Zapalenie dziąseł – Rokowania, prognozy i postęp choroby

Zapalenie dziąseł
Rokowania, prognozy i postęp choroby

Zapalenie dziąseł (gingivitis) jest odwracalnym stanem zapalnym tkanek dziąseł, którego wczesne rozpoznanie i leczenie, obejmujące profesjonalne oczyszczenie (skaling) oraz poprawę higieny jamy ustnej, pozwala na całkowite wyleczenie i zapobiega progresji do nieodwracalnego zapalenia przyzębia (periodontitis). Nieleczone zapalenie dziąseł prowadzi do utraty przyczepu łącznotkankowego, destrukcji kości wyrostka zębodołowego i ostatecznie utraty zębów. W populacji światowej przewlekłe zapalenie dziąseł jest powszechne, co podkreśla konieczność wczesnej interwencji stomatologicznej. W diagnostyce i monitorowaniu chorób przyzębia obiecujące są biomarkery ślinowe, takie jak MMP-8, MMP-9, TIMP-1, HGF, LBP oraz IL-1β, które w kombinacjach wykazują wysoką czułość i swoistość (do 90-100%) w rozróżnianiu stanów zapalnych dziąseł i przyzębia.

Prognoza w zapaleniu dziąseł – podstawowe informacje

Konsekwencje progresji choroby

Przewidywanie przebiegu i zdrowienia w zapaleniu dziąseł

Odpowiedź na leczenie
Biomarkery jako czynniki predykcyjne

Indeksy mikrobiologiczne w prognozowaniu zapalenia dziąseł

Modelowanie predykcyjne
Czynniki zależne od gospodarza

Specjalne uwarunkowania prognostyczne

Zespół metaboliczny a prognoza zapalenia dziąseł
Zapalenie dziąseł a rokowanie w nowotworach głowy i szyi

Powikłania i ich wpływ na prognozę

Powikłania ogólnoustrojowe
Stan przejściowy i jego znaczenie prognostyczne
Kolejne rozdziały

Prognoza w zapaleniu dziąseł – podstawowe informacje

Zapalenie dziąseł (gingivitis) stanowi istotny problem zdrowotny, nie tylko ze względu na choroby rozwijające się w jamie ustnej, ale także z powodu bezpośredniego związku ze zdrowiem ogólnym organizmu.¹ Prognoza w tej jednostce chorobowej jest ściśle uzależniona od czasu rozpoznania i wdrożenia odpowiedniego leczenia. Zapalenie dziąseł, jeśli zostanie wcześnie zidentyfikowane i leczone, może być całkowicie wyleczone, ponieważ stan ten jest odwracalny, a zmienione tkanki mogą powrócić do normy po usunięciu biofilmu nazębnego.²

Konsekwencje progresji choroby

Jeśli zapalenie dziąseł nie zostanie odpowiednio leczone, może przekształcić się w zapalenie przyzębia (periodontitis), powodując utratę przyczepu łącznotkankowego i destrukcję kości, co ostatecznie może prowadzić do utraty zębów.³ Nieleczone przewlekłe zapalenie dziąseł prowadzi do utraty zębów.⁴ Znacząca część światowej populacji nadal nie myje zębów codziennie, w wyniku czego większość dorosłej populacji na świecie cierpi na przewlekłe zapalenie dziąseł, a jeśli pozostaje nieleczone, część z nich ostatecznie rozwinie zapalenie przyzębia.⁵

Warto podkreślić, że w przeciwieństwie do innych stadiów chorób dziąseł, zapalenie dziąseł jest wyleczalne, pod warunkiem odpowiednio wczesnego leczenia. Jeśli zauważysz objawy zapalenia dziąseł, powinieneś umówić się na wizytę u dentysty i natychmiast zacząć praktykować lepszą higienę jamy ustnej w domu.⁶ Nieleczone zapalenie dziąseł może się pogorszyć i przekształcić w zapalenie przyzębia. Na tym etapie choroby dziąseł, dochodzi do utraty kości wokół zębów, co stanowi trwały efekt uboczny prowadzący do efektu domina w problemach zdrowia jamy ustnej.⁷

Przewidywanie przebiegu i zdrowienia w zapaleniu dziąseł

Odpowiedź na leczenie

Po początkowym oczyszczeniu i skalingu we wczesnych stadiach, zapalenie dziąseł jest zwykle odwracalne przy dobrej higienie jamy ustnej. Zapalenie dziąseł generalnie dobrze reaguje na odpowiednie leczenie.⁸ Im wcześniej wykryjesz chorobę dziąseł, tym łatwiej możesz nią zarządzać. Zapalenie dziąseł jest odwracalne przy odpowiedniej pielęgnacji i konserwacji, ale może powrócić. Musisz dobrze dbać o zęby i dziąsła między wizytami w gabinecie stomatologicznym.⁹ Najszybszym sposobem na pozbycie się zapalenia dziąseł jest wizyta u dentysty w celu oczyszczenia i poprawa nawyków higieny jamy ustnej w domu między wizytami.¹⁰

Warto zauważyć, że zmiana zapalna może zostać wyleczona po odpowiedniej profesjonalnej opiece, natomiast niekontrolowane zapalenie dziąseł może prowadzić do nieodwracalnego stanu zapalenia przyzębia, charakteryzującego się zniszczeniem tkanek podtrzymujących zęby i kości wyrostka zębodołowego u podatnych osób, co ostatecznie prowadzi do utraty zębów.¹¹

Biomarkery jako czynniki predykcyjne

Istnieje kilka biomarkerów ślinowych, które mogą służyć jako kandydaci do diagnozowania zapalenia dziąseł i przyzębia, głównych zagrożeń dla zdrowia jamy ustnej, wpływających na dziąsła.¹² Główne wnioski wskazują, że połączenie wielu testów biomarkerów, a nie stosowanie pojedynczych, może oferować dokładność predykcyjną na poziomie 90% dla grup z zapaleniem dziąseł w porównaniu do grup zdrowych; oraz 100% dla grup z zapaleniem przyzębia w porównaniu do grup zdrowych i grup z zapaleniem dziąseł w porównaniu do grup z zapaleniem przyzębia.¹³

Kliniczna rola przyszłego wdrożenia tych biomarkerów w praktyce klinicznej związana jest z:

wczesną diagnozą wyżej wymienionych stanów, przyczyniając się do zapobiegania chorobom
precyzyjnym monitorowaniem poprawiającego się stanu zdrowia podczas odpowiedniego leczenia periodontologicznego¹⁴

Analiza ROC i AUC dla MMP-8, MMP-9 i TIMP-1 wykazała interesujące wyniki: mimo że tylko MMP-9, jako pojedynczy biomarker, wydawał się zdolny do rozróżniania (tylko) między grupami zdrowymi a grupami z zapaleniem przyzębia, różne kombinacje tych trzech biomarkerów okazały się skutecznie rozróżniać:

między wszystkimi trzema porównaniami grup, poprzez stosunki MMP-9/TIMP-1 i (MMP-8+MMP-9)/TIMP-1
między grupami zdrowymi a zapaleniem przyzębia oraz grupami z zapaleniem dziąseł a zapaleniem przyzębia poprzez stosunek MMP-8/TIMP-1 i sumę MMP-8+MMP-9¹⁵

Analiza CART określiła panel biomarkerów, w tym HGF, MMP-9, LBP, TIMP-1 i IL-1b, które najskuteczniej przewidywały pacjentów z zapaleniem przyzębia lub zapaleniem dziąseł z dokładnością 90%, osiągając nawet 100% w niektórych przypadkach.¹⁶ Ogólnie wyniki wskazały przede wszystkim, że kombinacje biomarkerów (wśród MMP-8, MMP-9 i TIMP-1) mogą mieć istotną wartość dyskryminacyjną i moc prognostyczną wśród trzech grup, ale także inne biomarkery, takie jak HGF, OPG, IL-1b i LBP, wykazały ważną wartość dyskryminacyjną według analizy CART.¹⁷

Indeksy mikrobiologiczne w prognozowaniu zapalenia dziąseł

Modelowanie predykcyjne

Modelowanie predykcyjne chorób ludzkich w oparciu o mikrobiotę ma wielki potencjał, ale pozostaje wyzwaniem.¹⁸ Proponowane mikrobiologiczne indeksy zapalenia dziąseł klasyfikowały typy gospodarzy z 74% wiarygodnością, a gdy testowano je na innej kohorcie 41 członków, rozróżniały zdrowe od chorych osób z 95% dokładnością.¹⁹ Ponadto stan mikrobioty w naturalnie występującym zapaleniu dziąseł przewidywał stan mikrobioty i nasilenie późniejszego eksperymentalnie wywołanego zapalenia dziąseł (EG) (ale nie stan mikrobioty podczas zdrowego okresu bazowego).²⁰

Wyniki sugerowały, że struktura mikrobiologiczna płytki nazębnej jest w stanie klasyfikować podatność i nasilenie zapalenia dziąseł w naturalnych populacjach ludzkich, a populacja mikrobiologiczna płytki nazębnej podczas naturalnego zapalenia dziąseł (NG) może przewidzieć strukturę populacji podczas późniejszego epizodu eksperymentalnie wywołanego zapalenia dziąseł u tego samego podmiotu.²¹

Czynniki zależne od gospodarza

Utrzymywanie się wyników choroby, a także struktury mikrobioty u większości gospodarzy podczas EG (w porównaniu z NG) sugerowało obecność czynników zależnych od gospodarza (i prawdopodobnie osobistych) w określaniu podatności na ponowne wystąpienie zapalenia dziąseł w naturalnych populacjach ludzkich.²² Silna korelacja między PC1 a objawem choroby (Wskaźnik Dziąsłowy Mazza) zarówno między podmiotami, jak i w ramach podmiotów, sugerowała więc, że PC1 mógłby potencjalnie modelować progresję choroby i klasyfikować podmioty zgodnie z ich stanem chorobowym.²³

MiG27 był silnie skorelowany ze Wskaźnikiem Dziąsłowym Mazza podczas przejścia zarówno z NG do wartości wyjściowej, jak i z wartości wyjściowej do EG: obszar pod krzywą charakterystyki operacyjnej odbiornika wynosił 99,52% dla przejścia NG do wartości wyjściowej i 99,84% dla przejścia od wartości wyjściowej do EG.²⁴

Moc prognostyczna MiG27 została przetestowana poprzez przewidywanie stanu zapalenia dziąseł u 41 gospodarzy w kohorcie 41 gospodarzy przy użyciu ich mikrobioty NG.²⁵ MiG15 mógł różnicować zapalenie dziąseł i zdrowie dla 41 podmiotów walidacyjnych z wysoką dokładnością, podobnie jak MiG27.²⁶ Indeks MiG-S został obliczony dla każdego gospodarza.²⁷

Specjalne uwarunkowania prognostyczne

Zespół metaboliczny a prognoza zapalenia dziąseł

Osoby narażone na komponenty zespołu metabolicznego (MetS) miały o 54% wyższe ryzyko krwawienia dziąseł (tj. niestabilnego zapalenia przyzębia lub zapalenia dziąseł) (surowy OR 1,54; 95% C.I. 1,29-1,85; p<0,01) niż osoby nienarażone.²⁸ Obserwowany specyficzny dla kobiet związek krwawienia dziąseł z pojedynczymi i złożonymi komponentami MetS rozwija periodontologię płci i precyzji.²⁹

Na każdy wzrost jednostkowy składników MetS istniało równoległe zwiększone ryzyko krwawienia dziąseł o 18% (OR 1,18; 95% C.I. 1,10-1,25; p<0,001).³⁰ Każdy dodatkowy składnik MetS zwiększał ryzyko zapalenia dziąseł o 16% (OR 1,16; 95% C.I. 1,07-1,25; p<0,001) i niestabilnego zapalenia przyzębia o 26% (OR 1,26; 95% C.I. 1,14-1,39; p<0,001).³¹ Jedyną cechą MetS z istotnym związkiem u mężczyzn było wysokie ciśnienie tętnicze z zapaleniem przyzębia.³² Składniki MetS nie poprawiły istotnie przewidywania krwawiących/niekrwawiących chorób przyzębia.³³

Zapalenie dziąseł a rokowanie w nowotworach głowy i szyi

Stopień utraty kości wyrostka zębodołowego, określony przez OPG, oraz jakość życia związana ze zdrowiem jamy ustnej (HRQoL) uzyskane w momencie diagnozy raka płaskonabłonkowego głowy i szyi (HNSCC), przewidywały długoterminowe przeżycie.³⁴ Obecna utrata kości wyrostka zębodołowego przewidywała przeżycie (RR=2,28, CI: 1,22-4,28, p=0,01).³⁵ Zgłoszona dentystyczna HRQoL przewidywała przeżycie (RR=2,17, CI: 1,17-4,01, p=0,014).³⁶

Długoterminowe przeżycie było dalej badane za pomocą wieloczynnikowych analiz regresji Coxa. Współzmienne kontrolne obejmowały wiek w momencie diagnozy, płeć, status guza HPV, stadium kliniczne, palenie tytoniu, spożycie alkoholu i choroby współistniejące (ACE-27). W tej analizie zgłoszona dentystyczna HRQoL przewidywała przeżycie (RR=2,17, CI: 1,17-4,01, p=0,014), podczas gdy tempo utraty kości wyrostka zębodołowego wykazywało tendencję do przewidywania przeżycia, ale nie osiągnęło istotności statystycznej (RR=1,95, CI: 0,98-3,87, p=0,056).³⁷ Obecna praca wykazała, że zapalenie przyzębia w momencie diagnozy raka głowy i szyi przewiduje dalsze przeżycie. Podobnie, pacjenci zgłaszający niską dentystyczną HRQoL doświadczali gorszych wyników przeżycia.³⁸

Powikłania i ich wpływ na prognozę

Powikłania ogólnoustrojowe

Zapalenie dziąseł nie stanowi bezpośredniego znaczącego zagrożenia dla zdrowia zdrowej osoby, ale może przyczyniać się do chorób i powodować lokalne i ogólnoustrojowe powikłania.³⁹ Najczęstszym powikłaniem przewlekłego zapalenia dziąseł jest progresja do choroby przyzębia i utrata zębów.⁴⁰

Ostre martwicze wrzodziejące zapalenie dziąseł (ANUG) reaguje na leczenie, jeśli obrona gospodarza jest nienaruszona. Noma wymaga agresywnego leczenia antybiotykami i miejscowego oczyszczania. Zwykły przebieg jest ostry, nawracający, przerywany i przewlekły.⁴¹ ANUG może postępować do miejscowych tkanek miękkich jamy ustnej, powodując nomę lub cancrum oris, lub może rozprzestrzeniać się drogą krwi do dowolnej innej części ciała.⁴² ANUG, które postępuje do nomy, wiąże się ze śmiertelnością na poziomie do 70% bez odpowiednich antybiotyków i oczyszczania.⁴³

Stan przejściowy i jego znaczenie prognostyczne

W badaniach mikrobiologicznych zaobserwowano, że większość dorosłych doświadcza epizodów zapalenia dziąseł, które mogą postępować do nieodwracalnego, przewlekłego stanu zapalenia przyzębia, ale rola płytki nazębnej w powstawaniu zapalenia dziąseł i progresji do zapalenia przyzębia pozostaje nieuchwytna.⁴⁴ Dlatego postawiono hipotezę, że dni 1-3 po skalingu zębów reprezentują stadium stanu zdrowia (SoH).⁴⁵ Stadium SoH charakteryzowało się wyraźną aktywacją zarówno cytokin pro-, jak i przeciwzapalnych, które stabilizowały się w późniejszych stadiach eksperymentalnego zapalenia dziąseł (EG).⁴⁶

Warto zauważyć, że tempo deplecji betainy i bakterii Rothia podczas indukcji EG nie jest stałe: oba stromo spadły podczas stadium SoH, a następnie stopniowo się stabilizowały.⁴⁷ Stadium SoH, pomimo braku klinicznie obserwowalnych zmian w krwawieniu (w porównaniu z wartością wyjściową), jest najbardziej aktywną i ważną fazą zarówno w zmianie strukturalnej mikrobiomów, jak i w metabolizmie mikrobowym napędzającym zapalenie dziąseł.⁴⁸ Odpowiedzi mikrobiomów jamy ustnej na stan chorobowy, czy to zapalenie dziąseł, czy zapalenie przyzębia, mogą być wysoce spójne w populacjach ludzkich.⁴⁹

Wzorce i charakter takich zmian mikrobiomów leżących u podstaw rozwoju chorób przewlekłych, niezależnie od tego, czy są zachowane, czy rozbieżne wśród wielu przewlekłych stanów zapalnych w jamie ustnej lub innych miejscach ludzkiego ciała, mogą rzucić nowe światło na etiologię chorób i pomóc w udoskonaleniu diagnozy, zapobiegania i leczenia.⁵⁰ W ten sposób mikrobiom określony, przejściowy stan dziąseł SoH jest kluczowym ogniwem między zapaleniem dziąseł, zapaleniem przyzębia i starzeniem się.⁵¹

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Materiały źródłowe

#1 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
Oral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. […] There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. […] The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. […] The intended use of such a multi-marker test is the identification of the most promising biomarkers and their combination for the most efficient molecular-based differentiation between healthy, periodontitis and gingivitis individuals.
#2 Gingivitis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557422/
Gingivitis, if identified and treated, can easily be resolved as the condition is reversible and the altered tissues can return to normal once the dental biofilm has been removed. […] If gingivitis progress to periodontitis, connective tissue attachment loss, and bone destruction will occur, which may ultimately result in tooth loss.
#3 Gingivitis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557422/
Gingivitis, if identified and treated, can easily be resolved as the condition is reversible and the altered tissues can return to normal once the dental biofilm has been removed. […] If gingivitis progress to periodontitis, connective tissue attachment loss, and bone destruction will occur, which may ultimately result in tooth loss.
#4 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#5 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. […] Most adults experience episodes of gingivitis, which can progress to the irreversible, chronic state of periodontitis, yet roles of plaque in gingivitis onset and progression to periodontitis remain elusive. […] Thus, the microbiome-defined, transient gum SoH stage is a crucial link among gingivitis, periodontitis, and aging. […] Notably, this inflammatory lesion can be resolved (i.e., reversed) following appropriate professional care, whereas uncontrolled gingivitis can progress to the irreversible condition periodontitis, which is characterized by destruction of tooth-supporting tissues and alveolar bone in susceptible individuals, eventually leading to tooth loss.
#6 Gingivitis: Symptoms & How To Treat It
https://my.clevelandclinic.org/health/diseases/10950-gingivitis-and-periodontal-disease-gum-disease
The earlier you catch gum disease, the more you can manage it. Gingivitis is reversible with proper care and maintenance, but it can come back. You must take good care of your teeth and gums between office visits. […] If you don’t treat gingivitis, it can turn into a more serious gum disease. Known as periodontitis, this gum disease damages the structures that keep your teeth anchored. […] Unlike the other stages of gum disease, gingivitis is curable as long as you treat it early enough. If you notice symptoms of gingivitis, you should schedule an appointment with a dentist and immediately begin practicing better oral hygiene at home. […] Untreated gingivitis can worsen and turn into periodontitis. At this stage of gum disease, you start to lose bone around your teeth a permanent side effect that results in a domino effect of oral health issues. […] The fastest way to get rid of gingivitis is to see a dentist for a cleaning and improve your oral hygiene habits at home between visits.
#7 Gingivitis: Symptoms & How To Treat It
https://my.clevelandclinic.org/health/diseases/10950-gingivitis-and-periodontal-disease-gum-disease
The earlier you catch gum disease, the more you can manage it. Gingivitis is reversible with proper care and maintenance, but it can come back. You must take good care of your teeth and gums between office visits. […] If you don’t treat gingivitis, it can turn into a more serious gum disease. Known as periodontitis, this gum disease damages the structures that keep your teeth anchored. […] Unlike the other stages of gum disease, gingivitis is curable as long as you treat it early enough. If you notice symptoms of gingivitis, you should schedule an appointment with a dentist and immediately begin practicing better oral hygiene at home. […] Untreated gingivitis can worsen and turn into periodontitis. At this stage of gum disease, you start to lose bone around your teeth a permanent side effect that results in a domino effect of oral health issues. […] The fastest way to get rid of gingivitis is to see a dentist for a cleaning and improve your oral hygiene habits at home between visits.
#8 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#9 Gingivitis: Symptoms & How To Treat It
https://my.clevelandclinic.org/health/diseases/10950-gingivitis-and-periodontal-disease-gum-disease
The earlier you catch gum disease, the more you can manage it. Gingivitis is reversible with proper care and maintenance, but it can come back. You must take good care of your teeth and gums between office visits. […] If you don’t treat gingivitis, it can turn into a more serious gum disease. Known as periodontitis, this gum disease damages the structures that keep your teeth anchored. […] Unlike the other stages of gum disease, gingivitis is curable as long as you treat it early enough. If you notice symptoms of gingivitis, you should schedule an appointment with a dentist and immediately begin practicing better oral hygiene at home. […] Untreated gingivitis can worsen and turn into periodontitis. At this stage of gum disease, you start to lose bone around your teeth a permanent side effect that results in a domino effect of oral health issues. […] The fastest way to get rid of gingivitis is to see a dentist for a cleaning and improve your oral hygiene habits at home between visits.
#10 Gingivitis: Symptoms & How To Treat It
https://my.clevelandclinic.org/health/diseases/10950-gingivitis-and-periodontal-disease-gum-disease
The earlier you catch gum disease, the more you can manage it. Gingivitis is reversible with proper care and maintenance, but it can come back. You must take good care of your teeth and gums between office visits. […] If you don’t treat gingivitis, it can turn into a more serious gum disease. Known as periodontitis, this gum disease damages the structures that keep your teeth anchored. […] Unlike the other stages of gum disease, gingivitis is curable as long as you treat it early enough. If you notice symptoms of gingivitis, you should schedule an appointment with a dentist and immediately begin practicing better oral hygiene at home. […] Untreated gingivitis can worsen and turn into periodontitis. At this stage of gum disease, you start to lose bone around your teeth a permanent side effect that results in a domino effect of oral health issues. […] The fastest way to get rid of gingivitis is to see a dentist for a cleaning and improve your oral hygiene habits at home between visits.
#11 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. […] Most adults experience episodes of gingivitis, which can progress to the irreversible, chronic state of periodontitis, yet roles of plaque in gingivitis onset and progression to periodontitis remain elusive. […] Thus, the microbiome-defined, transient gum SoH stage is a crucial link among gingivitis, periodontitis, and aging. […] Notably, this inflammatory lesion can be resolved (i.e., reversed) following appropriate professional care, whereas uncontrolled gingivitis can progress to the irreversible condition periodontitis, which is characterized by destruction of tooth-supporting tissues and alveolar bone in susceptible individuals, eventually leading to tooth loss.
#12 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
Oral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. […] There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. […] The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. […] The intended use of such a multi-marker test is the identification of the most promising biomarkers and their combination for the most efficient molecular-based differentiation between healthy, periodontitis and gingivitis individuals.
#13 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
Oral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. […] There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. […] The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. […] The intended use of such a multi-marker test is the identification of the most promising biomarkers and their combination for the most efficient molecular-based differentiation between healthy, periodontitis and gingivitis individuals.
#14 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
Thus, the clinical role of future implementation of these biomarkers in the clinical practice is related to (i) the early diagnosis of the aforementioned conditions, contributing to disease prevention; and (ii) the precise monitoring of the improving health status during relevant periodontal treatment. […] The ROC and AUC analysis for MMP-8, MMP-9 and TIMP-1 showed interesting findings: although only MMP-9, as a single biomarker, appeared able to discriminate (only) between health and periodontitis groups, various combinations of these three biomarkers proved able to effectively discriminate: (i) between all three group comparisons, through the MMP-9/TIMP-1 and the (MMP-8+MMP-9)/TIMP-1 ratios; and (ii) between health vs periodontitis and gingivitis vs periodontitis groups through the MMP-8/TIMP-1 ratio and the MMP-8+MMP-9 sum.
#15 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
Thus, the clinical role of future implementation of these biomarkers in the clinical practice is related to (i) the early diagnosis of the aforementioned conditions, contributing to disease prevention; and (ii) the precise monitoring of the improving health status during relevant periodontal treatment. […] The ROC and AUC analysis for MMP-8, MMP-9 and TIMP-1 showed interesting findings: although only MMP-9, as a single biomarker, appeared able to discriminate (only) between health and periodontitis groups, various combinations of these three biomarkers proved able to effectively discriminate: (i) between all three group comparisons, through the MMP-9/TIMP-1 and the (MMP-8+MMP-9)/TIMP-1 ratios; and (ii) between health vs periodontitis and gingivitis vs periodontitis groups through the MMP-8/TIMP-1 ratio and the MMP-8+MMP-9 sum.
#16 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
The CART analysis determined a panel of biomarkers including HGF, MMP-9, LBP, TIMP-1 and IL-1b that most efficiently predicted the patients with periodontitis or gingivitis with an accuracy of 90%, even reaching 100% in some cases. […] Overall, the results indicated primarily that combinations of biomarkers (among MMP-8, MMP-9, and TIMP-1) can have a significant discriminatory value and predictive power among the three groups, but also other biomarkers such as HGF, OPG, IL-1b and LBP exhibited important discriminatory value according to the CART analysis.
#17 Validation and verification of predictive salivary biomarkers for oral health | Scientific Reports
https://www.nature.com/articles/s41598-021-85120-w
The CART analysis determined a panel of biomarkers including HGF, MMP-9, LBP, TIMP-1 and IL-1b that most efficiently predicted the patients with periodontitis or gingivitis with an accuracy of 90%, even reaching 100% in some cases. […] Overall, the results indicated primarily that combinations of biomarkers (among MMP-8, MMP-9, and TIMP-1) can have a significant discriminatory value and predictive power among the three groups, but also other biomarkers such as HGF, OPG, IL-1b and LBP exhibited important discriminatory value according to the CART analysis.
#18 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. […] Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. […] Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). […] Our results suggested that the plaque microbial structure is able to classify gingivitis susceptibility and severity in natural human populations, and that the plaque microbial population during NG can predict the population structure during a later episode of experimentally induced gingivitis in the same subject.
#19 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. […] Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. […] Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). […] Our results suggested that the plaque microbial structure is able to classify gingivitis susceptibility and severity in natural human populations, and that the plaque microbial population during NG can predict the population structure during a later episode of experimentally induced gingivitis in the same subject.
#20 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. […] Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. […] Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). […] Our results suggested that the plaque microbial structure is able to classify gingivitis susceptibility and severity in natural human populations, and that the plaque microbial population during NG can predict the population structure during a later episode of experimentally induced gingivitis in the same subject.
#21 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. […] Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. […] Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). […] Our results suggested that the plaque microbial structure is able to classify gingivitis susceptibility and severity in natural human populations, and that the plaque microbial population during NG can predict the population structure during a later episode of experimentally induced gingivitis in the same subject.
#22 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The persistence of disease outcome as well as microbiota structure for majority of the hosts during EG (as compared with NG) suggested the presence of host-dependent (and likely personal) factors in determining the susceptibility to gingivitis reoccurrence in natural human populations. […] The strong correlation between PC1 and disease symptom (Mazza Gingival Index) both between subjects and within subjects thus suggested that PC1 could potentially model disease progression, and classify subjects according to their disease state. […] The MiG27 was highly correlated with Mazza Gingival Index during the transition both from NG to baseline and from baseline to EG: the area under the receiver operating characteristic curve was 99.52% for the NG to baseline transition, and 99.84% for the baseline to EG transition.
#23 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The persistence of disease outcome as well as microbiota structure for majority of the hosts during EG (as compared with NG) suggested the presence of host-dependent (and likely personal) factors in determining the susceptibility to gingivitis reoccurrence in natural human populations. […] The strong correlation between PC1 and disease symptom (Mazza Gingival Index) both between subjects and within subjects thus suggested that PC1 could potentially model disease progression, and classify subjects according to their disease state. […] The MiG27 was highly correlated with Mazza Gingival Index during the transition both from NG to baseline and from baseline to EG: the area under the receiver operating characteristic curve was 99.52% for the NG to baseline transition, and 99.84% for the baseline to EG transition.
#24 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The persistence of disease outcome as well as microbiota structure for majority of the hosts during EG (as compared with NG) suggested the presence of host-dependent (and likely personal) factors in determining the susceptibility to gingivitis reoccurrence in natural human populations. […] The strong correlation between PC1 and disease symptom (Mazza Gingival Index) both between subjects and within subjects thus suggested that PC1 could potentially model disease progression, and classify subjects according to their disease state. […] The MiG27 was highly correlated with Mazza Gingival Index during the transition both from NG to baseline and from baseline to EG: the area under the receiver operating characteristic curve was 99.52% for the NG to baseline transition, and 99.84% for the baseline to EG transition.
#25 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The predictive power of MiG27 was tested by predicting the gingivitis status of the 41 hosts in the 41-host cohort using their NG microbiota. […] The MiG15 could differentiate gingivitis and health for 41 validation subjects with high accuracy as MiG27. […] The MiG-S index was computed for each host.
#26 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The predictive power of MiG27 was tested by predicting the gingivitis status of the 41 hosts in the 41-host cohort using their NG microbiota. […] The MiG15 could differentiate gingivitis and health for 41 validation subjects with high accuracy as MiG27. […] The MiG-S index was computed for each host.
#27 Predictive modeling of gingivitis severity and susceptibility via oral microbiota | The ISME Journal
https://www.nature.com/articles/ismej201432
The predictive power of MiG27 was tested by predicting the gingivitis status of the 41 hosts in the 41-host cohort using their NG microbiota. […] The MiG15 could differentiate gingivitis and health for 41 validation subjects with high accuracy as MiG27. […] The MiG-S index was computed for each host.
#28 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#29 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#30 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#31 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#32 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#33 Association between metabolic syndrome components and gingival bleeding is women-specific: a nested cross-sectional study | Journal of Translational Medicine | Full Text
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04072-z
Individuals exposed to MetS components had a 54% higher risk of gingival bleeding (i.e. either unstable periodontitis or gingivitis) (crude OR 1.54; 95% C.I. 1.29-1.85; p<0.01) than nonexposed. [...] The observed women-specific association of gingival bleeding with single and combined MetS components advances gender and precision periodontology. [...] For every unitary increase in MetS components, there was a parallel increased risk of gingival bleeding by 18% (OR 1.18; 95% C.I. 1.10-1.25; p<0.001). [...] Each additional MetS component increased the risk of gingivitis by 16% (OR 1.16; 95% C.I. 1.07-1.25; p<0.001) and that of unstable periodontitis by 26% (OR 1.26; 95% C.I. 1.14-1.39; p<0.001). [...] The only MetS feature with significant association in men was high BP with periodontitis. [...] MetS components did not substantially improve the prediction of bleeding/non-bleeding periodontal disease.
#34 Periodontitis and dental quality of life predict long-term survival in head and neck cancer | BMC Oral Health | Full Text
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05170-0
The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. […] Present alveolar bone loss predicted survival (RR=2.28, CI: 1.224.28, p=0.01). […] Reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014). […] Long-term survival was further studied using Cox regression multivariate analyses (Table 5). Control covariates included age at diagnosis, gender, HPV tumor status, clinical stage, smoking, alcohol use, and comorbidity (ACE-27). In this analysis, reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014), while the rate of alveolar bone loss showed a trend toward predicting survival but did not reach statistical significance (RR=1.95, CI: 0.983.87, p=0.056). […] The present work has demonstrated that periodontitis at the time of HNC diagnosis predicts subsequent survival. Similarly, patients reporting low dental HRQoL experienced worse survival outcomes.
#35 Periodontitis and dental quality of life predict long-term survival in head and neck cancer | BMC Oral Health | Full Text
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05170-0
The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. […] Present alveolar bone loss predicted survival (RR=2.28, CI: 1.224.28, p=0.01). […] Reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014). […] Long-term survival was further studied using Cox regression multivariate analyses (Table 5). Control covariates included age at diagnosis, gender, HPV tumor status, clinical stage, smoking, alcohol use, and comorbidity (ACE-27). In this analysis, reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014), while the rate of alveolar bone loss showed a trend toward predicting survival but did not reach statistical significance (RR=1.95, CI: 0.983.87, p=0.056). […] The present work has demonstrated that periodontitis at the time of HNC diagnosis predicts subsequent survival. Similarly, patients reporting low dental HRQoL experienced worse survival outcomes.
#36 Periodontitis and dental quality of life predict long-term survival in head and neck cancer | BMC Oral Health | Full Text
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05170-0
The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. […] Present alveolar bone loss predicted survival (RR=2.28, CI: 1.224.28, p=0.01). […] Reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014). […] Long-term survival was further studied using Cox regression multivariate analyses (Table 5). Control covariates included age at diagnosis, gender, HPV tumor status, clinical stage, smoking, alcohol use, and comorbidity (ACE-27). In this analysis, reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014), while the rate of alveolar bone loss showed a trend toward predicting survival but did not reach statistical significance (RR=1.95, CI: 0.983.87, p=0.056). […] The present work has demonstrated that periodontitis at the time of HNC diagnosis predicts subsequent survival. Similarly, patients reporting low dental HRQoL experienced worse survival outcomes.
#37 Periodontitis and dental quality of life predict long-term survival in head and neck cancer | BMC Oral Health | Full Text
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05170-0
The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. […] Present alveolar bone loss predicted survival (RR=2.28, CI: 1.224.28, p=0.01). […] Reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014). […] Long-term survival was further studied using Cox regression multivariate analyses (Table 5). Control covariates included age at diagnosis, gender, HPV tumor status, clinical stage, smoking, alcohol use, and comorbidity (ACE-27). In this analysis, reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014), while the rate of alveolar bone loss showed a trend toward predicting survival but did not reach statistical significance (RR=1.95, CI: 0.983.87, p=0.056). […] The present work has demonstrated that periodontitis at the time of HNC diagnosis predicts subsequent survival. Similarly, patients reporting low dental HRQoL experienced worse survival outcomes.
#38 Periodontitis and dental quality of life predict long-term survival in head and neck cancer | BMC Oral Health | Full Text
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05170-0
The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. […] Present alveolar bone loss predicted survival (RR=2.28, CI: 1.224.28, p=0.01). […] Reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014). […] Long-term survival was further studied using Cox regression multivariate analyses (Table 5). Control covariates included age at diagnosis, gender, HPV tumor status, clinical stage, smoking, alcohol use, and comorbidity (ACE-27). In this analysis, reported dental HRQoL predicted survival (RR=2.17, CI: 1.174.01, p=0.014), while the rate of alveolar bone loss showed a trend toward predicting survival but did not reach statistical significance (RR=1.95, CI: 0.983.87, p=0.056). […] The present work has demonstrated that periodontitis at the time of HNC diagnosis predicts subsequent survival. Similarly, patients reporting low dental HRQoL experienced worse survival outcomes.
#39 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#40 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#41 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#42 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#43 Gingivitis: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/763801-overview
Untreated chronic gingivitis eventually results in tooth loss. […] After an initial cleaning and scaling in its early stages, gingivitis usually is reversible with good dental hygiene. Gingivitis generally responds well to appropriate treatment. […] ANUG responds to treatment if host defenses are intact. Noma requires aggressive treatment with antibiotics and local debridement. The usual course is acute, relapsing, intermittent, and chronic. […] Chronic gingivitis leads to tooth loss. ANUG may progress into the local soft tissues of the mouth, resulting in noma or cancrum oris, or may spread hematogenously to any other part of the body. […] Gingivitis is not a direct significant threat to the health of a healthy individual, but it can contribute to illness and cause local and systemic complications. […] The most common complication of chronic gingivitis is progression to periodontal disease and tooth loss. […] ANUG that progresses to noma is associated with a mortality rate as high as 70% without proper antibiotics and debridement.
#44 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. […] Most adults experience episodes of gingivitis, which can progress to the irreversible, chronic state of periodontitis, yet roles of plaque in gingivitis onset and progression to periodontitis remain elusive. […] Thus, the microbiome-defined, transient gum SoH stage is a crucial link among gingivitis, periodontitis, and aging. […] Notably, this inflammatory lesion can be resolved (i.e., reversed) following appropriate professional care, whereas uncontrolled gingivitis can progress to the irreversible condition periodontitis, which is characterized by destruction of tooth-supporting tissues and alveolar bone in susceptible individuals, eventually leading to tooth loss.
#45 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#46 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#47 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#48 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#49 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#50 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
Therefore, we hypothesized that days 1 to 3 after dental scaling represent the SoH stage. […] The SoH stage featured prominent activation of both pro- and anti-inflammatory cytokines that stabilized in later stages of EG. […] Notably, the depletion rates of betaine and Rothia during EG induction are not constant: they both steeply decreased during the SoH stage and then gradually stabilized. […] The SoH stage, despite the lack of clinically observable changes in bleeding (versus baseline), is the most active and consequential phase in both microbiome structural change and the gingivitis-driving microbial metabolism. […] The oral-microbiome responses to a disease state, either gingivitis or periodontitis, can be highly consistent across human populations. […] The patterns and nature of such microbiome changes underlying chronic disease development, whether conserved or divergent among the many chronic inflammations at oral or other human body sites, can shed new light on disease etiology and help refine diagnosis, prevention, and treatment.
#51 Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
https://pmc.ncbi.nlm.nih.gov/articles/PMC8092283/
A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis. […] Most adults experience episodes of gingivitis, which can progress to the irreversible, chronic state of periodontitis, yet roles of plaque in gingivitis onset and progression to periodontitis remain elusive. […] Thus, the microbiome-defined, transient gum SoH stage is a crucial link among gingivitis, periodontitis, and aging. […] Notably, this inflammatory lesion can be resolved (i.e., reversed) following appropriate professional care, whereas uncontrolled gingivitis can progress to the irreversible condition periodontitis, which is characterized by destruction of tooth-supporting tissues and alveolar bone in susceptible individuals, eventually leading to tooth loss.