OXIDATIVE STRESS IN DENTAL CARIES AND PERIODONTAL DISEASE AMONG SECONDARY SCHOOL STUDENTS IN DUHOK, KURDISTAN REGION, IRAQ
Background: The main oral health concerns and markers of the oral health burden globally are dental caries and periodontal diseases. In the etiology and pathogenesis of various oral disorders, including dental caries and periodontal diseases, oxidative stress has been involved. The most commonly investigated markers of oxidative stress reactions include lipid peroxidation, protein oxidation, and antioxidant status.
Aim: The aim of the study was to evaluate the interrelation between markers of salivary oxidative stress on dental caries and periodontal disease among secondary school students in Duhok City.
Material and methods: Across a sectional study performed on a randomized sample of 809 high school students (395 females and 414 males) aged 14-20 years from eight secondary schools from 4 quarters of Duhok city from December 2018 to May 2019. Unstimulated saliva was collected for the analysis of total antioxidant capacity (TAC) and Malondialdehyde (MDA) followed by a clinical examination. Dental caries assessment was performed using the Decayed, Missing, and Filled/Teeth (DMFT) index and periodontal status were evaluated using the Gingival Index (GI) and the Plaque Index (PI). Subsequently were divided into high caries ≥ 5 and low caries group < 5 according to caries status; furthermore, they were subdivided according to the periodontal status into students with healthy/mild gingivitis and students with moderate/severe gingivitis.
Results: The study results showed that there was no significant difference between the mean TAC levels in terms of decay status and periodontal disease in females (p=0.057), males (p=0.110) and the whole sample (p=0.741). Concerning the MDA and the decayed status, the mean MDA level was higher in those with DMFT of ≥ 5 relative to those with DMFT <5 in the entire sample and male patients. While the difference between females was not significant between the two DMFT groups (p = 0.473). Significantly, higher MDA levels (p<0.01) were found in males with moderate to severe gingivitis compared with those with mild gingivitis. However, the difference among females was not significant (p = 0.890).
2. Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ & Marcenes W. Global burden of untreated caries: a systematic review and meta-regression. Journal of Dental Research.2015; 94, 650–658.
3. Pisoschi AM, Pop A. The role of antioxidants in the chemistry of oxidative stress: A review. Eur J Med Chem. 2015; 97:55-74.
4. Mahmoud HM, Al-Timimi DJ. Evaluation of DNA damage in type 1 diabetes patients. J ClinDiagn Res. 2019; 13(5): BC04-BC06.
5. Sies, H. Oxidative Stress: Eustress and Distress in Redox Homeostasis. In Stress: Physiology, Biochemistry, and Pathology; Fink, G., Ed.; Academic Press: Cambridge, MA, USA; Elsevier: Amsterdam, The Netherlands, 2019; pp. 153–163.
6. Ahmadi-Motamayel F, Goodarzi MT, Mahdavinezhad A, Jamshidi Z, Darvishi M. Salivary and Serum Antioxidant and Oxidative Stress Markers in Dental Caries. Caries Res. 2018; 52(6):565-569.
7. Ahmadi-Motamayel F, Goodarzi MT, Hendi SS, Kasraei S, Moghimbeigi A. Total antioxidant capacity of saliva and dental caries. Med Oral Patol Oral Cir Bucal. 2013 Jul 1; 18(4):e553-6.
8. Krawczyk D, Błaszczak J, Borowicz J, Mielnik-Błaszczak M. Life style and risk of development of dental caries in a population of adolescents. Ann Agric Environ Med. 2014; 21(3):576-80.
9. Rahmani M, Ghorchi V, Rezaei F, Vaisi-Raygani A. Evaluation of Total Antioxidant Capacity of Saliva in High School Students. Glob J Health Sci. 2015;8(4):89-94.
10. Banda NR, Singh G, Markam V. Evaluation of total antioxidant level of saliva in modulation of caries occurrence and progression in children. J Indian Soc Pedod Prev Dent. 2016 Jul-Sep;34(3):227-32. doi: 10.4103/0970-4388.186747. PMID: 27461805.
11. Jurczak A, Kościelniak D, Skalniak A, Papież M, Vyhouskaya P, Krzyściak W. The role of the saliva antioxidant barrier to reactive oxygen species with regard to caries development. Redox Rep. 2017; 22(6):524-533.
12. Zhang T, Andrukhov O, Haririan H, Müller-Kern M, Liu S, Liu Z, Rausch-Fan X. Total AntioxidantCapacity and Total Oxidant Status in Saliva of Periodontitis Patients in Relation to Bacterial Load. Front Cell Infect Microbiol. 2016;5:97.
13. Wang Y, Andrukhov O, Rausch-Fan X. Oxidative Stress and Antioxidant System in Periodontitis. Front Physiol. 2017; 8:910.
14. Ahmadi-Motamayel F, Goodarzi MT, Jamshidi Z, Kebriaei R. Evaluation of Salivary and Serum Antioxidant and Oxidative Stress Statuses in Patients with Chronic Periodontitis: A Case-Control Study. Front Physiol. 2017; 8:189.
15. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100):1211-1259.
16. Pari A, Ilango P, Subbareddy V, Katamreddy V, Parthasarthy H. Gingival diseases in childhood - a review. J Clin Diagn Res. 2014; 8(10):ZE01-4.
17. Stenberg WV. Periodontal problems in children and adolescents. In: Nowak, AJ, Christensen JR, Mabry TR, Townsend JA, Wells MH, eds. Pediatric Dentistry-Infancy through Adolescence, 6th ed. St. Louis, Mo.: Elsevier/ Saunders; 2017:371-8.
18. World Health Organization (WHO). Oral Health Surveys: Basic Methods. 6th ed. WHO; Geneva, Switzerland: 2013.
19. Silness J & Löe H. Periodontal Disease in Pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964; 22:1, 121-135.
20. Löe H &Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963; 21:533-551.
21. Navazesh M, Kumar SK; University of Southern California School of Dentistry. Measuring salivary flow: challenges and opportunities. J Am Dent Assoc. 2008;139 Suppl:35S-40S.
22. Cherian DA, Peter T, Narayanan A, Madhavan SS, Achammada S, Vynat GP. Malondialdehyde as a Marker of Oxidative Stress in Periodontitis Patients. J Pharm Bioallied Sci. 2019;11(Suppl 2):S297-S300. doi: 10.4103/JPBS.JPBS_17_19. PMID: 31198357
23. Zhang CZ, Cheng XQ, Li JY, Zhang P, Yi P, Xu X, Zhou XD. Saliva in the diagnosis of diseases. Int J Oral Sci. 2016 Sep 29;8 (3):133-7. doi: 10.1038/ijos.2016.38. PMID: 27585820; PMCID: PMC5113094.
24. Tóthová L, Kamodyová N, Červenka T, Celec P. Salivary markers of oxidative stress in oral diseases. Front Cell Infect Microbiol. 2015; 5:73.
25. Kumar S V, Kumar R H, Bagewadi N, Krishnan NA. A study to correlate dental caries experience with total antioxidant levels of saliva among adolescents in Mangalore. . Journal of Indian Association of Public Health Dentistry. 2015; 13 (2):p. 122.
26. Ahmadi-Motamayel F, Hendi SS, Goodarzi MT. Evaluation of Salivary Lipid Peroxidation End Product Level in Dental Caries. Infect Disord Drug Targets. 2020;20(1):65-68. doi: 10.2174/1871526519666181123182120. PMID: 30474541.
27. Pyati SA, Naveen Kumar R, Kumar V, Praveen Kumar NH, Parveen Reddy KM. Salivary Flow Rate, pH, Buffering Capacity, Total Protein, Oxidative Stress and Antioxidant Capacity in Children with and without Dental Caries. J Clin Pediatr Dent. 2018;42(6):445-449. doi: 10.17796/1053-4625-42.6.7. Epub 2018 Aug 7. PMID: 30085875.
28. Sánchez-Villamil JP, Pino-Vélez C, Trejos-Suárez J, Cardona N, España AL, Alfonso PA. Salivary markers of oxidative stress and periodontal pathogens in patients with periodontitis from Santander, Colombia. Biomedica. 2020; 40 (Suppl. 1):113-124.