Relationship Between Periodontal Disease and Severe Acute Respiratory Syndrome Coronavirus (Sars-Cov-2) Infection

Year 2023, , 509 - 515, 25.12.2023

İpek Naz Karasu , Dilan Işıldak Yusuf Can Kamani Rabia Nur Baltacı Aslı Çelik Eylem Gül Ateş , Nilgün Alptekin

https://doi.org/10.15311/selcukdentj.1232720

Abstract

AIM: There is a strong relationship between periodontal disease and systemic diseases. It has been reported that there is a similarity between the cytokine storm in severe COVID-19 disease and the cytokine expression profile in periodontitis. A possible link between periodontitis and COVID-19 and its associated complications has also been identified. The aim of this study was to evaluate the possible relationship between periodontal disease severity and COVID-19 disease severity.
MATERIAL & METHODS: 241 individuals were included in this retrospective study. Systemic and clinical parameters of the patients (plaque index, gingival index, clinical attachment loss, probing pocket depth, bleeding on probing and gingival recession) were obtained from previously recorded data. Patients with or without a history of COVID-19 were enrolled. The information about the patients’ environment, the symptoms if there are any and the need for ventilation were recorded. The patients were classified as healthy, gingivitis and periodontitis. Patients diagnosed with periodontitis were divided into Stages (I-II / III-IV).
RESULTS: According to the results of this study, no difference was found between the severity of periodontal disease and COVID-19 infection in terms of relationship and presence of symptoms (p= 0.366).
CONCLUSION: According to the data obtained in this study, no relationship was found between the severity of periodontal disease and COVID-19 and its’ symptoms, the need for intensive care and the need for a ventilation device. Future research is needed on this subject.
Keywords: Covıd, Stage, Perıodontıtıs, Sars Cov 2

Keywords

Covıd, Stage, Perıodontıtıs, Sars Cov 2

Project Number

Proje No: D-KA 22/03

Periodontal Hastalık ve Şiddetli Akut Solunum Sendromu Koronavirüs (Sars-Cov-2) Enfeksiyonu Arasındaki İlişki

Abstract

ÖZ
AMAÇ: Periodontal hastalıklar ve sistemik hastalıklar arasında güçlü bir ilişki vardır. Şiddetli SARS-CoV-2 enfeksiyonlarındaki sitokin fırtınası ile periodontitisteki sitokin ekspresyon profili arasında benzerlik olduğu belirtilmiştir. Ayrıca periodontitis ile COVID-19 ve ilişkili komplikasyonları arasında olası bir bağlantı olduğu da saptanmıştır. Bu çalışmanın amacı periodontal hastalık şiddeti ve SARS-CoV-2 enfeksiyon şiddeti arasındaki olası ilişkiyi değerlendirmektir.
GEREÇ ve YÖNTEM: Bu retrospektif çalışmaya 241 birey dahil edilmiştir. Hastaların sistemik bulguları ve klinik parametreleri (plak indeksi, gingival indeks, klinik ataşman kaybı, sondlanabilir cep derinliği, sondlamada kanama ve diş eti çekilmesi miktarı) önceden kaydedilmiş veriler arasından elde edilmiştir. COVID-19 hikayesi olan/ olmayan hastalar kaydedilmiştir. COVID-19 tespit edilen bireylerin hastalığı geçirdiği ortam, semptom varlığı, semptom var ise hangileri olduğu, ventilasyon cihazına ihtiyaç durumu ile ilgili bilgileri kaydedilmiştir. Hastalar; sağlıklı, gingivitis ve periodontitis olarak sınıflandırılmıştır. Periodontitis teşhisi olan hastalar Evrelere (I-II / III-IV) ayrılmıştır.
BULGULAR: Bu çalışmanın sonuçlarına göre periodontal hastalık şiddeti ve COVID-19 enfeksiyonu arasında ilişki ve semptom varlığı açısından fark bulunamamıştır (p= 0.366).
SONUÇ: Bu çalışmada elde edilen veriler doğrultusunda periodontal hastalık şiddeti ve SARS-CoV-2 hastalığının geçirilme şiddeti, semptomları, yoğun bakım ihtiyacı ve ventilasyon cihazına gereksinimi arasında bir ilişki bulunamamıştır. Bu konuda daha fazla araştırma yapılmasına ihtiyaç vardır.
ANAHTAR KELİME: COVID, EVRE, PERİODONTİTİS, SARS-COV 2

Keywords

PERİODONTİTİS, COVID, EVRE, SARSCOV-2

Supporting Institution

BAŞKENT ÜNİVERSİTESİ

Project Number

Proje No: D-KA 22/03

References

• 1. Hinrichs JE, Kotsakis GA: Periodontitis in Newman and Carranza’s Clinical Periodontology ed 13, 2018.
• 2. Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, et al. Periodontal disease: a risk factor for diabetes and cardiovascular disease. Int J Mol Sci 2019;20:1414
• 3. Graves D. Cytokines that promote periodontal tissue destruction. J Periodontol 2008;79:1585–91
• 4. Janket SJ, Jones JA, Meurman JH, Baird AE, Van Dyke TE. Oral infection, hyperglycemia, and endothelial dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105:173-179.
• 5. Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15:30-44.
• 6. Engin AB, Engin ED, Engin A. Two important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking. Environmental Toxicology and Pharmacology. 2020; 78: 103411.
• 7. Altıok D, Savcı EZ, Özkara B, Alkan K, Namdar DS, Tuncer G, et al. Host variations in SARS-COV-2 infection. Turkish Journal of Biology. 2020; 45(4),404
• 8. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; 395:470-473.
• 9. Pfutzner A, Lazzara M, Jantz J. Why do people with diabetes have a high risk for severe COVİD-19 Disease? - A dental hypothesis and possible prevention strategy. J Diabetes Sci Technol. 2020;14:769-771.
• 10. Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M. The cytokine storm in COVID-19: an overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev. 2020;53:25-32.
• 11. Thakur B, Dubey P, Benitez J, et al. A systematic review and meta-analysis of geographic differences in comorbidities and associated severity and mortality among individuals with COVID-19. Scientif Rep. 2021;11:8562.
• 12. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med 2020; 2:1069–1076.
• 13. Gomes-Filho IS, Cruz SSD, Trindade SC, Passos-Soares JS, Carvalho-Filho PC, Figueiredo ACMG, et al. Periodontitis and respiratory diseases: a systematic review with meta-analysis. Oral Dis 2020 ;26(2):439–446
• 14. Sahni V, Gupta S. COVİD-19 & Periodontitis: the cytokine connection. Med Hypotheses 2020 ;144:109908.
• 15. Badran Z, Gaudin A, Struillou X, Amador G, Soueidan A. Periodontal pockets: a potential reservoir for SARS CoV-2? Med Hypotheses. 2020; 143:109907.
• 16. Del Valle DM, Kim-Schulze S, Huang HH, et al. An enflammatory cytokine signature predicts COVİD-19 severity and survival. Nat Med. 2020; 26:1636-1643.
• 17. Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID‐ 19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363‐374.
• 18. Wu D, Yang XO. TH17 responses in cytokine storm of COVID-19: An emerging target of JAK2 inhibitor Fedratinib. J Microbiol Immunol Infect 2020.
• 19. Brandini DA, Takamiya AS, Thakkar P, Schaller S, Rahat R, Naqvi AR. Covid‐19 and oral diseases: crosstalk, synergy or association? Rev Med Virol. 2021;31(6): e2226.
• 20. Takahashi Y, Watanabe N, Kamio N, Kobayashi R, Iinuma T, Imai K. Aspiration of periodontopathic bacteria due to poor oral hygiene potentially contributes to the aggravation of COVID-19. J Oral Sci. 2020; 63:1-3.
• 21. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395:1033-1034.
• 22. Anand PS, Jadhav P, Kamath KP, Kumar SR, Vijayalaxmi S, Anil S. A case-control study on the association between periodontitis and coronavirus disease (COVID-19). J Periodontol. 2021;1-7
• 23. Pitones-Rubio V, Chávez-Cortez EG, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVİD-19 illness? Med Hypotheses. 2020 Nov;144:109969.
• 24. Tonetti MS, Greenwell H,Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1): S159–S172
• 25. Silness, J. and Löe, H.: Periodontal disease in pregnancy. II. Correlation between oral hygiene and perio- dontal condition. Acta odont. scand. 1964, 22:112-135
• 26. Loe H, Silness J. Periodontal disease in pregnancy I. Prevalence and Severity. Acta Odontol Scand. 1963;21:533–551
• 27. Papapanou PN, Sanz M, et al. Periodontitis: Consensus report of Workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S173–S182.
• 28. Papapanou PN, Lindhe J, Sterrett JD, et al: Considerations on the contribution of ageing to loss of periodontal tissue support. J Clin Periodontol 18:611, 1991.
• 29. Chung HY, Cesari M, Anton S, et al: Molecular inflammation: underpinnings of aging and age-related diseases. Ageing Res Rev 8:18, 2009
• 30. Chung HY, Lee EK, Choi YJ, et al: Molecular inflammation as an underlying mechanism of the aging process and age-related diseases. J Dent Res 90:830, 2011.
• 31. Bouchard P, Boutouyrie P, Mattout C, et al: Risk assessment for severe clinical attachment loss in an adult population. J Periodontol 77:479, 2006.
• 32. Yanbaeva DG, Dentener MA, Creutzberg EC, et al: Systemic effects of smoking. Chest 131:1557, 2007.
• 33. Bridges RB, Anderson JW, Saxe SR, et al: Periodontal status of diabetic and non-diabetic men: effects of smoking, glycemic control, and socioeconomic factors. J Periodontol 67:1185, 1996.
• 34. Brothwell DJ: Should the use of smoking cessation products be promoted by dental offices? An evidence-based report. J Can Dent Assoc 67:149, 2001.
• 35. Buduneli N, Biyikoglu B, Sherrabeh S, et al: Saliva concentrations of RANKL and osteoprotegerin in smoker versus non-smoker chronic periodontitis patients. J Clin Periodontol 35:846, 2008.
• 36. Aquino-Martinez & Hernández-Vigueras. Severe COVİD-19 Lung Infection in Older People and Periodontitis. J. Clin. Med. 2021; 10, 279.
• 37. De Nardin E. The role of inflammatory and immunological mediators in periodontitis and cardiovascular disease. Ann Periodontol. 2001;6(1):30-40.
• 38. Hansen PR, Holmstrup P. Cardiovascular Diseases and Periodontitis. Adv Exp Med Biol.2022;1373:261-280.
• 39. Dalla Vecchia CF, Susin C, Rösing CK, et al: Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 76:1721, 2005.
• 40. Gorman A, Kaye EK, Apovian C, et al: Overweight and obesity predict time to periodontal disease progression in men. J Clin Periodontol 39:107, 2012
• 41. Grossi SG, Zambon JJ, Ho AW, et al: Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol 65:260, 1994.
• 42. Sarfraz A, Sarfraz Z, Siddiqui A, Totonchian A, Syed Hashim Abbas Ali Bokhari SHAA, Hussain H, et al. Hypercoagulopathy in Overweight and Obese COVİD-19 Patients: A Single-Center Case Series. The Journal of Critical Care Medicine 2022;8(1):41-48
• 43. Sato K, Yoneyama T, Okamoto H, et al: The effect of subgingival debridement on periodontal disease parameters and the subgingival microbiota. J Clin Periodontol 20:359, 1993.
• 44. Sima C, Rhourida K, Van Dyke TE, et al: Type 1 diabetes predisposes to enhanced gingival leukocyte margination and macromolecule extravasation in vivo. J Periodontal Res 45:748, 2010.
• 45. Takeda M, Ojima M, Yoshioka H, et al: Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. J Periodontol 77:15, 2006.
• 46. Singu S, Acharya A, Challagundla K, Byrareddy SN. Impact of Social Determinants of Health on the Emerging COVİD-19 Pandemic in the United States. Front Public Health. 2020; 21;8:406.
• 47. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020 Mar 13;7(1):11.
• 48. Lawal IO, Kgatle MM, Mokoala K, Farate A, Sathekge MM. Cardiovascular disturbances in COVID-19: an updated review of the pathophysiology and clinical evidence of cardiovascular damage induced by SARS-CoV-2. BMC Cardiovasc Disord 2022; 9;22(1):93
• 49. Shamsoddin E. Is periodontitis associated with the severity of COVİD-19 Evid Based Dent. 2021;22(2):66-68.
• 50. Gupta S, Mohindra R, Singla M, et al. The clinical association between Periodontitis and COVID-19. Clin Oral Investig. 2022;26(2):1361-1374
• 51. Marouf N, Cai W, Said KN, et al. Association between periodontitis and severity of COVİD-19 infection: A case-control study. J Clin Periodontol. 2021;48(4):483-491.
• 52. González-Moles MÁ, Ramos-García P. State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med. 2021;10(22):5383.
• 53. Lai SW, Lin CL, Liao KF. Population-based cohort study investigating the correlation of diabetes mellitus with pleural empyema in adults in Taiwan. Medicine (Baltimore). 2017;96(36):e7763.
• 54. Burrows B, Halonen M, Barbee RA, et al: The relationship of serum immunoglobulin E to cigarette smoking. Am Rev Respir Dis 124:523, 1981.