Browsing by Subject "Periodontal disease"
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Item Does Nonsurgical Periodontal Treatment Improve Systemic Health?(Sage, 2021) Taylor, H.L.; Rahurkar, S.; Treat, T.J.; Thyvalikakath, T.P.; Schleyer, T.K.; Health Policy and Management, School of Public HealthClinicians frequently stress the importance of maintaining good oral health for multiple reasons, including its link to systemic health. Because periodontal treatment reduces inflammation in oral tissues, some hypothesize it may positively affect systemic outcomes by reducing inflammation in the body. A significant number of systematic reviews (SRs) and meta-analyses (MAs) have evaluated the effect of periodontal treatment on systemic outcomes. However, inconsistent findings and questionable methodological rigor make drawing conclusions difficult. We conducted a systematic review of reviews that studied the effect of nonsurgical periodontal treatment on systemic disease outcomes. We report on outcomes evaluated, categorizing them as biomarkers, and surrogate or clinical endpoints. In addition, we used A MeaSurement Tool to Access systematic Reviews 2 (AMSTAR 2) to evaluate the methodological quality of the reviews. Of the 52 studies included in our review, 21 focused on diabetes, 15 on adverse birth outcomes, 8 on cardiovascular disease, 3 each on obesity and rheumatoid arthritis, and 2 on chronic kidney disease. Across all studies, surrogate endpoints predominated as outcomes, followed by biomarkers and, rarely, actual disease endpoints. Ninety-two percent of studies had "low" or "critically low" AMSTAR 2 confidence ratings. Criteria not met most frequently included advance registration of the protocol, justification for excluding individual studies, risk of bias from individual studies being included in the review, and appropriateness of meta-analytical methods. There is a dearth of robust evidence on whether nonsurgical periodontal treatment improves systemic disease outcomes. Future reviews should adhere more closely to methodological guidelines for conducting and reporting SRs/MAs than has been the case to date. Beyond improved reviews, additional rigorous research on whether periodontal treatment affects systemic health is needed. We highlight the potential of large-scale databases containing matched medical and dental record data to inform and complement future clinical research studying the effect of periodontal treatment on systemic outcomes.Item Is Periodontal Disease a Partial Mediator of the Association Between Depressive Symptoms And Cardiovascular Disease?(2012-08-28) Khambaty, Tasneem; Stewart, Jesse C.; Cyders, Melissa A.; Salyers, Michelle P.Epidemiological studies suggest that depression may be an independent risk factor for cardiovascular disease (CVD). Although several possible mediators of this association have been proposed, the precise mechanisms are yet unknown. Accordingly, we examined periodontal disease as a novel mediator of the depression-CVD association, given its separate links with both depression and CVD. Data from the National Health and Nutrition Examination Survey (NHANES) I and its Epidemiologic Follow-up Study (NHEFS) were analyzed. Participants were 3,346 individuals aged 25-74 years free of CVD at baseline (53% female, 16% non-white). Depression was assessed by the, depressed mood subscale of the General Well-Being Schedule Based on the Russell Periodontal Index, periodontal disease (43%) was defined as the presence of four or more periodontal pockets identified by a licensed dentist during an examination. The primary outcome was incident CVD (n=727, 22%), defined as nonfatal or fatal coronary artery disease or cerebrovascular disease, identified during the follow-up period by interviews and death certificate records. All analyses were adjusted for demographic and cardiovascular risk factors. Logistic regression analyses revealed no association between the GWBS depressed mood score and periodontal disease (OR=1.05, 95% CI: 0.96-1.14, p=.24). Cox proportional hazard models revealed that both periodontal disease (HR=1.24, 95% CI: 1.06-1.46, p=.009) and depressed mood (HR=1.08, 95% CI: 1.01-1.17, p=.03) were significant predictors of incident CVD. However, Sobel analyses found that periodontal disease was not a partial mediator of the depressed mood-incident CVD association (t=1.01, p=.31). Overall, these mediation results suggest that (a) both periodontal disease and depressed mood are independent predictors of incident CVD and that (b) the effect of depressive symptoms on incident CVD is not mediated by periodontal disease.Item Perceptions and attitudes toward performing risk assessment for periodontal disease: a focus group exploration(BMC, 2018-05-21) Thyvalikakath, Thankam; Song, Mei; Schleyer, Titus; Cariology, Operative Dentistry and Dental Public Health, School of DentistryCurrently, many risk assessment tools are available for clinicians to assess a patient’s periodontal disease risk. Numerous studies demonstrate the potential of these tools to promote preventive management and reduce morbidity due to periodontal disease. Despite these promising results, solo and small group dental practices, where most people receive care, have not adopted risk assessment tools widely, primarily due to lack of studies in these settings. The objective of this study was to explore the knowledge, attitudes, and beliefs of dental providers in these settings toward risk-based care through focus groups.Item Periodontal diagnosis and treatment planning – An assessment of the understanding of the new classification system(Wiley, 2022-07-13) Kakar, Arushi; Blanchard, Steven; Shin, Daniel; Maupomé, Gerardo; Eckert, George J.; John, VanchitObjectives: Substantial variations are seen among clinicians in the diagnosis and treatment planning of periodontal diseases. Accurate diagnosis and treatment planning are fundamental requirements for effective outcome-based patient care. The aim of this study was to evaluate the understanding of the American Academy of Periodontology and the European Federation of Periodontology 2017 periodontal disease classifications in diagnoses and treatment plans across four study groups. Methods: The study recruited at least 20 participants in each of the four study groups. These included 1) Periodontal faculty and residents at Indiana University School of Dentistry (IUSD-PF) 2) IUSD general practice faculty (IUSD-GPF), 3) private practice periodontists (PPP), and 4) general practitioners (GP). The participants were provided with 10 HIPPA de-identified case records and a link to a survey. The survey comprised five demographic questions and two questions on diagnosis and treatment plan for each case along with a fixed list of responses. The responses were then compared against gold standards that were determined by a group of three board-certified periodontists. Results: Overall, for diagnostic questions, GP (69%) were correct significantly less often than IUSD-PF (86%, p < 0.001), IUSD-GPF (79%, p = 0.002), and PPP (80%, p = 0.001). No significant differences (p > 0.05) in the overall correct treatment plan responses were found among the four groups (IUSD-PF: 69%, IUSD-GPF: 62%, PPP: 68%, and GP: 60%). The multi-rater kappas for with-in-group agreement on overall diagnosis ranged from 0.36 (GP) to 0.55 (IUSD-PF) and on overall treatment plan ranged from 0.32 (IUSD-GPF) to 0.42 (IUSD-PF). Overall agreement for diagnosis and treatment plans among the four groups was relatively low and none of the groups were statistically different from each other (p > 0.05). Conclusion: Regular participation in calibration sessions may lead to more accurate adoption of the 2017 periodontal classification and thereby help provide consistent diagnosis and treatment.Item Principales razones de extracción de dientes permanentes en una muestra de adultos mexicanos(2013) Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; De la Rosa-Santillana, Rubén; de Jesús Navarete-Hernández, José; Maupomé, GerardoBackground. Tooth extractions are one of the most common procedures in oral surgery. The objective of this study was to identify the reasons for tooth extraction in adult patients seeking care at teaching dental clinics. Material and methods. A cross-sectional study was carried out in 331 subjects between 18 and 85 (45.37± 13.85) years of age seeking dental care in dental clinics of the Universidad Autónoma del Estado de Hidalgo, from January 2009 to December, 2009. Data pertaining to age, sex, tooth number and the reason for extraction according to Kay & Blinkhorn were analyzed with non-parametric tests. Results. 779 extractions were undertaken. The main reason for extraction was dental caries (43.1%), periodontal disease (PD) (27.9%), and prosthetic reasons (21.5%). There was no significant difference across sex for reasons of extraction (p › 0.05). Significant differences (p ‹ 0.001) were found for age (extraction due to periodontal disease increased with age); in patients attending in a single visit vs. patients attending a series of dental appointments (caries reasons were more common in patients having a single appointment vs. PD in those attending a series of appointments); for type of teeth (upper, posterior, and molars were extracted primarily because of caries, while lower, anterior and incisors were more often extracted because of PD). Conclusions. Dental caries was the most common reason for tooth extraction, followed by periodontal disease. Differences in the reasons for extraction were observed across patient characteristics and type of tooth.