Ω
A common oral bacteria, Fusobacterium nucleatum, acts like a key to open a door in human blood vessels and leads the way for it and other bacteria like Escherichia coli to invade the body through the blood and make people sick, according to dental researchers at Case Western Reserve University.
Yiping Han, professor of periodontics at the Case Western Reserve School of Dental Medicine, made the discovery in her continued work with the Fusobacterium nucleatum bacterium, one of the most prevalent of the more than 700 bacteria in the mouth.
She found the gram-negative anaerobe has a novel adhesin or bonding agent she's named FadA that triggers a cascade of signals that break the junctures in an interlocking sheath of endothelial cells on blood vessel's surface just enough to allow F. nucleatum and other bacteria into the blood.
A description of bond-breaking process was described in the Molecular Microbiology article, "Fusobacterium nucleatum adhesin FadA binds vascular endothelial cadherin and alters endothelial integrity."
The microbiologist at the dental school has studied the oral bacteria over the past decade and was the first to find direct evidence that linked it to preterm labor and fetal death. But its presence is found in other infections and abscesses in the brain, lungs, liver, spleen and joints.
After finding and genetically matching the oral bacteria in the fetal death, she began to unravel the mystery of how an oral bacterium can be found throughout the body and jumps the blood-brain and placental barriers that usually block disease-causing agents.
Through years of lab work, her research led to the vascular endothelial (VE)-cadherin, cell-cell junctures that link the endothelial vascular cells together on the blood vessels.
These junctures are like a hook and loop connection, but for some unknown reason when F. nucleatum invades the body through breaks in the mucous membranes of the mouth, due to injuries or periodontal disease, this particular bacterium triggers a cascade of signals that causes the hook to recede back into the endothelial cell. The oral bacterium leads the way with any other harmful invaders following along.
This "deceding" was observed by confocal microscopy when Han used cells from human umbilical cord. The researchers introduced F. nucleatum and demonstrated the VE-cadherins break on bonds on the endothelial cells and creating enough space in the endothelium for the invaders to move in.
Lab tests included introducing F. nucleatum with and without other bacteria. When E. coli alone was introduced, the bond did not break. But when F. nucleatum was introduced first, the bond broke, and the E. coli bacteria were able to move through the otherwise intact cell layers.
"This cascade knocks out the guard on duty and allows the bacteria to enter the blood and travel like a bus loaded with riders throughout the system. Whenever the F. nucleatum wants to get off the bus at the liver, brain, spleen, or another place, it does," Han said.
When it disembarks from its ride through the blood, it begins to colonize. The colony of bacteria induces an inflammatory reaction that has a range of consequences from necrosis of tissue to fetal death.
Saturday, December 17, 2011
Wednesday, December 14, 2011
Oral Surgery Protocol to Control Bleeding for Heart Patients Shows Positive Results
Cardiac patients that take anticoagulant medications and need a tooth extraction face an increased risk of bleeding that must be addressed by the treating clinician. Therefore, a protocol for heart patients is needed that will avoid significant bleeding after dental extractions without suspending anticoagulant therapy.
A study reported in the current issue of the Journal of Oral Implantology evaluated the use of leukocyte- and platelet-rich fibrin biomaterial. This material is commonly used in dentistry to improve healing and tissue regeneration. It was tested as a safe filling and hemostatic material after dental extractions in 50 heart patients undergoing oral anticoagulant therapy.
These heart patients had mechanical valve substitutions, and then were placed on anticoagulant oral therapy with warfarin. It is not recommended that the anticoagulant be suspended and replaced with heparin before a minor surgery, although this substitution may control the risk of postoperative bleeding.
One method of controlling bleeding without suspending the anticoagulant is the use of platelet-rich plasma gel placed in postextraction tooth sockets. Although this protocol has been successful, there are barriers to its daily use. The platelet concentrates are expensive and take a long time to prepare.
Platelet-rich fibrin offers an alternative biomaterial that is simple and inexpensive to prepare. Blood is collected in tubes without anticoagulant and centrifuged. It divides into three layers, creating a strong platelet-rich fibrin clot in the middle layer. Platelet-rich fibrin has proved useful in daily dental practice as filling material for regeneration in order to place implants.
In this study, 50 heart patients following an anticoagulant therapy were treated with leukocyte- and platelet-rich fibrin clots placed into postextraction sockets. Complications of bleeding were reported in only two of these patients, and 10 had mild bleeding. All complications were resolved within a few hours after the oral surgery.
Additionally, the study reported no painful events, quick healing of soft tissue, and complete wound closure within one week after oral surgery. Leukocyte- and platelet-rich fibrin offers an excellent option for use in heart patients on an anticoagulant regimen.
Full text of the article, “Prevention of Hemorrhagic Complications After Dental Extractions Into Open Heart Surgery Patients Under Anticoagulant Therapy: The Use of Leukocyte- and Platelet-Rich Fibrin ,” Journal of Oral Implantology, Vol. 37, No. 6, 2011, is available at http://www.joionline.org/ .
###
About Journal of Oral Implantology
The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry. For more information about the journal or society, please visit: http://www.aaid-implant.org/index.html
Tuesday, December 6, 2011
Dental X-rays can predict fractures
It is now possible to use dental X-rays to predict who is at risk of fractures, reveals a new study from researchers at the Sahlgrenska Academy reported in the journal Nature Reviews Endocrinology.
In a previous study, researchers from the University of Gothenburg's Sahlgrenska Academy and Region Västra Götaland demonstrated that a sparse bone structure in the trabecular bone in the lower jaw is linked to a greater chance of having previously had fractures in other parts of the body.
X-rays investigates bone structure
The Gothenburg researchers have now taken this a step further with a new study that shows that it is possible to use dental X-rays to investigate the bone structure in the lower jaw, and so predict who is at greater risk of fractures in the future. Published in the journal Bone, the results were also mentioned in both Nature Reviews Endocrinology and the Wall Street Journal.
Linked to risk of fractures
"We've seen that sparse bone structure in the lower jaw in mid-life is directly linked to the risk of fractures in other parts of the body, later in life,"says Lauren Lissner, a researcher at the Institute of Medicine at the Sahlgrenska Academy.
Study started 1968
The study draws on data from the Prospective Population Study of Women in Gothenburg started in 1968. Given that this has now been running for over 40 years, the material is globally unique. The study included 731 women, who have been examined on several occasions since 1968, when they were 38-60 years old. X-ray images of their jaw bone were analysed in 1968 and 1980 and the results related to the incidence of subsequent fractures.
For the first 12 years fractures were self-reported during followup examinations. It is only since the 1980s that it has been possible to use medical registers to identify fractures. A total of 222 fractures were identified during the whole observation period.
One out of five in higher risk
The study shows that the bone structure of the jaw was sparse in around 20% of the women aged 38-54 when the first examination was carried out, and that these women were at significantly greater risk of fractures.
The study also shows that the older the person, the stronger the link between sparse bone structure in the jaw and fractures in other parts of the body.
Applies for both sexes
Although the study was carried out on women, the researchers believe that the link also applies for men.
"Dental X-rays contain lots of information on bone structure," says Grethe Jonasson, the researcher at the Research Centre of the Public Dental Service in Västra Götaland who initiated the fractures study. "By analysing these images, dentists can identify people who are at greater risk of fractures long before the first fracture occurs."
In a previous study, researchers from the University of Gothenburg's Sahlgrenska Academy and Region Västra Götaland demonstrated that a sparse bone structure in the trabecular bone in the lower jaw is linked to a greater chance of having previously had fractures in other parts of the body.
X-rays investigates bone structure
The Gothenburg researchers have now taken this a step further with a new study that shows that it is possible to use dental X-rays to investigate the bone structure in the lower jaw, and so predict who is at greater risk of fractures in the future. Published in the journal Bone, the results were also mentioned in both Nature Reviews Endocrinology and the Wall Street Journal.
Linked to risk of fractures
"We've seen that sparse bone structure in the lower jaw in mid-life is directly linked to the risk of fractures in other parts of the body, later in life,"says Lauren Lissner, a researcher at the Institute of Medicine at the Sahlgrenska Academy.
Study started 1968
The study draws on data from the Prospective Population Study of Women in Gothenburg started in 1968. Given that this has now been running for over 40 years, the material is globally unique. The study included 731 women, who have been examined on several occasions since 1968, when they were 38-60 years old. X-ray images of their jaw bone were analysed in 1968 and 1980 and the results related to the incidence of subsequent fractures.
For the first 12 years fractures were self-reported during followup examinations. It is only since the 1980s that it has been possible to use medical registers to identify fractures. A total of 222 fractures were identified during the whole observation period.
One out of five in higher risk
The study shows that the bone structure of the jaw was sparse in around 20% of the women aged 38-54 when the first examination was carried out, and that these women were at significantly greater risk of fractures.
The study also shows that the older the person, the stronger the link between sparse bone structure in the jaw and fractures in other parts of the body.
Applies for both sexes
Although the study was carried out on women, the researchers believe that the link also applies for men.
"Dental X-rays contain lots of information on bone structure," says Grethe Jonasson, the researcher at the Research Centre of the Public Dental Service in Västra Götaland who initiated the fractures study. "By analysing these images, dentists can identify people who are at greater risk of fractures long before the first fracture occurs."
Thursday, November 17, 2011
New Mouthwash Targeting Harmful Bacteria May Render Tooth Decay a Thing of the Past
Ω
A new mouthwash developed by a microbiologist at the UCLA School of Dentistry is highly successful in targeting the harmful Streptococcus mutans bacteria that is the principal cause tooth decay and cavities.
In a recent clinical study, 12 subjects who rinsed just one time with the experimental mouthwash experienced a nearly complete elimination of the S. mutans bacteria over the entire four-day testing period. The findings from the small-scale study are published in the current edition of the international dental journal Caries Research.
Dental caries, commonly known as tooth decay or cavities, is one of the most common and costly infectious diseases in the United States, affecting more than 50 percent of children and the vast majority of adults aged 18 and older. Americans spend more than $70 billion each year on dental services, with the majority of that amount going toward the treatment of dental caries.
This new mouthwash is the product of nearly a decade of research conducted by Wenyuan Shi, chair of the oral biology section at the UCLA School of Dentistry. Shi developed a new antimicrobial technology called STAMP (specifically targeted anti-microbial peptides) with support from Colgate-Palmolive and from C3-Jian Inc., a company he founded around patent rights he developed at UCLA; the patents were exclusively licensed by UCLA to C3-Jian. The mouthwash uses a STAMP known as C16G2.
The human body is home to millions of different bacteria, some of which cause diseases such as dental caries but many of which are vital for optimum health. Most common broad-spectrum antibiotics, like conventional mouthwash, indiscriminately kill both benign and harmful pathogenic organisms and only do so for a 12-hour time period.
The overuse of broad-spectrum antibiotics can seriously disrupt the body's normal ecological balance, rendering humans more susceptible to bacterial, yeast and parasitic infections.
Shi's Sm STAMP C16G2 investigational drug, tested in the clinical study, acts as a sort of "smart bomb," eliminating only the harmful bacteria and remaining effective for an extended period.
Based on the success of this limited clinical trial, C3-Jian Inc. has filed a New Investigational Drug application with the U.S. Food and Drug Administration, which is expected to begin more extensive clinical trials in March 2012. If the FDA ultimately approves Sm STAMP C16G2 for general use, it will be the first such anti-dental caries drug since fluoride was licensed nearly 60 years ago.
"With this new antimicrobial technology, we have the prospect of actually wiping out tooth decay in our lifetime," said Shi, who noted that this work may lay the foundation for developing additional target-specific "smart bomb" antimicrobials to combat other diseases.
"The work conducted by Dr. Shi's laboratory will help transform the concept of targeted antimicrobial therapy into a reality," said Dr. No-Hee Park, dean of the UCLA School of Dentistry. "We are proud that UCLA will become known as the birthplace of this significant treatment innovation."
A new mouthwash developed by a microbiologist at the UCLA School of Dentistry is highly successful in targeting the harmful Streptococcus mutans bacteria that is the principal cause tooth decay and cavities.
In a recent clinical study, 12 subjects who rinsed just one time with the experimental mouthwash experienced a nearly complete elimination of the S. mutans bacteria over the entire four-day testing period. The findings from the small-scale study are published in the current edition of the international dental journal Caries Research.
Dental caries, commonly known as tooth decay or cavities, is one of the most common and costly infectious diseases in the United States, affecting more than 50 percent of children and the vast majority of adults aged 18 and older. Americans spend more than $70 billion each year on dental services, with the majority of that amount going toward the treatment of dental caries.
This new mouthwash is the product of nearly a decade of research conducted by Wenyuan Shi, chair of the oral biology section at the UCLA School of Dentistry. Shi developed a new antimicrobial technology called STAMP (specifically targeted anti-microbial peptides) with support from Colgate-Palmolive and from C3-Jian Inc., a company he founded around patent rights he developed at UCLA; the patents were exclusively licensed by UCLA to C3-Jian. The mouthwash uses a STAMP known as C16G2.
The human body is home to millions of different bacteria, some of which cause diseases such as dental caries but many of which are vital for optimum health. Most common broad-spectrum antibiotics, like conventional mouthwash, indiscriminately kill both benign and harmful pathogenic organisms and only do so for a 12-hour time period.
The overuse of broad-spectrum antibiotics can seriously disrupt the body's normal ecological balance, rendering humans more susceptible to bacterial, yeast and parasitic infections.
Shi's Sm STAMP C16G2 investigational drug, tested in the clinical study, acts as a sort of "smart bomb," eliminating only the harmful bacteria and remaining effective for an extended period.
Based on the success of this limited clinical trial, C3-Jian Inc. has filed a New Investigational Drug application with the U.S. Food and Drug Administration, which is expected to begin more extensive clinical trials in March 2012. If the FDA ultimately approves Sm STAMP C16G2 for general use, it will be the first such anti-dental caries drug since fluoride was licensed nearly 60 years ago.
"With this new antimicrobial technology, we have the prospect of actually wiping out tooth decay in our lifetime," said Shi, who noted that this work may lay the foundation for developing additional target-specific "smart bomb" antimicrobials to combat other diseases.
"The work conducted by Dr. Shi's laboratory will help transform the concept of targeted antimicrobial therapy into a reality," said Dr. No-Hee Park, dean of the UCLA School of Dentistry. "We are proud that UCLA will become known as the birthplace of this significant treatment innovation."
Wednesday, November 16, 2011
Teeth Crowded in Seniors, as Jaws Shrink
Ω
The size of our jaws decreases with age. This is shown in a unique study from the Faculty of Dentistry at Malmö University that followed a cohort of dentists throughout their adult lives.
The unique study started in 1949. Plaster molds were made of the jaws of dental students, who were then in their twenties. Ten years later the procedure was repeated, and in 1989, forty years after the first molds, a final round was performed. On that occasion the researchers were in touch with 18 of the original 30 participants.
"We found that over these forty years there was less and less room for teeth in the jaw," says Lars Bondemark, professor of orthodontics, who analyzed the material together with his colleague Maria Nilner, professor of clinical bite physiology at the College of Dentistry, Malmö University .
This crowdedness comes from shrinkage of the jaw, primarily the lower jaw, both in length and width. While this is only a matter of a few millimeters, but it is enough to crowd the front teeth.
"We can also eliminate wisdom teeth as the cause, because even people who have no wisdom teeth have crowded front teeth."
How much the jaw shrinks is individual, but for some patients the changes are sufficiently great for them to perceive that something is happening to their bite.
"In that case it's good to know that this is normal," says Lars Bondemark, who maintains that dentists need to take into consideration the continuous shrinking of the jaws when they plan to perform major bite constructions on their patients.
"We're working against nature, and it's hard to construct something that is completely stable."
Why the jaws change throughout life is not known, but the magnitude of the change is probably determined by both hereditary and anatomical factors, including what the patient's bite looks like.
The size of our jaws decreases with age. This is shown in a unique study from the Faculty of Dentistry at Malmö University that followed a cohort of dentists throughout their adult lives.
The unique study started in 1949. Plaster molds were made of the jaws of dental students, who were then in their twenties. Ten years later the procedure was repeated, and in 1989, forty years after the first molds, a final round was performed. On that occasion the researchers were in touch with 18 of the original 30 participants.
"We found that over these forty years there was less and less room for teeth in the jaw," says Lars Bondemark, professor of orthodontics, who analyzed the material together with his colleague Maria Nilner, professor of clinical bite physiology at the College of Dentistry, Malmö University .
This crowdedness comes from shrinkage of the jaw, primarily the lower jaw, both in length and width. While this is only a matter of a few millimeters, but it is enough to crowd the front teeth.
"We can also eliminate wisdom teeth as the cause, because even people who have no wisdom teeth have crowded front teeth."
How much the jaw shrinks is individual, but for some patients the changes are sufficiently great for them to perceive that something is happening to their bite.
"In that case it's good to know that this is normal," says Lars Bondemark, who maintains that dentists need to take into consideration the continuous shrinking of the jaws when they plan to perform major bite constructions on their patients.
"We're working against nature, and it's hard to construct something that is completely stable."
Why the jaws change throughout life is not known, but the magnitude of the change is probably determined by both hereditary and anatomical factors, including what the patient's bite looks like.
Monday, November 14, 2011
Professional dental cleanings may reduce risk of heart attack, stroke
Ω
Professional tooth scaling was associated with fewer heart attacks and strokes in a study (Abstract 17704) from Taiwan presented at the American Heart Association's Scientific Sessions 2011.
Among more than 100,000 people, those who had their teeth scraped and cleaned (tooth scaling) by a dentist or dental hygienist had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke compared to those who had never had a dental cleaning. The participants were followed for an average of seven years.
Scientists considered tooth scaling frequent if it occurred at least twice or more in two years; occasional tooth scaling was once or less in two years.
The study included more than 51,000 adults who had received at least one full or partial tooth scaling and a similar number of people matched with gender and health conditions who had no tooth scaling. None of the participants had a history of heart attack or stroke at the beginning of the study.
The study didn't adjust for heart attack and stroke risk factors — such as weight, smoking and race — that weren't included in the Taiwan National Health insurance data base, the source of the information used in the analysis.
"Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year," said Emily (Zu-Yin) Chen, M.D., cardiology fellow at the Veterans General Hospital in Taipei, Taiwan.
Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke, she said.
Hsin-Bang Leu M.D., is the study co-author. Author disclosures and funding are on the abstract.
Type of periodontal disease predicts degree of risk for heart attack, stroke, and heart failure
In a separate study (abstract 10576), researchers found that the value of markers for gum disease predict heart attack, congestive heart failure and stroke in different ways and to different degrees.
Anders Holmlund, D.D.S., Ph.D. Centre for Research and Development of the County Council of Gävleborg, Sweden, and senior consultant; Specialized Dentistry, studied 7,999 participants with periodontal disease and found people with:
- Fewer than 21 teeth had a 69 percent increased risk of heart attack compared to those with the most teeth.
- A higher number of deepened periodontal pockets (infection of the gum around the base of the tooth) had a 53 percent increased risk of heart attack compared to those with the fewest pockets.
- The least amount of teeth had a 2.5 increased risk of congestive heart failure compared to those with the most teeth.
- The highest incidence of gum bleeding had a 2.1 increased risk of stroke compared to those with the lowest incidence.
Professional tooth scaling was associated with fewer heart attacks and strokes in a study (Abstract 17704) from Taiwan presented at the American Heart Association's Scientific Sessions 2011.
Among more than 100,000 people, those who had their teeth scraped and cleaned (tooth scaling) by a dentist or dental hygienist had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke compared to those who had never had a dental cleaning. The participants were followed for an average of seven years.
Scientists considered tooth scaling frequent if it occurred at least twice or more in two years; occasional tooth scaling was once or less in two years.
The study included more than 51,000 adults who had received at least one full or partial tooth scaling and a similar number of people matched with gender and health conditions who had no tooth scaling. None of the participants had a history of heart attack or stroke at the beginning of the study.
The study didn't adjust for heart attack and stroke risk factors — such as weight, smoking and race — that weren't included in the Taiwan National Health insurance data base, the source of the information used in the analysis.
"Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year," said Emily (Zu-Yin) Chen, M.D., cardiology fellow at the Veterans General Hospital in Taipei, Taiwan.
Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke, she said.
Hsin-Bang Leu M.D., is the study co-author. Author disclosures and funding are on the abstract.
Type of periodontal disease predicts degree of risk for heart attack, stroke, and heart failure
In a separate study (abstract 10576), researchers found that the value of markers for gum disease predict heart attack, congestive heart failure and stroke in different ways and to different degrees.
Anders Holmlund, D.D.S., Ph.D. Centre for Research and Development of the County Council of Gävleborg, Sweden, and senior consultant; Specialized Dentistry, studied 7,999 participants with periodontal disease and found people with:
- Fewer than 21 teeth had a 69 percent increased risk of heart attack compared to those with the most teeth.
- A higher number of deepened periodontal pockets (infection of the gum around the base of the tooth) had a 53 percent increased risk of heart attack compared to those with the fewest pockets.
- The least amount of teeth had a 2.5 increased risk of congestive heart failure compared to those with the most teeth.
- The highest incidence of gum bleeding had a 2.1 increased risk of stroke compared to those with the lowest incidence.
Wednesday, November 9, 2011
Lose the fat and improve the gums
Ω
Case Western Reserve University School of Dental Medicine researchers found the human body is better at fighting gum disease when fat cells, which trigger inflammation, disappear.
Findings come from a pilot study of 31 obese people with gum disease. Half of the group with an average body mass index (BMI) of 39 had gastric bypass surgery and had fat cells from the abdomen removed. That half fared better than a control group of obese people with a BMI of 35 who also were treated for gum disease but did not have the gastric bypass surgery or fat removed.
What intrigued the researchers is that the majority of those who underwent surgery had a drop in their glucose levels after the procedure, a result that bodes well for overweight people predisposed to diabetes and insulin-related problems.
All study participants underwent nonsurgical periodontal treatments of scaling/root planing and oral hygiene instructions for home care. While both groups showed improvement, the surgery group did even better on the measures for periodontal attachment, bleeding, probing depths and plaque levels.
Inflammation that continues to brew in the body can have harmful effects over time, and inflammation from gum disease can erode bone and cause tooth loss. It can also cause breaks in the gums where harmful oral bacteria can enter the blood stream. Such bacteria have been linked to preterm birth, fetal death, heart disease, diabetes and arthritis, said Nabil Bissada, chair of the department of periodontics at Case Western Reserve School of Dental Medicine.
Bissada is the lead author of the study, “Response to periodontal therapy in subjects who had weight loss following bariatric surgery and obese counterparts: a pilot study,” published in the Journal of Periodontology.
This study raises two hypotheses about why the surgery group improved.
The first theory is that excessive fat cells (adipocytes) secrete more cytokines (such as TNF and IL-6), which make insulin more resistant to doing its function.
As a result, more accumulation of sugar in the blood (hyperglycemia) occurs. Losing weight, therefore, makes insulin less resistant and improves the diabetic status. This in turn helps in the response to periodontal treatment.
The other theory relates to the presence of the leptin hormone that regulates appetite. Leptin plays a role in regulating metabolism and has been linked to inflammation by increasing the production of cytokines and the –C-reactive protein, which is also linked to inflammation. Bissada said leptin production was reduced after bariatric surgery and may be one explanation for the better outcomes in the periodontal treatment.
As the researchers look to the further their research, their next step will be to conduct a longitudinal study to support their preliminary findings.
Case Western Reserve University School of Dental Medicine researchers found the human body is better at fighting gum disease when fat cells, which trigger inflammation, disappear.
Findings come from a pilot study of 31 obese people with gum disease. Half of the group with an average body mass index (BMI) of 39 had gastric bypass surgery and had fat cells from the abdomen removed. That half fared better than a control group of obese people with a BMI of 35 who also were treated for gum disease but did not have the gastric bypass surgery or fat removed.
What intrigued the researchers is that the majority of those who underwent surgery had a drop in their glucose levels after the procedure, a result that bodes well for overweight people predisposed to diabetes and insulin-related problems.
All study participants underwent nonsurgical periodontal treatments of scaling/root planing and oral hygiene instructions for home care. While both groups showed improvement, the surgery group did even better on the measures for periodontal attachment, bleeding, probing depths and plaque levels.
Inflammation that continues to brew in the body can have harmful effects over time, and inflammation from gum disease can erode bone and cause tooth loss. It can also cause breaks in the gums where harmful oral bacteria can enter the blood stream. Such bacteria have been linked to preterm birth, fetal death, heart disease, diabetes and arthritis, said Nabil Bissada, chair of the department of periodontics at Case Western Reserve School of Dental Medicine.
Bissada is the lead author of the study, “Response to periodontal therapy in subjects who had weight loss following bariatric surgery and obese counterparts: a pilot study,” published in the Journal of Periodontology.
This study raises two hypotheses about why the surgery group improved.
The first theory is that excessive fat cells (adipocytes) secrete more cytokines (such as TNF and IL-6), which make insulin more resistant to doing its function.
As a result, more accumulation of sugar in the blood (hyperglycemia) occurs. Losing weight, therefore, makes insulin less resistant and improves the diabetic status. This in turn helps in the response to periodontal treatment.
The other theory relates to the presence of the leptin hormone that regulates appetite. Leptin plays a role in regulating metabolism and has been linked to inflammation by increasing the production of cytokines and the –C-reactive protein, which is also linked to inflammation. Bissada said leptin production was reduced after bariatric surgery and may be one explanation for the better outcomes in the periodontal treatment.
As the researchers look to the further their research, their next step will be to conduct a longitudinal study to support their preliminary findings.
Subscribe to:
Posts (Atom)