Periodontal therapy and endothelial function in coronary artery disease: A randomized controlled trial.

OBJECTIVE: To assess the effects of periodontal treatment on endothelial function in patients with coronary artery disease. MATERIALS AND METHODS: A randomized controlled trial was conducted with 69 patients with stable coronary disease and severe periodontitis. The test group received nonsurgical periodontal therapy consisting of personalized oral hygiene instructions, subgingival scaling, and root planing per quadrant, whereas the control group received equal treatment after the study period. Endothelial function was assessed by measurement of brachial artery flow-mediated dilation, concentrations of sVCAM-1, sICAM-1, and P-selectin in serum before and 3 months after periodontal therapy. RESULTS: The test group exhibited statistically better periodontal parameters-plaque, probing depth, periodontal attachment loss, and bleeding on probing. No significant improvements were observed in the control (1.37%) and test (1.39%) groups in flow-mediated dilation, with no significant between-group difference. sVCAM-1 concentration increased in the control group (997.6 ± 384.4-1201.8 ± 412.5; p = 0.03), whereas in the test group, no significant changes were observed (915.1 ± 303.8-1050.3 ± 492.3; p = 0.17), resulting in a significant difference between the two groups (p = 0.04). The same pattern was observed for concentrations of sICAM-1. CONCLUSION: Periodontal treatment did not provide better vasodilation in patients with coronary disease in a short-term follow-up period, although it maintained blood concentrations of markers of vascular inflammation.

Self-reported Use of Dental Floss over 13 Years: Relationship with Family Income, Mother's Age and Educational Level.

PURPOSE: To determine whether family income, age and educational level of the mother of the family are associated with self-reported use of dental floss over a 13-year period in a city in southern Brazil. MATERIALS AND METHODS: A comparison of two household surveys was carried out where mothers of the family were interviewed using a structured questionnaire in order to obtain demographic, behavioural and socioeconomic information. In total, 852 and 984 households were included in 1996 and 2009, respectively. Self-reported use of dental floss was assessed dichotomously (yes/no). Poisson regression models were fitted to study the association between sociodemographic variables with the use of dental floss. Proportion ratios (PR) and 95% confidence intervals (95% CI) were reported. RESULTS: The proportion of dental floss use increased from 48% to 59% over 13 years. The probability of dental floss use increased 1.23 times from 1996 to 2009 (PR = 1.23; 95% CI 1.13-1.34). Households with mothers ≥50 years old presented a 28% lower probability of using dental floss than households with mothers ≤35 years old. In households with higher family income and higher educational level of the mother, probabilities of flossing were 90% and 97% higher. CONCLUSION: Family income, age and educational level of the mother of the family are associated with self-reported use of dental floss over 13 years.

Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW). MATERIAL AND METHODS: Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (n = 147, test group) or after delivery (n = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits. RESULTS: At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected <15% of sites. Compared to controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%, p < 0.001), gingival bleeding (23.3% vs. 2.5%, p < 0.001), calculus (21.3% vs. 4.1%, p < 0.001), bleeding on probing (38.1% vs. 2.6%, p < 0.001) and probing depth ≥3 mm (19.97% vs. −2.45%, p < 0.001). No significant differences were observed between the groups in the occurrence of PT (11.7% vs. 9.1%, p = 0.57), LBW (5.6 % vs. 4.1%, p = 0.59), and PTLBW (4.15% vs. 2.60%, p = 0.53). CONCLUSIONS: Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.

Periodontal disease affects oral cancer progression in a surrogate animal model for tobacco exposure.

For decades, the link between poor oral hygiene and the increased prevalence of oral cancer has been suggested. Most recently, emerging evidence has suggested that chronic inflammatory diseases from the oral cavity (e.g., periodontal disease), to some extent, play a role in the development of oral squamous cell carcinoma (OSCC). The present study aimed to explore the direct impact of biofilm­induced periodontitis in the carcinogenesis process using a tobacco surrogate animal model for oral cancer. A total of 42 Wistar rats were distributed into four experimental groups: Control group, periodontitis (Perio) group, 4­nitroquinoline 1­oxide (4­NQO) group and 4NQO/Perio group. Periodontitis was stimulated by placing a ligature subgingivally, while oral carcinogenesis was induced by systemic administration of 4NQO in the drinking water for 20 weeks. It was observed that the Perio, 4NQO and 4NQO/Perio groups presented with significantly higher alveolar bone loss compared with that in the control group. Furthermore, all groups receiving 4NQO developed lesions on the dorsal surface of the tongue; however, the 4NQO/Perio group presented larger lesions compared with the 4NQO group. There was also a modest overall increase in the number of epithelial dysplasia and OSCC lesions in the 4NQO/Perio group. Notably, abnormal focal activation of cellular differentiation (cytokeratin 10­positive cells) that extended near the basal cell layer of the mucosa was observed in rats receiving 4NQO alone, but was absent in rats receiving 4NQO and presenting with periodontal disease. Altogether, the presence of periodontitis combined with 4NQO administration augmented tumor size in the current rat model and tampered with the protective mechanisms of the cellular differentiation of epithelial cells.

Analysis of gingival margin esthetic clinical conditions by dental students.

It has been suggested that one of the main factors contributing to the perception of esthetics is the position of the gingival tissues in the upper arch. The aim of this study was to evaluate the esthetic perception of dental students regarding different pictures of classical periodontal situations related to the gingival margin. This was an observational cross-sectional study involving 161 dental students. Five clinical situations defined by pictures from books were presented to the students. The cases included unchanged periodontium, gingival smile, uneven gingiva, localized gingival recession and generalized gingival recession. Esthetic perception was evaluated by a Visual Analogue Scale (VAS). The different situations were compared by One-way ANOVA, with Tukey test as post-hoc. The results showed statistically significant differences between groups (p < 0.05). The best esthetics was attributed to the periodontium without changes in shape (7.60 +/- 1.80), followed by gingival smile (6.92 +/- 2.34). The worst esthetic situation in this evaluation was the uneven gingiva (3.45 +/- 2.00). In the intermediate group are the gingival recessions. The perception of localized (5.19 +/- 1.91) and generalized (5.69 +/- 2.18) gingival recession did not differ significantly. This study concluded that different positions of the gingival tissues affect the esthetic perception of smile.

Effect of the topical application of triclosan in periodontally treated patients.

The aim of this clinical parallel, double-blind study was to evaluate the effect of irrigating, with 0.6% triclosan, periodontal pockets 2 4 mm showing persisting signs of inflammation 90 days after sub-gingival scaling and root planing. 14 patients, aged 35-61 years, were randomly assigned to test group (TG) or placebo group (PG). In TG, pockets were rinsed with 10 ml of triclosan while in PG, pockets were rinsed with placebo. Irrigations were repeated fort-nightly for 70 days (total 6 rinses). Clinical examinations consisted of Plaque Index (PlI), Gingival Index (GI), Bleeding on Probing (BOP), Periodontal Probing Depth (PPD) and Clinical Attachment Level (CAL). Median values of PlI, GI and BOP were analyzed over time with the Friedman test and for the multiple comparisons with Wilcoxon and Mann-Whitney tests. Means for PPD, and CAL were analyzed with repeated measurements ANOVA (p<0.05). There were no statistically significant differences in the PlI and GI between groups. BOP was reduced significantly in both groups in a similar fashion. Significant reductions in PPD were observed for both groups. TG showed a PPD reduction of 0.8 mm whereas PG reduced 0.4 mm. No difference was found among groups for PPD. CAL gain for the TG group was 0.7 mm and for the PG of 0.5 mm. Only the gains observed for the TG group were significant. It can be concluded that 0.6% triclosan or placebo irrigation, 3 months after non-surgical treatment, of sites with persistent signs of inflammation, produced similar results.

Self-reported periodontitis in cannabis club members in Montevideo, Uruguay. An exploratory study.

In 2013, the Oriental Republic of Uruguay enacted a law regulating the cannabis market, and since then, an increasing number of users has been registered. Previous reports based on data from other countries link cannabis smokers to worse periodontal health status. The aim of this study is to describe self-reported gingival and periodontal health status and estimate the prevalence of periodontitis among Uruguayan cannabis club members. A cross-sectional study was conducted on a convenience sample of cannabis club members in Uruguay. A survey was used to gather sociodemographic data and information on oral hygiene, use of cannabis and other drugs, and self-reported gingival and periodontal health status. Eight questions validated in Spanish were used to estimate the prevalence of total periodontitis and severe periodontitis, based on two previously implemented predictive models. The survey was completed by 50 people, of whom 68% were male and 78% were in the 20-40 year age range. Based on the first model, estimated prevalence was 12% for total periodontitis and 10% for severe periodontitis. Based on the second model, estimated prevalence was 36% for total periodontitis and 12% for severe periodontitis. These findings suggest that smoking cannabis could potentially have a detrimental effect on oral health status.

En 2013 se aprobó la ley que regula el mercado del cannabis en la República Oriental del Uruguay y desde entonces se ha registrado un creciente número de consumidores. Reportes previos a partir de datos de otros países vinculan un peor estado de salud periodontal en fumadores de cannabis. El objetivo de este estudio es describir el estado gingivo-periodontal auto-reportado y estimar la prevalencia de periodontitis en participantes de clubes cannábicos uruguayos. Se realizó un estudio transversal a partir de una muestra por conveniencia de integrantes de clubes cannábicos en Uruguay. Mediante una encuesta se recolectaron datos socio-demográficos, de higiene oral, de consumo de cannabis y otras drogas, así como de auto-reporte del estado de salud gingivo-periodontal. A partir de 8 preguntas validadas en español se estimó la prevalencia de periodontitis total y severa a través de dos modelos predictivos previamente implementados. Un total de 50 personas completaron la encuesta. El 68% eran hombres y el 78% estaba dentro del rango de 20 a 40 años de edad. Con el primer modelo la prevalencia estimada de periodontitis total fue 12% y de periodontitis severa 10%. Con el segundo modelo fue 36% para periodontitis total y 12% para periodontitis severa. Estos hallazgos sugieren que fumar cannabis podría tener un potencial efecto deletéreo sobre las condiciones de salud bucal.

Effect of Obesity and/or Ligature-induced Periodontitis on Aortic Wall Thickness in Wistar Rats.

The purpose of this study was to evaluate aortic wall thickness after periodontal disease and/or obesity induction in a Wistar rat model.Sixty male Wistar rats were randomly divided into four groups: control (CT), periodontal disease (PD), obesity (OB), and obesity plus periodontal disease (OB+PD). Groups OB and OB+PD received cafeteria diet for 17 weeks. After they had acquired obesity (week 12), periodontal disease was induced by placing a silk ligature on the maxillary right second molar of groups PD and OB+PD. During the experimental period, body weight and Lee index were assessed. Mean alveolar bone loss (ABL) was evaluated, and aortas were prepared for histometric analysis of the aortic wall by ImageJ software. Body weight and Lee index increased in rats exposed to cafeteria diet. Mean ABL was higher in Groups PD and OB+PD than in control and OB (p<0.05). ABL was 18% higher in Group OB+PD than in Group PD, with statistically significant difference (p<0.001). Aortas were thicker in Groups OB and OB+PD than in control and PD groups, respectively (2.31mm ± 0.28 and 2.33 ± 0.29 vs. 2.18 ± 0.26 and 2.14 ± 0.27). Group OB differed significantly from the control group (p=0.036), and OB+PD and OB differed significantly from PD (p=0.004 and p= 0.001, respectively). Obesity alters aortic wall thickness in Wistar rats. However, the presence of periodontal disease did not affect the aortic wall thickness under the conditions of the present study.

O objetivo deste estudo foi avaliar a espessura da parede da aorta após modelos de indução de doença periodontal e/ou obesidade em ratos Wistar. Sessenta ratos Wistar machos foram aleatoriamente divididos em quatro grupos: controle (CT), doença periodontal (DP), obesidade (OB), obesidade mais doença periodontal (OB+DP). Os grupos OB e OB+DP rece beram dieta de cafeteria por 17 semanas. Após de adquirirem obesidade, (semana 12), doença periodontal foi induzido pela colocação de ligaduras de seda no segundo molar superior direito dos grupos DP e OB+DP. Durante o período experi mental, o peso corporal e índice de Lee foram obtidos. Média de perda óssea alveolar (POA) foi avaliada e as aortas preparadas para análise histométrica da parede aórtica (em mm) pelo software ImageJ. Ratos expostos a dieta de cafeteria demonstraram um aumento do peso corporal e do índice de Lee. Uma POA media maior foi observada nos grupos DP e OB+DP comparado aos grupos controle e OB (p<0.05). O grupo OB+DP, quando comparado ao grupo DP, apresentou POA 18% maior e essa diferença foi estatisticamente significativa (p<0.001). Os grupos OB e OB+DP exibiram uma espessura de aorta maior comparado aos grupos DP e controle, respectivamente (2.31 ± 0.28 e 2.33 ± 0.29 vs. 2.18 ± 0.26 e 2.14 ± 0.27). Diferenças significativas foram observadas nas comparações dos grupos OB e controle (p=0,036), e OB+DP e OB comparado ao grupo DP (p=0.004 e p= 0.001, respectivamente). A obesidade parece afetar a espessura da parede da aorta em ratos Wistar. Entretanto, a presença de doença periodontal não afetou a espessura da parede da aorta sob as condições do presente estudo.

Efficacy of two soft-bristle toothbrushes in plaque removal. A randomized controlled trial.

The aim of the present examiner-blind randomized controlled clinical study was to compare the efficacy two soft-bristle toothbrushes in terms of plaque removal. Seventy volunteers were randomly allocated to Group A (tapered-tip toothbrush) or Group B (end-rounded toothbrush). At baseline appointment (Day 0), volunteers underwent plaque examination using the Improved Plaque Identification Index. Under supervision, they brushed their teeth for 1 minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers continued the oral hygiene regimen (assigned toothbrush and a regular dentifrice provided by the researchers) for 7 days. The experimental procedures of Day 0 were then repeated. Separate statistical analyses were performed for mean percent reduction of plaque in the whole-mouth, interproximal and gumline scores at both times, using Mann-Whitney test, p<0.05. After a single toothbrushing, on Day 0, mean percent plaque was significantly reduced in both groups (p<0.05), with statistically greater reductions of whole-mouth (21.39±12.44 vs. 11.40±11.17), gumline (6.32±7.37 vs. 2.89±4.57) and interproximal (10.82±10.49 vs. 5.21±7.68) for Group A as compared to Group B. However, on day 7, no significant difference was observed between groups for whole-mouth (29.94±20.91 vs. 26.58±18.64), gumline (14.04±18.82 vs. 13.78±17.63) and interproximal surfaces (26.41±22.77 vs. 23.12±20.98) (p>0.05). In conclusion, on Day 0, Group A presented higher efficacy in supragingival plaque removal than Group B, as reflected by whole-mouth, gumline and interproximal plaque scores.

O objetivo desse ensaio clínico, examinador-cego, randomizado e controle foi de comparadas a eficácia de duas escovas de cerdas macias em relação ao controle de placa. Setenta voluntários foram randomicamente alocados para Grupo A (escova com ponta cônica) ou Grupo B (escova com ponta arredondada). Na consulta inicial (dia 0), voluntários receberam exame de placa utilizando o Índice de identificação de placa melhorado. Sob supervisão, eles escovaram seus dentes por 1 minuto com as escovas designadas e o exame de placa foi repetido. Voluntários continuaram seu regime de higiene oral (escova dental alocada e dentifrício comum fornecidos pelos pesquisadores) durante 7 dias. Os procedimentos da consulta inicial foram novamente repetidos. Análises estatísticas distintas foram realizadas para percentual de redução média de placa para os escores de boca toda, interproximal e linha gengival em ambos os momentos, utilizando teste de Mann-Whitney, p<0,05. Após único uso da escova, no dia 0, o percentual de redução média de placa foi significativamente reduzido em ambos os grupos (p<0,05), com reduções significativas para boca toda (21,39±12,44 vs. 11,40±11,17), linha gengival (6,32±7,37 vs. 2,89±4,57) e interproximal (10,82±10,49 vs. 5,21±7,68) no Grupo A quando comparada com o Grupo B. Entretanto, no dia 7, nenhuma diferença significativa foi observada entre os grupos para boca toda (29,94±20,91 vs. 26,58±18,64), linha gengival (14,04±18,82 vs. 13,78±17,63) e interproximal (26,41±22,77 vs. 23,12±20,98) (p>0,05). Em conclusão, no dia 0, a escova do Grupo A apresentou eficácia superior na remoção de placa suprageng ival quando comparada com a escova do Grupo B, como demonstrado nos escores de placa de boca toda, linha gengival e interproximal.

Effects of Chronic Ethanol Consumption and Ovariectomy on the Spontaneous Alveolar Bone Loss in Rats.

Postmenopausal estrogen deficiency and ethanol (EtOH) abuse are known risk factors for different diseases including bone tissues. However, little is known about the synergic effects of EtOH abuse and estrogen deficiency on alveolar bone loss in women. The present study evaluated the effects of EtOH chronic exposure and ovariectomy on the alveolar bone loss in female rats. For this, 40 female Wistar rats were randomly divided into 4 groups: control, EtOH exposure, ovariectomy (OVX), and OVX plus EtOH exposure. Initially, half of the animals were ovariectomized at 75 days of age. After that, the groups received distilled water or EtOH 6.5 g/kg/day (20% w/v) for 55 days via gavage. Thereafter, animals were sacrificed and the mandibles were collected, dissected, and separated into hemimandibles. Alveolar bone loss was evaluated by measuring the distance between the cementoenamel junction and the alveolar bone crest through a stereomicroscope in 3 different anatomical regions of the tissue. One-way ANOVA and post hoc Tukey were used to compare groups (p < 0.05). The results showed that the ovariectomy and EtOH exposure per se were able to induce alveolar bone loss, and their association did intensify significantly the effect. Therefore, OVX associated with heavy EtOH exposure increase the spontaneous alveolar bone loss in rats.

Association among menopause, hormone replacement therapy, and periodontal attachment loss in southern Brazilian women.

BACKGROUND: The aim of the present study was to evaluate the association among menopause, hormone replacement therapy (HRT), and periodontal attachment loss (PAL). METHODS: Three hundred twenty-eight women (40 to 69 years old) who participated in a previous oral survey in South Brazil were included. Women who reported not having their monthly menstrual cycles for >or=12 months were classified as postmenopausal. Postmenopausal women were categorized according to HRT. Women with >or=30% teeth with PAL >or=5 mm were classified as having periodontitis. The data were analyzed using a multivariable logistic regression model and adjusted for age, smoking, socioeconomic status, and dental care. RESULTS: The prevalence of periodontitis was significantly greater among postmenopausal women not using HRT (HRT-) than among premenopausal women (64.4% versus 46.3%; P = 0.005). Similarly, the multivariable analysis demonstrated a significantly higher chance of having periodontitis in postmenopausal HRT- women than in premenopausal women (odds ratio [OR], 2.1; 95% confidence interval [CI]: 1.1 to 4.0). In contrast, no significant differences were observed in the prevalence of periodontitis between postmenopausal women using HRT (HRT+) and premenopausal women (48.8% versus 46.3%; P = 0.77). After adjusting for cofactors, postmenopausal HRT+ women did not have a greater likelihood of having periodontitis than premenopausal women (OR, 1.2; 95% CI: 0.6 to 2.5). No significant differences in tooth loss were observed among the study groups after adjusting for confounders. CONCLUSIONS: Postmenopausal HRT- women had a greater chance of having periodontitis than premenopausal women. In contrast, postmenopausal HRT+ women and premenopausal women had similar periodontal status. HRT may have a beneficial effect on periodontal health.

Self reported dentin hypersensitivity in south brazilian adolescents: occurrence and risk indicators.

The aim of this study was to assess the occurrence of selfreported dentin hypersensitivity (DH) and its risk indicators in adolescents from a southern Brazilian city. 736 students (1519 years old) were randomly selected from 20 public and private schools in the city of Passo Fundo, Brazil. DH was assessed through the answers on a Likert scale to the question: "Do you have tooth sensitivity?".Participants underwent a clinical examination in which present teeth were counted, and answered an interview based on a structured questionnaire on sociode mographic information, history of dental bleaching, orthodontic treatment and oral health habits. The dependent variable (DH) was dichotomized at the point where hypersen sitivity occurs fairly often or always. Data were analyzed by multivariable logistic regression, including demographic, health history, socioeconomic and behavioral variables. Results: 556 (75.5%) subjects reported having sensitive teeth never, rarely or sometimes, while 180 (24.5%) reported having sensitive teeth fairly often or always. In the final model, number of present teeth, age, skin color, flossing, smoking, bleaching and orthodontic history were not associated with selfreported DH. Females showed significantly greater chance of having DH than males [odds ratio (OR)=1.91; 95% confidence interval (95%CI) 1.342.72]. The likelihood of DH in students at public schools was 63% higher than in those at private schools (OR=1.63 95%, CI 1.012.75). DH is a common perception among adolescents and is associated with female gender and studying at public schools.

O objetivo deste estudo foi determinar a ocorrência de hipersensibilidade dentinária (HD) autorreportada e seus indicadores de risco de uma cidade do sul do Brasil. 736 estudantes (1519 anos) foram selecionados aleatoriamente em 20 escolas públicas e privadas da cidade de Passo Fundo, Brasil. HD foi aferida pela resposta em escala Likert à pergunta: "Você tem sensibilidade nos dentes?". O exame clínico incluía a contagem de dentes presentes e um questionário estruturado foi aplicado incluindo dados sociodemográficos, história de clareamento dental, tratamento ortodôntico e hábitos de saúde bucal.A variável de pendentes (HD) foi dicotomizada no ponto que a hipersensibilidade ocorria repetidamente ou sempre. Os dados foram analisados por meio de regressão logística multivariada, incluindo variáveis demográficas, histórico de saúde, dados socioeconômicos e comportamentais. Nos resultados 556 (75.5%) indivíduos reportaram experiência de sensibilidade dentinária, nunca raramente ou às vezes, enquanto 180 (24.5%) reportaram ter sensibilidade repetidamente ou sempre. No modelo final, número de dentes presentes, idade, raça, uso do fio dental, tabagismo, histórico de clareamento dental e tratamento ortodôntico não foram associados com HD autorreportada. Mulheres mostraram uma chance significativamente maior de ter HD comparado aos homens [odds ratio (OR)=1,90; 95% intervalo de confiança (95%CI) 1.332.71]. Frequentar escolas públicas aumentou a chance de HD em 63% comparado com escolas particulares (OR=1,63 95%IC 1.012.75). HD é uma percepção comum entre adolescentes e está associada com gênero feminino e estudar em escolas públicas.

Tooth loss and associated factors in the elderly in Cruz Alta, Brazil: a crosssectional study.

The aim of this study was to evaluate severe tooth loss and associated factors among the elderly. A homebased crosssectional study, using random probabilistic sampling, was conducted with elderly persons from Cruz Alta, Rio Grande do Sul, Brazil. Oral health was examined and a structured questionnaire was answered. Associations between severe tooth loss and independent variables were determined using Poisson regression with robust variance. The level of significance adopted was 5%. Overall, 287 elderly persons were included. Among the elderly, 86 (29.9%) were edentulous, and 282 (98.3%) had lost at least one tooth. In this sample, median tooth loss was 21 (mean±standard deviation: 19.69±8.21). The sample was dichotomized into two groups according to the definition of severe tooth loss: less than nine remaining teeth or ≥9 remaining teeth. The prevalence of severe tooth loss was 60.3% (n=173). Females were associated with higher prevalence ratio (PR) of severe tooth loss (PR; 95% CI: 1.77; 1.39 - 2.24). Higher level of education was associated with lower PR of severe tooth loss (PR; 95% CI: 0.48; 0.30 - 0.77). The lack of access to dental care was associated with severe tooth loss (PR; 95% CI: 1.38; 1.13 - 1.67). Conversely, frequency of toothbrushing was not significantly associated with severe tooth loss (PR; 95% CI: 0.88; 0.73 - 1.06). High prevalence of severe tooth loss among the elderly was observed and found to be associated with sex, level of education, and access to dental care.

Esse estudo objetivou avaliar a perda dentária severa e seus fatores associadas em idosos. Um estudo transversal, de base populacional, usando uma amostra probabilística, foi condu zido com os idosos de Cruz Alta, Rio Grande do Sul, Brasil. Exames de saúde bucal e um questionário estruturado foram realizados. Associações entre perda dentária severa e as variáveis independentes foram feitas, utilizando regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. No total, 287 idosos foram incluídos. Entre os idosos, 86 (29,9%) eram edêntulos, e 282 (98,3%) apresen tavam pelo menos uma perda dentária. Nessa amostra, a mediana de perda dentária foi 21 (média ± desvio padrão: 19,69±8,21). A amostra foi dividida em dois grupos de acordo com a definição de perda dentária severa: menos de nove dentes remanescentes ou ≥9 dentes presentes. A prevalência de perda dentária severa foi de 60,3% (n=173). As mulheres estiveram associadas com maior razão de prevalência (RP) de terem perda dentária severa (RP; IC95%: 1,77; 1,39 ­ 2,24). Alto nível educacional esteve associados com menor RP de ter perda dentária severa (RP; IC95% 0,48; 0,30 ­ 0,77). A falta de acesso ao dentista esteve associada com maiores taxas de perda de dentária severa (RP; IC95%: 1,38; 1,13 ­ 1,67). Por outro lado, frequência de escovação não esteve significati vamente associada perda dentária severa (RP; IC95%: 0,88; 0,73 ­ 1,06). Alta prevalência de perda dentária severa foi detectada entre os idosos e ela foi associada com sexo, nível educacional, e acesso ao dentista.

Effect of red wine and its major components on periodontitis and systemic inflammation in rats.

OBJECTIVES: To evaluate the influence of red wine exposure, alcohol, grape juice and resveratrol in the occurrence of spontaneous and ligature induced periodontitis as well as CRP, TNFα and IL-6 levels in Wistar rats. METHODOLOGY: 50 male Wistar rats were randomly assigned to 5 groups (Control, Red Wine, Grape Juice, 12% Alcohol and 0.05mg/mL Resveratrol). All groups were fed with laboratory rat chow and liquid intake according to group allocation. After 8 weeks, ligatures were placed around the maxillary right second molars. The contra-lateral molars remained as intra-group controls. After 14 days, animals were killed, blood samples collected and specimens prepared for analysis. Group comparisons were performed by ANOVA. A cut-off point in the 75th percentile in the side without ligature was used for definition of spontaneous periodontitis. RESULTS: All animals completed the experiment. According to mean alveolar bone loss, no statistically significant differences were found. Animals exposed to red wine presented a lower occurrence of spontaneous periodontitis, lower levels of TNF-α (0.97 ng/mL) and CRP (0.29 mmol/µL) compared to controls (1.97 ng/mL, p = 0.008 and 0.45 mmol/ µL, p less than or equal to 0.05 respectively). CONCLUSION: Red wine exposure potentially affects the occurrence of spontaneous periodontitis, CRP and TNF-α levels in Wistar rats.

Azithromycin as an adjunctive treatment of aggressive periodontitis: 12-months randomized clinical trial.

AIM: To assess the effect of systemic azithromycin as a supplement to scaling and root planing (SRP) in the treatment of aggressive periodontitis (AgP). MATERIAL AND METHODS: Twenty-four individuals (13-26 years old) underwent a plaque control program, and then were treated with SRP. Subjects were assigned randomly into two groups; the test group used 500 mg azithromycin once a day for 3 days, whereas the control group used a placebo. Clinical variables were assessed at baseline, 3, 6, 9, and 12 months. The periodontal status at baseline and 12 months was compared using the Wald test, and adjusting for the effect of clustering of teeth within subjects. RESULTS: There were no significant differences in visible plaque, gingival bleeding, and supragingival calculus between groups throughout the study. Periodontal probing depth (PPD) and clinical attachment level improved significantly from baseline to 12 months in both groups, with the test group showing significantly more reduction in mean PPD compared with controls (2.88 mm versus 1.85 mm, respectively, p=0.025). Subjects administering azithromycin showed a higher percentage of teeth with attachment gain >or=1 mm (81.34 versus 63.63, p=0.037), whereas the controls had higher percentage of teeth with attachment loss >or=1 mm (11.57 versus 2.24, p=0.015). CONCLUSIONS: The adjunctive use of azithromycin has the potential to improve periodontal health of young patients with AgP.

Aggressive periodontitis presents a higher degree of bilateral symmetry in comparison with chronic periodontitis.

The purpose of this cross-sectional study was to evaluate the occurrence of bilateral symmetry in the distribution of clinical parameters in subjects with generalized aggressive periodontitis (GAP) and severe chronic periodontitis (SCP). The sample comprised 53 subjects with GAP and 33 with SCP. Probing depth (PD) and clinical attachment loss (CAL) were recorded from both buccal and lingual interproximal sites of incisors and molars. The symmetry of periodontal destruction was analyzed in terms of intraclass coefficient correlations (ICC) for pairs of contralateral sites at which PD and/or CAL was ≥5 mm at one of the sites of the subjects in each group. GAP patients had a higher proportion of both PD and CAL ≥ 5 mm and also a higher mean proportion of subjects having PD and/or CAL ≥ 5 mm at one or both sites. The GAP group had 20 pairs of contralateral sites with PD (ICC = 0.22-0.63) and 26 pairs with CAL (ICC = 0.20-0.63), the correlation being statistically significant, while the SCP group had only 2 pairs (ICC = 0.36-0.48) with PD and 5 pairs with CAL (ICC = 0.33-0.58) showing a significant correlation. It can be concluded that GAP shows more symmetric periodontal destruction than SCP.

Nutritional assessment and associated factors in the elderly: apopulation-based cross-sectional study.

OBJECTIVE: The aim of this study was to assess nutritional status and associated factors in elderly individuals. METHODS: This cross-sectional study was conducted in residential homes with a probabilistic cluster sample. Two-hundred eighty-seven individuals 65-74 y of age were interviewed and examined in the city of Cruz Alta, state of Rio Grande do Sul, Brazil. A structured questionnaire was used to assess the socioeconomic, behavioral, and general health conditions; the number of present teeth were counted. Nutrition was assessed with a validated instrument-the Mini Nutritional Assessment-which classifies the patient as normal (eutrophic), at nutritional risk, or malnourished. For data analysis, the participants were categorized in eutrophic or at nutritional risk (at risk of malnutrition + malnourished). The associations were assessed by either the χ2 or Mann-Whitney tests. Uni- and multivariate Poisson regression analyses verified the associations. The significance level was set at 5%. RESULTS: The prevalence of nutritional risk was 48.4%. In the multivariate model, edentulous individuals with no complete denture or with only one complete denture (prevalence ratio PR, 1.59; 95% confidence interval [CI], 1.18-2.13) and elderly individuals with no access to the dentist (PR, 1.48; 95% CI, 1.11-1.88) presented higher potential for nutritional risk than their respective controls. CONCLUSIONS: The results showed that approximately half of the participants (48.4%) were at nutritional risk. The lack of complete or partial rehabilitation of edentulous patients and the lack of access to the dentist were associated with higher nutrition risk.

Correlation between crestal alveolar bone loss with intracanal bacteria and apical lesion area in necrotic teeth.

OBJECTIVE: This study aimed to analyze the correlation between crestal alveolar bone loss with the presence of some bacterial species in root canals and the apical lesion area of necrotic teeth. DESIGN: Data from 20 patients with diagnosis of pulp necrosis and acute apical abscesses, without active periodontal diseases, were evaluated. Patients with history of antibiotic usage three months prior to the study, with exposed pulp cavity, and with probing depth >3 mm were not included. The root size, the distance between the bone crest to the tooth apex in the mesial and distal surfaces, and the apical lesion area were measured from standard periapical radiographies by a calibrated examiner. Root canal samples were collected using sterilized paper points. In multirooted teeth, the largest root canal was sampled. Culture, microbial isolation and identification by phenotypic methods were performed. Spearman correlation and exact Fischer test were calculated between higher/lower existing bone crests, according to the median and the presence of specific bacteria. RESULTS: No statistically significant differences were found between occurrence of pathogenic bacteria, such as Porphyromonas gingivalis, Porphyromonas endodontalis, and Prevotella intermedia, and groups with higher/lower degree of bone loss (p > 0.05). A negative significant correlation was found between Parvimonas micra and periodontal bone loss (p = 0.02). Additionally, no statistically significant association was found between crestal bone loss and the apical lesion area. CONCLUSIONS: It was concluded that, in patients without active periodontitis, the presence of pathogenic bacteria in the root canal was not correlated with periodontal bone loss.

Association between history of orthodontic treatment and sociodemographic factors in adolescents.

The aim of this study was to assess history of orthodontic treatment and its determinants in adolescents. This was a crosssectional study conducted in the city of Passo Fundo, Brazil, on a representative sample of adolescents aged 15 to 19 years, regularly enrolled in 20 high schools. A structured questionnaire was applied to assess demographic, behavioral and health variables. The association between history of orthodontic treatment and the dependent variables was analyzed by the chi-square test or Fisher's exact test. Additionally, multivariate regression with robust variance was performed. A total 736 students were examined and interviewed, of whom 57. 6% had undergone orthodontic treatment, while 42. 4% had not. In the multivariable analysis, the following variables were significantly associated with history of orthodontic treatment: female (PR= 1. 26; 95% CI: 1. 11-1. 43), white (PR= 1. 32; 95% CI: 1. 11-1. 56), mothers with higher level of education (PR=1. 49; 95% CI: 1. 28 -1. 74), tooth loss (PR=1. 21; 95% CI: 1. 06-1. 39), and concern about oral health (PR=0. 69; 95% CI: 0. 61-0. 78). Attending a private school was not significantly associated with history of orthodontic treatment (p>0. 05). This study found a high rate for history of orthodontic treatment among adolescents, associated with gender, ethnicity, adolescent's mother with higher education, and tooth loss. Concern about oral health was a protective factor for orthodontic treatment.

Esse estudo objetivou verificar o histórico de tratamento ortodontico e seus fatores associados. Esse estudo transversal foi conduzido na cidade de Passo Fundo, Brasil, com uma amostra representativa dos adolescentes regularmente matriculados no ensino médio, com idades entre 15 e 19 anos, de 20 escolas. Um questionário estrutura foi aplicado para acessar variáveis demográficas, comportamentais e de saúde. As associações entre histórico de tratamento ortodontico e as variáveis independentes foram analisadas pelos testes de qui-quadrado ou exato de Fisher. Além disso, regressão multivariada com variáncia robusta foi realizada. 736 estudantes foram examinados e entrevistados. Tratamento ortodontico foi realizado por 57,6% dos adolescentes, enquanto que 42,4% dos participantes nao o mencionaram. Na análise multivariada, as seguintes variáveis estiveram significativamente associadas com histórico de tratamento ortodôntico: sexo feminino (PR= 1,26; 95%CI: 1,11-1,43), branco (PR= 1,32; 95%CI: 1,11-1,56), mâes com alto nivel educacional (PR=1,49; 95%CI: 1,28-1,74), perda dentária (PR=1,21; 95%CI: 1,06-1,39) epreocupaçâo com a saúde bucal (PR=0,69; 95%CI: 0,61-0,78). Ir a uma escola fiprivada nao esteve significativamente associado com histórico de tratamento ortodôntico (p>0,05). Esse estudo demonstrou que altos niveis de histórico de tratamento ortodôntico são encontrados em adolescentes e isso está associado com sexo, etnia, alta escolaridade da mae do adolescente eperda dentária. Preocupaçâo com a saúde bucal mostrou-se como um fator protetorpara o tratamento ortodôntico.

Spontaneous alveolar bone loss after 4NQO exposure in Wistar rats.

OBJECTIVE: This study evaluated the effect of an experimental carcinogenic, 4-Nitroquinoline 1-oxide (4NQO), in the spontaneous alveolar bone loss (ABL) in an animal model. DESIGN: Twenty-two male Wistar rats were included in this study. They were randomly divided into two groups: the control group (n = 10) received food and water ad libitum, and the test group (n = 12) receive the same food; however, 25 ppm of 4NQO was diluted in the drinking water. All animals were euthanized after 20 weeks, and the tongues were removed and analyzed macroscopically to determine the presence of oral mucosal lesions. All specimens were paraffin-embedded and histological sections were obtained. The microscopic analysis was based on routine procedure (haematoxylin and eosin stain). The analysis of spontaneous ABL was performed by a calibrated examiner using standardized photographs and imaging software. Differences in spontaneous ABL were assessed among the three resulting groups: control, 4NQO with oral squamous cell carcinoma (OSCC), and 4NQO without OSCC. RESULTS: In the 4NQO-treated group, nine animals developed OSCC. The animals in the 4NQO with OSCC group presented significantly more spontaneous ABL (0.65 ±â€¯0.21 mm) than the control group (0.34 ±â€¯0.05) (p < 0.001). The animals in the 4NQO without OSCC group showed a mean spontaneous ABL of 0.47 ±â€¯0.13 mm, which was not statistically significant different when compared to the control group (p = 0.096). CONCLUSIONS: It was concluded that the presence of OSCC enhanced spontaneous ABL in Wistar rats when compared to control animals. Additionally, it was shown that, solely, administration of 4NQO may not be considered responsible for alveolar bone destruction.