The periodontium of periodontitis patients contains citrullinated proteins which may play a role in ACPA (anti-citrullinated protein antibody) formation

Aim To determine the presence and location (stroma versus epithelium) of citrullinated proteins in periodontitis tissue as compared to non-periodontitis tissue and synovial tissue of RA patients. Materials & Methods Periodontitis, healthy periodontal and RA-affected synovial tissue samples were collected in addition to buccal swabs. These samples were stained for the presence of citrullinated proteins using polyclonal (Ab5612) and monoclonal (F95) antibodies. Furthermore, Western blotting with F95 was performed on lysates prepared from periodontal and synovial tissues. Results In periodontitis stroma, increased citrullinated protein presence (80%) was observed compared with control stroma (33%), the latter was associated with inflammation of non-periodontitis origin. Periodontal epithelium always stained positive for Ab5612. Noteworthy, only periodontitis-affected epithelium stained positive for F95. All buccal mucosal swabs and 3 of 4 synovial tissue samples stained positive for both Ab5612 and F95. Western blotting with F95 showed presence of similar citrullinated proteins in both periodontitis and RA-affected synovial tissue. Conclusion Within the periodontal stroma, citrullination is an inflammation-depended process. In periodontal epithelium, citrullination is a physiological process. Additional citrullinated proteins are formed in periodontitis, apparently similar to those formed in RA-affected synovial tissue. Periodontitis induced citrullination may play a role in the aetiology of rheumatoid arthritis

The periodontal inflamed surface area as inflammatory burden : in diabetes and rheumatoid arthritis patients

Periodontitis may endanger overa I I health as bacteria and inflammatory mediators involved in periodontitis enter the systemic circulation and cause infection and inflammation beyond the oral cavity. The first study in this thesis shows that periodontitis patients suffer from diabetes mellitus (DM) and rheumatoid arthritis (RA) more often than non¬periodontitis controls. To further assess the relationship between periodontitis and DM and RA, a method was developed to quantify the surface area of the ulcerating wound caused by periodontitis, i.e. the periodontal inflamed surface area (PISA). Application of PISA showed that DM patients indeed have an increased PISA and that an increased PISA is accompanied by increased levels of HbAic. Thus, worsening periodontal condition may result in worsening blood glucose regulation. Two additional studies showed that RA patients have periodontitis 6 to 13 times more often than healthy controls, that treatment of periodontitis reduces RA disease activity, and that periodontitis tissue contains citrullinated proteins that could play a role in the etiology of RA.

Periodontal Disease and Decreased Kidney Function in Japanese Elderly

Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no longitudinal study has been performed and no study has been performed in Japan. The aim of this longitudinal study was to investigate the effect of periodontal disease on kidney function in community-dwelling Japanese elderly. Study Design: Retrospective cohort. Setting & Participants: Members of this cohort were drawn from a longitudinal interdisciplinary study of aging. Included for this analysis were 317 participants (166 men, 151 women) aged 75 years in 2003. Predictor: The periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated for each participant. Participants were classified in quartile groups according to PISA, then divided into 2 groups (highest quartile vs the other 3 groups combined). Outcomes: The primary outcome for the analysis was decreased kidney function, defined as a decrease in estimated glomerular filtration rate at follow-up. Measurements: Multivariable logistic regression analyses were performed to predict decreased kidney function on the basis of periodontal status, risk factors for kidney disease, and other potentially relevant covariates. Results: During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates. Limitations: Extension of interpreting the findings to other age groups is limited. Conclusion: These results suggest that periodontal disease may be a risk factor for decreased kidney function in Japanese elderly. Am J Kidney Dis. 59(2):202-209. (C) 2012 by the National Kidney Foundation, Inc

Periodontitis Prevalence and Severity in Indonesians With Type 2 Diabetes

Background: The prevalence of diabetes mellitus type 2 (DM2) in Indonesia is high and still rising. Periodontitis is associated with DM2. No study has investigated this association in Indonesia, nor has any study investigated this association using a variety of methods to operationalize periodontitis. Therefore this study compared prevalence and severity of periodontitis in DM2 patients to healthy controls, using different methods to operationalize periodontitis. Methods: 78 DM2 and 76 healthy subjects underwent a full mouth periodontal screening assessing probing pocket depth, gingival recession, plaque index and bleeding on probing. Using these measurements, periodontitis prevalence and severity was operationalized in various ways. Differences in periodontitis prevalence and severity between DM2 and healthy subjects were analyzed using univariate analyses. In regression analyses, periodontitis prevalence and severity were predicted on the basis of DM2 presence, controlling for confounders and effect modification. Results: Prevalence of periodontitis was significantly higher in DM2 compared to healthy subjects, showing odds ratios of 5.0 and 6.1. Likewise, periodontitis severity was significantly higher in DM2 subjects. Conclusion: Indonesian DM2 subjects had more prevalent and more severe periodontitis than Indonesian healthy subjects, independent of confounding factors or the methods used to operationalize periodontitis

Virtual reality and collaborative learning: a systematic literature review

Background: While research on Virtual Reality’s potential for education continues to advance, research on its support for Collaborative Learning is small in scope. With remote collaboration and distance learning becoming increasingly relevant for education (especially since the COVID-19 pandemic), an understanding of Virtual Reality’s potential for Collaborative Learning is of importance. To establish how this immersive technology can support and enhance collaboration between learners, this systematic literature review analyses scientific research on Virtual Reality for Collaborative Learning with the intention to identify 1) skills and competences trained, 2) domains and disciplines addressed, 3) systems used and 4) empirical knowledge established.Method: Two scientific databases—Scopus and Web of Science—were used for this review. Following the PRISMA method, a total of 139 articles were analyzed. Reliability of this selection process was assessed using five additional coders. A taxonomy was used to classify these articles. Another coder was used to assess the reliability of the primary coder before this taxonomy was applied to the selected articlesResults: Based on the literature reviewed, skills and competences developed are divided into five categories. Educational fields and domains seem interested in Virtual Reality for Collaborative Learning because of a need for innovation, communities and remote socialization and collaboration between learners. Systems primarily use monitor-based Virtual Reality and mouse-and-keyboard controls. A general optimism is visible regarding the use of Virtual Reality to support and enhance Collaborative LearningConclusion: Five distinct affordances of Virtual Reality for Collaborative Learning are identified: it 1) is an efficient tool to engage and motivate learners, 2) supports distance learning and remote collaboration, 3) provides multi- and interdisciplinary spaces for both learning and collaborating, 4) helps develop social skills and 5) suits Collaborative Learning-related paradigms and approaches. Overall, the reviewed literature suggests Virtual Reality to be an effective tool for the support and enhancement of Collaborative Learning, though further research is necessary to establish pedagogies

Periodontitis Prevalence and Severity in Indonesians With Type 2 Diabetes

Background: The prevalence of diabetes mellitus type 2 (DM2) in Indonesia is high and still rising. Periodontitis is associated with DM2. No study has investigated this association in Indonesia, nor has any study investigated this association using a variety of methods to operationalize periodontitis. The present study compares prevalence and severity of periodontitis in patients with DM2 to healthy controls, using different methods to operationalize periodontitis. Methods: A total of 78 subjects with DM2 and 65 healthy control subjects underwent a full-mouth periodontal screening assessing probing depth, gingival recession, plaque index, and bleeding on probing. Using these measurements, the prevalence and severity of periodontitis was operationalized in various ways. Differences in the prevalence and severity of periodontitis between subjects with DM2 and healthy subjects were analyzed using univariate analyses. In regression analyses, the prevalence and severity of periodontitis were predicted on the basis of DM2 presence, controlling for confounders and effect modification. Results: Prevalence of periodontitis was significantly higher in subjects with DM2 compared to healthy subjects, showing odds ratios of 5.0 and 6.1. Likewise, periodontitis severity was significantly higher in subjects with DM2. Conclusion: Indonesian subjects with DM2 had more prevalent and more severe periodontitis than healthy Indonesian subjects, independent of confounding factors or the methods used to operationalize periodontitis. J Periodontol 2011; 82:550-557