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1.
PLoS One ; 11(1): e0147518, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26808490

RESUMEN

BACKGROUND: There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar. AIMS: To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD. METHODS: A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed. RESULTS: Gum bleeding always/often was significantly associated with ≥ 3 asthma symptoms (OR 2.58, 95% CI 2.10-3.18), asthma (1.62 [1.23-2.14]) and self-reported COPD (2.02 [1.28-3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥ 3 symptoms: gum bleeding sometimes 1.42 [1.25-1.60], often/always 2.58 [2.10-3.18]), and there was no heterogeneity between centres (p(heterogeneity) = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (p(interaction) = 0.004). CONCLUSIONS: A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.


Asunto(s)
Asma/complicaciones , Hemorragia Gingival/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Europa (Continente) , Femenino , Hemorragia Gingival/complicaciones , Humanos , Masculino , Persona de Mediana Edad
2.
J Int Acad Periodontol ; 15(2): 36-42, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23705534

RESUMEN

OBJECTIVES: To study whether in vitrofertilization (IVF) treatment has any effect on women's preexisting periodontal status and, if pre-existing women's periodontal status has any impact on IVF outcomes, such as superovulation for multiple follicles maturation, oocyte retrieval and embryo transfer, as well as on pregnancy and its outcomes. METHODS: Sixty women aged 29 to 41 years were recruited in the study. Gingival inflammation (simplified gingival index, GI-S), plaque levels (plaque control record index, PCR), bleeding on probing (BOP) and probing depth (PD), were recorded for all participants before and after IVF. Blood tests were performed prior to IVF. RESULTS: A statistically significant increase in GI-S after IVF was observed in all women (31.9 +/- 18.7% to 61.7 +/- 23.5%), and was higher in women with gingivitis (37.1 +/- 5.7% to 77.6 +/- 6.7%). Women with periodontitis demonstrated a statistically significant increase in BOP (67.7 +/- 6.6% to 89.5 +/- 7.1%), and in the sum of probing pocket depths (from 243.8 +/- 56.2 mm to 250.5 +/- 58.3 mm). A trend for negative correlation between the number of follicles and transferred embryos and the gingival index, before and after IVF respectively, was recorded in all women. There was a similar trend with bleeding on probing after IVF in women with periodontitis. CONCLUSIONS: Periodontal clinical parameters worsened in women undergoing IVF treatment. On the other hand, a poor pre-existing periodontal status seems to be associated with poorer outcomes of IVF treatment.


Asunto(s)
Fertilización In Vitro , Gingivitis/fisiopatología , Adulto , Índice de Placa Dental , Transferencia de Embrión , Estradiol/sangre , Femenino , Hemorragia Gingival/fisiopatología , Humanos , Recuperación del Oocito , Folículo Ovárico/fisiología , Inducción de la Ovulación , Índice Periodontal , Bolsa Periodontal/fisiopatología , Periodontitis/fisiopatología , Embarazo , Resultado del Embarazo , Superovulación/fisiología , Resultado del Tratamiento
3.
PLoS One ; 8(3): e59492, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23544074

RESUMEN

The association between chronic obstructive pulmonary disease (COPD) and periodontal disease is sparsely studied. The aim was to describe the co-variation of periodontitis and lung function impairment in smokers. The hypothesis was that the destructive processes in the mouth and the lungs are interdependent due to a general individual susceptibility to detrimental effects of tobacco smoke. Smokers with COPD (n = 28) stage II and III according to GOLD guidelines and smokers without COPD (n = 29) and healthy non-smokers (n = 23) participated in the study. The groups of smokers were matched for cumulative exposure to tobacco smoke. Radiographic, general and dental clinical examination, lung function measurements and quality of life (SF-36) assessment were conducted. The relationship between respiratory and dental outcomes was analyzed. Dental health, assessed by plaque, gingival bleeding, periodontal pocket depth and loss of teeth was impaired in the smokers compared with non-smokers with no major differences between smokers with and without COPD. There was, however, a weak correlation between periodontitis and emphysema/impaired diffusion capacity. Impaired quality of life was associated with smoking and impaired lung function but not influenced by dental status. In conclusion periodontitis was strongly associated with smoking, weakly associated with lung tissue destruction and very weakly or even not at all associated with chronic airflow limitation. The results indicate that, although there was a co-variation between periodontitis and pathologic lung processes in smokers, the risk of developing COPD, as defined by spirometric outcomes, is not associated with the risk of impaired dental health in smokers.


Asunto(s)
Salud Bucal , Enfermedad Pulmonar Obstructiva Crónica/patología , Fumar/efectos adversos , Adulto , Anciano , Estudios de Casos y Controles , Placa Dental/complicaciones , Placa Dental/patología , Placa Dental/fisiopatología , Femenino , Hemorragia Gingival/complicaciones , Hemorragia Gingival/patología , Hemorragia Gingival/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Bolsa Periodontal/complicaciones , Bolsa Periodontal/patología , Bolsa Periodontal/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Calidad de Vida , Radiografía Torácica , Pruebas de Función Respiratoria , Encuestas y Cuestionarios
5.
J Contemp Dent Pract ; 13(2): 178-81, 2012 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-22665744

RESUMEN

INTRODUCTION: Changes in hormonal levels, such as those that occur during puberty, pregnancy, menstruation and menopause, have varying effects on oral cavity. Many researchers have proposed a direct link between changing hormonal status and oral health among females. OBJECTIVES: To study the various symptoms and clinical manifestations of oral cavity during normal course of menstrual cycle in healthy women. METHOD: Our study comprised of forty healthy young women volunteers with normal menstrual cycle of 28 to 30 days. A proper menstrual history was recorded from the study subjects. The entire cycle was divided into four phases comprising of bleeding, proliferative, ovulation and secretory. All the study subjects had a menstrual cycle of 28 to 30 days. Thorough recording of oral discomforts during various phases of the cycle was done during the study period. RESULTS: 30% of study subjects complained of aphthous ulcers, 5% had herpes labialis, 25% of them complained of depression, 8% showed gingival bleeding. CONCLUSION: Complaints, like oral ulcerations, mood variations, recurrent herpetic lesions, gingival bleeding in females during normal menstrual period, are attributed to the role of female sex hormones. CLINICAL SIGNIFICANCE: Lesions, like oral ulcers, recurrent herpetic lesions and increased gingival bleeding, seen in females during normal menstrual periods, could be related to hormonal turnover and therefore treated accordingly.


Asunto(s)
Hormonas Esteroides Gonadales/fisiología , Herpes Labial/fisiopatología , Ciclo Menstrual/fisiología , Mucosa Bucal/fisiopatología , Estomatitis Aftosa/fisiopatología , Adolescente , Adulto , Depresión/fisiopatología , Femenino , Líquido del Surco Gingival/metabolismo , Hemorragia Gingival/fisiopatología , Humanos , Encuestas y Cuestionarios , Evaluación de Síntomas , Adulto Joven
6.
J Public Health Dent ; 71(2): 143-51, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21774138

RESUMEN

OBJECTIVES: Assess periodontal disease progression among GullahAfrican Americans with type 2 diabetes mellitus (T2DM) according to health insurance coverage. METHODS: From an ongoing clinical trial among T2DM Gullah, we extracted a cohort that was previously enrolled in a cross-sectional study (N=93). Comparing prior exam to trial initiation, total tooth sites/person with periodontal disease progression events [evaluated separately: 2+ mm of clinical attachment loss (CAL), 2+ mm increased periodontal probing depths (PPD), bleeding on probing (BOP) emergence] were evaluated according to health insurance coverage using regression techniques appropriate for data with different counts of potential events per subject (varying tooth sites available). We used negative binomial regression techniques to account for overdispersion and fit multivariable models that also included baseline glycemic control (poor: glycated hemoglobin > OR =7 percent, well: glycated hemoglobin <7 percent), history of established periodontitis, age, gender, body mass index, annual income, and oral hygiene behaviors. Final models included health insurance status, other significant predictors, and any observed confounders. RESULTS: Privately insured were most prevalent (41.94 percent), followed by uninsured (23.66 percent), Medicare (19.35 percent), and Medicaid (15.05 percent). Those with poor glycemic control (65.59 percent) were more prevalent than well-controlled (34.41 percent). CAL events ranged from 0 to 58.8 percent tooth sites/ person (11.83 +/- 12.44 percent), while PPD events ranged from 0 to 44.2 percent (8.66 +/- 10.97 percent) and BOP events ranged from 0 to 95.8 percent (23.65 +/- 17.21 percent). Rates of CAL events were increased among those who were uninsured [rate ratio (RR) = 1.75, P = 0.02], Medicare-insured (RR = 1.90, P = 0.03), and Medicaid-insured (RR = 1.89, P = 0.06). CONCLUSIONS: Increased access to health care, including dental services, may achieve reduction in chronic periodontal disease progression (as determined by CAL) for this study population. These results are very timely given the March 2010 passing of the US healthcare reform bills.


Asunto(s)
Negro o Afroamericano/etnología , Diabetes Mellitus Tipo 2/complicaciones , Cobertura del Seguro , Seguro de Salud , Enfermedades Periodontales/fisiopatología , Adulto , Factores de Edad , Anciano , Índice de Masa Corporal , Periodontitis Crónica/complicaciones , Periodontitis Crónica/fisiopatología , Estudios de Cohortes , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Progresión de la Enfermedad , Femenino , Hemorragia Gingival/complicaciones , Hemorragia Gingival/fisiopatología , Hemoglobina Glucada/análisis , Humanos , Renta , Masculino , Medicaid , Pacientes no Asegurados , Medicare , Persona de Mediana Edad , Higiene Bucal , Pérdida de la Inserción Periodontal/complicaciones , Pérdida de la Inserción Periodontal/fisiopatología , Enfermedades Periodontales/complicaciones , Bolsa Periodontal/complicaciones , Bolsa Periodontal/fisiopatología , Factores Sexuales , South Carolina , Estados Unidos
7.
Ceylon Med J ; 56(1): 5-9, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21542426

RESUMEN

INTRODUCTION: Different systems of traditional medicine of the Indian subcontinent, have used Acacia chundra Willd, Adhatoda vasica Nees., Mimusops elengi L., Piper nigrum L., Pongamia pinnata L. Pirerre, Quercus infectoria Olivier., Syzygium aromaticum L., Terminalia chebula Retz., Zingiber officinale Roscoe., individually or in combinations, to cure oral diseases. OBJECTIVE: To investigate the oral hygiene and gingival health benefits of toothpaste formulated with a mixture of the above herbs (15% w/w). METHODS: Sixty participants (test n = 30, control n = 30, mean age 23.6 +/- 2.25 vs 23.9 +/- 3.2 years) who fulfilled the selection criteria and had similar plaque (1.734 +/- 0.29 vs 1.771 +/- 0.33) and percentage of sites with gingival bleeding (19.6 +/- 7 vs 20.7 +/- 8) were studied in a double blind randomised clinical trial. Brushing instructions to all and a scaling for those with calculus were provided two weeks before baseline examination. One ml of resting saliva was collected to ascertain anaerobic (SAnB) and aerobic (SAB) bacterial counts, plaque index (PI), percentage sites with bleeding on probing (BOP) and pocket depth (PD) (at 6 sites/tooth) were recorded at baseline, followed by home use of the allocated toothpaste (test or placebo) twice a day for 12 weeks. Measurements were repeated at 4, 8, and 12 weeks. RESULTS: PI, BOP and SAnB decreased significantly in the test group at 4, 8, and 12 weeks compared to baseline measurements (Wilcoxon-Signed Rank Test, p < 0.01). There was no statistically significant improvement in PI, BOP, and SAnB in the placebo group. CONCLUSIONS: Our study indicates the beneficial effects of this herbal toothpaste (Sudantha) on oral hygiene and gingival health variables when compared with the placebo. Further clinical trials using patients with gingivitis are necessary to confirm the therapeutic benefits of this herbal toothpaste.


Asunto(s)
Placa Dental/tratamiento farmacológico , Hemorragia Gingival/tratamiento farmacológico , Fitoterapia , Extractos Vegetales , Pastas de Dientes , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Carga Bacteriana/efectos de los fármacos , Cariostáticos/administración & dosificación , Cariostáticos/efectos adversos , Placa Dental/microbiología , Índice de Placa Dental , Método Doble Ciego , Femenino , Hemorragia Gingival/fisiopatología , Humanos , Masculino , Boca/efectos de los fármacos , Boca/microbiología , Boca/patología , Boca/fisiopatología , Higiene Bucal , Extractos Vegetales/administración & dosificación , Extractos Vegetales/efectos adversos , Saliva/efectos de los fármacos , Pastas de Dientes/administración & dosificación , Pastas de Dientes/efectos adversos , Resultado del Tratamiento
8.
J Periodontol ; 82(9): 1279-87, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21342000

RESUMEN

BACKGROUND: To our knowledge, prospective studies (matched for sex, smoking, and diabetes) that investigated the influence of compliance in the progression of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs were not previously reported. METHODS: A total of 58 regular complier (RC) and 58 erratic complier (EC) individuals were recruited from a prospective cohort with 238 patients under PMT and matched by sex, diabetes, and smoking habits. A full-mouth periodontal examination that included bleeding on probing (BOP), probing depths (PDs), clinical attachment levels, and number of teeth were determined at all PMT visits during a 3-year interval. The influence of variables of interest was tested through multivariate logistic regression. RESULTS: The progression of periodontitis and tooth loss was significantly lower among RC compared to EC patients. A higher progression of periodontitis was observed among EC patients who smoked. The final logistic model for the progression of periodontitis in the RC group included smoking (odds ratio [OR]: 4.2) and >30% of sites with BOP (OR: 2.8), and the final logistic model for the progression of periodontitis in the EC group included smoking (OR: 7.3), >30% of sites with BOP (OR: 3.2), PDs of 4 to 6 mm in 10% of sites (OR: 3.5), diabetes (OR: 1.9), and number of lost teeth (OR: 3.1). CONCLUSIONS: RC patients presented a lower progression of periodontitis and tooth loss compared to EC patients. This result highlighted the influence of the pattern of compliance in maintaining a good periodontal status. Moreover, important risk variables such as smoking and diabetes influenced the periodontal status and should be considered when determining the risk profile and interval time for PMT visits.


Asunto(s)
Periodontitis Crónica/fisiopatología , Cooperación del Paciente , Adolescente , Adulto , Pérdida de Hueso Alveolar/fisiopatología , Pérdida de Hueso Alveolar/prevención & control , Estudios de Casos y Controles , Periodontitis Crónica/prevención & control , Estudios de Cohortes , Índice de Placa Dental , Profilaxis Dental , Complicaciones de la Diabetes/fisiopatología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Defectos de Furcación/fisiopatología , Defectos de Furcación/prevención & control , Hemorragia Gingival/fisiopatología , Hemorragia Gingival/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Higiene Bucal , Pérdida de la Inserción Periodontal/fisiopatología , Pérdida de la Inserción Periodontal/prevención & control , Bolsa Periodontal/fisiopatología , Bolsa Periodontal/prevención & control , Estudios Prospectivos , Recurrencia , Retratamiento , Medición de Riesgo , Fumar , Pérdida de Diente/etiología , Adulto Joven
10.
J Clin Periodontol ; 37(6): 501-9, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20507373

RESUMEN

AIM: To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). MATERIALS AND METHODS: From an ongoing clinical trial among T2DM Gullah, we extracted a cohort previously in a cross-sectional study (N=88). Time from baseline (previous study) to follow-up (trial enrollment, before treatment interventions) ranged 1.93-4.08 years [mean=2.99, standard deviation (SD)=0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of > or =2 mm, periodontal probing depth (PPD) increases of > or =2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled=HbA(1c)<7%, poorly-controlled=HbA(1c)> or =7%) using multivariable generalized estimating equations logistic regression, nesting tooth sites/person. RESULTS: Poorly-controlled T2DM (68.18%) was more prevalent than well-controlled T2DM (31.82%). Proportions of tooth sites/person with CAL progression between baseline and follow-up ranged 0.00-0.59 (mean=0.12, SD=0.12), while PPD and BOP progression ranged 0.00-0.44 (mean=0.09, SD=0.11) and 0.00-0.96 (mean=0.24, SD=0.18), respectively. Site-level PPD at baseline was a significant effect modifier of associations between poorly-controlled T2DM and site-level CAL and PPD progression [adjusted odds ratios (OR) according to poorly-controlled T2DM among PPD at baseline=3, 5 and 7 mm, respectively: CAL progression=1.93, 2.64, and 3.62, PPD progression=1.98, 2.76, and 3.84; p<0.05 for all]. Odds of site-level BOP progression were increased (OR=1.24) for poorly-controlled T2DM, yet the results were not significant (p=0.32). CONCLUSIONS: These findings from a distinct, homogenous population further support the clinical relevance of identifying patients with poor glycaemic control and periodontitis, particularly among those with disparities for both diseases.


Asunto(s)
Negro o Afroamericano , Glucemia/análisis , Diabetes Mellitus Tipo 2/prevención & control , Etnicidad , Periodontitis/fisiopatología , Adulto , Anciano , Índice de Masa Corporal , Estudios de Cohortes , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/etnología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Hemorragia Gingival/etnología , Hemorragia Gingival/fisiopatología , Hemoglobina Glucada/análisis , Humanos , Hipoglucemiantes/uso terapéutico , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etnología , Pérdida de la Inserción Periodontal/fisiopatología , Bolsa Periodontal/etnología , Bolsa Periodontal/fisiopatología , Periodontitis/etnología , Fumar , South Carolina
11.
J Clin Periodontol ; 36(10): 836-42, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19703238

RESUMEN

AIMS: To assess rates of periodontal disease progression in subjects with cleft lip, alveolus and palate (CLAP) over a 25-year period without regular maintenance care in a specialist setting and to compare those with those of subjects without alveolar clefts, i.e. cleft lip (CL) or cleft palate (CP). MATERIAL AND METHODS: Ten subjects with CLAP and 10 subjects with CL/CP were examined in 1979, 1987, 1993 and 2004. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque control record (PCR) scores were recorded in all 20 subjects. RESULTS: High plaque and BoP scores were recorded at all examinations in both groups. Over 25 years, a statistically significant loss of mean full-mouth CAL of 1.52 +/- 0.12 mm (SD) and 1.66 +/- 0.15 mm occurred in the CLAP and CL/CP group respectively (p<0.05). A statistically significant increase (p<0.05) in mean full-mouth PPD of 0.35 +/- 0.12 mm was observed in the CL/CP group, whereas only a trend for a mean full-mouth increase in PPD of 0.09 +/- 0.11 mm was observed in the CLAP group. In subjects with CLAP, a statistically significant increase (p<0.05) in PPD of 0.92 +/- 1.13 mm at cleft sites was observed compared with that of 0.17 +/- 0.76 mm at control sites. With respect to CAL, the loss at the corresponding sites amounted to 2.71 +/- 1.46 and to 2.27 +/- 1.62 mm, respectively (p=0.36). CONCLUSIONS: When stringent and well-defined supportive periodontal therapy was not provided, subjects with orofacial clefts were at high risk for periodontal disease progression. Over 25 years, alveolar cleft sites tended to have more periodontal tissue destruction compared with control sites.


Asunto(s)
Proceso Alveolar/anomalías , Periodontitis Crónica/fisiopatología , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Adulto , Estudios de Cohortes , Placa Dental/fisiopatología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Hemorragia Gingival/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/fisiopatología , Bolsa Periodontal/fisiopatología , Factores de Riesgo , Pérdida de Diente/fisiopatología
12.
J Periodontol ; 79(9): 1645-51, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18771364

RESUMEN

BACKGROUND: Because periodontitis presents many similarities with rheumatoid arthritis (RA) with regard to tumor necrosis factor-alpha (TNF-alpha)-induced bone resorption, the benefits of TNF-alpha blockade in RA prompted us to determine its efficacy in treating coexisting periodontitis. METHODS: Periodontal status was evaluated in 40 subjects with RA who were divided into two groups: Group I contained 20 subjects who had received infliximab every 6 weeks for > or =22 months at the time of periodontal evaluation. The 20 subjects in group II were evaluated before their first infusion with infliximab. Nine subjects in group II had periodontitis. These subjects were reevaluated after they received nine infusions of infliximab. RESULTS: Infliximab tended to aggravate gingival inflammation as indicated by differences in the modified gingival and papillary bleeding indices between subjects in groups I and II with coexisting periodontitis before and after treatment. Methotrexate had no effect on periodontal status. Although the plaque index revealed that bacterial infection persisted, the probing depth was equal in groups I and II and equivalent before and after treatment in subjects with periodontitis, whereas attachment loss was decreased after infliximab treatment. CONCLUSIONS: Inflammation and destruction constitute two interrelated yet separate components of periodontitis in patients with RA. Therefore, TNF-alpha blockade could be beneficial in the treatment of periodontitis.


Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Gingivitis/fisiopatología , Pérdida de la Inserción Periodontal/fisiopatología , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto , Anciano , Anticuerpos Monoclonales/uso terapéutico , Antirreumáticos/uso terapéutico , Estudios Transversales , Índice de Placa Dental , Femenino , Hemorragia Gingival/fisiopatología , Humanos , Infliximab , Estudios Longitudinales , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Índice Periodontal , Bolsa Periodontal/tratamiento farmacológico , Bolsa Periodontal/fisiopatología , Periodontitis/tratamiento farmacológico , Periodontitis/microbiología , Periodontitis/fisiopatología , Fumar
13.
J Periodontol ; 79(7): 1184-91, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18597600

RESUMEN

BACKGROUND: Low-calorie diets are commonplace for reducing body weight. However, no information is available on the effects of a reduced-calorie diet on periodontal inflammation and disease. The purpose of this study was to evaluate the clinical effects of a long-term calorie-restriction (CR) diet on periodontitis in an animal model of periodontitis. METHODS: Periodontitis was induced in 55 young, healthy, adult rhesus monkeys (Macaca mulatta) by tying 2.0 silk ligatures at the gingival margins of maxillary premolar/molar teeth. Animals on a CR diet (30% CR; N = 23) were compared to ad libitum diet controls (N = 32). Clinical measures, including the plaque index (PI), probing depth (PD), clinical attachment level (CAL), modified gingival index (GI), and bleeding on probing (BOP) were recorded at baseline and 1, 2, and 3 months after ligature placement. RESULTS: Significant effects of CR were observed on the development of inflammation and the progression of periodontal destruction in this model. Compared to controls, CR resulted in a significant reduction in ligature-induced GI (P <0.0001), BOP (P <0.0015), PD (P <0.0016), and CAL (P <0.0038). Periodontal destruction, as measured by CAL, progressed significantly more slowly in the CR animals than in the controls (P <0.001). CONCLUSIONS: These clinical findings are consistent with available evidence that CR has anti-inflammatory effects. Moreover, these experimental findings are the first observations, to the best of our knowledge, that CR dampens the inflammatory response and reduces active periodontal breakdown associated with an acute microbial challenge.


Asunto(s)
Restricción Calórica , Enfermedades Periodontales/fisiopatología , Periodontitis/fisiopatología , Animales , Diente Premolar/patología , Índice de Placa Dental , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Femenino , Hemorragia Gingival/fisiopatología , Gingivitis/fisiopatología , Macaca mulatta , Masculino , Diente Molar/patología , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Bolsa Periodontal/fisiopatología , Factores de Tiempo
14.
J Clin Periodontol ; 35(8): 685-95, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18549447

RESUMEN

BACKGROUND: Limited evidence exists on the significance of residual probing pocket depth (PPD) as a predictive parameter for periodontal disease progression and tooth loss. AIM: The aim of this study was to investigate the influence of residual PPD >or=5 mm and bleeding on probing (BOP) after active periodontal therapy (APT) on the progression of periodontitis and tooth loss. MATERIAL AND METHODS: In this retrospective cohort, 172 patients were examined after APT and supportive periodontal therapy (SPT) for 3-27 years (mean 11.3 years). Analyses were conducted using information at site, tooth and patient levels. The association of risk factors with tooth loss and progression of periodontitis was investigated using multilevel logistic regression analysis. RESULTS: The number of residual PPD increased during SPT. Compared with PPDor=7 mm 37.9 and 64.2, respectively. At patient level, heavy smoking, initial diagnosis, duration of SPT and PPD>or=6 mm were risk factors for disease progression, while PPD>or=6 mm and BOP>or=30% represented a risk for tooth loss. CONCLUSION: Residual PPD>or=6 mm represent an incomplete periodontal treatment outcome and require further therapy.


Asunto(s)
Bolsa Periodontal/fisiopatología , Periodontitis/fisiopatología , Pérdida de Diente/fisiopatología , Adolescente , Adulto , Anciano , Estudios de Cohortes , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Predicción , Defectos de Furcación/fisiopatología , Hemorragia Gingival/fisiopatología , Recesión Gingival/fisiopatología , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/fisiopatología , Bolsa Periodontal/terapia , Estudios Retrospectivos , Factores de Riesgo , Fumar/fisiopatología , Movilidad Dentaria/fisiopatología , Resultado del Tratamiento
15.
Gerodontology ; 25(4): 245-50, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18380783

RESUMEN

OBJECTIVE: To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly. BACKGROUND: Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships. MATERIAL AND METHODS: Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of > or =3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and >20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline. RESULTS: Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p < or = 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3). CONCLUSION: Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.


Asunto(s)
Calcio/sangre , Enfermedades Periodontales/sangre , Anciano , Glucemia/análisis , Progresión de la Enfermedad , Escolaridad , Femenino , Estudios de Seguimiento , Hemorragia Gingival/sangre , Hemorragia Gingival/fisiopatología , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Pérdida de la Inserción Periodontal/sangre , Pérdida de la Inserción Periodontal/fisiopatología , Enfermedades Periodontales/fisiopatología , Bolsa Periodontal/sangre , Bolsa Periodontal/fisiopatología , Factores de Riesgo , Albúmina Sérica/análisis , Factores Sexuales , Fumar/sangre , Pérdida de Diente/sangre , Pérdida de Diente/fisiopatología
16.
J Dent Res ; 87(1): 79-83, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18096899

RESUMEN

Alveolar bone destruction can be magnified in the presence of generalized skeletal disorders. We questioned whether severe generalized periodontitis patients display signs of bone metabolism disturbances. Our objective was to assess skeletal bone mineral density (BMD) and biochemical bone parameters in premenopausal women with periodontitis. Forty-five patients and 40 control individuals were included in the study. We measured BMD by dual-energy x-ray absorptiometry. The results showed no difference in BMD values between the periodontitis and control groups (p > 0.05). A positive relationship between the clinical attachment level and Body Mass Index (BMI) scores was observed (p = 0.03). Increased serum creatinine levels were noted in the periodontitis group (p = 0.04). Analysis of the data suggests that there is no evidence for an association between skeletal BMD and severe periodontitis in premenopausal women. There may be a link between elevated creatinine levels and periodontitis. The persons with high BMI scores seemed to be at risk for periodontitis.


Asunto(s)
Densidad Ósea/fisiología , Periodontitis/fisiopatología , Premenopausia/fisiología , Absorciometría de Fotón , Adulto , Análisis Químico de la Sangre , Índice de Masa Corporal , Creatinina/sangre , Cálculos Dentales/fisiopatología , Índice de Placa Dental , Femenino , Hemorragia Gingival/fisiopatología , Articulación de la Cadera , Humanos , Vértebras Lumbares , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Bolsa Periodontal/fisiopatología , Periodontitis/sangre , Factores de Riesgo , Pérdida de Diente/fisiopatología
17.
J Periodontol ; 78(8): 1620-6, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17668982

RESUMEN

BACKGROUND: Inflammatory and anti-inflammatory mediators may play a significant role in patients with gingivitis. The purpose of this study was to assess the short-term effects of the systemic administration of two different concentrations of aspirin (81 and 325 mg/day, by mouth) on clinical periodontal parameters and gingival crevicular fluid (GCF) levels of 15-epi-lipoxin A4 (15-epi-LXA4), lipoxin A4, leukotriene B4 (LTB4), prostaglandin E2 (PGE2), and interleukin (IL)-6 and -1beta in a sample of naturally occurring gingivitis patients. METHODS: At day 0, after initial screening for entry, baseline periodontal parameters, including bleeding on probing (BOP), periodontal probing depths (PDs), and plaque index (PI) were measured, and GCF was sampled from 12 intrasulcular sites with filter paper strips for the measurement of six types of inflammatory and anti-inflammatory mediators using competitive enzyme immunoassay and enzyme-linked immunosorbent assay (prevalues). Forty-seven subjects were assigned randomly to one of three treatment groups: placebo (15 subjects); aspirin, 81 mg (16 subjects); and aspirin, 325 mg (16 subjects) once daily. On day 7, subjects were recalled for the measurement of periodontal parameters and collection of GCF samples for the measurement of six types of mediators (postvalues). RESULTS: Changes in inflammatory and anti-inflammatory mediator levels were not statistically significant for any of the three treatment groups. However, when pre- and postvalues were compared in the subjects receiving aspirin, 325 mg, there was a negative trend in the relationship between 15-epi-LXA4 and PGE2, whereas the relationship between LTB4 and PGE2 was not as strong. This might indicate that the subjects responding to aspirin-mediated PGE2 suppression effects produced higher 15-epi-LXA4 in GCF than non-responders. No statistically significant differences in PD and PI between pre- and postvalues were found for any of the three treatment groups. However, the results demonstrated a significant increase in BOP when aspirin, 325 mg was compared to placebo (P <0.001) and aspirin, 81 mg (P = 0.001). CONCLUSIONS: Aspirin can have an affect on BOP in naturally occurring gingivitis patients. Although most of the inflammatory mediators did not show significantly detectable changes after aspirin treatment for 7 days, the trend of aspirin-associated increases of 15-epi-LXA4 implied that this recently discovered aspirin-dependent eicosanoid may be associated with the increased incidence of BOP observed in the subjects who received aspirin therapy.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Aspirina/farmacología , Líquido del Surco Gingival/efectos de los fármacos , Gingivitis/fisiopatología , Mediadores de Inflamación/análisis , Adulto , Antiinflamatorios no Esteroideos/administración & dosificación , Aspirina/administración & dosificación , Índice de Placa Dental , Dinoprostona/análisis , Femenino , Líquido del Surco Gingival/inmunología , Hemorragia Gingival/clasificación , Hemorragia Gingival/fisiopatología , Gingivitis/inmunología , Humanos , Interleucina-1beta/análisis , Interleucina-1beta/efectos de los fármacos , Interleucina-6/análisis , Leucotrieno B4/análisis , Lipoxinas/análisis , Masculino , Bolsa Periodontal/clasificación , Placebos
18.
Clin Oral Investig ; 11(4): 377-83, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17576606

RESUMEN

The purpose of this study was to assess the degree of pain during periodontal probing and mechanical non-surgical therapy according to age, gender, and intersubject variation such as tooth type, tooth surfaces or regions of mouth, probing depth, and bleeding on probing. The study was carried out on 64 patients with chronic periodontitis. Pain/discomfort of patients during both periodontal probing and scaling and root planing (SRP) was measured using a visual analog scale (VAS). During periodontal probing and SRP, VAS scores decreased with increasing age for two procedures (Spearman rho, -0.301 and -0.348, respectively; P < 0.01). VAS scores were considerably lower for oral sites than for facial sites. VAS scores in probing were significantly higher in sites > or =4 mm deep than sites <4 mm deep. Sites bleeding on probing had a significantly higher VAS scores than sites no bleeding on probing (p < 0.05). The results showed that although there is no difference between genders, the intensity of pain during periodontal probing and SRP was different dramatically between patients as well as vary between different locations in the same mouth. If pain responses for probing in different several regions in the same mouth during initial examination were noted into patient chart used for initial examination, the therapist will recognize patients with elevated pain responses. If need be, they will then apply some pain control medication or anesthetic for patients during probing and SRP.


Asunto(s)
Raspado Dental , Dimensión del Dolor , Periodontitis/diagnóstico , Aplanamiento de la Raíz , Adolescente , Adulto , Factores de Edad , Anciano , Femenino , Hemorragia Gingival/diagnóstico , Hemorragia Gingival/fisiopatología , Hemorragia Gingival/terapia , Humanos , Incisivo/patología , Masculino , Persona de Mediana Edad , Diente Molar/patología , Dolor/fisiopatología , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/fisiopatología , Bolsa Periodontal/terapia , Periodoncia/instrumentación , Periodontitis/fisiopatología , Periodontitis/terapia , Factores Sexuales
19.
J Oral Maxillofac Surg ; 65(6): 1065-9, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17517287

RESUMEN

PURPOSE: This study was conducted to evaluate the association between third molar periodontal pathology at enrollment and periodontal disease progression during pregnancy. PATIENTS AND METHODS: The data were derived from patients in an institutional review board-approved prospective study known as the Oral Conditions and Pregnancy (OCAP) study. Demographic, health behavior, and medical history data were obtained from medical records. Full-mouth periodontal examinations of 6 periodontal probing sites for each visible tooth, including third molars, were conducted at less than 26 weeks of pregnancy and within 72 hours postpartum. The primary outcome variable was periodontal progression (4 or more probing sites with at least a 2 mm increase in probing depth (PD), all at least 4 mm deep), between the enrollment and postpartum examinations. The primary predictor variables at enrollment were at least 1 PD >or=4 mm around the third molars, and the upper tertile of the number of third molar probing sites recorded as bleeding on probing (BOP). Bivariate analyses were performed for baseline characteristics. The chi2 test was used to determine statistical significance (P = .05). Significant variables were included in unconditional logistic multivariable models to derive relative risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS: Data from enrollment and term were available for 360 subjects with visible third molars (mean age, 27.3 years; standard deviation, 5.5 years). At the postpartum examination, 122 subjects (34%) demonstrated periodontal progression. These subjects included 74 of the 176 subjects (42%) in whom a third molar PD >or=4 mm was detected at baseline and 48 of the 184 (26%) without third molar PD >or=4 mm (P = .001). Periodontal progression was found in 40 of the 77 subjects (52%) who were in the upper tertile of the number of third molar probing sites exhibiting BOP at enrollment versus 82 of the 203 (29%) in the lower tertiles (P = .0002). In multivariable models, either third molar PD >or=4 mm at enrollment (RR = 1.4; 95% CI = 1.1 to 2.0) or third molar bleeding on probing (RR = 1.7; 95% CI = 1.3 to 2.3) was associated with periodontal disease progression. CONCLUSION: Third molar periodontal pathology appears to be a significant risk indicator for periodontal disease progression during pregnancy.


Asunto(s)
Tercer Molar/patología , Enfermedades Periodontales/complicaciones , Complicaciones del Embarazo , Adulto , Progresión de la Enfermedad , Etnicidad , Femenino , Servicios de Alimentación , Predicción , Hemorragia Gingival/complicaciones , Hemorragia Gingival/fisiopatología , Conductas Relacionadas con la Salud , Humanos , Estado Civil , Pacientes no Asegurados , Enfermedades Periodontales/fisiopatología , Índice Periodontal , Bolsa Periodontal/complicaciones , Bolsa Periodontal/fisiopatología , Embarazo , Nacimiento Prematuro , Estudios Prospectivos , Factores de Riesgo , Fumar
20.
J Dent Res ; 85(12): 1134-7, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17122168

RESUMEN

The objective of this cross-sectional study was to evaluate whether gingivitis susceptibility is associated with periodontitis. We analyzed data of 462 men in the VA Dental Longitudinal Study aged 47 to 92 years who had never smoked or had quit smoking 5+ years previously. Multiple logistic regression models, with tooth-level bleeding on probing at sites with attachment loss

Asunto(s)
Gingivitis/fisiopatología , Periodontitis/fisiopatología , Factores de Edad , Anciano , Anciano de 80 o más Años , Ácido Ascórbico/administración & dosificación , Índice de Masa Corporal , Estudios de Cohortes , Estudios Transversales , Coronas , Cálculos Dentales/fisiopatología , Placa Dental/fisiopatología , Complicaciones de la Diabetes/fisiopatología , Susceptibilidad a Enfermedades , Escolaridad , Hemorragia Gingival/fisiopatología , Humanos , Renta , Estudios Longitudinales , Masculino , Estado Civil , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/fisiopatología , Estudios Prospectivos , Vitaminas/administración & dosificación
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