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  1. Vaithilingam RD, Safii SH, Baharuddin NA, Karen-Ng LP, Saub R, Ariffin F, et al.
    Oral Dis, 2015 Jan;21(1):e62-9.
    PMID: 24930489 DOI: 10.1111/odi.12267
    Periodontal bio-repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad-based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.
  2. Kerishnan JP, Mohammad S, Alias MS, Mu AK, Vaithilingam RD, Baharuddin NA, et al.
    PeerJ, 2016;4:e2327.
    PMID: 27635317 DOI: 10.7717/peerj.2327
    Periodontitis is one of the most common oral diseases associated with the host's immune response against periodontopathogenic infection. Failure to accurately diagnose the stage of periodontitis has limited the ability to predict disease status. Therefore, we aimed to look for reliable diagnostic markers for detection or differentiation of early stage periodontitis using the immunoprotemic approach.
  3. Md Tahir K, Ab Malek AH, Vaithilingam RD, Saub R, Safii SH, Rahman MT, et al.
    BMC Oral Health, 2020 02 14;20(1):52.
    PMID: 32059714 DOI: 10.1186/s12903-020-1039-3
    BACKGROUND: Non-surgical periodontal therapy (NSPT) known as gold standard treatment in managing periodontitis. The aim of this study was to investigate the response of NSPT in periodontitis subjects who were obese. Clinical parameters of periodontitis, changes in serum resistin and periodontal pathogens in subgingival plaque were compared before and after NSPT in periodontitis subjects who were obese and with normal weight.

    METHODS: A total of 48 periodontitis subjects (obese, n = 18; normal weight, n = 30) were recruited (hereafter will be referred as participants) to participate into a prospective, before and after clinical trial. Obesity status is defined by body mass index (BMI) criteria (obese: ≥30 kg/ m2; normal weight 

  4. Noor Azam AMI, Li NK, Zulkefli NN, Masdar MS, Majlan EH, Baharuddin NA, et al.
    Polymers (Basel), 2023 Jan 21;15(3).
    PMID: 36771861 DOI: 10.3390/polym15030560
    An investigation was conducted to determine the effects of operating parameters for various electrode types on hydrogen gas production through electrolysis, as well as to evaluate the efficiency of the polymer electrolyte membrane (PEM) electrolyzer. Deionized (DI) water was fed to a single-cell PEM electrolyzer with an active area of 36 cm2. Parameters such as power supply (50-500 mA/cm2), feed water flow rate (0.5-5 mL/min), water temperature (25-80 °C), and type of anode electrocatalyst (0.5 mg/cm2 PtC [60%], 1.5 mg/cm2 IrRuOx with 1.5 mg/cm2 PtB, 3.0 mg/cm2 IrRuOx, and 3.0 mg/cm2 PtB) were varied. The effects of these parameter changes were then analyzed in terms of the polarization curve, hydrogen flowrate, power consumption, voltaic efficiency, and energy efficiency. The best electrolysis performance was observed at a DI water feed flowrate of 2 mL/min and a cell temperature of 70 °C, using a membrane electrode assembly that has a 3.0 mg/cm2 IrRuOx catalyst at the anode side. This improved performance of the PEM electrolyzer is due to the reduction in activation as well as ohmic losses. Furthermore, the energy consumption was optimal when the current density was about 200 mA/cm2, with voltaic and energy efficiencies of 85% and 67.5%, respectively. This result indicates low electrical energy consumption, which can lower the operating cost and increase the performance of PEM electrolyzers. Therefore, the optimal operating parameters are crucial to ensure the ideal performance and durability of the PEM electrolyzer as well as lower its operating costs.
  5. Lew PH, Rahman MT, Safii SH, Baharuddin NA, Bartold PM, Sockalingam S, et al.
    BMC Oral Health, 2021 07 20;21(1):360.
    PMID: 34284769 DOI: 10.1186/s12903-021-01712-y
    BACKGROUND: Previous studies have reported conflicting findings between serum anti-citrullinated protein antibodies (ACPA) levels in rheumatoid arthritis (RA) participants with and without periodontitis (Pd). This study aimed to analyse possible correlations between serum ACPA levels and clinical parameters in Pd and RA participants.

    METHODS: Full mouth periodontal examination (probing pocket depth, clinical attachment levels, gingival bleeding index, visual plaque index) was conducted and serum samples obtained from 80 participants comprising RA, Pd, both RA and Pd (RAPd) and healthy individuals (HC). Erythrocyte sedimentation rates (ESR) and periodontal inflamed surface area (PISA) were obtained. Serum samples were analysed for ACPA quantification using enzyme-linked immunosorbent assay (ELISA).

    RESULTS: Median levels (IU/mL) of ACPA (interquartile range, IQR) in RAPd, RA, Pd and HC groups were 118.58(274.51), 102.02(252.89), 78.48(132.6) and 51.67(91.31) respectively. ACPA levels were significantly higher in RAPd and RA as compared to HC group (p  RA > Pd > HC. However, lack of any significant correlation between the serum ACPA levels with the clinical Pd and RA parameters warrants further studies to investigate the causal link between RA and Pd for such a trend. Further studies involving more inflammatory biomarkers might be useful to establish the causal link between Pd in the development and progression of RA or vice versa.

  6. Akram Z, Baharuddin NA, Vaithilingam RD, Rahim ZH, Chinna K, Krishna VG, et al.
    J Oral Sci, 2017 Mar 31;59(1):93-102.
    PMID: 28049964 DOI: 10.2334/josnusd.16-0127
    This study investigated changes in periodontal outcomes after nonsurgical periodontal treatment (NSPT) and evaluated associations of change in salivary resistin level with periodontal outcomes in obese Malaysians with chronic periodontitis. Sixty-two obese adults with chronic periodontitis were randomly divided into a test group (n = 31), which received NSPT, and a control group (n = 31), which received no treatment. Plaque score (PS), gingival bleeding index (GBI), probing pocket depth (PPD), and clinical attachment loss (CAL) were measured at baseline and at 6 and 12 weeks after NSPT. Salivary resistin levels were evaluated by using an enzyme-linked immunosorbent assay. PS was significantly lower in patients who received NSPT than in the control group at 6 and 12 weeks (P < 0.05). In the NSPT group the percentages of sites with shallow and moderate pockets decreased significantly, but there was no significant change in deep pockets. Resistin levels significantly decreased after NSPT (P < 0.05). Change in salivary resistin level was not significantly associated with periodontal outcomes. In obese Malaysians, NSPT significantly improved PS and GBI, and improved PPD and CAL for shallow and moderately deep pockets but not for deep pockets. Salivary resistin level was not associated with improvement in either periodontal variable.
  7. Akram Z, Rahim ZH, Taiyeb-Ali TB, Shahdan MS, Baharuddin NA, Vaithilingam RD, et al.
    Arch Oral Biol, 2017 Jan;73:311-320.
    PMID: 27567495 DOI: 10.1016/j.archoralbio.2016.08.016
    OBJECTIVES: To determine the serum and gingival crevicular fluid (GCF) levels of resistin between individuals with chronic periodontitis (CP) and those without CP, and to evaluate the role of resistin in CP.

    MATERIALS AND METHODS: The addressed focused question was "Is there a difference in the resistin levels between individuals with CP and those without CP?" four electronic databases: Medline, PubMed (National Institutes of Health, Bethesda), EMBASE, and Science direct databases from 1977 up to March 2016 for appropriate articles addressing the focused question. EMBASE and Medline were accessed using OVID interface which facilitated simultaneous search of text words, MeSH or Emtree. Unpublished studies (gray literature) were identified by searching the Open-GRAY database and references of the included studies (cross referencing) were performed to obtain new studies. In-vitro studies, animal studies, studies that reported levels of other cytokines but not resistin, letters to the editor and review papers were excluded.

    RESULTS: Ten studies were included. Nine studies compared resistin levels between CP and periodontally healthy (H) individuals and reported higher mean serum and GCF levels of resistin in CP patients than the H controls. Two studies showed comparable resistin levels from GCF and serum between diabetes mellitus with CP (DMCP) and CP groups. Three studies included obese subjects and showed comparable serum and GCF resistin levels between obese subjects with CP (OBCP) and CP subjects.

    CONCLUSIONS: CP patients were presented with elevated levels of GCF or serum resistin as compared with H individuals. Resistin modulates inflammation in chronic periodontal disease and may be used as surrogate measure to identify subjects at risk for periodontitis. Resistin levels in patients with CP and systemic inflammatory disorders such as diabetes, obesity, or rheumatoid arthritis was not significantly higher than the levels in patients with only CP.

  8. Zulkefli NN, Noor Azam AMI, Masdar MS, Baharuddin NA, Wan Isahak WNR, Mohd Sofian N
    Molecules, 2022 Dec 17;27(24).
    PMID: 36558155 DOI: 10.3390/molecules27249024
    This study reports on the synthesis of bi-metal compound (BMC) adsorbents based on commercial coconut activated carbon (CAC), surface-modified with metal acetate (ZnAc2), metal oxide (ZnO), and the basic compounds potassium hydroxide (KOH) and sodium hydroxide (NaOH). The adsorbents were then characterized by scanning electron microscopy and elemental analysis, microporosity analysis through Brunauer-Emmett-Teller (BET) analysis, and thermal stability via thermogravimetric analysis. Adsorption-desorption test was conducted to determine the adsorption capacity of H2S via 1 L adsorber and 1000 ppm H2S balanced 49.95% for N2 and CO2. Characterization results revealed that the impregnated solution homogeneously covered the adsorbent surface, morphology, and properties. The adsorption test result reveals that the ZnAc2/ZnO/CAC_B had a higher H2S breakthrough adsorption capacity and performed at larger than 90% capability compared with a single modified adsorbent (ZnAc2/CAC). Therefore, the synthesized BMC adsorbents have a high H2S loading, and the abundance and low cost of CAC may lead to favorable adsorbents in H2S captured.
  9. Vaithilingam RD, Safii SH, Baharuddin NA, Ng CC, Cheong SC, Bartold PM, et al.
    J Periodontal Res, 2014 Dec;49(6):683-95.
    PMID: 24528298 DOI: 10.1111/jre.12167
    Studies to elucidate the role of genetics as a risk factor for periodontal disease have gone through various phases. In the majority of cases, the initial 'hypothesis-dependent' candidate-gene polymorphism studies did not report valid genetic risk loci. Following a large-scale replication study, these initially positive results are believed to be caused by type 1 errors. However, susceptibility genes, such as CDKN2BAS (Cyclin Dependend KiNase 2B AntiSense RNA; alias ANRIL [ANtisense Rna In the Ink locus]), glycosyltransferase 6 domain containing 1 (GLT6D1) and cyclooxygenase 2 (COX2), have been reported as conclusive risk loci of periodontitis. The search for genetic risk factors accelerated with the advent of 'hypothesis-free' genome-wide association studies (GWAS). However, despite many different GWAS being performed for almost all human diseases, only three GWAS on periodontitis have been published - one reported genome-wide association of GLT6D1 with aggressive periodontitis (a severe phenotype of periodontitis), whereas the remaining two, which were performed on patients with chronic periodontitis, were not able to find significant associations. This review discusses the problems faced and the lessons learned from the search for genetic risk variants of periodontitis. Current and future strategies for identifying genetic variance in periodontitis, and the importance of planning a well-designed genetic study with large and sufficiently powered case-control samples of severe phenotypes, are also discussed.
  10. Khan S, Saub R, Vaithilingam RD, Safii SH, Vethakkan SR, Baharuddin NA
    BMC Oral Health, 2015;15:114.
    PMID: 26419358 DOI: 10.1186/s12903-015-0098-3
    Chronic periodontitis (CP) is a global public health issue. Studies have suggested CP could be linked to obesity due to their similar pathophysiological pathway. The aim of this study is to determine the prevalence of CP and to assess the predictors for CP among the obese Malaysian population.
    METHODS: This is a cross-sectional study on obese participants. Obesity is defined as an individual who has Body Mass Index (BMI) ≥ 27.5 kg/m(2). A convenience sampling method was used. A total of 165 paricipants were recruited. This study involved answering questionnaires, obtaining biometric and clinical measurements of Visible plaque index (VPI), Gingival bleeding index (GBI), Probing pocket depth (PPD) and Clinical attachment loss (CAL). Data analysis was carried out using SPSS statistical software (SPSS Inc., version 20, US).
    RESULTS: A total of 165 participants; 67 (40.6%) males and 98 (59.4%) females participated in the study. Mean age of the participants was 43.9 (± 8.9). The prevalence of CP among the obese population was found to be 73.9%. Out of this, 43 and 55% were categorised as moderate and severe CP respectively. Around 64% of participants had sites with CAL ≥ 4 mm and participants with sites with PPD ≥ 4 mm were reported to be 25%. Around 83% of the participants had sites with GBI ≥ 30 and 92% of participants had sites with VPI ≥ 20%. GBI and VPI were found to have significantly higher odds for CP.
    CONCLUSION: Prevalence of CP was high among obese Malaysians. GBI and VPI were potential predictors for CP in this obese population.
  11. Akram Z, Safii SH, Vaithilingam RD, Baharuddin NA, Javed F, Vohra F
    Clin Oral Investig, 2016 Jun;20(5):903-14.
    PMID: 27005812 DOI: 10.1007/s00784-016-1793-4
    OBJECTIVE: There is a controversy over the influence of obesity on the periodontal treatment outcome in patients with chronic periodontitis (CP). The aim of the present systematic review was to evaluate the efficacy of non-surgical periodontal therapy (NSPT) in the management of CP among obese and non-obese patients.
    MATERIALS AND METHODS: The addressed focused question was "What is the efficacy, of NSPT with respect to clinical, radiographic, biochemical, microbiological, and patient-centered outcomes in obese as compared to non-obese chronic periodontitis patients?" Databases were searched from 1977 up to and including December 2014 using relevant key indexing terms. Unpublished data, experimental studies, letters to the editor, review articles, case reports, and commentaries were excluded. Meta-analysis of three studies was performed.
    RESULTS: Five clinical studies were included. The total number of patients ranged between 30 and 260 individuals. The mean age of patients was between 42.5 and 48.8 years. In three studies, the clinical periodontal parameters (plaque index (PI), gingival bleeding index (GBI), periodontal pocket depth (PPD), and clinical attachment loss (CAL)) in obese and non-obese patients following NSPT was comparable. Meta-analysis of PPD and CAL among obese and non-obese subjects showed comparable outcomes (PPD P = 0.91, I (2) 67.36 %; CAL P = 0.87, I (2) 77.16 %). However, in three studies, NSPT resulted in a significantly better clinical periodontal outcome among non-obese subjects than obese subjects. The difference in the levels of serum pro-inflammatory cytokine levels (IL-1β, IL-6, TNF-α, IFN-γ, leptin, adiponectin, and CRP) among obese and non-obese patients following treatment for CP was inconsistent.
    CONCLUSION: It remains unclear whether NSPT has a significantly higher impact on the clinical periodontal outcomes in obese patients than in non-obese patients with chronic periodontitis, given that the number of selected studies was relatively low and the reported findings were inconsistent.
    CLINICAL RELEVANCE: Although the effect of obesity on the outcome of NSPT still remains unclear, nevertheless clinicians are prompted to manage obesity prior to and during periodontal treatment.
    KEYWORDS: Cytokines; Inflammatory markers; Obese; Overweight; Periodontal therapy; Periodontitis
  12. Lee YH, Lew PH, Cheah CW, Rahman MT, Baharuddin NA, Vaithilingam RD
    J Int Acad Periodontol, 2019 07 01;21(3):99-110.
    PMID: 31473702
    Periodontitis (PD), a chronic inflammatory disease which results in irreversible attachment loss, bone destruction and tooth loss, is a major oral health problem. Rheumatoid arthritis (RA), with a global prevalence of 1%, is an autoimmune disease characterized as a chronic inflammatory disorder leading to synovial inflammation and destruction of cartilage and bone. Studies have reported an association between PD and RA whereby PD is reportedly more severe in patients with established RA. Justification for the plausible link between both conditions is based on shared characteristics and pathogenic similarities with regard to risk factors, immunogenetics and tissue destruction pathways. The search for the possible mechanism linking PD to RA continues as it can play an important role in enabling early intervention in the form of prevention and treatment of infection. This will ultimately improve patients' oral health related quality of life and reduce societal burden related to increased patient discomfort and treatment costs. The current review provides an update on the cellular and molecular events that have thus far explained the link.
  13. Sulaiman L, Saub R, Baharuddin NA, Safii SH, Gopal Krishna V, Bartold PM, et al.
    Oral Health Prev Dent, 2019;17(4):365-373.
    PMID: 31093611 DOI: 10.3290/j.ohpd.a42502
    PURPOSE: To assess the impact of extent and severity of chronic periodontitis (CP) on oral health-related quality of life (OHRQoL).

    MATERIALS AND METHODS: A cross-sectional comparative study was performed on subjects from multiple dental centres in Malaysia using a questionnaire covering sociodemographics, OHRQoL using the Malaysian Oral Health Impact Profile questionnaire, OHIP-14(M) and self-reported symptoms. Participants with severe CP were age-and gender-matched with periodontally healthy/mild periodontitis (HMP) participants based on inclusion and exclusion criteria. Full mouth periodontal examination was performed on participants. Outcome measures were OHIP-14(M) prevalence of impact and severity of impact scores.

    RESULTS: One hundred and thirty (130) participants comprising 65 severe CP and 65 HMP participants were included in the study. Prevalence of impact on OHRQoL was significantly higher in the severe CP than HMP group, with an odds ratio of 3. Mean OHIP-14(M) score was significantly higher in the severe CP (18.26 ± 10.22) compared to HMP (11.28± 8.09) group. The dimensions of psychological discomfort and functional limitation, and factors such as 'discomfort due to food stuck' and 'felt shy' were impacted more in severe CP compared to HMP group (p < 0.05). When compared with the HMP group, generalised severe CP participants showed higher prevalence of impact on OHRQoL [OR=5] (p < 0.05) compared to localised severe CP [OR=2] (p = 0.05). Participants who had experienced self-reported symptoms had statistically significant impacts on OHRQoL.

    CONCLUSIONS: Severe CP had a greater impact on OHRQoL compared to HMP. Impacts were mainly for functional limitation and psychological discomfort dimensions. When considering extent of disease, the impact on OHRQoL was mostly in generalised severe CP subgroup.

  14. Abdul Hayei NA, Yahya NA, Safii SH, Saub R, Vaithilingam RD, Baharuddin NA
    BMC Oral Health, 2021 03 31;21(1):169.
    PMID: 33789646 DOI: 10.1186/s12903-021-01540-0
    BACKGROUND: The influence of scaler tip design on root surface roughness, tooth substance loss and patients' pain perception is investigated.

    METHODS: This article was divided into the following parts: Part 1 Surface roughness and substance loss: an in vitro study, which involves intact extracted teeth sectioned and treated using a piezoelectric ultrasonic device (PM200 EMS Piezon, Switzerland) with a conventional scaler tip (FS-407) and a Perio Slim (PS) scaler tip (Perio Slim DS-016A). All sectioned samples for tooth surface roughness (n = 20) and tooth substance loss (n = 46) analyses were measured and compared using a 3D surface texture analyser and scanning electron microscope (SEM) respectively, at baseline and following scaling. Part 2 Pain Perception: a clinical study, which was a split mouth study design including 30 participants with gingivitis and/or mild chronic periodontitis; treated with supra-gingival scaling from teeth #13 to #23. Subjects were randomised to group A or group B. Group A was treated first with PS scaler tips, whereas group B was treated first with conventional scaler tips. Pain perception was recorded using the visual analogue scale (VAS).

    RESULTS: In vitro study: both scaler tips caused significant reduction in root substance roughness after scaling (p  0.05) was observed. The PS scaler tip caused statistically significantly less root substance loss (p 

  15. Lee YH, Baharuddin NA, Chan SW, Rahman MT, Bartold PM, Sockalingam S, et al.
    Clin Oral Investig, 2021 Mar;25(3):1441-1450.
    PMID: 32656595 DOI: 10.1007/s00784-020-03452-9
    OBJECTIVES: It has been proposed that citrullination and carbamylation occur in the inflamed periodontium and could be the plausible mechanisms for the generation of antigens involved in the development and progression of RA. The purpose of this study was to determine the presence and location of citrullinated and carbamylated proteins in the gingival tissues and compare their abundance in periodontitis (PD) patients with or without RA.

    MATERIALS AND METHODS: Gingival tissue samples of healthy (n = 5), PD with RA (n = 5) and PD without RA (n = 5) were collected. Specimens were formalin fixed, paraffin embedded and sectioned at 4 μm. The tissue sections were analysed for the presence of citrullinated and carbamylated proteins by immunohistochemistry. Semi-quantitative analysis was performed to quantify and compare the protein abundance between groups.

    RESULTS: The number of cells containing citrullinated and carbamylated proteins with higher intensity was markedly increased in gingival tissues from PD with or without RA in comparison with healthy controls.

    CONCLUSION: Inflamed gingival tissue is a potential source of citrullinated and carbamylated proteins other than synovial tissues. The extent to which the local accumulation of these proteins contributes to the pathogenesis of RA needs further elucidation.

    CLINICAL RELEVANCE: If PD is a potential source of post-translationally modified proteins, untreated PD should not be taken lightly in the context of RA. Hence, addressing gingival inflammation should be viewed as an important preventive measure in the general population not only for the progression of periodontal disease but also reducing the risk of developing extra-oral comorbidities.

  16. Han PSH, Saub R, Baharuddin NA, Sockalingam S, Bartold PM, Vaithilingam RD
    BMC Oral Health, 2020 11 23;20(1):332.
    PMID: 33225923 DOI: 10.1186/s12903-020-01275-4
    BACKGROUND: This study aimed to assess the impact of periodontitis (PD) on the health related quality of life (HRQoL) and oral health related QoL (OHRQoL) of subjects with rheumatoid arthritis (RA) and PD.

    METHODS: Subjects from dental and RA clinics were screened. Complete periodontal examinations were performed. Subjects were divided into 4 groups: RA-PD, RA, PD and healthy controls (HC). Questionnaires on characteristics and Malaysian versions of Oral Health Impact Profile (OHIP-14(M)) and Health Assessment Questionnaire (HAQ-DI)) were answered.

    RESULTS: A total of 187 subjects were included (29 RA-PD, 58 RA, 43 PD and 57 HC). OHIP-14(M) severity score was highest in the PD group (17.23 ± 10.36) but only significantly higher than the HC group (p 

  17. Tengku H TNN, Peh WY, Shoaib LA, Baharuddin NA, Vaithilingam RD, Saub R
    Children (Basel), 2021 May 22;8(6).
    PMID: 34067484 DOI: 10.3390/children8060435
    This study aimed to investigate the association between oral disease burden and oral health related quality of life (OHRQoL) among overweight/obese (OW/OB) and normal weight (NW) Malaysian adolescents. A total of 397 adolescents were involved in the two-year prospective observational cohort study. OHRQOL was measured through a self-administered questionnaire containing the short version of the Malaysian Oral Health Impact Profile (OHIP[M]). Body mass index (BMI) was used for anthropometric measurement. Whilst, decayed, missing, and filled teeth (DMFT) index, Significant Caries Index (SiC), simplified basic periodontal examination (S-BPE), and gingival bleeding index (GBI) were used for clinical assessment tools. Higher dental caries prevalence was observed in the NW group while higher SiC was reported in the OW/OB group. Regardless of the obesity status, the prevalence of gingivitis (BPE code 1 and 2) was high in this study. A reduction of GBI prevalence was observed in the two-year follow-up results with an increased prevalence of OHRQoL impact in the OW/OB group compared to the NW group (p > 0.05). The findings from this study suggested that obesity status did not have influence over the burden of oral diseases and OHRQoL. It offers insights referring to the changes in adolescents' oral diseases burden and OHRQoL.
  18. Cheah CW, Al-Maleki AR, Vadivelu J, Danaee M, Sockalingam S, Baharuddin NA, et al.
    Int J Rheum Dis, 2020 Oct;23(10):1344-1352.
    PMID: 32743970 DOI: 10.1111/1756-185X.13919
    INTRODUCTION: Rheumatoid arthritis (RA) is associated with chronic periodontitis (CP) due to shared risk factors, immuno-genetics and tissue destruction pathways. Human cathelicidin LL-37 has been suggested as a possible mechanistic link for these diseases. This study investigated the levels of salivary and serum LL-37 in subjects with RA and CP and their correlation with disease parameters.

    METHOD: Subjects were allocated into RA (n = 49) or non-RA (NRA) (n = 55) groups, where 3 subgroups were further established; chronic periodontitis (CP), gingivitis (G) and periodontal health (H). Demographic and periodontal parameters were collected. Rheumatology data were obtained from hospital records. Serum and salivary LL-37 levels were measured using enzyme-linked immunosorbent assay and compared for all groups.

    RESULTS: For salivary LL-37, RA-CP was significantly higher than NRA-G and NRA-H (P = .047). For serum LL-37, all RA and NRA-CP were significantly higher than NRA-G and NRA-H (P = .024). Salivary LL-37 correlated negatively with clinical attachment loss (CAL) (P = .048), but positively with erythrocyte sedimentation rate (ESR) in RA-H (P = .045). Serum LL-37 showed positive correlation with ESR (P = .037) in RA-G, with C-reactive protein (P = .017) in RA-H, but negative correlation with number of teeth (P = .002) in NRA-CP. Rheumatology data correlated positively with periodontal parameters in RA-CP group.

    CONCLUSION: NRA-CP subjects with high serum LL-37 should receive comprehensive periodontal therapy. Positive correlation between rheumatology data and periodontal parameters showed that RA disease stability may be obtained by assessing the periodontal condition. Periodontal therapy is necessary to compliment RA treatment to achieve optimum outcome for RA patients with concurrent CP.

  19. Jagender Singh JK, Vaithilingam RD, Ng CC, Baharuddin NA, Hasnur Safii S, Rahman MT
    Malays J Pathol, 2021 Dec;43(3):425-434.
    PMID: 34958064
    INTRODUCTION: In line with the association of prostaglandin-endoperoxide synthase 2 (PTGS2) and defensin beta 1 (DEFB1) single nucleotide polymorphisms (SNPs) with periodontitis among the Chinese and European populations, the current study was aimed to assess the same association among the Malays in Malaysia.

    METHODS: Blood samples of individuals with periodontitis (PD) (n=72) and periodontally healthy (PH) (n=62) donors were obtained from Malaysian Periodontal Database and Biobanking system (MPDBS). Genomic DNA samples were analyzed for three PTGS2 SNPs (rs5275, rs20417, rs689466,) and one DEFB1 SNP (rs1047031) using Taqman SNP genotyping assays. Notably, rs20417 and rs689466 were located in the promoter region while rs5275 and rs1047031 were located in the 3' untranslated region of the transcript. Association between the SNPs and PD were then analyzed using genotypic association analysis (additive, dominant and recessive models).

    RESULTS: The allelic frequency for the rs689466-G was higher in PD group (35.2%) compared that in PH group (29.0%). However, the association of rs689466-G and other SNPs with PD was not statistically significant (at 95% CI). No associations were observed for genotypic associations between the PTGS2 and DEFB1 SNPs with PD susceptibility.

    CONCLUSIONS: PTGS2 (rs5275, rs20417, and rs689466) and DEFB1 (rs1047031) polymorphism was not associated with PD in Malays, unlike the Chinese, Taiwanese & European population. This suggests that other causal variants might be involved in the development and progression of PD among Malays.

  20. Basher SS, Saub R, Vaithilingam RD, Safii SH, Daher AM, Al-Bayaty FH, et al.
    Health Qual Life Outcomes, 2017 Nov 21;15(1):225.
    PMID: 29157276 DOI: 10.1186/s12955-017-0793-7
    BACKGROUND: Oral Health Related Quality of Life (OHRQoL) is an important measure of disease and intervention outcomes. Chronic periodontitis (CP) is an inflammatory condition that is associated with obesity and adversely affects OHRQoL. Obese patients with CP incur a double burden of disease. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis.

    MATERIALS AND METHODS: This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. A total of 66 obese patients with chronic periodontitis were randomly allocated into the treatment group (n=33) who received NSPT, while the control group (n=33) received no treatment. Four participants (2 from each group) were non-contactable 12 weeks post intervention. Therefore, their data were removed from the final analysis. The protocol involved questionnaires (characteristics and OHRQoL (Oral Health Impact Profile-14; OHIP-14)) and a clinical examination.

    RESULTS: The OHIP prevalence of impact (PI), overall mean OHIP severity score (SS) and mean OHIP Extent of Impact (EI) at baseline and at the 12-week follow up were almost similar between the two groups and statistically not significant at (p=0.618), (p=0.573), and (p=0.915), respectively. However, in a within-group comparison, OHIP PI, OHIP SS, and OHIP EI showed a significant improvement for both treatment and control groups and the p values were ((0.002), (0.008) for PI), ((0.006) and (0.004) for SS) and ((0.006) and (0.002) for EI) in-treatment and control groups, respectively.

    CONCLUSION: NSPT did not significantly affect the OHRQoL among those obese with CP. Regardless, NSPT, functional limitation and psychological discomfort domains had significantly improved.

    TRIAL REGISTRATION: ( NCT02508415 ). Retrospectively registered on 2nd of April 2015.

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