• 대한지역사회영양학회지
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• 제19권1호
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• pp.84-94
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• 2014

Periodontal disease is one of the most common chronic inflammatory diseases in the oral cavity, and this is the leading cause of loss of teeth. Studies on the association between diet and periodontal diseases are very limited. The purpose of this study was to investigate the association between food and nutrient intakes and the prevalence of periodontitis. Subjects were 13,391 adults participating in the 2008-2010 Korea Health and Nutrition Examination Survey. Periodontitis was diagnosed by dentists using the Community Periodontal Index. Nutrient intakes were estimated by the 24-hour dietary recall. Consumption frequencies of foods were from the food frequency questionnaire. Subjects were categorized into 'smoking' or 'non-smoking' groups. Multiple logistic regression analysis was applied to determine the association between diet and periodontitis. The proportions of subjects having periodontitis were 26% in the non-smoking group and 37.5% in the smoking group. In the nonsmoking group, intakes of fruits, dairy products, green tea, energy and vitamin C were inversely associated with the prevalence of periodontitis, but fish and coffee intakes were positively associated with the prevalence of periodontitis after adjusting for covariates. In the smoking group, protein and retinol intakes were inversely associated with the prevalence of periodontitis after adjusting for covariates. These results suggest that certain food and nutrient intakes such as fruits, dairy products, green tea, vitamin C, protein, or retinol intakes may affect the prevalence of periodontitis among Korean adults. Further studies are required to confirm these findings in other research settings.

• 치위생과학회지
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• 제17권3호
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• pp.233-241
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• 2017

This study identified an effective control method for periodontitis by investigating the association between blood levels of vitamin D and periodontitis in Korean elderly based on raw data from the fifth Korea National Health & Nutrition Examination Survey of 2010 (KNHANES). In this study, 1,021 adults over 65 years of age were evaluated based on data from the KNHANES. Periodontal disease was assessed using community periodontal index (CPI), with CPI codes ${\geq}3$ defined as periodontitis. Blood levels of vitamin D were measured from blood samples and divided into four groups (first quartile: ${\leq}13.23ng/ml$, second quartile: 13.24~16.95 ng/ml, third quartile: 16.96~21.58 ng/ml), and fourth quartile >21.59 ng/ml). Using multiple logistic regression analyses, the variables were adjusted for general characteristics, oral health-related characteristics, health-related characteristics, and bone mineral density. The statistical analysis was performed using the SAS (ver. 9.2). The results of this study are as follows: the prevalence of periodontitis was 42.6% in Korean elderly. After adjusting for general, oral health-related, and health-related, the risk of periodontitis in the first quartile group was 1.74 times (95% confidence interval [CI], 1.02~2.98) higher than that of the fourth quartile group (p=0.041). After adjusting for general, oral health-related, and health-related characteristics as well as bone mineral density, the risk of periodontitis in the first quartile group was 1.73 times (95% CI, 1.02~2.96) higher than that of the four quartile group (p=0.042). There was a significant relationship between blood vitamin D level and periodontitis in Korean elderly. For the prevention of periodontitis, factors related to vitamin D should be considered along with other risk factors.

• 대한치위생과학회지
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• 제4권1호
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• pp.39-51
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• 2021

Background: Limited information is available regarding the associations of various nutrients and periodontitis in Korea. Furthermore, these associations have been controversial in previous studies. Therefore, the present study aimed to evaluate the associations between several nutrients and periodontitis. Methods: Pooled data from the 2007~2010 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES) were used for the present study. Periodontitis was defined using the World Health Organization (WHO) Community Periodontal Index. All participants completed the Food Frequency Questionnaire (FFQ), which was analyzed using CAN-Pro 4.0. Vitamins A, B₁, B₂, and C, iron, phosphorus, calcium, and protein were selected for analysis. Multiple logistic regression analyses were used to estimate the odds ratios (ORs) for periodontitis. Results: Lower intake of phosphorus (adjusted odds ratio [AOR] = 1.86), calcium (AOR = 1.25), and protein (AOR = 1.52) were associated with periodontitis in males, and lower intake of vitamins A (AOR = 1.32), B1 (AOR = 1.21), B2 (AOR = 1.24), and C (AOR = 1.21), iron (AOR = 1.25), phosphorus (AOR = 1.33), and protein (AOR = 1.27) showed significant relationships with periodontitis in females. In the sociodemographic, somatic, and health behavior-adjusted models, lower phosphorus (AOR = 2.68) and protein (AOR = 1.68) intake in younger males, and lower vitamin A intake (AOR = 1.37) in middle-aged females were significantly associated with periodontitis. Conclusions: The results of the present study demonstrated a significant association between periodontitis and nutrient intake. To avoid an insufficient nutrient supply for a patient with periodontal disease, the patient's diet should be closely monitored.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.383-391
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• 2022

Purpose: Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Materials and Methods: Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. Results: The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics(i.e., dice coefficient and intersection-over-union [IoU] score). MultiLabel U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Conclusion: Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

• International Journal of Oral Biology
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• 제37권3호
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• pp.109-114
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• 2012

In the gingival tissues of patients with periodontitis, inflammatory responses are mediated by a wide variety of genes. In this study, we screened for differentially expressed genes (DEGs) in periodontitis compared with normal tissue using an annealing control primer (ACP) system. By ACP RT-PCR analysis, we obtained about 160 amplicons, 8 of which were found to be differentially expressed. DEGs in patients with periodontitis were thus successfully and reliably identified by the ACP-based RT PCR technique. The DEGs identified in the screen may also enhance our understanding of the pathogenesis of periodontitis.

• Journal of Periodontal and Implant Science
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• 제43권3호
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• pp.111-120
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• 2013

Periodontitis is a common oral disease that is characterized by infection and inflammation of the tooth supporting tissues. While its incidence is highly associated with outgrowth of the pathogenic microbiome, some patients show signs of predisposition and quickly fall into recurrence after treatment. Recent research using genetic associations of candidates as well as genome-wide analysis highlights that variations in genes related to the inflammatory response are associated with an increased risk of periodontitis. Intriguingly, some of the genes are regulated by epigenetic modifications, supposedly established and reprogrammed in response to environmental stimuli. In addition, the treatment with epigenetic drugs improves treatment of periodontitis in a mouse model. In this review, we highlight some of the recent progress identifying genetic factors associated with periodontitis and point to promising approaches in epigenetic research that may contribute to the understanding of molecular mechanisms involving different responses in individuals and the early detection of predispositions that may guide in future oral treatment and disease prevention.

• International Journal of Oral Biology
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• 제43권4호
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• pp.201-207
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• 2018

Porphyromonas gingivalis is among the major etiological pathogens of chronic periodontitis. The virulence mechanisms of P. gingivalis is yet to be identified as its activity is largely unknown in actual disease process. The purpose of this study is to identify antigens of P. gingivalis expressed only in patients with chronic periodontitis using a unique immunoscreening technique. Change Mediated Antigen Technology (CMAT), an antibody-based screening technique, was used to identify virulence-associated proteins of P. gingivalis that are expressed only during infection stage in patients having chronic periodontitis. Out of 13,000 recombinant clones screened, 22 tested positive for reproducible reactivity with rabbit hyperimmune anti-sera prepared against dental plaque samples acquired from periodontitis patients. The DNA sequences of these 18 genes were determined. CMAT-identified protein antigens of P. gingivalis included proteins involved in energy metabolism and biosynthesis, heme and iron binding, drug resistance, specific enzyme activities, and unknown functions. Further analysis of these genes could result in a novel insight into the virulence mechanisms of P. gingivalis.

• 한국치위생학회지
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• 제20권1호
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• pp.53-62
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• 2020

Objectives: The purpose of the study was to analyze the association between dyslipidemia and periodontitis in Korean adults aged 30 and older. Methods: We examined 3,992 subjects participating in the 2015 Korean National Health and Nutrition Examination Survey. Periodontal status was evaluated using the community periodontal index (CPI). People with 3 or 4 CPI codes were classified as the periodontitis group. For statistical analyses, chi-square test and logistic multiple regression were used. Results: The prevalence of periodontitis was higher in men, people aged 70 and over, people whose income status was among the lower 25%, and people whose educational level was high school or lower (p<0.001). The prevalence of periodontitis was higher in people who brushed their teeth twice or less, those who did not use interdental cleaning devices, those who did not have a dental checkup in the last 12 months, and those who had not drunk or smoked (p<0.05). The prevalence of periodontitis was increased with individuals whose BMI was ≥25 kg/㎡, those whose glycated hemoglobin was ≥6.5%, and whose lipid levels were higher or lower than the normal range. In the logistic regression model, an increase in triglyceride was found to increase the prevalence of periodontitis (p<0.05). Conclusions: The study suggests that dyslipidemia, especially hypertriglyceridemia, is a predictor of periodontitis.

• Journal of Periodontal and Implant Science
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• 제42권1호
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• pp.3-12
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• 2012

Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

• International Journal of Oral Biology
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• 제40권3호
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• pp.111-116
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• 2015

To determine the effect of diabetes on root resorption in periodontitis, we investigated odontoclast formation and root resorption in diabetic rats with periodontitis. Odontoclast formation was observed in three groups of F344 rats: Controls (C) were normal rats without diabetes or periodontitis; the periodontitis (P) group had mandibular first molars to be ligatured; the periodontitis with diabetes (PD) group was intravenously administered streptozotocin (50 mg/kg) to induce diabetes and had mandibular first molars to be ligatured. On days 3, 10, and 20 after ligature, tumor necrosis factor (TNF)-${\alpha}$ and receptor activator of nuclear factor-${\kappa}B$ ligand (RANKL) expression, odontoclast formation, and root resorption areas were evaluated by immunohistochemistry, tartrate-resistant acid phosphatase staining, and hematoxylin and eosin staining, respectively. The PD group showed frequent urination, weight loss, and hyperglycemia. Numbers of TNF-${\alpha}$- and RANKL-positive cells were higher in the P and PD groups than in the C group. It was more prevalent in PD group on day 3. Odontoclast formation was greater in the P and PD groups than in the C group on days 3 and 10, then decreased to same level as the C group by day 20. Root resorption in the PD and P groups showed increases on days 3 and 10, respectively, compared to the C group. These results suggest that diabetes may transiently increase root resorption on day 3 with high expression of TNF-${\alpha}$ and RANKL after periodontitis induction. This study could aid the understanding of root resorption in diabetic patients with periodontitis.