Publications by authors named "Huanxin Meng"

80 Publications

Pro-inflammatory cytokine interleukin-6-induced hepcidin, a key mediator of periodontitis-related anemia of inflammation.

J Periodontal Res 2021 Mar 3. Epub 2021 Mar 3.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Objectives: To investigate whether anemia of inflammation (AI) occurs in periodontitis patients and to further explore underlying pathogenesis of periodontitis-related AI by an experimental periodontitis model.

Background: Previous studies have reported periodontitis patients could show a tendency toward AI. However, the relationship between periodontitis and AI remains unclear, and the related pathological mechanisms have not been identified.

Materials And Methods: Periodontal clinical parameters, inflammatory markers, and anemia-related indicators were compared between 98 aggressive periodontitis (AgP) patients and 103 healthy subjects. An experimental periodontitis model was induced by ligature placement in mice. The changes in mice inflammatory markers, anemia indicators, hepcidin mRNA expression, and serum hepcidin concentrations were measured. Human and mouse liver cells were treated with interleukin-6 (IL-6) for analyzing the changes in hepcidin expression based on mRNA and protein levels.

Results: AgP patients exhibited higher white blood cell counts, IL-6, and C-reactive protein. Adjusted linear regression analyses showed correlations between AgP and decreased hemoglobin (HGB) and hematocrit (HCT). The ligature-induced periodontitis caused systemic inflammation and elevated IL-6 levels. Lower red blood cell counts, HGB, and HCT were detected, whereas the levels of hepcidin mRNA expression and serum hepcidin concentrations increased. The treatment of hepatocytes with IL-6 induced both hepcidin mRNA expression and hepcidin secretion.

Conclusions: Systemic inflammation induced by periodontitis leads to an increased risk for AI. IL-6-induced hepcidin could play a central mediator role and act as a key pathologic mechanism. Our results demonstrate periodontitis may be considered as an additional inflammatory disease contributing to the development of AI.
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http://dx.doi.org/10.1111/jre.12865DOI Listing
March 2021

The occurrence of peri-implant mucositis associated with the shift of submucosal microbiome in patients with a history of periodontitis during the first two years.

J Clin Periodontol 2021 03 21;48(3):441-454. Epub 2020 Dec 21.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Aim: To investigate the dynamic changes of peri-implant microbiome in patients with a history of periodontitis and to construct a microbial prediction model.

Materials And Methods: The prospective study was performed at one month (T1), one year (T2) and two years (T3) after restoration. Clinical examinations [probing depth (PD), bleeding on probing (BOP), suppuration (SUP)], radiographic examinations and sample collection were conducted at three timepoints. Peri-implant sulcular fluid (PISF) was collected and analysed by 16S rRNA gene sequencing. Generalized linear mixed model (GLMM) was used to identify differences.

Results: Totally, 168 subjects were assessed for eligibility. Twenty-two patients were recruited in the longitudinal study. Eventually, 67 PISF samples from 24 implants of 12 patients were collected and analysed. Peri-implant microbiome showed increasing diversity and complexity over time. Disease-associated genera Porphyromonas, Tannerella, Treponema and Prevotella dramatically increased from T1 to T3. The prediction model for clinical suppuration at T1 showed a high accuracy of 90%.

Conclusion: The dysbiosis of peri-implant microbiome increased with time during the two-year observation in patients with a history of periodontitis. Genera of Porphyromonas, Tannerella, Treponema and Prevotella were biomarkers of peri-implant mucositis. Microbiota at the early stage could predict subsequent microbial dysbiosis and clinical suppuration.
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http://dx.doi.org/10.1111/jcpe.13410DOI Listing
March 2021

Expression of vitamin D 1α-hydroxylase in human gingival fibroblasts in vivo.

PeerJ 2021 4;9:e10279. Epub 2021 Jan 4.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Vitamin D 1α-hydroxylase CYP27B1 is the key factor in the vitamin D pathway. Previously, we analyzed the expression of CYP27B1 in human gingival fibroblasts in vitro. In the present study, we analyzed the gingival expression of CYP27B1 in vivo.

Methods: Forty-two patients with periodontitis Stage IV Grade C and 33 controls were recruited. All patients with periodontitis had unsalvageable teeth and part of the wall of the periodontal pocket was resected and obtained after tooth extraction. All controls needed crown-lengthening surgery, and samples of gingiva resected during surgery were also harvested. All the individuals' gingivae were used for immunohistochemistry and immunofluorescence. In addition, gingivae from seventeen subjects of the diseased group and twelve subjects of the control group were analyzed by real-time PCR.

Results: Expression of CYP27B1 was detected both in gingival epithelia and in gingival connective tissues, and the expression in connective tissues colocalized with vimentin, indicating that CYP27B1 protein is expressed in gingival fibroblasts. The expression of CYP27B1 mRNA in gingival connective tissues and the CYP27B1 staining scores in gingival fibroblasts in the diseased group were significantly higher than those in the control group.

Conclusions: Expression of CYP27B1 in human gingival tissues was detected, not only in the fibroblasts of gingival connective tissues, but also in the gingival epithelial cells, and might be positively correlated with periodontal inflammation.
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http://dx.doi.org/10.7717/peerj.10279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789863PMC
January 2021

A double-edged sword: Role of butyrate in the oral cavity and the gut.

Mol Oral Microbiol 2021 04 19;36(2):121-131. Epub 2020 Nov 19.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Butyrate, a four-carbon short-chain fatty acid (SCFA), is a metabolite of anaerobic bacteria. Butyrate has primarily been described as an energy substance in the studies on the digestive tract. The multiple mechanisms of its protective function in the gut and on underlying diseases (including metabolic diseases, diseases of the nervous system, and osteoporosis) via interaction with intestinal epithelial cells and immune cells have been well documented. There are many butyrogenic bacteria in the oral cavity as well. As essential components of the oral microbiome, periodontal pathogens are also able to generate butyrate when undergoing metabolism. Considerable evidence has indicated that butyrate plays an essential role in the initiation and perpetuation of periodontitis. However, butyrate is considered to participate in the pro-inflammatory activities in periodontal tissue and the reactivation of latent viruses. In this review, we focused on the production and biological impact of butyrate in both intestine and oral cavity and explained the possible pathway of various diseases that were engaged by butyrate. Finally, we suggested two hypotheses, which may give a better understanding of the significantly different functions of butyrate in different organs (i.e., the expanded butyrate paradox).
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http://dx.doi.org/10.1111/omi.12322DOI Listing
April 2021

The prevalence and severity of periodontal disease in Mainland China: Data from the Fourth National Oral Health Survey (2015-2016).

J Clin Periodontol 2021 02 18;48(2):168-179. Epub 2020 Nov 18.

Chinese Stomatological Association, Beijing, China.

Aim: To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey.

Materials And Methods: Data of adult subjects (35- to 44-year-old group [N = 4409], 55- to 64-year-old group [N = 4622], and 65- to 74-year-old group [N = 4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders.

Results: The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females.

Conclusion: Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status.
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http://dx.doi.org/10.1111/jcpe.13396DOI Listing
February 2021

A case of acute necrotizing periodontitis with not known origin.

Clin Case Rep 2020 Oct 23;8(10):2034-2039. Epub 2020 Jun 23.

Department of Periodontology Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology Beijing China.

In cases of aggressive periodontal bone destruction, subgingival microbial analysis should be done, tooth extractions should be planned to control disease progression if non-surgical periodontal treatment is ineffective.
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http://dx.doi.org/10.1002/ccr3.3062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7562895PMC
October 2020

Calprotectin levels in gingival crevicular fluid and serum of patients with chronic periodontitis and type 2 diabetes mellitus before and after initial periodontal therapy.

J Periodontal Res 2021 Jan 16;56(1):121-130. Epub 2020 Sep 16.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: This study is aimed to compare the total amount of calprotectin in gingival crevicular fluid (GCF) and the concentration of calprotectin in serum among the patients with type 2 diabetes mellitus and chronic periodontitis (DM-P), the patients with chronic periodontitis (CP) and the healthy controls, as well as the variation of these indicators before and three months after the initial periodontal therapy for the DM-P patients.

Methods: 35 patients with DM-P patients, 32 patients with CP patients, and 43 healthy controls were recruited. Calprotectin levels in serum and GCF, periodontal parameters, fasting blood glucose (FBG), and HbA1c were measured at baseline for all the groups and three months after the initial periodontal therapy for the DM-P patients.

Results: At baseline, the calprotectin levels in GCF and serum were the highest in DM-P, followed by CP, and the lowest in healthy controls. GCF calprotectin was significantly and positively correlated with serum calprotectin and probing depth (PD), while serum calprotectin had a significant positive correlation with GCF calprotectin and HbA1c. Periodontal parameters, HbA1c, and serum and GCF calprotectin became significantly reduced after the initial periodontal treatment. The reduction of serum calprotectin was consistent with that of HbA1c, while the decrease of GCF calprotectin was in agreement with that of PD, attachment loss (AL), and bleeding on probing (BOP).

Conclusions: The levels of calprotectin in serum and GCF in the DM-P patients are significantly higher than those in CP patients and healthy controls, which significantly reduced 3 months after the initial periodontal therapy. Furthermore, it suggests diabetic patients might exhibit more pronounced inflammation periodontally and systemically.
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http://dx.doi.org/10.1111/jre.12800DOI Listing
January 2021

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

J Periodontol 2021 04 6;92(4):507-513. Epub 2020 Oct 6.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Background: Host inflammatory mediators are associated with tissue destruction in patients suffering from generalized aggressive periodontitis (GAgP). However, the correlations between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with GAgP remain unknown.

Methods: Periodontal clinical parameters, including probing depth (PD), bleeding index (BI) and attachment loss (AL) were collected from patients with GAgP and healthy controls. Complete blood cells analyses were obtained; further, NLR and PLR were calculated using neutrophil, platelet, and lymphocyte counts. Smooth curve fitting and segmented regression models were used to analyze the roles and predictive value of NLR with GAgP.

Results: In total, 505 participants from a Chinese population were recruited, including 133 healthy controls and 372 patients with GAgP. Periodontal clinical parameters, NLR, and neutrophil counts were significantly higher in patients with GAgP than the control group. Moreover, NLR was positively correlated with the risk and clinical parameters of GAgP. When NLR < 3, the risk of GAgP increased by 20.6% for each 0.1 increase in NLR, reaching saturation when NLR > 3. An increase in NLR equivalent to 1 was associated with an increase in PD, BI, and AL by 0.41 mm, 0.26, and 0.57 mm, respectively. Notably, PLR did not show obvious correlations with GAgP.

Conclusions: NLR but not PLR may be a potential marker to identify GAgP in healthy individuals, particularly in a Chinese population.
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http://dx.doi.org/10.1002/JPER.20-0282DOI Listing
April 2021

Copper(0)/PPh-Mediated Bisheteroannulations of -Nitroalkynes with Methylketoximes Accessing Pyrazo-Fused Pseudoindoxyls.

Org Lett 2020 08 20;22(15):6117-6121. Epub 2020 Jul 20.

Key Laboratory for Green Organic Synthesis and Application of Hunan Province, Key Laboratory of Environmentally Friendly Chemistry and Application of Ministry of Education, College of Chemistry, Xiangtan University, Xiangtan 411105, China.

A copper(0)/PPh-mediated cascade bisheteroannulation reaction of -nitroalkynes with methylketoximes has been developed that provides viable access to a diverse range of pyrazo-fused pseudoindoxyl compounds. Synthetically useful functional groups including sensitive C-I bonds are compatible with this system. Mechanistic studies suggest a reaction cascade involving sequential PPh-mediated deoxygenative cycloisomerization and copper-catalyzed [3 + 2] pyrazo-annulation.
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http://dx.doi.org/10.1021/acs.orglett.0c02180DOI Listing
August 2020

A nomogram prediction for mandibular molar survival in Chinese patients with periodontitis: A 10-year retrospective cohort study.

J Clin Periodontol 2020 09 26;47(9):1121-1131. Epub 2020 Jul 26.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Aims: To develop a nomogram prediction model of mandibular molar survival by comprehensively analysing clinical and radiographic risk factors of mandibular molar loss.

Materials And Methods: Four hundred and seventy-eight mandibular molars of 139 subjects who underwent non-surgical periodontal treatment were examined retrospectively within a mean follow-up period of 11.1 years. The association of risk factors including clinical and radiographic parameters with mandibular molar loss was assessed using univariate and multivariate Cox regression analyses. A nomogram prediction model was developed, and the validation and discriminatory ability of it were analysed.

Results: Hundred and four molars were lost in this study. Probing depth (PD), attachment loss (AL), furcation involvement (FI), bleeding on probing (BOP), tooth mobility and radiographic bone loss were significantly associated with tooth loss (p < .01). A gradient effect of degree of FI on mandibular molar loss existed increasing from degree Ⅱ (HR = 2.37, 95% CI: 1.48, 3.79) to Ⅲ (HR = 5.61, 95% CI: 3.01, 10.45) versus none & degree Ⅰ. The area under the curve (AUC) of the model was 0.891. The calibration curve and decision curve analysis demonstrated good performance and high net benefit of nomogram, respectively.

Conclusions: A specific nomogram could be adopted to predict the mandibular molar survival and formulate tailored treatment plans in Chinese.
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http://dx.doi.org/10.1111/jcpe.13343DOI Listing
September 2020

Well-maintained patients with a history of periodontitis still harbor a more dysbiotic microbiome than health.

J Periodontol 2020 12 8;91(12):1584-1594. Epub 2020 Jul 8.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Background: It remains unclear whether well-maintained subjects, with periodontitis in the past, effectively treated, and maintained for a long time, have the same subgingival microbiome as healthy subjects. Therefore, the objective of this study was to investigate the characteristics of the subgingival microbiome in well-maintained patients with a history of periodontitis compared with healthy subjects.

Methods: We recruited in 17 well-maintained individuals (no evidence of clinical inflammation and progress of periodontitis) and 21 healthy individuals. Periodontal clinical parameters, consisting of missing teeth, plaque index (PLI), periodontal depth (PD), and bleeding index (BI), were recorded and analyzed. The pooled subgingival samples from mesiobuccal sites of two maxillary first molars were collected. The V3-V4 region of 16S rRNA gene from 38 subgingival samples was sequenced and analyzed. Alpha diversity, microbial composition, types of bacteria, functional pathways between well-maintained group and health group were compared using Mann-Whitney U test. Spearman correlation was used in analyzing the symbiotic relationship among taxa. A classification model was constructed to distinguish two ecological types.

Results: The maintained individuals demonstrated a different microbiome from healthy subjects, with higher diversity, more disordered structure, more pathogenic microbiota, and more host-destructive metabolism pathways. The genera Actinomyces, Streptococcus, Leptotrichia, Capnocytophaga, Lautropia, and Fusobacterium were predominant components with relative abundance >5% in the subgingival microbiome of well-maintained patients. The classification model by microbiota got a remarkable accuracy of 83.33%.

Conclusions: Individuals with well-maintained periodontitis showed a more dysbiotic microbial community than healthy individuals. Therefore, close monitoring and scheduled maintenance treatment are necessary for them to maintain a healthy periodontal condition.
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http://dx.doi.org/10.1002/JPER.19-0498DOI Listing
December 2020

The association of rs2237051 variant, serum EGF levels and generalized aggressive periodontitis: a preliminary study.

PeerJ 2020 19;8:e9212. Epub 2020 May 19.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Epidermal growth factor (EGF) is a pro-inflammatory small peptide that stimulates cell growth, proliferation and differentiation through binding to its receptor. rs2237051 and serum EGF levels have been demonstrated to be related with a variety of diseases, including several tumors and inflammatory diseases. Therefore, this study aims to investigate the association of the rs2237051 variant and serum EGF levels in Chinese patients with generalized aggressive periodontitis (GAgP).

Material And Methods: A case-control study was conducted among 216 patients with GAgP and 138 healthy controls. The clinical parameters of plaque index, probing depth, attachment loss and bleeding index were recorded. The polymorphism was genotyped using time-of-flight mass spectrometry, and serum EGF levels were determined. Logistic and linear regression models were used to investigate the association between the genotypes of rs2237051, serum EGF levels and GAgP risk.

Results: The AA genotype of rs2237051 showed higher risk for GAgP than the combined genotypes GG and AG (adjusted OR = 1.65, 95% CI [1.06-2.57]). Increased serum EGF levels were associated with GAgP (adjusted OR = 1.18, 95% CI [1.14-1.22]). Moreover, the serum EGF level for the AA genotype was significantly higher than that for the AG/GG genotypes in patients with GAgP (adjusted β = 4.70, 95% CI [2.09-7.31]).

Conclusion: We demonstrated that rs2237051 variant and the increased level of serum EGF were associated with the risk of GAgP, the serum EGF was up-regulated in patients with GAgP. It was indicated that serum EGF might be a biomarker of GAgP and rs2237051 may be related to the genetic background of GAgP.
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http://dx.doi.org/10.7717/peerj.9212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243814PMC
May 2020

The width of keratinized mucosa around dental implants and its influencing factors.

Clin Implant Dent Relat Res 2020 Jun 7;22(3):359-365. Epub 2020 May 7.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: A few evidence is available in the literature concerning the pattern of variation in the width of keratinized mucosa (KMW) around dental implants and factors that may affect the KMW.

Purpose: The purpose of this study is to investigate the KMW at the buccal aspect of dental implants and to analyze its influencing factors.

Materials And Methods: The current study was a retrospective study conducted on 726 patients with 1252 dental implants. The following parameters were evaluated by reviewing the medical records of each patient, including the age, gender and smoking status of each patient, the reasons of teeth loss, the position of implants, the bone augmentation procedures, and the KMW. Binary logistic regression analysis with the generalized estimating equations was utilized to analyze the factors that may affect the KMW of dental implants.

Results: The KMW of implants located in the maxilla was significantly higher than that of implants located in the mandible (P < .01), except for the upper and lower canines. The logistic regression analysis indicated that the risk of the implants presenting inadequate KMW (<2 mm) in the periodontitis-caused tooth loss group was 1.91 times of the non-periodontitis-caused tooth loss group. The risk of implants presenting inadequate KMW after receiving simple and complex bone augmentation procedures was 1.65 and 2.62 times of the risk of implants without bone augmentation, respectively. The longer the follow-up period, the higher the risk of implants presenting inadequate KMW will be.

Conclusions: The KMW at the buccal aspect of implants is related to the position of implants. Tooth loss due to periodontitis, the bone augmentation procedures, and the process of functional period would increase the risk of implants presenting an inadequate amount of keratinized mucosa.
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http://dx.doi.org/10.1111/cid.12914DOI Listing
June 2020

Influence of vertical soft tissue thickness on occurrence of peri-implantitis in patients with periodontitis: a prospective cohort study.

Clin Implant Dent Relat Res 2020 Jun 6;22(3):292-300. Epub 2020 Apr 6.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: The influence of vertical soft tissue thickness on health of peri-implant tissue has been addressed in few studies; thus, further research is needed.

Purpose: To evaluate the influence of vertical soft tissue thickness on the risk of peri-implantitis and peri-implant condition in patients with a history of periodontitis.

Design/methods: A total of 92 patients with a history of periodontitis were included in this study. During the implant placement, the distance from palatal soft tissue edge to the alveolar crest, which was defined as vertical soft tissue thickness, was measured. The characteristics of patients and implants were recorded at baseline (T1). After more than 2 years follow-up period, 65 patients with 159 implants finally came back for T2 evaluation, and parameters of peri-implant tissue were recorded. The associations of vertical soft tissue thickness with peri-implant parameter and occurrence of peri-implantitis were analyzed using the generalized estimating equation accompanying linear regression and logistic regression. In addition to conventional multivariate analysis, a propensity score for adjustment was used to reduce confounding bias.

Results: At follow-up examination (T2), survival rate at implant-level was 98.8%. The peri-implant parameters, including peri-implant probing depth and marginal bone loss, increased significantly with the increasing of soft tissue thickness (P < 0.05) after adjusting for a propensity score. In multivariate analysis adjusted for different confounding factors and propensity score, the odd ratios were all approximately 2.5, which meant that the risk of peri-implantitis increased 1.5 times for 1 mm increase of soft tissue thickness.

Conclusions: The excessive vertical soft tissue thickness around implants in patients with history of periodontitis has an adverse influence on health of the peri-implant tissue. This observation raises an important question on the association between vertical soft tissue thickness during implant surgery and history of periodontitis. Effective approaches to prevent the adverse effect of excessive soft tissue thickness on peri-implant tissue are necessary to be further investigated.
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http://dx.doi.org/10.1111/cid.12896DOI Listing
June 2020

Peri-implant mucositis sites with suppuration have higher microbial risk than sites without suppuration.

J Periodontol 2020 10 6;91(10):1284-1294. Epub 2020 Mar 6.

Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Background: The aims of the present study were to compare the microbial differences between peri-implant mucositis sites with or without suppuration, and to construct a classification model with microbiota.

Methods: Twenty-four implants with peri-implant mucositis were divided into suppuration (SUP) group and non-suppuration (Non-SUP) group. Clinical assessments of bleeding index, probing depth, suppuration following probing (SUP) were recorded. Submucosal samples were collected from mesiobuccal sites and distobuccal sites, and analyzed by 16S rRNA gene sequencing. Generalized linear mixed model was used to adjust age, gender, location of implants, and intraindividual correlation.

Results: It was demonstrated that the microbial richness was lower in SUP group. The relative abundance of some pathogenic taxa, such as genera of Fusobacterium, Tannerella, and Peptostreptococcus, were significantly higher in SUP group than Non-SUP group. In addition, SUP group had less Gram-positive bacteria, aerobic bacteria, and more metabolic pathway related to life activity. The classification model constructed with 12 genera got a 100% accuracy in identifying sites with or without suppuration.

Conclusions: The results from this study demonstrate a higher pathogenicity of microbiome at peri-implant mucositis sites with suppuration than without suppuration, which supports suppuration as a clinical indicator for higher microbial risk.
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http://dx.doi.org/10.1002/JPER.19-0634DOI Listing
October 2020

A three-year study on periodontal microorganisms of short locking-taper implants and adjacent teeth in patients with history of periodontitis.

J Dent 2020 04 15;95:103299. Epub 2020 Feb 15.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China. Electronic address:

Objective: To analyze the change of six periodontal pathogens around short locking-taper implants and adjacent teeth in patients with different periodontal conditions for three years.

Methods: Sixty implants and 62 adjacent teeth from 24 patients with different periodontal conditions were included: 5 patients with history of aggressive periodontitis (AgP group), 14 patients with history of chronic periodontitis (CP group), and 5 patients with healthy condition or slight gingivitis (H group). Subgingival samples were collected at five timepoints: before implant placement (T1); before second stage operation (T2); one month after restoration (T3); one year after functional loading (T4) and two years after functional loading (T5). Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans were detected by polymerase chain reaction (PCR).

Results: Pathogens were hardly found around implants or adjacent teeth until T4. The detection rates of five pathogens other than A. actinomycetemcomitans raised up from T3 to T5. F. nucleatum and P. gingivalis were mostly detected followed by P. intermedia, T. forsythia, and T. denticola. The detection rate of P. gingivalis in implants were higher than natural teeth. There was significant correlation between pathogenic bacteria from implants and adjacent teeth. A. actinomycetemcomitans were only detected positively in peri-implant sites of AgP group. Peri-implantitis sites showed significantly higher detection rates of T. denticola, F. nucleatum at T4, and P. gingivalis, F. nucleatum at T5 than peri-implant mucositis and healthy groups.

Conclusion: This three-year longitudinal study demonstrated that periodontal pathogens accumulate over time around short locking-taper implants and adjacent natural teeth after restoration. Adjacent teeth may become the microbial reservoir for peri-implant bacteria. Therefore, periodontally compromised patients may face higher risk for peri-implant disease.

Clinical Significance: Plaque control of implant should be intensified with time instead of diminished. Patients with history of periodontitis need more frequent and individualized implant maintenance. Treatment and maintenance for adjacent teeth is as important as for implants..
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http://dx.doi.org/10.1016/j.jdent.2020.103299DOI Listing
April 2020

Integration of genome-wide association study and expression quantitative trait loci data identifies AIM2 as a risk gene of periodontitis.

J Clin Periodontol 2020 05 20;47(5):583-593. Epub 2020 Feb 20.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

Aim: To identify risk variants associated with gene expression in peripheral blood and to identify genes whose expression change may contribute to the susceptibility to periodontitis.

Material And Methods: We systematically integrated the genetic associations from a recent large-scale periodontitis GWAS and blood expression quantitative trait loci (eQTL) data using Sherlock, a Bayesian statistical framework. We then validated the potential causal genes in independent gene expression data sets. Gene co-expression analysis was used to explore the functional relationship for the identified causal genes.

Results: Sherlock analysis identified 10 genes (rs7403881 for MT1L, rs12459542 for SIGLEC5, rs12459542 for SIGLEC14, rs6680386 for S100A12, rs10489524 for TRIM33, rs11962642 for HIST1H3E, rs2814770 for AIM2, rs7593959 for FASTKD2, rs10416904 for PKN1, and rs10508204 for WDR37) whose expression may influence periodontitis. Among these genes, AIM2 was consistent significantly upregulated in periodontium of periodontitis patients across four data sets. The cis-eQTL (rs2814770, ~16 kb upstream of AIM2) showed significant association with AIM2 (p = 6.63 × 10 ) and suggestive association with periodontitis (p = 7.52 × 10 ). We also validated the significant association between rs2814770 and AIM2 expression in independent expression data set. Pathway analysis revealed that genes co-expressed with AIM2 were significantly enriched in immune- and inflammation-related pathways.

Conclusion: Our findings implicate that AIM2 is a susceptibility gene, expression of which in gingiva may influence periodontitis risk. Further functional investigation of AIM2 may provide new insight for periodontitis pathogenesis.
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http://dx.doi.org/10.1111/jcpe.13268DOI Listing
May 2020

Platelets as inflammatory mediators in a murine model of periodontitis.

J Clin Periodontol 2020 05 12;47(5):572-582. Epub 2020 Mar 12.

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Aim: To investigate the role of platelets during the development of ligature-induced experimental periodontitis in mice.

Materials And Methods: Experimental periodontitis was induced by placement of sterilized 5-0 cotton ligatures around the maxillary and mandibular second molars of C57BL/6 wild-type mice. Flow cytometry was used to analyse platelet activation and platelet-leucocyte aggregate formation, and histologic analysis was used to evaluate inflammation and localization of platelets and leucocytes in periodontal tissues during the development of experimental periodontitis and in experimental periodontitis with and without antiplatelet drug treatment.

Results: Experimental periodontitis induced platelet activation and platelet-leucocyte interaction. Platelets and leucocytes gradually infiltrated in inflammatory gingival tissues during the development of experimental periodontitis. The inhibition of platelet activation via drug therapy led to significant inhibition of leucocyte migration and marked reduction in periodontal inflammation.

Conclusion: This study revealed that platelets are critical for inflammation and tissue injury in periodontitis and serve as mediators of inflammation in periodontal tissue.
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http://dx.doi.org/10.1111/jcpe.13265DOI Listing
May 2020

Preliminary investigation on the molecular mechanisms underlying the correlation between VDR-FokI genotype and periodontitis.

J Periodontol 2020 03 21;91(3):403-412. Epub 2020 Feb 21.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, P.R. China.

Background: The only polymorphism that could change the protein structure in vitamin D receptor (VDR) is the FokI polymorphism (rs2228570). The FF genotype has the strongest transcriptional activity of VDR and is correlated with higher susceptibility to periodontitis. To reveal the possible molecular mechanisms for the correlation preliminarily, the influence of VDR-FokI genotype on the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) in human gingival fibroblasts (hGFs) and human periodontal ligament cells (hPDLCs) was investigated in this study.

Methods: hGFs and hPDLCs from 15 donors (five FF, seven Ff, and three ff) were treated with 1,25OH D , with or without the specific knockdown of VDR using siRNA. The mRNA and protein expression of OPG and RANKL were detected using real-time PCR and enzyme-linked immunosorbent assay, respectively.

Results: Both in hGFs and hPDLCs, 1,25OH D could significantly induce the mRNA and protein expression of RANKL, and FF genotype had significantly higher induction than the other genotypes, however, neither 1,25OH D nor VDR-FokI had significant influence on the OPG expression. As a result, the RANKL/OPG ratio was significantly elevated under 1,25OH D stimulation and FF genotype had the most remarkable elevation. When VDR was knocked down, all the differences among the three genotypes disappeared.

Conclusion: The strongest transcriptional activity of FF genotype might contribute to the strongest enhancement of RANKL expression and RANKL/OPG ratio in hGFs and hPDLCs stimulated by 1,25OH D , which might help to reveal the mechanisms of the correlation between FF genotype and susceptibility to periodontitis.
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http://dx.doi.org/10.1002/JPER.19-0368DOI Listing
March 2020

A novel multi-locus genetic risk score identifies patients with higher risk of generalized aggressive periodontitis.

J Periodontol 2020 07 9;91(7):925-932. Epub 2020 Jan 9.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Each genetic variant individually explains only a tiny proportion of the genetic variation with insignificant predictive power. The tool of multi-locus genetic risk score (GRS), which aggregates information from multiple genetic variants, has been widely used in many complex diseases but not yet applied to generalized aggressive periodontitis (GAgP).

Methods: A total of 335 GAgP patients and 114 healthy controls were enrolled in the case-control study. The unweighted GRS (uGRS) and weighted GRS (wGRS) were calculated based on significant variants. Logistic regression models were conducted for the GRS-based association analyses on the risk of GAgP. Receiver operating characteristic analysis was performed to compare the discriminatory ability of predictors of GAgP risk.

Results: Four loci were found to be significantly associated with GAgP. They were matrix metalloproteinase 8 rs11225395 (odds ratio [OR] = 1.40, 95% CI: 1.03 to 1.91), epidermal growth factor rs2237051 (OR = 1.41, 95% CI: 1.03 to 1.93), PPAR-a rs4253623 (OR = 1.53, 95% CI: 1.03 to 2.26), and apolipoprotein E rs429358 (OR = 1.79, 95% CI: 1.08 to 2.97). Each additional point of the uGRS/wGRS was associated with a 50%/31% increased risk of developing GAgP (OR = 1.50, 95% CI: 1.21 to 1.85 or OR = 1.31, 95% CI: 1.14 to 1.51, respectively) after adjusting for age, sex, and body mass index (BMI). Participants in the high group of uGRS/wGRS (OR = 2.87, 95% CI: 1.59 to 5.17 or OR = 2.67, 95% CI: 1.46 to 4.88, respectively) and the middle group of uGRS/wGRS (OR = 2.21, 95% CI: 1.29 to 3.78 or OR = 1.88, 95% CI: 1.09 to 3.08, respectively) had an increased risk of GAgP compared with those in the low group of score after adjustment for age, sex, and BMI. The addition of GRS to a model of conventional risk factors improved discrimination by 4.5% (from 0.695 to 0.740, P = 0.048).

Conclusions: We demonstrated that the multi-locus GRS based on four significant single nucleotide polymorphisms might be useful to assess genetic predisposition to GAgP. The GRS in combination with conventional risk factors significantly improved the power of identifying subgroups of Chinese population with a particularly high risk for GAgP.
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http://dx.doi.org/10.1002/JPER.19-0135DOI Listing
July 2020

TLR4 polymorphisms may increase susceptibility to periodontitis in Pg-positive individuals.

PeerJ 2019 21;7:e7828. Epub 2019 Nov 21.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Objective: To investigate the correlation between the single nucleotide polymorphisms (SNPs) in the toll-like receptor 4 (TLR4) gene and the susceptibility to chronic periodontitis.

Design: 241 Chinese subjects from the cohort of Beijing Shijingshan Community were recruited. Buccal swab samples, the whole unstimulated saliva and periodontal clinical parameters were collected. Human DNA extracted from buccal swab samples were used for genotyping eight SNPs of the TLR4 gene (rs11536889, rs1927906, rs1927911, rs2149356, rs4986790, rs4986791, rs2737190, rs787384) by the Sequenom MassARRAY system. () was detected from the deposition of the whole unstimulated saliva through polymerase chain reaction (PCR) method based on 16S rRNA. The correlation between SNPs of TLR4 and chronic periodontitis susceptibility in the whole subjects and the patients detected with was investigated.

Results: The variants of rs4986790 and rs4986791 were not found in 241 Chinese subjects. Moreover, there was no significant difference in the distribution of theother6 SNPs of TLR4 between groups of none/mild -periodontitis and moderate/severe-periodontitis subjects. When combined with infection, rs1927911 (TT/CC+CT), rs2149356 (TT/GG+GT) and rs2737190 (GG/AA+AG) were independent risk factors of chronic periodontitis.

Conclusion: Three SNPs of TLR4, i.e., rs1927911 (TT/CC+CT), rs2149356 (TT/GG+GT) and rs2737190 (GG/AA+AG), were associated with moderate/severe chronic periodontitis in Chinese population infected with . , which interacted with TLR4 gene plays an important role in the pathogenesis of periodontitis.
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http://dx.doi.org/10.7717/peerj.7828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875378PMC
November 2019

Ferritin expression in the periodontal tissues of primates.

Eur J Histochem 2019 Sep 3;63(3). Epub 2019 Sep 3.

Peking University School and Hospital of Stomatology.

Ferritin, an iron-binding protein, is composed of two subunits, a heavy chain and a light chain. It regulates many biological functions, such as proliferation, angiogenesis, and immunosuppression. The objective of this study was to determine the expression and distribution of ferritin in the periodontal tissuesof primates.First, we assessed the expression of ferritin in primary cultured cells isolated from human periodontal tissues using the polymerase chain reaction and immunofluorescent staining. Second, we investigated the expression and distribution of ferritin in the periodontal tissues of Macaca fascicularis, human gingival tissues, and human gingival carcinoma tissues using immunohistochemistry.Both protein and mRNA of ferritin were constitutively present in human primary cultured cells, including those from the dental apical papilla, periodontal ligament, dental pulp, and gingival epithelium, as well as gingival fibroblasts. In M. fascicularistissues, the immunohistochemical staining was particularly strong in blood vessel and mineralizing areas of the dental pulp and periodontal ligament. Ferritin heavy chain exhibited specific immunopositivity in in the stratum basale of the epithelium in human gingival tissue and strong immunostaining was found in peripheral regions of gingival carcinoma sites. Ferritin is constitutivelypresent andwidelydistributed in the periodontal tissues of primates. Ferritin may play roles in epithelial proliferation, vascular angiogenesis, and mineralization in these tissues.
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http://dx.doi.org/10.4081/ejh.2019.3046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755262PMC
September 2019

Microbiome in maintained periodontitis and its shift over a single maintenance interval of 3 months.

J Clin Periodontol 2019 11 28;46(11):1094-1104. Epub 2019 Aug 28.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Aim: To assess the subgingival microbial shift of maintained periodontitis treated by ultrasonic scaling (US) or air polishing (AP) during a 3-month maintenance interval.

Materials And Methods: We conducted a 12-week randomized split-mouth controlled trial with US and AP in 17 maintained subjects (bleeding on probing [BOP%] ≤25%, probing depth [PD] ≤5 mm). They were monitored at baseline, week 2, week 8 and week 12. The V3-V4 region of the 16S rDNA from 136 subgingival plaque samples was sequenced and analysed.

Results: Treatment by US or AP could effectively reduce the PD, microbial richness, diversity, periodontitis-associated microbiota and pathogenic metabolism in maintained periodontitis. Bacteria recolonized after treatment and returned to the pre-treatment level 12 weeks after treatment. Ultrasonic scaling group demonstrated slight advantage in reducing BOP (%), pathogenic bacteria and metabolism than AP group. Pathogenic microbiota and commensal microbiota kept a balance in subgingival community of maintained patients during the 3-month interval.

Conclusions: Treatment by US or AP effectively reduced the pathogenicity of subgingival microbiome by reducing microbial diversity, proportion of periodontitis-associated microbiota and pathogenic metabolism. It helped to keep a balanced subgingival community and stable periodontal condition over a single maintenance interval of 3 months.
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http://dx.doi.org/10.1111/jcpe.13177DOI Listing
November 2019

Butyrate rather than LPS subverts gingival epithelial homeostasis by downregulation of intercellular junctions and triggering pyroptosis.

J Clin Periodontol 2019 09;46(9):894-907

Center of Medical and Health Analysis, Peking University, Beijing, China.

Aim: To investigate the effects of sodium butyrate (NaB) and lipopolysaccharide (LPS) on gingival epithelial barrier.

Material And Methods: We cultured human primary gingival epithelial cells and investigated the effects of NaB and LPS on gingival epithelial barrier and involved mechanisms at in vitro and in vivo levels by immunostaining, confocal microscopy, field emission scanning electron microscopy (FE-SEM), transmission electronic microscopy (TEM), transepithelial electrical resistance (TEER), FTIC-dextran flux, flow cytometry, real-time PCR and Western blot assays.

Results: Our results showed that NaB, rather than LPS, destroyed the epithelial barrier by breaking down cell-cell junctions and triggering gingival epithelial cell pyroptosis with characteristic morphological changes, including swollen cells, large bubbles, pore formation in the plasma membrane and subcellular organelles changes. The upregulated expression of pyroptosis-related markers, caspase-3 and gasdermin-E (GSDME) contributed to this effect. Pyroptosis aroused by NaB is a pro-inflammatory cell death. Pyroptotic cell death provoked inflammatory responses by upregulation of IL-8 and MCP-1, and releasing intracellular contents into the extracellular microenvironment after pyroptotic rupture of the plasma membrane.

Conclusions: Our new findings indicate that butyrate is a potent destructive factor of gingival epithelial barrier and pro-inflammatory mediator, which shed a new light on our understanding of periodontitis initiation.
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http://dx.doi.org/10.1111/jcpe.13162DOI Listing
September 2019

Interactions among moderate/severe periodontitis, ADIPOQ-rs1501299, and LEPR-rs1137100 polymorphisms on the risk of type 2 diabetes in a Chinese population.

Arch Oral Biol 2019 Jul 17;103:26-32. Epub 2019 May 17.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Objective: Type 2 diabetes mellitus (T2DM) is a complex disease influenced by genes and the environment. Periodontitis a demonstrated risk factor of T2DM. Previous studies related to gene-environment interactions on the risk of T2DM mainly focused on gene-obesity interactions. However, the impact of gene-periodontitis interaction on the risk of T2DM has not yet been investigated. This study aimed to investigate gene-environment interactions among moderate/severe periodontitis, polymorphisms of adiponectin (ADIPOQ)-rs1501299, and leptin receptor (LEPR)-rs1137100 on T2DM risk in Chinese subjects.

Design: A case-control study was conducted in 239 Chinese participants from Beijing Hypertension Association Institute (BHAL). After full-mouth periodontal examinations, the participants underwent bilateral buccal swabs for DNA testing. ADIPOQ-rs1501299 and LEPR-rs1137100 were used for genotyping. Generalised multifactor dimensionality reduction (GMDR) and logistic regression were used to examine the interactions among single nucleotide polymorphisms (SNPs) and moderate/severe periodontitis on the risk of T2DM.

Results: The risk of T2DM was higher in moderate/severe periodontitis [adjusted odds ratio (AOR) = 3.67, 95% confidence interval (95%CI): 1.26-10.71] in ADIPOQ-rs1501299 GG genotype (AOR = 3.42, 95%CI: 1.81-6.46) and LEPR-rs1137100 GG genotype (AOR = 3.16, 95%CI: 1.56-6.39). The GMDR model indicated that there was a significant three-factor model (p = 0.001) involving rs1501299, rs1137100, and moderate/severe periodontitis, demonstrating a potential gene-environment interaction among periodontitis, polymorphisms of rs1501299, and rs1137100 influencing the risk of T2DM. Moderate/severe periodontitis patients with rs1501299-GG and rs1137100-GG have the highest T2DM risk after adjusting for age, gender, BMI, WHR, smoking status, alcohol consumption, economic status, and hypertension (AOR = 20.39, 95%CI: 2.64-157.26).

Conclusions: Interactions among moderate/severe periodontitis, rs1501299-GG, and rs1137100-GG were associated with an increased risk of T2DM. This study may provide a new insight into the effect of gene-environment interactions on T2DM.
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http://dx.doi.org/10.1016/j.archoralbio.2019.05.014DOI Listing
July 2019

Association of CYP1A1 rs1048943 variant with aggressive periodontitis and its interaction with hyperlipidemia on the periodontal status.

J Periodontal Res 2019 Oct 29;54(5):546-554. Epub 2019 Apr 29.

Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.

Background And Objective: CYP1A1 rs1048943 polymorphism was reported to be correlated with periodontitis; however, its association with aggressive periodontitis (AgP) has not yet been investigated. The aim of the study was to investigate the association between the CYP1A1 gene rs1048943 variant with generalized aggressive periodontitis (GAgP) and platelet activation and analyse whether its interaction with hyperlipidemia affects periodontal status in a Chinese population.

Methods: A case-control study of 224 GAgP patients and 139 healthy controls was conducted. The clinical parameters of probing depth (PD), attachment loss (AL) and bleeding index (BI) were recorded. Platelet count (PLT), platelet distribution width (PDW), platelet large cell ratio (PLCR), mean platelet volume (MPV), serum total cholesterol (TC), triacylglycerol (TG), high and low-density lipoprotein (HDL and LDL) were also measured. The CYP1A1 rs1048943 SNP was genotyped by time-of-flight mass spectrometry. Logistic and linear regression models were used to measure correlation.

Results: The CYP1A1 rs1048943 AG/GG genotype was associated with GAgP (OR = 1.56, 95%CI: 1.01, 2.42), PD, AL and decreased PDW, PLCR and MPV after adjustment for covariates. Gene-lipid interactions were found between CYP1A1 rs1048943 and HDL for PD (P = 0.0033), BI (P = 0.0311) and AL (P = 0.0141) and between CYP1A1 rs1048943 and LDL for PD (P = 0.013) among patients with GAgP.

Conclusion: The G allele of the CYP1A1 rs1048943 gene was associated with GAgP, periodontal status and platelet-related inflammation status in a Chinese population. Hyperlipidemia could modulate the effect of CYP1A1 rs1048943 on the periodontal status of GAgP.
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http://dx.doi.org/10.1111/jre.12658DOI Listing
October 2019

A nomogram prediction of peri-implantitis in treated severe periodontitis patients: A 1-5-year prospective cohort study.

Clin Implant Dent Relat Res 2018 Dec 29;20(6):962-968. Epub 2018 Oct 29.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: No nomogram of peri-implantitis was reported before which is valuable for risk-estimating, clinical decision-making, and better-patients-communicating.

Purpose: To identify the risk indicators and develop a nomogram prediction model of peri-implantitis in treated severe periodontitis patients.

Materials And Methods: A prospective study was conducted on 100 patients with 214 implants. Periodontal and peri-implant parameters were evaluated at implant surgery procedure (T1), and at follow-up (T2). Risk factors were analyzed by logistic regression analyses with generalized estimating equations. Nomogram was developed and the discriminatory ability of the model was analyzed.

Results: The incidence of peri-implantitis at patient-level and implant level were 16% and 11.2% respectively, with no implant lost. The variables associated with peri-implantitis were the PD  ≥ 6 mm (%) > 10%, the implant position, length, and diameter after adjusting for covariates. A nomogram prediction model of peri-implantitis were developed with factors of PD  ≥ 6 mm (%) > 10% and implant placed in posterior. The area under the ROC curves of stepwise model was 0.794.

Conclusions: The residual pockets and implants position were identified as predictors for the peri-implantitis. The nomogram can be used to estimate the risk of peri-implantitis in treated severe periodontitis patients.
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http://dx.doi.org/10.1111/cid.12686DOI Listing
December 2018

A retrospective cohort study of peri-implant condition in Chinese patients with different periodontal condition and maintenance frequency.

Clin Oral Implants Res 2018 Nov 19;29(11):1135-1142. Epub 2018 Oct 19.

Department of Periodontology, Peking University School of Stomatology, Beijing, China.

Objectives: To compare the periodontal and peri-implant conditions of Chinese patients with a history of moderate or severe periodontitis and periodontally healthy patients (PHP); to evaluate the influence of maintenance therapy frequency on the outcome of implant therapy.

Methods: A total of 140 participants with 227 sand-blasted acidetched (SLA) implants were divided into three groups: PHP, moderate periodontally compromised patients (PCP) and severe PCP. The three groups were further categorized into two groups based on the frequency of maintenance (MF): MF ≥ 1 per year and MF < 1 per year. The following clinical parameters of implants were assessed: implant survival/loss, peri-implant probing depth (PDi), peri-implant bleeding index (BIi), peri-implant bleeding on probing (BOPi), implant bone loss (BLi). Comparisons of the peri-implant conditions were performed between the patients with different periodontal conditions.

Results: Implant survival rate was 100% for all three groups. The severe PCP group showed significantly higher deepest PDi, mean PDi, mean BIi, and PLIi compared with PHP (p < 0.05). The severe PCP group had more implants affected with PDi ≥ 5 mm and BOPi+ compared with the PHP group (Adjusted OR = 10.89, 95% CI: 2.34, 50.74). In the patients with severe PCP, the MF < 1 per year group had a greater prevalence of PDi ≥ 5 mm and BOPi+ compared with the MF ≥ 1 per year group (Adjusted OR = 8.23, 95% CI: 2.44, 27.78).

Conclusions: The patients in the severe PCP group were at greater risk of peri-implant disease than those in the PHP group. In particular, severe PCP who had poor adherence to maintenance care showed a higher incidence of biologic complications.
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http://dx.doi.org/10.1111/clr.13377DOI Listing
November 2018

Detection of T. forsythia and other important bacteria in crestal and subcrestal implants with ligature-induced peri-implant infection in dogs.

J Periodontol 2019 03 9;90(3):306-313. Epub 2018 Oct 9.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: The study was designed to compare peri-implant microbial colonization of inflamed implants placed at different levels in dogs.

Methods: Two screwed-in (SI) and two tapped-in (TI) conical connection implants were placed on each side of mandibles in six dogs respectively. Four experimental groups were constituted according to implant types and placement depth in one side: SI crestally (SIC), SI 1.5 mm subcrestally (SIS), TI crestally (TIC), and TI 1.5 mm subcrestally (TIS). Plaque accumulation of implants was promoted by cotton ligatures at either side randomly selected in each dog four weeks after abutment connection. Peri-implant sulcular fluid (PISF) samples were collected at 4 weeks, 10 weeks, and 16 weeks after abutment connection. Common periodontal pathogens in PISF were analyzed by PCR and realtime-PCR to investigate the influence of placement depth on microbial accumulation. The microbial results were further correlated with clinical parameters.

Results: At ligatured sides, detection rates of T. forsythia and P. gingivalis increased significantly in four groups. T. forsythia levels increased significantly from baseline in four groups at ligatured sides at 16 weeks (p < 0.05). TIS group harbored significantly more T. forsythia than TIC at ligatured sides at 16 weeks (p < 0.05). At ligatured sides, probing depth was correlated to T. forsythia level in four groups as well as in total.

Conclusions: Subcrestal placement could increase the peri-implant T. forsythia level at the early stage of peri-implantitis. The T. forsythia level in the peri-implant sulcus is associated with probing depth.
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http://dx.doi.org/10.1002/JPER.18-0223DOI Listing
March 2019

A novel U-shaped relationship between BMI and risk of generalized aggressive periodontitis in Chinese: A cross-sectional study.

J Periodontol 2019 01 29;90(1):82-89. Epub 2018 Aug 29.

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Association between BMI and periodontitis were controversial. A study indicated that not only overweight or obesity but also underweight was correlated with generalized aggressive periodontitis (GAgP). However, the exact relationship between BMI and GAgP and the optimal BMI value for the lowest risk of GAgP remain unknown.

Objective: To explore the exact relationship between BMI and GAgP risk, periodontal status and WBC (white blood cell) count and find the optimal BMI value associated with the lowest risk, periodontal status and lowest WBC of GAgP in Chinese.

Methods: 300 GAgP patients and 133 healthy controls were recruited. Height and weight of participants were accurately measured to calculate BMI value. Clinical periodontal parameters, including probing depth (PD), attachment loss (AL), and bleeding index (BI) were recorded. WBC was obtained from routine blood examination. Smooth curve fitting and segmented regression model were used to analyze the threshold effect between BMI and variables. The shape of the curve was used to describe the relationships between BMI and GAgP.

Results: U-shaped relationships between BMI and risk of GAgP, AL, and WBC count in GAgP patients were observed. The optimal value of BMI for the lowest risk of GAgP and lowest WBC count was 22 kg/m . The risk of GAgP increased by 39% in patients per unit increase of BMI when BMI ranged from 22 to 28 kg/m (adjusted OR = 1.39, 95% CI: 1.17, 1.67) and increased by 18% per unit decrease of BMI when BMI ranged from 22 to 18 kg/m (adjusted OR = 0.82, 95% CI: 0.69, 0.97). The count of WBC increased by 1.12 × 10 /L in patients per unit increase of BMI when BMI ranged from 22 to 28 kg/m (adjusted β = 0.12, 95% CI: 0.01, 0.23) and increased by 0.2 × 10 /L per unit decrease of BMI when BMI ranged from 22 to18 kg/m (adjusted β = -0.2, 95% CI: -0.35, -0.04).

Conclusion: U-shaped relationships exist between BMI and risk of GAgP, AL, and WBC count in patients with GAgP among Chinese aged below 36 years old with their BMI range from 18 to 28 kg/m ; the optimal BMI value for lowest odds ratio and lowest WBC count of GAgP was 22 kg/m .
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http://dx.doi.org/10.1002/JPER.18-0064DOI Listing
January 2019