Fusobacterium nucleatum and Prevotella in women with periodontitis and preterm birth.

BACKGROUND: Studies try to explain the hypothesis that maternal periodontitis may be associated with preterm birth. MATERIAL AND METHODS: This is a case-control study with 120, 40 cases (gestational age <37 weeks) and 80 controls (gestational age ≥37 weeks), that were submitted to the clinical periodontal examination and subgingival biofilm collection. Bacterial DNA of subgingival biofilm was performed and processed by qPCR. RESULTS: Periodontitis was statistically significant in the Case group (35%) when compared to the Control group (11.2%) and Gingival Bleeding Index (GBI), sites with PS ≥ 4mm and sites with CAL ≥ 5mm were statistically higher in the Case group (p < 0.05). The proportions of Pi (p = 0.026) and Fn (p = 0.041) of subgingival biofilm were higher in the Case group. A greater number of sites with PS ≥ 4mm (r = -0.202; p = 0.026) and CAL ≥ 5mm (r = -0.322; p < 0.001) were correlated to lower gestational age. CONCLUSIONS: Periodontitis, preterm delivery, and/or low birth weight may have a possible relationship based on clinical parameters and the ratio of Pi and Fn at periodontal sites.

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial.

BACKGROUND: To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction. MATERIAL AND METHODS: The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student's t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides. RESULTS: There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration. CONCLUSIONS: Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars.

Implant osseointegration in irradiated bone: an experimental study.

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the effect of radiotherapy on the osseointegration of dental implants in the tibia and the action of platelet-rich plasma (PRP) as an adjuvant therapy. MATERIAL AND METHODS: A total of 18 rabbits received two implants in each tibial epiphysis, totalizing 72 implants. The control group (group I) was composed by six rabbits and did not receive radiotherapy. The test groups (II and III) received a single dose of 1727 cGy. Group II was composed by six irradiated animals and group III by six animals that received irradiation and PRP during implant placement. The implant success rate, the bone-implant contact (BIC), and the bone volume were analyzed. RESULTS: There was no osseointegration in four of the implants, three in group II and one in group III. Total BIC was significantly higher in group I, when compared to the other groups. There was a significant difference of osteoid BIC only between irradiated animals (group II, 8.5%; group III, 4.7%; p = 0.001). On the other hand, the mineralized BIC was significantly higher in group I. Furthermore, group II had a lower mineralized BIC than group III (p = 0.002). Bone volume was higher in the control group (41.3%), followed by group III (33.4%) and II (25.1%), with differences between groups I and II (p = 0.001) and groups II and III (p = 0.022). CONCLUSIONS: The present study showed that both the bone volume and BIC were higher in the control group. However, the failure rates of the implants were low in both irradiated groups. The PRP was a positive adjuvant in the osseointegration process.

Possible evidence of systemic lupus erythematosus and periodontal disease association mediated by Toll-like receptors 2 and 4.

Toll-like receptors (TLRs) participate in the innate immune response and trigger the immune responses of the body. Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown aetiology, characterized by an excessive autoimmune response in the body affecting the connective tissues. The disease is possibly triggered by both environmental aetiological factors and pathological organic processes such as exposure to sunlight, chronic infectious processes and genetic factors. Conversely, periodontal disease is an infectious disease caused by microorganisms in the oral cavity, resulting in a chronic inflammatory process which continuously stimulates the immune response, thus causing damage to the periodontal tissues. The expression of both TLR-2 and TLR-4 receptors are increased in both SLE and periodontal disease. Periodontitis might trigger excessive activation of immune response occurring in SLE by maintaining a high expression of TLRs, leading in turn to the acceleration of the onset and progression of autoimmune reactions. In addition, periodontal treatment is able to reduce the expression of these receptors and therefore the symptoms of SLE. Here we discuss the possible interaction between SLE and periodontitis, and suggest further studies evaluating common features in both factors that could explored, due to morbidity and mortality of SLE and the high incidence of periodontal infections around the world.

Association between periodontal changes and osteoporosis in postmenopausal women.

OBJECTIVE: To investigate the possible association between periodontal changes and osteoporosis in postmenopausal women through a longitudinal study. METHODS: This longitudinal study included 33 patients. The participants were divided into three groups according to the bone mineral density assessed in the lumbar region: normal bone (G1, n = 15), osteopenia (G2, n = 12) and osteoporosis (G3, n = 6). Periodontal evaluation included clinical attachment level, probing depth, gingival bleeding index and visible plaque index, evaluated by two examiners blinded to systemic bone condition. The statistical process included the t-test for paired samples, with a significance level of 5% to check for changes in periodontal parameters considered at initial and final systemic bone density. RESULTS: The results showed that, after follow-up, there was a significant increase in gingival bleeding index in the group of women who had normal initial bone condition and progressed to osteopenia (after 3 years, 59.89%, p = 0.010) and osteoporosis (after 3 years, 74.37%, p = 0.035). In addition, the group diagnosed with osteopenia at baseline who progressed to osteoporosis after 3 years also showed a significant increase in gingival bleeding index (p < 0.001). CONCLUSIONS: The findings suggest that periodontal changes can be associated with osteoporosis in postmenopausal women.