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Biomedical subjects

Nabil F Bissada

Publications and source records attributed to Nabil F Bissada.

18 recordsLinked to original sources
PubMed2006

Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth.

Intrauterine infection is a recognized cause of preterm birth. The infectious organisms are believed to originate primarily from the vaginal tract and secondarily from other parts of the body. It is plausible that microbes in the oral cavity can be transmitted to the pregnant uterus. However, direct evidence supporting such a transmission is lacking. In this study, amniotic fluids of 34 pregnant women were examined by PCR using 16S and 23S rRNA universally conserved primers. Bacterial DNA was amplified from the only patient with clinical intrauterine infection and histologic necrotizing acute and chronic chorioamnionitis. One strain, Bergeyella sp. clone AF14, was detected and was 99.7% identical to a previously reported uncultivated oral Bergeyella strain, clone AK152, at the 16S rRNA level. The same strain was detected in the subgingival plaque of the patient but not in her vaginal tract. The 16S-23S rRNA sequence of clone AF14 matched exactly with the sequences amplified from the patient's subgingival plaque. These observations suggest that the Bergeyella strain identified in the patient's intrauterine infection originated from the oral cavity. This is the first direct evidence of oral-utero microbial transmission. The patient's periodontal health during pregnancy was unclear. She did not have detectable periodontal disease during postpartum examination. Bergeyella spp. had not been previously associated with preterm birth and were detected in subgingival plaque of women without clinical levels of intrauterine infection. Uncultivated species may be overlooked opportunistic pathogens in preterm birth. This study sheds new light on the implication of oral bacteria in preterm birth.

Adult↗
PubMed2006

Periodontitis and cardiovascular disease: a review of shared risk factors and new findings supporting a causality hypothesis.

Periodontitis is a common chronic disease worldwide. It is a major cause of tooth loss among adults and recently has been suggested to increase the risk for developing several systemic diseases, including cardiovascular disease. Populations are not equally affected by periodontal disease because there are several environmental and host factors modulating susceptibility. Cardiovascular disease shares many of the same susceptibility factors. The purpose of this report is to identify risk factors and indicators common to periodontitis and cardiovascular disease, and also to discuss their possible interrelationship in this association. Recent findings to support a causal association between the 2 conditions are also presented.

Cardiovascular Diseases↗
PubMed2006

Aggressive periodontitis in a patient with chronic cutaneous lupus erythematosus: a case report.

Lupus erythematosus is considered to be a high risk factor for periodontitis. As an autoimmune disease of unknown origin, cutaneous lupus erythematosus (CLE) is subdivided into 3 categories: chronic (CCLE), subacute (SCLE), and acute (ACLE). While the ACLE has a high prevalence of conjunctive periodontal lesions, aggressive periodontitis in patients with CCLE has been rarely reported. This article describes the case of a patient diagnosed with aggressive periodontitis. Three months after the diagnosis of periodontitis, the patient experienced advancing hair loss (alopecia), pale fingers and toes, as well as edema in the legs and around the eyes. Skin biopsy showed follicular hyperkeratosis with perivascular mononuclear cell infiltrate. Colliquation of the basal cells, thickening of the basal lamina, and vacuolar degeneration of basal keratinocytes were also found. A lupus band test was positive, and diagnosis of CCLE was established. Three months following the treatment of lupus with antimalarial agents, the periodontal condition became stable with no further exacerbation or progression of the existing periodontitis. An 11-month postsurgical follow-up revealed stable periodontal and general medical conditions. A patient's medical history should be re-evaluated in the event of recurrence of periodontal lesions refractory to periodontal treatment. The control of systemic conditions like lupus erythematosus is essential for a good prognosis in the treatment of periodontitis as well as for the general health of the patient.

Adult↗
PubMed2005

Periodontal assessment of postmenopausal women receiving risedronate.

OBJECTIVE: The purpose of this study was to compare periodontal status of postmenopausal women with mild to moderate osteoporosis who use risedronate therapy with those who do not. DESIGN: In this cross-sectional study, a total of 60 age-matched postmenopausal women with mild to moderate osteoporosis diagnosed by a bone density scan T score below -2.5 at either spine or hip were divided into two groups. Women in the experimental group had used systemic risedronate once weekly (35 mg) for at least 3 months. Women in the control group had never used bisphosphonate therapy. The periodontal status of each subject was evaluated through a clinical periodontal examination including evaluation of periodontal probing depth, gingival recession, gingival index, plaque score, attachment loss, and alveolar bone level. The significance in differences between the two groups was assessed using two-tailed paired t tests. RESULTS: Significant differences (P < 0.05) were found between risedronate and control groups for periodontal probing depth (2.6 vs 2.9 mm), gingival index (0.37 vs 0.71), plaque score (56.2 vs 77.0), attachment loss (2.8 vs 3.2 mm), and alveolar bone level (3.1 and 4.0), respectively. Gingival recession parameters did not differ significantly. Five of six periodontal parameters evaluated show that postmenopausal women with mild to moderate osteoporosis using risedronate therapy have healthier periodontal status than those who do not use bisphosphonates. CONCLUSIONS: Women using risedronate therapy show significantly less plaque accumulation, less gingival inflammation, lower probing depths, less periodontal attachment loss, and greater alveolar bone levels. These observations suggest that risedronate therapy may play a beneficial role in periodontal status.

Absorptiometry, Photon↗
PubMed2005

Increased physical activity reduces prevalence of periodontitis.

OBJECTIVES: Physical activity has been shown to have a protective relationship with several chronic diseases. Recently, physical activity was also found to reduce the risk of periodontitis in a study in male health professionals. However, the relationship between physical activity and periodontitis in a diverse group of individuals is not thoroughly examined. The purpose of this study was to examine if there is an association between sustained physical activity and periodontitis in a subset of the third national health and nutrition examination survey (NHANES III). METHODS: NHANES III participants 18 years of age or older who had had a periodontal examination and reported to have a similar physical activity (or inactivity) level for 10 years or longer were selected (n=2521). Multivariable logistic regression analysis was used to estimate the association between physical activity and periodontitis. The analysis was adjusted for: age, gender, race, education, smoking, body mass index, poverty index, vitamin use, healthy eating index, time since last dental visit, gingival bleeding, and dental calculus. RESULTS: Engaging in the recommended level of physical activity was significantly associated with lower periodontitis prevalence (OR=0.58, 95% CI, 0.35-0.96). Smoking, however, was found to modify this relationship. The association was strong and significant among never (OR=0.46, 95% CI, 0.23-0.93) and former smokers (OR=0.26, 95% CI: 0.09-0.72), but not among current smokers (OR=1.10, 95% CI: 0.48-2.53). CONCLUSIONS: These results suggest that engaging in the recommended level of exercise is associated with lower periodontitis prevalence, especially among never and former smokers.

Adult↗
PubMed2005

Periodontitis and three health-enhancing behaviors: maintaining normal weight, engaging in recommended level of exercise, and consuming a high-quality diet.

BACKGROUND: Maintaining normal weight, engaging in the recommended level of exercise, and eating healthy food are known to improve general health. The impact of these behaviors on periodontal health is not well documented. This study is aimed at examining whether the increased number of these behaviors is associated with a decrease in the prevalence of periodontitis in a United States population. METHODS: This study utilized data on 12,110 individuals who participated in the third National Health and Nutrition Examination Survey. Multivariate logistic regression analysis was used to estimate the association between the number of health-enhancing behaviors and periodontitis prevalence. Health enhancing behaviors included maintaining normal weight (body mass index [BMI], 18.5 to 24.9 kg/m(2)), engaging in the recommended level of exercises (>or=episodes of moderate or >or=episodes of vigorous-intensity physical activity per week), and having a high-quality diet (healthy eating index >80). RESULTS: After controlling for age, gender, race\ethnicity, cigarette smoking, other tobacco products, education, diabetes, poverty index, census region, acculturation, vitamin use, time since the last dental visit, dental calculus, and gingival bleeding, a 1-unit increase in the number of the three health-enhancing behaviors was associated with a 16% reduction in the prevalence of periodontitis (odds ratio [OR]=0.84; 95% confidence interval [CI]: 0.77 to 0.93). Individuals who maintained normal weight, engaged in the recommended level of exercise, and had a high-quality diet were 40% less likely to have periodontitis compared to individuals who maintained none of these health-enhancing behaviors. CONCLUSION: An increased number of health-enhancing behaviors is associated with a lower periodontitis prevalence.

Adult↗
PubMed2005

Diet and periodontitis.

The importance of diet in maintaining optimum body health is well recognized. An unhealthy diet has been implicated as a risk factor for several chronic diseases such as cardiovascular disease, hypertension, diabetes and certain cancers. The relationship between diet and periodontitis is not clear. The purpose of this article is to critically review the available literature and to shed new light on the impact of the overall diet on the prevalence and severity of chronic periodontitis in a given population.

Animals↗
PubMed2005

Predictability of connective tissue grafts for root coverage: clinical perspectives and a review of the literature.

Several techniques using subepithelial connective tissue for root coverage have recently been described in the periodontal literature. The predictability of such procedures, however, varies among the different reports. The factors responsible for these differences are not fully understood. The purpose of this article is to review and comment on factors that may enhance the predictability of root coverage.

Connective Tissue↗
PubMed2004

Effect of connective tissue graft orientation on root coverage and gingival augmentation.

The present study was undertaken to assess the width of keratinized tissue and root coverage achieved when orienting the superficial surface of a connective tissue graft toward either the gingival flap or the root surface. Sixteen pairs of bilateral gingival recessions (Miller Class I and II) in 13 subjects were divided into two groups. In each subject, one side received a connective tissue graft with its superficial surface facing the gingival flap, while the contralateral side received a connective tissue graft with its superficial surface facing the root surface. Plaque Index, Gingival Index, probing depth, gingival recession, and relative clinical attachment level were recorded at baseline and 3 months postoperative. Root length was measured on periapical radiographs to calculate the percentage of actual root coverage. ANOVA was used to detect significant differences between the two treatment groups. The results indicated that surface orientation of a connective tissue graft has no significant effect on the clinical outcome of either root coverage or gingival augmentation.

Adult↗
PubMed2004

Poor overall diet quality as a possible contributor to calculus formation.

PURPOSE: An association between diet and calculus deposits was suggested by animal studies. The objective of the present analysis was to examine whether or not there is an association between overall diet quality, as measured by the healthy eating index, and extent of dental calculus deposits using a subset of the third National Health and Nutrition Examination Survey (NHANES III) data. MATERIALS AND METHODS: NHANES III participants 18-years of age or older who had data on dental calculus and diet quality were selected (n = 12405). The healthy eating index (HEI), used as an indicator of overall diet quality, has a minimum score of zero (poorest) and a maximum score of 100 (best) and was divided into three categories, poor (HEI < 51), fair (HEI, between 51 - 80) and good (HEI > 80). Ordinal logistic regression models were used to examine the association between the HEI and the percentage of sites with calculus deposits. RESULTS: Overall diet quality was found to be significantly associated with calculus deposits controlling for: age, gender, race, education, poverty income ratio, smoking, diabetes, history of vitamin and mineral use, body mass index, time elapsed since last dental visit and gingival bleeding. The adjusted odds ratios for having a greater percentage of sites with calculus were 1.54 (1.19 - 1.98), 1.30 (1.02 - 1.60) and 1.00 (reference) for subjects with poor, fair, and good diet quality respectively. CONCLUSION: Poor diet quality is significantly associated with more calculus deposits. Further studies are needed to examine if poor diet quality is a predisposing factor for calculus formation and/or a risk factor for periodontal diseases.

Adolescent↗
PubMed2003

Obesity and periodontal disease in young, middle-aged, and older adults.

BACKGROUND: The growing prevalence of increased body weight and obesity in the United States has raised significant public health concerns. Obesity has been implicated as a risk factor for several chronic health conditions, as well as being associated with increased mortality. Recently, an association between obesity and periodontal disease was found in a Japanese population. The purpose of the present study is to examine the relation between body weight and periodontal disease in a representative United States sample. METHODS: Participants in the third National Health and Nutrition Examination Survey (NHANES III) who were > or =18 years and had undergone a periodontal examination were selected for the analysis (n = 13,665). Body mass index (BMI) and waist circumference (WC) were used as measures of overall and abdominal fat content, respectively. Univariable and multivariable logistic regression models were used to estimate the association between increased body weight and periodontal disease. BMI and WC were assessed independently in a multivariable logistic model containing the following variables: gender, race, education, poverty index, smoking, diabetes, and time elapsed since last dental visit. Significant interactions with age were found and analyses were then stratified by age: younger (18 to 34 years old), middle-aged (35 to 59 years old), and older (60 to 90 years old) adults. RESULTS: A significant association between the measures of body fat and periodontal disease was found among the younger adults, but not middle or older adults. The adjusted odds ratios (OR) for having periodontal disease were 0.21 (0.080 to 0.565), 1.00 (0.705 to 1.407), and 1.76 (1.187 to 2.612) for subjects with BMI < 18.5 kg/m2, 25-29.9 kg/m2, and > or = 30 kg/m2, respectively. Young subjects with high WC had an adjusted OR of 2.27 (1.480 to 3.487) for having periodontal disease. CONCLUSIONS: In a younger population, overall and abdominal obesity are associated with increased prevalence of periodontal disease, while underweight (BMI < 18.5) is associated with decreased prevalence. Obesity could be a potential risk factor for periodontal disease especially among younger individuals. Promotion of healthy nutrition and adequate physical activity may be additional factors to prevent or halt the rate of progression of periodontal disease.

Adipose Tissue↗
PubMed2002

Women's health issues and their relationship to periodontitis.

BACKGROUND: The emergence of sex-specific associations between periodontitis and certain systemic disorders has prompted researchers to investigate the possibility of associations between periodontitis and specific women's health issues. The authors review the potential relationships between periodontitis and hormonal changes and their ramifications in regard to pregnancy outcomes, cardiovascular disease, or CVD, and osteoporosis. METHODS: Changes in hormone levels, such as those that occur during puberty, pregnancy, menstruation and menopause, as well as those that occur with the use of hormonal supplements, have long been associated with the development of gingivitis. Furthermore, bacterial anaerobes have been found to change during the normal hormonal cycle. In periodontitis, the inflammatory response results in ulceration of the gingivae and the subsequent entry of bacterial cells, bacterial products, peptidoglycan fragments and hydrolytic enzymes into the systemic circulation. The result is a systemic response of increased cytokines and biological mediators, as well as increased levels of serum antibodies. RESULTS: Some researchers have found that pregnant women with periodontitis were 7.5 times more likely to have a preterm low-birth-weight infant than were control subjects. Other researchers reported that the risk of preterm birth was directly related to the severity of periodontitis. Similarly, researchers have linked periodontitis to CVD. Many studies have indicated that estrogen exerts a protective effect against CVD development, and much evidence suggests that when hormone replacement therapy is administered to postmenopausal women, this effect continues. A relationship between periodontitis and osteoporosis has been established, such that more clinical attachment loss has been noted in osteoporotic people. CONCLUSIONS: The literature suggests that more sex-specific research is essential to determine the strategies needed to prevent and treat adverse pregnancy outcomes, CVD and osteoporosis through hormone modification and periodontitis control. CLINICAL IMPLICATIONS: Dentists must assume greater responsibility for the overall health of their patients, and acquire knowledge of relevant systemic conditions to interact meaningfully with medical colleagues.

Bacteria, Anaerobic↗
PubMed2002

Periodontal assessment of patients undergoing angioplasty for treatment of coronary artery disease.

BACKGROUND: The purpose of this cross-sectional study was to assess the periodontal condition of patients with coronary artery disease (CAD) in order to verify the association between CAD and certain periodontal parameters. METHODS: Eighty patients (48 males and 32 females) were recruited from the Cleveland University Hospitals, Division of Cardiology (aged 23 to 83, median age 54 years). Upon cardiac catheterization, 50 were diagnosed with severe CAD (experimental group) and 30 with no angiographic evidence of CAD (control group). Patients with CAD were divided into 3 subgroups according to the clinical diagnosis of acute infarction (Al) (n = 20), stable angina (SA) (n = 20), and unstable angina (UA) (n = 10). The following dental, medical, and social histories were recorded: number of dental visits/year, frequency of brushing/day and flossing/week, tobacco use, presence/absence of hypertension, diabetes, total cholesterol level, and the highest level of education completed. The following periodontal parameters were also assessed for each subject: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and number of missing teeth. Logistic regression analysis was used to determine whether there was a significant correlation between these periodontal parameters and CAD. RESULTS: The significant confounding factors for the present study were found to be age and gender. The periodontal condition of the 80 subjects was clinically diagnosed as gingivitis and/or mild periodontitis. Analysis of the data after adjusting for age and gender demonstrated a statistically significant association between BOP and GI and CAD in patients with Al; and facial/lingual CAL in patients with UA. No significant associations were found between PD, interproximal CAL, number of missing teeth, or dental/medical histories and CAD. CONCLUSION: Based on the results of this study, gingival inflammation may be considered a more significant risk factor for CAD than previously reported.

Adult↗
PubMed2002

Emerging concepts in periodontal therapy.

Conventional periodontal therapy consists of mechanical scaling and root planing, and surgical treatment. This is still the mainstay of periodontal treatment. Adjunctive antimicrobial treatments, both systemic and local delivery, are becoming more sophisticated and useful in the treatment of recurrent periodontitis. Also very promising are adjunctive treatments that modulate the host response and decrease levels of destructive pro-inflammatory cytokines or matrix metalloproteinases. Smoking is a major risk factor for periodontitis and has a profound impact on the progression of periodontal bone and attachment loss. In the interest of improved periodontal health patients should be encouraged to stop smoking. Finally bacterial endotoxins that stimulate the release of pro-inflammatory cytokines can have systemic effects and may lead to pre-term, low birthweight babies, and cardiovascular diseases such as atherosclerosis, myocardial infarction and stroke. Health professionals need to be cognisant of the effect dental health can have on systemic diseases and refer for treatment when appropriate to ensure that optimum oral and systemic health is achieved for their patients.

Anti-Infective Agents↗
PubMed2002

Comparison of three methods using calcium sulfate as a graft/barrier material for the treatment of Class II mandibular molar furcation defects.

The purpose of this study was to compare the effectiveness of three methods using calcium sulfate as a graft/barrier for the treatment of Class II mandibular furcation defects. Thirty-six defects in 17 patients were treated with a graft/barrier of pure calcium sulfate, calcium sulfate plus doxycycline, or demineralized freeze-dried bone allograft (DFDBA) in a 2:1 ratio by volume. Defects were randomly selected for treatment, and all measurement parameters were standardized to a light-cured acrylic resin stent at baseline and 6, 9, and 12 months. Linear regression, ANOVA, and chi-squared analysis revealed that all three groups showed significant bone fill (P < .05), vertical and horizontal probing depth reduction, defect volume reduction, and a gain in vertical clinical attachment. Furthermore, the addition of either doxycycline or DFDBA to calcium sulfate significantly enhanced the clinical outcome more than did the calcium sulfate alone, and the addition of DFDBA was more effective in the treatment of Class II mandibular furcation defects than doxycycline.

Adult↗
PubMedDate not supplied

Gingival enlargement and resolution during and after orthodontic treatment.

Gingival enlargement (GE) is a condition that commonly develops during orthodontic treatment. Thirty adolescent subjects with clinically significant GE were analyzed at pre-orthodontic treatment (T1), when the appliances were removed (T2), and 3 to 12 months after (T3). The mean GE decreased from T2 to T3, but was significantly higher on T3 than T1 (p<.05). It may be concluded that complete resolution of GE developed during orthodontic treatment is not always attained after removal of the fixed appliances.

Adolescent↗