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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We explored the association between social factors and adult periodontitis by comparing self-reported information for daily strains and symptoms of depression in 71 cases and 77 controls. Cases and controls were selected from among 1,426 participants in the Erie County Risk Factor Study. We found differences among those who scored higher than their peers on measures of social strain. The odds ratio (OR) and 95% confidence interval (95% CI) for the association between case status and Role Strain score of 2.27 or more was 2.84, 95% CI = 1.08 to 7.46. We also examined serum antibody, dichotomized at the median, for three periodontal pathogens (Bacteroides forsythus [IgG Bf], Porphyromonas gingivalis [IgG Pg], Actinobacillus actinomycetemcomitans [IgG Aa]), and assessed interaction between antibody levels and a Depression score derived from the Brief Symptom Inventory. IgG Pg and IgG Aa were both strongly associated with case status (OR = 4.52, 95% CI = 1.99 to 10.3 and OR = 5.29, 95% CI = 2.34 to 12.0, respectively). IgG Bf was associated with periodontal disease but only among individuals who had higher scores for Depression (OR = 6.75, 95% CI = 1.25 to 36.5). Smoking status was associated with case status (OR = 4.95, 95% CI = 1.86 to 13.2). We assessed these findings prospectively by examining factors associated with more extensive disease among the 71 case subjects after 1 year of follow-up. We found baseline smoking status and IgG Bf among individuals scoring high on Depression at baseline to be associated with more extensive disease (8.1% or more of the sites showing further breakdown). In this population an elevated Depression score may be a marker for social isolation, which could play a role in immune function during periods of social strain. This exploratory analysis has served to identify specific lines of inquiry concerning psychosocial measures as important environmental factors in adult periodontitis.
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PMID:Exploratory case-control analysis of psychosocial factors and adult periodontitis. 891 Aug 24

Periodontal disease is rare in nature but widespread in domestic dog and cat populations. Unnatural diets are known to facilitate the buildup of oral microbial communities which then interact with host-immune defences giving rise to periodontitis. Eight of 14 animals undergoing dental treatment and dietary change at a suburban veterinary practice were investigated and found to have low leucocyte counts. Follow-up testing revealed changes averaging a 77.7 per cent increase with concomitant 'subjective good health'. These findings serve to cast doubt on the commonly used haematological reference ranges where the subject animals may have suffered from periodontal disease. The demonstrated reversibility of white cell depression associated with periodontal disease should provide a focus for further research.
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PMID:Periodontal disease and leucopenia. 892 23

Psychological disturbances may lead patients to neglect oral hygiene. This study investigated whether a number of psychosocial factors (depression, state and trait anxiety, total and average perceived stress, and loneliness) could predict dental plaque levels in patients with adult onset rapidly progressive periodontitis (RPP) and routine chronic adult periodontitis (RCAP), before periodontal treatment. It was also examined whether RPP and RCAP patients differed on plaque and smoking. Plaque was scored in a sample of 6 teeth in each of 80 subjects, 40 with RPP, 40 with RCAP, before psychosocial questionnaire completion. Multiple regression was performed between plaque as the dependent and psychosocial factors, gender, education, form of periodontitis and smoking as independent variables. Only gender contributed significantly to prediction of plaque, t=-2.70, p=0.01, partial regression coefficient -0.37, 95% CI: -0.64 to -0.10, indicating that plaque was on average 0.37 lower for females than males, after adjusting for the other predictor variables. It was confirmed that RPP and RCAP patients did not differ significantly on plaque, univariate t-test(69.99)= 0.65, p=0.13. However, RPP patients smoked significantly more than RCAP patients t(69.72)=2.36, p=0.02. There was also a marginally significant correlation between depression and smoking, r=0.16, p=0.07. One possible reason advanced for the lack of an association between psychosocial factors and plaque, and the absence of a difference in plaque between RPP and RCAP patients is the fact that the patients involved in the present study were seen as secondary referrals. The gender difference in plaque levels and the greater incidence of smoking in RPP patients may be of significance in planning interventions with patients with periodontitis.
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PMID:Psychosocial factors, dental plaque levels and smoking in periodontitis patients. 966 86

Cardiovascular diseases, including atherosclerosis and myocardial ischemia, occur as a result of a complex set of genetic and environmental factors. During periodontitis, dental plaque microorganisms may disseminate through the blood to infect the vascular endothelium and contribute to the occurrence of atherosclerosis and risk of myocardial ischemia and infarction. Myocardial ischemia and infarction are often preceded by acute thromboembolic events. In an in vitro model of thrombosis, certain dental plaque bacteria induce platelets to aggregate. Aggregation of platelets is induced by the platelet aggregation-associated protein [PAAPJ expressed on plaque bacteria, including Streptococcus sanguis and Porphyromonas gingivalis. Intravenous infusion of S. sanguis into rabbits has been shown previously to cause changes in the electrocardiogram (ECG), heart rate, blood pressure, and cardiac contractility. These changes are consistent with the occurrence of myocardial infarction. The ECG changes are now shown to begin within 30 seconds after infusion of PAAP+ S. sanguis, followed by alterations in blood pressure and respiratory rate. These changes occurred intermittently over a 30-minute period and changed within one heartbeat to a normal pattern and suddenly back to abnormal. Intermittent ECG abnormalities were seen in 13 of 15 rabbits, including left axis deviation, ST-segment depression, preventricular contractions, alternans, and bigemnia. Dose-dependent thrombocytopenia, accumulation of 111Indium-labeled platelets in the lungs, and tachypnea also occurred. No changes occurred with the PAAp- strain. The data indicated that PAPP+ S. sanguis interacts with circulating platelets, inducing thromboemboli to cause the pulmonary and cardiac abnormalities. During periodontitis, therefore, PAAP+ S. sanguis and P. gingivalis bacteremia may contribute to the chance of acute thromboembolic events.
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PMID:Dental plaque, platelets, and cardiovascular diseases. 972 99

The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating patients with unusual forms of periodontal disease such as early-onset, refractory and rapidly progressive disease. There appears to be a strong genetic component in some types of periodontal disease and genetic testing for disease susceptibility has potential for future use, but more research is needed to determine its utility for use in clinical practice. Treatment of the periodontal diseases may be divided into four phases: systemic, hygienic, corrective and maintenance or supportive periodontal therapy. Regardless of the type of treatment provided, periodontal therapy will fail or will be less effective in the absence of adequate supportive periodontal therapy.
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PMID:Periodontal risk assessment, diagnosis and treatment planning. 1115 81

Periodontitis are diseases of the supportive tissues of the teeth provoked by bacteria and characterized by gingival inflammation and bone destruction. We have developed a new strategy to repair tissues by administrating agents (RGTA) that mimic heparan sulfates by protecting selectively some of the growth factors naturally present within the injured tissue and interfering with inflammation. After periodontitis induction in hamsters, the animals were left untreated or received weekly i.m. injections of RGTA1507 at a dose of 100 microg/kg, 400 microg/kg, 1.5 mg/kg, or 15 mg/kg for 4 wk. RGTA treatment significantly reduced gingival tissue inflammation, thickened the pocket epithelium by increasing cell proliferation, and enhanced collagen accumulation in the gingiva. A marked reduction in bone loss was observed, resulting from depression of osteoclasia and robust stimulation of bone formation at the dose of 1.5 mg/kg. RGTA treatment for 8 wk at this dose reversed macroscopic bone loss, sharply contrasting with the extensive bone destruction in the untreated animals. RGTA treatment decreased gelatinase A (MMP-2) and B (MMP-9) pro-forms in gingival tissues. Our data indicate that a 4 wk treatment dose-dependently attenuated gingival and bone manifestations of the disease, whereas a longer treatment restored alveolar bone close to controls. By modulating and coordinating host responses, RGTA has unique therapeutic properties and is a promising candidate for the treatment of human periodontitis.
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PMID:A new approach to treat tissue destruction in periodontitis with chemically modified dextran polymers. 1266 77

Systemic immunity was studied in patients with chronic generalized parodontitis. This group of patients had distinct changes in immunologic system: depression of T- and stimulation of B-cellular immunity without accumulation of plasma cells and initiation of effective humoral response. Increased peripheral blood number of lymphocytes expressing induction of apoptosis CD95 receptors and ligand for this receptor CD95L (Fas-L) can lead to intensification of lymphocyte apoptosis and may be the reason for T-cell deficit development. The results of the study confirm the important role of immune system disturbances in pathogenesis of chronic generalized parodontitis.
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PMID:[Immunologic disorders in pathogenesis of chronic generalized parodontitis]. 1600 4

This paper highlights the typical clinical features of aggressive periodontitis (formerly known as juvenile periodontitis in the South Western region of Nigeria), the attending psychological effect following tooth loss, and the rehabilitative management offered which included periodontal therapy, psychotherapy, and prosthetic replacement of the missing teeth. The psychotherapy is the main distinguishing treatment in this study from previously reported modes of management of this disease entity. Subjects were from a part of the South Western region of Nigeria, and ages ranged from 15 to 22 years. They all presented very late with subsequent gross periodontal breakdown and subsequent psychological depression. The mean values of the probing depth (mm), degree of mobility, and the amount of bone fill (mm) from the periapical radiographs were recorded pre and post-operatively. The missing teeth were replaced with acrylic dentures, and psychotherapy was offered at three levels (individual, group, and conjoint-family psychotherapy). There was significant improvement of these clinical parameters six months after treatment, and the partial denture replacement of the missing teeth improved their appearance as expected but did not totally improve the initial depressive state. The psychotherapy offered gave the patients positive psychological effects that further restored their ability to socialize in their environment, which added to their positive experience of life. In conclusion the typical clinical features of localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP) patients in our environment are late presentation with gross periodontal tissue breakdown. Psychotherapy is an important aspect in the management of this group of patients in conjunction with the periodontal and prosthetic management, which gives total rehabilitation.
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PMID:Rehabilitative management offered Nigerian localized and generalized aggressive periodontitis patients. 1612 71

When defining the relationship between psychosocial factors and periodontitis several issues should be considered: most published studies support a positive association periodontitis, and several psycho-social factors: social isolation, socio-economic status, personality factors, anxiety, depression and life stress; many studies are cross-sectional in nature, include relatively small sample sizes and have inadequate control of potential confounding factors; varying methods to assess both psychosocial factors and periodontitis were used; psychological variables are usually measured by self-report scales and the informers may supply incorrect information and the situation bias may also take place that is the condition of instability of the clinical phenomenon being evaluated; the demographic makeup of the population under study (age, gender, education level, race) and control of potential confounding variables (smoking, oral hygiene status) differs markedly across studies. The findings indicate that the main mechanisms by which psychosocial factors promote gingivitis and periodontitis development included: 1) behavioural mechanisms, whereby the given factor exacerbates lifestyles known to potentiate periodontal disease (e.g., neglect of oral hygiene, changes in diet, increase in smoking), and 2) direct pathophysiological effects on host resistance. As a result, interferences on the association between psychosocial factors and periodontal disease require careful considerations.
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PMID:Psychological perspectives on the pathogenesis of periodontal disease. 1838 4

Susceptibility to and development of periodontal disease have been associated with psychological conditions. Previous studies have associated the presence of polymorphism in the promoter region of the serotonin transporter with several behavioral traits and psychological conditions such as depression, anxiety, and stress. The short allele S has a reduced transcriptional efficiency and is associated with lowered serotonin expression and uptake. The purpose of the present study was to investigate the association between 5-HTTLPR polymorphism and aggressive periodontitis in a sample of Brazilian individuals. This study involved 61 individuals affected by aggressive periodontitis and 71 without periodontitis. Genomic DNA was obtained from oral swabs, amplified by polymerase chain reaction (PCR), and genotyped at 5-HTTLPR. The Chi-square test and multivariate logistic regression were used for statistical analysis. The aggressive periodontitis group displayed a significantly higher occurrence of genotype SS (P < 0.01) and of allele S (P < 0.01). After adjustment for gender and age, it was observed that genotype SS occurred 8 times more frequently in this group. Our findings suggest that 5-HTTLPR polymorphism might be associated with aggressive periodontitis in the Brazilian population.
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PMID:Polymorphism in the promoter region of the gene for 5-HTT in individuals with aggressive periodontitis. 1858 10


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