Periodontitis and Systemic Lupus Erythematosus: A systematic review and meta‐analysis

Hussain, Syed Basit; Leira, Yago; Zehra, Syeda Ambreen; Botelho, João; Machado, Vanessa; Ciurtin, Coziana; D’Aiuto, Francesco; Orlandi, Marco

doi:10.1111/jre.12936

Cited by 14 publications

(7 citation statements)

References 48 publications

(73 reference statements)

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“…Potential antimicrobial action of omega-3 PUFAs against periodontal pathogens seems to be crucial not only in the context of treatment of periodontitis. P. gingivalis , T. denticola and A. actinomycetemcomitans were shown to be linked to various systemic diseases, including cardiovascular diseases, Alzheimer’s disease, rheumatoid arthritis and systemic lupus erythematosus [ 48 , 49 ]. Thus, decrease of key periodontal bacteria abundance support periodontal treatment and protect from other chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

et al. 2023

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Purpose This study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined with scaling and root planing (SRP) in untreated periodontitis stage III and IV. Methods Forty patients were randomly assigned to the test group receiving SRP plus omega-3 PUFAs (n = 20) or control group receiving SRP alone (n = 20). Clinical changes of pocket probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP) and rates of closed pockets (PPD ≤ 4 mm without BOP) were evaluated at baseline and after 3 and 6 months. Phorphyromonas gingivalis, Tanarella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans counts were analysed at baseline and at 6 months. Serum was subjected to lipid gas chromatography/mass spectrometry analysis at baseline and at 6 months. Results Significant improvement of all clinical parameters at 3 and 6 months was observed in both groups. For the primary outcome “change of mean PD,” no significant difference was detected between the groups. Patients treated with omega-3 PUFAs demonstrated significantly lower rates of BOP, higher gain of CAL and higher number of closed pockets at 3 months in comparison to the control group. After 6 months, no clinical differences between the groups were found, with the exception of lower BOP rates. Moreover, in the test group, the number of key periodontal bacteria was significantly lower than in the control group at 6 months. Increased proportions of serum n-3 PUFAs and decreased proportions of n-6 PUFAs were detected at 6 months in the patients from the test group. Conclusion High-dose omega-3 PUFA intake during non-surgical treatment of periodontitis results in short-term clinical and microbiological benefits. The study protocol was approved by the ethical committee of Medical University of Lodz (reference number RNN/251/17/KE) and registered at clinicaltrials.gov (NCT04477395) on 20/07/2020.

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Section: Discussionmentioning

confidence: 99%

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

et al. 2023

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“…Potential antimicrobial action of omega-3 PUFAs against periodontal pathogens seems to be crucial not only in the context of treatment of periodontitis. P. gingivalis, T. denticola and A. actinomycetemcomitans were shown to be linked to various systemic diseases, including cardiovascular diseases, Alzheimer's disease, rheumatoid arthritis and systemic lupus erythematosus [50,51]. Thus, decrease of key periodontal bacteria abundance support periodontal treatment and protect from other chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

Stańdo-Retecka

Piatek

Namiecińska

et al. 2023

Preprint

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Purpose This study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined with scaling and root planning (SRP) in untreated periodontitis stage III and IV. Methods Forty patients were randomly assigned to test group receiving SRP plus omega-3 PUFAs (n = 20) and control group receiving SRP alone (n = 20). Clinical changes of pocket probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP) and proportions of closed pockets (PPD ≤ 4 mm without BOP) were evaluated at baseline and after 3 and 6 months. Subgingival biofilm Phorphyromonas gingivalis, Tanarella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans counts were analysed at baseline and at 6 months. Serum was subjected to lipid gas chromatography/mass spectrometry analysis at baseline and at 6 months. Results Significant improvement of all clinical parameters over 3 and 6 months was observed in both groups. For the primary outcome “change of mean PD,” no significant differences were detected between the groups. Patients treated with omega-3 PUFAs demonstrated significantly lower rates of BOP, higher gain of CAL and higher number of closed pockets at 3 months in comparison to the control group. After 6 months, no clinical differences between the groups were found, with exception of lower BOP rates. Moreover, in the test group, the number of key periodontal bacteria was significantly lower than in the control group at 6 months. Increased proportions of serum n-3 PUFAs and decreased proportions of n-6 PUFAs in the patients form the test group were detected at 6 months. Conclusion High-dose omega-3 PUFA intake during non-surgical treatment of periodontitis results in short-term clinical and microbiological benefits. The study protocol was approved by the ethical committee of Medical University of Lodz (reference number RNN/251/17/KE) and registered at clinicaltrials.gov (NCT04477395) on 22/07/2020.

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“…Anemia in AD has multifactorial mechanisms, clinically being manifested with oral mucosal pallor, among other manifestations; the panel of AD comorbidity-related anemia varies from endocrine disorders (autoimmune hypogonadism, DM, autoimmune hypothyroidism/myxoedema) to a heterogeneous group of nonendocrine autoimmune conditions [ 120 , 121 ]. Rheumatologic diseases such as lupus erythematosus and systemic sclerosis involve particular oral features; for instance, lupus induces ulcerations, honeycomb plaques, keratotic plaques, angular cheilitis, buccal petechial lesions, and a higher risk of periodontitis [ 120 , 121 , 122 , 123 , 124 , 125 , 126 ]. Gastroenterological conditions such as Crohn’s disease, ulcerative colitis, and gastritis have various oral anomalies; Crohn’s disease presents oral ulcerations, mucogingivitis, and a 2–3 times higher risk of PD than the general population [ 127 , 128 , 129 , 130 ].…”

Section: Methodsmentioning

confidence: 99%

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

et al. 2022

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This review highlights oral anomalies with major clinical impact in Addison disease (AD), including dental health and dermatologic features, through a dual perspective: pigmentation issues and AD comorbidities with oral manifestations. Affecting 92% of AD patients, cutaneomucosal hyperpigmentation is synchronous with or precedes general manifestations by up to a decade, underlying melanocytic infiltration of the basal epidermal layer; melanophages in the superficial dermis; and, rarely, acanthosis, perivascular lymphocytic infiltrate, and hyperkeratosis. Intraoral pigmentation might be the only sign of AD; thus, early recognition is mandatory, and biopsy is helpful in selected cases. The buccal area is the most affected location; other sites are palatine arches, lips, gums, and tongue. Pigmented oral lesions are patchy or diffuse; mostly asymptomatic; and occasionally accompanied by pain, itchiness, and burn-like lesions. Pigmented lingual patches are isolated or multiple, located on dorsal and lateral areas; fungiform pigmented papillae are also reported in AD individuals. Dermoscopy examination is particularly indicated for fungal etiology; yet, it is not routinely performed. AD’s comorbidity burden includes the cluster of autoimmune polyglandular syndrome (APS) type 1 underlying AIRE gene malfunction. Chronic cutaneomucosal candidiasis (CMC), including oral CMC, represents the first sign of APS1 in 70–80% of cases, displaying autoantibodies against interleukin (IL)-17A, IL-17F ± IL-22, and probably a high mucosal concentration of interferon (IFN)-γ. CMC is prone to systemic candidiasis, representing a procarcinogenic status due to Th17 cell anomalies. In APS1, the first cause of mortality is infections (24%), followed by oral and esophageal cancers (15%). Autoimmune hypoparathyroidism (HyP) is the earliest endocrine element in APS1; a combination of CMC by the age of 5 years and dental enamel hypoplasia (the most frequent dental complication of pediatric HyP) by the age of 15 is an indication for HyP assessment. Children with HyP might experience short dental roots, enamel opacities, hypodontia, and eruption dysfunctions. Copresence of APS-related type 1 diabetes mellitus (DM) enhances the risk of CMC, as well as periodontal disease (PD). Anemia-related mucosal pallor is related to DM, hypothyroidism, hypogonadism, corresponding gastroenterological diseases (Crohn’s disease also presents oral ulceration (OU), mucogingivitis, and a 2-3 times higher risk of PD; Biermer anemia might cause hyperpigmentation by itself), and rheumatologic diseases (lupus induces OU, honeycomb plaques, keratotic plaques, angular cheilitis, buccal petechial lesions, and PD). In more than half of the patients, associated vitiligo involves depigmentation of oral mucosa at different levels (palatal, gingival, alveolar, buccal mucosa, and lips). Celiac disease may manifest xerostomia, dry lips, OU, sialadenitis, recurrent aphthous stomatitis and dental enamel defects in children, a higher prevalence of caries and dentin sensitivity, and gingival bleeding. Oral pigmented lesions might provide a useful index of suspicion for AD in apparently healthy individuals, and thus an adrenocorticotropic hormone (ACTH) stimulation is useful. The spectrum of autoimmune AD comorbidities massively complicates the overall picture of oral manifestations.

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Periodontitis and Systemic Lupus Erythematosus: A systematic review and meta‐analysis

Cited by 14 publications

References 48 publications

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden

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