Association between breastfeeding and periodontitis in Korean women using Korea National Health and Nutrition Examination Survey (KNHANES): a cross-sectional study.

OBJECTIVES: The effect of breastfeeding on periodontal disease in women remains unclear. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey to explore the association between breastfeeding and periodontitis in Korean women using data from the Korean National Health and Nutrition Examination Survey (KNHANES VII). MATERIALS AND METHODS: Cross-sectional data was analyzed from the KNHANES 2016-2018. The study population included 5,587 parous women aged ≥ 30 years. The outcome variable was the presence or absence of periodontitis. The explanatory variable, period of breastfeeding, was defined as "none", "1-11 months", and "more than 12 months". Confounder variables (socio-educational, personal healthcare practice, and systemic medical characteristics) were adjusted for in the logistic regression analysis. RESULTS: Approximately 60% of the participants breastfed for ≥ 12 months. In all statistical models, the prevalence of periodontitis was approximately 60% greater in women that did not breastfeed compared to women that had breastfed for 12 months or longer. When adjusted for age, statistical significance was only present in the 50-59 years age group (adjusted odds ratio [aOR], 1.678; 95% confidence interval [CIs], 1.046-2.691). CONCLUSION: Our study shows that women that breastfed for a relatively long duration had a lower risk of periodontitis. Therefore, breastfeeding may be beneficial for women's periodontal health. These results are expected to be helpful in oral health education for pregnant women.

S100A8 and S100A9 in saliva, blood and gingival crevicular fluid for screening established periodontitis: a cross-sectional study.

BACKGROUND: Periodontitis is one of major oral diseases, which has no consensus on early screening tool. This study aimed to compare the association and screening ability of S100A8 and S100A9 in saliva, blood and gingival crevicular fluid (GCF) for periodontitis status. METHODS: We recruited 149 community Korean adults, 50 no or initial periodontitis (NIPERIO) and 99 established periodontitis (PERIO). Using clinical attachment loss and a panoramic radiograph, stage II-IV of new classification of periodontitis proposed at 2018 was considered cases as PERIO. Enzyme linked immunosorbent assay kit was used to quantify S100A8 and S100A9. T-test, analysis of covariance, Mann-Whitney test and correlation analysis were applied to compare the relationship of S100A8 and S100A9 in saliva, blood, and GCF for periodontitis. Receiver operating characteristic curve was applied for screening ability. RESULTS: Among S100A8 and S100A9 in saliva, blood and GCF, S100A8 in saliva was significantly higher in PERIO than in NIPERIO (p < 0.05). However, S100A8 and S100A9 in GCF were higher in NIPERIO (p < 0.05). The screening ability of salivary S100A8 was 75% for PERIO, while that of GCF S100A8 was 74% for NIPERIO. Salivary S100A8 was positively correlated to blood S100A8 (p < 0.05). CONCLUSION: Salivary S100A8 could be a potential diagnostic marker for established periodontitis and be useful for screening established periodontitis.

Diagnostic and Prognostic ability of salivary MMP-9 and S100A8 for periodontitis.

OBJECTIVES: Salivary diagnostic using matrix metalloproteinase (MMP) and S100 for periodontitis is a promising issue. However, its prognostic effect is still unclear. This study aimed to evaluate the prognostic ability of salivary MMP-9 and S100A8 for periodontitis through non-surgical periodontitis treatment clinical trial. MATERIALS AND METHODS: Total 149 participants, 99 periodontitis and 50 healthy, were recruited. Among 99 non-surgical periodontitis treatment participants, 74 participants were revisited after three months. Periodontitis was classified as stage II-IV of new classification of periodontitis proposed at 2018. Enzyme-linked immunosorbent assay kit was used to quantify salivary MMP-9 and S100A8. Receiver operating characteristic curve was applied for diagnostic ability. Paired t test was applied for prognostic ability evaluating changes in salivary markers between pre- and post-treatment. RESULTS: Salivary MMP-9 and S100A8 were associated with periodontitis (p < .05). The screening ability of algorithm using salivary MMP-9 and S100A8 for periodontitis was 0.86 (p < .05). After treatment, reduction rate of salivary S100A8 and MMP-9 was 83.7% and 23.5%, respectively, (p < .05): only salivary S100A8 was superior compared to clinical parameters. CONCLUSION: Algorithm using salivary MMP-9 and S100A8 showed high diagnostic power for periodontitis. Both salivary S100A8 and MMP-9 showed prognostic ability for periodontitis, but S100A8 was better.

Diagnostic ability of salivary matrix metalloproteinase-9 lateral flow test point-of-care test for periodontitis.

AIM: This cross-sectional study aimed to examine the diagnostic ability of salivary matrix metalloproteinase (MMP)-9 lateral flow test (LFT) point-of-care (POC) kit and develop an algorithm for diagnosis of periodontitis. MATERIALS AND METHODS: Through Seoul National Dental Hospital, 137 participants (46 LFT negatives, 91 LFT positives) were recruited. For salivary diagnostics, 150 µl of the unstimulated saliva was applied to LFT-POC kit. To make a diagnosis of periodontitis, stage II-IV in modified new international classification system was used. Covariates encompassing age, sex, smoking and obesity were evaluated through face-to-face interview. Enzyme-linked immunosorbent assay was used for quantification of salivary MMP-9. To develop a diagnostic algorithm, multivariable logistic regression analysis was used. Receiver operating characteristic curve was applied for evaluating diagnostic ability. RESULTS: Diagnostic ability of salivary MMP-9 LFT-POC test was 0.82 (sensitivity of 0.92, specificity of 0.72) in total participants. Diagnostic algorithm using POC test resulted in a response equation, that is algorithm score = -3.675 + 2.877*LFT + 0.034*age + 0.121*sex + 0.372*smoking + 0.192*obesity. Diagnostic ability of the algorithm was 0.88 (sensitivity of 0.92, specificity of 0.85) with cut-off score of 0.589. CONCLUSIONS: Salivary MMP-9 LFT-POC kit showed appropriate diagnostic ability for periodontitis and would be an efficient tool for screening of periodontitis.

Chronic periodontitis and community-acquired pneumonia: a population-based cohort study.

BACKGROUND: This study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database. METHODS: Data from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates. RESULTS: A total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models. CONCLUSION: The results of this study show that CP may not be a potential risk factor for CAP.

Characteristics of Local Delivery Agents for Treating Peri-Implantitis on Dental Implant Surfaces: A Preclinical Study.

Local delivery agents (LDAs) are widely used in peri-implantitis treatments. The aim of this study was to identify LDAs remaining on the dental implant surfaces and to analyze the components of these residues after applying various cleaning methods. Implants were prepared with a sand-blasted, large-grit, acid-etched surface. Four kinds of LDAs were applied on the implant surfaces: chlorhexidine gel (group 2), tetracycline solution (group 3), and 2 kinds of minocycline hydrochloride agents (groups 4 and 5). Group 1 received normal saline as a control. Two cleaning methods were applied for different durations as follows: (1) running distilled water for 10 seconds (subgroup A), 5 minutes (subgroup B), and 15 minutes (subgroup C); and (2) water spray of a dental-unit chair for 10 seconds (subgroup D) and 5 minutes (subgroup E). Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to analyze the surface morphology and residue components for all implants. The amount of LDA removed from the implant surfaces in groups 1, 2, 3, and 5 increased with the cleaning duration and pressure. However, Minocline remained coated on the implant surfaces in group 4 under all cleaning conditions. Minocline could not be cleaned off well by water due to its hydrophobicity. Therefore, directly using this agent on implant surfaces with peri-implantitis should be carefully considered. The presence of LDA residues without drug efficacies on implant surfaces might interfere with reosseointegration and act as a reservoir of microorganisms.

The use of an interdental brush mitigates periodontal health inequalities: the Korean National Health and nutrition examination survey (KNHANES).

BACKGROUND: The purpose of this study was to evaluate the mitigating effect of the use of interdental brushes on periodontal health inequality. METHODS: This study was based on the data acquired in the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI; 2013-2015). A total of 17,583 participants (7,633 males and 9,950 females)) aged 19 years or older completed the KNHANES VI between 2013 and 2015. Multivariable logistic regression analysis was performed using socioeconomic characteristics (sex, age, level of education, individual income), personal health practice (smoking, toothbrushing, dental flossing, interdental brushing, dental clinic visiting), systematic medical factors (diabetes mellitus, hypercholesterolemia, hypertension, obesity) and the community periodontal index. We confirmed differences in the prevalence of periodontal disease with the use of an interdental brushes stratified according to individual income. RESULTS: Three logistic regression models adjusted for covariates hierarchically. In all models, individuals who used an interdental brush were not significantly different from individuals who did not use an interdental brush. The adjusted odds ratio (OR) for interdental brushing was 0.918 with a 95% confidence intervals (CIs) of 0.797-1.057. When periodontal disease was the outcome of the model, the lowest income group had 1.266 (95% CIs 1.066 to 1.502) times the odds of having periodontal disease than the highest income group. In interdental brush nonusers, the lowest income group had 1.276 (95% CI 1.061-1.533) times the odds of having periodontal diseases than the highest income group. However, in the interdental brush users, there were no significant differences in periodontal disease prevalence among income groups. CONCLUSIONS: The results suggest that the use of interdental brushes could alleviate periodontal health inequality.

Inequality in dental flossing behavior among Korean adults based on household income levels.

OBJECTIVES: The aim of this study was to estimate the association between household income and dental flossing. METHODS: This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices. RESULTS: In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27 to 2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86 to 7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05 to 2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07 to 2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24 to 2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23 to 2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10 to 2.44). CONCLUSIONS: The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.

Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015.

OBJECTIVES: Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis. METHODS: We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization's Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables. RESULTS: The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91). CONCLUSIONS: Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.

Dental service sector and patient-reported oral health outcomes: Modification by trust in dentists.

Objective: The study aimed to examine the association between patient-reported oral health outcomes and the dental service sector and trust in dentists. The possible interaction effect of trust on this association was also explored. Methods: Randomly selected adults aged over 18 years living in South Australia were surveyed using self-administered questionnaires. The outcome variables were self-rated dental health and the evaluation outcome of the Oral Health Impact Profile. The dental service sector and the Dentist Trust Scale were included in bivariate and adjusted analyses with sociodemographic covariates. Results: Data from 4,027 respondents were analyzed. Unadjusted analysis showed that poor dental health and oral health impact were associated with sociodemographic characteristics, including lower income/education, public dental service, and lower trust in dentists (p < 0.01). Adjusted associations were similarly maintained (p < 0.05) but attenuated with the loss of statistical significance, mainly in the trust tertiles. Lower trust in dentists in the private sector had an interaction effect, with a higher prevalence ratio of oral health impact (prevalence ratio = 1.51; 95% confidence interval, 1.06-2.14; p < 0.05). Conclusion: Patient-reported oral health outcomes were associated with sociodemographic characteristics, the dental service sector, and trust in dentists. Implications for public health: The inequality of oral health outcomes between dental service sectors needs to be addressed both independently and in association with covariates including socioeconomic disadvantage.

Effect of interdental cleaning devices on proximal caries.

OBJECTIVES: To estimate the association between the use of interdental cleaning devices and proximal caries experience. METHODS: This study used a cross-sectional data from the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). A total of 13 525 adults aged 19-64 years who participated in both the nutrition survey and the health examination survey were included. Data on sociodemographic factors (age and sex), socioeconomic factors (level of education and household income) and personal health practices (frequency of toothbrushing, visits to dental clinic, frequency of snacking and self-rated oral health status), and number of proximal caries were collected. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were calculated using the multivariable Poisson generalized linear model according to use of dental floss or an interdental brush. The risk of proximal caries for dental floss following the stratification of participants into various subgroups related to oral health was assessed. RESULTS: While nonflossers had 1.46 times (PR 1.46, 95% CI: 1.16-1.84) higher risk for proximal caries than flossers, the use of an interdental brush was not associated with proximal caries. In the nonflossers, the association for proximal caries was the strongest in those in their 40s (PR 2.28, 95% CI: 1.29-4.03), followed by those in their 30s (PR 1.85, 95% CI: 1.18-2.90). Although nonflossers with middle-low household income had a 59% higher risk (PR 1.59, 95% CI: 1.24-2.03) for proximal caries than those with high household income, there were no significant differences in household income in flossers. CONCLUSIONS: The findings of the study suggest that flossing at home along with toothbrushing is one of the easiest ways to prevent proximal caries. Therefore, dental floss should not be excluded from oral healthcare products.

The use of interdental cleaning devices and periodontal disease contingent on the number of remaining teeth in Korean adults.

This study aimed to investigate the effect of interdental brushes and dental floss on the prevention of periodontitis in participants with ≥ 20 or < 20 remaining teeth by using the Korea National Health and Nutrition Examination Survey 2016-2018. Data from 11,614 participants were analysed using multivariate logistic regression after adjusting for sociodemographic factors (age and sex), socioeconomic factors (level of education and individual income), oral health-related variables (daily toothbrushing), and systemic health-related variables (smoking, diabetes, and obesity). The adjusted odds ratio (AOR) showed statistically significant results for both floss (AOR, 1.41; 95% confidence interval (CI) 1.22-1.64) and interdental brushes (AOR, 1.16; 95% CI 1.01-1.34). However, no significant difference was found in the subjects with fewer than 20 teeth. The subgroup analysis showed that interdental brushes had a significant preventive effect on women who had more than 20 teeth. Among participants with fewer than 20 teeth, interdental brush users had more periodontitis in men. Regarding those with more than 20 teeth, health inequality was alleviated when floss and interdental brushes were used. The bottom line is that the effect of preventing periodontitis in interdental brushes and dental floss was more evident in participants with ≥ 20 remaining teeth rather than in participants with < 20 remaining teeth.

Correlation analysis of periodontal tissue dimensions in the esthetic zone using a non-invasive digital method.

PURPOSE: Direct intraoral scanning and superimposing methods have recently been applied to measure the dimensions of periodontal tissues. The aim of this study was to analyze various correlations between labial gingival thickness and underlying alveolar bone thickness, as well as clinical parameters among 3 tooth types (central incisors, lateral incisors, and canines) using a digital method. METHODS: In 20 periodontally healthy subjects, cone-beam computed tomography images and intraoral scanned files were obtained. Measurements of labial alveolar bone and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images. Clinical parameters including the crown width/crown length ratio, keratinized gingival width, gingival scallop, and transparency of the periodontal probe through the gingival sulcus were examined. RESULTS: Gingival thickness at the alveolar crest level was positively correlated with the thickness of the alveolar bone plate (P<0.05). The central incisors revealed a strong correlation between labial alveolar bone thickness at 1 and 2 mm, respectively, inferior to the alveolar crest and the thickness of the gingiva at the alveolar crest line (G0), whereas G0 and labial bone thickness at every level were positively correlated in the lateral incisors and canines. No significant correlations were found between clinical parameters and hard or soft tissue thickness. CONCLUSIONS: Gingival thickness at the alveolar crest level revealed a positive correlation with labial alveolar bone thickness, although this correlation at identical depth levels was not significant. Gingival thickness, at or under the alveolar crest level, was not associated with the clinical parameters of the gingival features, such as the crown form, gingival scallop, or keratinized gingival width.

Association between the Number of Prosthetic Crowns and Periodontitis: The Korea National Health and Nutrition Examination Survey (KNANES VII) from 2016-2018.

Although the presence of prosthetic restorations has been associated with plaque accumulation, gingivitis, and periodontitis, there is a lack of large epidemiological investigations providing evidence on the association of prosthetic crowns with periodontitis. This study aimed to analyze the association between the number of prosthetic crowns and the presence of periodontitis. This study was based on the Seventh Korea National Health and Nutrition Examination Survey (2016-2018). A total of 12,689 participants over the age of 19 years were surveyed. Multivariate logistic regression analyses were used to identify the association between the number of prosthetic crowns and periodontitis after adjusting for potential confounders, including demographic variables, socio-economic characteristics, oral health-related variables, and oral and systemic clinical variables. The odds ratio of periodontitis showed statistically significant differences in the anterior and posterior regions, and the prevalence of periodontal disease increased as the number of crown prostheses increased. Participants with 6-10 and 11 prosthetic crowns had 1.24 and 1.28 times higher prevalence of periodontitis, respectively, than patients with no prosthetic crown. The results of this study show that the number of prosthetic crowns present in adults is related to the prevalence of periodontitis.

Effect of Triweekly Interdental Brushing on Bleeding Reduction in Adults: A Six-Month Retrospective Study.

This study assessed the effect of triweekly interdental brushing for a period of 6 months using the bleeding on full-mouth interdental brushing (BOFIB) index. All participants answered questionnaires and were instructed to clean all interdental areas using an interdental brush at least every second day. A dentist assessed the BOFIB index of 28 participants at baseline and at 3- and 6-month follow-up visits. We stratified the participants into three groups: IB-NN, those who used the interdental brush less than three times per week both before and after this program; IB-NY, those who used the interdental brush less than three times per week before the program but at least three times per week after the program; and IB-YY, those who used it at least three times per week both before and after the program. Owing to the weekly number of interdental brushings, the IB-YY and the other two groups showed a significant difference at baseline. At the 6-month follow-up, the weekly number of interdental brushings led to a significant difference between the IB-NN and the other two groups. The BOFIB index was lower among the compliant participants than among the noncompliant participants after 3 and 6 months of triweekly interdental brushing.

Comparison of implant stability measurements between a resonance frequency analysis device and a modified damping capacity analysis device: an in vitro study.

PURPOSE: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. METHODS: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. RESULTS: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was -6.76 (-25.05 to 11.53, P<0.05). CONCLUSIONS: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

Histologic Analyses of Immediate Implant Placement in Infected and Noninfected Sockets: An Experimental Pilot Study in Beagle Dogs.

PURPOSE: To investigate the histologic differences between immediate implants placed in chronically infected sites and noninfected sites in a canine model. The histologic results of immediate implant placement also were evaluated on the basis of healing time and implant surface modification. MATERIALS AND METHODS: Chronic endodontic-periodontic combined lesions were induced on the second, third, and fourth premolars of the hemimandible in six dogs, with the contralateral teeth as controls. Implants were immediately placed following the infected and noninfected tooth extractions using implants with a machined surface, sandblasted with alumina and acid-etched surface, and chemically modified sandblasted with alumina and acid-etched with calcium solution surface. After 1 and 3 months, three dogs were euthanized and the bone-to-implant contact, bone area fraction occupied, buccal and lingual first bone-to-implant contact from the implant platform, and buccal and lingual marginal bone loss were calculated. RESULTS: On histologic evaluation, no inflammation was observed around implants placed in the infected or noninfected sockets. At 1 month, no statistically significant differences were observed between the infected and noninfected sockets in buccal marginal bone loss in the machined implant group (P = .046), lingual first bone-to-implant contact from the implant in the sandblasted with alumina and acid-etched group (P = .046), lingual marginal bone loss in the sandblasted with alumina and acid-etched implant group (P = .028), buccal first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .028), and lingual first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .046). At 3 months, no statistically significant differences were observed in parameters between the infected and noninfected sockets for three implant surfaces. Differences between the infected and noninfected sockets were observed between the machined and sandblasted with alumina and acid-etched implant at 1 month (P = .023). CONCLUSION: Immediate implant placement in an infected socket did not lead to any differences when compared with placement in a noninfected socket when sufficient healing time was provided.

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia.

OBJECTIVES: Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN: Retrospective cohort study. SETTING: Population based. PARTICIPANTS: The study population was derived from the Korean National Health Insurance Service-Health Screening Cohort. Among 262 349 participants, diagnosis of chronic periodontitis was determined during 2003-2004. MEASUREMENTS: Starting from 2005, participants were followed up for overall dementia, Alzheimer's disease, and vascular dementia until 2015. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementia according to chronic periodontitis. RESULTS: Compared with nonchronic periodontitis participants, chronic periodontitis patients had elevated risk for overall dementia (aHR = 1.06; 95% CI = 1.01-1.11) and Alzheimer's disease (aHR = 1.05; 95% CI = 1.00-1.11). There was a tendency toward increased vascular dementia risk among chronic periodontitis patients (aHR = 1.10; 95% CI = 0.98-1.22). The risk-increasing effect of chronic periodontitis on dementia tended to be stronger among participants with healthy lifestyle behaviors including never-smokers and those who exercised and did not consume alcohol. CONCLUSION: Chronic periodontitis may be associated with a higher risk of developing dementia. Future studies that investigate whether preventing chronic periodontitis may lead to reduced risk of dementia are needed.

Association between regular walking and periodontitis according to socioeconomic status: a cross-sectional study.

Physical activity reduces the risk and mortality risk of inflammatory diseases. This study aimed to examine the relationship between regular walking and periodontitis in a Korean representative sample of adults according to socioeconomic status. Data acquired by the Sixth Korea National Health and Nutrition Examination Survey in 2014 and 2015 were used. The survey was completed by 11,921 (5,175 males; 6,746 females) participants (≥19 years). Individuals without values on periodontitis were excluded, and 9,728 participants remained. Multivariable logistic regression analysis was done using socio-demographic characteristics (age, gender, income, education), oral health-related variables (flossing, interdental brushing, community periodontal index), oral and general health status and behaviour (smoking, diabetes mellitus), and regular walking. In all models, subjects who walked regularly had significantly lower risks of periodontitis. After adjusting for age, gender, income, education, smoking, diabetes mellitus, flossing, and interdental brushing, the odds ratio for periodontitis in subjects who walked regularly was 0.793 (95% Confidence interval: 0.700-0.898). Non-regular walking groups showed similar social gradients. Risk of low socioeconomic status was not significant in the regular walking group after adjusting for age, gender, income, and education. This study found that regular walking is associated to lower prevalence of periodontitis and can attenuate the relationship between periodontitis and low socioeconomic status.

Severity of dental caries and risk of coronary heart disease in middle-aged men and women: a population-based cohort study of Korean adults, 2002-2013.

We aimed to evaluate the risk of coronary heart disease (CHD) according to dental caries status in middle-aged patients using a population-based cohort database containing medical/dental claims, health examination, and death records in the Republic of Korea. A total of 234,597 patients were identified in the database who were without history of cardiovascular disease, including 104,638 patients without dental caries, 41,696 with incipient/moderate stage dental caries, and 88,262 advanced/severe dental caries. We used Cox proportional hazards model adjusted for sociodemographic, lifestyle, and medical characteristics to compute hazard ratio (HR) and 95% confidence intervals (95% CI) for CHD according to severity of dental caries. During 1,491,190 person-years of follow-up, there were a total of 6,015 CHD events. After adjustment for potential confounders, patients in the highest quartile of outpatient visits for advanced/severe stage dental caries was associated with an increase in CHD risk (HR = 1.13; 95% CI: 1.04-1.22) as compared with patients without dental caries. When the analysis was restricted to the patients with advanced/severe dental caries, dose-response relationship between number of outpatient visits for dental caries and risk of CHD was observed (Ptrend: <0.001). Prevention and control of dental caries might be worth promoting in clinical practice to prevent CHD.