Tuomas Saxlin

Saxlin T, Ylöstalo P, Suominen‐Taipale L, Aromaa A, Knuuttila M. Overweight and obesity weakly predict the development of periodontal infection. J Clin Periodontol 2010; doi: 10.1111/j.1600‐051X.2010.01633.x. Aim: The aim of this study was to investigate the association between body weight and periodontal infection in a longitudinal setting.Material and methods: This study was based on a subpopulation of the Health 2000 Survey that included dentate, non‐diabetic subjects aged 30–59 years, who had never smoked and who had participated in the Follow‐Up Study on Finnish Adults' Oral Health approximately 4 years later (n=396). The number of new teeth with deepened (4 mm deep or deeper) periodontal pockets in the follow‐up examination was used as the outcome variable. Body weight was measured using body mass index, categorized into three categories: Results: Body weight was weakly, but not statistically significantly, associated with the number of new teeth with deepened periodontal pockets among subjects who were periodontally healthy in the baseline examinations, whereas only a minuscule association was found among subjects who had periodontal infection at baseline.Conclusions: The results of this follow‐up study do not provide evidence that overweight and obesity can be considered significant risk factors in the pathogenesis of periodontal infection.

Aim: The aim of this study was to investigate the association between statin medication and periodontal infection in an adult population.Material and Methods: The study was based on a subpopulation of the Health 2000 Survey, which included dentate non‐diabetic, non‐rheumatic subjects who did not smoke, aged 40–69 years (n=2032). The main outcome variable was the number of teeth with periodontal pockets of 4 mm or more. Statin medication was categorized in two ways: firstly, subjects with statin medication of some sort (n=134) versus those with none, and secondly, subjects taking either simvastatin (n=58), atorvastatin (n=38), some other statin (n=38) or no statin medication. Relative risks (RR) were estimated using negative binomial and Poisson regression models.Results: We found a weak negative association between statin medication and periodontal infection among subjects with dental plaque or gingival bleeding. Among subjects with no gingival bleeding, statin medication was found to be associated with an increased likelihood of having deepened periodontal pockets.Conclusion: Statin medication appears to have an effect on the periodontium that is dependent on the inflammatory condition of the periodontium. More evidence is needed to achieve a comprehensive understanding of the effects of statins.

Aim: To study the role of serum cytokines tumour necrosis factor α (TNF‐α) and interleukin 6 (IL‐6) as potential mediators in the association between body weight and periodontal infection among an adult population.Material and Methods: This study was based on a subpopulation of the Health 2000 Health Examination Survey, which included dentate non‐diabetic, non‐rheumatic subjects, aged between 45 and 64 years, who had never smoked and whose serum levels of TNF‐α and IL‐6 were analysed and whose periodontal status was clinically determined (effective n=425). The number of teeth with periodontal pockets of 4 mm or more and the number of teeth with periodontal pockets of 6 mm or more were used as outcome variables. Relative risks and 95% confidence intervals were estimated using Poisson regression models.Results: Serum IL‐6, but not TNF‐α associated with teeth with deepened periodontal pockets. Multivariate models showed that IL‐6, but not TNF‐α, could mediate the effect of body weight on periodontium.Conclusion: In this population of non‐diabetic and non‐rheumatic subjects, who had never smoked, serum IL‐6 was associated with periodontal infection. The results suggest that serum IL‐6 could be one mediating factor that connects body weight and periodontal infection.

Objective: The aim of the study was to investigate the association between serum lipids and periodontal infection and the role of serum lipids in the association between body weight and periodontal infection.Material and Methods: The Health 2000 Health Examination Survey, which included 8028 subjects aged 30 or older living in continental Finland. This study was based on a subpopulation of dentate, non‐diabetic subjects who had never smoked and were aged under 50 years (n=1297). Periodontal infection was defined as the presence of teeth with deepened periodontal pockets. Serum levels of triglycerides, high‐density lipoprotein (HDL)‐cholesterol and low‐density lipoprotein (LDL)‐cholesterol were analysed enzymatically.Results: We found no consistent association between serum lipid levels and periodontal infection among normoweight subjects. There was an association of high serum triglycerides and low HDL with periodontal infection among obese subjects. The association between body mass index and periodontal infection was not essentially affected by serum lipids.Conclusion: In this study population serum lipid levels were not associated with periodontal infection among normoweight subjects. Obese subjects with a high serum triglyceride level and/or a low HDL‐cholesterol level could be at higher risk of periodontal infection. Our results suggest that the association between body weight and periodontal infection was mainly mediated through a mechanism other than serum lipids.