The association between smoking and periapical periodontitis: a systematic review

The purpose of this systematic review was to examine if, in adult patients, the absence or presence of smoking influenced the prevalence of periapical peri     

牙周炎与非酒精性脂肪性肝病相关性的研究进展

非酒精性脂肪性肝病是一种常见的慢性肝病,可引起肝脏不同程度的病变,从脂肪变性、非酒精性脂肪性肝炎到纤维化,最终可发展为肝硬化和肝细胞癌。诸多研究表明,系统性炎症和肠道菌群失调可能参与该疾病的发生与发展。牙周炎作为细菌感染性疾病,可能通过牙周致病菌和炎症介质等方式调节机体的免疫炎症反应,影响肝脏健康。本文就目前牙周炎与非酒精性脂肪性肝病的相关性研究作一综述,期待从口腔医学视点为非酒精性脂肪性肝病的防治开辟新思路。     

The association between oral hygiene and periodontitis: a systematic review and meta‐analysis

Objective

Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta‐analysis.

Material and methods

The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random‐effects meta‐analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed.

Results

A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65–2.53] and 5.01 (95% CI: 3.40–7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47–0.94) and 0.68 (95% CI: 0.47–0.98) were obtained, respectively.

Conclusions

Fair to poor OH increases the risk of periodontitis by two‐ to five‐fold. This risk can be reduced by regular toothbrushing and dental visits.     

The association between periodontitis and coronary heart disease: A quality assessment of systematic reviews

BackgroundThe existence of an association between periodontitis and cardiovascular disease has been proposed by investigators in several clinical studies and further confirmed by the results of several systematic reviews. The aim of the Authors' study was to assess the quality of published systematic reviews focused on the association between periodontitis and coronary heart disease (CHD) by using established systematic review assessment checklists.MethodsTwo reviewers conducted a search for systematic reviews focusing on the association between periodontitis and CHD. Three independent reviewers appraised the quality of the selected 13 reviews by using an established and validated assessment tool for systematic reviews and another checklist. They gave each article a total score according to the number of criteria on each checklist that the article fulfilled.ResultsNine reviews satisfied six or more items on the assessment tool, whereas two reviews each satisfied only one item. This assessment shows that published systematic reviews of the periodontitis-CHD association exhibit significant structural and methodological variation, which the authors further confirmed by using the second checklist.ConclusionSystematic reviews of the association between periodontitis and CHD exhibited significant differences in their methodological quality.Practical ImplicationsClinicians should be aware that not all systematic reviews of the periodontitis-CHD association are conducted in a rigorous manner and should be capable of differentiating well-conducted reviews from poorly conducted ones.     

The potential association between gingival crevicular fluid inflammatory mediators and adverse pregnancy outcomes: a systematic review

Objectives

The association between periodontal disease and adverse pregnancy outcomes (APO), primarily preterm birth (PTB), is still controversially discussed in the literature. Therefore, the aim of the present systematic review was to analyze the existing literature on the potential association between inflammatory mediators detected in gingival crevicular fluid (GCF) and APO.

Materials and methods

MEDLINE (PubMed) and EMBASE databases were searched for entries up to April 2012 and studies were selected by two independent reviewers.

Results

The majority of the eight studies included confirmed a positive association between GCF mediators, such as interleukin-1β, prostaglandin E₂, and tumor necrosis factor-alpha, and APO. Due to the heterogeneity and variability of the available studies, no meta-analysis could be performed.

Conclusions

A positive association between GCF inflammatory mediator levels and APO/PTB might be present but the results need to be considered with great caution because of the heterogeneity and variability among the studies. Further studies with an adequate number of patients allowing for an appropriate analysis are warranted to definitely confirm this association.

Clinical relevance

The present findings suggest that an association between GCF inflammatory mediator levels and APO might exist.     

The association between migraines and periodontal disease: A systematic review of clinical studies

BackgroundRecent studies have postulated several hypotheses explaining the association between migraines and periodontitis. We aimed to systematically review and assess if there is an association between inflammatory mediators in migraines and periodontal disease. Indexed database search was performed from inception up to and including April 2022. Data such as study design, study grouping, participants, age, sex, migraine characteristics, assessment criteria for periodontitis and outcomes were collected. Methodological index for non-randomized studies was used to assess the risk of bias. The systematic analysis format was personalized to review the appropriate information.HighlightsLevels of pro-inflammatory mediators such as serum procalcitonin, leptin, calcitonin gene related peptide and interleukin-6 were elevated in patients with chronic periodontitis and migraines.ConclusionChronic periodontitis may be a contributing factor for migraines. However, future standardized studies are required to understand the true relationship at a clinical and molecular level. This may better help in managing patients with comorbid conditions in the future.     

Periodontal disease could be a potential risk factor for non-alcoholic fatty liver disease: An 11-year retrospective follow-up study

Objective

This study aimed to evaluate the association of periodontal disease with non-alcoholic fatty liver disease (NAFLD).

Materials and methods

A retrospective follow-up study using the National Health Insurance Service-National Sample Cohort was performed from 2002 to 2015 in the Korean population. A total of 165,032 subjects were followed up for incident NAFLD during 11 years. Periodontal disease and NAFLD were defined by a diagnosis using the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes. Periodontal status was used as the severity of periodontal status and the number of dental visit due to PD.

Results

Periodontitis was associated with a 4% increase in risk for NAFLD after adjusting for socio-demographic factor, health behaviors, and systemic diseases (adjusted hazard ratio [aHR]?=?1.04, 95% CI?=?1.01 to 1.07). Between the number of dental visit due to PD and the risk for NAFLD was observed a dose–effect association (aHR?=?1.02, 95% CI?=?0.99 to 1.05 for once; aHR?=?1.10, 95% CI?=?1.06 to 1.15 for two times; aHR?=?1.14, 95% CI?=?1.06 to 1.24 for three times).

Conclusions

Our data confirmed that periodontitis showed an association with a higher incidence of NAFLD.

Clinical relevance

Prevention and management of periodontal disease could be beneficial for reducing the risk of NAFLD.

     

The association between inflammatory bowel disease and periodontitis among Jordanians: a case-control study

Habashneh RA, Khader YS, Alhumouz MK, Jadallah K, Ajlouni Y. The association between inflammatory bowel disease and periodontitis among Jordanians: a case–control study. J Periodont Res 2012; 47: 293–298. © 2011 John Wiley & Sons A/S Background and Objective: Inflammatory bowel disease (IBD) is hypothesized to involve immuno‐inflammatory alterations, and the condition has been related to increased susceptibility to oral challenges. The objective of the study was to determine the association between the prevalence, severity and extent of periodontitis and both ulcerative colitis (UC) and Crohn’s disease (CD). Material and Methods: A case–control study was conducted among patients who attended outpatient clinics at King Hussein Medical City in Jordan during the study period. All participants completed the questionnaire and underwent thorough oral and periodontal examinations. Periodontitis was defined as presence of four or more teeth with one or more sites with probing pocket depth ≥ 4mm and clinical attachment level ≥ 3mm. The general linear model multivariate procedure and multivariate binary logistic regression were used to analyse the data. Results: This case–control study included 260 Jordanian adults (101 with UC, 59 with CD and 100 with no IBD) with a mean (SD) age of 39.4 (0.7) years. The prevalence of periodontitis was much higher among patients with CD and those with UC compared with subjects having no IBD in the age groups < 36 and 36–45 years old only. After adjusting for age and number of missing teeth, patients with CD (odds ratio 4.9, 95% confidence interval 1.8–13.2) and patients with UC (odds ratio 7.00, 95% confidence interval 2.8–17.5) had significantly higher odds of periodontitis than subjects with no IBD. In multivariate analysis, the severity of periodontitis was significantly higher among patients with CD and patients with UC when compared with subjects having no IBD. Ulcerative colitis patients but not CD patients had significantly higher prevalence of deep ulcers in oral soft tissues than the non‐IBD group (p = 0.004). Conclusion: Patients with IBD have higher prevalence, severity and extent of periodontitis compared with those having no IBD.     

Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate the effects of metronidazole and amoxicillin in combination with mechanical therapy for the treatment of aggressive periodontitis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Record of Systematic Reviews (CRD42018111595). The research was performed using PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library databases till December 2019 and included randomized clinical trials that analyzed whether the use of systemic metronidazole and amoxicillin improved the treatment response in patients with aggressive periodontitis. Altogether, 137 articles were identified and 4 studies were selected after applying the inclusion and the exclusion criteria. No statistically significant difference was observed in the clinical attachment level between the use of systemic antibiotics combined with scaling and root planning (SRP) and SRP without antibiotics (p = 0.52, mean deviation [MD]: 0.21, 95% confidence interval [CI]: −0.04–0.46). There was a statistically significant difference in the probing depth between the use of systemic antibiotics with SRP and the use of SRP alone (p = 0.02, MD: 0.40, 95% CI: 0.02–0.78). Gain in the clinical attachment level was not significantly higher when systemic antibiotics were used with SRP compared to SRP without antibiotics in the treatment of aggressive periodontitis. However, a statistically significant difference was observed in reduction in the probing depth.     

The association between head and cervical posture and temporomandibular disorders: a systematic review

AIMS: To carry out a systematic review to assess the evidence concerning the association between head and cervical posture and temporomandibular disorders (TMD). METHODS: A search of Medline, Pubmed, Embase, Web of Science, Lilacs, and Cochrane Library databases was conducted in all languages with the help of a health sciences librarian. Key words used in the search were posture, head posture, cervical spine or neck, vertebrae, cervical lordosis, craniomandibular disorders or temporomandibular disorders, temporomandibular disorders, and orofacial pain or facial pain. Abstracts which appeared to fulfill the initial selection criteria were selected by consensus. The original articles were retrieved and evaluated to ensure they met the inclusion criteria. A methodological checklist was used to evaluate the quality of the selected articles and their references were hand-searched for possible missing articles. RESULTS: Twelve studies met all inclusion criteria and were analyzed in detail for their methodology and information quality. Nine articles that analyzed the association between head posture and TMD included patients with mixed TMD diagnosis; 1 article differentiated among muscular, articular, and mixed symptomatology; and 3 articles analyzed information from patients with only articular problems. Finally, 2 studies evaluated the association between head posture and TMD in patients with muscular TMD. Several methodological defects were noted in the 12 studies. CONCLUSION: Since most of the studies included in this systematic review were of poor methodological quality, the findings of the studies should be interpreted with caution. The association between intra-articular and muscular TMD and head and cervical posture is still unclear, and better controlled studies with comprehensive TMD diagnoses, greater sample sizes, and objective posture evaluation are necessary.     

The association between generalized joint hypermobility and temporomandibular joint disorders: a systematic review

To analyze conflicting evidence in the literature for the association between temporomandibular joint disorders (TMD) and generalized joint hypermobility (GJH), we performed a bibliographic search. The methodological quality of the 14 papers found was assessed according to 14 criteria. Papers were included in the analysis if the study population was clinically relevant, if range of motion of 2 or more joints was assessed on the left and right sides, and if cases had a TMD. Four studies fulfilled these selection criteria. Data from 3 studies, 113, cases and 95 controls, were available for analysis. Twenty-six cases and five controls were hypermobile (odds ratio, 5.4). In a sensitivity analysis, the odds ratio changed from significant to non-significant in 2 of 5 scenarios. As a result, it is not clear whether GJH is associated with TMD, and more rigorous studies are needed.     

Association between apical periodontitis and cardiovascular diseases: a systematic review of the literature

A systematic review was conducted to assess the association between apical periodontitis (AP) and cardiovascular disease (CVD). Studies published from the earliest date available until September 2015 were retrieved from the Medline, PubMed and Embase databases. The included studies reported the results from observational studies and assessed the link between AP and CVD as confirmed by one of the following criteria: diagnosed coronary artery disease, angina pectoris, acute myocardial infarction, stroke or mortality caused by cardiac pathology. The study characteristics were abstracted by independent researchers following the PRISMA standard protocol. NOS criteria were used to rate the quality of the studies, and the GRADE was used for level of evidence evaluation. Nineteen epidemiological studies fulfilled the predetermined inclusion criteria: 10 case–control studies, five cross‐sectional studies and four cohort studies. There was considerable heterogeneity amongst the included studies in terms of their study design, population, outcomes of interest and AP evaluation methods. Considering the limited availability and the heterogeneity amongst the studies, meta‐analysis was not attempted. Thirteen of the 19 included studies found a significant positive association between apical periodontitis and cardiovascular disease, although in two of them, the significance was present only in univariate analysis. Five studies failed to reveal positive significance, and one study reported a negative association. In conclusion, although most of the published studies found a positive association between apical periodontitis and cardiovascular disease, the quality of the existing evidence is moderate–low and a causal relationship cannot be established.     

Resistin as potential biomarker for chronic periodontitis: A systematic review and meta-analysis

ObjectivesTo determine the serum and gingival crevicular fluid (GCF) levels of resistin between individuals with chronic periodontitis (CP) and those without CP, and to evaluate the role of resistin in CP.Materials and methodsThe addressed focused question was “Is there a difference in the resistin levels between individuals with CP and those without CP?” four electronic databases: Medline, PubMed (National Institutes of Health, Bethesda), EMBASE, and Science direct databases from 1977 up to March 2016 for appropriate articles addressing the focused question. EMBASE and Medline were accessed using OVID interface which facilitated simultaneous search of text words, MeSH or Emtree. Unpublished studies (gray literature) were identified by searching the Open-GRAY database and references of the included studies (cross referencing) were performed to obtain new studies. In-vitro studies, animal studies, studies that reported levels of other cytokines but not resistin, letters to the editor and review papers were excluded.ResultsTen studies were included. Nine studies compared resistin levels between CP and periodontally healthy (H) individuals and reported higher mean serum and GCF levels of resistin in CP patients than the H controls. Two studies showed comparable resistin levels from GCF and serum between diabetes mellitus with CP (DMCP) and CP groups. Three studies included obese subjects and showed comparable serum and GCF resistin levels between obese subjects with CP (OBCP) and CP subjects.ConclusionsCP patients were presented with elevated levels of GCF or serum resistin as compared with H individuals. Resistin modulates inflammation in chronic periodontal disease and may be used as surrogate measure to identify subjects at risk for periodontitis. Resistin levels in patients with CP and systemic inflammatory disorders such as diabetes, obesity, or rheumatoid arthritis was not significantly higher than the levels in patients with only CP.     

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty‐five articles met the inclusion criteria, comprising 16 non‐randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.