Skip to main content
Log in

Risque parodontal chez le patient obèse

Periodontal risk in obese patients

  • Revue Scientifique / Scientific Review
  • Published:
Obésité

Résumé

De nombreuses données épidémiologiques montrent une association positive entre indice de masse corporelle et parodontites chroniques. Les parodontites sont des maladies inflammatoires multifactorielles d’origine bactérienne, dépendantes de la réponse immunitaire de l’hôte. Sans traitement, ces maladies entraînent la perte des dents par destruction du système d’attache gingivale et de l’os de soutien. La susceptibilité des patients obèses aux parodontites chroniques impliquerait l’action délétère directe des facteurs inflammatoires sécrétés par le tissu adipeux (adipokines), du stress oxydatif ou des mécanismes indirects liés aux pathologies associées à l’obésité (diabète de type 2, hypertension artérielle, dyslipidémies). Par ailleurs, les parodontites pourraient indirectement contribuer à l’obésité en induisant des troubles de la mastication dus à une augmentation globale de la mobilité et de la perte des dents. Ainsi, un examen parodontal et dentaire systématique des patients obèses devrait permettre un diagnostic et un traitement précoce améliorant la capacité de mastication et la santé orale de ces malades.

Abstract

Many epidemiological studies indicate a positive association between body mass index and chronic periodontitis. Periodontitis are multifactorial inflammatory diseases with a bacterial etiology, and are immune response dependent. Without treatment, these diseases lead to tooth loss through destruction of the gingival attachment system and the supporting bone. The chronic periodontitis susceptibility of the obese patients might involve the direct deleterious effect of inflammatory factors secreted by adipose tissue (adipokines), oxidative stress, or indirect mechanisms related to obesity-associated diseases (type 2 diabetes, hypertension, dyslipidemia). On the other hand, periodontitis may indirectly contribute to obesity by inducing chewing disorders due to an overall increase in teeth mobility and loss. Thus, a routine periodontal and dental examination of the obese patients should allow early diagnosis and treatment improving their chewing ability and oral health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Références

  1. Kopelman PG (2000) Obesity as a medical problem. Nature 404:635–43

    CAS  PubMed  Google Scholar 

  2. Veyrune JL, Miller CC, Czernichow S, et al (2008) Impact of morbid obesity on chewing ability. Obes Surg 18:1467–72

    Article  PubMed  Google Scholar 

  3. Modeer T, Blomberg CC, Wondimu B, et al (2010) Association Between Obesity, Flow Rate of Whole Saliva, and Dental Caries in Adolescents. Obesity (Silver Spring)

  4. Amar S, Zhou Q, Shaik-Dasthagirisaheb Y, et al (2007) Dietinduced obesity in mice causes changes in immune responses and bone loss manifested by bacterial challenge. Proc Natl Acad Sci USA 104:20466–71

    Article  CAS  PubMed  Google Scholar 

  5. Perlstein MI, Bissada NF (1977) Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol 43:707–19

    Article  CAS  PubMed  Google Scholar 

  6. Bouchard P, Boutouyrie P, Mattout C, et al (2006) Risk assessment for severe clinical attachment loss in an adult population. J Periodontol 77:479–89

    Article  CAS  PubMed  Google Scholar 

  7. Saito T, Shimazaki Y, Sakamoto M (1998) Obesity and periodontitis. N Engl J Med 339:482–83

    Article  CAS  PubMed  Google Scholar 

  8. Saito T, Shimazaki Y, Koga T, et al (2001) Relationship between upper body obesity and periodontitis. J Dent Res 80:1631–6

    Article  CAS  PubMed  Google Scholar 

  9. Al Zahrani MS, Bissada NF, Borawskit EA (2003) Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol 74:610–5

    Article  PubMed  Google Scholar 

  10. D’Aiuto F, Sabbah W, Netuveli G, et al (2008) Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey. J Clin Endocrinol Metab 93:3989–94

    Article  PubMed  Google Scholar 

  11. Reeves AF, Rees JM, Schiff M, et al (2006) Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med 160:894–99

    Article  PubMed  Google Scholar 

  12. Wood N, Johnson RB, Streckfus CF (2003) Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol 30:321–27

    Article  PubMed  Google Scholar 

  13. Khader YS, Bawadi HA, Haroun TF, et al (2009) The association between periodontal disease and obesity among adults in Jordan. J Clin Periodontol 36:18–24

    Article  PubMed  Google Scholar 

  14. Han DH, Lim SY, Sun BC, et al (2010) The association of metabolic syndrome with periodontal disease is confounded by age and smoking in a Korean population: the Shiwha-Banwol Environmental Health Study. J Clin Periodontol 37:609–16

    Article  PubMed  Google Scholar 

  15. Dalla Vecchia CF, Susin C, Rosing CK, et al (2005) Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 76:1721–8

    Article  PubMed  Google Scholar 

  16. Ekuni D, Yamamoto T, Koyama R, et al (2008) Relationship between body mass index and periodontitis in young Japanese adults. J Periodontal Res 43: 417–21

    Article  CAS  PubMed  Google Scholar 

  17. Linden G, Patterson C, Evans A, et al (2007) Obesity and periodontitis in 60–70-year-old men. J Clin Periodontol 34: 461–6

    Article  PubMed  Google Scholar 

  18. Kongstad J, Hvidtfeldt UA, Gronbaek M, et al (2009) The relationship between body mass index and periodontitis in the Copenhagen City Heart Study. J Periodontol 80:1246–53

    Article  PubMed  Google Scholar 

  19. Torrungruang K, Tamsailom S, Rojanasomsith K, et al (2005) Risk indicators of periodontal disease in older Thai adults. J Periodontol 76:558–65

    Article  PubMed  Google Scholar 

  20. Cancello R, Clément K (2006) Is obesity an inflammatory illness? Role of low-grade inflammation and macrophage infiltration in human white adipose tissue. BJOG 113:1141–7

    Article  CAS  PubMed  Google Scholar 

  21. Bozkurt FY, Yetkin AZ, Sutcu R, et al (2006) Gingival crevicular fluid leptin levels in periodontitis patients with long-term and heavy smoking. J Periodontol 77:634–40

    Article  CAS  PubMed  Google Scholar 

  22. Johnson RB, Serio FG (2001) Leptin within healthy and diseased human gingiva. J Periodontol 72:1254–57

    Article  CAS  PubMed  Google Scholar 

  23. Karthikeyan BV, Pradeep AR (2007) Gingival crevicular fluid and serum leptin: their relationship to periodontal health and disease. J Clin Periodontol 34:467–72

    Article  CAS  PubMed  Google Scholar 

  24. Shimada Y, Komatsu Y, Ikezawa-Suzuki I, et al (2010) The effect of periodontal treatment on serum leptin, interleukin-6, and C-reactive protein. J Periodontol

  25. Bullon P, Morillo JM, Ramirez-Tortosa MC, et al. (2009) Metabolic syndrome and periodontitis: is oxidative stress a common link? J Dent Res 88:503–18

    Article  CAS  PubMed  Google Scholar 

  26. Cock TA, Auwerx J (2003) Leptin: cutting the fat off the bone. Lancet 362:1572–4

    Article  CAS  PubMed  Google Scholar 

  27. Takeda S, Elefteriou F, Levasseur R, et al (2002) Leptin regulates bone formation via the sympathetic nervous system. Cell 111:305–17

    Article  CAS  PubMed  Google Scholar 

  28. Arita Y, Kihara S, Ouchi N, et al. (1999) Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 257: 79–83

    Article  CAS  PubMed  Google Scholar 

  29. Yamaguchi N, Kukita T, Li YJ, et al (2007) Adiponectin inhibits osteoclast formation stimulated by lipopolysaccharide from Actinobacillus actinomycetemcomitans. FEMS Immunol Med Microbiol 49:28–34

    Article  CAS  PubMed  Google Scholar 

  30. Yamaguchi N, Hamachi T, Kamio N, et al (2010) Expression levels of adiponectin receptors and periodontitis. J Periodontal Res 45:296–300

    Article  CAS  PubMed  Google Scholar 

  31. Furugen R, Hayashida H, Yamaguchi N, et al (2008) The relationship between periodontal condition and serum levels of resistin and adiponectin in elderly Japanese. J Periodontal Res 43:556–62

    Article  CAS  PubMed  Google Scholar 

  32. Saito T, Yamaguchi N, Shimazaki Y, et al (2008) Serum levels of resistin and adiponectin in women with periodontitis: the Hisayama study. J Dent Res 87:319–22

    Article  CAS  PubMed  Google Scholar 

  33. Steppan CM, Lazar MA (2002) Resistin and obesity-associated insulin resistance. Trends Endocrinol Metab 13:18–23

    Article  CAS  PubMed  Google Scholar 

  34. Yudkin JS, Kumari M, Humphries SE, et al (2000) Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 148:209–14

    Article  CAS  PubMed  Google Scholar 

  35. Dandona P, Weinstock R, Thusu K, et al (1998) Tumor necrosis factor-alpha in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab 83:2907–10

    Article  CAS  PubMed  Google Scholar 

  36. Gemmell E, Marshall RI, Seymour GJ (1997) Cytokines and prostaglandins in immune homeostasis and tissue destruction in periodontal disease. Periodontol 2000 14:112–43

    Article  CAS  PubMed  Google Scholar 

  37. Ritchie CS, Kinane DF (2003) Nutrition, inflammation, and periodontal disease. Nutrition 19:475–76

    Article  PubMed  Google Scholar 

  38. Linden GJ, McClean K, Young I, et al (2008) Persistently raised C-reactive protein levels are associated with advanced periodontal disease. J Clin Periodontol 35:741–7

    Article  CAS  PubMed  Google Scholar 

  39. Noack B, Genco RJ, Trevisan M, et al (2001) Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol 72:1221–7

    Article  CAS  PubMed  Google Scholar 

  40. Slade GD, Ghezzi EM, Heiss G, et al (2003) Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study. Arch Intern Med 163:1172–9

    Article  PubMed  Google Scholar 

  41. Glurich I, Grossi S, Albini B, et al (2002) Systemic inflammation in cardiovascular and periodontal disease: comparative study. Clin Diagn Lab Immunol 9:425–32

    PubMed  Google Scholar 

  42. Kinnby B, Lindberg P, Lecander I, et al (1999) Localization of plasminogen activators and plasminogen-activator inhibitors in human gingival tissues demonstrated by immunohistochemistry and in situ hybridization. Arch Oral Biol 44:1027–34

    Article  CAS  PubMed  Google Scholar 

  43. Xiao Y, Li H, Bunn C, et al (2001) The expression of plasminogen activator system in a rat model of periodontal wound healing. J Periodontol 72:849–57

    Article  CAS  PubMed  Google Scholar 

  44. Chapple IL, Milward MR, Dietrich T (2007) The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations. J Nutr 137:657–64

    CAS  PubMed  Google Scholar 

  45. Tomofuji T, Yamamoto T, Tamaki N, et al (2009) Effects of obesity on gingival oxidative stress in a rat model. J Periodontol 80:1324–9

    Article  CAS  PubMed  Google Scholar 

  46. Ohnishi T, Bandow K, Kakimoto K, et al (2009) Oxidative stress causes alveolar bone loss in metabolic syndrome model mice with type 2 diabetes. J Periodontal Res 44:43–51

    Article  CAS  PubMed  Google Scholar 

  47. Socransky SS, Haffajee AD (2005) Periodontal microbial ecology. Periodontol 2000 38:135–87

    Article  PubMed  Google Scholar 

  48. Goodson JM, Groppo D, Halem S, et al (2009) Is obesity an oral bacterial disease? J Dent Res 88:519–23

    Article  CAS  PubMed  Google Scholar 

  49. Ritchie CS, Kinane DF (2003) Nutrition, inflammation and periodontal disease. Nutrition 19:475–6

    Article  PubMed  Google Scholar 

  50. Palacios C, Joshipura KJ, Willettt WC (2009) Nutrition and health: guidelines for dental practioners. Oral Diseases 15:369–81

    Article  CAS  PubMed  Google Scholar 

  51. Range H, Huchon C, Ciangura C, et al (2008) Maladies parodontales et obésité. JPIO 27:295–303

    Google Scholar 

  52. Beck J, Garcia R, Heiss G, et al (1996) Periodontal disease and cardiovascular disease. J Periodontol 67:1123–37

    CAS  PubMed  Google Scholar 

  53. Mattout C (2008) Le diabète et les maladies parodontales: le rôle de l’inflammation. JPIO 27:273–80

    Google Scholar 

  54. Saito T, Shimazaki Y (2007) Metabolic disorders related to obesity and periodontal disease. Periodontol 2000 43:254–66

    Article  PubMed  Google Scholar 

  55. Merchant AT, Pitiphat W, Franz M, Joshipura KJ (2006) Whole-grain and fiber intakes and periodontitis risk in men. Am J Clin Nutr 83:1395–400

    CAS  PubMed  Google Scholar 

  56. Chapple IL, Milward MR, Dietrich T (2007) The prevalence of inflammatory periodontitis is negatively associated with serum antioxydant concentrations. J Nutr 137:657–64

    CAS  PubMed  Google Scholar 

  57. Dietrich T, Joshipura KJ, Dawson-Hughes B, Bischoff-Ferrari HA (2004) Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr 80:108–13

    CAS  PubMed  Google Scholar 

  58. Nishida M, Grossi SG, Dunford RG, et al (2000) Calcium and the risk for periodontal disease. J Periodontol 71:1057–66

    Article  CAS  PubMed  Google Scholar 

  59. Al-Zahrani MS (2006) Increased intake of dairy products is related to lower periodontitis prevalence. J Periodontol 77:289–94

    Article  PubMed  Google Scholar 

  60. Krall EA, Wehler C, Garcia RI, et al (2001) Calcium and vitamin D supplements reduce tooth loss in the ederly. Am J Med 111:452–6

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Bouchard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rangé, H., Huchon, C., Poitou, C. et al. Risque parodontal chez le patient obèse. Obes 5, 67–73 (2010). https://doi.org/10.1007/s11690-010-0238-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11690-010-0238-5

Mots clés

Keywords

Navigation