Potential Application of Anti-Cyclic Citrullinated Peptide (Anti-CCP) for the Diagnosis of Periodontal Disease in Patients with Rheumatoid Arthritis with Cut-Off Determination.

Background: Rheumatoid arthritis (RA) and periodontal disease (PD) are both characterized by an inflammatory reaction. Anti-cyclic citrullinated peptide (anti-CCP) is a common diagnostic test for RA. Anti-CCP is proposed to be used as a serological biomarker to detect PD in patients with RA.Methods: A case-control study was designed for 94 subjects; 42 patients with RA and 52 without RA. PD and its types were investigated among these subjects. An enzyme-linked immunosorbent assay (ELISA) test was used to measure anti-CCP levels in these subjects.Results: Subjects were recategorized into four groups after PD diagnosis: group 1 for RA with PD (34.04%); group 2 for RA only (10.63%); group 3 for PD only (30.85%); and group 4 for individuals without RA and PD (24.46%). Anti-CCP may be considered an effective biomarker for predicting the development of PD in RA patients based on five current results found in group 1 compared to other groups. These included the detection of significantly higher anti-CCP levels, a high sensitivity (63.15%), low specificity (50%), higher cut-off value (58.53 U/ml), high positive predictive value (94.73%), and low negative predictive value (8.69%) of anti-CCP. Chronic periodontitis is the most common and has a significant association with elevated levels of anti-CCP.Conclusion: Measuring the anti-CCP level in RA patients may be a good indicator for PD diagnosis based on the suggested cut-off value. The sensitivity of the test is sufficiently reliable to produce true positive results. Anti-CCP may also be useful in the diagnosis of PD type, especially chronic periodontitis.

EVALUATION OF DENTAL AND PERIODONTAL STATUS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS.

Diabetes mellitus is a well-known predisposing factor for oral diseases. AIM: To evaluate dental caries and periodontal status of children with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS: Eighty children with type 1 diabetes mellitus (age 10-15 years) have received a comprehensive oral health examination, that included the DMFT index for permanent teeth, plaque index (PI), gingival index (GI), and stimulated salivary flow rate (SSFR). P<0.05 was considered significant. RESULTS: HbA1c values indicated poor metabolic control of diabetes in children, which also adversely affected their oral health (9.45±2.87). The mean DMFT index in children with type 1 diabetes mellitus was notably higher at 6.56±3.56. Similarly, the plaque index (PI) and gingival index (GI) were significantly higher (2.04±0.39/1.18±0.63). In contrast, the stimulated salivary flow rate (SSFR) was observed to be lower (0.86±0.16). There was significant positive correlation between DMFT index and PI (p<0.01). CONCLUSION: Children with T1DM exhibit poor oral health conditions related to the level of metabolic control. Maintenance of toothbrushing habits and regular dental check-ups recommended to manage and prevent these complications. Additionally, proper management of metabolic control can also help mitigate the adverse effects on oral health.

Relationship between periodontal disease and preterm birth. A systematic review and meta-analysis.

BACKGROUND: Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, it affects around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators. MATERIAL AND METHODS: Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies. RESULTS: Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results. CONCLUSIONS: There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.

Assessment of oral health-related quality of life and periodontal state in patients with end-stage renal disease: a comparison study using propensity score-matched analysis.

BACKGROUND: The purpose of this study was to examine the periodontal state and oral health-related quality of life (OHRQoL) of patients with end-stage renal disease (ESRD) and the effect of ESRD on OHRQoL by comparison with age- and sex-matched systemic healthy controls with similar periodontal status levels. MATERIAL AND METHODS: Fifty patients with ESRD and 150 healthy individuals without ESRD were recruited. Medical characteristics were recorded for the test group and periodontal examination was performed in both groups. A structured Korean version of the Oral Health Impact Profile (OHIP-14K) questionnaire for subjective evaluation of OHRQoL was administered. To evaluate the effect of ESRD on OHRQoL, 50 healthy controls who had been matched for age, sex, and periodontal status were selected and compared with ESRD patients by using propensity score-matched analysis. RESULTS: ESRD patients had significantly higher mean score of Community Periodontal Index and mean numbers of missing teeth compared with the controls (P < 0.05). Mean OHIP-14K total score and mean scores of all subdomains were significantly higher in the test group than in the controls (P < 0.05). Even after matching analysis, mean OHIP-14K total score and mean scores of subdomains were significantly higher in the test group than in the control group (P < 0.05), except in one subdomain (physical pain). CONCLUSIONS: Within the limitations of this investigation, the present study showed worse periodontal state and lower level of OHRQoL in ESRD patients compared with those in healthy subjects. Through comparison with matched healthy controls, ESRD was found to have a negative effect on OHRQoL.

Is there an association between periodontal disease and infertility? A systematic review.

BACKGROUND: Today, idiopathic infertility is becoming more frequent, affecting more than 186 million people in the world. The presence of comorbidities makes patient management complex, requiring individualized infertility treatment. Periodontal diseases could contribute negatively to the management of infertility, increasing inflammation, oxidative stress and insulin resistance, and contributing negatively to the development and progression of comorbidities associated with these two entities. The aim of this systematic review is to explore whether there is an association between periodontal diseases and male and female infertility and deepen into the possible mechanisms underlying this association. MATERIAL AND METHODS: The studies analyzed in this research included a total of 4871 patients (732 men and 4139 women), were original studies with high quality, mostly with a control group. Authors who have investigated idiopathic infertility suggest that infertility is associated with diseases that present low-grade chronic inflammation, oxidative stress and insulin resistance (such as obesity, type 2 diabetes and polycystic ovary syndrome), which are in turn related to periodontal diseases. RESULTS: A higher prevalence of periodontal disease was found in patients with infertility compared with controls. Periodontal diseases could initially be mediated by a local and systemic proinflammatory environment, which favors a pro-oxidant state, leading to oxidative stress and, finally, irreversible destruction of the periodontal tissue. Insulin resistance, oxidative stress and inflammation are present in the pathologies associated with an increase in the prevalence and severity of periodontal diseases (such as obesity, type 2 diabetes and polycystic ovary syndrome). Therefore, IR, low-grade chronic inflammation and the oxidative stress could be the pathophysiological mechanisms linking idiopathic infertility and periodontal diseases. CONCLUSIONS: Studies suggest an association between infertility and periodontitis. Future researches are necessary to find causality factors. Studying the patient in a global and multidisciplinary way could help in the management and treatment of idiopathic infertility.

Association of Periodontal Condition With Impaired Glucose Tolerance: Results of a 15-Year Follow-Up Study.

OBJECTIVES: The aim of this study was to investigate whether periodontal condition is associated with the development of impaired glucose tolerance (IGT). MATERIAL AND METHODS: This study was based on a subpopulation of a cohort of persons born in 1935 and living in Oulu, Finland, on October 1, 1990. The participants were normoglycemic (no previously diagnosed diabetes mellitus and a 2-h oral glucose tolerance test [OGTT] blood glucose < 7.8 mmol/L) in the baseline examinations (1990-1992) and had fasting blood glucose < 7.0 mmol/L in the follow-up examinations (2007-2008) (n = 225). The outcome was IGT on follow-up, measured by a blood glucose level of ≥ 7.8 mmol/L after OGTT. The exposure was the periodontal condition at baseline categorized into four groups: 0, 1-6, ≥ 7 sites with deepened (≥ 4 mm) periodontal pockets, and edentulousness. RESULTS: A total of 23% of the participants developed IGT. The adjusted incidence rate ratios with 95% confidence intervals (CI) for dentate participants with 1-6 sites and ≥ 7 sites with deepened periodontal pockets, and edentate participants (reference category dentate participants without deepened periodontal pockets) were 1.5 (95% CI, 0.6-4.0), 1.8 (95% CI, 0.7-4.4), and 1.6 (95% CI, 0.6-4.0), respectively. CONCLUSIONS: Poor periodontal condition may predispose individuals to IGT; however, further studies on this matter are warranted.

Meta Analysis of the Correlation between Periodontal Health and Cognitive Impairment in the Older Population.

OBJECTIVE: To explore the correlation between periodontal health and cognitive impairment in the older population to provide the evidence for preventing cognitive impairment from the perspective of oral health care in older adults. METHODS: A comprehensive search was conducted in PubMed, Embase, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure, Wanfang Data, the China Science and Technology Journal Database, and the China Biomedical Literature Database, to include both cross-sectional and longitudinal cohort studies on the association between periodontal health and cognitive impairment in older adults. The search was completed in April 2023. Following quality assessment and data organization of the included studies, meta-analysis was performed using Review Manager 5.4. RESULTS: Twenty-two studies involving a total of 4,246,608 patients were included to comprehensively assess periodontal health from four dimensions (periodontitis, tooth loss, occlusal support, and masticatory ability), with the outcome variable of cognitive impairment (including mild cognitive impairment, Alzheimer's disease and all-cause dementia). Meta-analysis showed that, compared to those of periodontally healthy older adults, the risk of cognitive impairment in older adults with poor periodontal health, after adjusting for confounders, was significantly greater for those with periodontitis (OR=1.45, 95% CI: 1.20-1.76, P<0.001), tooth loss (OR=1.80, 95% CI: 1.50-2.15, P<0.001), compromised occlusal support (OR=1.87, 95% CI: 1.29-2.70, P=0.001), and reduced masticatory ability (OR=1.39, 95% CI: 1.11-1.75, P=0.005). The risk of cognitive impairment was higher in older adults with low-dentition than in those with high-dentition. Subgroup analysis revealed older individuals with fewer remaining teeth were at a higher risk of developing cognitive impairment compared to those with more remaining teeth, as shown by the comparison of number of teeth lost (7-17 teeth compared to 0-6 teeth) (OR=1.64, 95% CI: 1.13-2.39, P=0.01), (9-28 teeth compared to 0-8 teeth) (OR=1.13, 95% CI: 1.06-1.20, P<0.001), (19-28 teeth compared to 0-18 teeth) (OR=2.52, 95% CI: 1.32-4.80, P=0.005), and (28 teeth compared to 0-27 teeth) (OR=2.07, 95% CI: 1.54-2.77, P<0.001). In addition, tooth loss in older adults led to a significantly increased risk of mild cognitive impairment (OR=1.66, 95% CI: 1.43-1.91, P<0.001) and all-cause dementia (OR=1.35, 95% CI: 1.11-1.65, P=0.003), although the correlation between tooth loss and the risk of Alzheimer's disease was not significant (OR=3.89, 95% CI: 0.68-22.31, P=0.13). CONCLUSION: Poor periodontal health, assessed across four dimensions (periodontitis, tooth loss, occlusal support, and masticatory ability), represents a significant risk factor for cognitive impairment in older adults. The more missing teeth in older adults, the higher risk of developing cognitive impairment, with edentulous individuals particularly susceptible to cognitive impairment. While a certain degree of increased risk of Alzheimer's disease was observed, no significant association was found between tooth loss and the risk of developing Alzheimer's disease. Enhancing periodontal health management and delivering high-quality oral health care services to older adults can help prevent cognitive impairment.

Association of self-reported periodontal disease and inequities with long haul COVID-19.

In 2000, the Surgeon General's report highlighted that the mouth is a mirror for overall health of an individual and that disparities in oral health are directly proportionate to general health inequities. Among patients hospitalized due to COVID-19, diabetes and cardiovascular disease are the most common comorbidities; several studies support the association of these conditions with periodontal disease. This study's main aim is to assess the disproportionate impact of the COVID-19 pandemic on populations from lower socioeconomic statuses. The study also aims to assess the association of self-reported periodontal disease with COVID-19 disease course and severity. A sample population of Indiana residents with positive diagnosis of SARS-CoV-2 were recruited. A validated survey tool was sent to this cohort inquiring about sociodemographic distribution; co-morbid conditions, current symptoms of "long haul COVID," course of their COVID-19 infection; history of periodontal disease, existing periodontal disease symptoms, and oral hygiene habits. 209 individuals with a history of positive COVID test were returned to the survey, and association of participant characteristics and periodontal disease-related survey items with COVID-related survey items were evaluated using chi-square tests. Lower sense of smell ratings was associated with less education (p = 0.021), being unemployed/disabled (p = 0.008), worse health status (p<0.001), more frequent bleeding gums (p = 0.031), more frequent toothache (p<0.001), lower oral health rating (p = 0.002), and vaccine status (p = 0.011). Lower sense of taste ratings were associated with older age (p = 0.018), worse health (p<0.001), more frequent bleeding gums (p<0.001), more frequent mobile or loose tooth (p = 0.010), presence of gum disease (p<0.001), more frequent loss of teeth (p = 0.013), more frequent toothache (p<0.001), worse oral health (p = 0.001), teeth lost due to gum disease (p = 0.006), and vaccine status (p = 0.001). History of hospitalization due to COVID-19 was found to be associated with a history of gum disease within the past 12 months.

Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management.

BACKGROUND: Palatal groove represents a relatively uncommon developmental root anomaly, usually found on the palatal aspect of maxillary incisors. While its origin is controversial, its presence predisposes to severe periodontal defects. AIM: This study aimed to provide a systematic review of the literature focusing on the varied diagnostic techniques and treatment modalities for periodontal lesions arising from the presence of palatal groove. Based on the existing evidence and knowledge, the study also provides a comprehensive decisional tree, guiding clinicians in the challenging decision-making process face to a palatal groove. METHODS: The literature search was conducted on Medline and Cochrane databases by two independent reviewers, who also performed the screening and selection process, looking for English written articles reporting on diagnosis and management (all treatment approaches) of periodontal lesion(s) associated with a palatal groove. Based on this literature, a comprehensive decisional tree, including a standardized palatal groove evaluation and tailored treatment approaches, is proposed. Moreover, a clinical case is described to demonstrate the practical application of the developed decisional tree. RESULTS: Over a total of 451 articles initially identified, 34 were selected, describing 40 patients with 40 periodontal lesions associated with palatal grooves. The case report illustrates a deep, large, circumferential intra-bony defect on the palatal side of the tooth #22 associated with a shallow, moderately long palatal groove in an 18-year-old male patient. Following reevaluation, a single flap surgery was deemed necessary, combined with a regenerative procedure. At 2 years post-treatment, the tooth #22 is healthy, in a functional and esthetic position. The decision-making process, based on local and systemic patient's conditions, should allow an early and precise diagnosis to prevent further complications and undertake an adequate treatment. CONCLUSION: Palatal grooves are relatively rare; however, they are frequently associated with severe periodontal defects. The identification, diagnosis, prompt, and tailored management of the associated lesion is essential to mitigate potential periodontal and endodontic complications related to the presence of palatal groove. SYSTEMATIC REVIEW REGISTRATION: [ https://www.crd.york.ac.uk/prospero/ ], identifier [C CRD42022363194].

Examining the Potential Correlation Between Periodontal Disease and Chronic Kidney Disease.

Chronic kidney disease (CKD) refers to any abnormalities in kidney structure or function that remain longer than 3 months and negatively impact health. Characterized by a loss of nephrons and a decline in the glomerular filtration rate, CKD can stem from various diseases, such as glomerular, vascular, and others, with treatment options including dialysis or kidney transplantation. Many patients with CKD go undetected because they exhibit no symptoms. Periodontal disease is an inflammatory reaction that results in destruction in the periodontium's connective tissues and alveolar bone, potentially leading to such clinical signs and symptoms as edema, erythema, bleeding on probing, suppuration, tooth mobility and migration, alveolar bone loss, and tooth loss. Recent studies point to a connection between periodontal disease and systemic conditions, including CKD. Periodontal disease severity and presence may correlate with the occurrence of CKD. While various bacteria can cause periodontal disease, specific ones, such as Gram-negative bacilli, are linked to the beginning and progression of CKD, especially in people with compromised immune systems. It is beneficial, therefore, for clinicians to understand the association between CKD and periodontal disease.

Association between Periodontal Diseases and the Risk of Site-Specific Gastrointestinal Cancers: A Systematic Review and Meta-Analysis.

The association between periodontal diseases and the risk of gastrointestinal cancers, especially site-specific gastrointestinal cancers, remains unclear. Here, we comprehensively searched PubMed, EMBASE, Web of Science, and Google Scholar from inception to April 2024 to identify relevant studies. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were conducted to confirm the robustness of the main findings in different populations. This study was reported according to PRISMA 2020 guidelines. In total, we identified 19 studies, including 16.6 million participants. Individuals with periodontal diseases had an increased risk of overall gastrointestinal cancers compared with those without periodontal diseases (HR 1.31, 95% CI 1.16-1.49). Periodontal diseases significantly increased the risk of esophageal cancer by 39% (HR 1.39, 95% CI 1.15-1.68), gastric cancer by 13% (HR 1.13, 95% CI 1.01-1.26), colorectal cancer by 21% (HR 1.21, 95% CI 1.05-1.39), pancreatic cancer by 35% (HR 1.35, 95% CI 1.00-1.82), and liver cancer by 9% (HR 1.09, 95% CI 1.04-1.13). The risk of gastrointestinal cancers was significantly increased by periodontitis (HR 1.45, 95% CI 1.14-1.85), gingivitis (HR 1.03, 95% CI 1.01-1.04), and periodontitis/gingivitis (HR 1.27, 95% CI 1.07-1.51). Furthermore, severe periodontal diseases showed a significantly increased risk of gastrointestinal cancer (HR 1.79, 95% CI 1.07-2.99). Results of sensitivity analyses for site-specific gastrointestinal cancers were robust with the main findings. In summary, periodontal diseases, especially severe periodontitis, increase the risk of overall and site-specific gastrointestinal cancers. Interventions to prevent and manage periodontal diseases may reduce the risk of developing gastrointestinal cancers.

Blood Leukocyte DNA Methylation Markers of Periodontal Disease and Risk of Lung Cancer in a Case-Control Study Nested in the CLUE II Cohort.

BACKGROUND: Periodontal disease and DNA methylation markers have separately been associated with lung cancer risk. Examining methylation levels at genomic regions previously linked to periodontal disease may provide insights on the link between periodontal disease and lung cancer. METHODS: In a nested case-control study drawn from the CLUE II cohort, we measured DNA methylation levels in 208 lung cancer cases and 208 controls. We examined the association between 37 DNA-methylated 5'-C-phosphate-G-3' (CpG) sites at three genomic regions, homeobox 4 (HOXA4), zinc finger protein (ZFP57), and a long noncoding RNA gene located in Chr10 (ENSG00000231601), and lung cancer risk. RESULTS: Statistically significant associations with lung cancer risk were observed for all 14 CpG sites from HOXA4 (OR ranging 1.41-1.62 for 1 SD increase in the DNA methylation level, especially within 15 years) and 1 CpG site on gene ENSG00000231601 (OR = 1.34 for 1 SD increase in the DNA methylation level). Although CpG sites on gene ZFP57 were not associated with lung cancer risk overall, statistically significant inverse associations were noted for six CpG sites when restricting follow-up to 15 years (OR = 0.73-0.77 for 1 SD increase in the DNA methylation level). CONCLUSIONS: Key methylation levels associated with periodontal disease are also associated with lung cancer risk. For both HOXA4 and ZFP57, the associations were stronger within 15 years of follow-up, which suggest that, if causal, the impact of methylation is acting late in the natural history of lung cancer. IMPACT: Identifying biological pathways that link periodontal disease and lung cancer could provide new opportunities for lung cancer detection and prevention.

Association between geniquin therapy and the risk of developing periodontal disease in patients with primary Sjögren's syndrome: A population-based cohort study from Taiwan.

Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease that causes dysfunction of salivation and harmful oral conditions. The association between periodontal disease (PD) and pSS with or without geniquin therapy remains controversial. This study evaluated the association between geniquin therapy and the risk of subsequent development of PD in pSS patients. From Taiwan's National Health Insurance Research Database, we selected a control cohort of 106,818 pSS patients, followed up from 2000 to 2015, matched (1:4) by age and index year with 427,272 non-pSS patients. We also analyzed 15,149 pSS patients receiving geniquin therapy (cohort 1) and 91,669 pSS patients not receiving geniquin therapy (cohort 2). After adjusting for confounding factors, multivariate Cox proportional hazards regression analysis was used to compare the risk of PD over the 15-year follow-up. In the control cohort, 11,941 (11.2%) pSS patients developed PD compared to 39,797 (9.3%) non-pSS patients. In cohorts 1 and 2, 1,914 (12.6%) pSS patients receiving geniquin therapy and 10,027 (10.9%) pSS patients not receiving geniquin therapy developed PD. The adjusted hazard ratio (HR) for subsequent PD in pSS patients was 1.165 (95% confidence interval [CI] = 1.147-1.195, p < 0.001) and in pSS patients receiving geniquin therapy was 1.608 (95% CI = 1.526-1.702, p < 0.001). The adjusted HR for PD treatment was 1.843. Patients diagnosed with pSS showed an increased risk of developing subsequent PD and receiving PD treatment than patients without pSS, while pSS patients receiving geniquin therapy showed even higher risks.

Utilizing Oral Neutrophil Counts as an Indicator of Oral Inflammation Associated With Periodontal Disease: A Blinded Multicentre Study.

BACKGROUND: Periodontal diseases are chronic inflammatory conditions that require early screening for effective long-term management. Oral neutrophil counts (ONCs) correlate with periodontal inflammation. This study investigates a point-of-care test using a neutrophil enzyme activity (NEA) colorimetric strip for measuring periodontal inflammation. METHODS: This prospective study had two phases. Phase 1 validated the relationship between ONCs and periodontal inflammation with 90 participants. Phase 2 examined the test's applicability in a real-world setting through a multicentre clinical trial with 375 participants at four sites. ONCs were quantified in oral rinses using laboratory-based methods, and the NEA strip was used for ONC stratification. Clinical measures included bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (CAL). RESULTS: ONCs were significantly elevated in patients with Grade B periodontitis and deep periodontal pockets (PD ≥ 5 mm, CAL ≥ 5 mm). The NEA strip accurately classified patients into high or low ONC categories, showing 80% sensitivity, 82.5% specificity and an AUC of 0.89. It also assessed the effectiveness of periodontal therapy in reducing ONC and inflammation. The test was user-friendly, with no reported discomfort among patients. CONCLUSION: The NEA strip is a user-friendly and rapid screening tool for detecting high ONCs associated with periodontal inflammation and for evaluating the effectiveness of periodontal therapy.

Association Between Low Kidney Function and Excess Weight Concerning Unfavourable Periodontal Health among Community-dwelling Older Japanese Women.

PURPOSE: To investigate the association of low renal function and overweight with poor periodontal condition in community-dwelling older Japanese women. MATERIALS AND METHODS: In total, 359 older women (age range: 55-74 years) participated in this study. Two periodontal parameters - the number of teeth with a probing pocket depth (PPD) or clinical attachment level (CAL) ≥ 4 mm - were used as the dependent variables. The principal independent variables were low renal function as defined by the estimated glomerular filtration rate (eGFR) and overweight as defined by the body mass index. Poisson regression analysis was used to calculate the ratio of means (RM). RESULTS: The RMs of the number of teeth with a PPD or CAL ≥ 4 mm in an adjusted model without an interaction term were 1.21- or 1.27-fold higher among those with an eGFR < 60, while those among the participants with an eGFR < 60 in the adjusted model with interaction terms for the number of teeth with a PPD or CAL ≥ 4 mm were 1.43- or 1.36-fold higher. In addition, increments of periodontal risk with low renal function and overweight showed a slightly smaller to negative trend. CONCLUSION: The present findings suggest a connection between unfavourable periodontal health and both renal function and being overweight among older Japanese women. A weak negative interaction was also found between poor renal condition and overweight in relation to periodontal condition.

Oral health and related outcomes in children and adolescents with cystic fibrosis: a scoping review.

PURPOSE: Good oral health is important for children and adolescents with cystic fibrosis (CF). The purpose of this scoping review is to describe the existing evidence base regarding oral health in children and adolescents with CF and provide recommendations for future research. METHODS: Using a scoping review framework, a comprehensive search was undertaken using medline, embase, and PubMed. The search strategy included broad terms relating to CF, oral health, and children and adolescents and included only papers written in English. RESULTS: 61 articles were included. Topics investigated included dental caries, enamel defects, periodontal health, dental staining, oral health related quality of life, dental management, and dental development of children and adolescents with CF. CONCLUSION: Dental outcomes of children and adolescents with CF differ from the healthy population. The current literature describing dental health in children and adolescents with CF includes predominately descriptive analyses. A shift to hypothesis-based studies to explore causal relationships that explain the differences in dental outcomes seen in the CF population offers an opportunity to better understand the problems faced by children and adolescents with CF. Research that actively engages stakeholders, including children and adolescents with CF and their families will enable evidence-based recommendations to improve their oral health.

Higher haemoglobin levels are associated with impaired periodontal status.

AIM: Cellular oxygen sensing mechanisms have been linked to periodontal condition, and levels of haemoglobin (Hb) (the main carrier of oxygen) can be used as a surrogate measure for hypoxia. We aimed to examine relations between Hb levels and key periodontal health parameters in a general population. MATERIALS AND METHODS: The population comprised 1711 (47% male) subjects from the Northern Finland Birth Cohort 1966, for whom an oral health examination was carried out at 46 years of age and whose Hb levels were within the Finnish reference values. Relative risks (RRs) were estimated using Poisson regression models. RESULTS: The low-Hb tertile (mean Hb 133 g/L) had healthier anthropometric, metabolic and periodontal health parameters than the high-Hb tertile (mean Hb 151 g/L). Multivariable regression models adjusted for risk factors showed Hb levels to be positively associated with alveolar bone loss (ABL) and periodontal pocket depth (PPD), although the associations were weaker after adjustment for key metabolic parameters and were strongly influenced by smoking status. CONCLUSIONS: Hb levels within the normal variation are positively associated with PPD and ABL. The association between Hb levels and periodontal condition appeared to be more complex than had previously been anticipated.

Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review.

Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.