Faculty Profiles - EKUNI Daisuke

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Relationship Between Prehypertension/Hypertension and Periodontal Disease: A Prospective Cohort Study International journal

Yuya Kawabata, Daisuke Ekuni, Hisataka Miyai, Kota Kataoka, Mayu Yamane, Shinsuke Mizutani, Koichiro Irie, Tetsuji Azuma, Takaaki Tomofuji, Yoshiaki Iwasaki, Manabu Morita

AMERICAN JOURNAL OF HYPERTENSION 29 ( 3 ) 388 - 396 2016.3

Language：English Publisher：OXFORD UNIV PRESS

BACKGROUND
Most cross-sectional studies have found a significant positive relationship between periodontal disease and prehypertension/hypertension. However, these studies had limitations and there are few prospective cohort studies in young adults. The purpose of this prospective cohort study was to investigate whether periodontal disease was related to prehypertension/hypertension in Japanese university students.
METHODS
Students (n = 2,588), who underwent health examinations before entering university and before graduation, were included in the analysis. The association between periodontal disease such as the percentage of bleeding on probing (BOP) and community periodontal index (CPI) scores, and change in blood pressure status was determined.
RESULTS
At the reexamination, the numbers of participants with prehypertension (systolic blood pressure 120-139 mm Hg or diastolic blood pressure 80-89 mm Hg) and hypertension (>= 140/90 mm Hg) were 882 (34.1%) and 109 (4.2%), respectively. In a logistic regression model, the risk of hypertension was significantly associated with male (odds ratio (OR): 6.31; 95% confidence interval (CI): 2.63-15.13; P < 0.001), no habitual physical activity at baseline (OR: 2.90; 95% CI: 1.56-5.38; P < 0.01) and periodontal disease defined as the presence of both probing pocket depth (PPD) >= 4 m and BOP >= 30% at baseline (OR: 2.74; 95% CI: 1.19-6.29; P = 0.02) in participants with prehypertension at baseline. On the other hand, the risk of prehypertension was not associated with presence of periodontal disease (OR: 0.93; 95% CI: 0.51-1.70; P = 0.82).
CONCLUSION
In the short-term prospective cohort study, a significant association between presence of periodontal disease and hypertension was observed in Japanese university students.

DOI： 10.1093/ajh/hpv117

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口腔ケアの感染症予防・治療への有効性上部消化癌患者と健常者における舌苔と口腔内アセトアルデヒド濃度との関連

山中玲子, 横井彩, 丸山貴之, 江國大輔, 森田学

日本化学療法学会雑誌 64 ( 2 ) 314 - 315 2016.3

口腔ケアの感染症予防・治療への有効性上部消化癌患者と健常者における舌苔と口腔内アセトアルデヒド濃度との関連

山中玲子, 横井彩, 丸山貴之, 江國大輔, 森田学

感染症学雑誌 90 ( 2 ) 168 - 169 2016.3

Type D personality and periodontal disease in university students: A prospective cohort study.

Mizutani S, Ekuni D, Yamane-Takeuchi M, Azuma T, Taniguchi-Tabata A, Tomofuji T, Iwasaki Y, Morita M

J Health Psychol 1 - 9 2016

造血幹細胞移植後に起こる口腔粘膜上細菌叢の変化-PCR-DGGE法を用いた解析

室美里, 室美里, 曽我賢彦, 片岡広太, 江國大輔, 飯田征二, 森田学

日本造血細胞移植学会総会プログラム・抄録集 38th 2016

大学生における自覚的口腔健康観と口腔内の臨床所見・口腔保健行動との関連

山根真由, 江國大輔, 友藤孝明, 森田学

日本公衆衛生学会総会抄録集 74回 442 - 442 2015.10

MicroRNAs in Salivary Exosome as Potential Biomarkers of Aging International journal

Tatsuya Machida, Takaaki Tomofuji, Daisuke Ekuni, Takayuki Maruyama, Toshiki Yoneda, Yuya Kawabata, Hirofumi Mizuno, Hisataka Miyai, Muneyoshi Kunitomo, Manabu Morita

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES 16 ( 9 ) 21294 - 21309 2015.9

Language：English Publisher：MDPI AG

The aim of this study was to examine whether salivary exosomal miRNAs could be identified as aging biomarkers. Fifteen young healthy volunteers (median age, 21.0 years) and 13 old individuals (median age, 66.0 years) were recruited. Unstimulated whole saliva was collected, salivary exosomes were isolated, and total RNA was extracted. In a microarray, 242 miRNAs were commonly detected in these two mixed samples. Based on the cut-off values of 2- or 0.5-fold changes (FC) and regulatory power for aging process, six candidate miRNAs (miR-24-3p, miR-371a-5p, miR-3175, miR-3162-5p, miR-671-5p, and miR-4667-5p) were selected. After comparing each total RNA obtained by the 15 young and 13 old individuals to validate the FC values using quantitative real-time PCR, miR-24-3p was identified as a novel candidate aging biomarker. This pilot study suggested that salivary exosomal miRNAs could be identified as candidate aging biomarkers. To confirm whether miR-24-3p in salivary exosomes are suitable biomarkers of aging, further validation research is required.

DOI： 10.3390/ijms160921294

Gingival condition and tooth-brushing behavior after alcohol consumption

S. Mizutani, D. Ekuni, T. Tomofuji, M. Yamane, T. Azuma, Y. Iwasaki, M. Morita

JOURNAL OF PERIODONTAL RESEARCH 50 ( 4 ) 494 - 499 2015.8

Language：English Publisher：WILEY-BLACKWELL

Background and ObjectiveVarious studies have reported the relationship between alcohol consumption and gingival condition. However, they focus on the direct effects of alcohol consumption or alcohol sensitivity on gingival condition, and it is unclear how oral health behaviors relate these relationships. The aims of this study were to assess the inter-relationships between gingival condition, tooth-brushing behavior after drinking alcohol and alcohol sensitivity in university students who drink more than once per week on average.
Material and MethodsA total of 808 students (541 males, 267 females) that habitually consume alcohol were analyzed. The disease activity of gingival condition was assessed as the percentage of bleeding on probing (%BOP). Additional information regarding alcohol sensitivity and oral health behaviors, including tooth-brushing behavior after drinking, were also collected.
ResultsThirteen percent of the current participants reported neglecting tooth-brushing after drinking, and their alcohol consumption was higher than those who did not neglect tooth-brushing. Logistic regression analysis showed that high %BOP (%BOP 20) was associated with male (OR=1.53; 95% CI, 1.01-2.33), neglect of tooth-brushing after drinking (OR=2.60; 95% CI, 1.20-5.61) and debris index (OR=8.38; 95% CI, 4.24-16.60) in participants with low alcohol sensitivity. In participants with high alcohol sensitivity, high %BOP was associated with debris index (OR=7.60; 95% CI, 3.12-18.51), but not with any oral health behaviors.
ConclusionsThe study revealed that alcohol consumption was indirectly related to gingival disease activity through the neglect of tooth-brushing after drinking alcohol in university students with low alcohol sensitivity.

DOI： 10.1111/jre.12233

Relationship between Acute Phase of Chronic Periodontitis and Meteorological Factors in the Maintenance Phase of Periodontal Treatment: A Pilot Study International journal

Noriko Takeuchi, Daisuke Ekuni, Takaaki Tomofuji, Manabu Morita

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 12 ( 8 ) 9119 - 9130 2015.8

Language：English Publisher：MDPI AG

The acute phase of chronic periodontitis may occur even in patients during supportive periodontal therapy. However, the details are not fully understood. Since the natural environment, including meteorology affects human health, we hypothesized that weather conditions may affect occurrence of acute phase of chronic periodontitis. The aim of this study was to investigate the relationship between weather conditions and acute phase of chronic periodontitis in patients under supportive periodontal therapy. Patients who were diagnosed with acute phase of chronic periodontitis under supportive periodontal therapy during 2011-2013 were selected for this study. We performed oral examinations and collected questionnaires and meteorological data. Of 369 patients who experienced acute phase of chronic periodontitis, 153 had acute phase of chronic periodontitis without direct-triggered episodes. When using the autoregressive integrated moving average model of time-series analysis, the independent covariant of maximum hourly range of barometric pressure, maximum hourly range of temperature, and maximum daily wind speed were significantly associated with occurrence of acute phase of chronic periodontitis (p < 0.05), and 3.1% of the variations in these occurrence over the study period were explained by these factors. Meteorological variables may predict occurrence of acute phase of chronic periodontitis.

DOI： 10.3390/ijerph120809119

Impact of Oral Commensal Bacteria on Degradation of Periodontal Connective Tissue in Mice International journal

Koichiro Irie, Takaaki Tomofuji, Daisuke Ekuni, Manabu Morita, Yoshihiro Shimazaki, Richard P. Darveau

JOURNAL OF PERIODONTOLOGY 86 ( 7 ) 899 - 905 2015.7

Language：English Publisher：AMER ACAD PERIODONTOLOGY

Background: Innate and adaptive immunosurveillance mechanisms in response to the normal commensal bacteria can affect periodontal innate defense status. However, it is still unclear how commensal bacteria contribute to the inflammatory responses of junctional epithelium (JE) and periodontal connective tissue (PCT). The aim of the present study is to investigate the contribution of commensal bacteria on inflammatory responses in JE and PCT in mice.
Methods: The periodontal tissue of germ-free (GF) and specific-pathogen-free (SPF) mice were compared at age 11 to 12 weeks (n = 6 per group). In this study, the number of neutrophils and expression of intercellular adhesion molecule (ICAM)-1, fibroblast growth factor receptor (FGFR)-1, matrix metalloproteinase (MMP)-1, and MMP-8 within the JE and the PCT are evaluated. The collagen density was also determined in PCT stained with picrosirius red (PSR). PSR staining combined with or without polarized light microscopy has been used to assess the organization and maturation of collagen matrix.
Results: In the present findings, the area of JE in SPF mice was significantly greater than that in GF mice (P <0.05). In addition, the JE and PCT in SPF mice showed greater migration of neutrophils and higher expression of ICAM-1, FGFR-1, MMP-1, and MMP-8 than those in GF mice (P <0.05). Furthermore, the density of collagen in PCT in SPF mice was lower compared to GF mice (P <0.05).
Conclusion: These results indicate that commensal bacteria induced a low-grade inflammatory state in JE and that such conditions may contribute to degradation of collagen in PCT in mice.

DOI： 10.1902/jop.2015.150006

Structural equation modeling to assess gender differences in the relationship between psychological symptoms and dental visits after dental check-ups for university students International journal

Shinsuke Mizutani, Daisuke Ekuni, Takaaki Tomofuji, Koichiro Irie, Tetsuji Azuma, Yoshiaki Iwasaki, Manabu Morita

ACTA ODONTOLOGICA SCANDINAVICA 73 ( 5 ) 368 - 374 2015.7

Language：English Publisher：INFORMA HEALTHCARE

Objective. Some studies have shown a relationship between psychological symptoms and oral health behaviors. However, it is unknown whether gender differences affect the relationship between psychological symptoms and oral health behaviors. In addition, gender differences in the relationship between dental anxiety and dental visits for treatment or regular check-up are unclear. The objective of the present study was to explain the relationships among gender differences, psychological symptoms, oral health behaviors, dental anxiety and 'expectation of dental visit', evaluated as 'dental visits when treatments are recommended' in university students. Materials and methods. A total of 607 students (311 males, 296 females) aged 18-38 years old were examined. The information was collected via questionnaire regarding gender, psychological symptoms and oral health behaviors. Psychological symptoms were assessed using the Hopkins Symptom Checklist. Structural equation modeling was used to test pathways from these factors to 'expectation of dental visit'. Multiple-group modeling was also conducted to test for gender differences. Results. Psychological symptoms were related to low expectation of dental visit in females, but there was no such relationship in males. Oral health behaviors were related to expectation of dental visit in both genders. Conclusions. Psychological symptoms were directly related to expectation of dental visit in females and oral health behaviors were related to expectation of dental visit in both genders. To promote dental visits after dental check-ups at school, it might be necessary to improve oral health behaviors in both genders and to evaluate psychological symptoms, especially in females.

DOI： 10.3109/00016357.2014.968870

Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study

Kota Kataoka, Daisuke Ekuni, Shinsuke Mizutani, Takaaki Tomofuji, Tetsuji Azuma, Mayu Yamane, Yuya Kawabata, Yoshiaki Iwasaki, Manabu Morita

JOURNAL OF EPIDEMIOLOGY 25 ( 6 ) 423 - 430 2015.6

Language：English Publisher：JAPAN EPIDEMIOLOGICAL ASSOC

Objectives: Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students.
Methods: Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire.
Results: The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22-3.93) and underweight (BMI < 18.5 kg/m(2)) (OR 1.89; 95% CI, 1.31-2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males.
Conclusions: Awareness of clenching and underweight were related to malocclusion (crowding) in university male students.

DOI： 10.2188/jea.JE20140180

多職種連携の中で専門的口腔衛生管理を行い、経口摂取を継続しながら化学放射線治療が完遂できた一症例

志茂加代子, 丸山貴之, 横井彩, 山中玲子, 三浦留美, 江國大輔, 森田学

口腔衛生学会雑誌 65 ( 2 ) 187 - 187 2015.4

天然植物由来成分配合歯磨剤のラット歯周炎に対する影響

友藤孝明, 江國大輔, 東哲司, 米田俊樹, 片岡広太, 川端勇也, 山根真由, 森田学

日本歯周病学会会誌 57 ( 春季特別 ) 126 - 126 2015.4

2型糖尿病患者における非外科的歯周病治療の効果の検討

水野裕文, 江國大輔, 米田俊樹, 片岡広太, 川端勇也, 水谷慎介, 友藤孝明, 森田学

口腔衛生学会雑誌 65 ( 2 ) 186 - 186 2015.4

大学生における第二大臼歯の埋伏が第一大臼歯の歯周状態に与える影響

宮井久敬, 江國大輔, 水谷慎介, 東哲司, 片岡広太, 山根真由, 水野裕文, 國友宗義, 谷口綾乃, 大森智栄, 森田学

口腔衛生学会雑誌 65 ( 2 ) 180 - 180 2015.4

還元型コエンザイムQ10の抜歯窩創傷治癒への効果の検討

米田俊樹, 友藤孝明, 川端勇也, 江國大輔, 東哲司, 片岡広太, 國友宗義, 森田学

口腔衛生学会雑誌 65 ( 3 ) 312 - 312 2015.4

Relationship between xerostomia and gingival condition in young adults

S. Mizutani, D. Ekuni, T. Tomofuji, T. Azuma, K. Kataoka, M. Yamane, Y. Iwasaki, M. Morita

JOURNAL OF PERIODONTAL RESEARCH 50 ( 1 ) 74 - 79 2015.2

Language：English Publisher：WILEY-BLACKWELL

Background and ObjectiveXerostomia is a subjective symptom of dryness in the mouth. Although a correlation between xerostomia and oral conditions in the elderly has been reported, there are few such studies in the young adults. The aim of this study was to examine the relationship of xerostomia with the gingival condition in university students.
Material and MethodsA total of 2077 students (1202 male subjects and 875 female subjects), 18-24years of age, were examined. The disease activity and severity of the gingival condition were assessed as the percentage of teeth with bleeding on probing (%BOP) and the presence of teeth with probing pocket depth of 4mm, respectively. Additional information on xerostomia, oral health behaviors, coffee/tea intake and nasal congestion was collected via a questionnaire. Path analysis was used to test pathways from xerostomia to the gingival condition.
ResultsOne-hundred and eighty-three (8.8%) students responded that their mouths frequently or always felt dry. Xerostomia was related to %BOP and dental plaque formation, but was not related to the presence of probing pocket depth 4mm. In the structural model, xerostomia was related to dental plaque formation (p<0.01), and a lower level of dental plaque formation was associated with a lower %BOP. Xerostomia was associated with coffee/tea intake (p<0.01) and nasal congestion (p<0.001).
ConclusionXerostomia was indirectly related to gingival disease activity through the accumulation of dental plaque. Nasal congestion and coffee/tea intake also affected xerostomia. These findings suggest that xerostomia should be considered in screening for gingivitis risk in young adults.

DOI： 10.1111/jre.12183

Relationship between acetaldehyde concentration in mouth air and tongue coating volume International journal

Aya Yokoi, Takayuki Maruyama, Reiko Yamanaka, Daisuke Ekuni, Takaaki Tomofuji, Haruhiko Kashiwazaki, Yutaka Yamazaki, Manabu Morita

JOURNAL OF APPLIED ORAL SCIENCE 23 ( 1 ) 64 - 70 2015.1

Language：English Publisher：UNIV SAO PAULO FAC ODONTOLOGIA BAURU

Objective: Acetaldehyde is the first metabolite of ethanol and is produced in the epithelium by mucosal ALDH, while higher levels are derived from microbial oxidation of ethanol by oral microflora such as Candida species. However, it is uncertain whether acetaldehyde concentration in human breath is related to oral condition or local production of acetaldehyde by oral microflora. The aim of this pilot study was to investigate the relationship between physiological acetaldehyde concentration and oral condition in healthy volunteers. Material and Methods: Sixty-five volunteers (51 males and 14 females, aged from 20 to 87 years old) participated in the present study. Acetaldehyde concentration in mouth air was measured using a portable monitor. Oral examination, detection of oral Candida species and assessment of alcohol sensitivity were performed. Results: Acetaldehyde concentration [median (25%, 75%)] in mouth air was 170.7 (73.5, 306.3) ppb. Acetaldehyde concentration in participants with a tongue coating status score of 3 was significantly higher than in those with a score of 1 (p<0.017). After removing tongue coating, acetaldehyde concentration decreased significantly (p<0.05). Acetaldehyde concentration was not correlated with other clinical parameters, presence of Candida species, smoking status or alcohol sensitivity. Conclusion: Physiological acetaldehyde concentration in mouth air was associated with tongue coating volume.

DOI： 10.1590/1678-775720140223

Self-efficacy and progression of periodontal disease: a prospective cohort study. International journal

Shinsuke Mizutani, Daisuke Ekuni, Takaaki Tomofuji, Koichiro Irie, Tetsuji Azuma, Yoshiaki Iwasaki, Manabu Morita

Journal of clinical periodontology 42 ( 12 ) 1083 - 1089 2015

Language：English

AIM: The purpose of this longitudinal study was to investigate whether self-efficacy scale for self-care (SESS) was related to changes in oral health behaviours and progression of periodontal disease in Japanese university students. MATERIAL AND METHODS: Students (n = 533) who were interested in receiving oral health examinations before entering the university and before graduation were included in the analysis. Self-efficacy was assessed using SESS, which uses three subscales: self-efficacy for brushing of the teeth (SE-BR), for dentist consultations (SE-DC) and for dietary habits. The informations about oral health behaviours were also collected. For all participants, oral hygiene instructions was performed at baseline. After 3 years, the oral health behaviours and the periodontal condition were re-assessed. RESULTS: The progression of periodontal disease was related to low baseline SE-BR. Logistic regression analysis showed that progression of periodontal disease risk during a 3-year period was associated with low baseline SE-BR (OR: 1.516; 95% CI: 1.010-2.275; p < 0.05). The increase in the score of SE-DC was related to the increase in regular dental checkups (p < 0.05). CONCLUSION: Low SESS was associated with progression of periodontal disease and improvement of oral health behaviours in university students who received oral hygiene instructions at baseline.

DOI： 10.1111/jcpe.12476

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