Periodontal Status in Morbidly Obese Patients With and Without Obstructive Sleep Apnea Syndrome Risk: A Cross‐Sectional Study

Background: This cross‐sectional study aims to investigate the correlation between obstructive sleep apnea syndrome (OSAS) risk with periodontal disease and anthropometric measures in Class III obese patients. Methods: Anthropometric measurements were taken from 108 patients of both sexes, aged 30 to 60 years. The Berlin questionnaire (Bq) and the Epworth sleepiness scale (ESS) were applied to determine the risk for OSAS. Full‐mouth periodontal status was determined by probing depth, clinical attachment level, gingival bleeding index, and the presence of calculus. Unpaired Student t, χ², Fisher exact, and Mann–Whitney U tests were applied to analyze the differences between high and low risk for OSAS groups. Results: Overall, 81.5% of the patients showed high risk for OSAS, 46.3% had excessive daytime sleepiness, 41.5% were positive for both the Bq and ESS, and 97.2% had periodontal disease (periodontitis = 85.2% and gingivitis = 60.2%). Patients with periodontal disease showed high risk for OSAS (82.9%) and ESS (45.7%). However, there was no influence of periodontal disease on OSAS risk. Periodontitis was not associated with the ESS (odds ratio [OR] = 1.84, 95% confidence interval [CI] = 0.54 to 6.26) or Bq (OR = 0.87, 95% CI = 0.10 to 7.84), nor was gingivitis associated with the ESS (OR = 1.25, 95% CI = 0.48 to 3.25) or Bq (OR = 0.23, 95% CI = 0.03 to 1.84). Waist circumference (P = 0.03), neck circumference (NC, P <0.001), and the percentage of predicted NC (PPNC, P <0.001) were significantly larger in the patients at high risk for OSAS than in those at low risk for OSAS. Daytime sleepiness was also associated with NC (P = 0.02) and PPNC (P = 0.02). Conclusion: There was no association between periodontal disease and OSAS risk in Class III obese patients, but OSAS risk was associated with both NC and PPNC.     

牙周健康状况与胃幽门螺杆菌感染相关性的研究

目的探讨牙周健康状况与胃幽门螺杆菌感染率及感染程度的关系。方法通过13C尿素呼气试验（13C-urea breath test,13C-UBT）法检测牙周炎患者胃幽门螺杆菌感染程度,记录牙周健康状况,统计学分析两者之间的相关性。结果 84名患者中幽门螺杆菌感染阳性32名（38.1%）,阴性52名（61.9%）,两组间平均牙龈退缩差异有统计学意义（Z=1.978,P=0.048）;13C-UBT检测结果超基准值（delta over baseline,DOB）与平均牙周袋深度的相关系数r=0.413,两者间有正相关关系（P=0.019）。DOB值与平均牙龈退缩的相关系数r=-0.011（P=0.952）,与平均牙周附着丧失的相关系数r=0.299（P=0.096）。结论胃幽门螺杆菌感染与牙周炎患者的牙周破坏程度关系密切,牙周炎患者的牙周炎严重程度可能与胃幽门螺杆菌数量或菌株类型密切相关。     

Relationship Between Periodontal Screening and Recording Index Scores and Need for Periodontal Access Surgery

Background: The validity of using pretreatment Periodontal Screening and Recording (PSR) index sextant scores to estimate periodontal access surgery needs is evaluated in patients with chronic periodontitis before and after completion of non‐surgical periodontal therapy. Methods: In 110 adults, pretreatment probing data identified 486 sextants with PSR scores of 4 and 125 sextants with PSR scores of 3. Periodontal access surgery needs for all sextants were determined prior to treatment and after completion of non‐surgical periodontal therapy for 213 sextants in 38 patients by two experienced periodontist examiners. Results: PSR scores of 4 identified untreated sextants with periodontal access surgery needs significantly better than PSR scores of 3 (odds ratio = 27.8; P <0.001) in multilevel, mixed‐effects, logistic regression modeling analysis. However, only 37.6% of sextants with both pretreatment PSR scores of 4 and a pretreatment periodontal access surgery need continued to have surgical access needs after completion of non‐surgical periodontal therapy. A higher percentage of sextants with PSR scores of 4 or 3 revealed periodontal access surgical needs when Class II or III furcation involvements and/or Grade II or III tooth mobility were also detected in the sextant than when these parameters were not detected. Conclusions: Pretreatment PSR index scores of 4 were a strong indicator of periodontal access surgery needs in untreated dentition sextants but markedly overestimated surgical access needs remaining after completion of non‐surgical periodontal therapy. These findings raise questions about the usefulness of pretreatment PSR evaluations for estimating potential periodontal access surgery needs in patients to be initially treated with non‐surgical periodontal therapy.     

Relationship Between Periodontal Status and HbA1c in Nondiabetics

Objectives: Many studies have reported an association between diabetes and periodontitis. We analyzed the periodontal status and glycosylated hemoglobin (HbA1c) level in nondiabetic subjects to investigate the relationship between periodontitis and glucose control in nondiabetics. Methods: Periodontal status, HbA1c, serum cholesterol, triglyceride, body mass index (BMI), and demographic variables were assessed in 141 Japanese adults. The difference in the HbA1c level was evaluated among subjects according to periodontal status. Results: After adjusting for age, gender, BMI, and smoking, alcohol, and exercise habits as covariates, the mean HbA1c was significantly elevated with periodontal deterioration ( P =  0.023). Conclusions: There was a significant relationship between periodontal status and HbA1c levels in nondiabetics.     

牙周非手术治疗对慢性肾病伴牙周炎患者牙周状况及血清C反应蛋白的影响

目的：探讨牙周非手术治疗对慢性肾病（CKD）伴牙周炎患者牙周状况及血清C反应蛋白（CRP）的影响。方法：分两组,A组为无全身严重疾病的牙周炎中老年患者38例,B组为伴慢性肾病的牙周炎中老年患者46例,两组均进行牙周非手术治疗,于牙周治疗前、后3个月分别检测其血清CRP及牙周指标。结果：A组治疗前牙周状况与B组相比,差异非常显著（P〈0.01）。两组患者治疗后牙周状况与治疗前均有改善,差异非常显著（P〈0.01）,A组的治疗效果好于B组,差异有显著性（P〈0.01）。治疗后A组患者血清CRP与治疗前有明显降低,差异非常显著（P〈0.01）,B组患者CRP与治疗前也有降低,差异有显著性（P〈0.05）。患者血清CRP与BOP、PD、AL等指标均呈正相关（P〈0.05）。结论：牙周非手术治疗可能通过改善牙周状况而降低慢性肾病伴牙周炎患者的血清CRP水平。     

Dental Status and Periodontal Health of Patients with Phenylketonuria in Latvia

ObjectivesPhenylketonuria (PKU) is an autosomal recessive inherited disorder of phenylalanine metabolism resulting from a deficiency of phenylalanine hydroxylase. The aim of this study was to evaluate the dental status and periodontal health of PKU patients in Latvia.Material and MethodsForty-five PKU patients and age/sex-matched controls were recruited for this cross-sectional study. Their anamnestic data, periodontal health and dental status were assessed by one experienced dentist.ResultsDental and periodontal clinical evaluation revealed that the median number of filled teeth was significantly smaller among PKU patients compared to the control group (p=0.021). PKU patients had a significantly larger median number of carious teeth than their healthy counterparts (p<0.001). Significant differences between the PKU and control groups were observed for several oral hygiene indices (p<0.001): Silness-Löe plaque index, OR=29.3 (95% CI: 3.7–232.4); CPITN index, OR=35.2 (95% CI: 4.5–278.3); Greene-Vermillion index, OR=10.2 (95% CI: 2.8–38.0); calculus removal necessity, OR=12.3 (95% CI: 3.3–45.4).ConclusionDental status and periodontal health of PKU patients was found to be significantly inferior compared to healthy controls. This is likely due to the regular consumption of PKU formula and the difficulties which mentally and/or physically disabled PKU patients experience with their oral hygiene. To prevent tooth decay and periodontal disease, PKU patients should visit a professional oral hygienist every three to six months. Furthermore, they should adopt the habit of rinsing their mouth with water immediately after consuming PKU formula to counteract the acidity in their oral cavity.     

Association Between the Extent of Periodontal Inflammation and the Severity of Rheumatoid Arthritis in Japanese Patients With Rheumatoid Arthritis

ObjectivePeriodontal inflammation can affect the progression of rheumatoid arthritis (RA), and RA drugs may influence the periodontal condition of patients with RA. We examined whether the association between periodontal inflammation and the severity of RA is influenced by RA medication.MethodsThis cross-sectional study recruited 98 Japanese patients with RA from an orthopaedic clinic. We assessed the severity of RA using the Steinbrocker class and stage. The periodontal inflamed surface area (PISA) was used as an indicator of periodontal status. We obtained data on RA medications from medical records. We examined the associations among periodontal tissue inflammation, RA medications, and RA severity using multinomial logistic regression analyses.ResultsIn univariate multinomial logistic regression analyses, no significant association between PISA score and RA severity was observed. There was no significant association between PISA score and RA severity in multivariate analyses not including variables about RA drugs as independent variables. However, in multivariate analyses adjusted for RA drugs and other confounding variables, patients with a PISA >550 mm² had significantly higher odds ratios (ORs) for Steinbrocker class III-IV and stage III-IV (OR, 20.24; 95% confidence interval [CI], 1.78-229.85 and OR, 12.42; 95% CI, 1.79-86.49, respectively) compared to patients with PISA score ≤550 mm².ConclusionThe extent of periodontal inflammation is associated with the severity of RA independent of RA medications.     

Systemic Condition,Periodontal Status,and Quality of Life in Obese Women During Pregnancy and After Delivery

ObjectiveTo evaluate the systemic condition, periodontal status, and quality of life of obese women during pregnancy and after delivery.MethodsThis prospective cohort consisted of 60 women examined in the third trimester of pregnancy (32nd-36th gestational week [T1]) and after delivery (T2) and were divided into elevated body mass index (BMI; GO = 30) and normal BMI (GN = 30) according to the World Health Organization. The variables assessed were: (1) gestational weight gain, arterial hypertension (AH), and diabetes mellitus; (2) oral hygiene behaviour (frequency of dental floss using and toothbrushing); (3) probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and dental biofilm; and (4) quality of life (Oral Health Impact Project [OHIP]-14). Analysis of variance (ANOVA), Friedman, Cochran's Q and χ² tests, and logistic regression model were adopted (P < .05).ResultsGO showed a higher frequency of AH in T1 (P < .001). Both groups decreased the frequency of dental floss use (P = .013) and toothbrushing (P < .001) and increased the percentage of dental biofilm in T2 (P < .001). GO presented a greater PPD and CAL in T1 and T2 and higher BOP in T1 (P < .001), demonstrating a negative impact in the following dimensions of Oral Health Impact Project-14 during T1 functional limitation (P = .020), physical disability (P = .020), and handicap (P = .021).ConclusionObese women presented higher prevalence of AH during pregnancy and higher prevalence of periodontitis in both periods. They showed a poor quality of life in T1 regarding functional limitation, physical disability, and handicap.     

冠心病患者的牙周状况与Fg和hs-CRP相关性的研究

目的：通过牙周临床检查和血生化指标检测,观察冠心病患者的牙周状况,探讨纤维蛋白原和高敏C反应蛋白在两者间的相关关系。方法：按照冠心病及慢性牙周炎临床诊断标准随机选择200名研究对象,年龄35～80岁,分为急性冠脉综合征（ACS）组50人,慢性冠脉病（CAD）组50人,单纯慢性牙周炎（CP）组50人,健康（H）对照组50人,每组都进行牙周探诊深度（PD）、临床附着丧失度（CAL）、龈沟出血指数（SBI）和简化卫生指数（OHI-S）检查,采集清晨静脉血检测Fg和hs-CRP水平。结果：PD、CAL、OHI-S在ACS组中最高,与CP组比较有显著性差异（P〈0.001）;SBI在CAD组中最高,ACS组与CP组比较有显著性差异（P〈0.001）;Fg和hs-CRP在ACS组中测定值最高,与CP组比较有显著性差异（P〈0.05）;血生化指标Fg和hs-CRP的水平与牙周临床指标PD、CAL、SBI、OHI-S比较呈正相关（P〈0.01）。结论：冠心病患者无论是急性期还是稳定期牙周状况都比单纯慢性牙周炎患者严重;PD、CAL、OHI-S的升高可引起血清中Fg和hs-CRP水平的变化,牙周临床指标的改变可能与冠心病的急性发作和加重冠心病病程有关。     

Association Between Plasma Levels of Manganese and Periodontal Status: A Study Based on the Fourth Korean National Health and Nutrition Examination Survey

Background: This study aims to evaluate the association between plasma levels of manganese (Mn) and periodontal status in a representative sample of Korean adults. Methods: Plasma levels of Mn and periodontal status were analyzed in 1,679 participants, all of whom were ≥19 years old. Plasma levels of Mn were divided into four quartiles: first (<1.057 μg/dL), second (1.057 to 1.274 μg/dL), third (1.275 to 1.544 μg/dL), and fourth (>1.544 μg/dL). Periodontal status was assessed using the Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed after adjusting for sociodemographic variables, oral and general health behavior, oral health status, and systemic conditions. All analyses took into consideration the complex sampling design, and multivariate analyses were performed in the subgroups. Results: Multivariate logistic regression analyses revealed a significant association between plasma levels of Mn and higher CPI in the total sample. There was a moderate association between first‐quartile plasma levels of Mn and higher CPI in males (odds ratio [OR]: 2.13; 95% confidence interval [CI] 1.25 to 3.63) and current smokers (OR: 2.07; 95% CI 1.04 to 4.11), compared to the fourth quartile. Conclusion: Periodontal status is significantly associated with plasma levels of Mn in Korean adults, especially in men and smokers.     

Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study

Background: Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. The authors seek to examine to what extent periodontal disease is associated with kidney function decline. Methods: This retrospective cohort study examines 699 African American participants with preserved kidney function (defined by estimated glomerular filtration rate (eGFR) >60 mL/minute/1.73m² at baseline) who underwent complete dental examinations as part of the Dental‐Atherosclerosis Risk in Communities study (1996 to 1998) and subsequently enrolled in the Jackson Heart Study (2000 to 2004). Using multivariable Poisson regression, the authors examined the association of periodontal disease (severe versus non‐severe) with incident CKD, defined as incident eGFR <60 mL/minute/1.73m² and rapid (5% annualized) eGFR decline at follow‐up among those with preserved eGFR at baseline. Results: Mean (± SD) age at baseline was 65.4 (± 5.2) years, and 16.3% (n = 114) had severe periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow‐up of 4.8 (± 0.6) years. Compared with participants with non‐severe periodontal disease, those with severe periodontal disease had a four‐fold greater rate of incident CKD (adjusted incidence rate ratio 4.18 [95% confidence interval 1.68 to 10.39], P = 0.002). Conclusions: Severe periodontal disease is prevalent among a population at high risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration.     

Association Between Metabolic Syndrome and Periodontal Disease Measures in Postmenopausal Women: The Buffalo OsteoPerio Study

Background: The objective of this study is to characterize the association between metabolic syndrome (MetS) and periodontitis in women, for which there is limited evidence. Methods: Cross‐sectional associations between MetS and periodontitis were examined in 657 postmenopausal women aged 50 to 79 years enrolled in a periodontal disease study ancillary to the Women's Health Initiative Observational Study. Whole‐mouth measures of alveolar crest height (ACH), clinical attachment level (CAL), probing depth (PD), gingival bleeding, and supragingival plaque and measures to define MetS using National Cholesterol Education Program criteria were from a clinical examination. Study outcomes were defined as: 1) mean ACH ≥3 mm, two sites ≥5 mm, or tooth loss to periodontitis; 2) ≥2 sites with CAL ≥6 mm and ≥1 site with PD ≥5 mm; 3) gingival bleeding at ≥50% of sites; and 4) supragingival plaque at ≥50% of sites. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: In unadjusted analyses, MetS (prevalence: 25.6%) was significantly associated with supragingival plaque (OR = 1.74; 95% CI: 1.22 to 2.50) and non‐significantly associated with periodontitis defined by ACH (OR = 1.23; 95% CI: 0.81 to 1.85) and gingival bleeding (OR = 1.20; 95% CI: 0.81 to 1.77). Adjustment for age, smoking, and other confounders attenuated observed associations, though supragingival plaque remained significant (OR = 1.47; 95% CI: 1.00 to 2.16; P = 0.049). MetS was not associated with periodontitis defined by CAL and PD. Conclusions: A consistent association between MetS and measures of periodontitis was not seen in this cohort of postmenopausal women. An association between MetS and supragingival plaque requires further investigation.     

冠心病患者牙周状况及牙周细菌的检测

目的探讨冠心病患者牙周状况与牙龈卟啉单胞菌(Pg)和伴放线放线杆菌(Aa)的关系。方法试验分4组:冠心病伴慢性牙周炎组(A组)34例,冠心病组(B组)28例,慢性牙周炎组(C组)30例和对照组(D组)31例。记录各组牙周状况,取龈下菌斑进行Pg和Aa的分离培养及生化鉴定,检测牙周袋或龈沟内Pg和Aa阳性率。结果牙周状况A组比B组、C组差,C组比D组差。Pg、Aa阳性率A组比B组高,C组比D组高。结论冠心病患者的牙周健康状况较非冠心病患者差,提示慢性牙周炎可能是冠心病的又一危险因素。     

Low Social Position,Periodontal Disease,and Poor Oral Health‐Related Quality of Life in Adults With Systemic Arterial Hypertension

Background: There is little evidence on the association between periodontal disease and oral health‐related quality of life (OHRQoL) in individuals with chronic diseases, including hypertension. The aim of this study is to identify relationships among sociodemographic characteristics, smoking, tooth loss, dental caries, periodontal status, and OHRQoL in adults with systemic arterial hypertension. Methods: A cross‐sectional study involving 195 adults (mean age: 55.7 years) with systemic arterial hypertension used interviews and oral examinations to collect data on sociodemographic characteristics (age, sex, income); use of antihypertensive medication; smoking; tooth loss; dental caries; periodontal status (bleeding on probing, calculus, and attachment loss); and OHRQoL/oral health impact profile. The Wilson and Cleary (Wilson IB, Cleary PD. JAMA 1995;273:59‐65) conceptual model was used to test direct and indirect relationships among variables using structural equation modeling. Results: Lower age, male sex, smoking, and lower income directly predicted worse periodontal status. Tooth loss, dental caries, worse periodontal status, and smoking were directly linked to poor OHRQoL. Age was indirectly linked to worse periodontal status via income. Income and smoking indirectly predicted poor OHRQoL via periodontal status. Conclusions: Findings support an effect of periodontal disease on OHRQoL in people with systemic arterial hypertension. Periodontal status mediated associations of sociodemographic characteristics and smoking with OHRQoL through different pathways.     

Quantification of Periodontal Pathogens in Vascular,Blood, and Subgingival Samples From Patients With Peripheral Arterial Disease or Abdominal Aortic Aneurysms

Background: The aim of this investigation is to quantify periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, and Tannerella forsythia) in vascular, blood, and subgingival samples. As a secondary objective, two molecular bacterial identification methods (nested polymerase chain reaction [PCR] and quantitative PCR [qPCR]) are compared. Methods: Seventy consecutive patients provided a vascular lesion, a blood sample, and 36 subgingival samples. Bacterial DNA was extracted, and qPCR was used to determine the prevalence and amounts of the target pathogens in each sample. Nested PCR was performed only in the samples from vascular lesions. Periodontal examination was performed in 42 patients. Mann‐Whitney U or χ² tests were used to compare microbiologic results according to periodontal diagnosis. Results: All targeted periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia, or C. rectus) were detected in subgingival samples, with a prevalence rate of 72.2%, 47.2%, 74.3%, and 82.9%, respectively. In 7.1% and 11.4% of vascular and blood samples, bacterial DNA was detected. One patient was positive for A. actinomycetemcomitans in the three types of samples. No differences were found in the levels of targeted bacteria when comparing patients with and without periodontitis. Prevalence rates obtained with nested PCR were significantly higher than those obtained with qPCR. Conclusions: The presence of A. actinomycetemcomitans was demonstrated in vascular, blood, and subgingival samples in one of 36 patients. These results, although with a very low frequency, may support the hypothesis of a translocation of periodontal pathogens from subgingival microbiota to the bloodstream and then to atheromatous plaques in carotid or other peripheral arteries. Nested PCR is not an adequate method for identifying DNA of periodontal pathogens in low quantities because of the high number of false‐negative results.     

Propolis Improves Periodontal Status and Glycemic Control in Patients With Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Clinical Trial

Background: Propolis is a natural resin made by bees from various plant sources and exerts antimicrobial, anti‐inflammatory, immunomodulatory, antioxidant, and antidiabetic properties. The purpose of this study is to assess adjunctive benefit of propolis supplementation in individuals with chronic periodontitis (CP) and type 2 diabetes mellitus (DMt2) receiving scaling and root planing (SRP). Methods: A 6‐month masked, randomized clinical trial comparing SRP with placebo (placebo + SRP group, n = 26) or SRP combined with a 6‐month regimen of 400 mg oral propolis once daily (propolis + SRP group, n = 24) was performed in patients with long‐standing DMt2 and CP. Treatment outcomes included changes in hemoglobin (Hb) A1c (primary outcome), fasting plasma glucose (FPG), serum N^€‐(carboxymethyl) lysine (CML), and periodontal parameters (secondary outcomes). Results: After 3 and 6 months, average HbA1c levels in the propolis group decreased significantly by 0.82% and 0.96% units, respectively (P <0.01); however, there were no significant differences in the placebo group. Likewise, FPG and CML levels were significantly reduced in the propolis group, but not in the placebo group. After therapy, periodontal parameters of CP were significantly improved in both groups. The propolis group showed significantly greater probing depth reduction and clinical attachment level gain than the control group after 3 and 6 months. Conclusion: A 6‐month regimen of 400 mg propolis once daily is a potentially viable adjunct to SRP that significantly reduces levels of HbA1c, FPG, and CML, and improves periodontal therapy outcome in people with DMt2 and CP.     

Cross‐Sectional Evaluation of Periodontal Status and Microbiologic and Rheumatoid Parameters in a Large Cohort of Patients With Rheumatoid Arthritis

Background: This study evaluates periodontal conditions and microbiologic findings and their influence on rheumatologic disease parameters in patients with rheumatoid arthritis (RA). Methods: One hundred and sixty‐eight patients with RA were included. A healthy control group (HC, n = 168) was composed according to age, sex, and smoking habits. Rheumatologic data (duration of illness, Disease Activity Score 28, rheumatic factor [RF], anti‐cyclic citrullinated peptide [aCCP], medications) were extracted from patients’ records. Dental examination included: 1) dental findings (decayed, missing, and/or filled adult teeth [DMF‐T] index); 2) gingival inflammation (papillary bleeding index [PBI]); and 3) periodontal status (probing depth [PD], attachment loss [AL]). Periodontal condition was classified as healthy/mild, moderate, or severe periodontitis. Subgingival biofilm was analyzed regarding 11 periodontopathogenic bacteria. Statistical analyses included: 1) Kolmogorov–Smirnov test; 2) Mann–Whitney U test; 3) Pearson χ² test; 4) Kruskal–Wallis test; and 5) regression analysis; level of significance α = 5%. Results: Mean DMF‐T was significantly higher in patients with RA (19.3 ± 4.8) than in HC group (16.9 ± 5.8), especially owing to number of missing teeth (RA = 6.0 ± 5.4, HC = 3.1 ± 3.3; P <0.01). Patients with RA had a significantly higher proportion of increased PD (P <0.01) and AL compared with HC group (P <0.01). Moderate to severe periodontitis was noted in 98% of patients with RA and 82% of the HC group (P <0.01). RF‐positive patients with RA suffered from worse periodontal conditions than RF‐negative patients (P = 0.01). Age, PBI, and presence of Treponema denticola (P <0.03) are related to periodontal condition in patients with RA. Although not statistically significant, Porphyromonas gingivalis and Fusobacterium nucleatum occur in higher concentrations more often in aCCP‐positive patients with RA (P = 0.06). Conclusions: Patients with RA had worse periodontal conditions than HC participants. Although a trend for higher F. nucleatum and P. gingivalis concentrations in aCCP‐positive patients with RA was found, importance of periodontal pathogenic bacteria and rheumatoid parameters in the interrelationship between periodontitis and RA remains unclear.     

The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross‐Sectional Study

Background: Periodontitis is considered to be a risk factor for preterm birth. Mechanisms have been proposed for this pathologic relation, but the exact pathologic pattern remains unclear. Therefore, the objective of the present study is to evaluate levels of four major labor triggers, prostaglandin E₂ (PGE₂), interleukin (IL)‐1β, IL‐6, and tumor necrosis factor (TNF)‐α, in gingival crevicular fluid (GCF) and serum samples between women with preterm birth (PTB) and full‐term birth (FTB) and correlate them with periodontal parameters. Methods: PGE₂, IL‐1β, IL‐6, and TNF‐α levels were estimated using enzyme‐linked immunosorbent assays in GCF and serum samples collected 24 to 48 hours after labor from 120 women (60 FTB, 60 PTB). Results: Women with PTB exhibited significantly more periodontitis, worse periodontal parameters, and increased GCF levels of IL‐6 and PGE₂ compared with the FTB group; there were no significant differences in serum levels of measured markers. GCF levels of IL‐1β, IL‐6, and PGE₂ and serum levels of TNF‐α and PGE₂ were significantly higher in women with periodontitis compared with periodontally healthy women. Serum levels of PGE₂ were positively correlated with probing depth (PD) and clinical attachment level (CAL) as well as with GCF levels of TNF‐α in women with PTB. Conclusions: Women with PTB demonstrated worse periodontal parameters and significantly increased GCF levels of IL‐6 and PGE₂ compared with those with FTB. Based on significant correlations among serum PGE₂ and PD, CAL, and GCF TNF‐α in PTB, periodontitis may cause an overall increase of labor triggers and hence contribute to preterm labor onset.