和临床附着水平(平均差值:-0.5 和 -0.6)明显降低。在 6 个月的随访中,与对照组相比,AI 组和 AIHC 组的 OHRQoL(平均差:-4.5 和 -4.7)显著改善。在 3 个月的随访中,与 AI 组相比,AIHC 组的斑块指数(平均差异:-0.2)和 OHRQoL(平均差异:-4.3)均有较大改善:AI辅助DM可用于提醒牙周炎患者在家注意口腔卫生,并有效改善他们的牙周措施和长期OHRQoL.Plain language summary: 牙龈疾病是一个常见问题,但新技术可以提供帮助。在这项研究中,研究人员考察了人工智能如何影响牙龈健康和生活质量(QoL)。研究人员将参与者分为 3 组。一组使用人工智能系统在家监测牙龈。另一组使用人工智能并获得健康建议。第三组没有使用任何特殊技术。3 个月和 6 个月后,与未使用人工智能的组别相比,使用人工智能的组别牙龈更健康,牙周袋更少,牙龈附着力更好。同时获得健康建议的组别改善更大,比如牙齿更整齐,生活质量也有更大提高。这令人兴奋,因为牙龈疾病很难单独控制。人工智能系统似乎可以通过提醒人们护理牙齿和牙龈来提供帮助。在专家的指导下,人工智能将成为改善长期口腔健康和福祉的更强大工具。这项研究表明,人工智能等新技术可以改变我们处理常见健康问题的方式。通过提供个性化支持,人工智能可以让人们更好地管理自己的健康,从而获得更好的结果。
{"title":"Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients.","authors":"Fu-Tzu You, Pei-Chen Lin, Chiung-Lin Huang, Ju-Hui Wu, Yuji Kabasawa, Chih-Chang Chen, Hsiao-Ling Huang","doi":"10.1002/JPER.24-0082","DOIUrl":"https://doi.org/10.1002/JPER.24-0082","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effects of artificial intelligence (AI)-assisted dental monitoring (DM) with and without health counseling on the treatment outcomes and oral health-related quality of life (OHRQoL) of patients with periodontitis.</p><p><strong>Methods: </strong>Patients with periodontitis were randomly assigned to either an AI group (AI group, n = 28), an AI and health counseling group (AIHC group, n = 27), or a control group (n = 27). All patients underwent nonsurgical periodontal treatment. Patients in the AI and AIHC groups underwent additional AI-assisted DM and AI-assisted DM with oral health counseling, respectively, for 6 months. Data on OHRQoL and periodontal measures were collected at baseline and follow-ups.</p><p><strong>Results: </strong>At 3 months of follow-up, the AI and AIHC groups exhibited a significantly greater reduction in probing pocket depth (mean diff: -0.5 and -0.7) and clinical attachment level (mean diff: -0.5 and -0.6) compared with the control group. At 6 months of follow-up, the AI and AIHC groups exhibited a significantly greater improvement in OHRQoL (mean diff: -4.5 and -4.7) compared with the control group. At 3-month follow-up, the AIHC group exhibited a greater improvement in plaque index (mean diff: -0.2) and OHRQoL (mean diff: -4.3) compared with the AI group.</p><p><strong>Conclusion: </strong>AI-assisted DM can be used to remind patients with periodontitis of their oral hygiene at home and effectively improve their periodontal measures and long-term OHRQoL.</p><p><strong>Plain language summary: </strong>Gum disease is a common problem, but new technology could help. In this study, researchers looked at how AI affects gum health and quality of life (QoL). The researchers divided participants into 3 groups. One group used an AI system to monitor their gums at home. Another used AI plus got health advice. The third did not use any special technology. After 3 and 6 months, the AI groups had healthier gums, with less deep pockets and better gum attachment, compared to the group without AI. The group that also got health advice saw even greater improvements, like cleaner teeth and a bigger boost to their QoL. This is exciting because gum disease is tricky to manage alone. The AI system seems to help by reminding people to care for their teeth and gums. With expert guidance, the AI becomes an even more powerful tool for improving long-term oral health and well-being. This study shows how new technologies like AI could transform how we approach common health problems. By providing personalized support, AI can empower people to better manage their own health, leading to better outcomes.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appraising the life-course impact of Epstein-Barr virus exposure and its genetic signature on periodontitis. 评估 Epstein-Barr 病毒暴露及其基因特征对牙周炎的终生影响。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-04 DOI: 10.1002/JPER.24-0300
Xinjian Ye, Jian Yuan, Yijing Bai, Yitong Chen, He Jiang, Yue Cao, Qifei Ge, Zhiyong Wang, Weiyi Pan, Shan Wang, Qianming Chen
<p><strong>Background: </strong>Periodontitis arises from a multifaceted interplay of environmental variables and genetic susceptibility, where microbial infection plays an indispensable part. Epstein-Barr virus (EBV) exposure has long been considered associated with periodontitis activity; however, the causal relationship and genetic connection between them remain unknown.</p><p><strong>Methods: </strong>Within a life-course context, our study employed comprehensive Mendelian randomization (MR) methods, including univariable, multivariable, Bayesian model averaging, and reverse MR, to investigate the causal association between EBV exposure and periodontitis. Additionally, linkage disequilibrium score regression and colocalization analysis were utilized to assess the cross-trait genetic correlations, followed by transcriptome-wide association and enrichment analysis to discern the genetic-phenotypic biological profiles.</p><p><strong>Results: </strong>Heightened levels of EBV antibodies, particularly early antigen diffuses (which serve as indicators of early infection or reactivation), are associated with an increased risk of periodontitis (odds ratio [OR]: 1.27 [1.09-1.47], p = 6.05 × 10<sup>-3</sup>) and demonstrate a significant genetic correlation (p = 4.11 × 10<sup>-3</sup>). This pathogenesis may involve the high-confidence causal gene RNASEK located in 17p13.1. Genetically predicted early-life anti-EBV immunoglobulin G (IgG) levels are correlated to a reduced periodontitis risk (OR: 0.89 [0.82-0.97], p = 1.76 × 10<sup>-3</sup>).</p><p><strong>Conclusions: </strong>The present study highlights the impact of life-course EBV exposure and its genetic hallmark on periodontitis, providing novel perspectives into the underlying pathogenesis and management strategies for EBV-related periodontitis. These findings underscore diverse clinical and public health implications, encompassing antiviral therapies, viral vaccination strategies, and tailored interventions for individualized periodontitis management. Further research is required to validate and expand upon our findings.</p><p><strong>Plain language summary: </strong>Periodontitis is a chronic inflammatory disease driven by interactions between microbial pathogens and the host immune system. While bacteria have traditionally been the focus of research, recent studies highlight the significance of virus-bacteria interactions, particularly the role of Epstein-Barr virus (EBV)-a herpesvirus infecting over 90% of the global population-in the development of periodontitis. However, the underlying causal and genetic mechanisms remain unclear. Our study employed genome-wide multi-omics approaches to investigate the link between EBV exposure and periodontitis. We found that recent EBV infection or reactivation increases the risk of periodontitis, whereas early-life exposure, possibly enabling immune resistance, may reduce it. Essential genes were identified as potential mediators, including CRTC3-AS1, H
背景:牙周炎产生于环境变量和遗传易感性的多方面相互作用,其中微生物感染起着不可或缺的作用。长期以来,人们一直认为EB病毒(Epstein-Barr virus,EBV)暴露与牙周炎活动有关;然而,它们之间的因果关系和遗传联系仍然未知:我们的研究采用孟德尔随机化(Mendelian randomization,MR)方法,包括单变量、多变量、贝叶斯模型平均和反向 MR,在生命过程的背景下研究 EBV 暴露与牙周炎之间的因果关系。此外,还利用连锁不平衡得分回归和共定位分析来评估跨性状遗传相关性,然后利用全转录组关联分析和富集分析来鉴别遗传表型生物特征:结果:EB病毒抗体水平升高,尤其是早期抗原扩散(作为早期感染或再激活的指标),与牙周炎风险增加有关(比值比[OR]:1.27 [1.09-1.47],p = 6.05 × 10-3),并显示出显著的遗传相关性(p = 4.11 × 10-3)。这种发病机制可能涉及位于 17p13.1 的高置信度致病基因 RNASEK。遗传预测的生命早期抗 EBV 免疫球蛋白 G (IgG) 水平与牙周炎风险降低相关(OR:0.89 [0.82-0.97],p = 1.76 × 10-3):本研究强调了EBV暴露及其遗传特征对牙周炎的影响,为EBV相关牙周炎的潜在发病机制和管理策略提供了新的视角。这些发现强调了不同的临床和公共卫生影响,包括抗病毒疗法、病毒疫苗接种策略和个性化牙周炎管理的定制干预措施。我们还需要进一步的研究来验证和扩展我们的发现。白话摘要:牙周炎是一种慢性炎症性疾病,由微生物病原体和宿主免疫系统之间的相互作用驱动。虽然细菌一直是研究的重点,但最近的研究强调了病毒-细菌相互作用的重要性,尤其是 Epstein-Barr 病毒(EBV)--一种感染全球 90% 以上人口的疱疹病毒--在牙周炎发病中的作用。然而,潜在的成因和遗传机制仍不清楚。我们的研究采用了全基因组多组学方法来研究 EBV 暴露与牙周炎之间的联系。我们发现,近期的 EBV 感染或再激活会增加牙周炎的风险,而早年的暴露则可能会降低牙周炎的风险,因为早年的暴露可能会增强免疫抵抗力。基本基因被确定为潜在的介导因素,包括 CRTC3-AS1、HLA-DQA1 和 RNASEK。这些研究结果为了解 EBV 与牙周炎的关系提供了新的视角。例如,病毒检测和控制可使对标准细菌疗法无反应的患者受益,通过接种疫苗及早接触病毒可降低牙周炎的风险。要阐明这些基本机制以及病毒与细菌相互作用的贡献,还需要进一步的临床研究。
{"title":"Appraising the life-course impact of Epstein-Barr virus exposure and its genetic signature on periodontitis.","authors":"Xinjian Ye, Jian Yuan, Yijing Bai, Yitong Chen, He Jiang, Yue Cao, Qifei Ge, Zhiyong Wang, Weiyi Pan, Shan Wang, Qianming Chen","doi":"10.1002/JPER.24-0300","DOIUrl":"https://doi.org/10.1002/JPER.24-0300","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Periodontitis arises from a multifaceted interplay of environmental variables and genetic susceptibility, where microbial infection plays an indispensable part. Epstein-Barr virus (EBV) exposure has long been considered associated with periodontitis activity; however, the causal relationship and genetic connection between them remain unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Within a life-course context, our study employed comprehensive Mendelian randomization (MR) methods, including univariable, multivariable, Bayesian model averaging, and reverse MR, to investigate the causal association between EBV exposure and periodontitis. Additionally, linkage disequilibrium score regression and colocalization analysis were utilized to assess the cross-trait genetic correlations, followed by transcriptome-wide association and enrichment analysis to discern the genetic-phenotypic biological profiles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Heightened levels of EBV antibodies, particularly early antigen diffuses (which serve as indicators of early infection or reactivation), are associated with an increased risk of periodontitis (odds ratio [OR]: 1.27 [1.09-1.47], p = 6.05 × 10&lt;sup&gt;-3&lt;/sup&gt;) and demonstrate a significant genetic correlation (p = 4.11 × 10&lt;sup&gt;-3&lt;/sup&gt;). This pathogenesis may involve the high-confidence causal gene RNASEK located in 17p13.1. Genetically predicted early-life anti-EBV immunoglobulin G (IgG) levels are correlated to a reduced periodontitis risk (OR: 0.89 [0.82-0.97], p = 1.76 × 10&lt;sup&gt;-3&lt;/sup&gt;).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The present study highlights the impact of life-course EBV exposure and its genetic hallmark on periodontitis, providing novel perspectives into the underlying pathogenesis and management strategies for EBV-related periodontitis. These findings underscore diverse clinical and public health implications, encompassing antiviral therapies, viral vaccination strategies, and tailored interventions for individualized periodontitis management. Further research is required to validate and expand upon our findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Periodontitis is a chronic inflammatory disease driven by interactions between microbial pathogens and the host immune system. While bacteria have traditionally been the focus of research, recent studies highlight the significance of virus-bacteria interactions, particularly the role of Epstein-Barr virus (EBV)-a herpesvirus infecting over 90% of the global population-in the development of periodontitis. However, the underlying causal and genetic mechanisms remain unclear. Our study employed genome-wide multi-omics approaches to investigate the link between EBV exposure and periodontitis. We found that recent EBV infection or reactivation increases the risk of periodontitis, whereas early-life exposure, possibly enabling immune resistance, may reduce it. Essential genes were identified as potential mediators, including CRTC3-AS1, H","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of nonsurgical re‐instrumentation: Tooth‐related factors 非手术再镶牙的效果:与牙齿有关的因素
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-22 DOI: 10.1002/jper.24-0178
Caspar Victor Bumm, Falk Schwendicke, Vinay Pitchika, Katrin Heck, Elias Walter, Christina Ern, Richard Heym, Nils Werner, Matthias Folwaczny
BackgroundTo investigate tooth‐related factors that influence pocket closure (PC) and the reduction of pocket probing depths (PPD) after nonsurgical re‐instrumentation (NSRI) as part of step 3 therapy.MethodsA total of 480 patients (10,807 teeth) presenting with residual pockets 6.33 ± 3.79 months after steps 1 and 2 of periodontal therapy were included and retrospectively analyzed before and 5.93 ± 4.31 months after NSRI. Reduction of PPD and PC rates following NSRI were associated with tooth‐related factors, namely tooth type, arch, number of roots, furcation involvement (FI), pulp vitality, mobility, type of restoration, presence of plaque, and bleeding on probing (BOP), using mixed‐effects regression models.ResultsNSRI reduced periodontal pockets persisting after initial cause‐related therapy by (mean ± SD) 1.32 ± 1.79 mm in PPD, and PC rate was 40%. Moderate pockets (4–5 mm) responded better to NSRI than deep pockets (≥ 6 mm) in terms of PC (51% vs. 16%). Both PPD reduction and PC rates of deep residual pockets were significantly influenced by tooth type, arch, number of roots, and presence of BOP.ConclusionTooth type, arch, number of roots, and presence of BOP at re‐evaluation (before NSRI) had a significant and clinically relevant influence on NSRI as part of step 3 therapy. Considering these factors, particularly for deep residual pockets, may allow more tailored re‐intervention.Plain language summaryThe present study aimed to investigate the influence of tooth‐related factors on the outcome of repeated nonsurgical therapy of periodontitis. Therefore, 480 patients (10,807 teeth) presenting with clinical symptoms of persistent periodontitis after initial therapy were administered repeated nonsurgical therapy and retrospectively analyzed. Therapy outcomes were associated with tooth‐related factors, namely tooth type, tooth location (maxilla/mandible), number of roots, involvement of the root furcation area in multi‐rooted teeth, pulp vitality, mobility, restoration, presence of plaque and bleeding upon periodontal probing, using mixed‐effects models. The results revealed that repeated nonsurgical therapy was effective in reducing inflammation and clinical signs of disease, with moderate residual periodontal defects responding better than deep defects. Healing of deep defects after repeated nonsurgical therapy; however, was significantly influenced by the factors: tooth type, location, number of roots, and bleeding on probing. Considering these factors, particularly in deep residual defects which are commonly suggested to be treated surgically, may allow less invasiveness and thus a more tailored re‐intervention.
背景研究作为第三步治疗一部分的非手术再探查术(NSRI)后,影响牙周袋闭合(PC)和牙周袋探查深度(PPD)降低的牙齿相关因素。方法共纳入了480名患者(10,807颗牙齿),他们在牙周治疗第一步和第二步后6.33 ± 3.79个月出现残留牙周袋,并对NSRI前和NSRI后5.93 ± 4.31个月进行了回顾性分析。采用混合效应回归模型,将NSRI后PPD和PC率的降低与牙齿相关因素(即牙齿类型、牙弓、牙根数、毛面受累(FI)、牙髓活力、活动度、修复类型、牙菌斑的存在以及探诊出血(BOP))相关联。结果NSRI将初始病因相关治疗后持续存在的牙周袋的PPD降低了(平均±标度)1.32±1.79 mm,PC率为40%。就PC而言,中度牙周袋(4-5毫米)对NSRI的反应优于深度牙周袋(≥6毫米)(51%对16%)。结论牙齿类型、牙弓、牙根数和重新评估时(NSRI 之前)是否存在 BOP 对作为第三步治疗一部分的 NSRI 有显著的临床相关影响。考虑到这些因素,尤其是对深残留牙周袋的影响,可能会使再次干预更有针对性。本研究旨在探讨与牙齿相关的因素对牙周炎反复非手术治疗结果的影响。因此,对初次治疗后出现顽固性牙周炎临床症状的 480 例患者(10807 颗牙齿)进行了反复非手术治疗并进行了回顾性分析。采用混合效应模型,将治疗结果与牙齿相关因素(即牙齿类型、牙齿位置(上颌/下颌)、牙根数量、多根牙齿的牙根窝沟区受累情况、牙髓活力、活动度、修复情况、牙菌斑存在情况以及牙周探诊出血情况)联系起来。结果显示,反复非手术治疗能有效减轻炎症和疾病的临床症状,中度残留牙周缺损的反应优于深度缺损。然而,反复非手术治疗后深层缺损的愈合受到以下因素的显著影响:牙齿类型、位置、牙根数量和探诊出血。考虑到这些因素,尤其是通常建议手术治疗的深度残留缺损,可以减少创伤,从而进行更有针对性的再干预。
{"title":"Effectiveness of nonsurgical re‐instrumentation: Tooth‐related factors","authors":"Caspar Victor Bumm, Falk Schwendicke, Vinay Pitchika, Katrin Heck, Elias Walter, Christina Ern, Richard Heym, Nils Werner, Matthias Folwaczny","doi":"10.1002/jper.24-0178","DOIUrl":"https://doi.org/10.1002/jper.24-0178","url":null,"abstract":"BackgroundTo investigate tooth‐related factors that influence pocket closure (PC) and the reduction of pocket probing depths (PPD) after nonsurgical re‐instrumentation (NSRI) as part of step 3 therapy.MethodsA total of 480 patients (10,807 teeth) presenting with residual pockets 6.33 ± 3.79 months after steps 1 and 2 of periodontal therapy were included and retrospectively analyzed before and 5.93 ± 4.31 months after NSRI. Reduction of PPD and PC rates following NSRI were associated with tooth‐related factors, namely tooth type, arch, number of roots, furcation involvement (FI), pulp vitality, mobility, type of restoration, presence of plaque, and bleeding on probing (BOP), using mixed‐effects regression models.ResultsNSRI reduced periodontal pockets persisting after initial cause‐related therapy by (mean ± SD) 1.32 ± 1.79 mm in PPD, and PC rate was 40%. Moderate pockets (4–5 mm) responded better to NSRI than deep pockets (≥ 6 mm) in terms of PC (51% vs. 16%). Both PPD reduction and PC rates of deep residual pockets were significantly influenced by tooth type, arch, number of roots, and presence of BOP.ConclusionTooth type, arch, number of roots, and presence of BOP at re‐evaluation (before NSRI) had a significant and clinically relevant influence on NSRI as part of step 3 therapy. Considering these factors, particularly for deep residual pockets, may allow more tailored re‐intervention.Plain language summaryThe present study aimed to investigate the influence of tooth‐related factors on the outcome of repeated nonsurgical therapy of periodontitis. Therefore, 480 patients (10,807 teeth) presenting with clinical symptoms of persistent periodontitis after initial therapy were administered repeated nonsurgical therapy and retrospectively analyzed. Therapy outcomes were associated with tooth‐related factors, namely tooth type, tooth location (maxilla/mandible), number of roots, involvement of the root furcation area in multi‐rooted teeth, pulp vitality, mobility, restoration, presence of plaque and bleeding upon periodontal probing, using mixed‐effects models. The results revealed that repeated nonsurgical therapy was effective in reducing inflammation and clinical signs of disease, with moderate residual periodontal defects responding better than deep defects. Healing of deep defects after repeated nonsurgical therapy; however, was significantly influenced by the factors: tooth type, location, number of roots, and bleeding on probing. Considering these factors, particularly in deep residual defects which are commonly suggested to be treated surgically, may allow less invasiveness and thus a more tailored re‐intervention.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"62 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gingival inflammation and leukocyte-endothelium cell interactions in women with polycystic ovary syndrome. 多囊卵巢综合征妇女的牙龈炎症和白细胞-内皮细胞相互作用。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-15 DOI: 10.1002/jper.24-0148
Cecilia Fabiana Márquez-Arrico,Francisco Javier Silvestre,Meylin Fernández-Reyes,Sandra López-Domènech,Jonathan Hermenejildo,Zaida Abad-Jiménez,Javier Silvestre-Rangil,Pablo Fernández-Collazo,Carlos Morillas,José María Montiel-Company,Víctor M Víctor,Milagros Rocha
BACKGROUNDGiven the link between chronic inflammation and periodontal pathologies and increased cardiovascular risk, this study aims to investigate if gingivitis exacerbates the inflammatory response and subclinical atherosclerotic markers in women with polycystic ovary syndrome (PCOS).METHODSFor this case-control study, women were assigned to three groups: two PCOS groups (with and without gingivitis) and a control group. Anthropometric and biochemical variables were determined, along with periodontal parameters (probing pocket depth [PPD], clinical attachment level [CAL], bleeding on probing [BOP], plaque index, calculus index, and tooth loss), systemic and neutrophil inflammatory markers (tumor necrosis factor alpha [TNFα], C-reactive protein [CRP], and c-Jun N-terminal kinase [JNK]), systemic oxidative stress mediators (myeloperoxidase [MPO] and glutathione), soluble cellular adhesion molecules, and neutrophil-endothelium cell interactions (rolling flux, velocity, and adhesion).RESULTSOf 104 women recruited, 68 had PCOS, 24 of whom presented gingivitis, and 36 were controls. PCOS patients presented altered sexual hormone, lipid, and carbohydrate profiles. Levels of systemic inflammatory markers, MPO, and soluble platelet selectin (sP-selectin) were higher, and glutathione levels were lower in PCOS patients. BOP, plaque, and calculus index values were higher in PCOS patients with gingivitis. Neutrophils from PCOS patients showed increased JNK and decreased adhesion under flow conditions, with reduced rolling velocity and increased rolling flux and cellular adhesion, all of which were more pronounced in those with gingivitis. BOP was independently associated with rolling velocity, rolling flux, and cellular adhesion.CONCLUSIONNeutrophils of PCOS patients with gingivitis exhibit hyperactivity, promoting interaction with the endothelium and potentially contributing to atherosclerotic disease.PLAIN LANGUAGE SUMMARYCurrently, there is a high prevalence of diseases that affect tooth-supporting tissues (periodontal diseases) and negatively influence the oral health and quality of life of the adult population. These pathologies lead to movement of the teeth and impairment of chewing function, eventually resulting in the loss of teeth. In recent years, the concept of periodontal medicine has arisen and consists of studying how periodontal diseases can influence our general inflammatory system and how systemic inflammatory pathologies can affect our oral health. In the present study, we evaluate a group of women with polycystic ovary syndrome (PCOS), a condition characterized by alterations of sex hormones and lipid profile and weight gain (body mass index). Our results show a high prevalence of gum inflammation among women with PCOS, which affects the interaction of their leukocytes and endothelial cells. The leukocytes of these women are hyper-responsive, presenting greater endothelial adhesion, lower flow velocity and enhanced rolling compared to tho
背景鉴于慢性炎症和牙周病变与心血管风险增加之间的联系,本研究旨在调查牙龈炎是否会加剧多囊卵巢综合征(PCOS)女性的炎症反应和亚临床动脉粥样硬化标志物。方法在这项病例对照研究中,女性被分配到三个组:两个 PCOS 组(有牙龈炎和无牙龈炎)和一个对照组。研究人员测定了人体测量和生化变量,以及牙周参数(探诊袋深度 [PPD]、临床附着水平 [CAL]、探诊出血 [BOP]、牙菌斑指数、牙结石指数和牙齿脱落)、全身和中性粒细胞炎症标志物(肿瘤坏死因子α [TNFα]、C反应蛋白 [CRP]、TNFα [TNFα]、TNFα [TNFα])、C反应蛋白 [CRP] 和 c-Jun N 端激酶 [JNK])、全身氧化应激介质(髓过氧化物酶 [MPO] 和谷胱甘肽)、可溶性细胞粘附分子和中性粒细胞-内皮细胞相互作用(滚动通量、速度和粘附)。结果 在招募的 104 名女性中,68 人患有多囊卵巢综合症,其中 24 人患有牙龈炎,36 人为对照组。多囊卵巢综合症患者的性激素、血脂和碳水化合物状况发生了改变。多囊卵巢综合征患者的全身炎症标志物、MPO 和可溶性血小板选择素(sP-selectin)水平较高,谷胱甘肽水平较低。患有牙龈炎的多囊卵巢综合征患者的 BOP、牙菌斑和牙结石指数值较高。多囊卵巢综合征患者的中性粒细胞在流动条件下表现出 JNK 增加和粘附性降低,滚动速度降低,滚动通量和细胞粘附性增加,所有这些在牙龈炎患者中更为明显。结论患有牙龈炎的多囊卵巢综合征患者的中性粒细胞表现出过高的活性,促进了与内皮的相互作用,并可能导致动脉粥样硬化性疾病。这些病变导致牙齿移动和咀嚼功能受损,最终导致牙齿脱落。近年来,牙周医学的概念应运而生,它包括研究牙周疾病如何影响我们的全身炎症系统,以及全身炎症病理如何影响我们的口腔健康。在本研究中,我们对一组患有多囊卵巢综合征(PCOS)的妇女进行了评估,多囊卵巢综合征的特点是性激素和血脂状况的改变以及体重增加(体重指数)。我们的研究结果表明,患有多囊卵巢综合症的妇女牙龈炎症的发病率很高,这影响了她们的白细胞和内皮细胞之间的相互作用。与没有牙龈炎症的多囊卵巢综合症患者或对照组相比,这些妇女的白细胞反应过度,表现出更强的内皮粘附性、更低的流速和更强的滚动性。这项研究为分析牙龈炎患者的中性粒细胞如何表现出高活性,从而促进它们与内皮的相互作用,进而导致动脉粥样硬化疾病的发生提供了新的研究方向。
{"title":"Gingival inflammation and leukocyte-endothelium cell interactions in women with polycystic ovary syndrome.","authors":"Cecilia Fabiana Márquez-Arrico,Francisco Javier Silvestre,Meylin Fernández-Reyes,Sandra López-Domènech,Jonathan Hermenejildo,Zaida Abad-Jiménez,Javier Silvestre-Rangil,Pablo Fernández-Collazo,Carlos Morillas,José María Montiel-Company,Víctor M Víctor,Milagros Rocha","doi":"10.1002/jper.24-0148","DOIUrl":"https://doi.org/10.1002/jper.24-0148","url":null,"abstract":"BACKGROUNDGiven the link between chronic inflammation and periodontal pathologies and increased cardiovascular risk, this study aims to investigate if gingivitis exacerbates the inflammatory response and subclinical atherosclerotic markers in women with polycystic ovary syndrome (PCOS).METHODSFor this case-control study, women were assigned to three groups: two PCOS groups (with and without gingivitis) and a control group. Anthropometric and biochemical variables were determined, along with periodontal parameters (probing pocket depth [PPD], clinical attachment level [CAL], bleeding on probing [BOP], plaque index, calculus index, and tooth loss), systemic and neutrophil inflammatory markers (tumor necrosis factor alpha [TNFα], C-reactive protein [CRP], and c-Jun N-terminal kinase [JNK]), systemic oxidative stress mediators (myeloperoxidase [MPO] and glutathione), soluble cellular adhesion molecules, and neutrophil-endothelium cell interactions (rolling flux, velocity, and adhesion).RESULTSOf 104 women recruited, 68 had PCOS, 24 of whom presented gingivitis, and 36 were controls. PCOS patients presented altered sexual hormone, lipid, and carbohydrate profiles. Levels of systemic inflammatory markers, MPO, and soluble platelet selectin (sP-selectin) were higher, and glutathione levels were lower in PCOS patients. BOP, plaque, and calculus index values were higher in PCOS patients with gingivitis. Neutrophils from PCOS patients showed increased JNK and decreased adhesion under flow conditions, with reduced rolling velocity and increased rolling flux and cellular adhesion, all of which were more pronounced in those with gingivitis. BOP was independently associated with rolling velocity, rolling flux, and cellular adhesion.CONCLUSIONNeutrophils of PCOS patients with gingivitis exhibit hyperactivity, promoting interaction with the endothelium and potentially contributing to atherosclerotic disease.PLAIN LANGUAGE SUMMARYCurrently, there is a high prevalence of diseases that affect tooth-supporting tissues (periodontal diseases) and negatively influence the oral health and quality of life of the adult population. These pathologies lead to movement of the teeth and impairment of chewing function, eventually resulting in the loss of teeth. In recent years, the concept of periodontal medicine has arisen and consists of studying how periodontal diseases can influence our general inflammatory system and how systemic inflammatory pathologies can affect our oral health. In the present study, we evaluate a group of women with polycystic ovary syndrome (PCOS), a condition characterized by alterations of sex hormones and lipid profile and weight gain (body mass index). Our results show a high prevalence of gum inflammation among women with PCOS, which affects the interaction of their leukocytes and endothelial cells. The leukocytes of these women are hyper-responsive, presenting greater endothelial adhesion, lower flow velocity and enhanced rolling compared to tho","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"43 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical outcomes of using operating microscope for alveolar ridge preservation: A randomized controlled trial. 使用手术显微镜保留牙槽嵴的临床效果:随机对照试验
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-15 DOI: 10.1002/jper.24-0081
Benyapha Sirinirund,Janet Zalucha,Amanda B Rodriguez Betancourt,Oliver D Kripfgans,Chin-Wei Wang,Diego Velasquez,Hsun-Liang Chan
BACKGROUNDThe use of the operating microscope (OM) for extraction and alveolar ridge augmentation (ARP) is increasing due to enhanced magnification and illumination. The primary objective was to compare the wound healing and crestal bone quality after the use of OM and dental loupes (DL) for ARP.METHODSForty non-molar teeth with periapical lesions in need of extraction and ARP from 33 patients were randomly assigned to 2 groups: DL (control) or OM (test). All procedures were performed by 1 surgeon and assessments done by masked examiners. ARP was performed with an allograft and a resorbable collagen membrane. The presence of granulomatous tissue remnants after debridement was recorded. Cone-beam computed tomography (CBCT) and ultrasound (US) scans were taken during the healing phase up to 16-week visits. Bone cores were retrieved from implant osteotomies for histologic analysis. Patient-reported outcome measurements (PROMs) were assessed.RESULTSAll patients completed all study visits except 1 who dropped out before the last visit. After socket debridement, the test group exhibited significantly fewer sites with tissue remnants (p = 0.01) and a better healing score at 2-week (p = 0.04) and 4-week (p = 0.01) time points. There were no significant differences in 12-week crestal bone healing by histology (p = 0.1), US (p = 0.85), and CBCT healing (p = 0.64) at 12 weeks, as well as PROMs (p > 0.1).CONCLUSIONWithin the limitation of the study, the use of OM for ARP resulted in significantly fewer tissue remnants and favorable early visual wound healing. CBCT and US-derived-crestal bone quality did not show a difference between the 2 groups.PLAIN LANGUAGE SUMMARYAlveolar ridge preservation (ARP) by placing bone particulates in the extraction socket, covered by a wound dressing material, is commonly applied immediately after tooth extraction to reduce jawbone shrinkage in preparation for implant placement later. The jawbone healing varies, depending largely on the ability to remove the etiology, socket features, extent of surgical trauma, and wound stability. Healed jawbone with good quality is favorable for easiness of implant placement and could be related to maintenance of long-term implant health. The surgical microscope with high magnification (up to ∼25×) and co-axial illumination is ideal for assistance in the removal of granulomatous tissue that is believed to interfere with healing, performance of minimally invasive extraction, and stabilization of the wound with meticulous tissue management and fine sutures. This study compared the use of the surgical microscope to dental loupes for ARP in a randomized controlled design. The microscope-assisted ARP is associated with a significantly higher chance of removing granulomatous tissue, favorable early healing, and similar crestal bone quality. Removal of granulomatous tissue is significant for immediate implant placement. This study serves as a model for testing the benefits of the surgical microscop
背景由于放大率和照明度的提高,使用手术显微镜(OM)进行拔牙和牙槽嵴增高术(ARP)的情况越来越多。研究的主要目的是比较使用手术显微镜和牙科放大镜(DL)进行 ARP 后的伤口愈合情况和牙槽嵴骨质量:DL组(对照组)或OM组(试验组)。所有手术均由一名外科医生完成,并由蒙面检查人员进行评估。ARP 采用异体移植和可吸收胶原膜进行。记录清创后肉芽肿组织残留物的存在情况。在愈合期至16周的检查期间,进行锥形束计算机断层扫描(CBCT)和超声波扫描。从种植体截骨处提取骨芯进行组织学分析。结果除一名患者在最后一次就诊前退出外,其余患者均完成了所有就诊。牙槽窝清创后,试验组有组织残留的部位明显较少(p = 0.01),2 周(p = 0.04)和 4 周(p = 0.01)时点的愈合评分较高。在 12 周组织学(p = 0.1)、US(p = 0.85)和 CBCT 愈合(p = 0.64)以及 PROMs(p > 0.1)方面,12 周骨干愈合无明显差异。牙槽嵴保留(ARP)通过在拔牙窝内放置骨颗粒,并用伤口敷料覆盖,通常在拔牙后立即使用,以减少颌骨萎缩,为以后植入种植体做准备。颌骨的愈合情况各不相同,主要取决于去除病因的能力、牙槽的特征、手术创伤的程度以及伤口的稳定性。愈合后的颌骨质量良好,有利于种植体的植入,并能长期保持种植体的健康。手术显微镜具有高倍率(高达∼25×)和同轴照明功能,可帮助清除影响愈合的肉芽肿组织,进行微创拔牙,并通过细致的组织管理和精细缝合来稳定伤口。这项研究在随机对照设计中比较了使用手术显微镜和牙科放大镜进行 ARP 的情况。在显微镜辅助下进行 ARP,肉芽肿组织的清除率明显更高,早期愈合良好,骨嵴骨质相似。肉芽肿组织的清除对即刻种植体植入具有重要意义。这项研究为测试手术显微镜在更具挑战性的口腔内外科手术中促进早期愈合的优势提供了一个模型。
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引用次数: 0
The impact of intravenous versus submucosal dexamethasone on short-term patient response: A randomized controlled trial. 静脉注射与粘膜下注射地塞米松对患者短期反应的影响:随机对照试验。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-09 DOI: 10.1002/JPER.24-0127
Ellen P Pearce, David E Deas, Charles A Powell, Anibal Diogenes, Georgios A Kotsakis, Michael J Mader, Archontia Palaiologou

Background: The purpose of this randomized, cross-over trial was to determine if a preoperative dose of dexamethasone administered submucosally is as effective as intravenous (IV) dexamethasone in reducing pain, swelling, and analgesic consumption after periodontal flap surgery.

Methods: Thirty-nine patients planned for two similar flap surgeries under IV sedation were included. Before the first surgery, patients were randomized to receive 8 mg of IV or submucosal dexamethasone. Via the alternate route, 0.9% sodium chloride (placebo) was administered. Dexamethasone was administered via the opposite route during the second surgery. A standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen was used to manage postoperative pain. Patients recorded pain and swelling levels on a 21-point numerical rating scale (NRS-21) and a four-point visual rating scale (VRS-4), as well as analgesic usage via a phone application at 12, 24, 48, 72, and 168 h postoperatively.

Results: While NRS-21 and VRS-4 data suggest a trend toward decreased pain and swelling with IV administration, there were no significant differences in analgesic usage or pain at any time and a significant difference in swelling only at 72 h in favor of IV administration (p = 0.047).

Conclusions: There was no significant difference in pain or analgesic usage following periodontal flap surgery comparing IV and submucosal dexamethasone. A statistically significant difference in swelling between groups at 72 h is likely of limited clinical relevance. Submucosal dexamethasone is an effective way to mitigate pain following periodontal surgery, particularly when IV access for sedation is not required.

背景:这项随机交叉试验的目的是确定术前在黏膜下注射地塞米松是否与静脉注射地塞米松一样能有效减轻牙周皮瓣手术后的疼痛、肿胀和镇痛药用量:方法:39 名患者计划在静脉镇静下接受两次类似的翻瓣手术。在第一次手术前,患者被随机分配接受 8 毫克静脉注射或粘膜下地塞米松。通过备用途径,患者接受 0.9% 氯化钠(安慰剂)。第二次手术时,地塞米松通过相反的途径给药。采用 600 毫克布洛芬和 325 毫克对乙酰氨基酚的标准化方案来控制术后疼痛。患者在术后12、24、48、72和168小时分别用21点数字评分量表(NRS-21)和4点视觉评分量表(VRS-4)记录疼痛和肿胀程度,并通过手机应用软件记录镇痛药的使用情况:尽管NRS-21和VRS-4数据表明静脉注射有减轻疼痛和肿胀的趋势,但镇痛剂使用量或疼痛在任何时间都没有显著差异,只有在72小时时肿胀有显著差异,静脉注射更有利(p = 0.047):牙周翻瓣手术后,静脉注射地塞米松和粘膜下地塞米松在疼痛或镇痛剂用量上没有明显差异。72小时后各组间肿胀程度的统计学差异可能对临床意义有限。粘膜下地塞米松是减轻牙周手术后疼痛的有效方法,尤其是在不需要静脉注射镇静剂的情况下。
{"title":"The impact of intravenous versus submucosal dexamethasone on short-term patient response: A randomized controlled trial.","authors":"Ellen P Pearce, David E Deas, Charles A Powell, Anibal Diogenes, Georgios A Kotsakis, Michael J Mader, Archontia Palaiologou","doi":"10.1002/JPER.24-0127","DOIUrl":"https://doi.org/10.1002/JPER.24-0127","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this randomized, cross-over trial was to determine if a preoperative dose of dexamethasone administered submucosally is as effective as intravenous (IV) dexamethasone in reducing pain, swelling, and analgesic consumption after periodontal flap surgery.</p><p><strong>Methods: </strong>Thirty-nine patients planned for two similar flap surgeries under IV sedation were included. Before the first surgery, patients were randomized to receive 8 mg of IV or submucosal dexamethasone. Via the alternate route, 0.9% sodium chloride (placebo) was administered. Dexamethasone was administered via the opposite route during the second surgery. A standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen was used to manage postoperative pain. Patients recorded pain and swelling levels on a 21-point numerical rating scale (NRS-21) and a four-point visual rating scale (VRS-4), as well as analgesic usage via a phone application at 12, 24, 48, 72, and 168 h postoperatively.</p><p><strong>Results: </strong>While NRS-21 and VRS-4 data suggest a trend toward decreased pain and swelling with IV administration, there were no significant differences in analgesic usage or pain at any time and a significant difference in swelling only at 72 h in favor of IV administration (p = 0.047).</p><p><strong>Conclusions: </strong>There was no significant difference in pain or analgesic usage following periodontal flap surgery comparing IV and submucosal dexamethasone. A statistically significant difference in swelling between groups at 72 h is likely of limited clinical relevance. Submucosal dexamethasone is an effective way to mitigate pain following periodontal surgery, particularly when IV access for sedation is not required.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A population‐based study on the associations of thyroid cancer with chronic periodontitis 甲状腺癌与慢性牙周炎关系的人群研究
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-28 DOI: 10.1002/jper.24-0311
Tzong‐Hann Yang, Yen‐Fu Cheng, Herng‐Ching Lin, Chin‐Shyan Chen
BackgroundEmerging concerns link periodontitis to an array of cancers, notably thyroid cancer, though investigations into these associations are still in the nascent stages. This population‐based study aimed to investigate the association of thyroid cancer with chronic periodontitis using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010).MethodsThis case‐control study utilized LHID2010, selecting 2,775 patients diagnosed with thyroid cancer, matched with 8,325 controls based on age, sex, income, and the presence of diabetes, hypertension, hyperlipidemia, human papillomavirus infection, and tobacco use disorder using propensity‐score matching. Multivariate logistic regression models were used to evaluate the association of thyroid cancer with chronic periodontitis.ResultsA chi‐squared analysis demonstrated a significant disparity in the prevalence of chronic periodontitis between those diagnosed with thyroid cancer and the controls, with prevalence rates of 38.5% and 24.1% respectively, and a p‐value less than 0.001. The odds ratio (OR) for having prior chronic periodontitis among patients with thyroid cancer compared to controls was 1.991, with a 95% confidence interval (CI) of 1.816–2.184 and a p‐value less than 0.001. The association was similar between sexes, yielding adjusted ORs of 1.991 (95% CI = 1.816∼2.184) for men and 1.962 (95% CI = 1.765−2.182) for women, indicating a statistically significant higher prevalence of chronic periodontitis in both male and female patients diagnosed with thyroid cancer compared to their control counterparts.ConclusionThe findings highlight chronic periodontitis as a potential risk factor for thyroid cancer, underscoring the importance of integrated health surveillance and preventive strategies that encompass oral health.Plain Language SummaryThis study aimed to explore the link between thyroid cancer and chronic periodontitis. Using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010), we selected 2,775 patients with thyroid cancer and matched them with 8,325 individuals without the disease based on age, sex, income, and other health conditions such as diabetes, hypertension, high cholesterol, HPV infection, and smoking habits. The study used statistical models to examine the relationship between thyroid cancer and chronic periodontitis. The findings showed that 38.5% of thyroid cancer patients had chronic periodontitis, compared to 24.1% of the control group. The odds of having chronic periodontitis were nearly twice as high in thyroid cancer patients. This pattern was consistent for both men and women. The study underscores the strong connection between chronic periodontitis and thyroid cancer, emphasizing the importance of raising public awareness about the potential risks of periodontitis.
背景人们越来越关注牙周炎与一系列癌症(尤其是甲状腺癌)之间的关系,但对这些关系的调查仍处于初级阶段。方法这项病例对照研究利用台湾纵向健康保险数据库2010(LHID2010),选择了2,775名确诊为甲状腺癌的患者,根据年龄、性别、收入以及是否患有糖尿病、高血压、高脂血症、人类乳头瘤病毒感染和烟草使用障碍等因素,利用倾向分数匹配法与8,325名对照组进行匹配。结果卡方分析表明,甲状腺癌患者和对照组的慢性牙周炎患病率存在显著差异,患病率分别为38.5%和24.1%,P值小于0.001。与对照组相比,甲状腺癌患者患慢性牙周炎的几率比(OR)为1.991,95%置信区间(CI)为1.816-2.184,P值小于0.001。男女之间的相关性相似,男性的调整 OR 值为 1.991(95% CI = 1.816∼2.184),女性为 1.962(95% CI = 1.765-2.182),这表明与对照组患者相比,男性和女性甲状腺癌患者的慢性牙周炎患病率在统计学上都显著较高。本研究旨在探讨甲状腺癌与慢性牙周炎之间的联系。通过台湾纵向健康保险数据库2010(LHID2010),我们选取了2,775名甲状腺癌患者,并根据年龄、性别、收入和其他健康状况(如糖尿病、高血压、高胆固醇、HPV感染和吸烟习惯),将他们与8,325名无甲状腺癌患者进行配对。研究使用统计模型来检验甲状腺癌与慢性牙周炎之间的关系。研究结果显示,38.5%的甲状腺癌患者患有慢性牙周炎,而对照组的这一比例为24.1%。甲状腺癌患者患慢性牙周炎的几率几乎是对照组的两倍。这种模式在男性和女性中都是一致的。这项研究强调了慢性牙周炎与甲状腺癌之间的密切联系,强调了提高公众对牙周炎潜在风险认识的重要性。
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引用次数: 0
Evaluation of salivary interleukin-17 and developmental endothelial locus-1 in patients with periodontitis with and without type 2 diabetes mellitus. 评估伴有或不伴有 2 型糖尿病的牙周炎患者唾液中的白细胞介素-17 和发育内皮基因座-1。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-23 DOI: 10.1002/JPER.23-0720
Yong Zhang, Xu Su, Yuzhi Li, Yu Cai, Ni Kang, Jinyu Duan, Fan Chen, Fei Xue, Xiaotao Chen
<p><strong>Background: </strong>Bidirectional positive relationship between periodontitis and type 2 diabetes mellitus (T2DM) has been recognized, interleukin 17 (IL-17) and developmental endothelial locus-1 (Del-1) are proposed to play roles in periodontitis and T2DM. This study aims to investigate the association of IL-17 and Del-1 in patients with periodontitis with and without T2DM by measuring their salivary levels.</p><p><strong>Methods: </strong>A total of 80 participants were enrolled in a cross-sectional study and divided into healthy (H, n = 27), periodontitis (P, n = 29) and periodontitis with diabetes (PDM, n = 24) groups based on their periodontal and diabetic examination results. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment level [CAL]) as well as diabetic parameters (fasting plasma glucose [FG] and glycated hemoglobin [HbA1c]) were documented and unstimulated saliva was collected. Salivary IL-1β, active-matrix metalloproteinase-8 (aMMP-8), tumor necrosis factor-α (TNF-α), IL-6, IL-8, IL-17, and Del-1 were determined through enzyme-linked immunosorbent assay (ELISA) and their relationships with periodontal and diabetic parameters were examined.</p><p><strong>Results: </strong>The periodontitis and periodontitis with diabetes groups showed significantly higher levels of IL-17 and lower levels of Del-1 compared with healthy group. The periodontitis with diabetes group exhibited higher levels of IL-17 and lower levels of Del-1 compared with the periodontitis group. After correlation analysis, there were significant correlations between salivary IL-17 and Del-1 and clinical parameters, IL-17 and Del-1 were correlated with PD (r = 0.36, -0.39, p < 0.01), CAL (r = 0.40, -0.42, p < 0.01) and BOP (r = 0.35, -0.37, p < 0.01), they were correlated with FG (r = 0.26, -0.25, p < 0.05) and HbA1c (r = 0.28, -0.40, p < 0.05). Positive relationships were observed between IL-17 and IL-1β and between IL-17 and aMMP-8 (r = 0.80, 0.77, p < 0.01), while Del-1 exhibited negative correlations with IL-1β and aMMP-8 (r = 0.59, 0.69 p < 0.01). Comparison between IL-17 and Del-1 confirmed an inverse relationship (r = -0.71, p < 0.01). Salivary Del-1 levels in the older group were lower compared with young group across the H, P and PDM groups, although these differences were not statistically significant (p > 0.05).</p><p><strong>Conclusions: </strong>Salivary IL-17 and Del-1 levels in the periodontitis with diabetes group showed significant changes compared with the periodontitis group, they exhibited an inverse relationship and were both correlated with periodontal parameters (PD, CAL, and BOP) and diabetic parameters (FG and HbA1c).</p><p><strong>Plain language summary: </strong>Periodontitis and type 2 diabetes mellitus (T2DM) are two common diseases all over the world, some inflammatory mediators (interleukin 17 [IL-17] and developmental endothelial locus-1 [Del-1]) regulate neutrophil p
背景:白细胞介素17(IL-17)和发育内皮位点-1(Del-1)被认为在牙周炎和T2DM中发挥作用。本研究旨在通过测量牙周炎患者和非 T2DM 患者的唾液水平,研究 IL-17 和 Del-1 的相关性:方法: 共有 80 人参加了横断面研究,并根据牙周和糖尿病检查结果分为健康组(H,n = 27)、牙周炎组(P,n = 29)和牙周炎合并糖尿病组(PDM,n = 24)。记录牙周参数(菌斑指数[PI]、探诊出血[BOP]、探诊深度[PD]和临床附着水平[CAL])和糖尿病参数(空腹血浆葡萄糖[FG]和糖化血红蛋白[HbA1c]),并收集未刺激唾液。通过酶联免疫吸附试验(ELISA)测定唾液中的IL-1β、活性基质金属蛋白酶-8(aMMP-8)、肿瘤坏死因子-α(TNF-α)、IL-6、IL-8、IL-17和Del-1,并研究它们与牙周和糖尿病参数的关系:结果:与健康组相比,牙周炎组和牙周炎伴糖尿病组的 IL-17 水平明显较高,而 Del-1 水平较低。与牙周炎组相比,牙周炎伴糖尿病组的 IL-17 水平更高,Del-1 水平更低。经过相关分析,唾液中的IL-17和Del-1与临床指标有显著相关性,IL-17和Del-1与PD相关(r = 0.36,-0.39,P 0.05):结论:与牙周炎组相比,牙周炎合并糖尿病组患者唾液中的IL-17和Del-1水平有显著变化,两者呈反比关系,且均与牙周参数(PD、CAL和BOP)和糖尿病参数(FG和HbA1c)相关。白细胞介素 17 [IL-17] 和发育内皮位点-1 [Del-1])调控中性粒细胞的产生、募集和清除,被认为与牙周炎和糖尿病的进展有关。在这项研究中,我们招募了健康受试者、牙周炎患者、牙周炎合并糖尿病患者。我们对他们进行了牙科检查,评估了他们的血糖水平,收集了他们的唾液,并检测了唾液中 IL-17 和 Del-1 的水平。我们发现,与健康受试者相比,牙周炎患者和牙周炎合并糖尿病患者的 IL-17 水平较高,而 Del-1 水平较低。与牙周炎患者相比,牙周炎合并糖尿病患者的IL-17水平较高,而Del-1水平较低。唾液中的IL-17和Del-1水平均与牙科检查结果和血糖水平相关,唾液中的IL-17和Del-1呈反比关系。
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引用次数: 0
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Journal of periodontology
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