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.

Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study.

The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher's Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.

Obesity and periodontitis: systematic review and meta-analysis / Obesidade e periodontite: revisão sistemática e meta-análise

The scope of this study was to conduct a systematic review of the studies on the association between obesity and periodontitis. The methods applied included a literature search strategy and selection of studies using inclusion and exclusion in accordance with the criteria for characteristics of the studies and meta-analysis. The research was conducted in the PubMed, Embase and Lilacs databases through 2010. Selected papers were on studies on humans investigating whether or not obesity is a risk factor for periodontitis. Of the 822 studies identified, 31 studies met the inclusion criteria and were included in this meta-analysis. The risk of periodontitis was associated with obesity (or had a tendency for this) in 25 studies, though it was not associated in 6 studies. The meta-analysis showed a significant association with obesity and periodontitis (OR = 1.30 [95% Confidence Interval (CI), 1.25 - 1.35]) and with mean Body Mass Index (BMI) and periodontal disease (mean difference = 2.75). Obesity was associated with periodontitis, however the risk factors that aggravate these diseases should be better clarified to elucidate the direction of this association. Working with paired samples and avoiding confusion factors may contribute to homogeneity between the studies.

O objetivo deste estudo foi realizar uma revisão sistemática sobre a associação entre obesidade e periodontite. Os métodos aplicados incluíram uma estratégia de busca na literatura, seleção dos estudos por meio dos critérios de inclusão e exclusão de acordo com as características dos estudos e meta-análise. A busca foi realizada nas bases de dados PubMed, EMBASE e LILACS até 2010. Os artigos selecionados foram sobre estudos em humanos, investigando se a obesidade é um fator de risco para periodontite. Dos 822 estudos identificados inicialmente, 31 atendiam aos critérios de inclusão e foram incluídos na metanálise. O risco da periodontite esteve associado com obesidade (ou teve uma tendência para isso) em 25 estudos, sendo que 6 não encontraram esta associação. A meta-análise mostrou uma associação significativa entre obesidade e periodontite. (OR = 1,30 [95% Intervalo de Confiança (IC); 1,25 - 1,35]) e entre o Índice de Massa Corporal (IMC) médio e doença periodontal (diferença nas médias = 2,75). Obesidade esteve associada à periodontite, entretanto os fatores de risco que agravam essas doenças devem ser melhor esclarecidos para elucidar a direção dessa associação. Trabalhar com amostras pareadas e evitar fatores de confusão podem contribuir para a homogeneidade entre os estudos.

Diferentes sistemas de distalização de molares utilizando ancoragem esquelética indireta - relato de casos / Different systems of molar distalization using indirect skeletal anchorage - case reports

Uma opção de tratamento da má oclusão de Classe II dentária é a utilização de distalizadores intrabucais que costumam apresentar efeitos de perda de ancoragem nos dentes anteriores quando utilizado uma ancoragem convencional. Para minimizar esses efeitos a distalização pode ser realizada com apoio em mini-implantes que devido à sua versatilidade podem ser instalados em diferentes locais na cavidade bucal, proporcionando diferentes maneiras de se realizar essa mecânica. O objetivo deste artigo é apresentar dois casos clínicos da correção da má oclusão de Classe II com o uso de diferentes sistemas de distalização de molares associados à ancoragem esquelética indireta. No primeiro caso foi utilizado ancoragem esquelética por meio de mini-implantes instalados entre os pré-molares e molares superiores por vestibular e a distalização realizada com molas de NiTi. No segundo caso foi utilizado o aparelho distalizador First Class ancorado em mini-implantes no palato. Ambos mecanismos apresentaram distalização eficiente. O sistema com ancoragem no palato possui a vantagem de realizar apenas uma etapa cirúrgica de inserção dos mini-implantes, enquanto que na ancoragem por vestibular deve ser realizada outra cirurgia para reposicioná-los e permitir a retração anterior. A utilização desses sistemas minimizou os efeitos colaterais mostrando que mecânicas de distalização podem ser melhor controladas quando se utiliza ancoragem esquelética.

An option for treatment of Class II malocclusion is the use of intraoral distalizers, which often show effects of anchorage loss in anterior teeth when a conventional anchorage is used. To minimize these effects, mini-implant supported distalization can be performed. Due to their versatility, mini-implants can be placed in different locations in the oral cavity, enabling different ways of performing orthodontic mechanics. The objective of this paper was to present two cases of correction of Class II malocclusion with the use of different molar distalization systems associated with indirect skeletal anchorage. In the first case, skeletal anchorage was obtained by mini-implants inserted between maxillary premolars and molars buccally, and distalization performed with NiTi springs. In the second case, the First Class appliance was used, anchored to mini-implants in the palate. Both mechanisms presented efficient distalization. The system with anchorage in the palate has the advantage of requiring only one surgical step for mini-implant insertion, while for anchorage in the buccal region, another surgery is required to reposition them and allow anterior retraction. The use of these systems has minimized side effects of distalization, showing that mechanics can be better controlled when using skeletal anchorage.

Oral manifestations in HIV+ children in Mozambique / Manifestações orais em crianças HIV, em Moçambique

O objetivo deste estudo foi identificar a prevalência das manifestações bucais em pacientes HIV+/SIDA do Hospital Pediátrico DIA de Maputo. Foram incluídos 90 pacientes na pesquisa. Cárie dentária (índice ceod/CPOD), mucosa e fluxo salivar foram avaliados. Informações sobre alimentação e hábitos de higiene bucal foram obtidas por meio de um questionário. Para a análise estatística foram utilizados os testes t-student e qui-quadrado. A lesão oral mais frequente foi a candidíase (5,5 por cento) e no exame extra-oral foi observada uma prevalência de alargamento da parótida de 23 por cento. A média do ceod foi 2,6 (± 3,6) dentes, consideravelmente alta em relação ao CPOD que foi de 0,6 (±1,6) dentes, sendo esta diferença estatisticamente significante (p<0,05). A ocorrência de lesões na mucosa bucal foi maior em crianças que não faziam uso da terapia antiretroviral (TRA). O uso da TRA esteve associado com a redução da prevalência de lesões bucais em pacientes HIV+, contudo cáries rampantes foram maiores neste grupo. Pacientes HIV+ mostraram maior risco de cáries na dentadura decídua.

The scope of this study was to identify the prevalence of oral manifestations in HIV+/AIDS patients at the DIA Pediatric Hospital of Maputo. All 90 patients were included in the research. Data on dental caries (dmft/DMFT index), soft tissues and saliva flow were analyzed. Information on diet and hygienic habits was obtained in a semi-structured questionnaire. The t- student and chi-square tests were used for statistical assessment. The most frequent oral lesion was candidiasis (5.5 percent) and upon further oral examination the prevalence of parotid enlargement was 23.0 percent. The mean dmft 2.6 (SD 3.6) was considerably higher in relation to DMFT of 0.6 (SD 1.6), and the differences between them were statistically significant (P<0.05). The occurrence of mucosal lesions was higher in children who did not take antiretroviral therapy (ART) (p= 0.026). The use of ART is associated with reduced prevalence of oral lesions in HIV+ patients; however, rampant caries were highest in this group. Primary dentition of HIV+ patients should be considered high risk for caries.