Factors Associated with the Extent of Clinical Attachment Loss in Periodontitis: A Multicenter Cross-Sectional Study.

Periodontitis has significant public health implications, affecting individuals' overall health, well-being, and quality of life. This study aimed to assess the risk factors associated with the extent of clinical attachment loss (CAL) in a population diagnosed with periodontitis. Six hundred and sixty-seven patients with different degrees of CAL (mild, n = 223; moderate, n = 256; and advanced, n = 188) were enrolled. Socio-demographics, lifestyle, microbiological profiles, specific immune response, obesity, and single-nucleotide polymorphism of the IL1 gene were determined. Unconditional logistic regression models were conducted to determine the factors associated with the extent of CAL. Aging, smoking, microbial factors, plaque index, and IgG2 antibodies against Aggregatibacter actinomycetemcomitans were associated with advanced CAL. IgG2 antibodies against A. actinomycetemcomitans (OR 1.50; CI 95% 1.23-1.81), plaque accumulation (OR 2.69; CI 95% 2.20-3.29), Porphyromonas gingivalis (OR 1.93; CI 95% 1.35-2.76), Tanerella forsythia (OR 1.88; CI 95%1.30-2.70), and current smoking (OR 1.94; CI 95% 1.31-2.87) were associated with advanced CAL. Gene IL polymorphisms, obesity, and stress were not associated with the extent of CAL. Aging, plaque accumulation, smoking, and having antibodies against A. actinomycetemcomitans were the most critical factors associated with advanced CAL. In contrast, obesity, stress, and gene polymorphisms were not associated with the extent of CAL.

Prevalence of Peri-implant Disease According to Periodontal Probing Depth and Bleeding on Probing: A Systematic Review and Meta-Analysis.

PURPOSE: To compare changes in the prevalence of peri-implantitis when the unit of analysis is the subject and when the unit of analysis is the implant, by means of meta-analysis with subgroup and sensitivity analyses, according to the case definition and cutoffs. Periodontal probing depth (PPD) and bleeding on probing (BOP) were considered the primary variables. MATERIALS AND METHODS: Electronic and manual searches of observational studies of implants with loading of more than 6 months were conducted. The quality of the studies was evaluated, and finally, a description (qualitative analysis) and a meta-analysis (quantitative analysis) of the available studies were performed. RESULTS: Fifty-five studies were included in this systematic review, 32 of which met the criteria for evaluation of disease based on PPD and BOP. A total of 2,734 subjects and 7,849 implants were evaluated. The prevalence of peri-implantitis, defined by PPD and BOP, was 17% when the unit of analysis was the subject, and 11% when it was the implant. If the clinical criterion was PPD ≥ 4 mm, the prevalence by subject was 34% and by implant 11%. If PPD was ≥ 5 mm, the prevalence by subject was 12% and by implant 10%. Finally, if the clinical criterion was PPD ≥ 6 mm, the prevalence by subject was 18% and by implant 10%. CONCLUSION: The prevalence of peri-implantitis is influenced by the criteria used for the case definition, and the true prevalence may currently be incorrectly estimated.

Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study

Background: The validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches. Material and Methods: 578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination. Results: The optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test. Conclusions: Self-reported smoking and serum cotinine test ≥ 10ng/ml are accurate ,complementary and more reliable methods to assess the patient’s smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. Clinical Relevance: The serum cotinine level is more reliable to make associations with the patient’s periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies (AU)

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Enfermedad periodontal y su relación con las enfermedades cardiovasculares / Periodontal disease and its relation to cardiovascular disease

La periodontitis es una enfermedad de naturaleza crónica; en la cual se ven activadas proteínas de faseaguda como: Proteina C reactiva, activador del plasminógeno 1 y fibrinógeno. Por lo tanto, la enfermedadperiodontal podría desarrollar una inflamación sistémica y ser un factor de riesgo coadyuvante enla enfermedad cardiovascular. Se puede explicar la relación entre estas dos enfermedades por lainflamación sistémica, bacteremia o indirectamente por compartir características comunes. El objetivode este artículo fue revisar la literatura existente sobre la enfermedad periodontal como factor de riesgopara enfermedades cardiovasculares, y su impacto sobre marcadores inflamatorios bajo la perspectiva yanálisis de los criterios de causalidad de Bradford Hill.

Periodontitis is a disease of chronic nature, where acute phase proteins such as C-reactive protein,Plasminogen Activator 1 and Fibrinogen are activated. For that reason there is a hypothesis which saysthat Periodontal Disease could develop systemic inflammation and therefore be an adjuntive risk factorfor cardiovascular disease. The relationship between this two entities can be explain by the systemicinflamation, bacteremia or indirectly because they share common characteristics. The aim of this articleis to review the current knowledge about Periodontitis as a risk factor for Cardiovascular Diseases, andits impact on inflamatory markers analysed from the perspective of the criteria proposed by Bradford Hill.

Vulnerabilidad de los implantes dentales y ortopédicos / Vulnerability of dental and orthopedic implant

La colocación de implantes en diferentes partes del cuerpo ha sido realizada desde hace muchotiempo atrás. Se ha identificado diferentes factores de riesgo y complicaciones que pueden alterarlos tejidos perimplantares posterior a la colocación de estos. No existe evidencia científica que realice la comparación entre diferentes implantes colocados en diferentes partes del cuerpo.

The placement of implants on different body parts has been practiced since long ago. Variousrisk factors and complications that can alter perimplant tissue after placement of these have beenidentified. There is no scientific evidence to make the comparison among different implants placed indifferent parts of the body.

Demographic, clinical, and microbial aspects of chronic and aggressive periodontitis in Colombia: a multicenter study.

BACKGROUND: The microbial profile of periodontal disease varies among different human populations. This study evaluated the demographic, clinical, and microbiologic aspects of periodontitis in a multigeographic sample in Colombia. METHODS: Three hundred twenty-five patients with chronic periodontitis (CP), 158 patients with aggressive periodontitis (AgP), and 137 healthy-gingivitis controls from five regions of the country were studied. Clinical, microbial, and sociodemographic data were collected. Microbiologic identification was performed using polymerase chain reaction 16S rRNA gene on pooled subgingival samples, and the presence of Gram-negative enteric rods was evaluated by culture. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: Porphyromonas gingivalis occurred in 71.5% of individuals with periodontitis, Tannerella forsythensis occurred in 58.5%, Campylobacter rectus occurred in 57.5%, Actinobacillus actinomycetemcomitans occurred in 23.6%, and enteric rods occurred in 34.5%. P. gingivalis was more common in CP and AgP than controls. A. actinomycetemcomitans was increased in AgP compared to controls and patients with CP. T. forsythensis, C. rectus, and Eikenella corrodens had a low presence in the West Pacific and Central regions, and enteric rods were increased in the Central region (P <0.05). Other sociodemographic factors were not associated with these microorganisms. CONCLUSIONS: Geographic regions do not influence the microbiota, but the microbiota may vary by geographic region. P. gingivalis, T. forsythensis, and C. rectus are the most prevalent periodontophatic microorganisms in Colombia. A. actinomycetemcomitans was more common in AgP, and a large percentage of the population studied had enteric rods in the subgingival plaque.

Índice de extensión y severidad (ESI) como parámetro para describir la respuesta a la terapia clínica en el manejo de la enfermedad periodontal / Use of the extension and severity index (ESI) as a parameter for describing clincial response to periodontal treatment

La respuesta al tratamiento periodontal ha sido evaluada tradicionalmente con promedios de parámetros clínicos periodontales como el sangrado al sondaje (BOP), profundidad clínica al sondaje y nivel clínico de inserción. El propósito de este estudio fue describir la respuesta al tratamiento periodontal por medio de un índice nuevo (ESI de bolsa). De una base de datos de1145 pacientes de la consulta particular, se selecciono una muestra de 169 pacientes con periodontitis crónica quienes tenían un examen inicial y un reexamen después de la terapia periodontal. Se hizo un estudio retrospectivo comparativo donde se evaluó la respuesta a la terapia periodontal por medio de algunos parámetros clínicos: (Índice de placa, sangrado al sondaje–BOP y ESI de bolsa). Adicionalmente se comparó la respuesta al tratamiento periodontal entre pacientes fumadores y no fumadores, y según la extensión y severidad inicial de la enfermedad periodontal. Todos los parámetros clínicos evaluados tuvieron una reducción estadísticamente significativa desde el examen inicial hasta el reexamen. No se observaron diferencias estadísticamente significativas en la reducción de los parámetros clínicos entre fumadores y no fumadores. Tampoco se encontraron diferencias estadísticamente significativas en la reducción promedio de los parámetros clínicos de acuerdo a la extensión y severidad inicial de la enfermedad periodontal (105 localizados moderados, 45 localizados severos, 7 generalizados moderados y 12 generalizados severos). En este estudio se pudo observar que el ESI de bolsa puede ser un parámetro útil, efectivo y confiable para evaluar la respuesta a la terapia periodontal...

Elementos de análisis para la estructuración de un programa docente- asistencial. Vereda el Zacudo (Fredonia, Antioquia), 1998. II Parte: Representaciones y Prácticas Sociales de la Población con Relación a la Salud Bucal / Elements of analysis for the design and implementation of a teaching assistance program, in the communities of El Zancudo and Fredonia in Colombia Part II: Social practices and representations of the population in relation to their oral health

sociales de los habitantes de la vereda el Zancudo (Municipio de Fredonia, Antioquia) sobre el proceso salud enfermedad bucal, las prácticas de cuidado y autocuidado, así como las expectativas y opiniones sobre el programa docente asistencial que ofrece la Universidad para esta comunidad. La información fue obtenida a través de entrevistas semiestructuradas realizadas a mujeres madres de familia de esta comunidad. Los resultados se realizaron teniendo en cuenta tres categorías: Representaciones sociales de la salud-enfermedad bucal, Practicas sociales relacionadas con el autocuidado y recuperación de la salud y las opiniones y expectativas de las mujeres sobre el programa docente asistencial. A través de las entrevistas se pudo conocer que el concepto de enfermedad bucal tan frecuentemente utilizado por el discurso odontológico y con un sentido específico para el odontólogo no ha sido internalizado por la población. La necesidad de atención odontológica esta regulada en la mayoría de los casos por el dolor y los aspectos estéticos...

Tratamiento temprano de deficiencia esquelética del maxilar superior. Reporte de un caso / Early treatment of maxillary skeletal deficiency. Case Report

En pacientes con deficiencias anteroposteriores de tercio medio de cara, es muy importante establecer un diagnóstico temprano, ya que aquellos que han superado el pico de crecimiento, requieren necesariamente de cirugía ortognática, o de un tratamiento ortodóncico para realizar un camuflaje dental...