The Association Between Periodontitis, Periodontopathogens and Health Screening

Objectives: This study aimed to evaluate the association between periodontitis and periodontopathogens involved in the onset and progression of the periodontitis with health screening indices reflecting the systemic health status, and the relationship between periodontal health status and health screening indices by using complex periodontal index combined with the presence of periodontitis and periodontopathogen distribution.
Methods: A total of 237 people were enrolled from Seoul National University Hospital Health Screening Program. Health risk factors and systemic health status including obesity, cardiovascular conditions, diabetes and insulin resistance, bone metabolism, inflammatory and oxidative stress, tumor markers, and medical history and health habits (i.e. smoking, alcohol intake, and physical activity) were collected. Periodontal health status, oral health behaviors were obtained. The quantitative analysis performed for periodontopathogens in subgingival biofilm/gingival crevicular fluid using real-time PCR. As inducing the complex periodontal indices combined with the periodontitis and the quantitative levels of pathogens, the association between three different indices were analyzed in the multivariate logistic/linear regression model.
Results: Of health screening indices, serum apolipoprotein B, alkaline phosphatase, homocysteine, a tumor marker cancer antigen-125 were positively associated with periodontitis, whereas another tumor marker carbohydrate antigen-19-9 and osteoporosis history were done negatively. These indices also had the association with periodontopathogens and complex periodontal status including P. gingivalis, T. denticola, T. forsythia, P. intermedia, and F. nucleatum.
In stratification analysis according to sex, as the sex affected the interaction between periodontal health status and systemic health status, the direction of associations were different depending on sex. Most health indices such as obesity and hyperlipidemia showed a positive association with periodontal health indices in women, which was stronger whereas the significance was weaker or disappeared in men.
Conclusions: The complex periodontal indices combined with the presence of periodontitis and the level of periodontopathogens could explain the association between periodontal health and systemic health problems.