Exercise habituation is effective for improvement of periodontal disease status: a prospective intervention study

Figures & data

Table 1 Results of the questionnaire survey and medical interview pre- to postintervention

Variable	Preintervention	Postintervention	P-value
Exercise intervention group (n=50)
Number of brushings per day (times)*	2	2	0.807
Brushing time per day (minutes)*	6	6	0.206
Use of auxiliary instrument (floss interdental brush, etc.) (%)**	24	26	0.817
Regular visit to a dental office (%)**	20	20	1.000
Gingival bleeding during tooth brushing (%)**	28	24	0.648
Teeth stinging (%)**	24	36	0.190
The gingiva retracted and the tooth became longer (%)**	18	24	0.461
Dietary intervention group (n=21)
Number of brushings per day (times)*	2	2	0.180
Brushing time per day (minutes)*	6	7	0.937
Use of auxiliary instrument (floss interdental brush, etc.) (%)**	24	29	0.726
Regular visit to a dental office (%)**	24	24	1.000
Gingival bleeding during tooth brushing (%)**	29	33	0.739
Teeth stinging (%)**	24	33	0.495
The gingiva retracted and the tooth became longer (%)**	33	33	1.000

Notes:

* These data are the median. Wilcoxon signed-rank test was used for analysis.

** These data are the ratio of the number of people answering “Yes”. χ² test was used for analysis.

Table 2 Periodontal disease tests and bacterial quantities, amount of change from pre- to postintervention

Variable	Preintervention	Postintervention	Change	P-value
Exercise intervention group (n=50)
Number of remaining teeth	27.0±3.9	27.0±3.9	0	0.317
Number of teeth with PPD ≥4 mm (%)	14.4±12.9	5.6±8.5	−8.8	<0.001*
Number of BOP positive teeth (%)	39.8±18.0	14.4±7.7	−25.4	<0.001*
Porphyromonas gingivalis (×10^3 copy/5 µL saliva)	11,370.9±16,961.0	13,615.8±21,216.9	2,245.0	0.449
Tannerella forsythia (×10^3 copy/5 µL saliva)	1,416.4±2,000.9	747.8±958.6	−668.6	0.001*
Treponema denticola (×10^3 copy/5 µL saliva)	377.4±521.9	191.7±533.9	−185.7	0.001*
Dietary intervention group (n=21)
Number of remaining teeth	27.0±6.1	27.0±6.1	0	0.180
Number of teeth with PPD ≥4 mm (%)	12.5±18.7	9.1±27.0	−3.4	0.246
Number of BOP positive teeth (%)	39.6±17.5	48.7±28.6	9.1	0.092
P. gingivalis (×10^3 copy/5 µL saliva)	20,456.3±24,326.8	33,118.2±47,638.1	12,661.9	0.007*
T. forsythia (×10^3 copy/5 µL saliva)	4,933.8±5,614.6	6,107.8±1,829.8	1,174.0	0.357
T. denticola (×10^3 copy/5 µL saliva)	500.0±619.8	294.4±435.8	−205.6	0.023*

Notes: Values are presented as mean ± SD. Wilcoxon signed-rank test was used for analysis.

* P<0.05.

Abbreviations: BOP, bleeding on probing; PPD, probing pocket depth.

Table 3 Amount of change in body weight and blood test results from pre- to postintervention

Variable	Exercise intervention group (n=50)
	Pre	Post	Change	P-value
Body weight (kg)	83.5±13.6	84.0±13.6	0.5	0.018*
AST (U/L)	27.9±15.3	28.4±15.3	0.6	0.309
ALT (U/L)	40.7±34.1	37.6±31.4	−3.1	0.005*
γ-GT (U/L)	54.4±44.4	50.9±56.9	−3.5	0.004*
T-Cho (mg/dL)	205.6±32.6	204.4±36.5	−1.2	0.674
HDL-C (mg/dL)	50.0±11.1	52.0±11.6	2.0	0.014*
LDL-C (mg/dL)	130.0±28.1	127.7±30.3	−2.3	0.505
FFAs (mEq/L)	0.6±0.3	0.5±0.2	−0.2	<0.001*
Fasting blood glucose (mg/dL)	100.4±20.4	98.5±13.0	−1.9	0.836
Fasting insulin (µU/mL)	11.8±8.7	10.7±6.5	−1.1	0.248
HbA1c (%)	5.7±0.8	5.7±0.6	0.0	0.006*

Notes: Values are presented as mean ± SD. Wilcoxon signed-rank test was used for analysis.

* P<0.05.

Abbreviations: ALT, alanine transaminase; AST, aspartate transaminase alanine; FFAs, free fatty acids; γ-GT, gamma glutamyl transferase; HbA1c, hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 4 Amount of change in body weight and blood tests from pre- to postintervention

Variable	Dietary intervention group (n=21)
	Pre	Post	Change	P-value
Body weight (kg)	80.8±10.3	72.1±9.6	−8.6	<0.001*
AST (U/L)	26.8±10.1	20.0±5.7	−6.8	0.002*
ALT (U/L)	33.2±23.6	23.6±10.7	−9.6	0.026*
γ-GT (U/L)	41.6±18.8	24.0±9.9	−17.5	<0.001*
T-Cho (mg/dL)	212.7±39.0	185.3±40.4	−27.3	0.002*
HDL-C (mg/dL)	53.8±12.7	53.1±11.7	−0.6	0.497
LDL-C (mg/dL)	136.4±36.2	111.8±34.8	−24.6	0.002*
FFAs (mEq/L)	0.5±0.2	0.6±0.2	0.1	0.047*
Fasting blood glucose (mg/dL)	101.4±21.0	94.8±8.3	−6.6	0.102
Fasting insulin (µU/mL)	11.1±7.3	6.5±2.9	−4.6	0.002*
HbA1c (%)	5.7±0.5	5.3±0.2	−0.2	0.003*

Notes: Values are presented as mean ± SD. Wilcoxon signed-rank test was used for analysis.

* P<0.05.

Abbreviations: ALT, alanine transaminase; AST, aspartate transaminase alanine; FFAs, free fatty acids; γ-GT, gamma glutamyl transferase; HbA1c, hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Figure 1 Pearson’s product–moment correlation coefficient between the change in periodontal tests and the copy count of Treponema denticola. (A) Correlation between the change in the copy count of T. denticola and the median percentage of the number of teeth with PPD ≥4 mm (correlation coefficient r=0.417, significant difference P=0.003). (B) Correlation between the change in the copy count of T. denticola and the median percentage of teeth with BOP (correlation coefficient r=0.362, significant difference P=0.010).

Abbreviations: BOP, bleeding on probing; PPD, probing pocket depth.

Figure 2 Pearson’s product–moment correlation coefficient between the change in body weight and blood tests and the copy count of Treponema denticola. (A) Correlation between the change in the copy count of T. denticola and the change in body weight (correlation coefficient r=0.373, significant difference P=0.008). (B) Correlation between the change in the copy count of T. denticola and the change in LDL-C (correlation coefficient r=0.282, significant difference P=0.049). (C) Correlation between the change in the copy count of T. denticola and the change in fasting insulin (correlation coefficient r=0.293, significant difference P=0.041).

Abbreviation: LDL-C, low-density lipoprotein cholesterol.

Table 5 Correlation between change in the copy count of periodontal disease-causing bacteria and body weight, blood test results

Variable	Exercise intervention group (n=50)
	Porphyromonas gingivalis	Tannerella forsythia	Treponema denticola
Body weight (kg)	0.573	0.115	0.008*
AST (U/L)	0.768	0.840	0.488
ALT (U/L)	0.743	0.597	0.859
γ-GT (U/L)	0.999	0.761	0.485
T-Cho (mg/dL)	0.543	0.655	0.210
HDL-C (mg/dL)	0.644	0.372	0.556
LDL-C (mg/dL)	0.080	0.208	0.049*
FFAs (mEq/L)	0.397	0.102	0.952
Fasting blood glucose (mg/dL)	0.980	0.701	0.545
Fasting insulin (µU/mL)	0.532	0.355	0.041*
HbA1c (%)	0.960	0.201	0.111

Notes: All data are for the amount of change from pre- to postintervention. Pearson’s product–moment correlation coefficient was used for analysis.

* P<0.05.

Abbreviations: ALT, alanine transaminase; AST, aspartate transaminase alanine; FFAs, free fatty acids; γ-GT, gamma glutamyl transferase; HbA1c, hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 6 Correlation between change in the copy count of periodontal disease-causing bacteria and body weight, blood test results

Variable	Dietary intervention group (n=21)
	Porphyromonas gingivalis	Tannerella forsythia	Treponema denticola
Body weight (kg)	0.941	0.936	0.914
AST (U/L)	0.539	0.335	0.972
ALT (U/L)	0.199	0.200	0.578
γ-GT (U/L)	0.747	0.784	0.851
T-Cho (mg/dL)	0.729	0.460	0.724
HDL-C (mg/dL)	0.711	0.899	0.592
LDL-C (mg/dL)	0.903	0.421	0.446
FFAs (mEq/L)	0.078	0.807	0.807
Ferritin (µg/L)	0.236	0.233	0.493
Fasting blood glucose (mg/dL)	0.863	0.978	0.911
Fasting insulin (µU/mL)	0.521	0.996	0.266
HbA1c (%)	0.856	0.935	0.922

Notes: All data are for the amount of change from pre- to postintervention. Pearson’s product–moment correlation coefficient was used for analysis.

Abbreviations: ALT, alanine transaminase; AST, aspartate transaminase alanine; FFAs, free fatty acids; γ-GT, gamma glutamyl transferase; HbA1c, hemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.