Laser assisted periodontics: A review of the literature

Over the years, the use of the laser within health field and more particularly dentistry has been increasing and improving. The application of laser in the periodontal treatment takes part of a non-surgical and surgical approaches, is used for the decontamination of periodontal pockets due to its bactericidal effect, and the removal of granulation tissues, inflamed and diseased epithelium lining, bacterial deposits and subgingival calculus. However in spite of all the marketing surrounding, the use of laser highlighting its beneficial effect, the capacity of laser to replace the conventional treatment for chronic periodontitis is still debatable. In fact there is no evidence that any laser system adds substantial clinical value above conventional treatments of chronic periodontitis. Some studies showed a significant positive effect on clinical attachment level gain and probing depth reduction. In the other hand, several articles demonstrated no evidence of the superior effectiveness of laser therapy compared to root planing and scaling. Our aims is to review the literature on the capacity of erbium:Yttrium-aluminum-garnet and neodymium:Yttrium-aluminium-garnet laser to either replace or complete conventional mechanical/surgical periodontal treatments.

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.

Diagnostic value associated with the combination of saliva pepsin and microorganisms in functional heartburn and gastroesophageal reflux disease

Heartburn is a common symptom shared by both gastroesophageal reflux disease(GERD)and functional heartburn(FHB),which can make it challenging to differentiate between the two conditions.However,examining oral manifestations of GERD can be a cost-effective and readily available method to aid in this differentiation process.It may serve as a valuable tool in distinguishing GERD from FHB.

Brain abscess from oral microbiota approached by metagenomic next-generation sequencing: A case report and review of literature

BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine.

Periodontitis:An often-neglected complication of diabetes

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

Analysis of influencing factors of anxiety and depression in patients with periodontitis

BACKGROUND Periodontitis is a chronic oral disease caused by pathogenic microorganisms that corrode tooth tissue,form periodontal pockets,absorb alveolar bone,and finally lead to tooth loss.During treatment,patients are prone to anxiety,tension,and other negative emotions,which affect their ability to face the disease and may also lead to aggravation of the original condition and affect oral health.Therefore,it is important to improve the negative psychology of patients with periodontitis to clarify the factors that may lead to negative psychological emotions.AIM To investigate the risk factors that may lead to anxiety and depression in patients with periodontitis.METHODS One hundred patients with periodontitis were selected between March 2022 and March 2023 at our hospital.All patients were assessed with the Zung Self-rating Depression Scale(SDS)(≥53 points indicate a depressive state)and Zung Selfrating Anxiety Scale(SAS)(≥50 points indicates an anxious state).In this study,patients who experienced anxiety or depression were included in the occurrence group and those without anxiety or depression were included in the nonoccurrence group.The baseline data of the two groups were compared to explore the risk factors for anxiety and depression in patients with periodontitis.RESULTS A total of 100 patients with periodontitis were included in this study.According to the SDS,38 patients(38.00%)developed depression,with an average SDS score of(68.52±5.85)points.According to the SAS,40 patients(40.00%)developed anxiety,and the average SAS score was(72.15±4.15)points.In this study,56 patients with anxiety or depression were included.Compared with the nonoccurrence group,the occurrence group had higher ages(≥60 years),lower level of hope(low level),educational level(high school or below),disease perception(poor),and sleep disorder(yes).The negative coping dimension scores of the simplified coping style questionnaire(SCSQ)and Dental Fear Scale(DFS)in the occurrence group were higher,whereas the score of the positive coping dimension of the SCSQ was significantly lower(P<0.05).There were no significant differences in the other data between the groups(P>0.05).The results of multiple logistics regression analysis showed that age(≥60 years),level of hope(low level),educational level(high school or below),disease perception(poor),sleep disorder(yes),high negative coping dimension scores of SCSQ,high score of DFS,and low positive coping dimension scores of SCSQ were all factors contributing to the anxiety and depression in patients with periodontitis(odds ratio>1,P<0.05).CONCLUSION Age,hope level,educational level,disease perception,sleep disorders,coping style,and dental fear were all associated with anxiety and depression in patients with periodontitis.

Microsurgical management of radicular cyst using guided tissue regeneration technique:A case report

BACKGROUND Radicular cyst is a lesion of odontogenic origin that arises from epithelial remains due to periapical periodontitis caused by inflammatory reactions generated at the apex of affected teeth with infected or necrotic pulps.The therapeutic mana gement of radicular cysts is controversial.There is only one case report of enucleation of a radicular cyst managed with microsurgery and apicoectomy,but without the use of the guided tissue regeneration(GTR)technique in the same surgical procedure.The present clinical case describes the management of a radicular cyst with microsurgical approach,performance of an apicoectomy of the tooth associated with the entity,application of GTR technique,use of a resorbable membrane of type I bovine collagen,and bovine xenograft.CASE SUMMARY A 68-year-old patient presented with a radicular cyst from an upper lateral incisor.The microsurgical management used was aimed at enucleating the chemical membrane,performing apicoectomy of the tooth along with careful and precise retrograde filling,and implementing GTR technique using a resorbable collagen membrane and bovine xenograft.The diagnosis of radicular cyst was confirmed using histopathological analysis.The patient underwent follow-up evaluations at 10 and 30 d postoperatively.At 4 months postoperative evaluation,she remained asymptomatic,and radiographs showed significant periapical healing with adequate bone formation.CONCLUSION These results suggest that microsurgical management using the GTR technique with collagen membrane and xenograft,contributes to bone regeneration.

Poor oral health was associated with higher risk of gastric cancer: Evidence from 1431677 participants

BACKGROUND In recent years,the association between oral health and the risk of gastric cancer(GC)has gradually attracted increased interest.However,in terms of GC incidence,the association between oral health and GC incidence remains contro-versial.Periodontitis is reported to increase the risk of GC.However,some studies have shown that periodontitis has no effect on the risk of GC.Therefore,the present study aimed to assess whether there is a relationship between oral health and the risk of GC.AIM To assess whether there was a relationship between oral health and the risk of GC.METHODS Five databases were searched to find eligible studies from inception to April 10,2023.Newcastle-Ottawa Scale score was used to assess the quality of included studies.The quality of cohort studies and case-control studies were evaluated separately in this study.Incidence of GC were described by odds ratio(OR)and 95%confidence interval(CI).Funnel plot was used to represent the publication bias of included studies.We performed the data analysis by StataSE 16.RESULTS A total of 1431677 patients from twelve included studies were enrolled for data analysis in this study.According to our analysis,we found that the poor oral health was associated with higher risk of GC(OR=1.15,95%CI:1.02-1.29;I2=59.47%,P=0.00<0.01).Moreover,after subgroup analysis,the outcomes showed that whether tooth loss(OR=1.12,95%CI:0.94-1.29;I2=6.01%,P>0.01),gingivitis(OR=1.19,95%CI:0.71-1.67;I2=0.00%,P>0.01),dentures(OR=1.27,95%CI:0.63-1.19;I2=68.79%,P>0.01),or tooth brushing(OR=1.25,95%CI:0.78-1.71;I2=88.87%,P>0.01)had no influence on the risk of GC.However,patients with periodontitis(OR=1.13,95%CI:1.04-1.23;I2=0.00%,P<0.01)had a higher risk of GC.CONCLUSION Patients with poor oral health,especially periodontitis,had a higher risk of GC.Patients should be concerned about their oral health.Improving oral health might reduce the risk of GC.

Multifunctional role of oral bacteria in the progression of nonalcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)encompasses a spectrum of liver disorders of varying severity,ultimately leading to fibrosis.This spectrum primarily consists of NAFL and non-alcoholic steatohepatitis.The pathogenesis of NAFLD is closely associated with disturbances in the gut micr-obiota and impairment of the intestinal barrier.Non-gut commensal flora,particularly bacteria,play a pivotal role in the progression of NAFLD.Notably,Porphyromonas gingivalis,a principal bacterium involved in periodontitis,is known to facilitate lipid accumulation,augment immune responses,and induce insulin resistance,thereby exacerbating fibrosis in cases of periodontitis-associated NAFLD.The influence of oral microbiota on NAFLD via the“oral-gut-liver”axis is gaining recognition,offering a novel perspective for NAFLD management through microbial imbalance correction.This review endeavors to encapsulate the intricate roles of oral bacteria in NAFLD and explore underlying mechanisms,emphasizing microbial control strategies as a viable therapeutic avenue for NAFLD.

The Oral Health Status of Person with Special Needs in Kumasi

Background: The most prevalent non-communicable disease worldwide is oral health-related disease, with dental caries and periodontal conditions being common. Oral health status significantly impacts overall health and quality of life. Barriers to dental care affect children with special needs. This study evaluates the oral health status and treatment requirements of people with special needs. Methodology: This descriptive cross-sectional study in Kumasi, Ghana examined oral health status among people, 121 children with special needs over two months, in June-July 2022. Dental caries, periodontal changes, malocclusion, and trauma were assessed. The data was analyzed using SPSS 20.0. Results: The oral health status among people with special needs in this study was generally moderate, with a range from very good to very poor. The prevalence of dental caries was 37%, with a mean DMFT score of 2.82. Periodontal health showed unsatisfactory indicators such as mobile teeth, poor gingival health, high plaque scores, and the presence of halitosis. Conclusion: This descriptive study aimed to provide baseline data on the oral health status of special needs students in Kumasi, addressing the lack of knowledge in this area. It highlighted the importance of dental care in maintaining good oral health and overall well-being in individuals with special needs. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children.

Research Progress on the Immunomodulatory Effect of Mesenchymal Stem Cells on Chronic Periodontitis

Periodontal disease is an inflammatory and destructive disease of periodontal support tissue caused by microorganisms in dental plaque. During the development of periodontal disease, host immune regulation plays an important role, and unnecessary excessive immune regulation often exacerbates the course of chronic periodontal disease. Mesenchymal stem cells (MSCs) are adult stem cells with self replication ability and multi-directional differentiation potential. Many studies have found that MSCs have strong immunosuppressive effects on both adaptive and innate immunity. In recent years, literature has reported that MSCs are involved in the immune regulatory effect of chronic periodontal disease, inhibiting its inflammatory response and alveolar bone resorption, but the specific regulatory mechanism has not been elucidated. This article reviews the current research status of the immune regulatory effects of MSCs on chronic periodontitis.

Oral Hygiene in the Presence of Orthodontic Therapy

Orthodontic treatment offers great advantages in improving facial and smile aesthetics, self-confidence and the function of the stomatognathic apparatus. The pursuit of these advantages makes use of orthodontic appliances that could be fixed or removable. However, it’s worth stating that these appliances interfere with tooth brushing, making it more difficult to brush teeth effectively. Orthodontics appliances therefore promote the accumulation of dental plaque, which results in both quantitative and qualitative changes in the oral microbiota, hence, exposing patients to several adverse effects such as White spot lesions, dental caries, periodontal pathologies and halitosis. For this reason, oral assessment of patients before, during and after treatment is necessary as well as oral hygiene instructions and motivation. Orthodontists therefore, should educate patients on oral and periodontal hygiene in order to control dental and periodontal complications. Prescriptions of plaque control materials adapted to each patient are done in order to optimize the final result and minimize unwanted complications.

Effectiveness of Oral Care in Implant Denture Restoration in Chronic Periodontitis

Objective:To explore the effect of observation of oral care in implant denture restoration of chronic periodontitis.Methods:80 patients with chronic periodontitis implant denture restoration admitted from March 2022 to March 2023 in the hospital were selected.They were randomly divided into an observation group and a control group,with 40 cases in each group.Both groups of patients received routine treatment and care.The patients in the control group used routine oral care methods to carry out oral care,the patients in the observation group carried out oral care on the basis of the control group,observation and analysis of the patients'mastery of oral knowledge,as well as the depth of the probing and the level of clinical attachment.Results:The oral knowledge mastery of the observation group was 72.31±6.98 after the nursing intervention,which was significantly higher than the score of 86.12±7.36 of the patients in the control group who used conventional oral care,and the difference was statistically significant at P<0.05;the depth of probing and the clinical attachment level of the observation group were 2.43±0.58 and 4.31±0.86 respectively,which were significantly better than those of the control group.The depth of probing and clinical attachment level scores of the observation group were 2.99±0.54 and 5.36±1.02 respectively,and P<0.05 was considered statistically significant.Conclusion:The combination of conventional treatment and oral care can effectively improve the treatment effect of implant denture prosthesis for chronic periodontitis.However,it is necessary to pay attention to the psychological counseling of the patients in the specific clinical application to ensure that the patients can actively cooperate with the clinical treatment.

Evaluation of the Effectiveness and Safety of One-Time Endodontics in the Treatment of Chronic Apical Periodontitis with Sinus Tract in Pediatric Deciduous Teeth

Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.

Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and fibrosis.NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma.The oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis.Gut dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and cyclopentane.Moreover,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation.In particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis.NAFLD,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and diabetes.Periodontal disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively.In this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome.In conclusion,it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease,gut microbiota,and metabolic syndrome.Thus,the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics,prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.

Saliva:a challenging human fluid to diagnose brain disorders with a focus on Alzheimer's disease

Biomarkers are molecules of biological processes that help in both the diagnosis of human diseases and in follow-up assessments of therapeutic responses. Biomarkers can be measured in many human fluids, such as blood, cerebrospinal fluid, urine, and saliva. The-omics methods(genomics, RNomics, proteomics, and metabolomics) are useful at measuring thousands of markers in a small volume. Saliva is a human fluid that is easily accessible, without any ethical concerns. Yet, saliva remains unexplored in regard to many human disease biomarkers. In this review, we will give an overview on saliva and how it can be influenced by exogenous factors. As we focus on the potential use of saliva as a diagnostic tool in brain disorders(especially Alzheimer's disease), we will cover how saliva is linked to the brain. We will discuss that saliva is a heterogeneous human fluid, yet useful for the discovery of biomarkers in human disorders. However, a procedure and consensus that is controlled, validated, and standardized for the collection and processing of saliva is required, followed by a highly sensitive diagnostic approach.

Rescuing“hopeless”avulsed teeth using autologous platelet-rich fibrin following delayed reimplantation:Two case reports

BACKGROUND Tooth avulsion is one of the most severe types of dental trauma.Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis.The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin(PRF).CASE SUMMARY Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department.The diagnoses were avulsion of tooth 21,lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21.In case 2,a 17-year-old boy fell 2 h prior to his presentation to the hospital,and his left upper lateral incisor was completely knocked out of the alveolar socket.The diagnoses included avulsion of tooth 22,complicated crown fracture of tooth 11and complicated crown-root fracture of tooth 21.The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch.The root canals of the avulsed teeth were filled with calcium hydroxide paste,and root canal filling was performed 4 wk after reimplantation.The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-,6-,and 12-mo follow-up examinations after reimplantation with autologous PRF.In addition to the avulsed teeth,the other injured teeth were treated using corresponding conventional treatment methods.CONCLUSION These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth,and the application of PRF may provide new healing opportunities for traditionally“hopeless”avulsed teeth.

Dental evaluation is helpful in the differentiation of functional heartburn and gastroesophageal reflux disease

BACKGROUND Heartburn is identically the key symptom of both,gastroesophageal reflux disease(GERD)and functional heartburn(FHB),making the differential diagnosis resource-intensive.Oral manifestations of GERD can be easily examined;therefore,their exploration might be a cheap,widely available,and useful tool in the differentiation of GERD and FHB.AIM To evaluate the prevalence of dental erosions(DE)and periodontal diseases(PD)in patients with heartburn and their association with GERD and FHB.METHODS A total of 116[M/F:51/65,mean age:54(17-80)years]consecutive patients with heartburn were enrolled for detailed esophageal function and orodental examinations.RESULTS Dental disorders were detected in 89%(103/116).Patients with PD+DE had significantly more often pathologic reflux(90.0%vs 27.8%;P<0.05),higher esophagitis scores(1.8 vs 0.9;P<0.05),and a significantly different mean impedance curve(P=0.04)than those without any dental diseases.The opposite approach established that patients with GERD had significantly higher prevalence of DE and PD,especially if both were present(28.9%vs 2.0%;P<0.01),more severe PD(1.5 vs 1.0;P<0.01),and longer history of heartburn(15 years vs 9 years;P<0.01)than those with FHB.CONCLUSION The dental evaluation of patients with heartburn seems to be useful in the differential diagnosis of GERD and FHB.Among the studied parameters,the co-appearance of DE and PD seems to be the best predictor of GERD,whereas the absence of dental disorders was mostly observed in FHB.

Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus

BACKGROUND Type 2 diabetes mellitus(T2DM)is associated with periodontitis.Currently,there are few studies proposing predictive models for periodontitis in patients with T2DM.AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models.METHODS In this a retrospective study,300 patients with T2DM who were hospitalized at the First People’s Hospital of Wenling from January 2022 to June 2022 were selected for inclusion,and their data were collected from hospital records.We used logistic regression to analyze factors associated with periodontitis in patients with T2DM,and random forest and logistic regression prediction models were established.The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve(AUC).RESULTS Of 300 patients with T2DM,224 had periodontitis,with an incidence of 74.67%.Logistic regression analysis showed that age[odds ratio(OR)=1.047,95%confidence interval(CI):1.017-1.078],teeth brushing frequency(OR=4.303,95%CI:2.154-8.599),education level(OR=0.528,95%CI:0.348-0.800),glycosylated hemoglobin(HbA1c)(OR=2.545,95%CI:1.770-3.661),total cholesterol(TC)(OR=2.872,95%CI:1.725-4.781),and triglyceride(TG)(OR=3.306,95%CI:1.019-10.723)influenced the occurrence of periodontitis(P<0.05).The random forest model showed that the most influential variable was HbA1c followed by age,TC,TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showedthat in the training dataset, the AUC of the random forest model was higher than that of the logistic regressionmodel (AUC = 1.000 vs AUC = 0.851;P < 0.05). In the validation dataset, there was no significant difference in AUCbetween the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915;P > 0.05).CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the riskof periodontitis in patients with T2DM.

Could there be an interplay between periodontal changes and pancreatic malignancies?

The term"periodontal disease"refers to a group of chronic inflammatory illnesses caused by specific microorganisms from subgingival biofilm,that affect the toothsupporting tissues.Recent research has also shown that periodontal infection plays a role in aggravating systemic disease states at distal sites,reinforcing the significance of the oral cavity for general health.Additionally,it has been suggested that gastroenterological malignancies may be promoted by hematogenous,enteral or lymphatic translocation of periopathogens.In the past 25 years,the global burden of pancreatic cancer(PC)has more than doubled,making it one of the major causes of cancer-related mortality.Periodontitis has been linked to at least 50%increased risk of PC and it could be considered a risk factor for this malignancy.A recent study performed on 59000 African American women with a follow up of 21 years showed that participants who had poor dental health had higher chances of PC.The findings,according to researchers,might be related to the inflammation that some oral bacteria trigger.Regarding the mortality of PC,periodontitis considerably raises the chance of dying from PC.Microbiome alterations in the gut,oral cavity and pancreatic tissues of PC patients occur when compared to healthy flora,demonstrating a link between PC and microecology.Inflammation may also contribute to PC development,although the underlying pathway is not yet known.The function of the microbiome in PC risk has drawn more focus over the last decade.Future risk of PC has been linked to the oral microbiome,specifically increased levels of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and decreased relative abundance of Leptotrichia and Fusobacteria,suggesting that it may have an impact on the inflammatory condition by expanding,altering,and regulating the commensal microbiome.Patients who received periodontal treatment had significantly decreased incidence rate ratios for PC.By analyzing patterns in the microbiome composition throughout PC development and establishing strategies to enhance the cancerassociated microbial system,we can increase the efficacy of therapy and eventually find an application for the microbial system.The development of immunogenomics and gut microgenomics in the life sciences will result in a significant advancement in our understanding of how microbial systems and immunotherapy interact,and it may also have intriguing therapeutic implications for extending the lifetime of PC patients.