A Study Investigating the Relationship Between Periodontal Disease and Systematic Medical Conditions in Different Racial/ethnic Groups PDF Download

Author: Christos Diamantopoulos
Publisher:
ISBN:
Category :
Languages : en
Pages : 232

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Author: John P. Molloy
Publisher:
ISBN:
Category : Diseases
Languages : en
Pages : 184

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Author: Alexandrina L Dumitrescu
Publisher: Springer
ISBN: 9783642006791
Category : Medical
Languages : en
Pages : 135

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Periodontitis is a complex, multifactorial disease and its susceptibility is genetically determined. The present book systematically reviews the evidence of the association between the genetic variants and periodontitis progression and/or treatment outcomes. Genetic syndromes known to be associated with periodontal disease, the candidate gene polymorphisms investigated in relation to periodontitis, the heritability of chronic and aggressive periodontitis, as well as common guidelines for association studies are described. This growing understanding of the role of genetic variation in inflammation and periodontal chronic disease presents opportunities to identify healthy persons who are at increased risk of disease and to potentially modify the trajectory of disease to prolong healthy aging. The book represents a new concept in periodontology with its pronounced focus on understanding through knowledge rather than presenting the presently valid answers. Connections between genetics and periodontology are systematically reviewed and covered in detail.

Author:
Publisher:
ISBN:
Category : Health promotion
Languages : en
Pages : 338

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Author: Ngozi Nnonyelum Nwizu
Publisher:
ISBN:
Category :
Languages : en
Pages : 434

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Background: Periodontal disease typically presents as a chronic, low grade inflammatory process involving the periodontium. However, it also has the potential to produce systemic effects at distant organs sites and has been linked to several systemic conditions including cancer. Epidemiological studies on the association between periodontal disease and cancer risk are however limited, but most suggest a positive association. Only three studies (3) so far have examined total cancer risk in a prospective study. With respect to individual cancer sites, to our knowledge, no large epidemiological prospective study has examined the association between periodontal disease and colorectal cancer. This is in spite of evidence from experimental studies linking an established periodontal pathogen, Fusobacterium nucleatum, to premalignant and cancerous lesions of the colorectum. This prospective study evaluated the association between periodontal disease and risk of diagnosis of incident total-, as well as, colorectal cancer. Since periodontal disease may influence cancer risk through its ability to induce a chronic, low-grade, systemic inflammation, and serum CRP is an established biomarker of systemic inflammation; this study also investigated the association between prevalence and severity of measured periodontal disease, and serum hsCRP levels. Furthermore, independent evaluations of the role of active gingival inflammation, and presence of select periodontal pathogens, in influencing serum hsCRP levels respectively were conducted. Potential interactions of each of these measures with periodontal disease in relation to serum hsCRP levels were also explored. Methods: These studies were conducted utilizing data from the Women's Health Initiative Observational Study (WHI-OS). The study included three aims. Aim 1: evaluated the associations between periodontal disease and total cancer; Aim 2: evaluated the association of periodontal disease and colorectal cancer; and Aim 3 evaluated the association of periodontal disease and serum CRP levels. For the total cancer risk study, an analytic cohort of 65,869 postmenopausal women was used, while the colorectal cancer risk study involved 78,835 postmenopausal women. Periodontal disease status for these 2 studies was determined by self-report from the Year 5 Women's Health Initiative Observational Study (WHI-OS) follow-up questionnaire administered from 1999 through 2003. These women were between the ages of 54-86 years at the time the periodontal questionnaire was administered and were followed up for a maximum period of 15 years. Total cancer and colorectal cancer were evaluated using the first diagnosis of any incident cancer or colorectal cancer reported after the year-5 visit respectively.^Adjudication of cancer cases was determined via medical records by physicians. The risk of diagnosis of incident total-, regional-, site-specific and colorectal cancers were evaluated using Cox proportional hazards regression. For the association between periodontal disease and serum CRP levels, we conducted a cross-sectional study utilizing data from 620 postmenopausal women (aged 53-83 years) in an ancillary study of the Women's Health Initiative Observational Study (WHI-OS) in Buffalo NY, the OsteoPerio Study. Periodontal disease status was determined using clinical measures based on the Center for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) clinical case definition for periodontal disease; and independent measures of whole mouth mean, and worst site involvement of periodontal probing depth (PPD), and clinical attachment loss (CAL), respectively. Serum hsCRP concentration was evaluated using an immunoturbidimetric assay. Mean percentage of bleeding sites on gentle probing (>50% cut point), was used to confirm the presence of active gingival inflammation; while presence of select periodontal pathogens (Porphyromonas gingivalis, Tannerella Forsythia, Fusobacterium nucleatum, Prevotella intermedia, and Campylobacter rectus), were detected by immunofluorescence and phase contrast microscopy using pooled sub-gingival plaque samples. All statistical tests were two-sided. Results: 7,678 cases of primary incident cancer were diagnosed over a mean follow-up of 8. 32 years. Periodontal disease history was associated with a 12% statistically significant increased risk of diagnosis of cancer overall, after adjusting for potential confounders [HR 1. 12, 95% CI 1. 07-1. 18]. This finding remained significant among the sample of 34,097 women who had never smoked [HR 1. 11, 95% CI 1. 02-1. 20]. Statistically significant associations were also observed for cancers of the breast [HR 1. 10, 95% CI 1. 01-1. 19]; lung [HR 1. 31, 95% CI 1. 14-1. 51]; esophagus [HR 3. 28, 95% CI 1. 64-6. 53]; gallbladder [HR 1. 73, 95% CI 1. 01-2. 95]; and melanoma skin cancers [HR 1. 23, 95% CI 1. 02-1. 48]. There was a near significant association with stomach cancer [HR 1. 58, 95% CI 0. 94-2. 67], but no associations with cancers of the pancreas or genitourinary system. There was no association between periodontal disease and risk diagnosis of colorectal cancer, after adjusting for potential confounders [hazard ratio (HR) = 1. 08, 95% confidence interval (CI): 0. 92-1. 26]. Similarly, no associations were observed with respect to anatomic location (colon, rectum and recto-sigmoid cancers) and tumor characteristics respectively. There was significant interaction between periodontal disease and diagnosis of colorectal cancer according to hormone therapy (HT) use (p =0. 03), and stratified analyses suggest current HT users, particularly of estrogen plus progestin (E+P), with a history of periodontal disease have a higher risk of being diagnosed with colorectal cancer [HR =1. 76, 95% CI: 1. 20-2. 59]. This effect was enhanced on restriction to colon cancer alone [HR =2. 02, 95% CI: 1. 34-3. 05}. However, dose-response effect was not consistent with time on HT use. Other results from our study indicate that participants with "severe" periodontal disease according to the CDC/AAP Clinical Case Definition demonstrated an almost 2-fold higher odds of having high serum CRP concentrations (>3. 0mg/l), compared to those with no/mild disease, after adjusting for potential confounders (OR 1. 86, 95% CI 1. 06-3. 27). Positive, linear, but statistically insignificant associations were observed between whole mouth mean and worst site PPD and CAL measures. None of the select pathogens examined (alone or in groups), or the presence of active gingival inflammation evidenced by percentage of sites that bled on probing (>50%), were associated with serum hsCRP levels. Also, no significant interaction effects were observed between periodontal disease, and any of the pathogens, (alone or in groups), or mean percentage bleeding sites (>50% cut point), on the serum hsCRP concentrations. Conclusion: Periodontal disease may enhance the risk of being diagnosed with total cancer risk in postmenopausal women; this finding persisted when restricting to never smokers. This risk appears to be higher for certain anatomic sites, particularly those in close proximity to the oral cavity such as the esophagus and upper gastrointestinal regions, but does not appear to extend to lower gastrointestinal tract sites such as the colon and rectum. The observed association between women with periodontal disease who are on hormone therapy and risk of being diagnosed with incident colorectal cancer requires further exploration, and we cannot rule out that it may be due to chance. This study also affirms that chronic inflammation may be one mechanism by which periodontal disease is associated with cancer risk. Additional research in other prospective cohorts is needed.

Author: Xiangqun Ju
Publisher:
ISBN:
Category : Dental public health
Languages : en
Pages : 198

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Background: Periodontal disease is highly prevalent among older adults. The purpose of the current study was to improve the measurement of the incidence and progression of periodontal disease in older population with a high level of tooth loss, and to evaluate the relationship between daily life conditions (systemic diseases, functional limitation and cognitive impairment) and periodontal disease. Methods: Data were from the South Australian Dental Longitudinal Study (SADLS). All participants were 60+ years. Data collection started in 1991/1992 and repeated 2, 5 and 11 years later. This study investigated the measurement of periodontal disease first by the use of periodontal disease case definitions; then the calculation of individual incidence density of periodontal attachment loss (ALOSS≥ 3mm) events. The role of systemic diseases in predicting the incidence and progression of periodontal disease was estimated after adjusting for social demographic, dental characteristics and health-related behaviour covariates using Poisson regression with robust standard errors. Marginal structural models (MSMs) with stabilised inverse-probability weights were used to estimate the direct effect of functional limitations and/or cognitive impairment on the incidence and progression of periodontal disease while controlling for other risk factors such as systemic diseases and dental behaviours. Results: Of the 801 dentate participants examined at baseline (response rate: 66.5%), 596, 365 and 234 were re-examined at the 2, 5 and 11-year follow-up respectively. Large discrepancies in the prevalence of periodontal disease were found based on three different case definitions with the same population at different time points. Both the incidence and reversal of periodontal disease were associated with the number of teeth lost at baseline and across the follow-up intervals. The mean individual incidence density of ALOSS new events was 8.3 per 1,000 tooth-years with imputed missing values due to tooth loss and loss of participants to follow-up. The individual incidence density of ALOSS new events was 2 times higher in the 'tooth loss' groups under the different scenarios, compared to 'no tooth loss' group. The predictive analyses showed that among older adults who suffered from diabetes and chronic obstructive pulmonary disease (COPD), the average ALOSS events per 1,000 tooth-years was 1.3 and 1.2 times higher respectively than for those without these diseases. The estimated direct effect of people with functional limitation increased the risk of periodontal disease progression around 1.6 times, compared with those without functional limitation; people with cognitive impairment had nearly 1.7 times greater progression of periodontal disease than those who did not have cognitive impairment; and having both functional limitations and cognitive impairment raised the progression of periodontal disease to 1.8 times compared to those who did not have functional limitation or cognitive impairment. Conclusion: Individual-level incidence density of ALOSS new events was more appropriate to estimate the incidence and progression of periodontal disease in a population with a high level of tooth loss. Diabetes and COPD were risk predictors of the incidence and progression of periodontal attachment loss, and daily life (including functional limitation and/or cognitive impairment) had a direct effect on incidence and progression of periodontal disease that was not mediated by dental behaviours or systemic diseases.

Author: RICHARD CHARLES GRAVES
Publisher:
ISBN:
Category : Dentistry
Languages : en
Pages : 438

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Author: Ying Zheng
Publisher: Open Dissertation Press
ISBN: 9781361042748
Category : Medical
Languages : en
Pages : 202

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This dissertation, "Genetic Risks of Periodontal Disease" by Ying, Zheng, 鄭穎, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract GENETIC RISKS OF PERIODONTAL DISEASE By ZHENG YING For the Degree of Doctor of Philosophy at the University of Hong Kong Sep 2016 Periodontitis is a common dental noncommunicable disease. Numerous risk indicators are reported to be associated with chronic periodontitis (CP), including genetic susceptibility. The aim of this study was to investigate the genetic risk indicators of periodontitis in southern Chinese by candidate-gene and genome- wide association study approaches. Materials and methods In the first part of the study, the association of T helper 2 cell (Th2) regulatory and effector molecules' genetic polymorphisms with periodontitis in non-smokers was investigated. Th2 cells have been suggested to play an important role in periodontitis pathogenesis for decades, but the genetic background has not been thoroughly studied. 141 non-smoking CP patients and 163 periodontitis-free controls diagnosed clinically as well as characterized via radiograph assessment of alveolar bone loss were recruited. Genomic DNA from whole blood samples was collected and genotyped using Sequenom iPlex assays upon 129 SNPs of eleven IV Th2 cell regulatory or effector molecules genes (CD28, CTLA4, IL4, IL5, IL6, IL9, IL10, IL13, IL4R, GATA3, STAT6) and rs1537415, a recently reported SNPs related to aggressive periodontitis. In the second part of the study, 1,213 Southern Chinese were clinically examined and diagnosed based on the CDC/AAP classification of periodontitis and mean clinical attachment level (mCAL). A whole-genome association study (GWAS) was conducted to identify the genetic indicator for periodontitis in this Chinese cohort using HumanOmniZhongHua-8 BeadChip (Illumina), consisting of 814,285 SNPs after quality control. Single-marker, gene-based and pathway analysis were performed after imputation with the adjustment of age, gender, smoking, diabetes and plaque percentage. Results In the candidate gene study, three SNPs (rs4553808, rs16840252 and rs5742909) located in the promoter region of CTLA4 were identified to be closely inter- linked, and they were significantly associated with CP (pIn the GWAS, after single marker analysis with the mCAL-phenotype, four SNPs (rs78946930, rs77514260, rs78931888 and rs78399198) in the intron of the gene of Src homology domain containing 4A (SH2D4A) were found to be significantly V -8 associated with CP (p=1.32 2.5810 ). Gene-based analysis with mCAL- phenotype confirmed the significant association of SH2D4A with CP -7 (p=5.7410 ). Conclusion The candidate-gene study showed that SNPs in the region of CTLA4 was associated with CP in non-smoking Chinese. As CTLA4 was not exclusively expressed on Th2 cells, there was yet insufficient evidence to support the influence of Th2 cells on CP pathogenesis. The GWAS result suggested that SH2D4A was significantly associated with CP in Southern Chinese. Replication study and functional studies were underway to validate such observation. Word count: 452 VI Subjects: Periodontitis - Genetic aspects

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309186307
Category : Medical
Languages : en
Pages : 211

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Though it is highly preventable, tooth decay is a common chronic disease both in the United States and worldwide. Evidence shows that decay and other oral diseases may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. However, individuals and many health care professionals remain unaware of the risk factors and preventive approaches for many oral diseases. They do not fully appreciate how oral health affects overall health and well-being. In Advancing Oral Health in America, the Institute of Medicine (IOM) highlights the vital role that the Department of Health and Human Services (HHS) can play in improving oral health and oral health care in the United States. The IOM recommends that HHS design an oral health initiative which has clearly articulated goals, is coordinated effectively, adequately funded and has high-level accountability. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders from both the public and private sectors. Advancing Oral Health in America provides practical recommendations that the Department of Health and Human Services can use to improve oral health care in America. The report will serve as a vital resource for federal health agencies, health care professionals, policy makers, researchers, and public and private health organizations.

Author: Gerry McKenna
Publisher: Springer Nature
ISBN: 3030805263
Category : Medical
Languages : en
Pages : 84

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This book explores in depth the relationships between nutrition and oral health. Oral health is an integral part of general health across the life course, and this book examines nutritional and oral health considerations from childhood through to old age, with particular attention focused on the consequences of demographic changes. Current knowledge on the consequences of poor diet for the development and integrity of the oral cavity, tooth loss, and the progression of oral diseases is thoroughly reviewed. Likewise, the importance of maintenance of a disease-free and functional dentition for nutritional well-being at all stages of life is explained. Evidence regarding the impact of oral rehabilitation on nutritional status is evaluated, and strategies for changing dietary behaviour in order to promote oral health are described. Nutrition and Oral Health will be an ideal source of information for all who are seeking a clearly written update on the subject.