Background
An association between periodontitis and cardiovascular disease is now well documented; however, the effect of periodontitis severity levels on this outcome, specifically on acute ...myocardial infarction (AMI), remains unexplored. This study investigated the association between levels of periodontitis severity (exposure) and AMI (outcome).
Methods
This case‐control study, matched by sex and age, was conducted with 621 participants, with 207 individuals treated in the emergency department of Santa Izabel and Ana Nery Hospitals in Salvador, Bahia, Brazil, diagnosed with a first AMI event, and compared to 414 individuals without a diagnosis of AMI. Levels of periodontitis severity followed two criteria: (1) Center for Disease Prevention and Control and American Academy of Periodontology; (2) Gomes‐Filho et al. (2018) using criteria that also evaluated bleeding upon probing. Conditional logistic regression analysis was performed and odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained.
Results
The adjusted association measurements showed a positive association between both severe (ORadjusted ranged from 2.21 to 3.92; 95% CI ranged from 1.03 to 10.05) and moderate periodontitis (ORadjusted ranged from 1.96 to 2.51; 95% CI ranged from 1.02 to 6.19), and AMI, for both periodontitis diagnostic criteria. It demonstrated that among those with moderate and severe periodontitis, the chance of having AMI was approximately two to four times greater than among those without periodontitis.
Conclusion
The findings demonstrate that there is an association between the severity of the periodontal condition and AMI, suggesting a possible relationship among the levels of periodontitis severity and the cardiovascular condition.
To estimate the association between osteoporosis treatment and severe periodontitis in postmenopausal women.
This cross-sectional study comprised of 492 postmenopausal women, 113 women in ...osteoporosis treatment, and 379 not treated. Osteoporosis treatment consisted of systemic estrogen alone, or estrogen plus progestin, and calcium and vitamin D supplements, for at least 6 months. Severe periodontitis was defined as at least two interproximal tooth sites with clinical attachment loss of at least 6 mm, and at least one interproximal site with probing depth of at least 5 mm; and dental caries experience was measured using the decayed, missing, and filled teeth (DMFT) index. Analysis included descriptive statistics and Poisson multivariate analysis with robust variance.
Women receiving osteoporosis treatment had less periodontal probing depth, less clinical attachment loss, and less gingival bleeding than women not receiving treatment for osteoporosis (P ≤ 0.05). In the osteoporosis treatment group, the estimated mean DMFT index score was approximately 20, the most frequent component being the number of missing teeth, and in the nontreated group, the DMFT index was approximately 19. The prevalence of severe periodontitis was 44% lower in the osteoporosis treatment group than in the nontreatment group. The prevalence ratioadjusted was 0.56, 95% confidence interval was 0.31 to 0.99 (P = 0.05), after adjustments for smoking, age, family income, and visit to the dentist.
The results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment.
Objective
This study investigated the association between periodontitis severity (exposure) and metabolic syndrome (MetS - outcome), using two criteria for diagnosis of the outcome, since this ...relationship remains unexplored.
Materials and methods
A case-control study was conducted with 870 individuals: 408 with first MetS diagnosis (cases) and 462 without MetS (controls). Participants’ general information was obtained using a questionnaire and laboratory data was collected from medical records. Periodontitis severity criteria followed the Center for Disease Control and Prevention: none, mild, moderate, and severe. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by logistic regression analysis.
Results
Findings showed a positive association between moderate and severe periodontitis and MetS: OR
adjusted
= 1.64 (95% CI: 1.01 to 2.68) and OR
adjusted
= 1.94 (95% CI: 1.19 to 3.16), respectively, after adjustment for age, sex, schooling level, smoking habit, and cardiovascular disease. The adjusted measurements showed that among individuals with moderate or severe periodontitis, the probability of having MetS was around two times greater than among those without periodontitis, and that the chance was greater among participants with severe periodontitis than those with moderate periodontitis.
Conclusion
An association between the severity of periodontal status and MetS was found, suggesting a possible relationship between the two diseases.
Clinical relevance
MetS influences the etiology of cardiovascular diseases, one of the leading causes of mortality worldwide. The findings suggest that the greater the severity of periodontitis, the greater is the association magnitude with MetS. The health professional needs to recognize that the importance of periodontal disease may play in MetS.
Background: The aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW).
Methods: A case‐control study was conducted ...with 372 females divided into cases (109 mothers of newborns with birth weight <2,500 g) and controls (263 mothers of newborns with birth weight ≥2,500 g). The birth weight of children was obtained from medical records, whereas information on sociodemographic, lifestyle, and health characteristics of the participants was obtained through an interview. Glycated hemoglobin (HbA1c) levels were measured, and probing depth, clinical attachment levels, and bleeding on probing were used to determine the periodontal status. Results were analyzed using logistic regression.
Results: The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio ORadjusted = 6.02, 95% confidence interval CI = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic–level group (HbA1c levels <5.6%, unadjusted odds ratio ORunadjusted = 8.30, 95% CI = 3.56 to 19.35) and the high glycemic–level group (HbA1c levels ≥5.6% and <6.5%, ORunadjusted = 5.73, 95% CI = 1.75 to 18.70). After adjustment for confounders, the magnitude of the association continued to be strong in the normal glycemic–level group (ORadjusted = 7.59, 95% CI = 2.7 to 24.28), an increase of 25% when compared to the main association measurement. In those with high glycemic levels (ORadjusted = 4.03, 95% CI = 0.81 to 19.96), the OR decreased almost 50%, and the association lost statistical significance.
Conclusion: Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level.
Aim: To compare the use of different definitions for exposure measurement in cases of association between periodontal disease (PD) and prematurity and/or low birth weight (PLBW).
Material and ...Methods: A database from a previous case–control study was used to compare four different definitions for periodontitis: at least one site with probing depth 4 mm (1); at least one site with clinical attachment loss (CAL)3 mm (2); at least four teeth with one or more sites presenting probing depth 4 mm, with CAL3 mm at the same site (3); and at least four teeth with one or more sites with probing depth 4 mm, with CAL3 mm at the same site and presence of bleeding on probing (4). The PD frequency, diagnostic values and adjusted association measurements were calculated.
Results: PD frequency ranged from 33.1% to 94.7%. Odds ratioadjusted varied slightly according to the exposure measurement used.
Conclusions: The association between PD and PLBW weight was consistent, except for exposure measurement 1, i.e. using at least one site with CAL3 mm for periodontitis diagnosis, while the magnitude of this varied according to the definition established.
Background: The clinical importance of systemic bone loss as a contributory factor to alveolar bone loss and the subsequent loss of teeth merits further study, given that osteoporosis and periodontal ...disease lead to significantly increased morbidity and mortality and higher public expenditure of funds. This case‐control study evaluated the association between osteoporosis and periodontal disease.
Methods: The sample consisted of 139 postmenopausal women: 48 in the case group (with periodontal disease) and 91 in the control group (without periodontal disease). The diagnosis of periodontal disease was established following a complete clinical examination using measurements of probing depth, gingival recession and hyperplasia, clinical attachment loss, and bleeding index, and confirmed by panoramic radiography. The diagnosis of osteoporosis was made by reviewing densitometry reports obtained previously. Descriptive, stratified, and logistic regression analyses were applied to the data collected. Comparison of proportions was performed using the χ2 and Fisher tests. Association measurements (odds ratios ORs) with and without adjustment for confounding factors and control for effect modifiers were obtained at a significance level of 5%.
Results: The ORunadjusted for the principal association was 2.58 (95% confidence interval CI: 1.01 to 6.82). In subgroup analyses of the stratified model, the ORunadjusted for low education was 6.40 (95% CI: 1.77 to 23.18). When adjusted for smoking habit and age, the ORadjusted was 7.05 (95% CI: 1.90 to 26.19), which also was statistically significant.
Conclusion: Postmenopausal women with osteoporosis and low educational levels have a greater chance of having periodontal disease than do those without osteoporosis.
– Starting in the 1990s, several authors sought to investigate the hypothesis that periodontitis during pregnancy may contribute towards the birth of low‐weight children. However, this relationship ...is still not well established. The aim of this study was to evaluate whether this oral infection is associated with this gestational event.
Methods: This was a case‐control study among 548 puerperae, of whom 164 were the mothers of low‐weight live births (case group) and 384 were the mothers of live births of normal gestational weight (control group). They were selected at two public hospital units in two municipalities in the State of Bahia. From interviews and data gathered using live birth cards or birth certificates, information was obtained regarding age, height, previous diseases, marital status, socioeconomic situation, smoking and alcohol use. Mothers who presented at least four teeth on which one or more sites had a probing depth of greater than or equal to 4 mm, clinical attachment loss of greater than or equal to 3 mm and bleeding on probing, at the same site, were deemed to present periodontal disease. The data were analysed by stratification from logistic regression.
Results: Periodontal disease was diagnosed in 42.7% of the case group and 30% of the control group. A statistically significant association was found between periodontal disease and low birth weight (unadjusted OR = 1.74; 95% CI: 1.19–2.54), particularly among mothers with low schooling levels (adjusted OR = 2.30; 95% CI: 1.14–4.6).
Conclusion: The findings suggest an association between periodontal disease and low birth weight among mothers with low education levels.
OBJETIVO: Estudos recentes têm apresentado evidências de que a doença periodontal em gestantes pode ser um dos determinantes do baixo peso ao nascer. Realizou-se estudo para verificar a existência de ...associação entre doença periodontal materna e baixo peso ao nascer. MÉTODOS: Estudo do tipo caso-controle com 302 mulheres, sendo 102 mães de nascidos vivos de baixo peso (grupo caso) e 200 mães de nascidos vivos com peso normal (grupo controle). A existência de associação entre doença periodontal e baixo peso ao nascer foi avaliada mediante modelo multivariado de regressão logística, considerando outros fatores de risco para o baixo peso. RESULTADOS: Ambos os grupos de mães eram comparáveis no que se refere a idade, altura, peso pré-gestacional, tabagismo, alcoolismo, doenças prévias, estado civil, situação socioeconômica, número de escovações e uso de fio dental, número de refeições diárias, e visitas ao dentista. A doença periodontal foi diagnosticada em 57,8% das mães do grupo caso e 39,0% do grupo controle. A análise de regressão logística indicou associação positiva entre doença periodontal e baixo peso ao nascer (ORbruto=2,15; IC 95%: 1,32-3,48), especialmente entre as mães com escolaridade menor ou igual a quatro anos (ORajustada=3,98; IC 95%: 1,58-10,10). CONCLUSÕES: A doença periodontal é um possível fator de risco para o baixo peso ao nascer.
This study investigated the hypotheses that occupational exposure to acid mists is positively associated with periodontal disease, assessed by periodontal attachment loss. The study sample included ...530 male workers at a metal processing factory. Data were obtained from interviews and oral examinations. Periodontal attachment loss was defined as >or= 4mm at probing, in at least one tooth. A job exposure matrix was utilized for exposure evaluation. Exposure to acid mists was positively associated with periodontal attachment loss >or= 4mm at any time (prevalence ratio, PR(adjusted) = 2.17), past (PR(adjusted) = 2.11), and over 6 years of exposure (PR(adjusted) = 1.77), independently of age, alcohol consumption, and smoking, and these results were limited to workers who did not use dental floss. Exposure to acid mists is a potential risk factor for periodontal attachment loss, and further studies are needed, using longitudinal designs and more accurate exposure measures.
To estimate the prevalence and related aspects of periodontitis in a rural area of the State of Bahia, Brazil, this cross-sectional study was carried out in the village of Matinha dos Pretos, Feira ...de Santana County, Bahia, among 172 subjects ranging from 20 to 60 years of age. During household visits, a full-mouth periodontal exam was performed on each subject, who also answered a questionnaire about socio-demographic, economic and health-related issues. The factors assessed were plaque index, bleeding on probing index, probing depth, gingival recession or hyperplasia measurements. Clinical attachment loss was also calculated. The multivariate logistic regression method was used to evaluate the relative contribution of these factors to the periodontitis condition. The prevalence of periodontitis was 24.4%. The following factors were all positively associated with the presence of periodontitis: being male (OR = 1.58; 1.00 - 2.53), being 30 years of age or older (OR = 2.80; 1.00 - 7.39), living in a house where there was more than one person per room (OR = 1.53; 0.96 - 2.45), being a cigarette or pipe smoker or ex-smoker (OR = 1.49; 0.92 - 2.39), having a plaque index of over 65% (OR = 2.97; 2.72 - 7.39) and more than four missing teeth (OR = 1.51; 0.82 - 2.78). The authors concluded that socioeconomic and biological factors, especially poor oral hygiene and older age, are positively associated with periodontitis in the rural population of a small village in the county of Feira de Santana, State of Bahia, Brazil.
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