Association of metabolic syndrome and chronic periodontitis in Colombians.

BACKGROUND: Metabolic syndrome (MetS) is a common chronic condition that increases the cardiovascular disease risk and is also linked to periodontitis. The study aim was to determine if a relationship exists between MetS and chronic periodontitis in adult Colombians. METHODS: Participants were 220 healthy-gingivitis subjects and 431 periodontitis patients coming from the three largest Colombian cities. Periodontal status and MetS were determined in subjects. Univariate analysis and odds ratio were calculated within the 95 % confidence intervals and chi2 test compared the groups. Variables were compared among the clinical periodontal groups and MetS by Wilcoxon and multivariate analysis, and logistic regression was performed for MetS and periodontitis. RESULTS: MetS had higher prevalence in periodontitis group (6.3 %) versus controls (3.2 %). In multivariate analysis, periodontitis was associated with MetS (adjusted OR = 2.72, 95 % CI 1.09-6.79), glucose intolerance with another component of MetS (adjusted OR = 1.78, 1.16 to 2.72), glucose resistance (adjusted OR = 11.46, 95 % CI 1.41-92.88), smoking (OR = 1.72, 95 % CI 1.09-2.71), and city of origin (2.69, 95 % CI 1.79-4.04). CONCLUSION: The study confirmed the positive association between MetS and periodontitis, being glucose sensitivity the strongly associated component. CLINICAL RELEVANCE: MetS must be taken into account by the dentist when evaluating risk factors for periodontitis, being useful for dentists to evaluate glycemia, lipidic profile, central obesity, and high blood pressure in patients. Interdisciplinary treatment must be recommended when a patient with MetS and periodontitis is being treated.

Periodontal disease in children and adolescents of Latin America.

Periodontal diseases are a group of infectious diseases that mainly include gingivitis and periodontitis. Gingivitis is the most prevalent form of periodontal disease in subjects of all ages, including children and adolescents. Less frequent types of periodontal disease include aggressive periodontitis, acute necrotizing ulcerative gingivitis and various diseases of herpesviral and fungal origin. This review aimed to retrieve relevant information from Latin America on the prevalence of periodontal diseases among children and adolescents of the region. Gingivitis was detected in 35% of young Latin American subjects and showed the highest frequencies in Colombia (77%) and Bolivia (73%) and the lowest frequency in Mexico (23%). The frequency of gingivitis in subjects from other Latin American countries was between 31% and 56%. Periodontitis may affect <10% of the young population in Latin America, but the data are based on only a few studies. A more precise assessment of the distribution and severity of periodontal disease in children and adolescents of Latin America may help policy makers and dentists to institute more effective public health measures to prevent and treat the disease at an early age to avoid major damage to the permanent dentition.

Periodontal microbiology in Latin America.

This review article describes the microbiota associated with periodontal disease in Latin America. This vast territory includes 22 nations, which show great ethnic diversity, with large groups of White people, Black people, Mestizo people and Native people. Widespread poverty and limited access to education and health-care services, including periodontal care, are prominent predisposing factors for destructive periodontal disease in Latin America. Black people and Mestizo people seem to have particularly severe periodontal disease and are frequently colonized by the major periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The 'red complex' bacterial pathogens and A. actinomycetemcomitans predominate in chronic and aggressive periodontitis, but gram-negative enteric rods and herpesviruses can also play important periodontopathic roles in Latin America. The key to minimizing the risk of periodontal disease is control of the pathogens, and new low-cost periodontal treatments deserve serious consideration in Latin America.

The Oral Health of Patients with DiGeorge Syndrome (22q11) Microdeletion: A Case Report.

BACKGROUND: DiGeorge syndrome (DG) is a genetic disorder associated with 22q11 deletion. It involves various phenotypes, including craniofacial abnormalities, congenital heart disorders, endocrine dysfunction, cognitive deficits, and psychiatric disorders. Cases commonly involve multiple anomalies. However, little is known about the condition of the oral cavity in this disorder, although palate fissure, abnormal mandible, malocclusion, and tooth hypoplasia have been identified. We aimed to determine the odontological features of patients with 22q11.2 microdeletion, in relation to gingival health and oral hygiene. We report the systemic manifestations of nine patients and results of oral evaluation of two patients. In the oral examination, oral hygiene and gingivitis were evaluated. CASE PRESENTATION: In terms of the systemic manifestations, we found high frequencies of low weight and height at birth. In terms of the oral manifestations, both examined patients presented malocclusion, enamel hypoplasia, dental crowding, anodontia, and healthy periodontium. CONCLUSION: Although DG has been documented to involve periodontium disease, the patients in this study exhibited more dental manifestations such as enamel defects, misalignment between the teeth and the two dental arches, anodontia, and dental crowding. As such, a multidisciplinary approach combining dentistry and healthcare is recommended in this case.

Subgingival microbial profiles in chronic periodontitis patients from Chile, Colombia and Spain.

AIM: To investigate the subgingival microbiota of distinct periodontitis patient populations, in Chile, Colombia and Spain, using identical clinical and bacteriological methods. MATERIAL AND METHODS: In this multicentre study, 114 chronic periodontitis patients were selected. Patients were examined using an identical clinical protocol and pooled subgingival samples were obtained from each patient. Samples were processed in the three laboratories by means of culturing under identical clinical and microbiological protocols. Total anaerobic counts and frequency of detection and proportions of nine periodontal pathogens were calculated. Variables were analysed by means of anova, chi(2), Kruskal-Wallis and Dunn's multiple comparison tests. RESULTS: The Colombian population demonstrated greater severity of periodontitis, with significantly deeper mean probing pocket depth, and had a significantly lower percentage of current smokers. When comparing samples from the three patient populations, the total counts were significantly higher in the Colombian patients. The numbers of putative pathogens differed among groups. Tannerella forsythia was found less frequently in Chilean samples, while Parvimonas micra and enteric rods differed significantly among the three population groups. CONCLUSION: Significant differences among Chile, Colombia and Spain existed regarding the frequency and proportions of specific periodontal pathogens in the subgingival microbiota of periodontitis patients.

Subgingival human cytomegalovirus correlates with increased clinical periodontal parameters and bacterial coinfection in periodontitis.

BACKGROUND: Viruses from the Herpesviridae family may be implicated in the pathogenesis of periodontal disease. The aim of this investigation was to compare the subgingival frequency of human cytomegalovirus (HCMV) in subjects affected by periodontitis to periodontally healthy subjects and to assess the correlation of HCMV with periodontal clinical parameters and periodontopathic bacteria. METHODS: Thirty subjects with periodontitis (20 with chronic periodontitis and 10 with aggressive periodontitis) were included in the study. A group of 22 periodontally healthy individuals served as controls. Clinical periodontal parameters of probing depth (PD) and clinical attachment level (CAL) were recorded using a computerized periodontal probe. Subgingival plaque samples were processed for viral identification by nested polymerase chain reaction and bacterial identification by culture. Clinical periodontal parameters, frequency of detection of HCMV, and microbial composition were compared between the groups using the two-tailed Student t, chi(2), and Mann-Whitney tests. Logistic and linear regression analyses were performed to measure the association between virus-bacterial coinfection and clinical parameters (P < or =0.05). RESULTS: HCMV detection was more prevalent (P < or =0.05) in periodontally diseased subjects compared to healthy ones. Furthermore, in all groups, PD and CAL were increased in HCMV-positive sites. In the periodontitis groups, higher frequencies and levels of specific periodontopathic bacteria were detected in HCMV-positive sites. CONCLUSIONS: HCMV detection in periodontal pockets was associated with higher levels of periodontopathic bacteria and increased PD and CAL at sampled sites. HCMV/bacteria coinfection may be an important factor in periodontal destruction.

Occurrence of periodontopathic and superinfecting bacteria in chronic and aggressive periodontitis subjects in a Colombian population.

BACKGROUND: Differences in the composition of subgingival microbiota in periodontitis have been observed in different geographic locations. Some of these microbial differences could have clinical significance. This study describes clinical parameters and the composition of the subgingival microbiota in chronic periodontitis (CP) and aggressive periodontitis (AgP) patients in a Colombian population. METHODS: Clinical parameters (probing depth, clinical attachment level, bleeding on probing, and plaque index) and plaque samples from 68 CP, 12 AgP, and 30 periodontally healthy subjects were analyzed. Subgingival samples were processed using culture, biochemical tests, and polymerase chain reaction for the detection of periodontal and superinfecting pathogens. The analysis of variance, chi(2), and Kruskal-Wallis tests were used to evaluate differences between groups for clinical parameters and microbiologic composition (P

Demographic, clinical, and microbial aspects of chronic and aggressive periodontitis in Colombia: a multicenter study.

BACKGROUND: The microbial profile of periodontal disease varies among different human populations. This study evaluated the demographic, clinical, and microbiologic aspects of periodontitis in a multigeographic sample in Colombia. METHODS: Three hundred twenty-five patients with chronic periodontitis (CP), 158 patients with aggressive periodontitis (AgP), and 137 healthy-gingivitis controls from five regions of the country were studied. Clinical, microbial, and sociodemographic data were collected. Microbiologic identification was performed using polymerase chain reaction 16S rRNA gene on pooled subgingival samples, and the presence of Gram-negative enteric rods was evaluated by culture. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: Porphyromonas gingivalis occurred in 71.5% of individuals with periodontitis, Tannerella forsythensis occurred in 58.5%, Campylobacter rectus occurred in 57.5%, Actinobacillus actinomycetemcomitans occurred in 23.6%, and enteric rods occurred in 34.5%. P. gingivalis was more common in CP and AgP than controls. A. actinomycetemcomitans was increased in AgP compared to controls and patients with CP. T. forsythensis, C. rectus, and Eikenella corrodens had a low presence in the West Pacific and Central regions, and enteric rods were increased in the Central region (P <0.05). Other sociodemographic factors were not associated with these microorganisms. CONCLUSIONS: Geographic regions do not influence the microbiota, but the microbiota may vary by geographic region. P. gingivalis, T. forsythensis, and C. rectus are the most prevalent periodontophatic microorganisms in Colombia. A. actinomycetemcomitans was more common in AgP, and a large percentage of the population studied had enteric rods in the subgingival plaque.

Frequency of detection of periodontopathic and superinfecting bacteria in HIV-positive patients with periodontitis.

OBJECTIVE: The aim of this investigation was to establish the frequency of detection of periodontopathic bacteria and Gram-negative enteric rods in HIV-positive (HIV+) patients with periodontitis. MATERIALS AND METHODS: Clinical parameters and microbiological samples were obtained from 31 HIV+ periodontitis (H+PG) patients, 32 HIV-negative (HIV-) periodontitis (H-PG) patients and 32 systemically and periodontally healthy (CG) patients. Microbial samples were analyzed using culturing techniques for periodontopathic and superinfecting microorganisms. The ANOVA test was used to assess differences in the clinical parameters, and the Chi square and two-tailed Mann Whitney tests were used to find differences in the composition of the microbiota (p < 0.05). RESULTS: The frequency of detection of periodontopathic bacteria was higher in HIV- periodontitis patients (p < 0.05) compared to HIV+ and healthy subjects. In contrast, HIV+ patients harbor higher levels of superinfecting microorganisms (p < 0.05). Pseudomonas aeruginosa, Enterobacter cloacae and Klebsiella pneumoniae were identified. CONCLUSIONS: The frequency of detection and levels of periodontopathic bacteria were higher in the HIV- periodontitis patients compared to HIV+ patients and healthy subjects. In contrast, levels of superinfecting bacteria were found to be elevated in HIV+ periodontitis patients. Special attention should be paid to the presence of periodontopathic and superinfecting bacteria in these patients in order to avoid further periodontal and systemic complications.

Occlusal polygon area of the molars in six Colombian ethnic groups / Área del polígono oclusal de molares en seis grupos étnicos de Colombia

SUMMARY: Descriptive observational cross-sectional study to determine the AOP of the second molars (55, 65, 75, 85) and the first permanent molars (16, 26, 36 and 46) in 459 study models corresponding to six ethnic groups in Colombia, Embera indigenous of Alto Baudó (Chocó), Caucasoid mestizos of Cali (Valle del Cauca), African descent of Cali (Valle del Cauca), Misak indigenous of Silvia (Cauca), Nasa indigenous of Morales (Cauca), and indigenous of Leticia (Amazonas). There were no significant differences of AOP among the six ethnic groups except when compared to the Amazon Indians with African descent of Cali, Embera indigenous and Nasa indigenous. There was no sexual dimorphism except tooth 65 for all ethnic groups. There was bilateral symmetry except between teeth 16 and 26. The distance matrix showed that Caucasoid mestizos of Cali were grouped with microdont populations, Amazon indigenous, Embera indigenous, Misak indigenous and Nasa indigenous, and African descendants of Cali were grouped with mesodont populations. The Embera and Amazon indigenous had the highest values of OAP associated with the relative isolation and less mestizaje. Overall, there was no sexual dimorphism or bilateral asymmetry. This study coincides with the different theories about reducing the size of the teeth as evolutionary characteristic of hominids.

RESUMEN: Estudio observacional descriptivo de corte transversal en el que se determinó el APO de los segundos molars deciduos (55, 65, 75, 85) y de los primeros molares permanentes (16, 26, 36, 46) en 459 modelos de estudio correspondientes a seis grupos étnicos de Colombia: Indígenas embera del Alto Baudó (Chocó), mestizos caucasoides de Cali (Valle del Cauca), afrodescendientes de Cali (Valle del Cauca), indígenas misak de Silvia (Cauca), indígenas nasa de Morales (Cauca) e indígenas de Leticia (Amazonas). No se encontraron diferencias significativas en el APO de los seis grupos étnicos, excepto entre indígenas del Amazonas y de afrodescendientes de Cali, e indígenas embera e indígenas nasa. No se evidenció dimorfismo exual en ninguno de los seis grupos. Hubo simetría bilateral, excepto entre los dientes 16 y 26. La matriz de distancias demostró que los mestizos caucasoides de Cali se agrupan con poblaciones microdontes, indígenas del amazonas, indígenas embera, indígenas misak e indígenas nasa; mientras que los afrodescendientes de Cali se agrupan con poblaciones mesodentes. Los indígenas embera y del Amazonas presentaron altos valores del APO, asociado a su aislamiento relativo y bajo mestizaje. En términos generales, no hubo dimorfismo sexual ni asimetría bilateral. Los resultados de este estudio concuerdan con diferentes teorías sobre la reducción del tamaño dental como una característica evolutiva de los himínidos.

Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement.

INTRODUCTION: Dental plaque is organized in a biofilm complex that provides protection and nutrients for periodontopathic bacteria. Several factors can affect microbial colonization, including restorations and orthodontic brackets. The aim of this study was to investigate changes in subgingival microbiota and clinical parameters before and after bracket placement. METHODS: Clinical parameters and subgingival microbial samples were collected from 30 patients before and after bracket placement. Thirty additional patients with no orthodontic treatment served as controls. Samples were cultured and analyzed for periodontopathic and superinfecting bacteria. A descriptive analysis was conducted, and chi-square, Student t, Wilcoxon matched, and Mann Whitney rank sum tests were used to test for differences between groups (P < or=.05). RESULTS: No changes in probing depth or clinical attachment level were observed, but scores for bleeding on probing, plaque index, and gingival index increased after bracket placement (P < or =.05). Porphyromonas gingivalis, Prevotella intermedia/Prevotella nigrescens, Tannerella forsythia, and Fusobacterium species were elevated in the experimental group after bracket placement compared with the control group (P < or =.01). Superinfecting microorganisms such as Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, and Serratia marcescens were also found. CONCLUSIONS: Bracket placement influences the accumulation of plaque and the colonization of important periodontopathic and superinfecting bacteria, resulting in more inflammation and bleeding. Special attention should be paid to oral hygiene methods in orthodontic patients.

Porphyromonas gingivalis Fim-A genotype distribution among Colombians.

INTRODUCTION: Porphyromonas gingivalis is associated with periodontitis and exhibit a wide array of virulence factors, including fimbriae which is encoded by the FimA gene representing six known genotypes. OBJETIVE: To identify FimA genotypes of P. gingivalis in subjects from Cali-Colombia, including the co-infection with Aggregatibacter actinomycetemcomitans, Treponema denticola, and Tannerella forsythia. METHODS: Subgingival samples were collected from 151 people exhibiting diverse periodontal condition. The occurrence of P. gingivalis, FimA genotypes and other bacteria was determined by PCR. RESULTS: P. gingivalis was positive in 85 patients. Genotype FimA II was more prevalent without reach significant differences among study groups (54.3%), FimA IV was also prevalent in gingivitis (13.0%). A high correlation (p= 0.000) was found among P. gingivalis, T. denticola, and T. forsythia co-infection. The FimA II genotype correlated with concomitant detection of T. denticola and T. forsythia. CONCLUSIONS: Porphyromonas gingivalis was high even in the healthy group at the study population. A trend toward a greater frequency of FimA II genotype in patients with moderate and severe periodontitis was determined. The FimA II genotype was also associated with increased pocket depth, greater loss of attachment level, and patients co-infected with T. denticola and T. forsythia.

INTRODUCCIÓN: Porphyromonas gingivalis es una bacteria asociada con la periodontitis. Expresa una amplia gama de factores de virulencia, incluyendo las fimbrias, las cuales están codificadas por el gen FimA que representa seis genotipos conocidos. OBJETIVO: Identificar los genotipos de FimA de P. gingivalis en pacientes de Cali - Colombia, incluyendo la co -infección con Aggregatibacter actinomycetemcomitans, Treponema denticola y Tannerella forsythia . MÉTODOS: Se obtuvieron muestras subgingivales de 151 individuos con diferentes diagnósticos periodontales. La ocurrencia de P. gingivalis, los genotipos de FimA y otras bacterias se determinó por PCR. RESULTADOS: Porphyromonas gingivalis fue positiva en 85 pacientes. El genotipo FimA II fue más prevalente, pero no hubo diferencias significativas entre los grupos de estudio (54.3%) , FimA IV fue el más frecuente en la gingivitis (13.0%). Una alta correlación (p= 0.000 ) se encontró entre P. gingivalis , T. denticola y T. forsythia. El genotipo FimA II estuvo correlacionado con la detección de T. denticola y T. forsythia . CONCLUSIONES: Porphyromonas gingivalis tuvo una alta frecuencia incluso en el grupo de individuos sanos. Se encontró una tendencia hacia una mayor frecuencia de FimA II en pacientes con periodontitis moderada y severa. El genotipo FimA II también se asoció con una mayor profundidad de la bolsa, una mayor pérdida de nivel de inserción, y con los pacientes en los que se detectó co - infección con T. denticola y T. forsythia.

[Appendectomy by minimally invasive surgery]. / Apendicectomía por cirugía de invasión mínima.

OBJECTIVE: To analyze the results obtained with the laparoscopic appendectomy in a trial of 106 cases from 1997 to December of 2002 in a surgeons group. Comparing the results with the papers of the literature to qualified the safety and security of the method and to establish the advantages upon the open appendectomy. BACKGROUND DATA: The laparoscopic appendectomy is a technique that in the past ten years has proof its safety and efficacy to resolve the problems of vermiform appendix. METHODS: Prospective trial of 106 patients with probability or diagnosis of acute appendicitis approach to laparoscopic appendectomy. With statistical analysis of the data. RESULTS: 106 patients, 42 male and 62 female, average age 30.8, diagnosis of acute appendicitis before surgery of 70%, and with abdominal pain in 30%. Of the data obtained only the total count of leucocytes have the statistical value in the diagnosis of acute appendicitis. The average of surgical time was of 70.7 minutes, the average of length of hospital stay was of 74 hours. Diagnosis of acute appendicitis in 83% of the cases, normal appendix 10.3%, another pathology 6.7%. Conversion rate of 5.5% (6 patients). Abscess 3, peritonitis 1, hemorrhage 1, appendix rupture 1. Morbidity of 3.7% wound infection. Mortality 0%. CONCLUSIONS: The surgical indications for the laparoscopic appendectomy are the same that for open surgery. The technique is safe and effective that can be carried out in any patient, still in cases or perforated appendicitis or gangrenous. The success is depend of the experience of the surgical team. The wound infection, recovery time, postoperative pain are less in the laparoscopic appendectomy.

Acercamiento multifactorial a la fisiopatología de la obesidad. Modelo de abordaje COD2 / A multi-factor approach to the physiopathology of obesity: COD2 model

La obesidad en este momento representa una de las peores amenazas del sector salud. El acelerado aumento de la prevalencia y mortalidad a causa de enfermedades cardiovasculares establece un precedente histórico como problema de salud pública mundial. La elevada incidencia de obesidad y enfermedades crónicas ha llevado a múltiples áreas de la salud a entender y buscar un detonante claro que explique esta patología. Existen numerosas causas que explican su comportamiento agresivo, progresivo y crónico. Sin embargo, ninguna de ellas satisface como el solo factor desencadenante que ofrezca un tratamiento único que genere una reducción de su rápida expansión. En este artículo se buscan explicar las principales causas relacionadas con esta entidad así como los mecanismos que lo demuestran, para lograr entender el abordaje adecuado de los pacientes que acuden buscando el manejo de la obesidad (modelo COD2).

Obesity is currently considered as one of the major life-threatening conditions affecting the healthcare system. The accelerated increase in prevalence and mortality due to cardiovascular diseases establishes an historical precedent as a global public health issue. The increased incidence of obesity and chronic diseases, has led multiple health researchers to try to identify a clear triggering factor contributing to obesity. There are numerous causes which explain its aggressive, progressive and chronic behavior. However, they do not satisfactorily elucidate a unique triggering factor which would determine a unique treatment to help decelerate its rapid expansion. This article seeks to explain the major causal factors and mechanisms leading to obesity, in order to find the most appropriate approach for obese patients seeking treatment options (COD2 model).

Estilo de vida de estudiantes en primer semestre de odontología de una universidad privada, Cali 2016 / Lifestyles in first semester students of a private university, in Cali 2016

RESUMEN Objetivo: Identificar los estilos de vida de los estudiantes de primer semestre de Odontología en una universidad privada en el año 2016. Material y métodos: Estudio descriptivo, transversal, cuantitativo, con una muestra de 58 estudiantes de primer semestre de una universidad privada de Cali. Se diligenció de manera virtual y anónima el cuestionario Fantástico que consta de 25 preguntas cerradas de escala Likert, que mide varios dominios físicos, psicológicos y sociales relacionados con el estilo de vida. Se realizó análisis estadístico uni- y bivariado con el programa Stata 13®, buscando asociación entre cada ítem y el resultado final con el sexo del estudiante, mediante la prueba χ2 con un alfa de 0.05. Resultados: Las categorías en las que se obtuvo un bajo puntaje fueron actividad física, alimentación, fumar, consumo de alcohol, hábitos de sueño y estrés. Hubo diferencias significativas en el consumo de cigarrillo, siendo mayor en hombres. Conclusión: El estilo de vida en la mayoría de los estudiantes fue excelente y bueno.

ABSTRACT Objective: To identify the lifestyle of first semester students of Dentistry at a private university in 2016. Material and methods: Descriptive, cross-sectional, quantitative study with a sample of 58 first semester students from a private university in Cali. The questionnaire "FANTASTIC" consisting of 25 items Likert scale questionnaire which measures various physical, psychological and social domains related to lifestyle was digitally and anonymously filled out. Statistical analysis was performed with univariate and bivariate analysis with the program Stata 13®, seeking association between each item and the fi nal result with the student's sex, using the chi2 test with an alpha of 0.05. Results: The categories in which a low score were obtained were physical activity, feeding habits, smoking, alcohol consumption, sleep habits and stress. There were significant differences in cigarette smoking, being higher in men. Conclusion: The lifestyle in most students was excellent and good.

Association between periodontal disease and plasma levels of cholesterol and triglycerides.

OBJECTIVE: untreated periodontal disease seems to cause low grade systemic inflammation and blood lipid alteration leading to increased cardiovascular disease risk. To start testing this hypothesis in colombian patients, a multicentre study was conducted including the three main state capitals: bogota, medellin and cali. METHODS: in this study 192 (28.4%) advanced and 256 (37.8%) moderate periodontitis patients were investigated for socio-demographic variables, city of precedence, periodontal parameters, smoking, red complex periodontopathic bacteria, serum antibodies against porphyromonas gingivalis and aggregatibacter actinomycetemcomitans and blood lipids including total cholesterol, hdl, ldl and triglycerides (tg). Those parameters were compared to 229 (33.8%) controls having periodontal health or gingivitis. RESULTS: advanced periodontitis had worst periodontal indexes, than moderate periodontitis and controls. Interestingly, higher hdl and tg levels were present in periodontitis. Bmi <30 and smoking were associated with increased hdl, hdl-35, ldl and tg, while glycemia >100 mg/dl associated with hdl, hdl-35 and tg. Tannerella forsythia showed a significant association with hdl-35 in bivariate analysis and serum igg1 against p. Gingivalis associated with hdl-35 and serum igg1 against t. Forsythia associated with tg and serum igg2 against a. Actinomycetemcomitans correlated with levels of hdl y hdl-35. In logistic regression the periodontitis patients from cali presented reduced hdl levels as compared to bogota and medellin patients. Presence of igg1 antibodies against p. Gingivalis and a. Actinomycetemcomitans correlated with reduced hdl levels. CONCLUSION: this study confirmed that untreated periodontitis generates alteration in serum lipid levels and systemic bacterial exposure against important periodontopathic bacteria could be the biological link.

OBJETIVO: La periodontitis no tratada parece causar inflamación sistémica, así como alteración de los niveles sanguíneos de lípidos, lo que conduce a un mayor riesgo de enfermedades cardiovasculares. Para empezar a probar esta hipótesis en pacientes Colombianos, se realizó un estudio multicéntrico que incluyó las tres ciudades principales: Bogotá, Medellín y Cali. MÉTODOS: Se estudiaron 192 pacientes con periodontitis avanzada (2.,4%) y 256 (37.8%) con periodontitis moderada, para medir variables sociodemográficas, ciudad de procedencia, parámetros periodontales, fumar, presencia de bacterias periodontopáticas, anticuerpos séricos contra Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans, así como niveles de lípidos en sangre incluyendo colesterol total, HDL, LDL y triglicéridos (TG). Estos parámetros se compararon con 229 (33.8%) pacientes controles sanos/gingivitis. RESULTADOS: Los pacientes con periodontitis avanzada tuvieron peores índices periodontales que los de periodontitis moderada y los controles. Mayores niveles de HDL y TG estuvieron presentes en pacientes con periodontitis. El índice de masa corporal >30 y el hábito de fumar se asociaron con aumento de HDL, HDL-35, LDL y TG, mientras la glicemia >100 mg/dL se asoció con HDL, HDL-35 y TG. En el análisis bivariado Tannerella forsythia mostró asociación significativa con HDL-35 e IgG1 sérica contra P. gingivalis estuvo asociada a HDL-35 así como IgG1 contra T. forsythia con TG y la IgG2 contra A. actinomycetemcomitans se correlacionó con los niveles de HDL y HDL-35. En la regresión logística se observó que la región de Cali tuvo niveles menores de HDL en comparación con los pacientes de Bogotá y Medellín. La presencia de anticuerpos IgG1 contra P. gingivalis y A. actinomycetemcomitans se asoció con niveles reducidos de HDL. CONCLUSIÓN: Este estudio confirmó que la periodontitis no tratada genera alteración en los niveles de lípidos séricos y la exposición bacteriana sistémica a las bacterias periodontopáticas podría ser el vínculo biológico.

[Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients]. / Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia.

INTRODUCTION: Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. OBJECTIVE: Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. MATERIALS AND METHODS: In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student's t tests were used, with a significance level of p≤0.05. RESULTS: Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. CONCLUSION: Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Tooth and periodontal clinical attachment loss are associated with hyperglycemia in patients with diabetes.

BACKGROUND: Periodontal disease has been associated with diabetes, but there is still controversy on the relationship between periodontal clinical parameters and glycemic control. The purpose of this study is to assess the relationship between blood glucose levels and clinical parameters of periodontal disease in individuals with diabetes. METHODS: A total of 65 individuals with diabetes and 81 individuals without diabetes were included in the study. A full-mouth periodontal examination and preprandial fasting glycemia values were recorded for each individual. Glycosylated hemoglobin was only measured in patients with diabetes. A comparative analysis between groups (Mann-Whitney U test) and a correlation analysis between glycemia and periodontal parameters were performed (Spearman test). RESULTS: Patients without diabetes presented more teeth than individuals with diabetes (P <0.05). Patients with diabetes with periodontitis displayed loss of periodontal clinical attachment compared to patients without diabetes, but the highest value was observed in patients with periodontitis that reported a smoking habit. Furthermore, patients with diabetes with periodontitis presented higher glycemia and glycated hemoglobin values in contrast to patients with gingivitis. Patients with diabetes with hyperglycemia had a higher risk to develop periodontitis (odds ratio = 2.24; 95% confidence interval = 1.02 to 4.93). A positive correlation was observed between glycemia and clinical attachment loss (AL), whereas a negative correlation between glycemia and the number of teeth present was found (P <0.05). CONCLUSIONS: Tooth and periodontal AL were increased by hyperglycemia in individuals with diabetes. This study contributes additional evidence that diabetes could aggravate periodontal disease and affect the systemic health of individuals.

[Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease]. / Bacilos Gram negativos entéricos y no fermentadores de la glucosa en pacientes con enfermedad periimplante.

INTRODUCTION: Implants can be colonized by microorganisms from oral biofilms and may affect peri-implant tissues health. Among these bacteria, pathogens typically associated with periodontitis can be found, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, as well as Gram negative enteric bacilli not typically associated with periodontal diseases. OBJECTIVE: Superinfecting bacteria were characterized from peri-implant lesions in patients with history of periodontitis. MATERIALS AND METHODS: Sixty-eight implants were studied in 55 patients; the average patient age was 56 years. Forty-nine implants had peri-implant lesions and 19 were considered stable. Subgingival samples were obtained in affected and stable implants. The samples were streaked on Mac-Conkey agar and incubated at 37°C for 24 hours. The colonies were identified with the kit-BD BBL Crystal E/NF®. RESULTS: Superinfecting organisms were detected in 20 patients--they were seen more frequently at diseased implants (n=15) than at healthy implants (n=5). The prevalence of superinfecting bacteria on the selected implants was 33.8% (n=23/68). These bacteria were more prevalent among affected implants (n=17 or 25%) than those with stable implants n=6 (8.8%). Klebsiella pneumoniae was the most frequent Gram negative rod detected (n=12). CONCLUSIONS: One-third of the implants had superinfecting organisms. Implants with a peri-implant lesion had a higher frequency of superinfecting bacteria. Klebsiella pneumoniae was the most common superinfecting organism isolated. A multiple infection caused by superinfecting bacteria was present only at diseased implants. These microbial agents potentially affect implant stability.

Determinación de los cambios en altura y densidad ósea después de un proceso de preservación con un sustituto óseo sintético / Determination of changes in height and bone density after process preservation with synthetic bone substitute

Objetivo: Determinar los niveles de altura y densidad osea alcanzada en alvéolos pos - texodoncia, 15 dias y tres meses despues de ser injertados con un sustituto óseo experimental. Materiales y Métodos: Se distribuyeron aleatoriamente 37 alvéolos postexodoncia en dos grupos, uno experimental (n=21) y otro control (n=16). En el grupo expe- rimental se utilizó un material compuesto por ß-Fosfato tricalcico y quitosano, en el grupo control se empleó un producto co- mercial compuesto por una mezcla bifásica de hidroxiapatita (HA) y fosfato tricalcico (TCP). Se realizaron tomografías a los 15 días y 3 meses postquirúrgicos determi - nando niveles óseos (altura y anchura en la zona injertada); también se determinó la densidad ósea utilizando unidades Houns- field. La información obtenida se procesó con la aplicación STATA versión 13. Se calcularon frecuencias para el sexo, tipo de alvéolo y tipo de injerto utilizado, y para las variables numéricas de edad, densidad ósea, altura ósea, grosor crestal, se establecieron promedios y desviación estándar. El nivel de confianza se estableció en 95% y el nivel de significancia en 5%. Resultados: Al comparar la densidad y altura ósea en los dos grupos no se encon- traron diferencias estadísticamente signifi - cativas, pero si al comparar el ancho en la zona de la cresta ( p <0.05). Conclusiones: El biocompuesto cerámico con quitosano mostró ser útil en preservar niveles óseos en los alvéolos postexodoncia y presentó diferencias estadísticamente significas en el ancho del reborde

Aim: Determine bone density and height reached fifteen (15) days and three (3) months after being grafted an sockets with a synthetic bone substitute and compared with experimental ceramic biocomposite. Materials and Methods: Thirty-seven sockets (37) selected randomly were gra - fted in clinics of the University of Valle, sixteen sockets (16) for control group and twenty (21) for the experimental group. CT scans were performed at 15 days and 3 months post-surgery determining bone levels: vertical height and width in the gra - fted area; bone density is also determined by analyzing Hounsfield units. The infor - mation obtained was processed with the STATA version 13 application frequencies for gender, type of socket and type of graft used, and for numeric variables of age, bone density, bone height, thickness crestal, averages were established and deviation were calculated standard. The confidence level was set at 95% and the significance level of 5%. Results: Bone density and height, no statis - tically significant differences between the intervention group (group 1) and control (group 2). For peak thickness statistically significant differences ( p <0.05). The va - riation or change between start and end of follow within each group found that there is no statistically significant difference. Conclusions: The ceramic biocomposite with chitosan and graft tricalcium phospha - te and hydroxyapatite no statistically significant differences in density and height in the scans at 15 and 90 days. The bone width showed statistically significant differences