Association of periodontal disease treatment with mortality in patients with dementia: a population-based retrospective cohort study (2002-2018).

Dementia is one of the leading causes of death worldwide. In this study, we analyzed the association of periodontal treatment with the risk of death in patients with dementia. The analyzed data were obtained by linking the National Health Insurance Corporation claims data between 2002 and 2018 to the Statistics Korea death registry. In total, 1,131,406 patients with dementia aged ≥ 65 years had undergone dental treatment during the study period. Time-dependent Cox proportional hazards model was performed. The mortality rate was approximately 10% among the patients with dementia. The 17-years cumulative survival rates for patients who received periodontal treatment and their untreated counterparts were 83.5% and 71.5%, respectively. The crude hazard ratio of the periodontal group was approximately twice as high as that of the non-periodontal group (1.99; P < 0.001). Furthermore, in the regression model that was adjusted for socio-demographic variables and systematic chronic diseases, the risk of death in the non-periodontal group was approximately 1.83 times higher than that of the periodontal group (P < 0.00). These findings suggest that preventive periodontal treatment may decrease mortality risk in older people with dementia.

Vitamin intake and periodontal disease: a meta-analysis of observational studies.

OBJECTIVE: A meta-analysis was performed to assess the epidemiological correlation between dietary intake of various types of vitamin intake and the risk of periodontal disease. METHODS: A comprehensive computerized search was conducted in eight databases, namely PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine Disc, CNKI, VIP, and WanFang Database, and a random effect model was applied to combine pooled odds ratio (ORs) with corresponding 95% confidence intervals (CIs) of the included studies, and the sensitivity analysis was performed to explore the impact of a single study on the comprehensive results. RESULTS: We finally included 45 effect groups from 23 observational studies, with a total number of study participants of 74,488. The results showed that higher levels of vitamin A (OR: 0.788, 95% CI: 0.640-0.971), vitamin B complex (OR: 0.884, 95% CI: 0.824-0.948), vitamin C (OR: 0.875, 95% CI: 0.775-0.988), vitamin D (OR: 0.964, 95% CI: 0.948-0.981), and vitamin E (OR: 0.868, 95% CI: 0.776-0.971) intake all were negatively correlated with periodontal disease. After removing each study, leave-one-out sensitivity analysis indicated no significant change in the overall results of any of the five meta-analyses. CONCLUSIONS: The results from this meta-analysis demonstrated a negative association between high-dose vitamin A, vitamin B complex, vitamin C, vitamin D, and vitamin E consumption and the likelihood of developing periodontal disease, revealing the significant role of vitamins in preventing periodontal disease.

Medicinal herbs, especially Hibiscus sabdariffa, inhibit oral pathogenic bacteria.

OBJECTIVES: Medicinal herbs are plants with potential medicinal and health benefits. In recent years, they are being increasingly used as a treatment alternative owing to their effectiveness against various diseases. In this study, we investigated the inhibitory effects of 15 medicinal herbs on causative bacteria for dental caries and periodontal disease. METHODS: This study evaluated the effects of the extracts of 15 medicinal herbs on growth and biofilm formation in five oral pathogenic bacterial strains. The herbs were processed into extracts, and bacterial strains were cultured. Then, bacterial growth and biofilm formation were assessed using various methods. Finally, the extract of the herb Hibiscus sabdariffa (hibiscus) was analyzed using high-performance liquid chromatography. RESULTS: Incubation of bacteria with the herbal extracts showed that hibiscus exerted a significant inhibitory effect on all the oral pathogenic bacterial strains evaluated in this study. In addition, the pigment delphinidin-3-sambubioside, which is found in hibiscus extract, was identified as a particularly important inhibitory component. CONCLUSIONS: These results lay the ground work for the potential development of novel therapeutic or preventive agents against dental caries and periodontal disease, two major oral diseases.

Hyperbaric oxygen therapy as an adjunct treatment of periodontitis, MRONJ, and ONJ: a systematic literature review.

OBJECTIVE: To review the available prospective literature on hyperbaric oxygen (HBO) therapy for periodontal conditions. MATERIALS AND METHODS: A comprehensive electronic and manual search was performed to identify clinical studies on adult patients who underwent hyperbaric oxygen therapy for periodontal treatments. A systematic literature search was conducted in PubMed, Cochrane, and Dentistry Oral Sciences Source databases. RESULTS: Fourteen articles were included in the final literature review, of which five were RCTs and 11 were prospective clinical studies. Four studies discussed HBO as an adjunct to nonsurgical treatment of periodontitis, eight reported on HBO and osteoradionecrosis, and one examined HBO in bisphosphonate-related necrosis of the jaws. CONCLUSIONS: HBO has shown superior efficacy compared to antibiotics as a prophylactic measure in preventing osteoradionecrosis (ORN) in patients with a history of high mandibular irradiation. Clinicians should consider referring such patients for HBO therapy before and after tooth extractions. However, for the surgical excision of existing ORN lesions, HBO therapy does not yield significant benefits but does not negatively impact outcomes either. Regarding the treatment of periodontitis patients, the variability among studies prevents definitive conclusions. HBO therapy as an adjunct to SRP in periodontitis treatment produces mixed results. CLINICAL RELEVANCE: This study's clinical relevance lies in its exploration of the potential benefits of HBO for periodontal conditions. Also, it provides clinicians with insights into when and how to integrate HBO therapy into their treatment approaches, particularly for patients with a history of irradiation and those undergoing complex dental procedures.

Plant-derived galactolipids enhance specific antibody production and induce class-switch as vaccine adjuvant.

Various plant-derived compounds can activate immune responses against bacterial infections, and this property contributes to them being developed as effective and safe adjuvants for vaccines. This study evaluated the potential adjuvant effects of a galactolipid-enriched fraction generated from the medicinal plant Crassocephalum rabens (designated CRA). Heat shock protein 60 of periodontal disease pathogen Actinobacillus actinomycetemcomitans (AaHSP60) was taken as an antigen and mixed with CRA. The AaHSP60/CRA mixture was then injected intraperitoneally into the BALB/c mice. Titers and affinity of specific antibodies were measured by ELISA. Cytokine profiles in mouse serum or culture media of AaHSP60/CRA-treated splenocytes were analyzed by cytokine multiplex assay and ELISA kits. B cell differentiation and macrophage activation were determined by phenotyping. CRA dramatically enhanced specific antibody titers and induced Ig class switch, as shown by increases in the IgG2a, IgG2b, and IgG3 proportions of total Ig in mouse serum. Furthermore, CRA-induced anti-AaHSP60 antibodies had cross-reactivity to other bacterial HSP60s. Cell-based and animal results demonstrated that CRA induced the release of IL-21 and B cell activating factor (BAFF), which stimulated B cell differentiation. CRA enhanced cell proliferation, uptake ability, and antigen presentation in mouse phagocytes. CRA served as a vaccine adjuvant that enhance mouse immunity against pathogenic antigens. CRA strengthened the activation and capabilities of phagocytes and B cells. Therefore, CRA may be a promising adjuvant for bacterial vaccines including periodontal disease.

Occurrence of Luteolin in the Greek Flora, Isolation of Luteolin and Its Action for the Treatment of Periodontal Diseases.

Higher plants possess the ability to synthesize a great number of compounds with many different functions, known as secondary metabolites. Polyphenols, a class of flavonoids, are secondary metabolites that play a crucial role in plant adaptation to both biotic and abiotic environments, including UV radiation, high light intensity, low/high temperatures, and attacks from pathogens, among others. One of the compounds that has received great attention over the last few years is luteolin. The objective of the current paper is to review the extraction and detection methods of luteolin in plants of the Greek flora, as well as their luteolin content. Furthermore, plant species, crop management and environmental factors can affect luteolin content and/or its derivatives. Luteolin exhibits various biological activities, such as cytotoxic, anti-inflammatory, antioxidant and antibacterial ones. As a result, luteolin has been employed as a bioactive molecule in numerous applications within the food industry and the biomedical field. Among the different available options for managing periodontitis, dental care products containing herbal compounds have been in the spotlight owing to the beneficial pharmacological properties of the bioactive ingredients. In this context, luteolin's anti-inflammatory activity has been harnessed to combat periodontal disease and promote the restoration of damaged bone tissue.

The mechanism of the Shuang Bai Su Qing recipe in treating periodontitis based on network pharmacology and molecular docking technology.

AIM: To explore the material basis of action of the Shuang Bai Su Qing recipe in the treatment of periodontitis using network pharmacology. METHODS: Using TCMSP, we screened the chemical components of 5 drugs. The components were input into the UniProt and PubChem databases to obtain target proteins; Genecards, Online Mendelian Inheritance in Man (OMIM), and CEO databases were used to screen target proteins for periodontal disease. The targets were imported into the Cytoscape software to obtain intersecting targets, and conduct visual analysis to build the PPI network. The intersecting targets were then input into the Matescape database and subjected to biological process (BP) analysis, molecular function (MF) analysis, cell component (CC) analysis, and KEGG enrichment analysis. RESULTS: Twenty-seven TCM chemical components were obtained, with 198 target proteins associated with drugs and 2587 target proteins for periodontitis. Ten core targets were identified. Gene Ontology (GO) functional enrichment analysis yielded results for 20 BP, 11 MF, and 10 CC. KEGG analysis revealed that the main mechanisms of action were related to MAPK signaling pathway. Molecular docking results showed that luteolin strongly bind to TNF, IL6, and IL1B target proteins. CONCLUSION: The mechanism underlying the treatment of periodontitis with the recipe formula may be closely related to multiple targets in the MAPK signaling pathway.

Knowledge and Practice Behaviours of Obstetricians/Gynecologists and Midwives Concerning Periodontal Health and Pregnancy.

PURPOSE: The purpose of the present study was to evaluate the level of knowledge of prenatal health professionals concerning the relationship between periodontal diseases and pregnancy complications, as well as their professional implications in the oral health field. MATERIALS AND METHODS: A questionnaire was distributed to obstetricians/gynecologists, interns specialised in obstetrics/gynecology, midwives, and student midwives at Loire Atlantique and Vendée hospitals (France). The questionnaire included 5 sociodemographic questions and 14 questions regarding the level of knowledge about the relationship between periodontal diseases and pregnancy complications as well as the professionals' level of involvement in oral health care. RESULTS: Twenty-three obstetricians/gynecologists and 55 midwives responded to the questionnaire. Preterm delivery and chorioamnionitis were the most frequently mentioned complications of pregnancy, whereas the risk of pre-eclampsia was rarely mentioned. Half of the professionals said they were aware of the oral manifestations of pregnancy. Gingivitis and an increased risk of caries were the most frequently mentioned items, whereas epulis was the least frequently mentioned item. The level of involvement of prenatal care practitioners in oral health care was limited due to a lack of competence and time. Nevertheless, 64% of the participants discussed the risks of poor oral hygiene with their patients. CONCLUSION: There is good knowledge among French gynecologists/obstetricians and midwives regarding the oral manifestations of pregnancy. However, there is still a lack of knowledge concerning the links between periodontal diseases and pregnancy complications. The involvement and behaviour of pregnancy professionals in the oral health field is inadequate. The present survey highlights the need to improve the initial and continuing education of obstetricians and midwives on this topic.

The combined orthodontic and restorative treatment for patients with malocclusion and dentition defects: A randomized controlled trial.

BACKGROUND: To explore the effects of a combined orthodontic and restorative approach on chewing, swallowing, and language function in patients with malocclusion and dental defects. METHODS: A total of 112 patients with malocclusion and dentition defects admitted to the Lianyungang Hospital of Traditional Chinese Medicine from June 2019 to June 2022 were prospectively selected. The patients were divided into study and control groups using a simple random number table method, with 56 patients in each group. The control group received routine restoration, whereas the study group received a combination of orthodontic and restorative treatments. The chewing function, swallowing and language function, and gingival periodontal condition before and after treatment in both groups were compared using t-test or Wilcoxon test, while treatment satisfaction were compared using chi-square test or Fisher exact test. RESULTS: After treatment, maximum area frame bite force/max movie force in both groups increased compared to before treatment, while occlusion time, bite force distrbution balance, and standard deviation hue decreased compared to before treatment. Moreover, maximum area frame bite force/max movie force in the study group was higher than that in the control group, whereas occlusion time, bite force distrbution balance, and standard deviation hue were lower than those in the control group (P < .05). The swallowing and language function scores of the study group were higher than those of the control group (P < .05). After treatment, the bleeding index, plaque index, and probing depth of both groups decreased compared to before treatment, and the study group was lower than the control group (P < .05). The treatment satisfaction of the study group (94.64%) was higher than that of the control group (82.14%) (P < .05). CONCLUSION: Adopting a combined orthodontic and restorative approach to intervene in patients with malocclusion and dentition defects is beneficial for improving their periodontal condition, effectively restoring chewing, swallowing, and language functions, and achieving high patient satisfaction.

Aging and Oral Health: Biological and Sociobehavioral Perspectives.

As the life expectancy and growth of the aging population increase globally, efforts to promote healthy longevity become more important. Holistic policy guidelines and actions have been designed to advocate and fortify healthy aging at multiple levels. Oral health, a fundamental contributor of overall health and well-being, forms a core part of the noncommunicable disease agenda within the sustainable development goals set by the World Health Organization. Aging significantly heightens the risk of myriad oral disorders and other noncommunicable diseases. As of 2019, oral disorders accounted for 8.9 million disability-adjusted life-years in individuals older than 60 y. In addition to the development of multidisciplinary aging-friendly policies to promote healthy aging, basic biology and translational research has been encouraged that focuses on deciphering the underlying mechanisms involved in age-related physical and cognitive decline or dysregulation of oral tissues. Given the relevance of oral health aging as a critical component of the One Health Initiative, this special issue encompasses a collection of articles dedicated to recent advances in the behavioral and social implications of age-related oral diseases and tooth loss on several aspects of the quality of life of adults as they age. Furthermore, it includes articles detailing molecular mechanisms associated with cellular aging and their implications for oral tissue health, periodontal disease severity, and the regenerative potential of stem cells.

Dietary omega-3 fatty acids in the management of feline periodontal disease: What is the evidence?

Periodontal disease is an oral disorder with high prevalence in cats from 2 years of age, resulting from an inflammatory response against bacterial plaque. Treatment depends on the stage of the disease and may include dental scaling, local application of perioceutics, tissue regeneration and/or even tooth extraction and periodontal surgery. As multimodal therapy is often required, new strategies have been developed to improve the therapeutic response in these patients. Adjuvant use of omega-3 fatty acids has been reported in humans with periodontal disease, but the current evidence of its effect in companion animals, especially cats, is still considered to be scarce and conflicting. This review describes the state of the art regarding feline periodontal disease and seeks to clarify the potential effect of omega-3 fatty acids on its clinical management in light of the evidence available in the current literature.

Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis.

BACKGROUND: There are differences in vitamin D levels between periodontitis and healthy individuals, but the effect of vitamin D on periodontitis is controversial. The purpose of this Meta-analysis is twofold: (1) compare vitamin D levels in individuals with or without periodontitis; (2) assess the effects of vitamin D supplementation during scaling and root planing (SRP) on periodontal clinical parameters in individuals with periodontitis. METHODS: A systematic search was conducted in five databases (PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library), published from the database inception to 12 September 2022. The Cochrane Collaboration Risk of bias (ROB) assessment tool, the risk of bias in non-randomized studies of intervention (ROBINS-I) tool, the Newcastle-Ottawa Quality Assessment Scale (NOS), and Agency for Healthcare Quality and Research (AHRQ) were used to evaluate randomized controlled trial (RCT), non-RCT, case-control study, and cross-sectional study, respectively. Statistical analysis was performed using RevMan 5.3 and Stata 14.0 software, with weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence intervals (CI) as the effect measures, and heterogeneity was tested by subgroup analysis, sensitivity analysis, Meta-regression. RESULTS: A total of 16 articles were included. The results of Meta-analysis showed that periodontitis was associated with lower serum vitamin D levels compared to normal population (SMD = -0.88, 95%CI -1.75 ~ -0.01, P = 0.048), while there was no significant difference in serum or saliva 25(OH)D levels between periodontitis and normal population. Additionally, the Meta-analysis showed that SRP + vitamin D and SRP alone had a statistically significant effect on serum vitamin D levels in individuals with periodontitis (SMD = 23.67, 95%CI 8.05 ~ 32.29, P = 0.003; SMD = 1.57, 95%CI 1.08 ~ 2.06, P < 0.01). And SRP + vitamin D could significantly reduce clinical attachment level compared to SRP alone (WMD = -0.13, 95%CI -0.19 ~ -0.06, P < 0.01), but had no meaningful effect on probing depth, gingival index, bleeding index, respectively. CONCLUSION: The evidence from this Meta-analysis suggests that the serum vitamin D concentration of individuals with periodontitis is lower than that of normal people, and SRP along with vitamin D supplementation has been shown to play a significant role in improving periodontal clinical parameters. Therefore, vitamin D supplementation as an adjuvant to nonsurgical periodontal therapy has a positive impact on the prevention and treatment of periodontal disease in clinical practice.

Effect of photobiomodulation adjunct to periodontal therapy on individuals with type 2 diabetes mellitus regarding periodontal clinical parameters: a systematic review and meta-analysis.

The purpose of this study is to evaluate the scientific evidence on the impact of photobiomodulation adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus (T2DM). The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. A protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO #CRD42022310756). The research was carried out in seven databases, with no restrictions regarding the year of publication. Our work included studies that compared periodontal clinical parameters among individuals undergoing non-surgical periodontal therapy associated with photobiomodulation and a control group of individuals undergoing non-surgical periodontal treatment. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and a 95% confidence interval (CI) were provided. Three hundred forty-one studies were identified, of which eight studies were included. The meta-analysis demonstrated that photobiomodulation adjunctive to periodontal therapy in individuals with diabetes resulted in a greater reduction in probing depth and greater attachment gain in comparison to periodontal treatment alone (p < 0.05). The included studies exhibited a low risk of bias. Photobiomodulation adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameters in individuals with T2DM.

Antibiotic Resistance among Fusobacterium, Capnocytophaga, and Leptotrichia Species of the Oral Cavity.

PURPOSE: Antibiotics play an important role in treating periodontal diseases. Due to the effectiveness of antibiotic therapies, their usage in dentistry has significantly increased. The aim of this study focused on the in-vitro susceptibility of different gram-negative oral bacteria species - which are associated with periodontal diseases (Fusobacterium spp., Capnocytophaga spp. and Leptotrichia buccalis) and have different geographical origins (Asia and Europe) - against antimicrobials that are clinically relevant in dental therapy. MATERIALS AND METHODS: A total of 45 strains were tested (29 Fusobacterium spp., 13 Capnocytophaga spp. and 3 L. buccalis) that were either isolated from Chinese patients or were obtained from different strain collections. Their antimicrobial susceptibility to the antimicrobial agents benzylpenicillin, amoxicillin, amoxicillin-clavulanic acid, ciprofloxacin, moxifloxacin, clindamycin, doxycycline, tetracycline and metronidazole was tested using the E-Test. Strains with particular resistance to penicillin, clindamycin and metronidazole were further analysed for resistance genes. RESULTS: All tested bacterial isolates were sensitive to amoxicillin, amoxicillin-clavulanic acid, doxycycline and tetracycline, but showed variable sensitivity towards other antibiotics such as benzylpenicillin, ciprofloxacin, moxifloxacin, clindamycin and metronidazole. CONCLUSION: The results of the present study suggest that certain periodontal disease-related bacterial strains can be resistant towards antimicrobial agents commonly used in adjuvant periodontal therapy.

Potential Oral Health Benefits of Ginseng and Its Extracts.

This review discusses the effects of ginseng and its extracts in the treatment of dental caries, periodontal diseases, endodontic diseases, oral cancers, oral mucosal diseases, and some other dental associations. In the meantime, bioavailability and safety application of ginseng products are discussed. All of the articles reviewed were from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and VIP Chinese Science and Technology Periodicals Full-Text Database through November 2022, including full-text English or non-English publications. Ginseng and its extracts were shown to have beneficial effects on oral diseases, and further studies are needed to understand the mechanisms and confirm the effects in humans.

Camellia sinensis, a natural product to support the treatment of medical and stomatological conditions / Camellia sinensis, un producto natural de apoyo al tratamiento de afecciones médicas y estomatológicas - revisión sistemática

Introduction: The tea plant, Camellia sinensis, is one of the most popular non-alcoholic beverages in the world. The main components of Camellia sinensis include amino acids, fatty acids, phenolic compounds, flavins and purine alkaloids (xanthines). For this reason, in the field of medicine, Camellia sinensis has been used as an anticancer, anxiolytic, antidiabetic, antiobesity, anti-inflammatory, analgesic, antipyretic, chemopreventive, cytotoxic and apoptogenic, genoprotective, hepatoprotective, nephroprotective, hemato-protective, and in wound healing, among other uses. Objective: To carry out a systematic review of the use of C. sinensis as supportive therapy in the treatment of oral disorders. Materials and Methods: This systematic review was carried out following the PRISMA guidelines. The search was carried out in the PubMed, ScienceDirect and Google Academic databases. Articles from studies of Camellia sinensis were reviewed and those from a secondary source, such as literature review articles, were excluded Results: A total of 12 full-text articles were selected for review, in which the properties of Camellia sinensis are detailed. Conclusions: According to the bibliography reviewed, C. sinensis exhibits anticariogenic properties, applications in the treatment of dental erosion, applications in the treatment of gingivitis and bacterial plaque, and applications in the prevention of oral cancer; however, more controlled clinical trials are needed to confirm its effectiveness and safety of use.

Introducción: La planta del té es una de las bebidas no alcohólicas más populares en todo el mundo. Entre los principales componentes de Camellia sinensis tenemos los aminoácidos, ácidos grasos, compuestos fenólicos, flavinas y alcaloides de purina (xantinas). Por ello en medicina, la Camellia sinensis se ha utilizado como anticancerígeno, ansiolítico, antidiabético, antiobesidad, antiinflamatorio, analgésico, antipirético, quimiopreventivo, citotóxico y apoptógeno, genoprotector, hepatoprotector, nefroprotector, hematoprotector, cicatrizantes de heridas, entre otros. Objetivo: Realizar una revisión sistemática del uso de C. sinensis como apoyo en el tratamiento de afecciones bucales. Materiales y Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed, Science Direct y Google Academic. Se revisaron los artículos de estudios de Camellia sinensis y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura. Resultados: Se seleccionaron un total de 12 artículos de texto completo para la revisión. En los que se detalla las propiedades de la Camellia sinensis. Conclusión: De acuerdo a la bibliografía revisada, la C. sinensis exhibió efecto anticariogénico, aplicación en el tratamiento de la erosión dental, aplicación en el tratamiento de gingivitis y placa bacteriana, y aplicación en la prevención del cáncer bucal, sin embargo, se necesitan realizar más ensayos clínicos controlados que confirmen su efectividad y seguridad de uso.

Polyunsaturated Fatty Acids and Their Immunomodulatory Actions in Periodontal Disease.

Polyunsaturated fatty acids (PUFAs) are a diverse set of molecules with remarkable contributions to human physiology. They not only serve as sources of fuel but also cellular structural components as well as substrates that provide bioactive metabolites. A growing body of evidence demonstrates their role in inflammation. Inflammation in the presence of a polymicrobial biofilm contributes to the pathology of periodontitis. The role PUFAs in modulating immuno-inflammatory reactions in periodontitis is only beginning to be uncovered as research continues to unravel their far-reaching immunologic implications.

Periodontal disease severity is associated to pathogenic consortia comprising putative and candidate periodontal pathogens.

BACKGROUND: Based on a holistic concept of polymicrobial etiology, we have hypothesized that putative and candidate periodontal pathogens are more frequently detected in consortia than alone in advanced forms of periodontal diseases (PD). OBJECTIVE: To correlate specific consortia of periodontal pathogens with clinical periodontal status and severity of periodontitis. METHODOLOGY: Subgingival biofilm was obtained from individuals with periodontal health (113, PH), gingivitis (91, G), and periodontitis (209, P). Genomic DNA was purified and the species Aggregatibacter actinomycetemcomitans (Aa), Aa JP2-like strain, Porphyromonas gingivalis (Pg), Dialister pneumosintes (Dp), and Filifactor alocis (Fa) were detected by PCR. Configural frequency and logistic regression analyses were performed to correlate microbial consortia and PD. RESULTS: Aa + Pg in the presence of Dp (phi=0.240; χ2=11.9, p<0.01), as well as Aa JP2 + Dp + Fa (phi=0.186, χ2=4.6, p<0.05) were significantly more associated in advanced stages of P. The consortium Aa + Fa + Dp was strongly associated with deep pocketing and inflammation (p<0.001). The best predictors of disease severity (80% accuracy) included older age (OR 1.11 [95% CI 1.07 - 1.15], p<0.001), Black/African-American ancestry (OR 1.89 [95% CI 1.19 - 2.99], p=0.007), and high frequency of Aa + Pg + Dp (OR 3.04 [95% CI 1.49 - 6.22], p=0.002). CONCLUSION: Specific microbial consortia of putative and novel periodontal pathogens, associated with demographic parameters, correlate with severe periodontitis, supporting the multifactorial nature of PD.

Efeitos clínicos da fotobiomodulação como terapia adjuvante não-cirúrgica na periodontite crônica: uma revisão integrativa da literatura / Clinical effects of photobiomodulation as non-surgical adjuvant therapy for chronic periodontitis: an integrative literature review

Introdução: A doença periodontal, de origem infecciosa, constitui diferentes quadros clínicos de caráter multifatorial e inflamatório. A fotobiomodulação é uma técnica não invasiva que tem demonstrado ser capaz de diminuir a inflamação e proporcionar alívio da dor. Estudos também demonstraram que a adoção da fotobiomodulação adjuvante à raspagem e alisamento radicular tem sido capaz de reduzir a carga bacteriana proveniente da periodontite crônica. Objetivos: Analisar os efeitos da fotobiomodulação como terapia adjuvante à raspagem e ao alisamento radicular no tratamento da periodontite crônica publicados nos últimos cinco anos. Métodos: Trata-se de uma revisão integrativa da literatura, realizada no período de setembro a novembro de 2021, mediante a utilização dos seguintes descritores: "Periodontitis", "Photobiomodulation" e "Therapy, selecionando artigos publicados em inglês durante o período entre 2016 a 2021. Resultados: Foram identificados 47 trabalhos. Destes, foram excluídos 39 estudos que se dispersaram do tema e 2 que se encontravam indisponíveis para o acesso, resultando em 6 artigos que foram consultados integralmente. Foi consenso entre os artigos consultados que a prática da fotobiomodulação tornou-se um potencial agente terapêutico no tratamento da periodontite crônica contribuindo para a redução da contagem de periodontopatógenos e que atua de maneira coadjuvante às raspagens radiculares. Conclusão: A fotobiomodulação mostrou-se uma ferramenta promissora na área odontológica. Entretanto, a grande variedade nos parâmetros de tratamentos e protocolos utilizados na fotobiomodulação impossibilita uma comparação e uma análise mais crítica e rigorosa dos resultados obtidos nos trabalhos analisados.

Introduction: Periodontal disease, which has an infectious origin, constitutes a multifactorial and inflammatory different clinical condition of multifactorial, inflammatory, and infectious origin. Photobiomodulation is a non-invasive technique that has been shown to decrease inflammation and provide pain relief. Studies also have shown that the choosing of photobiomodulation as adjuvant therapy to scaling and root planing has been able to reduce the bacterial load from chronic periodontitis. Objectives: To analyze the effects of photobiomodulation as an adjuvant therapy to scaling and root planing in the treatment of chronic periodontitis in the studies published in the last five years. Methods: This is an integrative literature review, carried out from September to November 2021, using the following descriptors: "Periodontitis", "Photobiomodulation" and "Therapy, from selected articles published in English during the period between 2016 to 2021. Results: From the research and selection of studies to compose this integrative literature review, 47 studies were initially identified based on the descriptors. From those, 39 papers that were outside from the topic and 2 papers that were unavailable for access were excluded from the present review. Then remained, 6 articles that were fully consulted. The practice of photobiomodulation has become a potential therapeutic agent in the treatment of chronic periodontitis reducing the count of periodontopathogens and as an adjunct therapy to root scaling. Conclusion: Photobiomodulation therapy has become a promising tool in the dental field, however, the great variety in the treatment parameters and protocols used for photobiomodulation makes impossible to compare and perform a more critical and rigorous analysis of the results collected in the present work.

Psychological stress: neuroimmune roles in periodontal disease.

Periodontitis is a chronic inflammatory disease that starts with pathogenic bacteria and is mediated by a combination of multiple factors. Psychosomatic factors are considered to be one of the most critical risk factors for periodontal disease. Psychological stress may threaten periodontal immune homeostasis in multiple ways by affecting the hypothalamic-pituitary-adrenal cortex system, the locus ceruleus-sympathetic-adrenal medulla system, and the peptidergic nervous system. In this review, we outline the complex role of psychological stress in promoting the development of periodontal disease, focusing on the effects of stress on flora metabolism, tissue inflammation, and alveolar bone homeostasis. At the same time, we broadly and deeply summarize the potential mechanisms of psychological stress-induced periodontal disease, emphasize the importance of neuroimmune modulation for periodontal health, and expect to provide a new perspective for periodontal science based on psychoneuroimmunology.