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These effects contribute to the development of diseases such as diabetes mellitus, cardiovascular diseases, cold sores, lichen planus, and periodontitis [4-6].
Periodontitis is a chronic inflammatory disease that affects the supporting tissues of the teeth. In its development and progression, dysbiosis (imbalance in the microbiota) and the host’s immune-inflammatory response play fundamental roles [7].
JMIR Res Protoc 2024;13:e56765
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Periodontal diseases, commonly including gingivitis and periodontitis, arise in response to the accumulation of oral bacteria in the gingival sulcus and are characterized by tissue changes in the periodontium that occur as part of the inflammatory process [1].
JMIR Res Protoc 2024;13:e53222
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The impact on resource allocation can, in part, be addressed through the use of screening tools, such as risk prediction models, to identify those at high risk of severe periodontitis.
Identification of severe periodontitis risk factors has been achieved largely through cross-sectional investigations that have evaluated demographic features, risk behaviors, and oral characteristics [8-13].
JMIR Form Res 2023;7:e48351
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In particular, there is mounting evidence of a bidirectional relationship between type 2 diabetes mellitus (T2 DM) and periodontitis [3,4]. Individuals with T2 DM are more likely to develop severe periodontitis [5]. Conversely, individuals with periodontitis are at increased risk of developing T2 DM [6]. Considering that the number of people with undiagnosed T2 DM is expected to be rather high, identifying these patients should be a priority in health care systems [7].
J Med Internet Res 2023;25:e46381
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Inflammation limited to gingivae is known as gingivitis, whereas an extension of the inflammatory infiltrate can result in clinical attachment loss or periodontitis [2]. The progression to periodontitis depends on the host’s susceptibility and the host’s response to the dental biofilm [1].
JMIR Res Protoc 2021;10(7):e27471
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The role of nicotine in the development and maintenance of periodontitis is not clear [26,27]. Available literature suggests that nicotine affects gingival blood flow, cytokine production, and neutrophil and other immune cell function [28]. Although nicotine replacement therapy (NRT) is part of smoking cessation programs, it has not been reported as a major issue for periodontitis to date.
JMIR Res Protoc 2021;10(1):e15350
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