DOI:

10.37988/1811-153X_2023_2_52

Features of the course of chronic generalized periodontitis after a coronavirus infection

Authors

  • M.A. Amkhadova 1, PhD in Medical Sciences, full professor of the Surgical Dentistry and Implantology Department
    ORCID ID: 0000-0002-9105-0796
  • N.B. Petrukhina 2, PhD in Medical Sciences, full professor of the Clinical pharmacology and internal diseases propaedeutics Department
    ORCID ID: 0000-0002-1649-6448
  • I.V. Sandler 1, postgraduate at the the Surgical Dentistry and Implantology Department
    ORCID ID: 0000-0002-2326-7774
  • V.M. Polyakov 3, postgraduate at the Dentistry Department
    ORCID ID: 0000-0002-7477-3810
  • A.A. Demidova 3, PhD in Medical Sciences, associate professor and head of the Medical and biological physics Department
    ORCID ID: 0000-0003-3545-9359
  • M.V. Saltovets 4, PhD in Medical Sciences, associate professor of the Clinical, surgical, and maxillofacial surgery Department
    ORCID ID: 0000-0003-0673-2555
  • 1 Moscow Regional Research Clinical Institute (MONIKI), 129110, Moscow, Russia
  • 2 Sechenov University, 119991, Moscow, Russia
  • 3 Rostov State Medical University, 344022, Rostov-on-Don, Russia
  • 4 Pyatigorsk Medical and Pharmaceutical Institute, 357532, Pyatigorsk, Russia

Abstract

Systemic hyperinflammatory manifestations are a likely common pathogenetic link between COVID-19 and periodontal disease, mutually worsening the joint course of the two diseases. Aim — to study the direction of changes in periodontal status in patients with chronic generalized periodontitis (CGP) after a coronavirus infection and to establish the effect of COVID-19 drug therapy on the course of inflammatory periodontal diseases.
Materials and methods.
The study included 155 patients with CGP of moderate and severe severity after suffering COVID-19 and the duration of the post-COVID phase of 3—6 months (main group), as well as 89 patients with CGP without a history of coronavirus infection (control group). All 244 patients 6—12 months before the exacerbation of CGP within the framework of dental monitoring were examined by a dentist and questioned to fix the state of the periodontium.
Results.
An optimized questionnaire has been developed to collect information about the patient’s periodontal status and anamnestic features. In the main group, the progredient course was set at 41.3%, and in the control group at 18%. Among the patients of the main group with the progression of CGP, a systemic inflammatory reaction in the form of a cytokine storm was observed in 89.1%, and in patients with a stable course of CGP, a systemic increase in IL-6 occurred in 53.8%. In stable CGP, the use of antibiotic therapy was more frequent compared with patients in whom CGP progressed (84.6 vs. 40.6%, p<0.0001). The unfavorable course of CGP after a viral infection is associated with the use of glucocorticoids as immunosuppressants. The progression of periodontal inflammatory changes was the least common with the use of anticytokine therapy (3.5%) and was observed in 15.8% with the use of JAK-STAT inhibitors.
Conclusion.
The progredient course of CGP is associated with a new coronavirus infection and depends on the type of drug therapy for COVID-19.

Key words:

chronic generalized periodontitis, new coronavirus infection, cytokine storm, immunosuppressive therapy, antibiotic therapy

For Citation

[1]
Amkhadova M.A., Petrukhina N.B., Sandler I.V., Polyakov V.M., Demidova A.A., Saltovets M.V. Features of the course of chronic generalized periodontitis after a coronavirus infection. Clinical Dentistry (Russia).  2023; 26 (2): 52—56. DOI: 10.37988/1811-153X_2023_2_52

References

  1. Curtis M.A., Diaz P.I., Van Dyke T.E. The role of the microbiota in periodontal disease. Periodontol 2000. 2020; 83 (1): 14—25. PMID: 32385883
  2. Ramseier C.A., Anerud A., et al. Natural history of periodontitis: Disease progression and tooth loss over 40 years. J Clin Periodontol. 2017; 44 (12): 1182—1191. PMID: 28733997
  3. Acharya A.B., Thakur S., Muddapur M.V., Kulkarni R.D. Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus. Diabetes Metab Syndr. 2017; 11 (4): 277—278. PMID: 27989515
  4. Sahni V., Gupta S. COVID-19 & periodontitis: The cytokine connection. Med Hypotheses. 2020; 144: 109908. PMID: 32534336
  5. Elisetti N. Periodontal pocket and COVID-19: Could there be a possible link? Med Hypotheses. 2021; 146: 110355. PMID: 33183854
  6. Hu B., Huang S., Yin L. The cytokine storm and COVID-19. J Med Virol. 2021; 93 (1): 250—256. PMID: 32592501
  7. Descamps G., Verset L., Trelcat A., Hopkins C., Lechien J.R., Journe F., Saussez S. ACE2 protein landscape in the head and neck region: The conundrum of SARS-CoV-2 infection. Biology (Basel). 2020; 9 (8): 235. PMID: 32824830
  8. Xu H., Zhong L., Deng J., et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020; 12 (1): 8. PMID: 32094336
  9. Tay M.Z., Poh C.M., Rénia L., MacAry P.A., Ng L.F.P. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20 (6): 363—374. PMID: 32346093
  10. Coomes E.A., Haghbayan H. Interleukin-6 in Covid-19: A systematic review and meta-analysis. Rev Med Virol. 2020; 30 (6): 1—9. PMID: 32845568
  11. Otdelenov V.A., Tsvetov V.M., Sychev D.A. Possibility to use barycytinib in patients with COVID-19, including for treatment of “cytokine storm”. Good Clinical Practice. 2020; S4: 11—14. (In Russian). eLIBRARY ID: 44121038
  12. Larvin H., Wilmott S., Wu J., Kang J. The Impact of periodontal disease on hospital admission and mortality during COVID-19 pandemic. Front Med (Lausanne). 2020; 7: 604980. PMID: 33330570
  13. Nasonov E., Samsonov M. The role of Interleukin 6 inhibitors in therapy of severe COVID-19. Biomed Pharmacother. 2020; 131: 110698. PMID: 32920514
  14. Mazzoni A., Salvati L., et al. Impaired immune cell cytotoxicity in severe COVID-19 is IL-6 dependent. J Clin Invest. 2020; 130 (9): 4694—4703. PMID: 32463803
  15. Rudick C.P., Lang M.S., Miyamoto T. Understanding the pathophysiology behind chairside diagnostics and genetic testing for IL-1 and IL-6. Oral Dis. 2019; 25 (8): 1879—1885. PMID: 30614160
  16. RECOVERY Collaborative Group, Horby P., Lim W.S., et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021; 384 (8): 693—704. PMID: 32678530
  17. Murray R.D., Ekman B., et al. Management of glucocorticoid replacement in adrenal insufficiency shows notable heterogeneity data from the EU-AIR. Clin Endocrinol (Oxf). 2017; 86 (3): 340—346. PMID: 27801983
  18. Løvås K., Gjesdal C.G., Christensen M., Wolff A.B., Almås B., Svartberg J., Fougner K.J., Syversen U., Bollerslev J., Falch J.A., Hunt P.J., Chatterjee V.K., Husebye E.S. Glucocorticoid replacement therapy and pharmacogenetics in Addison›s disease: effects on bone. Eur J Endocrinol. 2009; 160 (6): 993—1002. PMID: 19282465
  19. Yukina M.Yu., Chernova M.O., Nuralieva N.F., Eremkina A.K., Troshina E.A., Melnichenko G.A., Mokrysheva N.G. Effect of glucocorticoids on bone metabolism in replacement therapy of adrenal insufficiency. Literature review. Obesity and Metabolism. 2020; 4: 357—368 (In Russian). eLIBRARY ID: 44805015

Received

February 27, 2023

Accepted

April 16, 2023

Published on

July 6, 2023