Proliferative Verrucous Leukoplakia: A Diagnostic Challenge in a Clinical and Histopathological Context-With Reflections on the Health Reality in Brazil.

Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct oral disorder with a high potential for malignant transformation (MT). It presents as multifocal lesions that progress over time and frequently recur, often developing carcinomas. Accurately diagnosing PVL is crucial to distinguish it from other oral mucosa lesions that have a lower risk of cancer progression. However, due to the diverse histological features observed in PVL, identifying clinical criteria and histological patterns that can be applied by unfamiliar professionals is challenging. In this study, we present a case of PVL associated with dysplasia in a 53-year-old female patient. The patient exhibited macular and leukoplakic nonscrapable lesions disseminated throughout the oral cavity, with continuous growth. The diagnosis of PVL was established during an 18-month follow-up. This case highlights the difficulties faced by both clinicians and pathologists in diagnosing PVL, emphasizing the need for careful evaluation and accurate diagnosis, particularly in patients with unusual oral lesions, and highlighting the discrepancies observed in the application of available protocols to our particular case. Distinguishing PVL from similar conditions can be challenging due to overlapping clinical signs and indistinct histopathological features.

Impact of Pregestational Obesity on the Oral Health-Related Quality of Life in Brazilian Pregnant Women: A Cohort Study.

The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02-1.83; <0.00), low income (RR 2.19; 95%CI 1.63-2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01-1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57-0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby.

The Relationship between Professional Variables and Burnout Syndrome in Brazilian Dentists during the COVID-19 Pandemic.

Burnout syndrome (BS) is a highly prevalent occupational disease among dentists who, during the COVID-19 pandemic, have been at greater risk of contracting the disease, generating stress and distancing. The aim of this study was to assess the association of social conditions, professional factors and perceptions of COVID-19 with Burnout Syndrome. This was a cross-sectional study of 302 Brazilian dentists working in the clinical and private sectors. The professionals completed the Oldenburg Burnout Inventory online and answered sociodemographic and professional questions and questions related to their perception of the pandemic. Poisson regression with unadjusted and adjusted robust variance was used to estimate the association between burnout syndrome (dependent variable) and the independent variables. The presence of BS was strongly associated with age, training in a private institution, professionals who claimed to have sufficient protective knowledge and fear of being contaminated by SARS-CoV-2 during patient care (p < 0.05). The findings of this study show that there has been an impact of the COVID-19 pandemic on the occurrence of Burnout syndrome in dentists, especially, those who worked in the public sector and those who were afraid to work with other health professionals.

The changes on salivary flow rates, buffering capacity and chromogranin A levels in adults after bariatric surgery.

OBJECTIVES: This study aimed to investigate changes in salivary flow rates, buffering capacity, and salivary chromogranin A (CHGA) levels in adults undergoing bariatric surgery (BS) compared with a non-obese control group. MATERIALS AND METHODS: Salivary analyses were performed on 62 participants aged over 50 years, stratified into two groups matched for age and gender-individuals who had undergone bariatric surgery (BS) (n = 31) and a corresponding healthy control group (n = 31). Before saliva collection, participants completed a comprehensive 11-point visual numerical rating scale (NRS 0-10) xerostomia questionnaire, assessing subjective perceptions of two key aspects: dryness of the oral mucosa and resultant impact on oral functional ability. Three distinct saliva measurements were obtained: unstimulated whole saliva (UWS), stimulated whole saliva (SWS), and unstimulated upper labial saliva (ULS). The buffering capacity of unstimulated saliva was assessed using pH indicator strips, and concentrations of salivary Chromogranin A (CHGA) were quantified in stimulated saliva via enzyme-linked immunosorbent assay (ELISA). RESULTS: After BS, more than 40% of BS group patients reported xerostomia, with 16.1% experiencing only mild symptoms without significant functional impact (p = 0.009). The prevalence of xerostomia and tongue dryness was higher in the BS group compared to the control group (p = 0.028 and p = 0.025, respectively). The comparative analysis unveiled no statistically significant differences in flow rates of unstimulated upper labial saliva (ULS), unstimulated whole saliva (UWS), and stimulated whole saliva (SWS) between the control group and patients who underwent bariatric surgery. However, in patients undergone BS with xerostomia, both ULS and UWS flow rates were significantly lower than in controls with xerostomia (p = 0.014 and p = 0.007, respectively). The buffering capacity was significantly lower in patients undergone BS than in controls (p = 0.009). No differences were found between groups regarding CHGA concentration and output values, nevertheless, higher values of CHGA concentrations were significantly correlated to lower flow rates. CONCLUSION: According to the results, this study suggests that individuals undergoing BS may exhibit altered salivary buffering capacity and reduced unstimulated salivary flows in the presence of xerostomia. Additionally, the findings suggest that elevated concentration of salivary CHGA might be associated, in part, with salivary gland hypofunction. CLINICAL RELEVANCE: The clinical significance of this study lies in highlighting the changes in salivary functions after BS. The identified salivary alterations might be attributed to adverse effects of BS such as vomiting, gastroesophageal reflux, and dehydration. Understanding these changes is crucial for healthcare professionals involved in the care of post-BS patients, as it sheds light on potential oral health challenges that may arise as a consequence of the surgical intervention. Monitoring and managing these salivary alterations can contribute to comprehensive patient care and enhance the overall postoperative experience for individuals undergoing BS.

Comparison of the Metabolic Profile between Unstimulated and Stimulated Saliva Samples from Pregnant Women with/without Obesity and Periodontitis.

This study aimed to compare the metabolic profile of unstimulated (US) and stimulated (SS) saliva samples from pregnant women with/without obesity and periodontitis. Ninety-six pregnant women were divided into: obesity + periodontitis (OP = 20); obesity/no periodontitis (OWP = 27); normal BMI + periodontitis (NP = 20); and normal BMI/no periodontitis (NWP = 29). US and SS samples were collected by expectoration and chewing of sterilized parafilm gum, respectively, and samples were individually analyzed by Proton Nuclear Magnetic Resonance (1H-NMR). Univariate (t test and correlations) and multivariate (Principal Component Analysis-PCA, and Partial Least Square-Discriminant Analysis-PLS-DA with Variance Importance Projection-VIP scores) and Metabolite Set Enrichment Analysis were done (p < 0.05). Metabolites commonly found in all groups in elevated concentration in US samples were 5-Aminopentoate, Acetic acid, Butyric acid, Propionic acid, Pyruvic acid, and Succinic acid. They were mainly related to the butyrate metabolism, citric acid cycle, amino sugar metabolism, fatty acids biosynthesis, pyruvate metabolism, glutamate metabolism, and Warburg effect. Metabolites commonly found in all groups that were in elevated concentration in SS samples were Citrulline, Fumaric acid, Histidine, N-acetyl glutamine, N-acetylneuraminic acid, para-hydroxyphenylacetic acid, Proline, Tyrosine. Although some differences were found between unstimulated and stimulated saliva samples from pregnant women with/without obesity and periodontitis, stimulated saliva collection seems adequate, demonstrating similar metabolic pathways to unstimulated saliva samples when groups are compared.

Is There a Difference in the Proteomic Profile of Stimulated and Unstimulated Saliva Samples from Pregnant Women with/without Obesity and Periodontitis?

This study aimed to compare the proteomic profile of stimulated and unstimulated saliva samples from pregnant women with/without obesity and periodontitis. Pregnant women were allocated into four groups: with obesity and periodontitis (OP); with obesity but without periodontitis (OWP); with normal BMI but with periodontitis (NP); with normal BMI and without periodontitis (NWP). Stimulated saliva (SS) and unstimulated saliva (US) samples were collected, and salivary proteins were extracted and individually processed by proteomic analysis (nLC-ESI-MS/MS). Proteins involved with the immune response process, antioxidant activity, and retina homeostasis were decreased or absent in SS samples from all groups (i.e., Antileukoproteinase, Lysozyme C, Alpha-2-macroglobulin-like protein 1, Heat shock proteins-70 kDa 1-like, 1A, 1B, 6, Heat shock-related 70 kDa protein 2, Putative Heat shock 70 kDa protein 7, Heat shock cognate 71 kDa). Additionally, proteins related to the carbohydrate metabolic process and glycolytic and glucose metabolic process were absent in SS, mainly from OP and OWP (i.e., Frutose-bisphosphate aldose A, Glusoce-6-phosphate isomerase, Pyruvate kinase). Saliva stimulation decreased important proteins involved with immune response and inflammation process in all groups. Unstimulated salivary samples seem to be the best choice for the proteomic approach in pregnant women.

Salivary Adiponectin and Albumin Levels on the Gingival Conditions of Patients Undergoing Bariatric Surgery: A Cohort Study.

This study analyzed the salivary proteomics, adiponectin and albumin, related to weight loss and periodontitis in patients undergoing bariatric surgery. This study included fourteen patients with morbid obesity (body mass index, BMI > 40 kg/m2) who underwent bariatric surgery Roux-en-Y gastric bypass (RYGB) in System Health Public in Brazil. Data on demographic and anthropometric measures were extracted from medical records preoperatively and 6 and 12 months post-surgery. The variables assessed were: probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and stimulated whole-mouth saliva. In this study, saliva samples were analyzed by electrophoresis and immunoblotting. The ELISA kit was used to measure the MMP8 levels to determine potential markers for obesity. Adiponectin and albumin levels were also evaluated. Weight loss was associated with significant changes in patients' periodontal clinical data. Although 7 out of 10 periodontal patients showed an increase in salivary adiponectin levels after root planning treatment, when analyzed by Western blotting, the increase was not statistically significant (21.1 ± 4.8 to 26.3 ± 9.4 arbitrary units, p > 0.99). There was no correlation between albumin levels and salivary adiponectin pre-surgery, nor 6 months or 12 months after surgery. Weight loss was not improved by low-grade inflammation in bariatric patients, since albumin levels were similar between periods. Periodontitis is an inflammatory disease that is modulated by several factors, among which adiponectin plays an important role for the treatment of periodontal disease.

Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis.

This meta-analysis aimed to investigate the effects of propolis on the severity of coronavirus disease symptoms by reducing periodontal disease. PubMed, EMBASE, SciELO, Web of Science, and SCOPUS databases were systematically searched. Studies have been conducted analyzing propolis's effects on COVID-19 and periodontitis. The study was conducted according to the PRISMA statement and registered in PROSPERO. Risk of Bias (RoB) assessment and meta-analysis of clinical studies were performed (Review Manager 5, Cochrane). The certainty of the evidence was assessed using GradePro (GDT). Studies have shown propolis flavonoids inhibit viral replication in several DNA and RNA viruses, including coronaviruses. Propolis components have an aminopeptidase inhibitor activity that can inhibit the main proteases of SARS viruses and seem to inhibit protein spikes, which are sites of most mutations in SARS-CoV strains. The meta-analysis showed favorable results with the use of propolis on probing depth (95%CI: 0.92; p < 0.001), clinical attachment level (95%CI: 1.48; p < 0.001), gingival index (95%CI: 0.14; p = 0.03), plaque index (95%CI: 0.11; p = 0.23), and blending on probing (95%CI: 0.39; p < 0.001). The antibacterial activity of propolis could be mediated through its direct action on microorganisms or the stimulation of the immune system, activating natural defenses. Thus, propolis inhibits the replication of SARS-CoV-2 as well as its bacterial activity. Treatment with propolis improves general health and facilitates the activation of the immune system against coronavirus.

Bariatric Surgery and Vitamin D: Trends in Older Women and Association with Clinical Features and VDR Gene Polymorphisms.

(1) Background: Obesity and its comorbidities can cause burdens and limitations. Bariatric surgery (BS) is indicated as a safe procedure to reduce body mass and improve present comorbidities. However, several complications were reported, such as vitamin D [25(OH)D] deficiency. We evaluated if 25(OH)D serum levels relate to clinical characteristics, symptoms, or habits in women after their BS, and whether the vitamin D receptor (VDR) gene's TaqI and FokI polymorphisms affected 25(OH)D levels and the total body bone mineral density (TBBMD). (2) Methods: This cohort cross-sectional comparative analytical prospective study consisted of 27 women, 61.6 ± 5.0 years, submitted to BS one year prior at a public reference hospital, DF-Brazil. All participants were asked to follow the physical and dietary activity recommendations and received vitamin D3 supplements. Their anthropometric, biochemical, and immunological measurements and blood samples were obtained. (3) Results: 73.3% of participants had low 25(OH)D levels, and their levels correlated positively with TBBMD and negatively with systolic pressure. VDR TaqI did not affect 25(OH)D levels, whereas VDR FokI's allele f presence correlated to a median rise in 25(OH)D levels. Neither polymorphism correlated to TBBMD. (4) Conclusions: 25(OH)D levels were positively correlated with TBBMD, negatively with systolic blood pressure, and were higher in those with the VDR FokI allele f.

Fluoride in Mozambique: retrospective study / Flúor em Moçambique: estudo retrospectivo

ABSTRACT Objective: The study aims to analyse the fluoride concentration in the water supply of the capital of each province of Mozambique, 2019 and compare with previous data 1978 and 2008. Methods: The water supply in cities of Mozambique were analysed in 1978, 2008 and 2019 and water from Tete's River in 1978 and 2019. The fluoride concentration of the water samples was determined in duplicate, using the ion-sensitive electrode (Orion 9609), coupled to a potentiometer (Procyon, model 720), adopting a significance level of 5%. Results: The average fluoride concentration found in the years 1978, 2008 and 2019 was 0.31, 0.33 and 0.14 mg F/L, respectively. The fluoride concentrations collected from household taps in 1978, 2008 and 2019 were: Cabo Delgado/Pemba (0.62, 0.28 and 0.07 mg F/L), Niassa/Lichinga (0.18, 0.98 and 0.07 mg F/L), Nampula/Nampula (0.18, 0.01 and 0.06 mg F/L), Zambézia/Quelimane (0.81, 0.37 and 0.15 mg F/L), Tete/Tete (1.00, 0.97 and 0 .46 mg F/L), Sofala/Beira (0.00, 0.01 and 0.10mg F/L), Manica/Chimoio (0.04, 0.01 and 0.07 mg F/L), Inhambane/Inhambane (0.00, 0.05 and 0.19 mg F/L), Gaza/Xai-Xai (0.01, 0.06 and 0.06 mg F/L) and Maputo (0.23, 0.36 and 0.23 mg F/L), respectively. In the waters of the Zambeze River was 5.5 mg F/L in 1978 and 0.12 mg F/L in 2019. There was no significant change between the fluoride concentrations in the water collected from the taps during the periods studied (p=0.83), however there was a significant difference in the water collected from the river (p<0.05). Conclusion: Tete' River showed a significant reduction in fluoride concentration, and in the piped water collected in all municipalities, the fluoride content was below optimum.

RESUMO Objetivo: O estudo visa analisar a concentração de flúor no abastecimento de água da capital de cada província de Moçambique, 2019 e comparar com dados anteriores de 1978 e 2008. Métodos: A água de abastecimento das cidades de Moçambique foi analisada em 1978, 2008 e 2019 e a água do Rio Tete em 1978 e 2019. A concentração de flúor das amostras de água foi determinada em duplicata, utilizando o eletrodo íon-sensível (Orion 9609), acoplado a um potenciômetro (Procyon, modelo 720), adotando-se nível de significância de 5%. Resultados: A concentração média de flúor encontrada nos anos de 1978, 2008 e 2019 foi de 0,31, 0,33 e 0,14 mg F/L, respectivamente. As concentrações de flúor recolhidas nas torneiras das casas em 1978, 2008 e 2019 foram: Cabo Delgado/Pemba (0,62, 0,28 e 0,07 mg F/L), Niassa/Lichinga (0,18, 0,98 e 0,07 mg F/L), Nampula/Nampula (0,18, 0,01 e 0,06 mg F/L), Zambézia /Quelimane (0,81, 0,37 e 0,15 mg F/L), Tete/Tete (1,00, 0,97 e 0,46 mg F/L), Sofala/Beira (0,00, 0,01 e 0,10 mg F/L), Manica/Chimoio (0,04, 0,01 e 0,07 mg F/L), Inhambane/Inhambane (0,00 , 0,05 e 0,19 mg F/L), Gaza/Xai-Xai (0,01, 0,06 e 0,06 mg F/L) e Maputo (0,23, 0,36 e 0,23 mg F/L), respectivamente. Nas águas do rio Zambeze foi de 5,5 mg F/L em 1978 e 0,12 mg F/L em 2019. Não houve alteração significativa entre as concentrações de flúor na água coletada das torneiras durante os períodos estudados (p=0,83), porém houve diferença significativa na água captada no Rio (p<0,05). Conclusão: O Rio Tete apresentou redução significativa na concentração de flúor, e na água das torneiras coletada em todas as cidades, o teor de flúor estava abaixo do ideal.

Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis

Abstract This meta-analysis aimed to investigate the effects of propolis on the severity of coronavirus disease symptoms by reducing periodontal disease. PubMed, EMBASE, SciELO, Web of Science, and SCOPUS databases were systematically searched. Studies have been conducted analyzing propolis's effects on COVID-19 and periodontitis. The study was conducted according to the PRISMA statement and registered in PROSPERO. Risk of Bias (RoB) assessment and meta-analysis of clinical studies were performed (Review Manager 5, Cochrane). The certainty of the evidence was assessed using GradePro (GDT). Studies have shown propolis flavonoids inhibit viral replication in several DNA and RNA viruses, including coronaviruses. Propolis components have an aminopeptidase inhibitor activity that can inhibit the main proteases of SARS viruses and seem to inhibit protein spikes, which are sites of most mutations in SARS-CoV strains. The meta-analysis showed favorable results with the use of propolis on probing depth (95%CI: 0.92; p < 0.001), clinical attachment level (95%CI: 1.48; p < 0.001), gingival index (95%CI: 0.14; p = 0.03), plaque index (95%CI: 0.11; p = 0.23), and blending on probing (95%CI: 0.39; p < 0.001). The antibacterial activity of propolis could be mediated through its direct action on microorganisms or the stimulation of the immune system, activating natural defenses. Thus, propolis inhibits the replication of SARS-CoV-2 as well as its bacterial activity. Treatment with propolis improves general health and facilitates the activation of the immune system against coronavirus.

Metabolomic Profiles Associated with Obesity and Periodontitis during Pregnancy: Cross-Sectional Study with Proton Nuclear Magnetic Resonance (1H-NMR)-Based Analysis.

This study aimed to elucidate the metabolomic signature associated with obesity and periodontitis during pregnancy in plasma and saliva biofluids. Ninety-eight pregnant women were divided into: with obesity and periodontitis (OP = 20), with obesity but without periodontitis (OWP = 27), with normal BMI but with periodontitis (NP = 21), with normal BMI and without periodontitis (NWP = 30). Saliva and plasma were analyzed by 1H-NMR for metabolites identification. Partial Least Squares-Discriminant Analysis (PLS-DA), Sparse PLS-DA (sPLS-DA), and Variable Importance of Projection (VIP) were performed. ANOVA and Pearson's correlation were applied (p < 0.05). Plasmatic analysis indicated the levels of glucose (p = 0.041) and phenylalanine (p = 0.015) were positively correlated with periodontal parameters and BMI, respectively. In saliva, periodontitis was mainly associated with high levels of acetic acid (p = 0.024), isovaleric acid, butyric acid, leucine, valine, isoleucine, and propionic acid (p < 0.001). High salivary concentrations of glycine (p = 0.015), succinic acid (p = 0.015), and lactate (p = 0.026) were associated with obesity. Saliva demonstrated a more elucidative difference than plasma, indicating the glucose-alanine cycle, alanine metabolism, valine, leucine and isoleucine degradation, glutamate metabolism, and Warburg effect as the main metabolic pathways.

Label-Free Quantitative Proteomic Analysis Reveals Inflammatory Pattern Associated with Obesity and Periodontitis in Pregnant Women.

Obesity and pregnancy may have synergistic effects on periodontal condition, and proteomics could be an ideal approach to highlight the pathophysiological mechanisms associated with these outcomes. This study analyzed the salivary proteomics related to obesity and periodontitis in women during pregnancy (T1) and after delivery (T2). Initially, 126 women were recruited and forty were allocated into groups: with obesity and periodontitis (OP); with obesity, but without periodontitis (OWP); with normal BMI, but with periodontitis (NP); with normal BMI and without periodontitis (NWP). Whole-mouth saliva was collected in T1 and T2, and proteins were extracted and individually processed by label-free proteomics (nLC-ESI-MS/MS). The up-regulations of Heat shock 70 kDa protein 1A, 1B, and 1-like were related to both obesity and periodontitis, separately. Albumin and Thioredoxin were up-regulated in periodontitis cases, while Cystatins (mainly S, SA, SN) and Lactotransferrin were down-regulated. The high abundances of Submaxillary gland androgen-regulated protein 3B, Protein S100-A8, Matrix metalloproteinase-9, Heat shock 70 kDa protein 2 and 6, Putative Heat shock 70 kDa protein 7, Heat shock 71 kDa protein, Haptoglobin and Plastin-1 were significant in the combination of obesity and periodontitis. Obesity and periodontitis remarkably altered the proteome of the saliva during pregnancy with substantial alterations after delivery.

Effect of fluoride group on dental erosion associated or not with abrasion in human enamel: A systematic review with network metanalysis.

OBJECTIVES: This systematic review evaluated the efficacy of monovalent and polyvalent fluoride group compared to the non-fluoride group on the prevention of enamel erosion associated or not with abrasion in in situ studies. DESIGN: This review was registered in the PROSPERO (CRD42017071118) and followed PRISMA 2020 guidelines. A systematic and comprehensive search was performed using PUBMED, WEB OF SCIENCE, SCOPUS, EMBASE, BBO, LILACS, SCIELO, and grey literature IBICT-BDTD. All in situ and ex vivo studies of erosion and erosion/abrasion tooth wear were included, with no language or date restrictions. RESULTS: 730 studies were obtained and after exclusion of duplicates, 311 were included for title and abstract reading. Two independent authors (kappa= 0.98) systematically conducted the selection phase. Considering the eligibility criteria and after full-text reading, 19 studies were included in qualitative and quantitative analysis. CONCLUSION: Network metanalysis showed that polyvalent fluoride group, especially Sn-compounded, prevented enamel wear by erosion and erosion/abrasion compared to the non-fluoride group and monovalent fluoride group. Both low and high concentration monovalent fluoride group were not able to prevent erosion wear associated or not with abrasion. Sensitivity analysis of the network metanalysis was performed with the low risk of bias studies and the results were confirmed. There is robust evidence that stannous-compounded fluoridated and titanium tetrafluoride agents are effective in preventing erosion and erosion/abrasion compared to the non-fluoride group and other interventions.

Assessment of Psychosocial Factors in Brazilian Dentists Facing Risk of SARS-CoV-2 Infection in the Public and Private Sectors.

Dentists are at high risk of SARS-CoV-2 infection due to their close proximity to patients. Thus, the fear of contamination or spreading the virus to family members, coupled with financial need, can lead professionals to experience significant overload and psychological suffering. We investigated the perceptions of dental professionals in the public and private sectors regarding fear and anxiety related to patient care and the risk of infection in the face of the COVID-19 pandemic. Based on the previous literature, we interviewed 302 dentists online using sociodemographic and professional questions. Among the professionals evaluated, 80.8% had suspended their activities for some time, 74.8% were afraid of infection at work, 86.1% feared transmitting the virus to their families, 30.1% had already been infected, 54% felt afraid when they heard the news of death caused by SARS-CoV-2, and 63.9% reported having the protective knowledge necessary to avoid infection. Dentists who worked only in the public sector and those who worked in both sectors were more afraid of being infected than professionals who worked only in private offices. Our results highlight the impact of the COVID-19 pandemic on emotional health in dentists. This study highlights the need for more support in the psychosocial field to enable dentists to overcome difficulties and maintain the provision of good dental care for the population. Continuing education should update professions with the requisite scientific and clinical knowledge to face the pandemic and achieve greater reflection on their role within this new context to improve their professional and emotional performance.

Association among gestational diabetes mellitus, periodontitis and prematurity: a cross-sectional study.

Objective: Gestational diabetes mellitus (GDM) causes maternal and infant morbidity. Periodontitis is associated with adverse pregnancy outcomes. The aim of this study was to evaluate periodontal status, prematurity and associated factors in pregnant women with and without GDM. Methods: This observational cross-sectional study included 80 pregnant women with GDM (G1 = 40) and without GDM (G2 = 40). Demographic and socioeconomic status, systemic and periodontal health condition, prematurity and newborns' birth weight were analyzed. For bivariate analysis, Mann-Whitney U-test, t test and Chi-squared test were used. Binary logistic regression analyzed independent variables for periodontitis and prematurity (p < 0.05). Results: Patients from G1 presented lower socioeconomic status, higher weight and body mass index (BMI). Prematurity (G1 = 27.5%; G2 = 2.5%; p < 0.05) and severe periodontitis percentages (G1 = 22.5%; G2 = 0; p = 0.001) were higher in G1 than in G2. Logistic regression analysis showed that household monthly income (OR = 0.65; 95% CI 0.48-0.86; p = 0.003) and maternal BMI (adjusted OR = 1.12; 95% CI 1.01-1.25; p = 0.028) were significant predictors of periodontitis during the third trimester of pregnancy. Presence of GDM remained in the final logistic model related to prematurity (adjusted OR = 14.79; 95% CI 1.80-121.13; p = 0.012). Conclusion: Pregnant women with GDM presented higher severity of periodontitis, lower socioeconomic status, higher overweight/obesity and a 10-fold higher risk of prematurity. Socioeconomic-cultural status and BMI were significant predictors for periodontitis, and GDM was a predictor to prematurity.

Is overweight associated with periodontitis in pregnant women? Systematic review and meta-analysis.

This systematic review and meta-analysis aimed to generate pooled evidence for the association between excessive weight and pregnancy induced periodontitis. EMBASE, SCOPUS, PubMed/MEDLINE, Web of Science, BVS/LILACS, Cochrane Library and SCIELO databases were accessed. Eligibility criteria were: human clinical studies published between year 2000 and 2021. Newcastle-Ottawa scale was used to evaluate risk of bias of the studies. Meta-analysis was performed using MedCalc® Statistical Software. Eleven studies were included, evaluating 2152 pregnant women (743 with overweight/obesity and 1409 with normal body mass index - BMI), with a mean age of 29.62 years. Most studies had low risk of bias. A positive association between overweight/obesity and periodontitis was found, with an average of 61.04% of women with overweight/obesity and periodontitis, showing the overall random-effects relative risk and 95% CI of 2.21 (1.53-3.17) (p < 0.001). Arterial hypertension, gestational diabetes mellitus and excessive gestational weight gain were the most common adverse effects of maternal obesity that may have been linked to periodontitis induced pro-inflammatory state. In conclusion, a positive association was found between overweight/obesity and periodontitis during pregnancy. However, the high heterogeneity between the studies related to sample size, periodontal classification and the cutoff-points for BMI are the main limitation.

Association among gestational diabetes mellitus, periodontitis and prematurity: a cross-sectional study

ABSTRACT Objective: Gestational diabetes mellitus (GDM) causes maternal and infant morbidity. Periodontitis is associated with adverse pregnancy outcomes. The aim of this study was to evaluate periodontal status, prematurity and associated factors in pregnant women with and without GDM. Subjects and methods: This observational cross-sectional study included 80 pregnant women with GDM (G1 = 40) and without GDM (G2 = 40). Demographic and socioeconomic status, systemic and periodontal health condition, prematurity and newborns' birth weight were analyzed. For bivariate analysis, Mann-Whitney U-test, t test and Chi-squared test were used. Binary logistic regression analyzed independent variables for periodontitis and prematurity (p < 0.05). Results: Patients from G1 presented lower socioeconomic status, higher weight and body mass index (BMI). Prematurity (G1 = 27.5%; G2 = 2.5%; p < 0.05) and severe periodontitis percentages (G1 = 22.5%; G2 = 0; p = 0.001) were higher in G1 than in G2. Logistic regression analysis showed that household monthly income (OR = 0.65; 95% CI 0.48-0.86; p = 0.003) and maternal BMI (adjusted OR = 1.12; 95% CI 1.01-1.25; p = 0.028) were significant predictors of periodontitis during the third trimester of pregnancy. Presence of GDM remained in the final logistic model related to prematurity (adjusted OR = 14.79; 95% CI 1.80-121.13; p = 0.012). Conclusions: Pregnant women with GDM presented higher severity of periodontitis, lower socioeconomic status, higher overweight/obesity and a 10-fold higher risk of prematurity. Socioeconomic-cultural status and BMI were significant predictors for periodontitis, and GDM was a predictor to prematurity.

IMPACT OF BARIATRIC SURGERY IN ANXIETY AND ORAL CONDITION OF OBESE INDIVIDUALS: A COHORT PROSPECTIVE STUDY.

BACKGROUND: Obesity and bariatric surgery may be related with mental and oral disorders. AIM: To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients. METHODS: Eighty-nine patients were divided in two groups: Control Group (CG) - obese patients and Experimental Group (EG) - patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered. RESULTS: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG. CONCLUSION: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.