Search

Impaired oral health is a well-known complication in individuals with eating disorders, although this is difficult to identify by mental health professionals. The aim of this study was to evaluate the relationship between routine blood parameters and two oral health outcomes (dental erosion, reduced periodontium) in women with eating disorders. A face-to-face interview and a clinical oral examination were carried out in a cohort of 70 women from an addiction and psychiatry hospital unit. Biochemical and hematological parameters were collected in medical records at admission. Biological factors associated with a generalized reduced periodontium (≥ 30% of sites with clinical attachment loss ≥ 3 mm) and dental erosion [a basic erosive wear examination (BEWE) score ≥ 3] were determined by logistic regression models. Forty-five women with either anorexia nervosa (n = 27) or bulimia nervosa (n = 18) were included in the study. None of the women had active periodontitis or other inflammatory comorbidity. Women with ≥ 30% of sites with clinical attachment loss ≥ 3 mm and those with a BEWE score ≥ 3 were older than women that did not exhibit a generalized reduced periodontium or dental erosion (37.1 ± 10.4 versus 28.8 ± 7.4, p

This study evaluates dental and periodontal health in anorexia nervosa and bulimia nervosa patients.Seventy females with eating disorders (36 anorexia nervosa) attending a public hospital Psychiatry and Addiction unit were compared with age-matched controls (n = 70). Full-mouth examination and oral hygiene behaviours were recorded for all participants.More frequent dental attendance and toothbrushing were observed in patients with eating disorders than in controls (p 0.01), while lower plaque index and bleeding on probing were observed in controls than in patients (p ≤ 0.03). Percentages of sites with gingival recession2 mm were higher in patients with eating disorders than in controls (2.3 ± 4.1 versus 0.0 ± 0.1, p 0.01). The BEWE score2 was significantly more frequent in bulimia nervosa patients than in anorexia nervosa patients (76.5% versus 41.7%, p 0.01). Regarding periodontal parameters, mean plaque index, bleeding on probing and clinical attachment loss were increased in anorexia nervosa patients compared to bulimia nervosa patients.The present data suggest different oral health approaches in eating disorder patients according to diagnosis type.Periodontal and dental health should be considered rigorously in patients with eating disorders. Personalized oral hygiene recommendations and treatments can be delivered according to the type of eating disorder.

Objective To review and analyze periodontal clinical parameters after bariatric surgery. Background Periodontitis, a dysbiotic inflammatory disease, has been associated with obesity. The purpose of bariatric surgery is to reduce weight and systemic inflammation. Consequently, it is of interest to systematically review the impact of bariatric surgery on periodontal status. Methods Electronic searches were conducted in MEDLINE, EMBASE, Thesis database, and the Cochrane Library databases. Gray literature and the main journals of both specialties were also reviewed. Only cross-sectional and prospective studies focusing on bleeding on probing, pocket depth, and clinical attachment levels were selected. Results After a thorough screening of 651 studies, 10 studies were selected by 2 independent reviewers. Four (n = 250) and 3 studies (n = 191) were included in the meta-analysis at 6- and 12-month follow-up, respectively. At 6-month follow-up increased periodontal inflammation (P = .03) and periodontal destruction were observed. However, 12 months after baseline, the difference between bariatric patients and control was no longer significant. Conclusion The present systematic review and meta-analysis suggests that deterioration of periodontal status may be observed in the first 6 months after surgery. Consequently, periodontal screening and management of the patient's request for bariatric surgery should be recommended to avoid further deterioration of periodontal status after bariatric surgery.

BackgroundThere is a lack of evidence on the impact of socioeconomic factors on masticatory efficiency. The present study investigates the relationship between individual and neighbourhood socioeconomic factors (main exposure) and the number of masticatory units (MUs) used as surrogate of the masticatory efficiency (main outcome).MethodsIn this cross-sectional study nested in the Paris Prospective Study 3, 4270 adults aged 50–75 and recruited from 13 June 2008 to 31 May 2012 underwent a full-mouth examination. Number of MUs defined as pairs of opposing teeth or dental prostheses allowing mastication, number of missing teeth and gingival inflammation were documented. The individual component of the socioeconomic status was evaluated with an individual multidimensional deprivation score and education level. The neighbourhood component of the socioeconomic status was evaluated with the FDep99 deprivation index. Associations were quantified using marginal models.ResultsIn multivariate analyses, having less than 5 MUs was associated with (1) the most deprived neighbourhoods (OR=2.27 (95% CI 1.63 to 3.17)), (2) less than 12 years of educational attainment (OR=2.20 (95% CI 1.66 to 2.92)) and (3) the highest individual score of deprivation (OR=3.23 (95% CI 2.24 to 4.65)). Associations with education and individual score of deprivation were consistent across the level of neighbourhood deprivation. Comparable associations were observed with the number of missing teeth. Associations with gingival inflammation were of lower magnitude; the relationship was present for deprivation markers but not for education.ConclusionPoor masticatory efficiency is associated with low educational attainment and high deprivation scores.

International audience; Genetic approaches have shown that several genes could modify caries susceptibility; AmelogeninX (AMELX) has been repeatedly designated. Here, we hypothesized that AMELX mutations resulting in discrete changes of enamel microstructure may be found in children with a severe caries phenotype. In parallel, possible AMELX mutations that could explain resistance to caries may be found in caries-free patients. In this study, coding exons of AMELX and exon-intron boundaries were sequenced in 399 individuals with extensive caries (250) or caries-free (149) individuals from nine French hospital groups. No mutation responsible for a direct change of amelogenin function was identified. Seven single-nucleotide polymorphisms (SNPs) were found, 3 presenting a high allele frequency, and 1 being detected for the first time. Three SNPs were located in coding regions, 2 of them being non-synonymous. Both evolutionary and statistical analyses showed that none of these SNPs was associated with caries susceptibility, suggesting that AMELX is not a gene candidate in our studied population.

Aim The definition and assessment of risk factors, risk indicators and predisposing factors are of paramount importance in the understanding of the pathogenesis of periodontitis, as well as in its prevention and treatment. This article aims to emphasize the concepts of causal chains and the causal network of risk factors in periodontitis. Materials and Methods This is a narrative review focusing on two main questions: (1) what is a risk in periodontology? and (2) how can a risk be assessed? Results The probability of the occurrence of an adverse outcome following exposure is not sufficient to analyse the impact of a risk factor on the disease. A network model for the pathway of risk factors in the pathogenesis of periodontitis is described. This article emphasizes the concepts of causal chains and the causal network of risk factors in periodontitis. Conclusion Chronic periodontal diseases are among the most complex non-communicable diseases. A conceptual framework intended to clarify the relationship between risk and causality may improve the understanding of the underlying mechanisms of chronic diseases. The proposed causal network may provide a model to assess the role of risk factors in periodontitis.

In this paper, we present a real-time decision support system whose objective is to propose the best order of trains to run at junctions in dense areas, based on passenger punctuality. This question typically arises when two branches of a railway line (say, A and B) coming from different origins in the network merge, and trains coming from these two branches must use the same track after the junction. For each couple of trains on both branches, a choice has to be made on which train should run first after the junction: train coming from A or from B? This choice can have a significant impact on the operating performance, and, to be efficient in terms of passenger quality of service, should take into account a large amount of information on the position of trains currently running before and after the junction, their service, the number of passengers on each origin-destination pair at a given time… A first real-world experiment was carried out during fall 2015 at one of the most highly used junctions in the Parisian area. This experiment was performed using a software prototype relying on a dedicated approach combining real-time data treatment, operations research and simulation algorithms.

De nombreuses donnees epidemiologiques montrent une association positive entre indice de masse corporelle et parodontites chroniques. Les parodontites sont des maladies inflammatoires multifactorielles d’origine bacterienne, dependantes de la reponse immunitaire de l’hote. Sans traitement, ces maladies entrainent la perte des dents par destruction du systeme d’attache gingivale et de l’os de soutien. La susceptibilite des patients obeses aux parodontites chroniques impliquerait l’action deletere directe des facteurs inflammatoires secretes par le tissu adipeux (adipokines), du stress oxydatif ou des mecanismes indirects lies aux pathologies associees a l’obesite (diabete de type 2, hypertension arterielle, dyslipidemies). Par ailleurs, les parodontites pourraient indirectement contribuer a l’obesite en induisant des troubles de la mastication dus a une augmentation globale de la mobilite et de la perte des dents. Ainsi, un examen parodontal et dentaire systematique des patients obeses devrait permettre un diagnostic et un traitement precoce ameliorant la capacite de mastication et la sante orale de ces malades.

Craniopharyngiomas are rare low-grade tumors located in the hypothalamic and/or pituitary region. Hypothalamic involvement and treatment resulting in hypothalamic damage are known to lead to development of "hypothalamic obesity" (HyOb) in 50% of cases. The management of HyOb, associated with eating disorders and rapid comorbidities, is an important issue. Bariatric surgery is the most effective therapy for weight loss in patients with severe exogenous obesity. The aim of this systematic review and meta-analysis was to determine the 12-month outcome of bariatric surgery for HyOb due to craniopharyngioma treatment.Relevant studies were identified by searches of the MEDLINE and EMBASE databases until January 2013. A total of 21 cases were included: 6 with adjustable gastric banding, 8 with sleeve gastrectomy, 6 with Roux-en-Y gastric bypass, and 1 with biliopancreatic diversion. After data pooling, mean weight difference was -20.9 kg after 6 months (95% confidence interval [CI], -35.4, -6.3) and -15.1 kg after 12 months (95% CI, -31.7, +1.4). The maximal mean weight loss was achieved by the gastric bypass group: -31.0 kg (95% CI, -77.5, +15.5) and -33.7 kg (95% CI, -80.7, +13.3) after 6 and 12 months, respectively.In this largest ever published study on the effect of bariatric surgery on obesity after craniopharyngioma treatment, we observed an important weight loss after 1 year of follow-up. Larger studies are warranted to establish appropriate selection criteria and the best surgical technique to perform bariatric surgery.

Introduction La presence d’anticorps circulants diriges contre les principaux pathogenes parodontaux a ete associee a l’incidence d’evenements coronariens chez des sujets sains. En revanche, l’impact de la presence de ces anticorps en prevention secondaire de la maladie coronarienne n’est pas connu. Materiels et methodes La cohorte nationale FAST-MI a pour objectif d’evaluer la prise en charge des patients admis en unite de soins intensifs pour un syndrome coronaire aigu avec ou sans sus-decalage du segment ST, et d’evaluer son impact sur le devenir a moyen et a long terme des patients. Les taux d’immunoglobulines G et d’immunoglobulines A (IgG et IgA) diriges contre Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia et Tannerella forsythia ont ete mesures par ELISA parmi les 992 patients qui avaient donne leur consentement pour la constitution d’une collection plasmatique. L’impact des taux de chaque anticorps en continu et en tertiles, et le risque de survenue d’un deces ou d’une recidive d’infarctus du myocarde a 1 an, a ete evalue par des modeles de Cox. Resultats Aucune association significative n’a ete trouvee entre le risque d’un evenement secondaire a 1 an et les taux d’IgG et d’IgA- anti-P. gingivalis (HR ; IC95 %: 0,96 ; 0,78-1,18 et 1,13 ; 0,90-1,42). De meme, les taux d’IgG et d’IgA diriges contre P. intermedia, A. actinomycetemcomitans et T. forsythia n’etaient pas correles aux evenements secondaires. Le statut diabetique ne modifiait pas ces relations. Conclusion Contrairement a la valeur predictive retrouvee en prevention pri-maire, les taux d’anticorps circulants diriges contre les principaux pathogenes parodontaux ne sont pas associes a un evenement secondaire. Les taux d’anti-corps mesurant l’exposition passee aux pathogenes, une etude s’interessant aux variables cliniques parodontales est necessaire pour mesurer l’importance de l’hygiene bucco-dentaire dans les programmes de readaptation car-diaque. Declaration d’interet Les auteurs declarent ne pas avoir d’interet direct ou indirect (financier ou en nature) avec un organisme prive, industriel ou commercial en relation avec le sujet presente.

BackgroundThe impact of socioeconomic inequalities on health is well-documented. Despite the links of periodontal disease with cardiovascular diseases, adverse pregnancy outcomes and diabetes, no meta-analysis of socioeconomic variations in periodontal disease exists. This meta-analytic review was conducted to determine the extent to which education attainment influences risk of periodontitis in adults aged 35+ years in the general population.MethodsThe authors searched studies published until November 2010 using EMBASE and MEDLINE databases. References listed were then scrutinised, our own files were checked, and, finally, we contacted experts in the field. The authors included only general population-based studies conducted in adults aged 35 years and more. All articles were blind reviewed by two investigators. In the case of disagreement, a third investigator arbitrated. Using PRISMA statement, two reviewers independently extracted papers of interest.ResultsRelative to the higher education group, people with low education attainment experience a greater risk of periodontitis (OR: 1.86 [1.66-2.10]; pConclusionsIn the studies reviewed, low educational attainment was associated with an increased risk of periodontitis. Although this evidence should be cautiously interpreted due to methodological problems in selected studies, efforts to eliminate educational inequalities in periodontitis should focus on early life interventions.