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      Relationship between hypothyroidism and periodontitis: A scoping review

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          Abstract

          Aim

          The objective of this study was to assess the existing literature to determine if a relationship exists between hypothyroidism and periodontitis.

          Methods

          We used a modified approach to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses by searching five databases in addition to the gray literature. Keywords in the title and abstract fields, as well as subject headings for both periodontal disease and hypothyroidism, were used to search the existing literature for publications relevant to evaluation of the thyroid–periodontitis relationship.

          Results

          The authors screened 847 unique publications which, after applying inclusion and exclusion criteria, yielded 29 publications, which were further analyzed for relevance and applicability. Most of the included papers were cross‐sectional studies and retrospective chart reviews. Following critical analysis, four publications, including one abstract, were used to further assess the hypothyroid–periodontitis relationship.

          Conclusions

          There are very few high‐quality studies describing the potential association between hypothyroidism and periodontitis. In general, and among the included papers with the fewest confounding factors, a positive relationship between hypothyroidism and periodontitis was found. Further well‐controlled, prospective clinical and immunologic studies will be required to confirm that relationship.

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          Alemtuzumab vs. interferon beta-1a in early multiple sclerosis.

          Alasdair Coles, D. Alastair S. Compston, Krzysztof Selmaj … (2008)
          Alemtuzumab, a humanized monoclonal antibody that targets CD52 on lymphocytes and monocytes, may be an effective treatment for early multiple sclerosis. In this phase 2, randomized, blinded trial involving previously untreated, early, relapsing-remitting multiple sclerosis, we assigned 334 patients with scores of 3.0 or less on the Expanded Disability Status Scale and a disease duration of 3 years or less to receive either subcutaneous interferon beta-1a (at a dose of 44 microg) three times per week or annual intravenous cycles of alemtuzumab (at a dose of either 12 mg or 24 mg per day) for 36 months. In September 2005, alemtuzumab therapy was suspended after immune thrombocytopenic purpura developed in three patients, one of whom died. Treatment with interferon beta-1a continued throughout the study. Alemtuzumab significantly reduced the rate of sustained accumulation of disability, as compared with interferon beta-1a (9.0% vs. 26.2%; hazard ratio, 0.29; 95% confidence interval [CI], 0.16 to 0.54; P<0.001) and the annualized rate of relapse (0.10 vs. 0.36; hazard ratio, 0.26; 95% CI, 0.16 to 0.41; P<0.001). The mean disability score on a 10-point scale improved by 0.39 point in the alemtuzumab group and worsened by 0.38 point in the interferon beta-1a group (P<0.001). In the alemtuzumab group, the lesion burden (as seen on T(2)-weighted magnetic resonance imaging) was reduced, as compared with that in the interferon beta-1a group (P=0.005). From month 12 to month 36, brain volume (as seen on T(1)-weighted magnetic resonance imaging) increased in the alemtuzumab group but decreased in the interferon beta-1a group (P=0.02). Adverse events in the alemtuzumab group, as compared with the interferon beta-1a group, included autoimmunity (thyroid disorders [23% vs. 3%] and immune thrombocytopenic purpura [3% vs. 1%]) and infections (66% vs. 47%). There were no significant differences in outcomes between the 12-mg dose and the 24-mg dose of alemtuzumab. In patients with early, relapsing-remitting multiple sclerosis, alemtuzumab was more effective than interferon beta-1a but was associated with autoimmunity, most seriously manifesting as immune thrombocytopenic purpura. The study was not powered to identify uncommon adverse events. (ClinicalTrials.gov number, NCT00050778.) 2008 Massachusetts Medical Society
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            Hypothyroidism.

            Paul Ladenson, Caroline G P Roberts (2004)
            Hypothyroidism is common, potentially serious, often clinically overlooked, readily diagnosed by laboratory testing, and eminently treatable. The condition is particularly prevalent in older women, in whom autoimmune thyroiditis is common. Other important causes include congenital thyroid disorders, previous thyroid surgery and irradiation, drugs such as lithium carbonate and amiodarone, and pituitary and hypothalamic disorders. Worldwide, dietary iodine deficiency remains an important cause. Hypothyroidism can present with nonspecific constitutional and neuropsychiatric complaints, or with hypercholesterolaemia, hyponatraemia, hyperprolactinaemia, or hyperhomocysteinaemia. Severe untreated hypothyroidism can lead to heart failure, psychosis, and coma. Although these manifestations are neither specific nor sensitive, the diagnosis is confirmed or excluded by measurements of serum thyrotropin and free thyroxine. Thyroxine replacement therapy is highly effective and safe, but suboptimal dosing is common in clinical practice. Patient noncompliance, drug interactions, and pregnancy can lead to inadequate treatment. Iatrogenic thyrotoxicosis can cause symptoms, and, even when mild, provoke atrial fibrillation and osteoporosis. We summarise present understanding of the history, epidemiology, pathophysiology, and clinical diagnosis and management of hypothyroidism.
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              Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection.

              Arnošt Komárek, Marc Quirynen, Ghada Alsaadi … (2007)
              The aim of this retrospective study was to assess the influence of systemic and local bone and intra-oral factors on the occurrence of early implant failures, i.e. up to the abutment connection. The surgical records of 2004 consecutive patients from the total patient population who had been treated in the period 1982-2003 (with a total of 6946 Brånemark system implants) at the Department of Periodontology of the Catholic University Leuven were evaluated. For each patient the medical history was carefully checked. Data collection and analysis mainly focused on endogenous factors such as hypertension, coagulation problems, osteoporosis, hypo-hyperthyroidy, chemotherapy, diabetes type I or II, Crohn's disease, some local factors [e.g. bone quality and quantity, implant (length, diameter, location), type of edentulism, Periotest value at implant insertion, radiotherapy], smoking habits and breach of sterility during surgery. A global failure rate of 3.6% was recorded. Osteoporosis, Crohn's disease, smoking habits, implant (length, diameter and location) and vicinity with the natural dentition were all significantly associated with early implant failures (p<0.05). The indication for the use of oral implants should sometimes be reconsidered when alternative prosthetic treatments are available in the presence of possibly interfering systemic or local factors.
              Article 0 comments Cited 81 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Lisa M. Yerke:
                ORCID: https://orcid.org/0000-0001-5272-2580
                lmyerke@buffalo.edu
                Journal
                Journal ID (nlm-ta): Clin Exp Dent Res
                Journal ID (iso-abbrev): Clin Exp Dent Res
                Journal ID (doi): 10.1002/(ISSN)2057-4347
                Journal ID (publisher-id): CRE2
                Title: Clinical and Experimental Dental Research
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2057-4347
                Publication date (Electronic): 26 September 2019
                Publication date Collection: February 2020
                Volume: 6
                Issue: 1 ( doiID: 10.1002/cre2.v6.1 )
                Pages: 147-157
                Affiliations
                [ 1 ] Department of Periodontics and Endodontics University at Buffalo, State University of New York, School of Dental Medicine Buffalo New York
                [ 2 ]Present address: Department of Periodontics and Community Dentistry King Saud University, College of Dentistry Riyadh Saudi Arabia
                Author notes
                [*] [* ] Correspondence

                Lisa M. Yerke, Department of Periodontics and Endodontics, University at Buffalo, The State University of New York, School of Dental Medicine, 250 Squire Hall, Buffalo, NY 14214.

                Email: lmyerke@ 123456buffalo.edu

                Author information
                https://orcid.org/0000-0001-5272-2580
                Article
                Publisher ID: CRE2247 Other ID: CRE2.20190139.R1
                DOI: 10.1002/cre2.247
                PMC ID: 7025985
                PubMed ID: 32067402
                SO-VID: 69d167f7-3428-4f9f-b571-eb268d629e06
                Copyright © © 2019 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 June 2019
                Date revision received : 20 August 2019
                Date accepted : 25 August 2019
                Page count
                Figures: 1, Tables: 4, Pages: 11, Words: 8236
                Funding
                Funded by: Department of Periodontics and Endodontics, University at Buffalo, School of Dental Medicine, State University of New York
                Funded by: William M. Feagans Endowed Chair Research Fund (SUNYAB)
                Award ID: (none)
                Categories
                Subject: Review Article
                Subject: Review Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date February 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:17.02.2020

                Keywords: hypothyroidism,periodontitis,scoping review
                Data availability:
                Keywords: hypothyroidism, periodontitis, scoping review

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