Faculty of Dentistry, Department of Periodontology, Bezmialem Vakif University, Istanbul, Turkey.
Faculty of Dentistry, Department of Periodontology, Istanbul Galata University, Istanbul, Turkey.
Clin Oral Investig. 2023 Dec 30;28(1):67. doi: 10.1007/s00784-023-05445-w.
This study aimed to investigate the effect of periodontitis and current occlusal relationship on the progression rate of Alzheimer's disease (AD).
Ninety Alzheimer's patients, who were divided into three groups as Stage I (n=42), Stage II (n=29), and Stage III (n=19), based on the Clinical Dementia Rating Scale, were included in the study. Cognitive status of the patients was evaluated with Standardized Mini-Mental Test (SMMT) at baseline and repeated 6 months later. Clinical periodontal examinations were recorded and occlusal relationship status was classified according to the Eichner Index.
Of 90 Alzheimer's patients, 65 were toothed individuals with periodontitis and 25 were edentulous individuals without active periodontal disease. Stage II and Stage III toothed Alzheimer's patients had higher percentage of bleeding on probing (BOP%) and clinical attachment level (CAL) values than Stage I patients (p<0.05). Stage III Alzheimer's patients had significantly higher probing pocket depth (PPD) values than Stage I individuals (p<0.05). ΔSMMT values showed positive correlation with BOP% (r=0.308, p=0.013) and PPD (r=0.275, p=0.027). Among the evaluated parameters, being in the AD Stage II-Stage III, having periodontitis and age variable had significant effects on ΔSMMT levels (p<0.05).
Within the limits of our study, it can be concluded that periodontitis may increase the severity and also accelerate the progression rate of AD.
These results are precious to show the necessity of proper oral hygiene activities and regular dental visits in patients with toothed AD.
This study was registered and approved by clinical trials (NCT05807100).
本研究旨在探讨牙周炎和当前咬合关系对阿尔茨海默病（AD）进展速度的影响。
根据临床痴呆评定量表（CDR），将 90 例阿尔茨海默病患者分为 3 组：Ⅰ期（n=42）、Ⅱ期（n=29）和Ⅲ期（n=19）。在基线和 6 个月后，使用标准化简易智力测试（SMMT）评估患者的认知状态。记录临床牙周检查结果，并根据 Eichner 指数对咬合关系进行分类。
在 90 例阿尔茨海默病患者中，65 例为有牙周炎的有牙患者，25 例为无活动性牙周病的无牙患者。Ⅱ期和Ⅲ期有牙阿尔茨海默病患者的探诊出血百分比（BOP%）和临床附着丧失（CAL）值高于Ⅰ期患者（p<0.05）。Ⅲ期阿尔茨海默病患者的探诊深度（PPD）值明显高于Ⅰ期患者（p<0.05）。ΔSMMT 值与 BOP%（r=0.308，p=0.013）和 PPD（r=0.275，p=0.027）呈正相关。在评估的参数中，AD 分期Ⅱ-Ⅲ期、患有牙周炎和年龄变量对ΔSMMT 水平有显著影响（p<0.05）。
在本研究的范围内，可以得出结论，牙周炎可能会增加 AD 的严重程度，并加速其进展速度。
这些结果表明，有牙 AD 患者需要进行适当的口腔卫生活动和定期牙科检查，这一点非常重要。
本研究已在临床试验（NCT05807100）中注册和批准。
