Constanza Jiménez

Introducción: Las enfermedades no transmisibles (ENT) son una carga importante en la mortalidad mundial. Se hipotetiza que la asociación entre la periodontitis y las ENT podría ser bidireccional. Objetivos: determinar la prevalencia de las enfermedades no transmisibles (ENTs) en individuos chilenos que padecen periodontitis, estratificándolos de acuerdo a la severidad de su condición periodontal. Métodos: Estudio cuantitativo, observacional, transversal. Se incluyeron pacientes inscritos en la Clínica de Periodoncia de la Universidad Andrés Bello. Se analizaron las fichas de los pacientes con una edad ≥18 años que contaban con historial clínico, registros médico-odontológicos y periodontogramas completos, entre marzo de 2017 hasta mayo de 2018. El diagnóstico periodontal se estableció siguiendo la clasificación de Page categorizada en leve o ausente, moderada y severa. Se documentó la existencia o ausencia de ENTs. Las ENTs se agruparon en: diabetes, afecciones cardiovasculares, complicaciones durante el embarazo, enfermedades respiratorias, problemas renales, artritis reumatoide, trastornos cognitivos, obesidad, cáncer, dislipidemias y psoriasis. Se calcularon las frecuencias absolutas, usando software estadístico Prism – GraphPad. Resultados: 152 individuos fueron incluidos, la mayoría del sexo femenino, con una edad promedio de 39.8 ± 14.8 años. Un 59.86% presentó periodontitis severa, un 21.71% periodontitis moderada y un 18% periodontitis leve/ausente. El 32.9% del total presentaron ENTs, de estas las más frecuentes fueron diabetes (11,84%), enfermedades cardiovasculares (9,87%) y obesidad (4,61%). La diabetes, enfermedad cardiovascular y obesidad se observó con mayor frecuencia en los pacientes que presentaban periodontitis en su forma leve. Conclusiones: En esta población de individuos con periodontitis, se registró una prevalencia del 32.9% de ENTs, siendo las enfermedades cardiovasculares y la diabetes los tipos más comunes. La periodontitis leves se asoció a mayor presencia de ENTs.

Objectives To assess the existing literature on the use of machine learning (ML) and deep learning (DL) models for diagnosing apical periodontitis (AP) in humans. Materials and methods A scoping review was conducted following the Arksey and O’Malley framework. The PubMed, SCOPUS, and Web of Science databases were searched, focusing on articles using ML/DL approaches for AP diagnosis. No restrictions were applied. Two independent reviewers screened publications and charted data in predefined Excel tables for analysis. Results Nineteen publications focused on diagnosing AP by identifying periapical radiolucent lesions (PRLs) in dental radiographs were included. The average sensitivity and specificity for reviewed models were 83% and 90%, respectively. Only three studies explored the direct impact of artificial intelligence (AI) assistance on clinicians’ diagnostic performance. Both consistently showed improved sensitivity without compromising specificity. Significant variability in dataset sizes, labeling techniques, and algorithm configurations was noticed. Conclusions Findings affirm AI models’ effectiveness and transformative potential in diagnosing AP by improving the accurate detection of periapical radiolucencies using dental radiographs. However, the lack of standardized reporting on crucial aspects of methodology and performance metrics prevents establishing a definitive diagnostic approach using AI. Further studies are needed to expand AI applications in AP diagnosis beyond radiographic analysis. Clinical relevance AI can potentially improve diagnostic accuracy in AP diagnosis by enhancing the sensitivity of PRL detection in dental radiographs without compromising specificity.

Introduction: Increasing evidence suggests an association between periodontitis and psoriasis. Both diseases share immunoinflammatory mechanisms and involve angiogenesis mediated by vascular endothelial growth factors (VEGF). Therefore, it is plausible that VEGF plays a role in connecting both diseases. Objetive: To systematically summarize current evidence regarding the biological plausibility of VEGF’s involvement in the association between periodontitis and psoriasis. Materials and Methods: A Scoping Review was conducted following established guidelines. Ad-hoc keywords and inclusion criteria were developed for a comprehensive literature search in PubMed. Only human studies published in the last 7 years were included, excluding non-English or non-Spanish publications. Two independent reviewers performed title and abstract screening, followed by full-text analysis and data extraction. Results: Twelve studies were included. Main focuses were the gingival crevicular fluid (GCF) levels of VEGF in patients with periodontitis (n=7), the blood serum levels of VEGF in patients with periodontitis (n=3), and the blood serum levels of VEGF in patients with psoriasis (n=3). No studies regarding the GCF levels of VEGF in patients with psoriasis were found. None of the included studies addressed individuals with concurrent periodontitis and psoriasis. Conclusions: Existing evidence shows elevated levels of VEGF in GCF and serum samples of patients with periodontitis. Increased levels of VEGF were also observed in serum samples of individuals with psoriasis. There is a knowledge gap regarding the GCF levels of VEGF among this group. The exact role of VEGF in the interplay between periodontitis and psoriasis remains to be explored.

Emerging epidemiological evidence links atopic dermatitis (AD) and periodontitis, although the mechanisms remain unclear. Th2-derived cytokines are key in the development of both diseases, and different gingival crevicular fluid (GCF) profiles among healthy and diseased subjects have been previously reported. This case–control study examined the GCF levels of interleukins (IL)-13, IL-31, and thymic stromal lymphopoietin (TSLP) in 29 subjects with moderate-to-severe AD and 33 controls. All subjects underwent comprehensive clinical and oral evaluations, followed by GCF collection. GCF levels of IL-13, IL-31, and TSLP were assessed using a multiplex-bead immunoassay. Demographic and periodontal parameters were similar among groups (p > 0.05). The GCF levels of IL-31 and TSLP were higher in AD subjects compared to controls (p < 0.05), whereas no significant differences in the GCF levels of IL-13 were noticed (p = 0.377). Moderate-to-severe AD was positively associated with the GCF levels of IL-31 and TSLP, whereas severe periodontitis was negatively associated with IL-31 (p < 0.05). The GCF levels of IL-13 showed no significant associations with either condition (p = 0.689). There was no significant interaction between AD and periodontitis for IL-31 (p < 0.869). These results suggest that AD and periodontitis independently influence the GCF levels of IL-31 in opposing ways, whereas AD alone influences the levels of TSLP.

Rosacea is a chronic inflammatory skin disease whose prevalence rates remain unknown in Chile. Laboratory benchmark testing for this disease is not useful, therefore, we aimed to evaluate the gingival crevicular fluid (GCF) levels of extracellular metalloproteinases (MMP)-2 and MMP-9 as novel rosacea biomarkers. We designed a cross-sectional study with a control group. Participants were systemically healthy adults (n = 20) and persons with rosacea (n = 18). We performed a periodontal evaluation and collected gingival crevicular fluid to measure MMP-2 and MMP-9 levels. Analysis showed mean and standard deviation of MMP-9 concentrations in the GCF for patients with rosacea was 764.52 ± 569.83 pg/mL; for healthy patients, it was 260.69 ± 170.43 pg/mL (p < 0.05). The diagnosis of rosacea was responsible for the levels of MMP-9 in the GCF (p < 0.05), as opposed to periodontitis, smoking, and age (p > 0.05). The Area under ROC for MMP-9 was 0.869 (95%, C.I: 0.719–0.956), with a sensitivity of 72.22% and specificity of 81.58% for the diagnosis of rosacea. We conclude that the quantification of MMP-9 in the GCF could be used as a biomarker of rosacea. Also, rosacea was responsible for increasing the levels of MMP-9 in the GCF independent of periodontal status.

Psoriasis is a prevalent worldwide chronic immuno-inflammatory skin disease with various variants and atypical cases. The use of biomarkers for the diagnosis of psoriasis can favor timely treatment and thus improve the quality of life of those affected. In general, the search for biomarkers in oral fluids is recommended as it is a non-invasive and fast technique. This narrative review aimed to identify biomarkers in gingival crevicular fluid (GCF) and saliva to diagnose psoriasis. To achieve this goal, we selected the available literature using the following MESH terms: “psoriasis”, “saliva” and “gingival crevicular fluid”. The studies analyzed for this review cover original research articles available in English. We found three full articles available for psoriasis biomarkers in GCF and ten articles available for psoriasis biomarkers in saliva. Studies showed that in the saliva of healthy individuals and those with psoriasis, there were differences in the levels of inflammatory cytokines, immunoglobulin A, and antioxidant biomarkers. In GCF, individuals with psoriasis showed higher levels of S100A8, IL-18 and sE-selectin in comparison to healthy individuals, independent of periodontal status. Despite these findings, more studies are required to determine an adequate panel of biomarkers to use in saliva or GCF for psoriasis.

Psoriasis is a chronic immunoinflammatory skin disease. Although its diagnosis is clinical, differences in the appearance and severity of lesions pose a challenge for clinicians worldwide. The use of accessible biomarkers for psoriasis could aid in the early diagnosis and treatment of the disease. To date, evidence on the analysis of gingival crevicular fluid (GCF) molecules as novel, accessible, and reliable biomarkers for psoriasis is limited. This cross-sectional study compared the GCF levels of IL-18, soluble (s)ICAM-1, and sE-selectin in psoriatic patients (n = 42) and healthy controls (n = 39). Individuals with psoriasis not undergoing treatment and healthy individuals were included independent of periodontal status. GCF samples were collected, and a multiplex bead immunoassay was performed to quantify the levels of the target molecules. Psoriatic patients presented higher concentrations of IL-18 and lower concentrations of sE-selectin compared to controls (p < 0.05). No differences were found in the levels of sICAM-1 between the two groups (p > 0.05). Psoriasis was associated with IL-18 and E-selectin levels regardless of periodontal status, age, and smoking habit (p < 0.05). The areas under the receiver operating characteristic curve (ROC) for IL-18 and sE-selectin were 0.77 and 0.68, respectively. In conclusion, IL-18 and sE-selectin levels in the GCF could be promising biomarker for psoriasis.