ABSTRACT
BACKGROUND: This study aimed to compare the periodontal status of liver transplant candidates (LTCs) with healthy controls. METHODS: Fifty liver transplant candidates (LTC group) and fifty patients without liver disease (control group) underwent a complete periodontal examination. The groups were matched according to sex, age, and smoking status. A structured questionnaire was applied to record demographic data, systemic health, and information related to liver disease. Full-mouth complete periodontal examination of six sites per tooth was performed: gingival recession (GR), probing depth (PD), attachment loss (AL), bleeding on probing (BOP), and visible plaque index (VPI). The groups were compared in regard to periodontal clinical variables. RESULTS: Patients with cirrhosis had greater prevalence of periodontitis than healthy controls (P < 0.001). In addition, they had greater mean percentage of sites with AL ≥3 mm (P = 0.008) and AL ≥5 mm (P = 0.023), greater mean AL (P = 0.003), greater mean gingival recession (P < 0.001), and more missing teeth than in the control group (P = 0.02). CONCLUSION: Liver transplant candidates presented greater prevalence, extent, and severity of periodontitis than matched control patients.
Subject(s)
Gingival Recession , Liver Transplantation , Periodontitis , Dental Plaque Index , Gingival Hemorrhage , Humans , Periodontal Attachment Loss , Periodontal IndexABSTRACT
The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.
Subject(s)
Chronic Periodontitis/etiology , Smoking Cessation/statistics & numerical data , Smoking/adverse effects , Smoking/therapy , Adult , Age Factors , Brazil , Carbon Monoxide/analysis , Chronic Periodontitis/therapy , Female , Humans , Logistic Models , Male , Middle Aged , Prospective Studies , Risk Factors , Smoking Cessation/psychology , Socioeconomic Factors , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
O transplante de fígado é o tratamento preconizado para a doença hepática terminal. Infecções são complicações frequentes e estão associadas à alta morbidade e mortalidade de pacientes pré e pós-transplantados. Assim, a prevenção de processos infecciosos é fundamental para reduzir a progressão da cirrose e diminuir o risco de complicações após o transplante. Portanto, o objetivo desta revisão de literatura é verificar quais são as condições bucais de candidatos ao transplante de fígado e de pós-transplantados, bem como verificar se a doença hepática está associada com pior condição bucal. Os artigos incluídos demonstraram higiene bucal ruim, alta prevalência de doença periodontal e de doença cárie. Alguns estudos observaram maior perda óssea e maior perda de inserção clínica em pré e pós-transplantados do que em pacientes sadios. A literatura é controversa em relação à associação entre condição hepática e doença cárie. Não há evidência suficiente para suportar a hipótese de que a doença hepática seja um fator de risco para doenças bucais
Liver transplantation is the indicated treatment for endstage hepatic disease. Infections are frequent complications in patients waiting for liver transplant and post-transplant patients, and have been associated with high morbidity and mortality.Thus, prevention of infections is important in the reduction of the progression of hepatic disease and in the reduction of complications in the transplanted patient. The aim of the review is to describe the oral conditions of liver transplant candidates and transplanted patients, and to verify if hepatic disease is associated with poor oral conditions. The included articles demonstrated poor oral hygiene, high prevalence of periodontal disease and caries disease. Some of the studies observed greater bone loss and clinical attachment loss in liver transplant candidates and transplanted patients, when compared to healthy controls. The literature is controversial regarding association between liver disease and dental caries. We concluded that there is not enough evidence to support the hypothesis that liver disease increases the risk for oral diseases
Subject(s)
Liver Cirrhosis , Periodontitis , Oral Health , Liver TransplantationABSTRACT
Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.
Subject(s)
Humans , Male , Female , Adult , Smoking/adverse effects , Smoking/therapy , Smoking Cessation/statistics & numerical data , Chronic Periodontitis/etiology , Socioeconomic Factors , Time Factors , Brazil , Carbon Monoxide/analysis , Logistic Models , Prospective Studies , Surveys and Questionnaires , Risk Factors , Age Factors , Treatment Outcome , Smoking Cessation/psychology , Chronic Periodontitis/therapy , Middle AgedABSTRACT
AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every 3 months. A calibrated examiner, blinded to smoking status, performed full-mouth periodontal examination in six sites per tooth at baseline, 3, 12 and 24 months of follow-up. Expired air carbon monoxide concentration measurements and interviews were performed to gather demographic and behavioural information. RESULTS: From the 116 enrolled subjects, 61 remained up to 24 months of follow-up. Of these, 18 quit smoking (Q), 32 continued smoking (NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in the proportion of sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ(p ≤ 0.05). CONCLUSION: Smoking cessation promoted additional benefits on NSPT in chronic periodontitis subjects.
Subject(s)
Chronic Periodontitis/therapy , Periodontal Debridement/methods , Smoking Cessation , Adult , Aged , Carbon Monoxide/analysis , Chronic Periodontitis/prevention & control , Dental Calculus/classification , Dental Plaque Index , Female , Follow-Up Studies , Gingival Hemorrhage/therapy , Gingival Recession/therapy , Health Behavior , Humans , Male , Middle Aged , Oral Hygiene/education , Periodontal Attachment Loss/therapy , Periodontal Pocket/therapy , Prospective Studies , Smoking , Treatment OutcomeABSTRACT
BACKGROUND: The purpose of the present investigation is to compare the presence and number of periodontal pathogens in the subgingival microbiota of smokers versus never-smokers with chronic periodontitis and matched probing depths (PDs) using real-time polymerase chain reaction (RT-PCR). METHODS: Forty current smokers and 40 never-smokers, matched for age, sex, and mean PD of sampling site, were included in this investigation. A full-mouth periodontal examination was performed, and a pooled subgingival plaque sample was collected from the deepest site in each quadrant of each participant. To confirm smoking status, expired carbon monoxide (CO) concentrations were measured with a CO monitor. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were determined using RT-PCR. RESULTS: Smokers had greater overall mean PD (P = 0.001) and attachment loss (P = 0.006) and fewer bleeding on probing sites (P = 0.001). An association was observed between smoking status and the presence of A. actinomycetemcomitans (P <0.001). The counts of A. actinomycetemcomitans (P <0.001), P. gingivalis (P = 0.042), and T. forsythia (P <0.001) were significantly higher in smokers. CONCLUSIONS: Smokers showed significantly greater amounts of P. gingivalis, A. actinomycetemcomitans, and T. forsythia than never-smokers. There was a significant association between smoking and the presence of A. actinomycetemcomitans.
Subject(s)
Bacteria/classification , Chronic Periodontitis/microbiology , Smoking , Adult , Aged , Aggregatibacter actinomycetemcomitans/isolation & purification , Bacterial Load , Bacteroides/isolation & purification , Carbon Monoxide/analysis , Case-Control Studies , Cross-Sectional Studies , Dental Plaque/microbiology , Female , Gingiva/microbiology , Gingival Hemorrhage/microbiology , Humans , Male , Middle Aged , Periodontal Attachment Loss/microbiology , Periodontal Pocket/microbiology , Porphyromonas gingivalis/isolation & purification , Real-Time Polymerase Chain Reaction/methods , Treponema denticola/isolation & purificationABSTRACT
O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com periodontite. Duzentos e um (201) sujeitos foram triados e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico e terapia antitabágica. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado e foi validada pela mensuração de monóxido de carbono expirado (CO). Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22 (42,31%), 17 (32,69%) e 17 (32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo
Smoking is the leading risk factor of several chronic diseases, including periodontitis. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12-month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment and smoking cessation therapy. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Among the 52 individuals that remained up to the 12-months examination, 22 (42.31%), 17 (32.69%) and 17 (32.69%) were not smoking at 3, 6 and 12 months, respectively. It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates
Subject(s)
Humans , Tobacco Use Cessation , Smoking , DentistryABSTRACT
O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Atualmente existe uma mobilização mundial contra o uso do tabaco. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com doença periodontal. Duzentos e um (201) sujeitos foram triados, e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico. Simultaneamente, os indivíduos receberam terapia antitabágica, que consistiu em quatro palestras consecutivas ministradas por um médico e uma dentista, terapia cognitiva comportamental realizada por uma psicóloga, e terapia de reposição de nicotina e medicação, de acordo com necessidades individuais. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado, e foi validada pela mensuração de monóxido de carbono expirado (CO).
Também foi aplicado o Questionário de Tolerância de Fagerström para verificar a dependência à nicotina. Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22(42,31%), 17(32,69%) e 17(32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. A cessação de tabagismo foi associada aos níveis iniciais de CO (p = 0,03), nível de dependência nicotínica de acordo com o questionário de Fageström (p=0,01) e escore médio do questionário de Fagerström (p<0,001). Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo. O abandono do hábito foi associado à exposição ao CO e à dependência nicotínica.
Smoking is the leading risk factor of several chronic diseases, including periodontitis. Nowadays, there is a world-wide mobilization against the use of tobacco. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12- month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment during four weeks. Subjects also received smoking cessation therapy, which consisted of four consecutive lectures given by a physician and a dentist, psychologist-assisted cognitive behavioral therapy, nicotine replacement therapy and medication, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques.
Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Participants were further asked about their nicotine dependence, by means of the Fagerström Tolerance Questionnaire. Among the 52 individuals that remained up to the 12-months examination, 22(42.31%), 17(32.69%) and 17(32.69%) were not smoking at 3, 6 and 12 months, respectively. Smoking cessation was associated with baseline CO levels (p = 0.03), Fagerströms nicotine dependence level (p=0.01) and mean Fagerström test score (p<0.001). It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates. Smoking cessation was associated with exposure to CO and nicotine dependence.
Subject(s)
Humans , Male , Female , Tobacco Use Cessation/methods , Chronic Periodontitis/diagnosis , Tobacco Use Disorder/adverse effectsABSTRACT
AIM: The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. MATERIALS AND METHODS: Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. RESULTS: Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p>0.05). CONCLUSION: Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.
Subject(s)
Chronic Periodontitis/therapy , Periodontal Attachment Loss/prevention & control , Smoking Cessation , Adult , Analysis of Variance , Breath Tests , Carbon Monoxide/analysis , Chi-Square Distribution , Dental Scaling , Female , Follow-Up Studies , Humans , Male , Middle Aged , Periodontal Index , Prospective Studies , Single-Blind Method , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
O fumo representa a maior causa de morte e invalidez passível de prevenção. É também o maior fator de risco na prevalência, extensão e gravidade das doenças periodontais. O abandono deste vício por meio de estratégias empregadas por profissionais da área da saúde é considerado uma ação extremamente efetiva. As três técnicas: aconselhamento, terapia de reposição de nicotina e terapia medicamentosa são as mais utilizadas para a terapia antitabágica pela praticidade, segurança e grau de eficiência. O objetivo desta revisão de literatura é descrever estas três técnicas, bem como suas taxas de sucesso e a importância do cirurgião-dentista em auxiliar os pacientes fumantes no abandono deste hábito.
Smoking is the largest single preventable cause of mortality and morbidity worldwide. It is also the most prominent risk factor for the prevalence, extent and severity of periodontal diseases. The cessation of this habit through anti-smoking strategies employed by health care professionalsis considered an extremely effective action. Three smoking cessation techniques: counseling, nicotine replacement therapy, and drug therapy are the ones most employed by their simplicity, safety and efficiency. The aim of this literature review is to describe these techniques, their success rates, and to highlight the importance of the dental team at assisting patients to quit smokin.
