Journal of periodontology最新文献

Background: Human papillomavirus (HPV) is implicated in oncogenesis and inflammatory processes, yet its role in periodontitis remains poorly defined.

Methods: We conducted a retrospective cohort study using the US Collaborative Network of the TriNetX platform. Adults (≥18 years) with at least two healthcare encounters were selected. The HPV-positive group, identified via ICD-10 codes from 2005 to 2018, was 1:1 propensity score-matched with HPV-negative controls after excluding individuals with prior periodontitis, cancer, or insufficient follow-up. New-onset periodontitis was defined using ICD-10 criteria, and hazard ratio estimates were derived using Cox proportional hazards models. Sensitivity analyses were performed with varying wash-out periods (12-36 months) and follow-up durations (5-15 years), while stratified analyses assessed differences by age, sex, race, and key comorbidities.

Results: After matching (n = 272,332 per group), the baseline characteristics were balanced. HPV-positive patients had significantly higher periodontitis risk, with a hazard ratio (HR) = 3.00 (95% CI: 2.67-3.37). Sensitivity analyses showed consistent findings. Age-stratified HRs were 3.74 (95% CI: 3.28-4.26) for 18-64 years old and 1.79 (95% CI: 1.13-2.84) for ≥65 years old. In racial stratification, White and Asian HPV patients presented significant risk of periodontitis.

Conclusion: HPV infection is associated with a markedly increased risk of periodontitis. These findings support enhanced periodontal screening for HPV-positive patients and warrant further investigation into the viral mechanisms driving chronic oral inflammation.

Plain language summary: Human papillomavirus (HPV) is well known for its link to certain cancers, but scientists are now investigating whether it might also play a role in gum disease. In this study, researchers analyzed health records from a large U.S. database to find out if people diagnosed with HPV were more likely to later develop periodontitis. They compared more than 270,000 adults with HPV with a similar group without the virus, making sure that both groups were alike in terms of age, health conditions, and other factors. The results showed that people with HPV had about three times the risk of developing periodontitis. This connection remained strong even when the researchers looked at different age groups, timeframes, and health backgrounds. Younger adults and those who were White or Asian showed particularly high risks. These findings suggest that HPV may play a role in long-term gum inflammation and damage. Although the study does not prove cause and effect, it highlights the need for more research and suggests that people with HPV might benefit from regular dental checkups to catch and manage gum disease early.

Background: The present study examined the impact of interruptions during the COVID-19 pandemic on the periodontal status of patients undergoing periodontal maintenance therapy (PMT).

Methods: De-identified data on demographic and periodontal characteristics of patients undergoing PMT seen at the University of Colorado School of Dental Medicine from January 1, 2018, to May 31, 2022, were extracted from the institutional dental database. Independent associations of the length of time between pre- and post-pandemic PMT visits with clinical attachment loss (CAL), bleeding on probing (BOP), and plaque were assessed using linear or logit mixed models. Associations between the number of teeth lost in the interval between the pre- and post-pandemic PMT visits and patient characteristics were tested using a negative binomial model. The null hypothesis was tested at a significance level α < 0.05.

Results: Among 279 subjects who met the inclusion criteria, the interval between pre- and post-pandemic visits was 12-23, 24-35, and ≥36 months in 33.3%, 49.8%, and 16.8% of the subjects, respectively. Plaque was significantly associated with a longer period between pre- and post-pandemic PMT visits (p = 1.54 × 10^-3), whereas no association was observed for CAL and BOP (p = 0.39 and 0.10, respectively). Male sex (p = 0.023) and current smoking (p = 5.23 × 10^-3) positively correlated with the number of missing teeth in the interval between the visits, whereas the number of pre-pandemic PMT visits (p = 1.20 × 10^-4) had the opposite correlation.

Conclusion: COVID-19-related PMT interruptions adversely affected plaque control, underscoring the importance of uninterrupted maintenance care.

Plain language summary: The COVID-19 pandemic had a major impact on patients who visit their dental professionals to maintain healthy gums and stable teeth. Usually, the more compliant these patients are, the better results they can achieve. However, during the pandemic, many patients could not come to get their teeth and gums cleaned as regularly as they could before the pandemic. The present study looked at whether the health of the teeth and gums of patients was affected by the amount of time that passed until a patient came for a dental visit after the pandemic at the University of Colorado. The study results showed that some criteria used to examine tooth and gum health were affected, but others were not. The authors concluded that overall, the length of the interruption to receive dental care after the COVID-19 pandemic caused damage to tooth and gum health. The study results stress the importance of regular dental visits.

Background: Epidemiological studies suggest a link between gestational diabetes mellitus (GDM) and periodontitis. In this context, Porphyromonas gingivalis (Pg) and its byproducts, including lipopolysaccharide (Pg-LPS), may translocate to the placenta, potentially intensifying pro-inflammatory mechanisms in a hyperglycemic environment. This study aimed to assess the pro-inflammatory simultaneous stimulus effect of hyperglycemia (HG) and Pg-LPS in human term placental explants.

Methods: Fresh placental explants from healthy (n = 10) and GDM (n = 5) pregnant women were stimulated under normoglycemia (NG), hyperglycemia (HG), Pg-LPS, and a dual stimulus of HG+Pg-LPS. Both placental explants and culture supernatants were assessed using histology, real-time quantitative polymerase chain reaction (RT-qPCR), Western blot, immunofluorescence, and multiplex immunoassay to analyze histopathological alterations, Toll-like receptor (TLR)-2, -4, -9 mRNA expression, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) phosphorylation and nuclear immunolocalization, NLRP3 inflammasome expression, and pro-inflammatory cytokines (interleukin [IL]-6, IL-1β, and tumor necrosis factor [TNF]-α).

Results: The dual stimulus (HG+Pg-LPS) increased fibrinoid necrosis (p < 0.05) and upregulated TLR-4 mRNA (p < 0.05) expression in placental explants, compared to other experimental conditions. NF-κB phosphorylation and nuclear immunolocalization, NLRP3 inflammasome and IL-6, IL-1β, and TNF-α mRNA expression increased upon the dual stimulus in healthy and GDM explants (p < 0.05). Additionally, levels of IL-6 (p < 0.01), IL-1β (p < 0.01), and TNF-α (p < 0.0001) increased in the supernatant from healthy and GDM explants under the dual stimulus. No differences in cytokine levels were observed between healthy and GDM placental explants under the dual stimulus.

Conclusions: A hyperglycemic environment amplifies the pro-inflammatory response to Pg-LPS in human placental explants, suggesting that hyperglycemia synergizes with Pg-LPS in the placenta.

Plain language summary: Bacteria that drive periodontitis, or their products, can enter the bloodstream and reach the placenta. In a high-glucose environment, this exposure can intensify placental inflammation. This study aimed to determine whether exposure to a high-glucose milieu, combined with byproducts of periodontal bacteria, activates inflammatory pathways in the placenta. Our results demonstrate that a high-glucose environment amplifies the inflammatory response to periodontal bacteria in human placentas from both healthy pregnancies and those complicated by gestational diabetes mellitus. These findings advance our understanding of the connection between periodontitis and gestational diabetes mellitus and underscore the role of oral bacterial translocation in placental tissues during pregnancy.