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Systemic circulating inflammatory burden and periodontitis in adolescents

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Abstract

Objectives

To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors.

Materials and methods

Using a population-based sample study (n = 405) of Brazilian adolescents (17–18 years old), direct and mediation pathways triggered by “Socioeconomic Status,” “Adiposity,” Smoking, and “Blood Pressure” were modelled for the association between the “Systemic Circulating Inflammatory Burden of CVD Risk” (IL-1β, IL-6, IL-8, TNF-α) and the “Initial Periodontitis” (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes “Gingivitis” (visible plaque; BoP); “Moderate Periodontitis” (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition).

Results

Higher “Systemic Circulating Inflammatory Burden of CVD Risk” was directly associated with higher “Initial Periodontitis” (standardized coefficient [SC] = 0.178, P value < 0.001). Lower “Socioeconomic Status” (SC = − 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the “Initial Periodontitis”, mediated by “Systemic Circulating Inflammatory Burden of CVD Risk”. Sensitivity analysis showed a dose-response relationship between “Systemic Circulating Inflammatory Burden of CVD Risk” and “Moderate Periodontitis” (SC = 0.323, P value = 0.021).

Conclusions

“Systemic Circulating Inflammatory Burden of CVD Risk” appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking.

Clinical relevance

The association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.

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Funding

This study was funded by FAPEMA (Maranhão State Foundation for Research and Scientific and Technological Development), CNPq (National Council for Scientific and Technological Development), CAPES (Coordination for the Improvement of Higher Education Personnel)Finance Code 001, and PPSUS (Research Program for the Unified Health System/SUS – Ministry of Health).

Author information

Authors and Affiliations

  1. Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, Brazil

    Cecilia C. C. Ribeiro, Cadidja D. S. Carmo, Bruno B. Benatti, C. M. C. Alves & A. R. O. Moreira

  2. Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil

    Renato V. C. Casarin

  3. Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark

    Gustavo G. Nascimento

Authors
  1. Cecilia C. C. Ribeiro
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  2. Cadidja D. S. Carmo
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  3. Bruno B. Benatti
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  4. Renato V. C. Casarin
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  5. C. M. C. Alves
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  6. Gustavo G. Nascimento
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  7. A. R. O. Moreira
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Contributions

C.C.C. Ribeiro, C.D.S. Carmo and A.R.O. Moreira contributed to conception, design, data acquisition, analysis and interpretation, drafted and critically revised the manuscript; C.M.C. Alves contributed to conception, design, data acquisition and interpretation, drafted and critically revised the manuscript; B.B. Benatti contributed to conception, data acquisition, drafted and critically revised the manuscript; R.V.C. Casarin and G.G. Nascimento contributed to conception and data interpretation, critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cecilia C. C. Ribeiro.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the Federal University of Maranhão (CAAE 12498713.8.0000.5087, process number 441.226) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing of interests.

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Ribeiro, C.C.C., Carmo, C.D.S., Benatti, B.B. et al. Systemic circulating inflammatory burden and periodontitis in adolescents. Clin Oral Invest 25, 5855–5865 (2021). https://doi.org/10.1007/s00784-021-03891-y

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