Longitudinal assessment of immunological and oral clinical conditions in patients undergoing anticancer treatment for leukemia.

OBJECTIVE: The aim of this study was to evaluate the evolution of the immunological and oral clinical conditions of children and adolescents undergoing anticancer treatment for leukemia (ATL). METHODS: Twenty patients aged 3-15 years undergoing chemotherapy seen at a referral center for cancer treatment in the State of Maranhão, Brazil, from 2008 to 2009, were evaluated at baseline (1st). Twenty-two controls were selected in public schools. Oral lesions, caries experience (deft and DMFT), plaque index (PI), gingival index (GI) and salivary IgA were analyzed. Patients and controls were evaluated after 6 months (2nd). The Shapiro Wilk, Mann-Whitney, Wilkoxon and Spearman correlation tests were carried out (alpha=5%). RESULTS: Gingivitis and mucositis were the most frequent manifestations in oral mucosae during the two phases. The mean DMFT index increased from 3.9 ± 4.2 (1st) to 4.4 ± 4.3 (2nd) (p = 0.04). The mean deft index was the same in the 1st (1.9 ± 2.7) and 2nd (1.9 ± 2.7) evaluation (p = 0.86). The GI also did not vary between assessments: 1st (1.3 ± 0.4) and 2nd (1.3 ± 0.3) - (p = 0.12), except on the lingual and distal surfaces, where increased from the 1st to 2nd evaluation (p < 0.01). The PI varied from 0.9 to 1.1, but this difference was not significant (p = 0.48), except for the lingual surface, where increased from 0.6 to 1.0 (p = 0.04). There was a reduction in salivary IgA levels from 2.9 to 1.9 µg/mL (p = 0.04), and mean IgA was significantly higher in the control group (5.4 µg/mL) if compared to cases (p < 0.01). CONCLUSION: The clinical and immunological oral conditions of children and adolescents undergoing ATL presented an unfavorable evolution. This study highlights the need for monitoring oral conditions during the ATL and draws attention to the additional responsibility of the otolaryngologist in referring ATL patients to the dentist, especially in the presence of clinical evidence of oral problems. We suggest that the planning of ATL take into account the oral health, in a multidisciplinary oncology team.

The interface between metabolic syndrome and periodontal disease

Introduction: Metabolic syndrome (MS) is a complex pathology that combines several risk factors for cardiovascular disease. It is defined by the presence of visceral obesity, elevated triglycerides, decreased HDL, elevated blood pressure and blood glucose. The presence of at least three of these factors characterizes the syndrome. Periodontal disease (PD) is a chronic infection that produces a local and systemic inflammatory response. PD has been suggested as a possible risk factor for some of the components of MS, such as diabetes, obesity and dyslipidemia. Objective: The aim of this study was to review the literature about the possible association between periodontal disease and metabolic syndrome and to identify the components of this syndrome that may contribute to this association. Literature review: PD in the body produces a subclinical inflammatory state characterized by the release of inflammatory cytokines. Conclusion: It is plausible that these substances may contribute to the development of metabolic syndrome.

Avaliação clínica de placa, gengivite e superfície dentária em usuários de prótese parcial removível / Clinical evaluation of dental plaque, gingivitis and dental surface of removable partial dentures

O objetivo desta pesquisa foi avaliar clinicamente os dentes pilares (148), não pilares (163) e antagonistas (226), de 30 pacientes usuários de prótese parcial removível, num total de 537 dentes. Calculou-se em cada grupo a freqüência dos escores 0, 1 e 2-3 de placa, gengivite na face vestibular e lingual e a freqüência de dentes cariados, restaurados e hígidos. Com relação à freqüência dos escores, o teste qui-quadrado mostrou haver significância apenas na face lingual, sendo o escore 2-3 o mais freqüente do índice de placa (46,62 por cento) e do índice gengival (23,65 por cento). Com relação à análise de superfície, houve significância estatística, sendo os dentes pilares os que apresentam mais freqüentemente cárie (22,97 por cento) e restauração (51,35 por cento), já os antagonistas foram os dentes com maior percentual de higidez (49,56 por cento). Os autores concluíram que os dentes em contato com a prótese (pilares) apresentam maior probabilidade de acumular placa, de apresentar gengivite marginal, bem como predispor à cárie e que a face lingual destes dentes apresentaram maior freqüência de acúmulo de placa e gengivite marginal