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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Evidence is increasing that oral health has important impacts on systemic health. This paper presents data from the third National Health and Nutrition Examination Survey (NHANES III) describing the prevalence of dental caries and periodontal diseases in the older adult population. It then evaluates published reports and presents data from clinical and epidemiologic studies on relationships among oral health status, chronic oral infections (of which caries and periodontitis predominate), and certain systemic diseases, specifically focusing on type 2 diabetes and aspiration pneumonia. Both of these diseases increase in occurrence and impact in older age groups. The NHANES III data demonstrate that dental caries and periodontal diseases occur with substantial frequency and represent a burden of unmet treatment need in older adults. Our review found clinical and epidemiologic evidence to support considering periodontal infection a risk factor for poor glycemic control in type 2 diabetes; however, there is limited representation of older adults in reports of this relationship. For aspiration pneumonia, several lines of evidence support oral health status as an important etiologic factor. Additional clinical studies designed specifically to evaluate the effects of treating periodontal infection on glycemic control and improving oral health status in reducing the risk of aspiration pneumonia are warranted. Although further establishing causal relationships among a set of increasingly more frequently demonstrated associations is indicated, there is evidence to support recommending oral care regimens in protocols for managing type 2 diabetes and preventing aspiration pneumonia.
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PMID:Impact of oral diseases on systemic health in the elderly: diabetes mellitus and aspiration pneumonia. 1124 53

The elderly lose teeth as a result of dental caries and periodontitis caused by pathogenic oral bacteria. Periodontitis produces inflammatory cytokines due to the presence of lipopolysaccharides from oral gram-negative bacteria. Although the number of circulating inflammatory cytokines is related to the severity of the periodontitis, it is unclear whether the concentrations also correlate with periodontitis in the elderly. We investigated the relationship between periodontitis status and the concentrations of serum interleukin-6 (IL-6) in the serum from 276 subjects of 70- and 80-year-olds. Of the 276 subjects, 227 (82%) were dentate, 149 (54%) were found to be positive for serum IL-6, and 29 (13%) of the dentate subjects had severe periodontitis. However, there were no significant differences between the severity of periodontitis or the number of teeth and the mean serum IL-6 concentrations. These results provided no evidence to support an association between circulating IL-6 and periodontitis in the elderly.
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PMID:Periodontitis and serum interleukin-6 levels in the elderly. 1142 44

Dental caries and periodontitis, although generally not life threatening, are nevertheless of significant importance. An understanding of the molecular nature of these diseases could aid the development of novel methods of prevention and control, and increase our knowledge of their etiology. The identification of virulence factors in oral bacteria could lead to the development of vaccines directed against these organisms, the design of inhibitors of biofilm formation, and the development of replacement therapy strategies.
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PMID:Virulence properties of oral bacteria: impact of molecular biology. 1147 73

Diabetes mellitus consists of a group of disorders, which are characterized by a lack of insulin production or insulin resistance. There can be various oral manifestations of diabetes, such as xerostomia and an increased incidence of dental caries. Recently, it has been suggested that periodontitis be added as the sixth complication of diabetes mellitus. It has been shown that uncontrolled or poorly controlled diabetics have a greater incidence of severe periodontal disease compared with those patients who are well controlled or have no diabetes mellitus. This has been found for both type 1 and type 2 diabetics. In addition, the diabetic patient may be predisposed to periodontal disease based on the production of advanced glycation end products, which bind to receptors on specific cells such as the monocyte. The success of periodontal treatment appears to be dependent on the control exhibited by the diabetic patient. The well-controlled diabetic will respond well to periodontal treatment, while the uncontrolled or poorly controlled will often not respond well or be stable in the long-term. Because of the large number of diabetics in the US population, dental therapists should be aware of the interactions of the patient's diabetic status, the proposed treatment, and the possible treatment outcomes as well as complications.
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PMID:Diabetes mellitus: a review of the literature and dental implications. 1169 99

Retention of teeth into advanced age makes caries and periodontitis lifelong concerns. Dental caries occurs when acidic metabolites of oral streptococci dissolve enamel and dentin. Dissolution progresses to cavitation and, if untreated, to bacterial invasion of dental pulp, whereby oral bacteria access the bloodstream. Oral organisms have been linked to infections of the endocardium, meninges, mediastinum, vertebrae, hepatobiliary system, and prosthetic joints. Periodontitis is a pathogen-specific, lytic inflammatory reaction to dental plaque that degrades the tooth attachment. Periodontal disease is more severe and less readily controlled in people with diabetes; impaired glycemic control may exacerbate host response. Aspiration of oropharyngeal (including periodontal) pathogens is the dominant cause of nursing home-acquired pneumonia; factors reflecting poor oral health strongly correlate with increased risk of developing aspiration pneumonia. Bloodborne periodontopathic organisms may play a role in atherosclerosis. Daily oral hygiene practice and receipt of regular dental care are cost-effective means for minimizing morbidity of oral infections and their nonoral sequelae.
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PMID:Infectious complications of dental and periodontal diseases in the elderly population. 1295 53

Indigenous micro-organisms in the oral cavity can cause two major diseases, dental caries and periodontal diseases. There is neither agreement nor consensus as to the actual mechanisms of pathogenesis of the specific virulence factors of these micro-organisms. The complexity of the bacterial community in dental plaque has made it difficult for the single bacterial agent of dental caries to be determined. However, there is considerable evidence that Streptococcus mutans is implicated as the primary causative organism of dental caries, and the cell-surface protein antigen (SA I/II) as well as glucosyltransferases (GTFs) produced by S. mutans appear to be major colonization factors. Various forms of periodontal diseases are closely associated with specific subgingival bacteria. Porphyromonas gingivalis has been implicated as an important etiological agent of adult periodontitis. Adherence of bacteria to host tissues is a prerequisite for colonization and one of the important steps in the disease process. Bacterial coaggregation factors and hemagglutinins likely play major roles in colonization in the subgingival area. Emerging evidence suggests that inhibition of these virulence factors may protect the host against caries and periodontal disease. Active and passive immunization approaches have been developed for immunotherapy of these diseases. Recent advances in mucosal immunology and the introduction of novel strategies for inducing mucosal immune responses now raise the possibility that effective and safe vaccines can be constructed. In this regard, some successful results have been reported in animal experimental models. Nevertheless, since the public at large might be skeptical about the seriousness of oral diseases, immunotherapy must be carried out with absolute safety. For this goal to be achieved, the development of safe antibodies for passive immunization is significant and important. In this review, salient advances in passive immunization against caries and periodontal diseases are summarized, and the biotechnological approaches for developing recombinant and human-type antibodies are introduced. Furthermore, our own attempts to construct single-chain variable fragments (ScFv) and human-type antibodies capable of neutralizing virulence factors are discussed.
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PMID:Passive immunization against dental caries and periodontal disease: development of recombinant and human monoclonal antibodies. 1200 12

An increasing number of elderly people suffer from the loss of teeth due to periodontitis or dental caries. Currently accepted functional prosthetic rehabilitation includes removable or fixed prostheses, with or without osseointegrated dental implants. All of them, however, are foreign bodies for the organism. In this regard, the ideal materials are natural teeth, which do not stimulate inflammatory responses. Tissue engineering has made great progress in regenerating a variety of cell types, such as bone cells. Regenerated tooth would be of great use and importance as a material for novel dental implants. However, clear mechanisms of tooth formation have not yet been elucidated. We describe here an experimental model where normal human tooth morphogenesis and dentition occur in NOD/scid mice subcutaneous tissues. Our system would contribute not only to developing, but also understanding the process of human tooth development.
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PMID:Histological analysis of human tooth development in NOD/scid mice. 1217 49

Success of fluoride in combating dental caries led to study of fluoride on periodontal disease, but studies are less reported in literature and results are varied in nature. To address this issue, the study was conducted to assess severity of periodontal disease among (n = 283) 36-45 years old adults residing in area of different concentration of fluoride in drinking water. The villages selected were having fluoride concentration in their drinking water are Shamnur (0.5 PPMF), Kundawada (1.1 ppmF) and Halebathi (3.17 ppm). Ion Selective Electrode Method (OrionUSA) estimated fluoride in drinking water. Community Periodontal Index (WHO, 1997) and Plaque Index (Silness and Loe, 1967) was used to assess periodontal status. There was consistent decrease in mean plaque score from 1.45+ _0.024 at 0.51 ppm, 1.21+ _0.009 at 1.1 ppm, and 1.12+ _0.08 at 3.17 ppm fluoride area. This difference was significant statistically (P < 0.001). As the fluoride concentration in drinking water increased there was decrease in severity of prevalence of periodontitis. This difference in observation was significant statistically (P < 0.05). There were no effects of fluoride on calculus, since little variability was found in three different fluoride areas. Thus it was concluded from the study results that the increase in fluoride concentration decreased the plaque accumulation. decreased the shallow and deep pockets. Hence lower prevalence and severity of periodontal disease.
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PMID:Prevalence of periodontal disease in endemically flourosed areas of Davangere Taluk, India. 3090 Jun 80

The successful management of multi-space orofacial odontogenic infections involves identification of the source of the infection, the anatomical spaces encountered, the predominant microorganisms that are found during the various stages of odontogenic fascial space infection, the impact of the infectious process on defense systems, the ability to use and interpret laboratory data and imaging studies, and a thorough understanding of contemporary antibiotic and supportive care. The therapeutic goals, when managing multi-space odontogenic infections, are to restore form and/or function while limiting patient disability and preventing recurrence. Odontogenic infections are commonly the result of pericoronitis, carious teeth with pulpal exposure, periodontitis, or complications of dental procedures. The second and third molars are frequently the etiology of these multi-space odontogenic infections. Of the two teeth, the third molar is the more frequent source of infection. Diagnostic imaging modalities are selected based on the patient's history, clinical presentation, physical findings and laboratory results. Periapical and panoramic x-rays are reliable initial screening instruments used in determining etiology. Magnetic resonance imaging and computed tomography are ideal imaging studies that permit assessment of the soft tissue involvement to include determining fluid collections, distinguishing abscess from cellulitis, and offering insight as to airway patency. Antibiotics are administered to assist the host immune system's effort to control and eliminate invading microorganisms. Early infections, first three (3) days of symptoms, are primarily caused by aerobic streptococci which are sensitive to penicillin. Amoxicillin is classified as an extended spectrum penicillin. The addition of clavulanic acid to amoxicillin (Augmentin) increases the spectrum to staphylococcus and other anaerobes by conferring beta-lactamase resistance. In late infections, more than three (3) days of symptoms, the predominant microorganisms are anaerobes, predominantly Peptostreptococcus, Fusobacterium, or Bacteroides, that are resistant to penicillin. Clindamycin is an attractive alternative drug for first line therapy in the treatment of these infections. The addition of metronidazole to penicillin is also an excellent treatment choice. Alternatively, Unasyn (Ampicillin/Sublactam), should be considered. The mainstay of management of these infections remains appropriate culture for bacterial identification, timely and aggressive incision and drainage, and removal of the etiology. It is usually preferable to drain multi-space infections involving the submandibular, submental, masseteric, pterygomandibular, temporal, and/or lateral pharyngeal masticator spaces, as early as possible from an extraoral approach. Trismus and airway management are important considerations and may preclude the selection of other surgical approaches. The patients with multi-space infections should be hospitalized and patient care provided by experienced clinicians capable of management of airway problems, in administration of parenteral antibiotics and fluids, utilization of interpretation of laboratory and diagnostic imaging studies, and control of possible surgical complications.
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PMID:Management of complex multi-space odontogenic infections. 1257 6

A 40-year-old man was hospitalized due to fever, muscular swelling and pain. He had poorly controlled diabetes with many dental caries and repeated periodontitis. CT revealed multiple intramuscular abscesses; administration of antibiotics and pus drainage were performed. Intraoral infection was suspected as the route of infection of pyomyositis, and a total of six teeth was extracted. In the clinical treatment of diabetic patients, it is important to instruct patients to routinely check for the presence of traumatic injuries of the lower extremities, and to have routine check-ups and dental care to check for dental caries or periodontitis.
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PMID:Type 2 diabetes complicated by multiple pyomyositis. 1263 37


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