Citation Information :
Suresh S, Mahendra J, Parthiban S, Sivsankar P, Selvakumar J, Elangovan R. Evaluation of Reactive Oxygen Metabolites, Resistin, and Red Complex Bacteria in Obese Subjects with or without Periodontitis. J Contemp Dent Pract 2022; 23 (7):703-708.
Aim: The study's aim was to assess and compare the clinical parameters, plasma reactive oxygen metabolites (ROM) levels, gingival crevicular fluid (GCF) resistin, serum resistin values, and red complex bacteria in obese or overweight subjects with and without periodontitis and also to determine the effect of non-surgical periodontal therapy (NSPT) on plasma ROM, serum, and GCF resistin values in obese or overweight subjects with chronic periodontitis.
Material and methods: A total of 160 subjects were recruited and designated into four groups with 40 subjects each as group I – obese with chronic periodontitis; group II – normal weight subjects with chronic periodontitis; group III – obese subjects with healthy periodontium; and group IV – normal weight subjects with healthy periodontium. The periodontal parameters, plasma ROM, GCF resistin and serum resistin, and red complex bacteria levels were estimated at baseline. After baseline assessment, scaling and root planing (SRP) were done in the patients of groups I and II. Two months after the completion of SRP, clinical parameters such as plaque index (PI), probing pocket depth (PPD), gingival index (GI), and clinical attachment loss (CAL), plasma ROM levels, serum resistin, and GCF resistin levels were analyzed.
Results: An increase in plasma ROM, GCF resistin, and red complex bacteria levels was observed in obese subjects with periodontal disease and the increase was noted in obese subjects with healthy periodontium. Comparing plasma ROM, GCF resistin values between groups I and II, 2 months after SRP, a decrease in these levels were observed in group II.
Conclusion: Our study results depict that obesity can be considered as a risk indicator for periodontal disease.
Clinical significance: Obesity has a negative impact on both general health and oral health. Promoting appropriate physical activity, healthy eating behavior, and oral hygiene practice are fundamental elements of the prevention of both obesity and periodontal disease.
Offenbacher S. Periodontal diseases: Pathogenesis. Ann Periodontol 1996;1(1): 821–878. DOI: 10.1902/annals.19126.96.36.1991.
Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of severe periodontitis in 1990−2010: A systematic review and meta-regression J Dent Res 2014;93(11):1045–1053. DOI: 10.1177/0022034514552491.
Petersen PE, Ogawa H. The global burden of periodontal disease: Towards integration with chronic disease prevention and control. Periodontol 2000. 2012;60(1):15–39. DOI: 10.1111/j.1600-0757.2011.00425.x.
Aronne LJ, Segal KR. Adiposity and fat distribution outcome measures: assessment and clinical implications. Obes Res 2002;10(Suppl 1):14S–21S. DOI: 10.1038/oby.2002.184.
Perlstein MI, Bissada NF. Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol 1977;43(5):707–719. DOI: 10.1016/0030-4220(77)90055-x.
Saito T, Shimazaki Y, Sakamoto M. Obesity and periodontitis. N Engl J Med 1998;339(7):482–483. DOI: 10.1056/NEJM199808133390717.
Al-Zahrani MS, Bissada NF, Borawskit EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol 2003;74(5):610–615. DOI: 10.1902/jop.2003.74.5.610.
Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: A systematic review and meta-analysis. J Periodontol 2010;81(12):1708–1724. DOI: 10.1902/jop.2010.100321.
Keller A, Rohde JF, Raymond K, et al. Association between periodontal disease and overweight and obesity: A systematic review. J Periodontol 2015;86(6):766–776. DOI: 10.1902/jop.2015.140589.
Sies H, Murphy ME. Role of tocopherols in the protection of biological systems against oxidative damage. J Photochem Photobiol B 1991:8:211–224. DOI: 10.1016/1011-1344(91)80061-l.
Makarov SS, NF-KappaB as a therapeutic target in chronic inflammation. Recent advances. Mol Med Today 2000:6(11):441–448. DOI: 10.1016/s1357-4310(00)01814-1.
Chapple, ILC. Potential mechanisms underpinning the nutritional modulation of periodontal inflammation. J Am Dent Assoc 2009;140(2):178–184. DOI: 10.14219/jada.archive.2009.0131.
Dede FO, Dogan SB, Balli U, et al. Glutathione levels in plasma, saliva and gingival crevicular fluid after periodontal therapy in obese and normal weight individuals. J Periodontal Res 2016;51(6):726–734. DOI: 10.1111/jre.12349.
Dursun E, Akalin FA, Genc T, et al. Oxidative stress and periodontal disease in obesity. Medicine (Baltimore) 2016;95(12):3136. DOI: 10.1097/MD.0000000000003136.
Ouchi N, Parker JL, Lugus JJ, et al. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011;11(2):85–97. DOI: 10.1038/nri2921.
Thommesen L, Stunes AK, Monjo M, et al. Expression and regulation of resistin in osteoblasts and osteoclasts indicate a role in bone metabolism. J Cell Biochem 2006;99(3):824–834. DOI: 10.1002/jcb.20915.
Rea R, Donnelly R. Effects of metformin and oleic acid on adipocyte expression of resistin. Diabetes Obes and Metab 2006;8(1):105–109. DOI: 10.1111/j.1463-1326.2005.00477.x.
Silswal N, Singh AK, Aruna B, et al. Human resistin stimulates the pro-inflammatory cytokines TNF-alpha and IL-12 in macrophages by NF-kappa B-dependent pathway. Biochem Biophys Res Commun 2005; 334(4):1092–1101. DOI: 10.1016/j.bbrc.2005.06.202.
Dobrovolskaia MA, Medvedev AE, Thomas KE, et al. Induction of in vitro reprogramming by Toll-like receptor (TLR)2 and TLR4 agonists in murine macrophages: Effects of TLR “homotolerance” versus “heterotolerance” on NFkB signaling pathway components. J Immunol 2003;170(1):508–519. DOI: 10.4049/jimmunol.170.1.508.
Matsushita K, Hamaguchi M, Hashimoto M, et al. The novel association between red complex of oral microbe and body mass index in whealthy Japanese: A population based cross-sectional study. J Clin Biochem Nutr 2015;57(2):135–159. DOI: 10.3164/jcbn.15-19.
Haffajee AD, Socransky SS. Relation of body mass index, periodontitis and Tannrella forsythia. J Clin Periodontol 2009;36(2):89–99. DOI: 10.1111/j.1600-051X.2008.01356.x.
Armitage GC. Development of a classification system for periodontal disease and conditions. Ann Periodontol 1999;4(1):1–6. DOI: 10.1902/annals.19188.8.131.52.
Silness J, Loe H. Periodontal disease in pregnancy: II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121–135. DOI: 10.3109/00016356408993968.
Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533–551. DOI: 10.3109/00016356309011240.
Tamaki N, Tomofuji T, Ekuni D, et al. Short term effects of non-surgical periodontal treatment on plasma level of reactive oxygen metabolites in patients with chronic periodontitis. J Periodontol 2009;80(6):901–906. DOI: 10.1902/jop.2009.080640.
Amar S, Leeman S. Periodontal innate immune mechanisms relevant to obesity. Mol Oral Microbiol 2013;28(5):331–341. DOI: 10.1111/omi.12035.
Suvan J, D'Aiuto F, Moles DR, et al. Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev 2011;12(5):381–404. DOI: 10.1111/j.1467-789X.2010.00808.x.
Khan NI, Naz L, Yasmeen G. Obesity: An independent risk factor for systemic oxidative stress. Pak J Pharm Sci 2006;19(1):62–65. PMID: 16632456.
Fernández–Sánchez A, Madrigal–Santillán E, Bautista M, et al. Inflammation, oxidative stress, and obesity. Int J Mol Sci 2011;12(5):3117–132. DOI: 10.3390/ijms12053117.
Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004;114(12):1752–1761. DOI: 10.1172/JCI21625.
Zimmermann GS, Bastos MF, Dias Goncalves TE, et al. Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis. J Periodontol 2013;84(5):624–633. DOI: 10.1902/jop.2012.120254
Silva–Boghossian CM, Cesário PC, Leão ATT, et al. Subgingival microbial profile of obese women with periodontal disease. J Periodontol 2018;89(2):186–194. DOI: 10.1002/JPER.17-0236.
Goncalves TED, Feres M, Zimmermann GS, et al. Effects of scaling and root planing on clinical response and serum levels of adipocytokines in obese patients with chronic periodontitis. J Periodontol 2015;86(1):53–61. DOI: 10.1902/jop.2014.140266.
Suvan J, Petrie A, Moles DR, et al. Body mass index as a predictive factor of periodontal therapy outcomes. J Dent Res 2014;93(1):49–54. DOI: 10.1177/0022034513511084.