title: Serum vitamin B12 is inversely associated with periodontal progression and risk of tooth loss: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to investigate the association of serum vitamin B12 with the progression of periodontitis and risk of tooth loss in a prospective cohort study.
  
  
  METHODS
  In the Study of Health in Pomerania, 1648 participants were followed from 2002-2006 to 2008-2012 (mean duration 5.9 years). Serum vitamin B12 was measured by chemiluminescent enzyme immunoassay. Probing pocket depth (PD) and clinical attachment loss (CAL) were measured to reflect periodontal status on a half-mouth basis at each survey cycle. Tooth numbers are based upon a full-mouth tooth count.
  
  
  CONCLUSIONS
  In multivariate regression models, baseline vitamin B12 was inversely associated with changes in mean PD (Ptrend = 0.06) and mean CAL (Ptrend = 0.01), and risk ratios of tooth loss (TL; Ptrend = 0.006) over time. Compared to participants in the highest vitamin B12 quartile, those in the lowest quartile had 0.10 mm (95%CI: 0.03, 0.17; Pdifference = 0.007) greater increase in mean PD, 0.23 mm (95%CI: 0.09, 0.36; Pdifference = 0.001) greater increase in mean CAL and a relative risk of 1.57 (95%CI: 1.22, 2.03; Pdifference < 0.001) for TL. Stratified analyses showed stronger associations between vitamin B12 and changes in mean CAL among never smokers (Pinteraction = 0.058). Further studies are needed to understand the potential mechanisms of these findings.
authors.affiliation: Unilever Research and Development, Vlaardingen, The Netherlands.
authors.forename: Geng
authors.initials: G
authors.lastname: Zong
authors.affiliation: Unit of Periodontology, University Medicine, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany.
authors.forename: Birte
authors.initials: B
authors.lastname: Holtfreter
authors.affiliation: Unilever Research and Development, Bebington, UK.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Scott
authors.affiliation: Institute for Community Medicine, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Petersmann
authors.affiliation: Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Dietrich
authors.affiliation: Unilever Research and Development, Vlaardingen, The Netherlands.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Newson
authors.affiliation: Unit of Periodontology, University Medicine, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kocher
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss; D010514:Periodontal Pocket; D010518:Periodontitis; D011446:Prospective Studies; D012907:Smoking; D016388:Tooth Loss; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D014805:Vitamin B 12
keywords: clinical attachment loss; probing depth; smoking; tooth loss; vitamin B12