Long-term impact of patients' compliance to peri-implant maintenance therapy on the incidence of peri-implant diseases: An 11-year prospective follow-up clinical study.

OBJECTIVE: To prospectively evaluate the incidence of peri-implant diseases and the associated risk factors during 11 years of peri-implant maintenance therapy (PIMT). MATERIAL AND METHODS: A sample of 80 partially edentulous individuals rehabilitated with dental implants was invited to participate in a PIMT program (T1-prior to entering the PIMT program). After 11 years, 51 individuals remained regularly or irregularly adherent to PIMT (T2-last recall after 11 years) and were classified as regular (RC; n = 27) or irregular (IC; n = 24) compliers. Data of interest were analyzed using univariate and multivariate logistic regression analyses. RESULTS: The incidence of peri-implant mucositis and peri-implantitis observed at T2 in the IC group (70.8% and 37.5%, respectively) were significantly higher than those observed in the RC group (37.0% and 11.1%, respectively). The incidence of peri-implant diseases was mostly attributable to potentially modifiable risk factors, as such: RC group-PM (p = 0.013); IC group-high plaque index (p < 0.001), irregular compliance (p < 0.001), the presence of PM (p = 0.015) and periodontitis (p < 0.039). CONCLUSION: Regular compliance during PIMT had a strong effect in minimizing the incidence of peri-implant diseases. Increasing regular dental visits and improving oral hygiene would provide benefits for preventing peri-implant diseases.

Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10-year follow-up.

BACKGROUND: The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10 years of periodontal maintenance therapy (PMT). METHODS: The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10 years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI ≤ 30%, n = 63); (2) fair OH (FOH; PI > 30% and ≤40%, n = 73); and (3) poor OH (POH; PI > 40%, n = 88). Data were analyzed using the chi-square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses. RESULTS: Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH > FOH > GOH; P < .001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10-4.38) and POH (OR 4.33; CI, 2.17-8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively. CONCLUSIONS: After 10 years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD ≥ 5 mm.

Impact of oral lesions on the quality of life of psoriatic individuals: A case-control study.

OBJECTIVES: To assess the presence of oral lesions and the impact of oral health-related quality of life (OHRQoL) on individuals with psoriasis. METHODS: This case-control study comprised 295 individuals with psoriasis and 359 controls. Oral examination to assess different types of oral lesions as angular cheilitis (AC), geographic tongue (GT), white (WP), and red plaque or red macule (RPM) was performed. To evaluate OHRQoL, the Oral Impact on Daily Performance (OIDP) questionnaire was applied. Data were analyzed using the chi-squared, Fisher, Kruskal-Wallis, Mann-Whitney, and Bootstrap Intervals tests. RESULTS: Individuals with psoriasis had significantly more oral lesions than controls (OR = 3.66, 95% CI: 2.33-5.85; p < .001) and higher global OIDP scores (12.17 case versus 6.93 controls; p = .008). Higher occurrence of GT (p < .001) and AC (p < .001) was observed in individuals with psoriasis. The final multivariate model demonstrated higher OIDP scores related to the following variables: alcohol use, diabetes, anxiolytics use, AC, and GT, showing worse OHRQoL. CONCLUSION: Psoriatic individuals had a higher frequency of AC and GT than controls. Worse OIDP scores in frequency and severity were observed in psoriatic individuals with oral lesions, revealing the negative impacts of these lesions on OHRQoL.

Periodontitis and the impact of oral health on the quality of life of psoriatic individuals: a case-control study.

AIM: To evaluate the periodontal condition and the impact of oral health on the quality of life (OHRQL) among individuals with and without psoriasis. METHODS: This case-control study comprised 295 individuals with psoriasis and 359 controls. A full mouth examination was performed for all periodontal clinical parameters. To evaluate OHRQL, the Oral Impact on Daily Performance (OIDP) questionnaire was applied. Data was analyzed using the chi-square, Fischer, Kruskal-Wallis, Mann-Whitney, and Bootstrap intervals tests to determine different profiles in relation to the OIDP. RESULTS: Individuals with psoriasis had a 1.40 greater chance of having periodontitis than controls (OR = 1.40 95%CI: 1.01-1.93; p = 0.019). Individuals with psoriasis with periodontitis (+P) had greater impacts on OHRQL (13.76 ± 15.58), when compared with those without periodontitis (-P) (4.83 ± 8.25; p < 0.001). Additionally, psoriasis +P stage III/IV patients (13.94 ± 15.68) had worse indicators than controls -P (9.49 ± 22.54; p = 0.001). The final multivariate model demonstrated higher OIDP scores related to the following variables: diabetes, anxiolytics use, periodontitis, and psoriasis, showing worse OHRQoL. CONCLUSIONS: This study demonstrated an important risk association between psoriasis and periodontitis, as both diseases demonstrated worse OHRQL indicators. Moreover, the severity of periodontitis and psoriasis significantly increased these negative impacts. CLINICAL RELEVANCE: Practical implications: Multidisciplinary interaction is desirable to improve the impact of these diseases on the QoL of individuals with psoriasis and periodontitis.

Important anatomical variations of the superior posterior alveolar artery: Studied by cone beam computed tomography.

The knowledge of anatomical variations of the posterior superior alveolar artery (PSAA) is very important in surgeries for maxillary sinus (MS) elevation and subsequent insertion of dental implants, avoiding common and serious surgical complications. The main objective of this study was to analyse important anatomical variations of the PSAA by means of cone beam computed tomography (CBCT) examinations. 180 tomographic CBCT were analysed, and MS was divided into three equal regions: (I) anterior, (II) intermediate and (III) posterior. Variables evaluated were the visualisation of the artery, distance from the artery to the ridge crest, distance from the artery to the sinus floor, alveolar ridge height and arterial diameter. The PSAA visualisation was more prevalent in males and region III (76.7%). The distance from the artery to the sinus floor presented no significant difference between regions II and III, with both regions showing significantly lower values than region I. A significant difference was observed in the diameter of the arteries with higher prevalence of diameters >1.0 mm in males and <1.0 mm in females. The PSAA can be well visualised frequently with a CBCT, and differences in artery diameter were observed in relation to gender (males > females). Additional care is recommended when it is necessary to extend surgeries to the posterior MS region, avoiding haemorrhages that are associated with failures in these procedures.

Effects of topical application of 1% sodium alendronate gel in the surgical treatment of periodontal intrabony defects: A 6-month randomized controlled clinical trial.

BACKGROUND: Sodium alendronate (ALN) is an aminobisphosphonate and potent inhibitor of bone resorption. It has been suggested that ALN might be a promising carrier of biomolecules for periodontal bone repair. The aim of this randomized split-mouth clinical trial was to evaluate the effects of the topical application of 1% ALN gel in intrabony defects during the surgical treatment of patients with periodontitis. METHODS: Sixty-four intrabony defects from 32 patients with periodontitis were randomly treated with either 1% ALN gel or placebo gel during periodontal surgeries. Full-mouth periodontal examination was performed at baseline and at 3 and 6 months after surgical treatment. Clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP) were recorded as the clinical outcomes. Bone defects were evaluated by digital subtraction radiography (DSR) at baseline and 6 months post-treatment. Analyses were performed through Fisher, Kruskal-Wallis, and ANOVA tests and a generalized estimation equations method. RESULTS: Both ALN and placebo groups showed significant improvements in BOP, PD, and CAL after periodontal surgical procedures (P < 0.001). Intergroup analysis showed significantly better outcomes in the ALN group with higher PD reduction and clinical attachment gain. DSR showed positive effects on periodontal bone repair strongly associated in the ALN group (P < 0.001). CONCLUSION: Topical application of 1% ALN may be a promising and beneficial adjuvant for the treatment of intrabony defects during surgical periodontal therapy.

Periodontitis as another comorbidity associated with psoriasis: A case-control study.

BACKGROUND: The association between periodontitis and immuno-mediated inflammatory diseases has been widely studied and recognized each more over the past few years. The aim of this study was to evaluate the potential association between psoriasis and periodontitis, as well as the influence of risk variables in this association. METHODS: This case-control study included 756 individuals, 397 with psoriasis, and 359 controls. A full-mouth periodontal examination was performed, recording therefore plaque index, probing depth, clinical attachment level, and bleeding on probing. The influence of risk variables was tested by univariate analysis and multivariate logistic regression. RESULTS: A high prevalence of periodontitis was observed among cases (46.1%) when compared to controls (33.1%). Individuals with psoriasis presented a 1.72 higher chance of having periodontitis than controls (OR = 1.72; 95% CI 1.28-2.32; p < 0.001) in the univariate analysis, but with no significance in the multivariate model. The prevalence of periodontitis increased significantly according to the severity of psoriasis [mild form (44.4%); moderate (46.3%); and advanced (47.1%)] when compared to the control group (33.1%). The final multivariate logistic model showed that the number of teeth (OR = 1.08; 95% CI 1.01-1.14; p = 0.018), smoking (OR = 1.91; 95% CI 1.19-3.07; p = 0.008), and body mass index (OR = 1.13; 95% CI 1.11-1.16; p < 0.001) remained significantly associated with the occurrence of periodontitis. CONCLUSIONS: The prevalence of periodontitis was higher in individuals with psoriasis than in controls. Severity of psoriasis also presented a strong relationship with all periodontal clinical parameters.

Effect of 1% sodium alendronate in the non-surgical treatment of periodontal intraosseous defects: a 6-month clinical trial.

BACKGROUND AND OBJECTIVES: Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). RESULTS: Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. CONCLUSIONS: Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.

Effect of 1% sodium alendronate in the non-surgical treatment of periodontal intraosseous defects: a 6-month clinical trial

Abstract Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). Results Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. Conclusions Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.

Effect of non-surgical periodontal treatment by full-mouth disinfection or scaling and root planing per quadrant in halitosis-a randomized controlled clinical trial.

OBJECTIVE: The objective of this study was to compare the effect of one-stage full-mouth disinfection (FMD) and conventional quadrant scaling in four weekly sessions (QS) on periodontal clinical parameters and halitosis among individuals with advanced chronic periodontitis. MATERIALS AND METHODS: In this randomized controlled clinical trial, 30 individuals were divided into two groups: FMD (n = 15) and QS (n = 15). The following data were collected at the baseline and 90 days after treatment: plaque index, tongue-coating index (TCI), bleeding on probing, probing depth, and clinical attachment level. Halimetry was performed by the organoleptic method, and the levels of volatile sulfur compounds (H2S and CH3SH) were measured by gas chromatography. The Chi-square, Fisher's exact, the Mann-Whitney, the McNemar, and the Wilcoxon tests were used for statistical analysis. RESULTS: Both groups showed statistically significant improvements in periodontal clinical parameters, reduction in TCI, organoleptic scores, and in CH3SH levels between times. However, major reduction was observed in FMD group. CONCLUSION: Non-surgical periodontal therapy, regardless of the protocol, was effective in improving periodontal clinical status of individuals, decreasing organoleptic scores and CH3SH levels between times, as well as reducing halitosis. CLINICAL RELEVANCE: This study contributed to the knowledge that non-surgical periodontal therapy, whether by FMD or QS, was effective in reducing halitosis in individuals with advanced chronic periodontitis.

Effect of local application of aminoguanidine on the biomechanical retention of implants in rats with induced diabetes.

PURPOSE: To evaluate the effect of surgical placement of an aminoguanidine (AG)-loaded chitosan membrane, which allows slow local release of AG, over an endosseous implant on mechanical retention of the implant in nondiabetic and diabetic rats. MATERIALS AND METHODS: Forty-eight male Wistar rats were randomly divided into six groups of eight animals each and subjected to three different treatment modalities: (1) implant placement in the femur, (2) placement of implant + chitosan membrane without AG at the surgical site, or (3) placement of implant + AG-loaded chitosan membrane (AG concentration of 7.35 mmol/kg body weight) at the surgical site. Groups 1, 2, and 3 were nondiabetic (control groups), and groups 4, 5, and 6 had chemically induced type 1 diabetes (test groups). At 4 weeks after implant placement, the animals were sacrificed and the countertorque force (CTF) required to disrupt the bone-implant interface was measured. Analyses of variance were performed, and the mean CTF values were compared between groups by using the Student t test. RESULTS: The mean CTF values were significantly lower in diabetic groups not treated with AG than in the corresponding nondiabetic animals that had received the same treatment modality. In groups that received AG locally, the mean CTF values were not statistically significantly different, regardless of diabetes status. CONCLUSIONS: Induced diabetes (type 1) negatively affected the CTF necessary for disrupting the bone-implant interface. Local availability of AG in diabetic animals led to an increase in the CTF values to the same level as that in nondiabetic animals.

Bisfosfonato alendronato na terapêutica periodontal / Bisphosphonate alendronate in the periodontal therapy

O alendronato de sódio é um medicamento utilizado no tratamento de doenças ósseas do metabolismo humano e, nos últimos anos, pesquisas apontam para a possibilidade do seu uso na terapia periodontal, devido a sua capacidade de controlar a reabsorção óssea, inibindo a atividade de osteoclastos e apresentando-se como potencial agente carreador de moléculas bioativas. Todavia, seu uso sistêmico e prolongado está relacionado com a ocorrência de osteonecrose dos maxilares. Interessantemente, são encontrados níveis muito baixos de resíduos do alendronato em aloenxertos ósseos, originados de indivíduos que faziam uso contínuo desse medicamento. A literatura científica ainda não apresenta um consenso sobre o uso do alendronato na terapêutica periodontal, uma vez que os resultados dos estudos são controversos

Alendronate is a medicine for the treatment of bone diseases of the human metabolism and in recent years, studies indicate the possibility of its use in periodontal therapy due to their ability to control bone resorption, mediating osteoclasts, osteoblasts and showing potential as carrier agent of bioactive molecules. However, systemic and prolonged use is associated with the occurrence of osteonecrosis in the jaw. Interestingly, they are found very low levels of residues of alendronate in bone allografts, originating from individuals who took continuous use of this drug. The scientific literature has not yet showed a consensus on the use of alendronate on periodontal therapy, since the results of the studies are controversies.

Influence of hyperbaric oxygen therapy on peri-implant bone healing in rats with alloxan-induced diabetes.

AIM: The influence of hyperbaric oxygen therapy (HBOT) on peri-implant bone healing in rats with alloxan-induced type-1 diabetes was studied. MATERIALS AND METHODS: Forty-eight male rats were randomly divided into six groups: (1) healthy rats (HR) that received no HBOT; (2) HR that underwent 10 sessions of HBOT before implant installation; (3) HR that underwent 10 sessions of HBOT after implant installation; (4) rats with induced diabetes (DR) without HBOT; (5) DR that underwent 10 sessions of HBOT before implant installation; (6) DR that underwent 10 sessions of HBOT after implant installation. A screw-shaped titanium implant was inserted into the femur. The animals were killed 28 days after implantation. The percentage of bone-to-implant contact (BIC) within the implant threads was evaluated. RESULTS: Lower BIC was observed in DR (35.35 ± 18.04) compared with the HR (69.07 ± 09.01) (p = 0.001). However, with HBOT, either before or after implantation, BIC was increased in DR. HBOT before implantation was p = 0.03; HBOT after implantation was p = 0.08. This increase reversed the negative effect of diabetes; therefore, the differences between DR and HR were not significant with HBOT (p ≥ 0.21). CONCLUSION: HBOT, either before or after implantation, increased the BIC in DR to the level of HR.

Desinfecção total da boca em um estágio: revisão da literatura / One-stage full-mouth disinfection: literature review

Estudos prévios têm sugerido que a técnica de desinfecção total da boca (DTB) em um estágio resulta em uma resposta mais favorável ao tratamento periodontal não cirúrgico. O objetivo desta revisão de literatura foi analisar os estudos relacionados ao protocolo de DTB em um estágio. A partir de 1995, várias investigações do tipo caso controle compararam os resultados do tratamento periodontal pela técnica de raspagem por quadrante (RQ) e do protocolo de DTB. Na última década diversos estudos mostraram que os parâmetros clínicos e microbiológicos apresentaram melhores respostas frente ao protocolo DTB, além da diminuição do tempo clínico de atendimento sugerindo à DTB em um estágio como uma alternativa mais efetiva e economicamente mais viável para o tratamento não cirúrgico da doença periodontal inflamatória. Esses resultados são advindos de uma variação muito grande de protocolos e faz-se necessário o desenvolvimento de mais estudos em busca de um protocolo bem definido assim como uma melhor avaliação dos efeitos adversos da DTB.

Previous studies have suggested that the full-mouth disinfection (DTB) in one stage results in a more favorable response to nonsurgical periodontal treatment. The aim of this review was to analyze the studies related to DTB protocol at an early stage. Since 1995, several case-control investigations have compared the results of periodontal treatment per quadrant scraping technique (RQ) and the protocol of DTB. In the last decade several studies have shown that the clinical and microbiological parameters showed better responses in the DTB protocol also decreased time to clinical care DTB suggesting at one stage as a more effective and more economically viable for the nonsurgical treatment of periodontal disease inflammatory. These results are coming from a very large range of protocols and it is necessary to develop further studies in search of a defined protocol and a better assessment of the adverse effects of DTB.

Periodontal therapy and risk for adverse pregnancy outcomes.

Periodontitis has been associated with adverse pregnancy outcomes. Results from intervention studies are few and controversial. The present study assessed the effects of non-surgical periodontal treatment in the occurrence of adverse pregnancy outcomes. Two hundred forty-six eligible women were randomly divided into two groups: periodontitis intervention (n = 122; undergoing non-surgical treatment during gestation) and periodontitis control (n = 124; not treated during gestation). Univariate analysis was performed and estimates of relative risk were reported. Data from 225 women were analyzed. No differences for preterm birth (p = 0.721), low birth weight (p = 0.198), and preterm low birth weight (p = 0.732) rates were observed. Relative risk estimates for preterm birth, low birth weight, and preterm low birth weight in the periodontitis intervention group were 0.915 (95% CI 0.561-1.493), 0.735 (95% CI 0.459-1.179), and 0.927 (0.601-1.431), respectively. Non-surgical periodontal treatment during the second semester of gestation did not reduce the risk for preterm birth, low birth weight, and preterm low birth weight.

Efeitos adversos da diabetes mellitus no reparo ósseo peri-implantar / Adverse effects of Diabetes mellitus in peri-implant bone repair

Alterações no processo de reparação tecidual representam um dos efeitos prejudiciais da diabetes mellitus de maior interesse na área da Implantodontia. Diversas evidências científicas demonstram que o estado hiperglicêmico é considerado a principal causa de complicações sistêmicas e locais advindas dessa condição. O objetivo do presente estudo foi revisar o conhecimento sobre os efeitos adversos da diabetes mellitus no processo de reparo ósseo peri-implantar. A pesquisa da literatura pertinente ao tema foi realizada a partir de consulta à base de dados Medline. A busca foi limitada a estudos na língua inglesa. Foram selecionados estudos experimentais, clínicos e revisões literárias. Embora vários estudos demonstrem efeitos prejudiciais da diabetes no processo de osseointegração, ainda é insuficiente a quantidade de informações disponíveis para determinar correlações entre avaliação laboratorial e impacto no processo de cicatrização peri-implantar. Na atualidade, ainda não existe um protocolo que leve em consideração o estabelecimento de critérios objetivos para indicação de tratamento com implantes osseointegráveis em indivíduos diabéticos. Os dados de estudos que abordam essa linha de investigação são conflitantes e novas pesquisas devem ser desenvolvidas em busca de melhor entendimento do processo cicatricial peri-implantar em diabéticos.

Some of the most adverse effects of diabetes mellitus, the changes caused on tissue repair, are of greatest interest to dental implant studies. Scientific evidences demonstrate that a hyperglycemic condition is considered the major cause of systemic and local complications resulting from this condition. This review aims to reporting some of the well-known facts about adverse effects of diabetes mellitus on the process of peri-implant bone repair. A literature review was conducted based on data obtained from Medline electronic database. This search was limited to studies published in English. Both experimental and clinical studies and book reviews were selected. Although several studies demonstrate the adverse effects of diabetes in the process of osseointegration, the amount of available information is still insufficient to determine correlations between laboratory tests and impact on peri-implant healing process. However, there is no objective criterion to treat individuals with osseointegrated implants suffering from diabetes. Data taken from borderline studies are conflicting. New research should be developed in order to achieve a better understanding of periimplant healing process in diabetic individuals.

Doença periodontal materna e parto pré-termo e/ou baixo peso ao nascimento: revisão de literatura / Maternal periodontal disease and pre-term birth and/or low birth weight: review of the literature

Estudos prévios têm sugerido que a infecção periodontal materna está associada com o parto pré-termo e/ou baixo peso ao nascimento (PPTBPN). O objetivo desta revisão de literatura foi analisar os estudos referentes à inter-relação entre doença periodontal materna e PPTBPN. A literatura pertinente ao tema foi consultada e os artigos foram selecionados de acordo com critérios de inclusão previamente estabelecidos. Diversos estudos epidemiológicos foram desenvolvidos a partir da década de 90, no entanto, relativamente poucas coortes e estudos de intervenção examinaram esta hipótese sendo a maioria dos estudos do tipo caso-controle. Várias evidências científicas apontam para uma associação significativa entre infecção periodontal e PPTBPN. Entretanto, os relatos que abordam essa linha de investigação são conflitantes e remetem à necessidade de novas pesquisas com metodologia mais apropriada em diferentes populações.

Prior studies have suggested that maternal periodontal infection is associated with pre-term birth and/or low birth weight (PTLBW). The aim of this review of the literature was to analyze studies regarding the inter-relation between maternal periodontal infection and PTLBW. Literature relevant to the topic was consulted and articles were selected according to previously established inclusion criteria. Many epidemiological studies were developed in the 1990’s, with the majority using the case-control methodology, while relatively few cohort and intervention studies examined this hypothesis. Much scientific evidence points toward a significant association between periodontal infection and PTLBW. However, the reports which treat this line of investigation are conflicting and call for further studies which employ the appropriate framework and methodology indifferent populations.

Demographic, pharmacologic, and periodontal variables for gingival overgrowth in subjects medicated with cyclosporin in the absence of calcium channel blockers.

BACKGROUND: The role of cyclosporin in the absence of calcium channel blockers and the associated risk variables of development and severity of gingival overgrowth have not yet been properly established. The present study was conducted to determine the effect of potential risk variables for gingival overgrowth severity in Brazilian renal transplant subjects medicated with cyclosporin in the absence of any calcium channel blockers. METHODS: A cross-sectional study was conducted in a public hospital in Belo Horizonte, Brazil. Demographic, pharmacologic, and periodontal data, recorded from 194 subjects taking cyclosporin in the absence of calcium channel blockers, were analyzed using independent sample t, chi2 statistic, or Mann-Whitney U tests. The effects of potential risk variables of gingival overgrowth severity were determined using backward stepwise regression analysis. RESULTS: The prevalence of clinically significant gingival overgrowth was 34.5% (N = 67). These subjects presented a significantly higher papillary bleeding index and a higher plaque index compared to those without clinically significant gingival overgrowth. When all demographic, pharmacologic, and periodontal data were evaluated in relation to gingival overgrowth severity, time since transplant, papillary bleeding index, serum cyclosporin concentration, and prednisolone and azathioprine dosages were significant in the univariate modeling (P <0.05) and remained significant when evaluated in the multivariate modeling (P <0.0001; adjusted R2 = 39.4%). CONCLUSIONS: In the absence of calcium channel blockers, this study showed that pharmacologic variables, such as cyclosporin serum concentration, prednisolone and azathioprine dosages, and time since transplant, are strongly related to gingival overgrowth. In addition, the periodontal variable papillary bleeding index highlighted the primary role of inflammation on the pathogenesis and severity of gingival overgrowth.

Associação entre doença periodontal materna e parto pré-termo e baixo peso ao nascimento / Association between maternal periodontal disease and pre-term birth and low birth weight

Este estudo teve como objetivo avaliar a associação da condição periodontal materna na ocorrência de parto pré-termo e baixo peso ao nascimento (PTBPN). Participaram do estudo 236 mulheres, com a média de 25 anos de idade e características socioeconômicas semelhantes, que deram à luz em uma instituição de saúde pública de Belo Horizonte (MG - Brasil). Os dados maternos, obstétricos e pediátricos foram obtidos nos prontuários médicos. O exame periodontal foi realizado no período de internação pós-parto, em seis sítios ao redor de todos os dentes presentes e incluiu a avaliação dos parâmetros clínicos profundidade de sondagem (PS), nível clínico de inserção (NIC) e sangramento à sondagem (SS). Para a análise considerou-se como caso de doença periodontal a presença de um sítio com PS e NIC e" 4 mm. Não houve diferenças significantes quando da análise das variáveis raça, escolaridade, prematuridade prévia, diabetes, infecção geniturinária, consumo de álcool, hábito de fumar e doença periodontal. O teste Qui-quadrado mostrou significância estatística para os fatores de risco hipertensão (p=0,016) e consumo de drogas ilícitas (p=0,017). Já o teste t Student mostrou significância estatística para a variável idade (p=0,010). Na análise multivariada somente o consumo de drogas ilícitas mostrou-se significativo: elevou de 25% para 66,7% a ocorrência de PTBPN. Esses resultados demonstraram que a condição periodontal materna não apresentou associação estatisticamente significativa com a ocorrência de PTBPN (p= 0,364).