Relationship between TNF-α, MMP-8, and MMP-9 levels in gingival crevicular fluid and the subgingival microbiota in periodontal disease.

Periodontitis is modulated by a complex dysbiotic microbiota, these species stimulate upward the production of pro-inflammatory cytokines such as TNF-α, which, in turn, upregulates the production of bone resorption molecules. Enzymes such as MMP-8 and 9 have been associated with the destructive disease. This study evaluated the composition of periodontal microbiota with the checkerboard hybridization technique and its correlation with TNF-α, MMP-8, and MMP-9 evaluated with ELISA, of 80 patients (45 healthy, and 35 with chronic periodontitis). The frequency of the 18 species evaluated was higher in patients with bone loss compared with control group. TNF-α in gingival crevicular fluid was significantly higher in bone loss group (p < 0.01); MMP-8 (p = 0.34) by MMP-9 (p < 0.05) in bone loss group obtained lower values than in control group. Positive correlation of TNF-α was obtained with Aggregatibacter actinomycetemcomitans (rho = 0.38; p < 0.01), Fusobacterium nucleatum (rho = 0.25; p < 0.05) and Porphyromonas gingivalis (rho = 0.26; p < 0.05); negative correlation of MMP-8 with A. actinomycetemcomitans (rho = 0.26; p < 0.01), Capnocytophaga sputigena (rho = 0.33; p < 0.01), and F. nucleatum (rho = 0.21; p < 0.05); also negative correlation of MMP-9 with F. nucleatum (rho = 0.23; p < 0.05), P. gingivalis (rho = 0.23; p < 0.05), and Tannerella forsythia (rho = 0.26; p < 0.01). TNF-α increased due to the increase in each count of A. actinomycetemcomitans (ß = 0.57; p = 0.00). The presence of A. actinomycetemcomitans (ß = 1.88; p = 0.00), Campylobacter rectus (ß = 0.78; p = 0.01), F. nucleatum (ß = 0.65; p = 0.04), and P. gingivalis (ß = 0.65; p = 0.04) significantly increases TNF-α levels. TNF-α in gingival crevicular fluid, despite the minimal amounts collected, is a good biomarker of periodontal disease; since levels of TNF-α increases with the increase of the most harmful species to the periodontium.

Expression of IL-33 in subjects with periodontitis: a systematic review and meta-analysis.

BACKGROUND: Activation of the IL-33/ST2 axis leads to the production of proinflammatory cytokines and thus to the triggering of osteoclastogenesis, which is why it plays an important role in the immunopathogenesis of periodontitis. The aim of this study was to compare IL-33 levels in serum, plasma, saliva and gingival crevicular fluid (GCF) of subjects with chronic periodontitis (CP) in comparison with the control group (CG). METHODS: This systematic review and meta-analysis followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/YHUWA . Six electronic databases were used for study identification; PubMed, Google Scholar, ScienceDirect, Web of Science, Scopus and Dentistry & Oral Sciences Source from March 10, 2012 to April 30, 2024. The Joanna Briggs Institute (JBI) tool was used to assess the quality of the included cross-sectional articles and clinical trials. RESULTS: Of the 949 articles identified, 14 were included according to the inclusion and exclusion criteria. The total number of individuals studied in the included investigations was 814 of whom 445 had CP and 369 were healthy. The reported age range was from 20 to 50 years, with a mean age ± standard deviation of 40.29 ± 7.83 years. Four hundred and twenty-six (52%) patients were men and 388 (48%) were women. Meta-analysis revealed that there is an increase in IL-33 levels in plasma, saliva and GCF of subjects with CP compared to CG (p = * < 0.05). CONCLUSIONS: This study found a significant increase in IL-33 levels in different biological samples (plasma, saliva and GCF) of individuals with CP compared to CG, thus IL-33 has potential to be a biomarker in the diagnosis of periodontitis.

Clinical Signs and Symptoms Associated with COVID-19: A Cross Sectional Study

ABSTRACT: Covid-19 is a viral disease that has spread throughout the world, becoming a pandemic. Dysgeusia and anosmia are some of its most frequent symptoms. The aim of the study was to determine the frequent signs and symptoms associated with COVID-19 patients. A cross-secional study from 370 patients with acute respiratory illness admitted by emergenc y services of a hospital in Acapulco. An institutional survey was applied to all patients as a data collection instrument, and a SARS-CoV-2 test, by RT-PCR processed by a certified laboratory. Statistical analysis was performed using the STATA V13 program. The numerical variables without normality were reported in medians, 25th and 75th percentiles, and the Mann W ithney U test was performed for differences between groups. The categorical variables were presented in percentages and differences between groups with Chi-square test. A generalized linear models (GLM) analysis was carried out to determine the most frequent symptoms and signs associated with COVID-19. Clinical signs and symptoms associated to COVID-19 in the bivariate análysis were dysgeusia, odynophagia, anosmia, arthralgia, myalgia, conjunctivitis, and age older than 40 years. In the final multivariate model only age older than 40 years (OR) 2.2; CI 95 % 1.3,3.8) and dysgeusia (OR 2.1; CI95 % 1.2,3.6) kept significance. Dysgeusia, odynophagia, anosmia, arthralgia, myalgia and conjunctivitis are clinical signs and symptoms that can appear in the early stages of the disease, so they could be important for an early diagnosis.

RESUMEN: El Covid-19 es una enfermedad viral que se ha extendido por todo el mundo, convirtiéndose en una pandemia. La disgeusia y la anosmia son algunos de sus síntomas más frecuentes. El objetivo del estudio fue determinar los signos y síntomas frecuentes asociados con los pacientes con COVID-19. Estudio transversal de 370 pacientes con enfermedad respiratoria aguda ingresados por los servicios de emergencia de un hospital de Acapulco. A todos los pacientes se les aplicó una encuesta institucional como instrumento de recolección de datos, y una prueba de SARS-CoV-2, por RT-PCR procesada por un laboratorio certificado. El análisis estadístico se realizó utilizando el programa STATA V13. Las variables numéricas sin normalidad se reportaron en medianas, percentiles 25 y 75, y se realizó la prueba U de Mann Withney para diferencias entre grupos. Las variables categóricas se presentaron en porcentajes y diferencias entre grupos con la prueba de Chi-cuadrado. Se realizó un análisis de modelos lineales generalizados (GLM) para determinar los síntomas y signos más frecuentes asociados a la COVID-19. Los signos y síntomas clínicos asociados a COVID-19 en el análisis bivariado fueron disgeusia, odinofagia, anosmia, artralgia, mialgia, conjuntivitis y edad mayor de 40 años. En el modelo multivariado final solo la edad mayor de 40 años (OR) 2,2; IC 95 % 1,3,3,8) y la disgeusia (OR 2,1; IC95 % 1,2,3,6) mantuvieron significanca estadística. Disgeusia, odinofagia, anosmia, artralgias, mialgias y conjuntivitis son signos y síntomas clínicos que pueden aparecer en etapas tempranas de la enfermedad, por lo que podrían ser importantes para un diagnóstico precoz.

Job satisfaction in graduates of the career of dental surgeon: a cross sectional study / Satisfação no trabalho em graduados da carreira de cirurgião-dentista: um estudo transversal

ABSTRACT This study aims to estimate job satisfaction levels in graduated of dental school of Autonomous University of Guerrero, México, and determine which factors influence such satisfaction levels. A cross-sectional study was carried out in 144 dentists graduated from the dental school of Autonomous University of Guerrero through a validated survey. Logistic regression analysis was performed to obtain OR, p-value and confidence intervals (95% CI) in the STATA13 statistical program. The overall percentage of job satisfaction was 92%, while the variables that explained the model were, the role of the dentist (Owner or employed) (OR = 2.2 , p = 0.03 95% CI 1.1-4.4), and the level of satisfaction of the knowledge acquired within their academic dental school training (OR = 19.2, p = 0.00 95%CI 3.1-118). The professional satisfaction of a dentist is of great importance, because it impacts their performance at work, and is closely related to overall satisfaction of life, since both contribute reciprocally to the happiness of a person, as well as the general welfare in the community.

RESUMO Este estudo tem como objetivo estimar os níveis de satisfação no trabalho de graduados da Faculdade de Odontologia da Universidade Autônoma de Guerrero, México, e determinar quais fatores influenciam esses níveis de satisfação. Foi realizado um estudo transversal com 144 dentistas formados pela Faculdade de Odontologia da Universidade Autônoma de Guerrero por meio de um questionário validado. Uma análise de regressão logística foi realizada para obter OR, valor de p e intervalos de confiança (IC95%) no programa estatístico STATA13. O percentual geral de satisfação no trabalho foi de 92%, enquanto as variáveis que explicaram o modelo foram a função do dentista (proprietário ou funcionário) (OR = 2,2 , p = 0,03 IC 95% 1,1-4, 4) e o nível de satisfação com o conhecimento adquirido na formação acadêmica em odontologia (OR = 19,2 , p = 0,00 IC95% 3,1-118).. A satisfação profissional do dentista é de grande importância, pois impacta no seu desempenho no trabalho, e está intimamente relacionada à satisfação geral de vida, uma vez que ambas contribuem para a felicidade da pessoa, bem como para o bem-estar geral da comunidade.

Periodontal disease distribution, risk factors, and importance of primary healthcare in the clinical parameters improvement / Distribución de la enfermedad periodontal, factores de riesgo e importancia de la atención primaria en salud en la mejora de los parámetros clínicos

The objective of this study is to show the distribution of periodontal disease, risk factors, and importance of primary healthcare, for the improvement of clinical parameters. Two phases study transversal and nonrandomized trial (before - after), with educational intervention and conservative treatment, were carried out at Dental School of the Universidad Autónoma de Guerrero México, in 161 subjects who met the inclusion criteria. Oral healthcare education was carried out as well as conservative periodontal treatment, with six months follow up. Clinical measurements were performed with a Williams probe, O'Leary plaque index, calculus index and dental mobility Miller method. Periodontal disease was found on 82 % of all participants. Multinomial logistic regression analysis showed an odds ratio of 14.3 (95 % CI: 2.5, 82.1), 13.4 (95 % CI: 1.7, 103.5), 29.2 (95 % CI: 3.2, 260.9) and 68 (95 % CI: 6.6, 711.0) plaque in gingivitis, mild, moderate and severe chronic periodontitis, respectively. The longitudinal panel data analysis showed a significant effect (p <0.001) in the mean decrease of the clinical parameters after intervention, probing depth 0.4 mm (95 % CI: -0.5, -0.3), pockets depth 1.1 mm (95 % CI: -1.3, -0.9), amount of pockets 4.5 (95 % CI: -5.2, -3.7), bleeding 5.2 (95 % CI: -5.9, -4.5) and dental mobility 0.6 degrees (95 % CI: -0.7, -0.5). Primary healthcare is still the best option to improve the periodontal health in population who do not have access to specialty services. Dentists can achieve significant clinical improvement at very low cost, if they are aware of primary health care.

El objetivo del estudio fue mostrar la distribución de la enfermedad periodontal, los factores de riesgo y la importancia de la atención primaria de salud, para la mejora de los parámetros clínicos. Material y método: Estudio de dos fases transversal y no aleatorizado (antes - después), con intervención educativa y tratamiento conservador, realizado en la Facultad de Odontología de la Universidad Autónoma de Guerrero México, en 161 sujetos que cumplieron con los criterios de inclusión. Se llevó a cabo una educación sanitaria oral, así como un tratamiento periodontal conservador, con un seguimiento de seis meses. Las mediciones clínicas se realizaron con una sonda Williams, el índice de placa O'Leary, el índice de cálculo y el método Miller de movilidad dental. Resultados: se encontró enfermedad periodontal en el 82 % de todos los participantes. El análisis de regresión logística multinomial mostró un odds ratio de 14.3 (IC 95 %: 2.5, 82.1), 13.4 (IC 95 %: 1.7, 103.5), 29.2 (IC 95 %: 3.2, 260.9) y 68 (IC 95 %: 6.6, 711.0) placa en gingivitis, periodontitis crónica leve, moderada y grave, respectivamente. El análisis de datos del panel longitudinal mostró un efecto significativo (p <0.001) en la disminución media de los parámetros clínicos después de la intervención, profundidad de sondeo 0.4 mm (IC 95 %: -0.5, -0.3), profundidad de bolsillos 1.1 mm (IC 95 %: -1.3, -0.9), cantidad de bolsillos 4.5 (IC 95 %: -5.2, -3.7), hemorragia 5.2 (IC 95 %: -5.9, -4.5) y movilidad dental 0.6 grados (IC 95 %: -0.7, - 0.5). Conclusiones: la atención primaria de salud sigue siendo la mejor opción para mejorar la salud periodontal en la población que no tiene acceso a servicios especializados. Relevancia clínica: los dentistas pueden lograr una mejora clínica significativa a un costo muy bajo, si conocen la atención primaria de salud.

Influencia de los vasoconstrictores añadidos a la anestesia dental en la frecuencia cardiaca y la tensión arterial / Influence of vasoconstrictors added to dental anesthetics on blood pressure and heart rate

Introduction: vasoconstrictors are substances added to local anesthetics to lengthen their time of action, reduce their toxicity and enhance their local hemostatic effect. There is controversy about whether the use of vasoconstrictors in dental anesthetics has a negative effect on blood pressure and heart rate. Objective: determine the influence of vasoconstrictors added to dental anesthetics on blood pressure and heart rate. Methods: an experimental study was conducted with 120 patients divided in two groups of 60. These patients attended clinics in the Dental Academic Unit of the Autonomous University of Guerrero from July to December 2015. Group A was given just 3 percent mepivacaine, whereas Group B was given mepivacaine with epinephrine at a concentration of 1:100 000. Measurements were taken of the patients' heart rate, systolic blood pressure and diastolic blood pressure at two moments: at baseline before infiltration and 5 minutes after infiltration. Statistical analysis was based on Student's t-test for independent samples. Results: heart rate and systolic blood pressure did not yield any statistically significant value. Diastolic blood pressure was the only hemodynamic parameter showing a statistically significant difference (t= 2.3; p= 0.02). Conclusions: the results obtained coincide with those reported by similar studies. At the doses recommended, epinephrine is safe for healthy patients as well as for those with controlled cardiovascular conditions(AU)

Introducción: los vasoconstrictores son substancias que han sido añadidas a los anestésicos locales con la finalidad de aumentar su tiempo de acción, disminuir su toxicidad y aprovechar su efecto hemostático local. Existe controversia sobre si el uso de vasoconstrictores en los anestésicos dentales produce efectos negativos en la tensión arterial y la frecuencia cardiaca. Objetivo: determinar la influencia de los vasoconstrictores añadidos a la anestesia dental en la frecuencia cardiaca y la tensión arterial. Métodos: se realizó un estudio experimental en 120 pacientes divididos en dos grupos de 60, que acudieron a las clínicas de la Unidad Académica de Odontología de la Universidad Autónoma de Guerrero en el periodo julio-diciembre de 2015. Al grupo A se le administró mepivacaína simple al 3 por ciento, y al grupo B se le administró mepivacaína con epinefrina a una concentración de 1:100 000. Se realizaron tomas de frecuencia cardiaca, tensión arterial sistólica y tensión arterial diastólica en dos momentos. Se realizó una toma basal de frecuencia cardiaca, tensión arterial sistólica y diastólica antes de la infiltración, y una segunda toma 5 min posteriores a la infiltración. Se realizó la prueba estadística t de Student para grupos independientes. Resultados: la frecuencia cardiaca y la tensión arterial sistólica no obtuvieron significancia estadística. El único parámetro hemodinámico que tuvo una diferencia estadísticamente significativa fue la tensión arterial diastólica (t= 2,3; p= 0,02). Conclusiones : los resultados obtenidos en esta investigación, coinciden con los reportados en otros estudios similares. La epinefrina puede ser utilizada de manera segura a las dosis recomendadas tanto en pacientes sin enfermedad cardiovascular, como en pacientes con compromiso cardiovascular en control(AU)

Prevalencia de gingivitis y factores asociados en estudiantes de la Universidad Autónoma de Guerrero, México / Prevalence of gingivitis and associated factors among students from the Autonomous University of Guerrero, Mexico

Introducción: la gingivitis es la enfermedad más común del periodonto, la medida profiláctica más efectiva y económica es la higiene bucal. Objetivos: estimar la prevalencia de gingivitis e identificar factores de riesgo asociados en universitarios de primer ingreso. Métodos: se realizó un estudio transversal de septiembre a diciembre de 2012. Se encuestó a 1 387 estudiantes de licenciatura de la Universidad Autónoma de Guerrero en Acapulco, México. No se estimó tamaño de la muestra porque se encuestó a todos los inscritos. Los instrumentos para la recolección de datos fue un cuestionario autoadministrado, formatos para inspección bucal y levantamiento de índice de higiene oral de Green y Vermillion simplificado, e índices de placa y gingivitis de Löe y Silness simplificados. El diagnóstico de gingivitis se hizo con los valores clínicos del índice de Löe y Silness considerando los puntajes de 0 a 0,09 como sano. La variable resultado fue gingivitis y las de causa: placa dentobacteriana, mala higiene bucal, tártaro, detritos, diastemas, aparatos de ortodoncia, apiñamiento dental y desgastes cervicales. Resultados: la prevalencia de gingivitis ponderada por conglomerado de escuelas fue 74,5 por ciento, de la cual 62,8 por ciento fue leve, 11,5 por ciento moderada, y 0,2 por ciento intensa. El 16 por ciento de los estudiantes, según el índice de Green y Vermillion, tuvo mala higiene y 87,3 pore ciento tuvo placa según criterio de Löe y Silness. Ajustando por conglomerados y los demás factores, cuatro factores fueron asociados a gingivitis: mala higiene bucal (OR 2,58 IC 95 por ciento 1,32-5,05), detritos (OR 2,62 IC 95 por ciento 1,49-4,58), diastemas (OR 1,72; IC 95 por ciento 1,13-2,64) y desgastes en cervical (OR 0,49; IC 95 por ciento 0,24-1,00). Conclusiones: la prevalencia de gingivitis se encontró dentro del rango reportado en otros estudios. La mala higiene bucal, detritos y diastemas fueron los factores de riesgo asociados a gingivitis(AU)

Introduction: gingivitis is the most common periodontal disease. The most effective prophylactic measure against this condition is oral hygiene. Objectives: estimate the prevalence of gingivitis and identify associated risk factors among first year university students. Methods: across-sectional study was conducted from September to December 2012 based on a survey applied to 1 387 students from the Autonomous University of Guerrero in Acapulco, Mexico. Sample size was not estimated because all the students registered were surveyed. The data collection tools used were a self-applied questionnaire, oral examination forms, the simplified Green and Vermillion oral hygiene index, and the simplified Löe and Silness plaque and gingivitis indices. Gingivitis was diagnosed with values on Löe and Silness indices, where scores from 0 to 0.09 were considered healthy. The result variable studied was gingivitis. Cause variables were dental plaque, poor oral hygiene, tartar, detritus, diastema, orthodontic appliances, dental crowding and cervical wear. Results: prevalence of gingivitis estimated by school cluster was 74.5 percent, of which 62.8 percent was mild, 11.5 percent was moderate and 0.2 percent was severe. According to the Green and Vermillion index, 16 percent of the students had poor hygiene, and according to the Löe and Silness indices 87.3 percent had plaque. Adjustment by clusters and other variables revealed four factors associated with gingivitis: poor oral hygiene (OR 2.58; CI 95 percent; 1.32-5.05), detritus (OR 2.62; CI 95 percent; 1.49-4.58), diastema (OR 1.72; CI 95 percent; 1.13-2.64) and cervical wear (OR 0.49; CI 95 percent; 0.24-1.00). Conclusions: prevalence of gingivitis was found to be within the range reported by other studies. Poor oral hygiene, detritus and diastema were the risk factors associated with gingivitis(AU)

Satisfacción de usuarios con los servicios de salud bucal y factores asociados en Acapulco, México / User satisfaction with dental services and associated factors in Acapulco, Mexico

Introducción: la medición de los niveles de satisfacción de los usuarios es parte fundamental para evaluar la calidad de los servicios de salud bucal. Objetivo: estimar la frecuencia de satisfacción y sus factores asociados en los usuarios de los servicios odontológicos en una jurisdicción sanitaria de Guerrero, México. Métodos: se realizó estudio transversal analítico en una muestra de 493 usuarios de los servicios de salud bucal mayores de 18 años de edad, a los que se aplicó cuestionario estructurado de 51 preguntas posterior a la atención dental. Se obtuvo información sobre datos sociodemográficos, satisfacción (variable resultado) y percepción del servicio odontológico recibido. Resultados: dos variables tuvieron efecto sobre la satisfacción: trato del estomatólogo y de la enfermera. La mayor fuerza de asociación (OR 7,37, cl IC 95 por ciento 3,73 ­ 35,78, RD 0,4 827 con cl IC 95 por ciento 0,3 332-0,6 322, ganancia 26/1 000) y ganancia se observó en la variable trato del estomatólogo. Tres variables tuvieron efecto sobre expectativa del usuario: trato del estomatólogo, comodidad de la sala de espera y del sillón de dental. La mayor fuerza de asociación (OR a 8,54, cl IC 95 por ciento 2,43 ­ 30,15) se observó en la variable trato del estomatólogo. La mayor ganancia la obtuvo comodidad del sillón dental (RD 0,2 924, cl IC 95 por ciento 0,1 894 ­ 0,3 855, ganancia 63/1 000). Se encontró alto nivel de satisfacción (88 por ciento, 434/493) con el servicio recibido, y un cumplimiento de la expectativa de los usuarios de 59 por ciento (285/484). Conclusión: el trato otorgado por el personal de salud es el principal aspecto donde las autoridades deberán implementar acciones para incrementar los niveles de satisfacción de los usuarios de los servicios dentales. El mejoramiento del trato a los usuarios por el equipo de salud bucal, estomatólogo y enfermera, deben considerarse dentro de los programas de mejora continua de estos servicios(AU)

Introduction: measurement of user satisfaction levels is an essential aspect of the quality evaluation of dental services. Objective: estimate the frequency of satisfaction and associated factors among users of dental services in a health area of Guerrero, Mexico. Methods: a analytical cross-sectional study was conducted of a sample of 493 users of dental services aged over 18 years who answered a structured questionnaire containing 51 questions after receiving dental care. Data were obtained about sociodemographics, satisfaction (variable result) and perception of the dental service received. Results: two variables had an effect on user satisfaction: attitude of the dentist and the nurse. The strongest association (OR 7.37, cl CI 95 percent; 3.73-35.78, RD 0.4827 with cl CI 95 percent; 0.3332-0.6322, gain 26/1 000) and gain were found in the variable attitude of the dentist. Three variables had an effect on user expectations: attitude of the dentist, comfort in the waiting room and comfort of the dental chair. The strongest association (OR 8.54, cl CI 95 percent; 2.43-30.15) was found in the variable attitude of the dentist. The greatest gain was obtained by comfort of the dental chair (RD 0.2924, cl CI 95 percent; 0.1894-0.3855, gain 63/1 000). Satisfaction with the service received was found to be high (88 percent, 434/493). Fulfillment of user expectation was 59 percent (285/484). Conclusion: authorities should implement actions aimed at improving the attitude of health personnel toward patients, with a view to raising the level of user satisfaction with dental services. Improvement in the attitude of dental care personnel, dentist and nurse, toward patients should be included in programs for the continued development of these services(AU)