Cambios en los conocimientos sobre la relación periodontitis/enfermedades sistémicas. Estudio transversal no analítico

Introducción: Las enfermedades periodontales tienen efectos locales y sistémicos sobre algunas enfermedades sistémicas. Propósito: Identificar cambios después de una jornada informativa preventiva sobre la relación de las EP y las enfermedades sistémicas en un ambiente universitario de carreras del área de la salud. Materiales y métodos: Estudio transversal no analítico cuyo objeto de estudio fue el cambio de la información obtenida por los participantes de una jornada de educación en salud en una muestra no aleatoria de 264 individuos de facultades de salud diferentes a odontología quienes recibieron encuestas "antes y después". Las variables de los cambios en los conocimientos se evaluaron mediante una escala Likert. Resultados: Antes de la estrategia, el 51,6% consideraban poco importante o que podría ser importante la salud oral como estilo de vida saludable vs un 99.2% al final. El 67.8 % de los sujetos, consideraban que la enfermedad periodontal no compartía factores de riesgo con condiciones sistémicas vs un 92.9%. Se incrementó de un 67.75% a 93.2% el reconocimiento del control del riesgo periodontal como estrategia para incidir en las enfermedades sistémicas. Conclusión: Una estrategia educativa sensibilizar positivamente sobre la importancia de la prevención de las enfermedades periodontales y las condiciones sistémicas.

Introduction: Periodontal diseases have local and systemic effects on some systemic diseases. Purpose: Identify changes after a preventive information session on the relationship between PD and systemic diseases in health faculties. Materials and methods: Non-analytical cross-sectional study whose object was the change in the information obtained by the participants of a health education session in a non-random sample of 264 individuals from health faculties other than dentistry who received "before and after" surveys. The variables were evaluated using a Likert scale. Results: Before the strategy, 51.6% considered oral health to be important for a healthy lifestyle vs. 99.2% at the end of the session. 67.8% of the subjects considered that periodontal disease shared risk factors with systemic conditions before the session vs. 92.9% after it. The recognition of periodontal risk control as a strategy to influence systemic diseases increased from 67.75% to 93.2%. Conclusion: An educational strategy raises a positive awareness of the importance of preventing periodontal diseases and systemic conditions.

PDCA cycle improves the image quality of oral photography in patients with periodontal disease / 中国现代医生

@#Objective To study the effect of PDCA cycle on the image quality of oral photography in patients with periodontal disease.Methods Totally 94 patients with periodontal disease admitted to our hospital from February to July 2022 were selected.47 patients who took oral photography images from February to April 2022 were included in the control group,and 47 patients who took oral photography images from May to July 2022 were included in the PDCA group.At the same time,9 nursing staff in the periodontal department of our hospital were selected.The patients in the control group were taken conventional photography,PDCA group used PDCA cycle on the basis of the control group.The image quality of the two groups of patients with periodontal disease and their satisfaction with the oral photography process were compared.The deduction of points for photography technology of nursing staff before and after the implementation of PDCA cycle were compared.Results The rate of reaching the standard of image quality in PDCA group was significantly higher than that in the control group(P<0.05).The satisfaction of PDCA group with oral photography was significantly higher than that of the control group(P<0.05).After the implementation of PDCA cycle,the deduction of points of material preparation,frontal,lateral,lingual,maxillofacial,maxillofacial,photography time and photography technology of nursing staff were significantly lower than those before the implementation(P<0.05).Conclusion PDCA circulation can effectively improve the rate of reaching the standard of oral photography image quality of patients with periodontal disease,increase their satisfaction with the photography process,and improve the nursing staff's photography technology score.

Application status of risk assessment models for periodontal disease / 口腔疾病防治

@#Risk assessment models for periodontal disease provide dentists with a precise and consolidated evaluation of the prognosis of periodontitis, enabling the formulation of personalized treatment plans. Periodontal risk assessment systems have been widely applied in clinical practice and research. The application fields of periodontal risk assessment systems vary based on the distinctions between clinical periodontal parameters and risk factors. The assessment models listed below are commonly used in clinical practice, including the periodontal risk calculator (PRC), which is an individual-based periodontal risk assessment tool that collects both periodontal and systemic information for prediction; the periodontal assessment tool (PAT), which allows for quantitative differentiation of stages of periodontal disease; the periodontal risk assessment (PRA) and modified periodontal risk assessment (mPRA), which are easy to use; and the classification and regression trees (CART), which assess the periodontal prognosis based on a single affected tooth. Additionally, there are orthodontic-periodontal combined risk assessment systems and implant periapical risk assessment systems tailored for patients needing multidisciplinary treatment. This review focuses on the current application status of periodontal risk assessment systems.

Orthodontic treatment of a patient with special needs: a case report / Tratamento ortodôntico de um paciente com necessidades especiais: um relato de caso

ABSTRACT This report presents the case of an adult patient with mental and intellectual limitations, whose main complaint was dental aesthetics. Dental treatment was performed at the Piracicaba Dental School and approved by the Ethics Committee (CAAE: 65752322.2.0000.5418). Clinically, the patient had inadequacies in the dental arrangement, with periodontal involvement that put the dental elements at risk. In intraoral clinical aspects, the deficiency was identified as maxillary atresia. The buccolingual inclination of the mandibular anterior teeth highlighted the severe crowding and anterior crossing of these teeth. Dental treatment was carried out aiming at the remission of periodontal and orthodontic problems in an integrated manner and with approaches that allowed greater interaction, participation, and patient compliance during treatment. Supra and subgingival scrapings and extraction of the upper left lateral incisor were performed. After three months of periodontal treatment, orthodontic treatment was started with fixed orthodontic appliances. The main objective was to level and align the teeth in both arches to achieve better aesthetic and functional conditions. Due to the COVID-19 pandemic, treatment has been discontinued. This resulted in the regression of the results obtained, including regarding self-care. People with disabilities require dental care with specific strategies for their needs, which must be carried out by a multidisciplinary team. Despite the access limitation imposed by the pandemic, the patient reestablished his motivation to restart treatment, which was facilitated by the bond of trust established between him and the team.

RESUMO Este relato apresenta o caso de um paciente adulto com limitações mentais e intelectuais, cuja queixa principal era a estética dental. O tratamento odontológico foi realizado na Faculdade de Odontologia de Piracicaba e aprovado pelo Comitê de Ética (CAAE: 65752322.2.0000.5418). Clinicamente, o paciente apresentava inadequações no arranjo dentário, com comprometimento periodontal, que colocava em risco os elementos dentais. Nos aspectos clínicos intrabucais, a deficiência foi identificada como atresia maxilar. A inclinação vestíbulo-lingual dos dentes anteriores inferiores destacou o apinhamento severo e o cruzamento anterior desses dentes. O tratamento odontológico foi realizado visando à remissão dos problemas periodontais e ortodônticos de forma integrada e com abordagens que permitissem maior interação, participação e adesão do paciente durante o tratamento. Foram realizadas raspagens supra e subgengivais e extração do incisivo lateral superior esquerdo. Após três meses de tratamento periodontal, iniciou-se o tratamento ortodôntico com aparelhos ortodônticos fixos. O objetivo principal foi nivelar e alinhar os dentes em ambas as arcadas para alcançar melhores condições estéticas e funcionais. Devido à pandemia de COVID-19, o tratamento foi interrompido. Isso resultou na regressão dos resultados obtidos, inclusive quanto ao autocuidado. As pessoas com deficiência requerem atendimento odontológico com estratégias específicas para suas necessidades, que devem ser realizadas por uma equipe multidisciplinar. Apesar da limitação de acesso imposta pela pandemia, o paciente restabeleceu sua motivação para reiniciar o tratamento, o que foi facilitado pelo vínculo de confiança estabelecido entre ele e a equipe.

Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis

Abstract Background The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). Methods The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). Results There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). Conclusions The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.

Relación entre la enfermedad periodontal y la enfermedad pulmonar obstructiva crónica: revisión bibliográfica / Relationship between periodontal disease and chronic obstructive pulmonary disease: a bibliographic review

Introducción: la enfermedad periodontal y la enfermedad pulmonar obstructiva crónica son patologías de origen inflamatorio crónico y progresivo que afectan a pacientes de edad avanzada, fumadores con mal estado de salud oral, encontrándose una correlación por el grado de severidad en la enfermedad periodontal sobre aquellos individuos con presencia de enfermedad pulmonar obstructiva crónica (EPOC) y exacerbaciones. Objetivos: determinar la relación de la enfermedad periodontal y la enfermedad pulmonar obstructiva crónica, explicando los factores de riesgo que intervienen en estas enfermedades. Material y métodos: se realizó una búsqueda en los principales buscadores de datos digitales: PubMed, SciELO, Science Direct, BMC, Journal of Periodontology, Web of Science y Scopus. Se escogieron artículos publicados en los últimos cinco años; se excluyeron artículos incompletos y que no se relacionan al tema. En el resultado de la búsqueda, 45 artículos cumplieron con el propósito de la revisión bibliográfica. Resultados: en esta revisión bibliográfica, se obtuvo que 18 artículos comprueban la relación de la enfermedad periodontal y la enfermedad pulmonar obstructiva crónica. Conclusiones: se ha comprobado la relación entre la enfermedad periodontal y enfermedad pulmonar obstructiva crónica. Se requiere el análisis de más estudios para determinar una relación directa entre estas dos enfermedades e incluir variables como la edad y el tratamiento (AU)

Introduction: periodontal disease and chronic obstructive pulmonary disease are diseases of chronic and progressive inflammatory origin that affect elderly patients, smokers with poor oral health, finding a correlation by the degree of severity in periodontal disease on those individuals with the presence of chronic obstructive pulmonary disease (COPD) and exacerbations. Objectives: to determine the relationship between periodontal disease and chronic obstructive pulmonary disease explaining the risk factors involved in these diseases. Material and methods: a search was carried out in the main digital data search engines: PubMed, SciELO, Science Direct, BMC, Journal of Periodontology, Web of Science, and Scopus, articles published in the last 5 years were chosen, incomplete articles and those not related to the subject were excluded, in the result of the search 45 articles fulfilled the purpose of the bibliographic review. Results: in this literature review it was obtained that 18 articles, prove the relationship between periodontal disease and chronic obstructive pulmonary disease. Conclusions: the relationship between periodontal disease and chronic obstructive pulmonary disease has been proved. More studies are needed to determine a direct relationship between these two diseases and to include variables such as age and treatment (AU)

Assessment of Subgingival Biofilm and its Relationship with the Status of Tumors in a Population with Breast Cancer

This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.

El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.

The association Between Sleep Quality, Fatigue and Periodontal Status: a pilot study / La asociación entre la calidad del sueño, la fatiga y el estado periodontal: un estudio piloto

Abstract Reduced sleep duration, poor sleep quality and fatigue are related to reduced immunity and increased inflammatory markers. Due to its potential to influence inflammation, poor sleep quality and fatigue could be factors for periodontitis and quality of life. Ninety-three individuals with untreated periodontitis and thirty-one individuals with healthy gingiva were included in the study. The research involved a clinical examination and a questionnaire. Demographic information, information on oral health, oral hygiene habits, the Pittsburgh Sleep Quality Index, Jenkins Sleep Scale, Multidimensional Assessment of Fatigue Scale, and Oral Health Impact Profile-14 were included in the questionnaire. Patients were diagnosed based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. No statistically significant difference was revealed between sleep quality, fatigue, oral health related quality of life, and stage-grade of periodontitis (p<0.05). However, periodontitis group had higher Oral Health Impact Profile-14 scores (p<0.05). A statistically significantly lower sleep duration was observed in stage IV periodontitis group than the other groups (p<0.05). A statistically significant positive correlation was observed between the Pittsburgh Sleep Quality Index and the scores of the other questionnaires (p<0.05). The stage of periodontitis may impact sleep duration.

Resumen La reducción de la duración del sueño, la mala calidad del sueño y la fatiga están relacionados con una inmunidad reducida y un aumento de los marcadores inflamatorios. Debido a su potencial para influir en la inflamación, la mala calidad del sueño y la fatiga podrían ser factores determinantes en el desarrollo de la periodontitis e incidir en la calidad de vida. Noventa y tres personas con periodontitis no tratada, además de treinta y una personas con encía sana se incluyeron en el estudio. La investigación involucró un examen clínico y un cuestionario. En el cuestionario se incluyeron información demográfica, información sobre salud bucal, hábitos de higiene bucal, el índice de calidad del sueño de Pittsburgh, la escala de sueño de Jenkins, la escala de evaluación multidimensional de la fatiga y el perfil de impacto en la salud bucal-14. Los pacientes fueron diagnosticados en base al Taller Mundial 2017 sobre la Clasificación de Enfermedades y Condiciones Periodontales y Periimplantarias. No se revelaron diferencias estadísticamente significativas entre la calidad del sueño, la fatiga, la calidad de vida relacionada con la salud bucal y el grado de etapa de la periodontitis (p<0,05). Sin embargo, el grupo de periodontitis tuvo puntajes más altos en el Perfil de Impacto en la Salud Oral-14 (p<0.05). Se observó una duración del sueño significativamente menor desde el punto de vista estadístico en el grupo de periodontitis en estadio IV que en los otros grupos (p<0,05). Se observó una correlación positiva estadísticamente significativa entre el Índice de Calidad del Sueño de Pittsburgh y las puntuaciones de los otros cuestionarios (p<0,05). La etapa de la periodontitis puede afectar la duración del sueño.

Enfermedad periodontal y su relación con la diabetes

La diabetes mellitus es una enfermedad sistémica padecida en la actualidad por gran parte de la población. Padecer una enfermedad sistémica predispone la aparición de enfermedades periodontales. La gravedad de la enfermedad periodontal está afectada por la respuesta inflamatoria. Células como IL-1β, IL-6 y TNF-α se elevan de forma crónica y persistente. La enfermedad periodontal prevalente en el paciente diabético suele ser la periodontitis por enfermedades sistémicas. Se observan ciertas afectaciones en ligamentos y hueso (deterioro o pérdida), por lo que resulta importante que el odontólogo conozca todo lo que involucra la enfermedad periodontal en un paciente diabético. Para la presente investigación se realizó una revisión bibliográfica en importantes bases de datos como: Pubmed y Scopus. El objetivo propuesto fue: establecer la interrelación entre las enfermedades periodontales y la diabetes y determinar entre las enfermedades periodontales la de mayor prevalencia en pacientes diabéticos.

Diabetes mellitus is a systemic disease currently suffered by a large part of the population. Having a systemic disease predisposes the appearance of periodontal diseases. The severity of periodontal disease is affected by the inflammatory response. Cells such as IL-1β, IL-6, and TNF-α are chronically and persistently elevated. The prevalent periodontal disease in diabetic patients is usually periodontitis due to systemic diseases. Certain affectations are observed in ligaments and bone (deterioration or loss), so it is important that the dentist knows everything that periodontal disease involves in a diabetic patient. For the present investigation, a bibliographic review was carried out in important databases such as: Pubmed and Scopus. The proposed objective was: to establish the relationship between periodontal diseases and diabetes and to determine the periodontal diseases with the highest prevalence in diabetic patients.

Diseño y validación de una escala de riesgo de parto pretérmino con enfoque periodontal / Design and validation of a preterm birth risk scale with a periodontal approach i: en

Introducción: La escala de riesgo diseñada para estimar la probabilidad de parto pretérmino con enfoque periodontal debe ser validada antes de su implementación en la práctica clínica. Objetivo: Diseñar y validar una escala de riesgo de parto pretérmino con enfoque periodontal. Métodos: Se realizó un estudio analítico, de casos y controles, de 1152 puérperas ingresadas en los hospitales maternos de la provincia de Santiago de Cuba en el período 2011-2022, para lo cual fueron seleccionadas 2 muestras: una de construcción del modelo (n=750) y otra de validación de la escala (n=402). Se determinaron los posibles predictores a través del análisis univariado y el cálculo del odds ratio, con un nivel de significación de p≤0,05; asimismo, se elaboró un modelo de regresión logística binaria multivariada y se obtuvo la escala de riesgo que fue validada por diferentes métodos. Resultados: La escala se obtuvo con 7 predictores y 2 estratos de riesgo. Esta alcanzó buena discriminación (80 %), así como buen nivel de ajuste y validez de constructo (p=0,72). Igualmente, aseguró una predicción correcta de más de 50 % de los partos pretérmino, valores de sensibilidad y especificidad aceptables (79,20 y 70,20 %, respectivamente), así como validez de contenido, validez interna y confiabilidad adecuadas. Conclusiones: La escala de riesgo para estratificar el riesgo de parto pretérmino incluye predictores de gravedad de la enfermedad periodontal, con buenos parámetros de validación para ser usada en la toma de decisiones para prevenir este tipo de parto.

Introduction: The risk scale designed to estimate the probability of preterm birth with periodontal approach should be validated before its implementation in the clinical practice. Objective: To design and validate a risk scale of preterm birth with periodontal approach. Methods: A cases and controls analytic study of 1152 newly-delivered women admitted to maternal hospitals in Santiago de Cuba province was carried out in the period 2011 - 2022, and 2 samples were selected: one of pattern construction (n=750) and another of scale validation(n=402). The possible predictors were determined through the single varied analysis and odds ratio calculation, with a significance level of p≤0.05; also, a multivariate binary logistical regression model was elaborated and the risk scale was obtained, which was validated by different methods. Results: The scale was obtained with 7 predictors and 2 risk stratum. It reached a good discrimination (80%), as well as a good adjustment level and construction validity (p=0.72). Likewise, it assured a correct prediction of more than 50% of preterm births, acceptable sensibility and specificity values (79.20 and 70.20%, respectively), as well as adequate content validity, internal validity and reliability. Conclusions: The risk scale to stratify the risk of preterm birth includes predictors of periodontal disease severity, with good validation parameters to be used in the decisions making to prevent this type of childbirth.

A modified tunnel technique to treat multiple gingival recessions: Case Series

Abstract This case series reports a modified tunnel technique with connective tissue graft for the root coverage of multiple Miller Class I, II, and III gingival recessions. The modified approach presents an innovative suture technique to improve the stability and position of the graft. Ten patients with multiple gingival recessions (n=85 teeth) received surgical root coverage treatment. The gingival recession height and width were measured and presented as median, minimum, and maximum values. The percentage of the root coverage after at least 12 months expressed the treatment effectiveness. The Shapiro-Wilk test evaluated the normality; pared Wilcoxon test determined the exact P-value for the differences in the height of the gingival recession before and after surgical treatment (α = 0.05). An average of 97.9% (± 5.6%, p < 0.0001) root coverage after treatment occurred, and 73 out of 85 recessions presented complete root coverage after 12 months. Treatment of Miller class I and II gingival recessions resulted in root coverage higher than 99 and class III higher than 95% (p < 0.0001). The presented case series report the efficacy of a modified surgical technique promoting more than 95% of root coverage after 12 months in multiple Miller Class I, II, and III gingival recessions. Well-designed blind randomized controlled trials are needed to validate the proposed technique.

Resumo Esta série de casos relata uma técnica de túnel modificada com enxerto de tecido conjuntivo para o recobrimento radicular de múltiplas recessões gengivais Classe I, II e III de Miller. A abordagem modificada apresenta uma técnica de sutura inovadora para melhorar a estabilidade e a posição do enxerto. Dez pacientes com múltiplas recessões gengivais (n=85 dentes) receberam tratamento cirúrgico de recobrimento radicular. A altura e a largura da recessão gengival foram mensuradas e apresentadas como valores medianos, mínimos e máximos. A eficácia do tratamento foi expressa como uma porcentagem da cobertura radicular após pelo menos 12 meses. O teste de Shapiro-Wilk avaliou a normalidade; o teste de Wilcoxon pared determinou o valor P exato para as diferenças entre a altura da recessão gengival antes e após o tratamento cirúrgico (α = 0,05). Uma média de 97,9% (± 5,6%, p < 0,0001) de cobertura radicular após o tratamento ocorreu, e 73 das 85 recessões apresentaram cobertura radicular completa após 12 meses. O tratamento das recessões gengivais classe I e II de Miller resultou em recobrimento radicular superior a 99 e classe III superior a 95% (p < 0,0001). A série de casos apresentada relata a eficácia de uma técnica cirúrgica modificada promovendo mais de 95% de cobertura radicular após 12 meses em múltiplas recessões gengivais Classe I, II e III de Miller. Ensaios controlados randomizados cegos bem desenhados são necessários para validar a técnica proposta.

Prevalência e Autoconhecimento de Indicadores de Inflamação Sugestivos de Doença Periodontal em Militares / Prevalence And Self-Knowledge Of Indicators Of Inflammation Suggestive of Periodontal Disease In Military Personne

O objetivo deste estudo foi identificar a prevalência e o autoconhecimento para indicadores de inflamação sugestivos de doença periodontal em militares de ambos os sexos. Os militares foram recrutados para realização de um censo odontológico para toda a população do Centro de Instrução Almirante Wandenkolk (CIAW) da Marinha do Brasil, totalizando 409 voluntários. Foram formados dois grupos para posterior análise: Grupo 1- contendo exclusivamente mulheres e Grupo 2- contendo exclusivamente homens. Foram realizados 409 exames clínicos e analisados 409 questionários. Os resultados demonstraram que, quanto aos participantes militares, 40,1% foram do sexo feminino e 59,9%, do sexo masculino; 87% faziam uso do fio dental, desses 56% usavam diariamente; 77% apresentaram frequência de escovação de três vezes ao dia ou mais; 74,3% relataram que visitam regularmente o dentista, e a proporção de mulheres que frequenta regularmente o dentista superou significativamente a proporção de homens que o fizeram (I.C. 95%; p < 0,001); 61,6% afirmaram conhecer a doença periodontal. A avaliação profissional verificou a presença de indicadores de inflamação sugestivos de doença periodontal em 45,2% participantes, desses 37% eram do gênero feminino e 63%, do gênero masculino, não sendo observada diferença estatística entre os gêneros (I.C. 95%; p = 0,2248). Concluiu-se que a prevalência de indicadores de inflamação sugestivos de doença periodontal encontrada foi de 45,2%; o autoconhecimento dos militares sobre doença periodontal foi baixo, apenas 19%; dessa forma foi verificada diferença estatística entre o conhecimento das mulheres e dos homens; e observou-se que a maioria dos participantes estava dentro da frequência correta para consulta de retorno ao dentista.

The objective of this study was to identify the prevalence and self-recognition for indicators of inflammation suggestive of periodontal disease in military personnel of both genders. The military personnel was recruited to conduct a dental census for the entire population of the Admiral Wandenkolk Training Center of the Brazilian Navy, totaling 409 volunteers. Two groups were formed for further analysis: Group 1- containing exclusively women and Group 2- containing exclusively men. A total of 409 clinical examinations were performed and the questionnaires were analyzed. The results showed that, regarding the military participants, 40.1% were female and 59.9% were male; 87% used dental floss, of which 56% used it daily; 77% brushed three times a day or more; 74.3% reported that they visited the dentist regularly, and the proportion of women who regularly visited the dentist significantly exceeded the proportion of men who did (C.I. 95%; p<0.001); 61.6% said they knew about periodontal disease. The professional evaluation verified the presence of inflammation indicators suggestive of periodontal disease in 45.2% of the participants, of which 37% were female and 63% were male, with no statistical difference between genders (95% CI, p=0.2248). The prevalence of inflammation indicators suggestive of periodontal disease was 45.2%; the self-knowledge of the military about the periodontal disease was low, only 19%; thus a statistical difference was found between the knowledge of females and males; and it was observed that most participants were within the correct frequency for return visits to the dentist.

Diferencia en la expresión del ligando de receptor activador para el factor nuclear K B, en tejido tumoral frente a la infección por diferentes patógenos periodontales / Difference in receptor activator of nuclear factor K B expression in tumoral tissue by different periodontal pathogens

La enfermedad periodontal es una de las principales causas de pérdida dentaria. Clínicamente, esta patología, mediada por la desregulación del sistema inmune producto de una disbiosis ocurrida en el surco gingival, inicia con la inflamación de la encía y evoluciona con el daño irreversible de los tejidos que rodean el diente. El hueso alveolar es uno de los tejidos afectados esta patología, esto debido a la activación de osteoclastos por la sobreexpresión de la proteína RANKL en el huésped. El propósito de este trabajo es determinar el nivel de sobreexpresión de RANKL, en un modelo de células tumorales U2OS, frente a la infección con Porphyromonas gingivalis y Prevotella intermedia. Para identificar el nivel de RANKL, se definieron cuatro grupos: Un grupo control, no tratado; Grupo PG, tratado con P. gingivalis; Grupo PI, tratado con P. Intermedia; y un grupo PG+PI, tratado con ambas bacterias. El nivel relativo de la proteína RANKL fue determinado en el sobrenadante y en los extractos celulares de manera independiente, mediante la técnica Western blot. En sobrenadantes, el grupo PG mostró mayores niveles de RANKL comparados con PI (p < 0,05). En extractos celulares los niveles fueron mayores en el grupo PG+PI (p < 0,05). El grupo PI mostró los niveles más bajos de RANKL. La infección polimicrobiana resulta en una mayor expresión de RANKL en células tumorales U2OS, mientras que frente a la infección P. gingivalis, se observó mayor cantidad de RANKL soluble.

SUMMARY: Periodontal disease is one of the main causes of tooth loss. Clinically, this pathology, mediated by the deregulation of the immune system due to a dysbiosis occurred in the gingival sulcus, begins with the inflammation of the gum and evolves with the irreversible damage of the tissues that surround the tooth. Alveolar bone is one of the most affected tissues by this disease, due to the activation of osteoclasts by the upregulation of RANKL in the host. The aim of this study is to determine the increase of RANKL, in a U2OS tumor cells model, inoculated with Porphyromonas gingivalis and Prevotella intermedia. To identify the level of RANKL, four groups were defined: A control group, not treated; PG group, treated with P.gingivalis; PI group, treated with P. intermedia; and a PG+PI group, treated with both bacteria. The relative level of RANKL was determined in the supernatant and cell extracts independently, using the Western blot technique. In supernatants, the PG group showed higher RANKL levels compared to PI (p < 0.05). In cell extracts the levels were higher in the PG+PI group (p < 0.05.). The PI group showed the lowest levels of RANKL.Polymicrobial infection results in a greater expression of of soluble RANKL was observed.

Clinical and microbiological assessment in a subpopulation of young Argentine patients with severe periodontitis / Periodontitis severa en jóvenes argentinos. Evaluación clínica y microbiológica en jóvenes argentinos con periodontitis severa

ABSTRACT Aggressive periodontitis (AP) is the most serious entity of periodontal disease (stage III/IV, grade C periodontitis according to the latest classification, 2017). Aim: to enhance knowledge of periodontal microbiota in AP in native Argentine patients and describe the effect of a combined pharmacological-mechanicalperiodontal treatment on clinical and microbiological parameters. Materials andMethod: The study analyzed 42 periodontal sites in 11 patients diagnosed with AP. Clinical periodontal parameters were recorded at baseline, 45, 90 and 180 days. Microbiological samples were taken before treatment and at 180 days. PCR was used to determine presence of the periodontopathic bacteria Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn). Patients underwent periodontal therapy including antibiotics (Amoxicillin 500mg + Metronidazole 250mg; 8hs/7 days), and were reevaluated at 45, 90 and 180 days. Results: Mean age was 28.4 ± 7.9 years. The initial PCR detected the following frequencies: Aa 14.3%, Pi 61.9%, Pg 71.4%, Tf 81.0%, Fn 95.2% and Td 97.6%. Baseline microbiological samples revealed significantly higher prevalence of Pg over Aa (p=0.012). Clinical parameters improved significantly after treatment (73.8% PS<5 mm; PS, NIC, SS p<0.001). At 180 days, a significant decrease in microbiological detection rates was observed (Fn, Td, Tf, Pi, Aa p<0.05). Aa was no longer detectable while Pg did not decrease significantly (p=0.052). Fn was the only study species detected in 100% (n=11:42) of residual pockets (PS>5 mm) (p=0.053). Conclusion: In the initial samples, there was significant prevalence of Pg over Aa. Significant clinical improvement was achieved after the mechanical-pharmacological treatment, with undetectable levels ofAa, while Fn persisted in residual pockets, and Pg was present at most of the treated sites.

RESUMEN La periodontitis agresiva (PA) es la entidad más grave de la enfermedad periodontal (clasificación 2017: periodontitis estadio III/IV, grado C). Objetivo: mejorar el conocimiento sobre la microbiota periodontal de la PA en sujetos nativos argentinos y describir el efecto de un tratamiento mecánico-farmacológico periodontal sobre los parámetros clínicos y microbiológicos. Materiales y Método: se estudiaron 42 sitios periodontales correspondientes a 11 pacientes con PA. Los parámetros clínicos se registraron a 0, 45, 90 y 180 días. Las tomas microbiológicas se realizaron antes de iniciar el tratamiento y a los 180 días. La determinación de especies periodontopáticas (Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf, Treponema denticola (Td), Prevotella intermedia (Pi) y Fusobacterium nucleatum (Fn)) se realizó por PCR. Los pacientes iniciaron terapia básica periodontal junto con antibioticoterapia (Amoxicilina 500 mg + Metronidazol 250 mg; 8 hs/7 días) y fueron evaluados a los 45, 90 y 180 días. Resultados: la edad media fue 28,4 ± 7,9 años. Las detecciones iniciales fueron: Aa 14,3%, Pi 61,9%, Pg 71,4%, Tf 81,0%, Fn 95,2% y Td 97,6%. En las muestras iniciales la prevalencia de Pg sobre Aa fue significativamente superior (p=0,012). Los pacientes tuvieron una respuesta clínica favorable al tratamiento (73,8% PS<5 mm; PS, NIC, SS p<0,001). A 180 días, se observó una disminución estadísticamente significativa en la detección microbiana (Fn, Td, Tf, Pi, Aa p<0,05). En igual plazo, Aa no fue detectado, mientras que Pg mostró una disminución no significativa (p=0,052). Fn fue el único detectado en el 100% (n=11:42) de las bolsas periodontales residuales (PS>5 mm) (p=0,053). Conclusión: Las muestras iniciales evidenciaron prevalencia significativa de Pg sobre Aa. El tratamiento logró una significativa mejora clínica con niveles indetectables de Aa. La persistencia de Fn en las bolsas residuales y de Pg en la mayoría de los sitios tratados, caracterizaron la muestra poblacional estudiada.

Clinical identification and endodontic management of furcation canals: a case series

Abstract In the case of endodontic infection, the presence of furcation canals can be at the origin of a periodontal lesion located in the furcation. The furcation being very close to the marginal periodontium, this type of lesion can be favorable to the genesis of an endo-periodontal lesion. These furcation canals are lateral canals located on the pulp chamber floor and constitute one of the many physiological communication pathways between endodontic and periodontal tissues. These canals are most often difficult to localize, shape, and to fill because of their small diameter and length. The disinfection of the pulp chamber floor with sodium hypochlorite solution may contribute to the disinfection of furcation canals when they are not identified, shaped, and/or filled. This case series illustrates the endodontic management of visible furcation canals associated with an endo-periodontal lesion. These furcation canals had a large diameter which allowed their identification during the endodontic treatment.

Resumo No caso de infecção endodôntica, a presença de canais cavo inter-radiculares pode estar na origem de uma lesão periodontal localizada na região de furca. Sendo a furca muito próxima do periodonto marginal, esse tipo de lesão pode ser favorável à fomação de uma lesão endo-periodontal. Esses canais estão localizados no assoalho da câmara pulpar e constituem uma das inúmeras vias de comunicação fisiológica entre os tecidos endodônticos e periodontais. Esses canais são na maioria das vezes difíceis de localizar, instrumentar e obturar por causa do diâmetro e comprimento reduzidos. A desinfecção do assoalho da câmara pulpar com solução de hipoclorito de sódio pode contribuir para a desinfecção dos canais cavo inter-radiculares quando eles não são localizados, instrumentamos e/ou obturados. Os casos clínicos descritos ilustram o manejo endodôntico de canais cavo inter-radiculares visíveis associados a uma lesão endo-periodontal. Esses canais cavo inter-radiculares tinham um grande diâmetro que permitiu sua localização durante o tratamento endodôntico.

Analysis of control status and related influencing factors of plaque in patients with periodontal disease / 新乡医学院学报

Objective To investigate the status of plaque control in patients with periodontal disease and its related in-fluencing factors.Methods A total of 350 periodontal disease patients admitted to the Hospital of Stomatological Xi'an Jiao-tong University from May 2018 to May 2022 were selected as the research subjects by the random sampling method.All patients underwent total supragingival oral prophylaxis.The total oral plaque assessment and detection,general oral examination,and a questionnaire survey on oral hygiene behavior will be conducted when patients came back for return visit at 7-10 days after operation.Single factor and multivariate logistic regression analysis were used to analyze the factors affecting the effectiveness of plaque control.Results A total of 350 questionnaires were distributed in this study,and 340 valid questionnaires(97.14％)were collected.The total plaque index of the patient was(68.42±16.93)％;the plaque index in maxillary was significantly lower than that in mandibular(P＜0.05);the plaque index in anterior tooth area was significantly lower than that in the poste-rior tooth area(P＜0.05);there was no significant difference in plaque index between the left and right halves of the mouth(P＞0.05);there was no significant difference in plaque index between zone 1 and zone 2(P＞0.05);there was no signifi-cant difference in plaque index between zone 3 and zone 4(P＞0.05);the plaque index in zone 3 and zone 4 was significantly higher than that in zone 1 and zone 2,respectively(P＜0.05).There was no significance difference in the plaque index be-tween distal and lingual surfaces(P＞0.05),while there was significance difference in the plaque index between the other dental surfaces(P＜0.05).The results of univariate analysis showed that there were significant difference in plaque index among patients with different genders,educational levels,disease severity,brushing duration,and brushing method(P＜0.05);the results of multivariate logistic regression analysis showed that the severity of the disease and brushing method were the factors affecting the plaque index(P＜0.05).Conclusion The overall control situation of plaque control in patients with periodontal disease is not ideal.The severity of the disease and the method of brushing teeth are factors affecting the effectiveness of plaque index control.Oral health education should be strengthened to promote plaque control in patients with periodontal disease.

Gingival Enlargement with Marfan Syndrome: A Case Report

@#Marfan syndrome (MFS) is an autosomal dominant and multisystemic disorder affecting the connective tissues. Patients with MFS may exhibit characteristic oral features including maxillary protrusion, high palate, crowded teeth, and fragility of the temporomandibular joint. Periodontal manifestations may include a higher prevalence of gingivitis and/or periodontitis owing to the high concentration of elastic fibres in the periodontal ligament. This case report describes the management of gingival enlargement associated with MFS. The patient was successfully managed with non-surgical and surgical periodontal therapy. In patients with oral manifestations of systemic disorders, patient motivation and effective treatment planning are able to achieve the optimum periodontal and oral health outcomes.

Prevalence of periodontitis in young adults living with HIV/Aids using antiretroviral therapy / Prevalência da periodontite em adultos jovens vivendo com HIV/Aids em uso de terapia antirretroviral

ABSTRACT The therapeutic management, as well as the HIV virus itself, has been associated with alterations at the bone level, which may also have a relationship with the maxillomandibular alveolar processes and potential development of periodontal diseases, especially periodontitis. Objective: The objective of this study was to evaluate the periodontal health condition of young adults living with HIV/AIDS, through the measurement of the Periodontal Clinical Insertion Level (CAL) and to raise general data on the health conditions facing HIV and on the quality of life of this audience. Methods: Data were collected at a Reference Center for STI/AIDS in São Paulo - SP, Brazil. The method used was guided by previously validated indicators. In total, 31 individuals aged between 20 and 24 years, both genders and using TAAP were evaluated. For the analyses, the Excel Microsoft® software was used. Results: There was a prevalence of periodontitis in the assessed public of 45.17%. In view of the quality of life, the public was classified as "Regular" and no cases of Necrozing Periodontitis were observed, which is strongly associated with HIV infection. Conclusions: The evaluated public showed a high prevalence of periodontitis, which reinforces the importance of Dentistry in monitoring People Living with HIV/AIDS, in order to prevent the worsening of periodontal diseases.

RESUMO O manejo terapêutico, bem como o próprio vírus do HIV tem sido associados à quadros de alterações em nível ósseo, podendo ter uma relação também com os processos alveolares maxilo-mandibulares e potencial desenvolvimento de quadros de doenças periodontais, em especial a periodontite. Objetivo: O objetivo do trabalho foi avaliar a condição da saúde periodontal de indivíduos adultos jovens vivendo com HIV/AIDS, por meio da aferição do Nível de Inserção Clínica Periodontal e levantar dados gerais sobre as condições de saúde frente ao HIV e sobre a qualidade de vida desse público. Os dados foram coletados em um Centro de Referência em IST/AIDS de São Paulo - SP, Brasil. Métodos: O método empregado teve como guia norteadora indicadores previamente validados. No total, foram avaliados 31 indivíduos com idades entre 20 e 24 anos, ambos os gêneros e em uso da terapia antirretroviral. Para as análises foi utilizado o software Excel Microsoft®. Resultados: Foi observado uma prevalência de periodontite no público avaliado de 45,17%. Frente a qualidade de vida o público foi classificado como "Regular" e não foi observado quadros de Periodontite Necrozante, que está fortemente associado a infecção pelo HIV. Conclusão: O público avaliado apresentou alta prevalência de periodontite, o que reforça a importância da Odontologia no acompanhamento das Pessoas Vivendo com HIV/Aids, no sentido de prevenir o agravamento dos quadros de doenças periodontais.

Exercise improves alveolar bone loss and the inflammatory profile of periodontal disease / El ejercicio mejora la pérdida de hueso alveolar y el perfil inflamatorio de la enfermedad periodontal / O exercício melhora a perda de osso alveolar e o perfil inflamatório da doença periodontal

ABSTRACT Periodontal disease (PD) is an inflammatory oral disease and alveolar bone loss is the most important sign of PD. However, the effects of exercise on inflammatory factors and alveolar bone loss in individuals with PD have been little studied. This meta-analysis assesses the effect of physical exercise on alveolar bone loss (ABL) and the inflammatory profile of PD in animal models. Relevant studies published through July 2020 in PubMed, Medline, Embase and Web of Science were searched after developing a PICOS statement. Quality assessment and risk of bias were analyzed according to the SYRCLE protocol. A total of 52 references were retrieved, 4 of which were considered eligible for inclusion. A total of thirty-four male Wistar rats from the included studies were evaluated for alveolar bone loss and assessed for inflammatory profile. The results indicated that physical exercise could reduce alveolar bone loss (95% CI -2.85 to -0.82, p = 0.002) and the pro-inflammatory tumor necrosis factor-α (TNF-α) in serum or gingival tissue (95% CI -0.45 to -0.24, p < 0.00001). Inversely, exercise increased anti-inflammatory interleukin-10 (IL-10) in serum or gingival tissue (95% CI 0.28 to 0.69, p < 0.00001). However, one study reported a negative result in the expression of TNF-α and IL-10. Current evidence indicates that physical exercise contributes to ameliorate PD by reducing alveolar bone loss and inflammation in animal PD models, which suggests that moderate exercise can be implemented in clinical practice to maintain periodontal health. Level of Evidence I; Systematic Review and Meta-analysis

RESUMEN La enfermedad periodontal (EP) es una enfermedad inflamatoria oral y la pérdida de hueso alveolar es su signo más importante. Sin embargo, los efectos del ejercicio sobre los factores inflamatorios y la pérdida ósea alveolar en individuos con EP han sido poco estudiados. Este meta-análisis evalúa el efecto del ejercicio sobre la pérdida ósea alveolar (POA) y el perfil inflamatorio de la EP en modelos animales. Se llevaron a cabo estudios relevantes publicados hasta julio de 2020 en PubMed, Medline, Embase y Web of Science tras desarrollar la investigación con el método PICO. La evaluación de la calidad y el riesgo de sesgo se analizaron según el protocolo SYRCLE. Se recuperó un total de 52 referencias, cuatro de las cuales se consideraron elegibles para su inclusión. En un total de 34 ratas Wistar macho de los estudios incluidos se evaluó la pérdida de hueso alveolar y el perfil inflamatorio. Los resultados indicaron que el ejercicio puede reducir la pérdida de hueso alveolar (IC del 95%: -2,85 a -0,82; p = 0,002) y el factor de necrosis tumoral proinflamatorio-α (TNFα) en suero o tejido gingival (IC del 95%: -0,45 a -0,24; p < 0,00001). Por el contrario, el ejercicio aumentó la interleucina-10 (IL-10) antiinflamatoria en el suero o en el tejido gingival (IC del 95%: 0,28 a 0,69; p < 0,00001). Sin embargo, un estudio informó de un resultado negativo en la expresión de TNFα e IL-10. Las pruebas actuales indican que el ejercicio contribuye a mejorar la EP al reducir la pérdida de hueso alveolar y la inflamación en modelos animales de EP, lo que sugiere que se puede implementar el ejercicio moderado en la práctica clínica para mantener la salud periodontal. Nivel de Evidencia I; Revisión Sistemática y Meta-análisis.

RESUMO A doença periodontal (DP) é uma doença inflamatória oral e a perda óssea alveolar é seu sinal mais importante. No entanto, os efeitos do exercício sobre os fatores inflamatórios e a perda óssea alveolar em indivíduos com DP têm sido pouco estudados. Esta metanálise avalia o efeito do exercício físico sobre a perda óssea alveolar (POA) e o perfil inflamatório da DP em modelos animais. Estudos relevantes publicados até julho de 2020 em PubMed, Medline, Embase e Web of Science foram pesquisados depois de desenvolver a pesquisa com o método PICO. A avaliação da qualidade e o risco de viés foram analisados de acordo com o protocolo SYRCLE. Um total de 52 referências foram recuperadas, quatro das quais foram consideradas elegíveis para inclusão. Um total de 34 ratos Wistar machos dos estudos incluídos foram avaliados quanto à perda de osso alveolar e avaliados quanto ao perfil inflamatório. Os resultados indicaram que o exercício físico pode reduzir a perda de osso alveolar (IC 95% -2,85 a -0,82, p = 0,002) e o fator de necrose tumoral pró-inflamatório-α (TNFα) no soro ou tecido gengival (IC 95% -0,45 a -0,24, p < 0,00001). Inversamente, o exercício aumentou a interleucina-10 anti-inflamatória (IL-10) no soro ou no tecido gengival (IC 95% 0,28 a 0,69, p < 0,00001). Contudo, um estudo relatou resultado negativo na expressão de TNFα e IL-10. As evidências atuais indicam que o exercício físico contribui para melhorar a DP, reduzindo a perda de osso alveolar e a inflamação em modelos animais de DP, o que sugere que o exercício moderado pode ser implementado na prática clínica para manter a saúde periodontal. Nível de Evidência I; Revisão Sistemática e Metanálise.

Impact of maternal periodontal health on fetus weight in Iraqi pregnant women: a clinical study / Impacto da saúde periodontal materna no peso fetal em gestantes iraquianas: um estudo clínico

Objective: the aim of this study was to investigate the relationship between periodontal health condition and the weight of fetuses in Iraqi pregnant women in order to magnify the importance of periodontal health maintenance during pregnancy. Material and Methods: fetus weight was determined using ultrasound scanning for 222 pregnant women, accordingly they were divided into two groups: group A: normal fetus weight and group B: below normal fetal weight. Their periodontal condition was examined by means of Plaque index (PI), Gingival index (GI), Bleeding on probing (BOP) and Clinical Attachment loss (CAL) using WHO CPITN periodontal probe. WHO charts of normal fetal weight for each week were considered to determine the normality of fetus weight. Results: significant value p=0.00 was obtained when comparing the examined periodontal parameters between groups A and B, mean of periodontal parameters of PI, GI and BOP were higher in group B (1.1964: 1.4541), (1.1877: 1.4925), (0.3553: 1.3748) respectively. Q2 and IQR of PI, BOP and GI in group A were (1.190:0.3), (0.30:0.5), (1.160:0.3) respectively. And (1.460:0.24) (1.50:0.7) (1.460:0.26) in Group B. There were 4 cases of CAL in group A as opposed to 88 cases in group B, Q2 of CAL in group A=0.00, Q2 in group B=1.00. IQR=0.00 in both groups. Non-significant value p=0. 503(p>0.05) was seen when comparing the incidence of low fetal weight between the three trimesters. Conclusion: it is important to maintain a good periodontal condition and oral Hygiene status in pregnant women for healthier fetal weight and healthier pregnancy with less complications. (AU)

Objetivo: o objetivo deste estudo foi investigar a relação entre a condição de saúde periodontal e a peso dos fetos em gestantes iraquianas para ampliar a importância da manutenção da saúde periodontal durante a gravidez. Material e Métodos: o peso do feto foi determinado por ultrassonografia 222 As gestantes, consequentemente, foram divididas em dois grupos: grupo A: peso normal do feto e grupo B: abaixo do peso fetal normal. Sua condição periodontal foi examinada por meio de índice de placa (IP), gengival índice (GI), Sangramento na sondagem (BOP) e Perda de Inserção Clínica (CAL) usando a sonda periodontal CPITN da OMS. Os gráficos da OMS de peso fetal normal para cada semana foram considerados para determinar a normalidade do peso feto. Resultados: obteve-se valor significativo p=0,00 quando comparados os parâmetros periodontais examinados entre nos grupos A e B, as médias dos parâmetros periodontais do IP, GI e BOP foram maiores no grupo B (1,1964: 1,4541), (1,1877: 1,4925), (0,3553: 1,3748), respectivamente. Q2 e IQR do PI, BOP e GI no grupo A foram (1,190:0,3), (0.30:0.5), (1.160:0.3) respectivamente.E (1.460:0.24) (1.50:0.7) (1.460:0.26) no Grupo B. Houve 4 casos de CAL no grupo A em oposição a 88 casos no grupo B, Q2 de CAL no grupo A=0,00, Q2 no grupo B=1,00. IQR=0,00 em ambos os grupos. Valor não significativo p=0. 503(p>0,05) foi observado quando comparada a incidência de baixo nível fetal peso entre os três trimestres. Conclusão:é importante manter uma boa condição periodontal e Estado de higiene bucal em gestantes para maior peso fetal e gravidez mais saudável com menos complicações. (AU)