Effect of smoking on subgingival microflora of patients with periodontitis in Japan

<p>Abstract</p> <p>Background</p> <p>Smoking is a risk factor for periodontitis. To clarify the contribution of smoking to periodontitis, it is essential to assess the relationship between smoking and the subgingival microflora. The aim of this study was to gain an insight into the influence of smoking on the microflora of Japanese patients with periodontitis.</p> <p>Methods</p> <p>Sixty-seven Japanese patients with chronic periodontitis (19 to 83 years old, 23 women and 44 men) were enrolled in the present study. They consisted of 30 smokers and 37 non-smokers. Periodontal parameters including probing pocket depth (PPD) and bleeding on probing (BOP) and oral hygiene status were recorded. Detection of <it>Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum/periodonticum, Treponema denticola </it>and <it>Campylobacter rectus </it>in subgingival plaque samples was performed by polymerase chain reaction. Association between the detection of periodontopathic bacteria and smoking status was analyzed by multiple logistic regression analysis and chi-square test.</p> <p>Results</p> <p>A statistically significant association was found between having a PPD ≥ 4 mm and detection of <it>T. denticola, P. intermedia, T. forsythia</it>, or <it>C. rectus</it>, with odds ratios ranging from 2.17 to 3.54. A significant association was noted between BOP and the detection of <it>C. rectus </it>or <it>P. intermedia</it>, and smoking, with odds ratios ranging from 1.99 to 5.62. Prevalence of <it>C. rectus </it>was higher in smokers than non-smokers, whereas that of <it>A. actinomycetemcomitans </it>was lower in smokers.</p> <p>Conclusions</p> <p>Within limits, the analysis of the subgingival microbial flora in smokers and non-smokers with chronic periodontitis suggests a relevant association between smoking and colonization by the specific periodontal pathogens including <it>C. rectus</it>.</p

Biological foundation for periodontitis as a potential risk factor for atherosclerosis

Links between periodontal diseases and systemic diseases have been well documented by epidemiological studies. Recently, research has shifted to elucidating the biologic mechanism for a causal relationship. One focus of interest is atherosclerosis, the underlying event of cardiovascular diseases due to its serious health impact. However, it is still not clear whether periodontopathic pathogens are truly etiologic agents or ubiquitous bystanders. This article reviews the current understanding about the molecular biological interactions between periodontal disease and atherosclerosis and the biological plausibility of periodontitis as a potential risk factor for cardiovascular disease. Materials and methods:  The current literature regarding periodontal diseases and atherosclerosis and coronary vascular disease was searched using the Medline and PubMed databases. Results:  In vitro experiments and animal models are appropriate tools to investigate the biological interactions between periodontal disease and atherosclerosis at the cell molecular level. The concepts linking both pathologies refer to inflammatory response, immune responses, and hemostasis. In particular, Porphyromonas gingivalis appears to have unique, versatile pathogenic properties. Whether or not these findings from isolated cells or animal models are applicable in humans with genetic and environmental variations is yet to be determined. Likewise, the benefit from periodontal therapy on the development of atherosclerosis is unclear. Approaches targeting inflammatory and immune responses of periodontitis and atherosclerosis simultaneously are very intriguing. Conclusion:  An emerging concept suggests that a pathogenic burden from different sources might overcome an individual threshold culminating in clinical sequela. P. gingivalis contributes directly and indirectly to atherosclerosis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66109/1/j.1600-0765.2004.00771.x.pd

Obesity and periodontal disease in diabetic pregnant women Obesidade e doença periodontal em gestantes diabéticas

This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL > 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% &plusmn; 27.99% and 78.85% &plusmn; 27.44%, respectively) and CAL (2.21 &plusmn; 0.41 and 2.61 &plusmn; 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients.<br>O objetivo do presente estudo foi examinar o efeito da massa corporal prévia à gestação (IMC - índice de massa corpórea) sobre o periodonto de pacientes com diabete mellitus gestacional (DMG). A amostra constituiu-se de 60 gestantes classificadas em 3 grupos segundo o IMC: normal, sobrepeso ou obeso. Os parâmetros de avaliação periodontal foram sangramento gengival (SG), sangramento à sondagem (SS) e perda de inserção clínica periodontal (PI) categorizada de acordo com os seguintes valores: 1) correspondente à ausência de perda de inserção; 2) PI entre 1 e 2 mm, 3) PI entre 3 e 5 mm; e 4) PI > 6 mm. Médias das porcentagens dos dentes com SG e SS e as médias dos valores categorizados, por dente, da perda de inserção foram comparadas por meio do teste ANOVA e as diferenças entre os grupos foram estabelecidas por meio do teste post hoc de Bonferroni para comparações múltiplas (p < 0,05). Diferenças estatisticamente significantes foram identificadas entre o grupo normal e obeso com relação às médias percentuais da presença de SG (52,76 &plusmn; 27,99% e 78,85 &plusmn; 27,44%, respectivamente) e às médias da categorização da PI (2,21 &plusmn; 0,41 mm e 2,61 &plusmn; 0,54 mm, respectivamente). Embora tenha se observado aumento no percentual médio de SS à medida do incremento do IMC, não foram observadas diferenças estatisticamente significantes entre os grupos, e a variação foi de 55,65% a 75,31%. Pacientes com DMG e obesidade pré-gestacional apresentaram significativamente mais gengivite e perda de inserção periodontal que aquelas com IMC pré-gestacional normal. O tratamento periodontal deve ser considerado na determinação de futuras recomendações de controle metabólico para esse grupo especial de pacientes