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Robert J Genco - One of the best experts on this subject based on the ideXlab platform.
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Recent epidemiologic trends in Periodontitis in the USA.
Periodontology 2000, 2019Co-Authors: Paul I. Eke, Wenche S. Borgnakke, Robert J GencoAbstract:The most important development in the epidemiology of Periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of Periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of Periodontitis in US adults. This initiative first suggested new Periodontitis case definitions for surveillance in 2007 and revised them slightly in 2012. This classification is now regarded as the global standard for Periodontitis surveillance and is used worldwide. First, application of such a standard in reporting finally enables results from different researchers in different countries to be meaningfully compared. Second, this initiative tackled the concern that prior national surveys, which used partial-mouth periodontal examination protocols, grossly underestimated the prevalence of Periodontitis of potentially more than 50%. Consequently, because previous national surveys significantly underestimated the true prevalence of Periodontitis, it is not possible to extrapolate any trend in Periodontitis prevalence in the USA over time. Any difference calculated may not represent any actual change in Periodontitis prevalence, but rather is a consequence of using different periodontal examination protocols. Finally, the initiative addressed the gap in the need for state and local data on Periodontitis prevalence. Through the direct efforts of the Centers for Disease Control and Prevention and the American Academy of Periodontology initiative, full-mouth periodontal probing at six sites around all nonthird molar teeth was included in the 6 years of National Health and Nutrition Examination Surveys from 2009-2014, yielding complete data for 10 683 dentate community-dwelling US adults aged 30 to 79 years. Applying the 2012 Periodontitis case definitions to the 2009-2014 National Health and Nutrition Examination Surveys data, the Periodontitis prevalence turned out to be much greater than previously estimated, namely affecting 42.2% of the population with 7.8% of people experiencing severe Periodontitis. It was also discovered that only the moderate type of Periodontitis is driving the increase in Periodontitis prevalence with age, not the mild or the severe types whose prevalence do not increase consistently with age, but remain ~ 10%-15% in all age groups of 40 years and older. The greatest risk for having Periodontitis of any type was seen in older people, in males, in minority race/ethnic groups, in poorer and less educated groups, and especially in cigarette smokers. The Centers for Disease Control and Prevention and the American Academy of Periodontology initiative reported, for the first time, the Periodontitis prevalence estimated at both local and state levels, in addition to the national level. Also, this initiative developed and validated in field studies a set of eight items for self-reported Periodontitis for use in direct survey estimates of Periodontitis prevalence in existing state-based surveys. These items were also included in the 2009-2014 National Health and Nutrition Examination Surveys for validation against clinically determined cases of Periodontitis. Another novel result of this initiative is that, for the first time, the geographic distribution of practicing periodontists in relation to the geographic distribution of people with severe Periodontitis is illustrated. In summary, the precise Periodontitis prevalence and distribution among subgroups in the dentate US noninstitutionalized population aged 30-79 years is better understood because of application of valid Periodontitis case definitions to full-mouth periodontal examination, in combination with reliable information on demographic and health-related measures. We now can monitor the trend of Periodontitis prevalence over time as well as guide public health preventive and intervention initiatives for the betterment of the health of the adult US population.
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update of the case definitions for population based surveillance of Periodontitis
Journal of Periodontology, 2012Co-Authors: Paul I. Eke, Roy C Page, Liang Wei, Gina Thorntonevans, Robert J GencoAbstract:Background: This report adds a new definition for mild Periodontitis that allows for better descriptions of the overall prevalence of Periodontitis in populations. In 2007, the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology developed and reported standard case definitions for surveillance of moderate and severe Periodontitis based on measurements of probing depth (PD) and clinical attachment loss (AL) at interproximal sites. However, combined cases of moderate and severe Periodontitis are insufficient to determine the total prevalence of Periodontitis in populations.Methods: The authors proposed a definition for mild Periodontitis as ≥2 interproximal sites with AL ≥3 mm and ≥2 interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm . The effect of the proposed definition on the total burden of Periodontitis was assessed in a convenience sample of 456 adults ≥35 years old and compared with other previously reported definitio...
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effect of Periodontitis on overt nephropathy and end stage renal disease in type 2 diabetes
Diabetes Care, 2007Co-Authors: Wendy A Shultis, Jennifer E Weil, Helen C Looker, Jeffrey M Curtis, Marc Shlossman, William C Knowler, Robert J Genco, Robert G NelsonAbstract:OBJECTIVE —The purpose of this study was to investigate the effect of Periodontitis on development of overt nephropathy, defined as macroalbuminuria, and end-stage renal disease (ESRD) in type 2 diabetes. RESEARCH DESIGN AND METHODS —Individuals residing in the Gila River Indian Community aged ≥25 years with type 2 diabetes, one or more periodontal examination, estimated glomerular filtration rate ≥60 ml/min per 1.73 m 2 , and no macroalbuminuria (urinary albumin-to-creatinine ratio ≥300 mg/g) were identified. Periodontitis was classified as none/mild, moderate, severe, or edentulous using number of teeth and alveolar bone score. Subjects were followed to development of macroalbuminuria or ESRD, defined as onset of renal replacement therapy or death attributed to diabetic nephropathy. RESULTS —Of the 529 individuals, 107 (20%) had none/mild Periodontitis, 200 (38%) had moderate Periodontitis, 117 (22%) had severe Periodontitis, and 105 (20%) were edentulous at baseline. During follow-up of up to 22 years, 193 individuals developed macroalbuminuria and 68 developed ESRD. Age- and sex-adjusted incidence of macroalbuminuria and ESRD increased with severity of Periodontitis. After adjustment for age, sex, diabetes duration, BMI, and smoking in a proportional hazards model, the incidences of macroalbuminuria were 2.0, 2.1, and 2.6 times as high in individuals with moderate or severe Periodontitis or those who were edentulous, respectively, compared with those with none/mild Periodontitis ( P = 0.01). Incidences of ESRD in individuals with moderate or severe Periodontitis or in those who were edentulous were 2.3, 3.5, and 4.9 times as high, respectively, compared with those with none/mild Periodontitis ( P = 0.02). CONCLUSIONS —Periodontitis predicts development of overt nephropathy and ESRD in individuals with type 2 diabetes. Whether treatment of Periodontitis will reduce the risk of diabetic kidney disease remains to be determined.
Raghavendra D. Kulkarni - One of the best experts on this subject based on the ideXlab platform.
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Cytokine ratios in chronic Periodontitis and type 2 diabetes mellitus
Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 2016Co-Authors: Anirudh B. Acharya, Srinath Thakur, Mahadevayya Veerayya Muddapur, Raghavendra D. KulkarniAbstract:Abstract Aim Chronic Periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic Periodontitis. Materials & methods Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic Periodontitis, and type 2 diabetes with, and without chronic Periodontitis. Results and conclusions Cytokine ratios showed significant differences in type 2 diabetes and chronic Periodontitis, were highest in participants having both type 2 diabetes and chronic Periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic.
Zhiqing Liao - One of the best experts on this subject based on the ideXlab platform.
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effect of aqueous extracts of scutellaria baicalensis georgi and radix paeoniae alba on the serum igg1 and igg2a of the Periodontitis mice
Chinese journal of stomatology, 2014Co-Authors: Ning Song, Guicong Ding, Zhumin Zhou, Shiguang Huang, Fangli Lu, Zhiqing LiaoAbstract:Objective To examine the effect of aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba on Periodontitis mice and compare the results of the two herbs for the treatment of the Periodontitis mice.Methods Sixty-four SPF 12-week-old male Kunming mice were selected and randomly divided into four groups:Control group (C) ;Experimental Periodontitis group (P):the peridontitis models in Kunming mice were prepared by wrapping silk ligature and inoculating with putative periodontopathic bacteria; Scutellaria baicalensis Georgi treatment group(SG):Periodontitis was induced by the same method described above,the mice were gavaged with Scutellaria baicalensis Georgi; Radix paeoniae Alba treatment group (RG):Periodontitis was induced by the same method described above,the mice were gavaged with Radix paeoniae Alba.Four mice were sacrificed at each time point of the end of 4,6,8 and 10 weeks in each group.The histopathological changes of periodontal tissue were observed under microscope with HE staining.The level of serum IgG1 and IgG2a was measured by enzyme-linked immunosorbent assay(ELISA).Results A serious inflammatory response,alveolar progressive absorption and a large number of osteoclasts were observed in the experimental Periodontitis group.However,in SG and RG,the inflammation of the periodontal tissue was decreased and tissue repair was significant.The level of serum IgG2a in SG(6 week:0.934 ± 0.006,8 week:0.743 ± 0.009,10 week:0.674 ± 0.008) and RG (6 week:1.023 ± 0.032,8 week:0.851 ± 0.032,10 week:0.790 ± 0.009) was significantly decreased after the mice were gavaged with the two herbs(P ＜ 0.01).The level of serum IgG2a in SG was significantly lower than that of RG(P ＜0.01).The level of serum IgG1 in SG(6 week:0.314 ±0.006,8 week:0.344 ± 0.004,10 week:0.367 ±0.006) and RG(6 week:0.287 ±0.005,8 week:0.303 ±0.058,10 week:0.336 ±0.006) were significantly increased(P ＜ 0.01).The level of serum IgG1 in SG was significantly higher than that of RG (P ＜ 0.0l).Conclusions Both the aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba showed therapeutic effect on Periodontitis in mice.Scutellaria baicalensis Georgi was more effective than Radix paeoniae Alba. Key words: Periodontitis; Scutellaria baicalensis; Thl-Th2 balance; Radix paeoniae Alba
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Effect of aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba on the serum IgG1 and IgG2a of the Periodontitis mice
Chinese journal of stomatology, 2014Co-Authors: Ning Song, Guicong Ding, Zhumin Zhou, Shiguang Huang, Fangli Lu, Zhiqing LiaoAbstract:OBJECTIVE: To examine the effect of aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba on Periodontitis mice and compare the results of the two herbs for the treatment of the Periodontitis mice. METHODS: Sixty-four SPF 12-week-old male Kunming mice were selected and randomly divided into four groups:Control group(C); Experimental Periodontitis group (P):the peridontitis models in Kunming mice were prepared by wrapping silk ligature and inoculating with putative periodontopathic bacteria; Scutellaria baicalensis Georgi treatment group (SG): Periodontitis was induced by the same method described above, the mice were gavaged with Scutellaria baicalensis Georgi; Radix paeoniae Alba treatment group (RG): Periodontitis was induced by the same method described above, the mice were gavaged with Radix paeoniae Alba.Four mice were sacrificed at each time point of the end of 4, 6, 8 and 10 weeks in each group. The histopathological changes of periodontal tissue were observed under microscope with HE staining. The level of serum IgG1 and IgG2a was measured by enzyme-linked immunosorbent assay (ELISA) . RESULTS: A serious inflammatory response, alveolar progressive absorption and a large number of osteoclasts were observed in the experimental Periodontitis group.However, in SG and RG, the inflammation of the periodontal tissue was decreased and tissue repair was significant. The level of serum IgG2a in SG (6 week:0.934 ± 0.006, 8 week:0.743 ± 0.009, 10 week: 0.674 ± 0.008) and RG (6 week: 1.023 ± 0.032, 8 week: 0.851 ± 0.032, 10 week:0.790 ± 0.009) was significantly decreased after the mice were gavaged with the two herbs(P < 0.01). The level of serum IgG2a in SG was significantly lower than that of RG (P < 0.01). The level of serum IgG1 in SG (6 week: 0.314 ± 0.006, 8 week: 0.344 ± 0.004, 10 week: 0.367 ± 0.006) and RG (6 week: 0.287 ± 0.005, 8 week: 0.303 ± 0.058, 10 week: 0.336 ± 0.006) were significantly increased (P < 0.01). The level of serum IgG1 in SG was significantly higher than that of RG (P < 0.01). CONCLUSIONS: Both the aqueous extracts of Scutellaria baicalensis Georgi and Radix paeoniae Alba showed therapeutic effect on Periodontitis in mice.Scutellaria baicalensis Georgi was more effective than Radix paeoniae Alba.
Yingampa Gleebbua - One of the best experts on this subject based on the ideXlab platform.
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porphyromonas gingivalis aggregatibacter actinomycetemcomitans and treponema denticola prevotella intermedia co infection are associated with severe Periodontitis in a thai population
PLOS ONE, 2015Co-Authors: Kitti Torrungruang, Supawadee Jitpakdeebordin, Orawan Charatkulangkun, Yingampa GleebbuaAbstract:Periodontitis is a polymicrobial infection of tooth-supporting tissues. This cross-sectional study aimed to examine the associations between five target species and severe Periodontitis in a Thai population. Using the CDC/AAP case definition, individuals diagnosed with no/mild and severe Periodontitis were included. Quantitative analyses of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), and Prevotella intermedia (Pi) in subgingival plaque were performed using real-time polymerase chain reaction. The association between target species and severe Periodontitis was examined using logistic regression analysis. The study subjects comprised 479 individuals with no/mild Periodontitis and 883 with severe Periodontitis. Bacterial prevalence and quantity were higher in subjects with severe Periodontitis than in those with no/mild disease. In the fully adjusted model, all species except Tf showed a dose-dependent relationship with Periodontitis. The mere presence of Pg, even in low amount, was significantly associated with severe Periodontitis, while the amount of Aa, Td, and Pi had to reach the critical thresholds to be significantly associated with disease. Compared to individuals with low levels of both Td and Pi, high colonization by either Td or Pi alone significantly increased the odds of having severe Periodontitis by 2.5 (95%CI 1.7–3.5) folds. The odds ratio was further increased to 14.8 (95%CI 9.2–23.8) in individuals who were highly colonized by both species. Moreover, the presence of Pg and high colonization by Aa were independently associated with severe Periodontitis with odds ratios of 5.6 (95%CI 3.4–9.1) and 2.2 (95%CI 1.5–3.3), respectively. Our findings suggest that the presence of Pg and high colonization by Aa, Td, and Pi play an important role in severe Periodontitis in this study population. We also demonstrate for the first time that individuals co-infected with Td and Pi were more likely to have Periodontitis than were those infected with a single pathogen.
Bruno G. Loos - One of the best experts on this subject based on the ideXlab platform.
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Progress in the Identification of Genetic Factors in Periodontitis
Current Oral Health Reports, 2014Co-Authors: M.l. Laine, Søren Jepsen, Bruno G. LoosAbstract:The susceptibility to Periodontitis is determined by a complex interplay between bacteria, the immune system, and life-style factors, and is mainly regulated by genes. The genetic factors contributing to the pathogenesis of Periodontitis are still not fully defined. The aim of the present review is to summarize and discuss the status of replicated candidate gene and genome-wide association studies (GWAS) in aggressive and chronic Periodontitis. Currently, 3 susceptibility genes, namely GLT6D1, ANRIL, and COX-2, have repeatedly been associated with Periodontitis in cohorts of sufficient size. Most of the associations have been reported in aggressive Periodontitis. Single nucleotide polymorphisms (SNPs) within ANRIL and COX-2 seem to also be associated with chronic Periodontitis. Further, SNPs within the IL-10 gene have shown suggestive associations with aggressive Periodontitis, and SNPs within DEFB1 with aggressive and chronic Periodontitis. Probably, the identified SNPs are “genetic markers” and not causative variants for aggressive and chronic Periodontitis.
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Modeling Susceptibility to Periodontitis
Journal of dental research, 2012Co-Authors: Marja L. Laine, Vassilis Moustakis, Lefteris Koumakis, George Potamias, Bruno G. LoosAbstract:Chronic inflammatory diseases like Periodontitis have a complex pathogenesis and a multifactorial etiology, involving complex interactions between multiple genetic loci and infectious agents. We aimed to investigate the influence of genetic polymorphisms and bacteria on chronic Periodontitis risk. We determined the prevalence of 12 single-nucleotide polymorphisms (SNPs) in immune response candidate genes and 7 bacterial species of potential relevance to Periodontitis etiology, in chronic Periodontitis patients and non-Periodontitis control individuals (N = 385). Using decision tree analysis, we identified the presence of bacterial species Tannerella forsythia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and SNPs TNF -857 and IL-1A -889 as discriminators between Periodontitis and non-Periodontitis. The model reached an accuracy of 80%, sensitivity of 85%, specificity of 73%, and AUC of 73%. This pilot study shows that, on the basis of 3 periodontal pathogens and SNPs, patterns may be recognized to identify patients at risk for Periodontitis. Modern bioinformatics tools are valuable in modeling the multifactorial and complex nature of Periodontitis.
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Genetic susceptibility to Periodontitis.
Periodontology 2000, 2011Co-Authors: Marja L. Laine, Wim Crielaard, Bruno G. LoosAbstract:In this systematic review, we explore and summarize the peer-reviewed literature on putative genetic risk factors for susceptibility to aggressive and chronic Periodontitis. A comprehensive literature search on the PubMed database was performed using the keywords ‘Periodontitis’ or ‘periodontal disease’ in combination with the words ‘genes’, ‘mutation’, ‘SNP’ or ‘polymorphism’. The studies selected were written in English, had a case–control design, and reported genotype distribution. Only studies with at least 100 individuals in either the case or control group were included. Research on genetic polymorphisms has only had limited success in identifying significant and reproducible genetic factors for susceptibility to aggressive Periodontitis and chronic Periodontitis. Taking together the data published on gene polymorphisms in aggressive and chronic Periodontitis, we conclude that there are differences among the various studies for the rare allele carriage rates. Nevertheless, there is some evidence that polymorphisms in the IL1B, IL1RN, FcγRIIIb, VDR and TLR4 genes may be associated with aggressive Periodontitis susceptibility, and polymorphisms in the IL1B, IL1RN, IL6, IL10, VDR, CD14, TLR4 and MMP1 genes may be associated with chronic Periodontitis susceptibility as a single genetic factor in certain populations. Future studies should apply stricter disease classifications, use larger study cohorts, adjust for relevant risk factors in aggressive and chronic periodontiti,s and include analysis of multiple genes and polymorphisms. Establishing consortia and performing collaborative studies may help to conquer the limitations of small sample size and limited statistical power.
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elevation of systemic markers related to cardiovascular diseases in the peripheral blood of Periodontitis patients
Journal of Periodontology, 2000Co-Authors: Bruno G. Loos, Jeroen Craandijk, Frans J Hoek, Paulien Wertheimvan M E Dillen, Ubele Van Der VeldenAbstract:Background: Periodontitis is a common, often undiagnosed, chronic infection of the supporting tissues of the teeth, epidemiologically associated with cardiovascular diseases. Since Creactive protein (CRP) and other systemic markers of inflammation have been identified as risk factors for cardiovascular diseases, we investigated whether these factors were elevated in Periodontitis. Methods: Consecutive adult patients with Periodontitis (localized n = 53; generalized n = 54), and healthy controls (n = 43), all without any other medical disorder, were recruited and peripheral blood samples were taken. Results: Patients with generalized Periodontitis and localized Periodontitis had higher median CRP levels than controls (1.45 and 1.30 versus 0.90 mg/L, respectively, p = 0.030); 52% of generalized Periodontitis patients and 36% of the localized Periodontitis patients were sero-positive for interleukin-6 (IL-6), compared to 26% of controls (p = 0.008). Plasma IL-6 levels were higher in Periodontitis patients th...
