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Prospective Longitudinal Changes in the Periodontal Inflamed Surface Area Following Active Periodontal Treatment for Chronic Periodontitis.

ABSTRACT: Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+/-173, 161+/-276, 184+/-320, 175+/-417, and 209+/-469 mm². Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingivalis were associated with changes in PISA at the patient- and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.

SUBMITTER: Nomura Y

PROVIDER: S-EPMC7998532 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Periodontal Inflamed Surface Area (PISA) associates with composites of salivary cytokines.

Project description:BackgroundPeriodontal disease (PerioD) is a chronic, complex inflammatory condition resulting from the interaction between subgingival dysbiotic bacteria and the host immune response leading to local inflammation. Since periodontal inflammation is characterized by multiple cytokines effects we investigated whether Periodontal Inflamed Surface Area (PISA), a continuous measure of clinical periodontal inflammation is a predictor of composite indexes of salivary cytokines.Methods and findingsIn a cross-sectional study of 67 healthy, well-educated individuals, we evaluated PISA and several cytokines expressed in whole stimulated saliva. Two salivary cytokine indexes were constructed using weighted and unweighted approaches based on a Principal Component Analysis [named Cytokine Component Index (CCI)] or averaging the (standardized) level of all cytokines [named Composite Inflammatory Index (CII)]. In regression analysis we found that PISA scores were significantly associated with both salivary cytokine constructs, (CCI: part R = 0.51, p<0.001; CII: part R = 0.40, p = 0.001) independent of age, gender and BMI showing that single scores summarizing salivary cytokines correlated with severity of clinical periodontal inflammation.ConclusionsClinical periodontal inflammation may be reflected by a single score encompassing several salivary cytokines. These results are consistent with the complexity of interactions characterizing periodontal disease. In addition, Type I error is likely to be avoided.

| S-EPMC9931150 | biostudies-literature

Estimation of the Periodontal Inflamed Surface Area by Simple Oral Examination.

Project description:The periodontal inflamed surface area (PISA) is a useful index for clinical and epidemiological assessments, since it can represent the inflammation status of patients in one contentious variable. However, calculation of the PISA is difficult, requiring six point probing depth measurements with or without bleeding on probing on 28 teeth, followed by data input in a calculation program. More simple methods are essential for screening periodontal disease or in epidemiological studies. In this study, we tried to establish a convenient partial examination method to estimate PISA. Cross-sectional data of 254 subjects who completed active periodontal therapy were analyzed. Teeth that represent the PISA value were selected by an item response theory approach. The maxillary second molar, first premolar, and lateral incisor and the mandibular second molar and lateral incisor were selected. The sum of the PISAs of these teeth was significantly correlated with the patient's PISA (R2 = 0.938). More simply, the sum of the maximum values of probing pocket depth with bleeding for these teeth were also significantly correlated with the patient's PISA (R2 = 0.6457). The simple model presented in this study may be useful to estimate PISA.

| S-EPMC7917734 | biostudies-literature

Periodontal Inflamed Surface Area Mediates the Link between Homocysteine and Blood Pressure.

Project description:Here, we assess the association between homocysteine (Hcy) serum levels and periodontal status in a large representative sample of the National Health and Nutrition Examination Survey (NHANES). Using the 2001-2002 and 2003-2004 NHANES databases, participants with a periodontal examination, medical self-reported data, blood pressure (BP) and blood samples to determine complete blood count, C-reactive protein (CRP) and Hcy levels. We then calculated the periodontal inflamed surface area (PISA) and the periodontal epithelial surface area (PESA). Multivariable regression analysis explored the association between Hcy, periodontal measures and BP. Mediation analysis was performed to understand the effect of PISA and PESA in the link between Hcy and BP. 4021 participants fulfilled the inclusion criteria. Hcy levels showed significant correlations with systolic BP, diastolic BP, PISA, PESA and age. PESA showed to be significantly associated with Hcy both for the crude and adjusted models (p < 0.01), but not PISA (p > 0.05). In the association of Hcy with systolic BP, PISA significantly mediated 17.4% and PESA 0.9%. In the association of Hcy with diastolic BP, PISA significantly mediated 16.3% and PESA 47.2%. In conclusion, Hcy and periodontitis are associated. Further, both PISA and PESA significantly mediated the association of Hcy with systolic BP and diastolic BP. Future studies shall deepen the mechanisms by which Hcy levels increase in a clinical situation of periodontitis.

| S-EPMC8231519 | biostudies-literature

The Associations of Periodontopathic Bacteria and Oral Candida with Periodontal Inflamed Surface Area in Older Adults Receiving Supportive Periodontal Therapy.

Project description:The periodontal inflamed surface area (PISA) has been proposed for assessment of the total periodontal inflammatory status in people with periodontitis. This study was performed to investigate the associations of periodontopathic bacteria and candida with PISA in older people. We enrolled 100 patients aged ≥ 60 years who visited Hiroshima University Hospital. PISA and periodontal epithelial surface area (PESA) were calculated in each patient. Oral rinse samples were collected for DNA extraction. Periodontopathic bacteria and candida were detected by polymerase chain reaction. The mean values of PISA and PESA were significantly greater in T.forsythia-positive patients than in T.forsythia-negative patients. T.forsythia/C. albicans double-positive patients exhibited significantly greater PISA values than did non-double-positive patients. Additionally, PISA values were significantly greater in T. forsythia//T. denticola/C. albicans triple-positive patients than in T. forsythia//T. denticola/C. albicans non-triple-positive patients (p = 0.02). Propensity score-matching was performed between periodontopathic bacteria-positive and -negative patients using propensity scores generated from clinical factors. Importantly, T.forsythia/T. denticola double-positive patients exhibited significantly greater PISA values than non-double-positive patients among 72 propensity score-matched patients. Our preliminary results highlight the importance of the presence of T.forsythia and T. denticola for periodontal inflammation severity in older Japanese people.

| S-EPMC8392537 | biostudies-literature

Periodontal inflamed surface area in patients on haemodialysis and peritoneal dialysis: a Croatian cross-sectional study.

Project description:BACKGROUND:The decision to initiate dialysis treatment via haemodialysis (HD) or peritoneal dialysis (PD) often involves the consideration of complex factors and remains a matter of debate. The purpose of this study was to quantify the inflammatory burden that periodontitis causes in dialysis patients and to examine whether patients on PD and HD differ in terms of the periodontal inflamed surface area (PISA), which can be helpful for selecting the most appropriate dialysis modality. METHODS:A cross-sectional study was performed on 58 consecutive patients on HD and 31 consecutive patients on PD. PISA was calculated using measurements of the clinical attachment level, recession and bleeding on probing. We performed the primary analysis using multivariable robust regression. RESULTS:Patients on PD had a 746 mm2 (93%) lower mean PISA than patients on HD after adjustment for 20 possible confounders, including the duration of dialysis. The type of dialysis was independently correlated with the PISA (semipartial correlation: - 0.50; p = 0.017; false discovery rate < 5%). After adjusting for confounding factors, the correlation between the duration and type of dialysis was not significant (F (2,44) = 0.01; p = 0.994; η2 = 0.00). Differences in the PISA between patients who had undergone dialysis for less than a year, 2-3 years or ≥ 3 years were not significantly different in either of the two dialysis groups. CONCLUSIONS:PISA levels in Croatian patients on dialysis indicate a high need for periodontal treatment. PD is associated with a smaller PISA independent of many sociodemographic, lifestyle, laboratory and clinical factors. The duration of dialysis does not influence PISA levels. TRIAL REGISTRATION:ISRCTN17887630. A clinical study to investigate gum infection in patients undergoing kidney dialysis.

| S-EPMC7118952 | biostudies-literature

Development of a Japanese Version of the Formula for Calculating Periodontal Inflamed Surface Area: A Simulation Study.

Project description:The periodontal inflamed surface area (PISA) is a useful indicator of periodontal status. However, its formula was based on a meta-analysis involving five countries, and racial differences in tooth root morphology could have affected the calculations. This study aimed to develop a Japanese version of the PISA and compare it with the original version. The formulas reported by a previous Japanese study calculating the amount of remaining periodontal ligament from clinical attachment measurements were used to calculate the PISA. A simulation was performed to compare the Japanese version with the original version by inputting probing pocket depth (PPD) from 1 to10 mm and by using clinical data. The PISA values in the Japanese version were larger and smaller than those in the original version for PPDs of 1-5 mm and 6-10 mm, respectively. The PISA values for the clinical data from the Japanese version were significantly higher than those from the original version. Both versions of the PISA values correlated equally well with body mass index. The Japanese version of the PISA can be used to assess the amount of inflamed periodontal tissue resulting from periodontitis in Japanese populations, taking into account racial heterogeneity in root morphologies.

| S-EPMC9408782 | biostudies-literature

Severity of Dementia Is Associated with Increased Periodontal Inflamed Surface Area: Home Visit Survey of People with Cognitive Decline Living in the Community.

Project description:No studies have measured the periodontal inflamed surface area in people with dementia, although periodontal disease is a major health issue in this group. This study aimed to determine the relationship between dementia severity and periodontal inflamed surface area. An interdisciplinary team, including a dentist and psychiatrist, conducted an in-home survey of older people living in the community. This cross-sectional study was designed as part of a larger cohort study. The interdisciplinary team visited 198 individuals with cognitive decline. We surveyed the clinical dementia rating, periodontal inflamed surface area, number of teeth, and other health issues. We used multiple linear regression analysis to assess the 75 people who were able to take part in all the visits. Number of teeth (Beta = 0.479, p < 0.001), clinical dementia rating (Beta = 0.258, p = 0.013), and age (Beta = 0.250, p = 0.017) were independently associated with periodontal inflamed surface area after adjusting for biological sex, depression, diabetes, collagen disease, visual disorder, and osteoporosis medication. To make communities more dementia-friendly, we must protect older people with dementia from developing poor oral health, which may require home visits for dental assessment.

| S-EPMC8618461 | biostudies-literature

A longitudinal study: changes in cortical thickness and surface area during pubertal maturation.

Project description:Sex hormones have been shown to contribute to the organization and function of the brain during puberty and adolescence. Moreover, it has been suggested that distinct hormone changes in girls versus boys may contribute to the emergence of sex differences in internalizing and externalizing behavior during adolescence. In the current longitudinal study, the influence of within-subject changes in puberty (physical and hormonal) on cortical thickness and surface area was examined across a 2-year span, while controlling for age. Greater increases in Tanner Stage predicted less superior frontal thinning and decreases in precuneus surface area in both sexes. Significant Tanner Stage and sex interactions were also seen, with less right superior temporal thinning in girls but not boys, as well as greater decreases in the right bank of the superior temporal sulcus surface area in boys compared to girls. In addition, within-subject changes in testosterone over the 2-year follow-up period were found to relate to decreases in middle superior frontal surface area in boys, but increases in surface area in girls. Lastly, larger increases in estradiol in girls predicted greater middle temporal lobe thinning. These results show that within-subject physical and hormonal markers of puberty relate to region and sex-specific changes in cortical development across adolescence.

| S-EPMC4368209 | biostudies-literature

Relationships between initial probing depth and changes in the clinical parameters following non-surgical periodontal treatment in chronic periodontitis.

Project description:Purpose:The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients. Subjects and Methods:A total of 1672 periodontal pockets having 3mm?IPD?9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results:Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm?IPD?9mm (p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG. Conclusion:NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.

| S-EPMC5624140 | biostudies-literature

Clinical and microbiological evaluation of non-surgical periodontal therapy in obese and non-obese individuals with periodontitis: a 9-month prospective longitudinal study.

Project description:Objective Obesity is a chronic disease that negatively affects an individual's general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy. Methodology This clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of Tannerella forsythia , Porphyromonas gingivalis , Treponema Denticola , and Aggregatibacter actinomycetemcomitans was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used. Results In both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p<0.05). Obese and non-obese patients equally responded to non-surgical periodontal therapy (p>0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy. Conclusions Obesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.

| S-EPMC7213783 | biostudies-literature

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