Host genetics role in the pathogenesis of periodontal disease and caries.

BACKGROUND: This study aimed to produce the latest summary of the evidence for association of host genetic variants contributing to both periodontal diseases and caries. MATERIALS AND METHODS: Two systematic searches of the literature were conducted in Ovid Medline, Embase, LILACS and Cochrane Library for large candidate gene studies (CGS), systematic reviews and genome-wide association studies reporting data on host genetic variants and presence of periodontal disease and caries. RESULTS: A total of 124 studies were included in the review (59 for the periodontitis outcome and 65 for the caries outcome), from an initial search of 15,487 titles. Gene variants associated with periodontitis were categorized based on strength of evidence and then compared with gene variants associated with caries. Several gene variants showed moderate to strong evidence of association with periodontitis, although none of them had also been associated with the caries trait. CONCLUSIONS: Despite some potential aetiopathogenic similarities between periodontitis and caries, no genetic variants to date have clearly been associated with both diseases. Further studies or comparisons across studies with large sample size and clear phenotype definition could shed light into possible shared genetic risk factors for caries and periodontitis.

Periodontal infectogenomics: systematic review of associations between host genetic variants and subgingival microbial detection.

BACKGROUND: Recent research is increasingly showing that host genetic variants can affect the colonization by specific microbes. The aim of this study was to systematically investigate the associations between host genetic variants and subgingival microbial detection and counts. MATERIALS AND METHODS: A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for studies reporting data on host genetic variants and detection of microbes subgingivally. RESULTS: A total of 43 studies were included in the review, from an initial search of 3887 titles. Studies consisted mainly of candidate gene studies and of one genome-wide analysis. Some promising associations were detected between single nucleotide polymorphisms and microbial detection. The only feasible meta-analysis failed to show any association between Interleukin 1 (IL1) genetic variants and detection of periodontopathogenic bacteria subgingivally. CONCLUSIONS: There is no evidence yet that neither IL1 genetic polymorphisms nor other investigated genetic polymorphisms are associated with presence and counts of subgingival bacteria. Further studies on large populations with replication samples should clarify the possible effects of other genetic variants on the subgingival microbiota.

Tooth loss in molars with and without furcation involvement - a systematic review and meta-analysis.

BACKGROUND: The aim of this study was to investigate risk of tooth loss in molars with furcation involvement (FI) based on initial diagnosis. MATERIALS AND METHODS: A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for longitudinal studies with at least 3 years follow-up including measures of FI and data on tooth loss. RESULTS: A total of 21 studies were included in the review, from an initial search of 1207 titles. The relative risk of tooth loss during maintenance therapy attributable to FI was 1.46 (95% CI = 0.99-2.15, p = 0.06) for studies up to 10 years and 2.21 (95% CI = 1.79-2.74, p < 0.0001) for studies with a follow-up of 10-15 years. A gradual increase in the risk of tooth loss was observed for molars with degree II and III FI. CONCLUSIONS: The presence of FI approximately doubles the risk of tooth loss for molars maintained in supportive periodontal therapy for up to 10-15 years. However, most molars, even with grade III FI respond well to periodontal therapy, suggesting that every effort should be made to maintain these teeth when possible. Long-term studies reporting patient-reported outcomes are needed to substantiate this conclusion.

Professional mechanical plaque removal for prevention of periodontal diseases in adults--systematic review update.

AIM: To update previous systematic review investigating effect of professional mechanical plaque removal (PMPR) on prevention of periodontal diseases. METHODS: Search for randomized controlled trials: 2004 to April 2014. Screening and data abstraction conducted independently/in duplicate and narrative synthesis. RESULTS: From 1655 titles and abstracts, 24 full-text articles screened and three new studies were eligible. Low-to moderate strength of evidence suggests that in adults, PMPR, particularly if combined with oral hygiene instructions (OHI), may achieve greater changes in measures of dental plaque and gingival bleeding/inflammation than no treatment. Moderate strength of evidence suggests there is no additional benefit to plaque and gingival bleeding outcomes from PMPR over that achieved by repeated and thorough OHI. There is no evidence from RCTs to inform on prevention of periodontitis. Low strength of evidence suggests that more frequent PMPR is associated with improved plaque and bleeding outcomes and possibly less annual attachment loss. CONCLUSIONS: There are insufficient data to inform directly on the effect of PMPR on primary prevention of periodontitis. However, in relation to gingival health, new studies strengthen the evidence that there is little value in providing PMPR without OHI. In fact, repeated, thorough OHI can achieve a similar benefit to repeated PMPR.