Overview
This study is aiming at exploring the association between periodontitis and dry eye disease, which are both chronic inflammatory diseases that might have common pathogenic mechanisms. It is a cross-sectional study being conducted on four specific groups: a healthy group, periodontitis only, dry eye disease only, and a group with both periodontitis and dry eye disease. For all individuals, both clinical periodontal and ophthalmic parameters and assessments are being recorded. The study also includes collection of both saliva and tear samples from all individuals for later analysis of inflammatory biomarkers. Saliva samples will be collected using the drooling method, while tear samples will be collected using Schirmer strips. The levels of specific inflammatory biomarkers, including interleukin-6 (IL-6), matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs), will be investigated using ELISA. The study aims to investigate the association between periodontal and ocular surface inflammation as well as investigate the common inflammatory pathways for both periodontitis and dry eye disease. These investigations might contribute to a better understanding of the systemic correlation that links both periodontal and ocular health.
Description
Periodontitis and dry eye disease are both multifactorial chronic inflammatory diseases that can affect the quality of life and are significantly recognized for their systemic associations. Periodontitis is an inflammatory disease mainly induced by a dental biofilm and characterized by progressive destruction of the supporting structures surrounding the teeth, as well as being mediated by the host's immune response. Similarly, dry eye disease is the inflammation of the ocular surface characterized by tear film instability, hyperosmolarity, and ocular surface inflammation, resulting in discomfort and visual disturbance. Both diseases involve complex inflammatory pathways and the release of pro-inflammatory mediators that may contribute to tissue damage locally and might exert systemic effects as well.
Studies suggest that periodontal health may affect extra-oral conditions through shared inflammatory mechanisms, yet the relationship between periodontitis and dry eye disease remains unknown or not sufficiently investigated. However, inflammatory biomarkers such as interleukin-6 (IL-6), matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs) have been implicated in the pathogenesis of both diseases. These biomarkers play important roles in the host's immune regulation; as a result, they can be used for exploring the association between periodontitis and dry eye diseases.
This study is designed to investigate the association between periodontitis and dry eye disease through both performing clinical assessments and performing biochemical analysis. Both saliva and tear samples will be collected using non-invasive methods to avoid discomfort for the participants. Saliva will be collected using the drooling method, while tear samples will be collected using Schirmer strips. The collected samples will later be analyzed by the use of ELISA to evaluate the levels of the inflammatory biomarkers.
In addition to biomarker analysis, clinical evaluations will be performed to assess periodontal health and ocular surface condition using standardized diagnostic examinations. This integration can enhance the exploration of the association between the two diseases.
The significance of this study lies in its ability to investigate whether an association exists between periodontitis and dry eye disease. Identifying such an association could have important implications for interdisciplinary healthcare, making the collaboration between dental and ophthalmologic practitioners significant. Moreover, the investigations might participate in the development of novel diagnostic markers and management strategies targeting systemic inflammation. This research may also provide a foundation for future longitudinal and interventional studies exploring causal relationships and therapeutic outcomes.
Eligibility
Inclusion Criteria:
- 30 - 65 years of age.
- Diagnosed with periodontitis according to clinical attachment loss (CAL) ≥3 mm at two or more non-adjacent sites and/or probing pocket depth (PPD) ≥4 mm.
- Diagnosed with dry eye disease that meets 3 out of 4 of the following criteria: Ocular surface disease index score of more than 12, tear film break-up time of 10 s or less, Schirmer test results without anesthesia of less than 10 mm/5 min, and ocular surface staining with more than five corneal spots, more than nine conjunctival spots, or lid margin involvement greater than 2 mm in length and 25% in width. When both eyes fulfilled the criteria, the eye with the more severe disease was selected. If both eyes showed equal severity, one eye was randomly chosen.
- Possessing more than 20 natural teeth. -
Exclusion Criteria:
- Individuals with diabetes mellitus, uveitis, conjunctivitis, or active ocular allergy.
- Individuals receiving topical or systemic corticosteroid treatment or immunomodulatory therapy. Those with previous use of ocular medications other than artificial tears. Those who have undergone major ocular surgeries or have undergone ocular surgery in the previous 3 months; those who wear contact lenses; and individuals with proptosis or eyelid abnormalities, as well as individuals with a history of laser-assisted in situ keratomileusis (LASIK) surgery.
- Smokers.
- Received periodontal treatment and antibiotics within the past 3 months
- Individuals with autoimmune diseases.
- Individuals who are pregnant and/or lactating.
- Individuals whose occupations involve prolonged screen exposure. -
