Periodontal disease and women's health.

BACKGROUND: Periodontal disease (PD) is a multifactorial inflammatory condition in which inappropriate interaction between the host immune response and specific groups of bacterial pathogens leads to destruction of connective and bone tissues supporting the tooth. Dissemination of pathogens, toxins, and immune complexes from and to periodontal lesions is at the basis of the increasingly recognized association between PD and various systemic diseases (SDs). Considering the growing attention of the medical community to "gender medicine", this review focuses on the association between PD and six systemic conditions heavily impacting women's health, with the aim of providing evidence in support of a joint effort between physicians and dentists to improve clinical management of these conditions. METHODS: We considered systematic reviews, meta-analyses and narrative reviews evaluating all possible associations between periodontitis, systemic diseases and women. RESULTS: Gender prevalence for PD is discordant, but the literature strongly supports an association between PD and female infertility and adverse pregnancy outcomes. Moreover, PD is bidirectionally linked to several systemic diseases characterized by an established female gender bias, i.e. osteoporosis (OP), cardiovascular diseases (CVD), autoimmunity, Alzheimer's disease (AD) and cancer. CONCLUSIONS: Overall, the literature data reviewed here provides a strong foundation for further characterization of molecular and microbial drivers of PD and of several female-prevalent systemic diseases, highlighting the possible importance of a good oral condition in preventing or attenuating women's systemic diseases.

Vitamin D: relevance in dental practice.

OBJECTIVE: The potential role of VDR gene variations in modulating periodontal susceptibility have been a subject of scientific investigations. The aim of this paper is to perform a literature review of the potential correlation between Vitamin D Receptor (VDR) gene polymorphisms and periodontal disease. MATERIALS AND METHODS: A PubMed literature search was made using "vitamin d receptor polymorphisms periodontal disease" as keys words. Only clinical studies in "Humans" as species and "English" as language were considered. Titles and abstracts of all identified records were examined to determine if the candidate articles contained sufficient information on the association of the VDR polymorphisms and the risk of development periodontal disease. CONCLUSIONS: Vitamin D may affect the risk of developing periodontal disease via an effect on bone mineral density or via immunomodulatory effects. There are scientific evidences about the correlation between some VDR polymorphisms, periodontitis and bone metabolism. The use of new simple and economics diagnostic techniques of genetic screening, allows to the dental specialists to identify periodontal patients with possible decreased bone mineral density. The complete acquisition of awareness by dentists of the strong relationship between skeletal bone density with periodontal health and osteointegrated implant success, could open a new therapeutic approach for periodontists with an important role in the early detection of osteoporosis and a better patient compliance of the periodontal therapy.

The impact of Platelet Rich Plasma (PRP) in osseointegration of oral implants in dental panoramic radiography: texture based evaluation.

PURPOSE: In this study the temporal texture differentiation associated with the bone formation properties, around loaded oral implants after Platelet Rich Plasma (PRP) employment, was investigated in Panoramic Radiographs. MATERIALS AND METHODS: Thirty eligible patients are randomly assigned to two groups. The test group received PRP application around new implants, while in the control group no PRP treatment was made. The bone-to-implant contact region was analyzed in a clinical sample of 60 Digitized Panoramic Radiographs, 30 corresponding to immediate implant loading (Class-I) and 30 after an 8 month follow-up period (Class-II). This region was sampled by 1146 circular Regions-of-Interest (ROIs), resulting from a specifically designed segmentation scheme based on Markov-Random-Fields (MRF). From each ROI, 41 textural features were extracted, then reduced to a subset of 4 features due to redundancy and employed as input to Receiver-Operating-Characteristic (ROC) analysis, to assess the textural differentiation between two classes. RESULTS: The selected subset, achieved Area-Under-Curve (AUC) values ranging from 0.77-0.81 in the PRP group, indicating the significant temporal textural differentiation has been made. In the control group, the AUC values ranged from 0.56-0.68 demonstrating lesser osseo integration activity. CONCLUSION: This study provides evidences that PRP application may favor bone formation around loaded dental implants that could modify the dental treatment planning.

Bacterial colonization patterns of periodontal pockets in different ages.

The aim of this study was to investigate subgingival bacterial composition of untreated Italian subjects with aggressive and chronic periodontitis. The total bacterial load, pathogenic bacteria belonging to "red" and "orange" complexes and Aggregatibacter actinomycetemcomitans were determined by Real-Time PCR in 1216 patients. Data were analysed by looking for relationships between bacteriological parameters, age and periodontal probing depth. The obtained results showed a significant higher number of red complex bacteria in older rather than in younger patients. The total number of bacteria and the presence of A. actinomycetemcomitans did not clearly associate with an age group.

IL-18 gene promoter polymorphisms are only moderately associated with periodontal disease in Italian population.

OBJECTIVE: The aim of this study was to determine the impact of the polymorphisms at position -607 (C/A) and -137 (G/C) in the promoter of the IL-18 gene and their haplotypes, on the individual susceptibility of developing Aggressive (AgP) and/or Chronic (CP) periodontitis. MATERIALS AND METHODS: A total of 213 unrelated Italian subjects with periodontitis (AgP=109 and CP=104) and 100 periodontal-health subjects were studied. IL-18 gene promoter polymorphisms were analyzed by TaqMan® SNP Genotyping Assays. Genotype and allele frequencies were analyzed using the chi-square test and multiple logistic regression analysis. RESULTS: χ(2) of comparisons between diseased patients and healthy controls indicated a significant differentiation between the control and AP and CP groups (χ(2)=26.359, P<0.02). Interestingly, genotypes AACG, AACC and AACG have a moderate association with AgP and CP. For alleles, multiple logistic regression analysis showed that the polymorphism CG at position -137 is moderately associated with AgP (ExpB=2.880), while the polymorphism AA at position -607 is moderately associated with CP (ExpB=2.076). Finally, a moderate association of CA at position -607 (ExpB=2.099) with the healthy status compared to aggressive periodontitis was found. CONCLUSIONS: Results obtained indicated the presence of some potential moderate protective and moderate susceptible alleles and genotypes to both aggressive and chronic periodontitis, demonstrating that IL-18 -607 C/A and -137 G/C gene promoter polymorphisms are not suitable diagnostic features for AgP and CP.