Obesity as predictive factor of periodontal therapy clinical outcomes: A cohort study

Suvan, Jean; Harrington, Zoë; Petrie, Aviva; Patel, Kalpesh; Darbar, Ulpee; Donos, Nikos; D’Aiuto, Francesco

doi:10.1111/jcpe.13261

Cited by 18 publications

(23 citation statements)

References 40 publications

(54 reference statements)

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“…Our results demonstrated there was a statistically significant difference in BMI between the GAgP group and healthy controls, although the BMI of all participants ranged from 18 to 28, and the difference between groups was small. Worse periodontal conditions have been reported in patients with higher BMI, and poorer response of non‐surgical periodontal therapy was found in obesity patients 20 . Elevated blood neutrophils are associated with higher BMI, 21,22 and BMI positively correlated with lymphocyte percentages 23 .…”

Section: Discussionmentioning

confidence: 99%

Elevated neutrophil‐to‐lymphocyte ratio but not platelet‐to‐lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population

Wang

et al. 2020

Journal of Periodontology

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Background Host inflammatory mediators are associated with tissue destruction in patients suffering from generalized aggressive periodontitis (GAgP). However, the correlations between neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) with GAgP remain unknown. Methods Periodontal clinical parameters, including probing depth (PD), bleeding index (BI) and attachment loss (AL) were collected from patients with GAgP and healthy controls. Complete blood cells analyses were obtained; further, NLR and PLR were calculated using neutrophil, platelet, and lymphocyte counts. Smooth curve fitting and segmented regression models were used to analyze the roles and predictive value of NLR with GAgP. Results In total, 505 participants from a Chinese population were recruited, including 133 healthy controls and 372 patients with GAgP. Periodontal clinical parameters, NLR, and neutrophil counts were significantly higher in patients with GAgP than the control group. Moreover, NLR was positively correlated with the risk and clinical parameters of GAgP. When NLR < 3, the risk of GAgP increased by 20.6% for each 0.1 increase in NLR, reaching saturation when NLR > 3. An increase in NLR equivalent to 1 was associated with an increase in PD, BI, and AL by 0.41 mm, 0.26, and 0.57 mm, respectively. Notably, PLR did not show obvious correlations with GAgP. Conclusions NLR but not PLR may be a potential marker to identify GAgP in healthy individuals, particularly in a Chinese population.

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Section: Discussionmentioning

confidence: 99%

Elevated neutrophil‐to‐lymphocyte ratio but not platelet‐to‐lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population

Wang

et al. 2020

Journal of Periodontology

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“…Another short period evaluation also demonstrated a lesser improvement in the extension of BOP in obese compared to non-obese individuals with periodontitis [ 86 ]. In a 6-month evaluation after treatment, Suvan et al [ 87 ••] were also able to demonstrate that obese patients had significantly less improvement in periodontal parameters after therapy compared to lean individuals. Those differences were detected in the final percent of PD > 4 mm, percent of PD > 5 mm, and percent of full-mouth bleeding (Table 1 ).…”

Section: Impact Of Obesity On Periodontal Treatmentmentioning

confidence: 99%

What Are the Clinical and Systemic Results of Periodontitis Treatment in Obese Individuals?

Silva-Boghossian

Dezonne

2021

Curr Oral Health Rep

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Purpose of Review Periodontitis and obesity are characterized by a dysregulated inflammatory state. Obese individuals have a higher chance of presenting periodontitis. Clinical studies in different populations demonstrate that individuals with obesity have worse periodontal conditions. This current review aims to explore recent literature to understand what the impacts of obesity on periodontal treatment outcomes are and to learn whether periodontal treatment can improve systemic biomarkers in obese individuals. Recent Findings Short- and long-term evaluations demonstrated that non-surgical periodontal treatment could improve clinical parameters in obese individuals, represented as the reduction in mean probing depth, sites with probing depth ≥ 4 mm, and extension of bleeding on probing. However, obese individuals may have less clinical improvement when compared to normal-weight individuals with a similar periodontal profile. Additionally, periodontal treatment may contribute to a reduction in systemic levels of retinol-binding protein 4 and leptin, while promoting an increase in systemic levels of adiponectin. Summary Overall, obese individuals with periodontitis can significantly benefit from non-surgical periodontal treatment. However, clinical improvements seem to be less prominent in obese individuals with periodontitis compared to non-obese individuals with similar periodontal status. Nevertheless, periodontal treatment may impact significantly on the reduction of several biochemical biomarkers of obesity with or without weight reduction. Further investigations are needed to improve our comprehension of the mechanisms underlying those findings.

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“…The group of non-obese individuals with periodontitis and without diabetes served as controls. The diagnosis of type 2 diabetes was excluded based on A c c e p t e d M a n u s c r i p t the patient self-reported clinical history and the absence of treatment with glucose-lowering medications (20).…”

Section: Participants and Methodsmentioning

confidence: 99%

Effect of Treatment of Periodontitis on Incretin Axis in Obese and Nonobese Individuals: A Cohort Study

Suvan

Masi

Harrington

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Periodontitis confers an increased risk of developing type 2 diabetes and, in patients with obesity, it might interfere with the incretin axis. The effect of periodontal treatment on glucoregulatory hormones remains unknown. Objective To evaluate the effect of periodontal treatment on incretin axis in obese and lean non-diabetic individuals. Setting King's College Dental Hospital and Institute, London, UK. Participants and Methods The metabolic profile of obese and BMI-normal individuals affected by periodontitis was studied at baseline, 2 and 6 months after intensive periodontal treatment, by measuring plasma insulin, glucagon, GLP-1 and GIP and markers of systemic inflammation and oxidative stress. Main Outcome Measure(s) Circulating levels of incretins and inflammatory markers. Results At baseline, periodontal parameters were worse for obese than non-obese; this was accompanied by higher levels of circulating hs-CRP, insulin and GLP-1. The response to periodontal treatment was less favourable in the obese group, without significant variations of hs-CRP or malondialdehyde. Gluco-regulatory hormones changed differently after treatment: while insulin and glucagon did not vary at 2 and 6 months, GLP-1 and GIP significantly increased at 6 months in both groups. In particular, GLP-1 increased more rapidly in obese participants, while the increase of GIP followed similar trends across visits in both groups. Conclusions Nonsurgical treatment of periodontitis is associated with increased GLP-1 and GIP levels in non-obese and obese patients; changes in GLP-1 were more rapid in obese participants. This might have positive implications for the metabolic risk of these individuals.

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Obesity as predictive factor of periodontal therapy clinical outcomes: A cohort study

Cited by 18 publications

References 40 publications

Elevated neutrophil‐to‐lymphocyte ratio but not platelet‐to‐lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population

Elevated neutrophil‐to‐lymphocyte ratio but not platelet‐to‐lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population

What Are the Clinical and Systemic Results of Periodontitis Treatment in Obese Individuals?

Effect of Treatment of Periodontitis on Incretin Axis in Obese and Nonobese Individuals: A Cohort Study

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