Increased Risk of Ulcerative Colitis in Patients with Periodontal Disease: A Nationwide Population-Based Cohort Study

Lin, Chien‐Yu; Tseng, Kuo Sen; Liu, Jui Ming; Chuang, Heng Chang; Lien, Chi Hone; Chen, Yi Chih; Lai, Chun Ying; Yu, Cheng; Hsu, Ren Jun

doi:10.3390/ijerph15112602

Cited by 30 publications

(40 citation statements)

References 37 publications

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“…In contrast, there is little evidence regarding the risk of developing IBD in patients with periodontitis. A Taiwanese cohort study reported a 1.56-fold significantly higher risk of UC, but not CD, in 27000 patients with periodontal diseases, including acute periodontitis, chronic periodontitis, and gingivitis[ 34 ], which is comparable with our results in a nationwide study of 1 million subjects with chronic periodontitis. Our study has the strength of demonstrating the impacts of chronic periodontitis, which may reflect the dynamics of chronic inflammatory conditions and lifestyle factors, such as cigarette smoking, on the pathogenesis of IBD.…”

Section: Discussionsupporting

confidence: 89%

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Kang

Chun

Kim

et al. 2020

WJG

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BACKGROUND Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease (IBD) remains unclear. AIM To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis. METHODS A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn’s disease (CD), ulcerative colitis (UC)] using the International Classification of Disease 10 th revision and rare intractable disease codes, was compared between the periodontitis and non-periodontitis groups until 2017. RESULTS A total of 1092825 individuals (11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the non-periodontitis group ( P < 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively ( P < 0.01). Men were 604307 (55.3%) and 4844383 (54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval (CI): 1.008-1.182], but not CD (adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis. CONCLUSION Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.

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Section: Discussionsupporting

confidence: 89%

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Kang

Chun

Kim

et al. 2020

WJG

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“…While a sustained release could be considered ideal, it is important to note that the kinetic of release is a parameter that is also influenced by the percentage of chitosan [82]. Drugs, such as statins [83], doxycycline [84], or other antibiotics/antiseptics such as tetracyclines, have been incorporated in such devices [85,86,87].…”

Section: Resultsmentioning

confidence: 99%

Application of Chitosan in Bone and Dental Engineering

et al. 2019

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Chitosan is a deacetylated polysaccharide from chitin, the natural biopolymer primarily found in shells of marine crustaceans and fungi cell walls. Upon deacetylation, the protonation of free amino groups of the d-glucosamine residues of chitosan turns it into a polycation, which can easily interact with DNA, proteins, lipids, or negatively charged synthetic polymers. This positive-charged characteristic of chitosan not only increases its solubility, biodegradability, and biocompatibility, but also directly contributes to the muco-adhesion, hemostasis, and antimicrobial properties of chitosan. Combined with its low-cost and economic nature, chitosan has been extensively studied and widely used in biopharmaceutical and biomedical applications for several decades. In this review, we summarize the current chitosan-based applications for bone and dental engineering. Combining chitosan-based scaffolds with other nature or synthetic polymers and biomaterials induces their mechanical properties and bioactivities, as well as promoting osteogenesis. Incorporating the bioactive molecules into these biocomposite scaffolds accelerates new bone regeneration and enhances neovascularization in vivo.

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“…Oral administration of Porphyromonas gingivalis (strain W83) in C57BL/6 mice had significant effects on the composition of gut microbes and on the barrier function of the intestines, and led to the spread of intestinal bacteria to the liver. Recently, two cohort studies conducted in Taiwan revealed an increased risk of periodontitis in CD patients compared with that in non‐CD subjects [hazard ratio (HR) = 1.36, 95% CI: 1.25–1.48], and the risk of UC was also increased in patients with periodontitis compared with that in controls (HR = 1.56, 95% CI: 1.13–2.15), indicating a two‐way interaction between IBD and periodontitis. However, the specific mechanisms of pathogenesis and interactions between the conditions remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

Zhang

Gao

Zhou

et al. 2020

International Dental Journal

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Objectives: Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls. Materials and methods: In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn's disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data. Results: After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63-6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24-3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50-7.95, P < 0.001; OR = 4.66, 95% CI: 2.49-8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients. Conclusions: Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.

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Increased Risk of Ulcerative Colitis in Patients with Periodontal Disease: A Nationwide Population-Based Cohort Study

Cited by 30 publications

References 37 publications

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Application of Chitosan in Bone and Dental Engineering

Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

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