OBJECTIVE: This review paper will explore the physiological functions of MT and Zn and hypothesise how dysregulation could negatively affect periodontal health, leading to PD.
FINDINGS: Bacterial lipopolysaccharide (LPS) derived from periodontal pathogens, namely P. gingivalis initiates the acute phase response, thus upregulating the expression of MT which leads to the subsequent deficiency of Zn, a hallmark of periodontal disease. This deficiency leads to ineffective NETosis, increases the permeability of the gingival epithelium, and disrupts the humoral immune response, collectively contributing to PD. In addition, the presence of LPS in Zn deficient conditions favours M1 macrophage polarisation and maturation of dendritic cells, and also inhibits the anti-inflammatory activity of regulatory T cells. Collectively, these observations could theoretically give rise to the chronic inflammation seen in PD.
CONCLUSION: A disrupted MT and Zn homeostasis is expected to exert an adverse impact on periodontal health and contribute to the development and progression of PD.
METHODS: National representative data from the 2009 Adult Dental Health Survey, United Kingdom, were used in this study. Periodontal disease severity was measured using periodontal pocket depth and categorized into three groups: pocket depth up to 3.5, 3.5-5.5 and more than 5.5 mm. OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14) scores. Bivariate and multivariable Zero-inflated Poisson regression analysis was used.
RESULTS: A total of 6378 participants was analysed in this study. Periodontal pocketing was significantly associated with higher OHIP-14 scores. Participants with periodontal pocket depths >3.5 mm had a significantly higher prevalence for functional limitation, physical pain and social disability than participants with pocket depths of less than 3.5 mm. Participants with periodontal pocket depth(s) >5.5 mm had significantly higher OFOVO prevalence in all the domains of OHIP-14 except handicap domain than participants with pocket depth(s) <3.5 mm.
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CONCLUSION: This study showed that for a nationally representative sample of the United Kingdom population, periodontal disease was significantly associated with the domains of OHRQoL.