RESUMO
OBJECTIVES: Patients with diabetes have a poor oral health-related quality of life (OHRQoL). It is not clear if this situation could be changed with effective periodontal treatment. This study examined both patients with diabetes and systemically healthy individuals to discover the impact of a gingivitis treatment protocol on OHRQoL and its relation to objective periodontal parameters. DESIGN: After ultrasonic debridement, patients were randomly assigned to an essential-oils (EO) or placebo mouthwash group. At baseline and 3 months, OHRQoL was assessed with the Oral Health and Quality of Life-United Kingdom questionnaire (OHQoL-UK) along with clinical, halitometric, microbiological and inflammatory objective parameters. The primary outcome was a change in OHQoL-UK scores. A factor analysis was performed and the impact of the extracted quality of life factor (QLF) and its interactions with diabetes, treatment, and time on the objective parameters, were tested by multiple linear regression models (p < 0.05). Chi-Square test compared questionnaire-answering profiles (p<0.05). RESULTS: Combined treatment with EO provided OHQoL improvements in both systemic conditions. Positive effect of oral health status on quality of life increased in EO groups but not in placebo groups. Question I (self-confidence) showed the greatest factorial weight, while Question A (food intake) showed the lowest factorial weight. All patients who showed OHRQoL improvements and used the EO rinse showed the lowest plaque and gingival indices and lower levels of bacteria and volatile sulfur compounds. CONCLUSIONS: OHRQoL positively changed overtime. Most effective treatment protocols would provide better improvements in OHRQoL which is related to periodontal objective measures.
Assuntos
Diabetes Mellitus , Gengivite/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Óleos Voláteis/uso terapêutico , Qualidade de Vida , Adulto , Brasil , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Although patients with diabetes are frequently affected by periodontitis, only a few investigations have focused on gingivitis in this at-risk population. This randomized placebo-controlled clinical trial compared the response to a gingivitis treatment protocol that combined mechanical procedures and daily use of an essential oil (EO) mouthrinse between patients with and without diabetes. METHODS: The whole-mouth periodontal probing depth (PD), gingival index (GI), and plaque index (PI) were monitored in gingivitis cases among systemically healthy patients (n = 60) or those with diabetes (n = 60) at baseline and 3 months after treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and total bacterial load were determined by a real-time polymerase chain reaction in intrasulci plaque samples. The volume of gingival crevicular fluid (GCF) was quantified, and interleukin-1ß (IL-1ß) levels were determined in GCF samples. After a full-mouth ultrasonic debridement, patients were randomly assigned to an EO or a placebo rinse for 90 days (40 mL/day). The data were analyzed through repeated-measures analysis of variance and multiple comparisons Tukey tests (P <0.05). RESULTS: GI was more severe in the diabetes group. Diabetes impaired GI and reduced GCF volume. PD, bacterial levels, and IL-1ß improved similarly in both systemic conditions. The adjunctive use of EO provided greater reductions of PI, GI, total bacterial load, T. forsythia, A. actinomycetemcomitans, and GCF volume. CONCLUSIONS: Response to gingivitis treatment in patients with diabetes can slightly differ from that in patients without diabetes. Daily use of an EO mouthrinse after ultrasonic debridement benefited patients with and without diabetes.
Assuntos
Complicações do Diabetes , Gengivite/terapia , Adulto , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Carga Bacteriana/efeitos dos fármacos , Bacteroides/efeitos dos fármacos , Bacteroides/isolamento & purificação , Placa Dentária/microbiologia , Índice de Placa Dentária , Complicações do Diabetes/imunologia , Complicações do Diabetes/microbiologia , Método Duplo-Cego , Feminino , Seguimentos , Líquido do Sulco Gengival/química , Líquido do Sulco Gengival/imunologia , Gengivite/imunologia , Gengivite/microbiologia , Humanos , Interleucina-1beta/análise , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Óleos Voláteis/uso terapêutico , Desbridamento Periodontal/métodos , Índice Periodontal , Bolsa Periodontal/classificação , Placebos , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/isolamento & purificação , Adulto JovemRESUMO
Introdução - O objetivo do presente estudo foi comparar, in vitro, a ação antimicrobiana dos extratos de cravo-da-índia (Syzygium aromaticum), sálvia (Salvia officinalis) e própolis sobre a microbiota da placa dentária supragengival e saliva não estimulada de 25 indivíduos com periodontite crônica. Métodos - Utilizou-se como controle positivo clorexidina a 0,12 por cento e, como controle negativo, água destilada. Em placas de Ágar TSA avaliou-se a ação antimicrobiana de cada substância pura e em diluições seriadas (1 :2, 1 :4, 1 :8). Resultados - Os resultados foram avaliados utilizando-se os testes Post Hoc, ANOVA e Coeficiente de correlação de Pearson (p < 0,05). As maiores médias de tamanho de halos de inibição foram obtidas com a clorexidina, seguida da própolis, cravo-da-índia e sálvia. Conclusão - A própolis apresentou correlação com a clorexidina tanto na inibição de amostras de placa dentária como da saliva. Além disso, também demonstrou propriedades antimicrobianas significativas e exibiu maior ação antimicrobiana sobre a microbiota da placa dentária supragengival quando comparada à microbiota da saliva