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1.
J Clin Periodontol ; 48(1): 14-23, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33010056

RESUMEN

AIM: To assess obesity as a risk factor for tooth loss over 5 years in an urban sample of Brazilian adults. MATERIALS AND METHODS: A total of 1586 individuals were surveyed using a multistage probabilistic approach. Five years later, 635 individuals 14-64 years old were re-examined. An incident case of tooth loss was determined for a participant that had lost at least one tooth over time. Obesity was evaluated by calculating body mass index at baseline and by the change in obesity status over time. RESULTS: Incident cases of tooth loss were significantly more frequent among obese (47.1%) than normal-weight individuals (32.4%) (p = .004). Obese individuals had 31% higher risk [relative risk (RR) =1.31; 95% confidence interval (95%CI) 1.04-1.65] for tooth loss than normal-weight individuals adjusting for age, socio-economic status, smoking, dental care and periodontitis. This association was significant for females (RR=1.47, 95%CI 1.08-2.01), but not for males. The risk for tooth loss was also modified by presence of periodontitis at baseline and lifetime smoking exposure. There was an increased risk for tooth loss for those that remained obese than those that remained normal weight. CONCLUSION: Obesity is associated with higher risk for tooth loss. This association was modified by sex, periodontal status and smoking.

2.
Cytokine ; : 155360, 2020 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-33221157

RESUMEN

BACKGROUND: The effect of non-surgical periodontal treatment on oral and systemic inflammatory mediators in subjects with periodontitis and hyperglycemia remains largely unknown. Therefore, the aim of this clinical study was to compare the short-term effect of non-surgical periodontal treatment on serum, saliva and GCF inflammatory markers levels in GP subjects with or without hyperglycemia. METHODS: Sixty subjects divided into four groups of equal size were selected to participate: type 2 diabetics with generalized periodontitis (T2DM + GP), pre-diabetics with GP (PD + GP), normoglycemic subjects with GP (NG + GP), and healthy controls. GCF, serum, and saliva samples were obtained at baseline and 30 days after scaling and root planning (SRP) and the levels of interleukin-1ß (IL-1 ß), IL-8, IL-6, IL-2, IL-5, IL-4, IL-10, Interferon gamma (IFN-γ), Granulocyte macrophage colony-stimulating factor (GM-CSF) and Tumor necrosis factor-alpha (TNF-α) were determined by ultrasensitive multiplex assay. Clinical periodontal measurements were recorded. RESULTS: SRP yielded significant improvement of all periodontal parameters for all GP groups (p < 0.01). A significant reduction in GCF levels of several cytokines were observed; however, only IL-1B and IFN-γ were consistently reduced post-treatment across all GP groups. Salivary levels of IL-1ß were significantly reduced in all GP groups following treatment. No significant differences were observed for serum levels after SRP. CONCLUSIONS: Periodontal treatment reduced local inflammatory markers, specifically IL-1B and IFN-γ, irrespective of the diabetes status. Periodontal treatment had no significant effect on serum levels of the inflammatory markers evaluated in this study.

3.
J Periodontal Res ; 55(4): 559-566, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32167175

RESUMEN

OBJECTIVE: To assess the association between weight status and gingivitis in a representative sample of 12-year-old schoolchildren from South Brazil. BACKGROUND: An association between obesity and gingivitis in children and adolescents has been observed; however, the present evidence has major limitations. METHODS: A cross-sectional study was conducted in Porto Alegre, South Brazil, from September 2009 to December 2010 and included a representative sample of 1528 12-year-old schoolchildren attending public and private schools. Data collection included the application of a questionnaire, recording of anthropometric measures (weight and height), and clinical examination (gingival bleeding index, recorded in four sites per tooth). The outcome of the study was the prevalence of gingivitis, defined as the proportion of schoolchildren presenting ≥52% of bleeding sites (based on the median). Weight status was categorized according to body mass index into normal, overweight, or obese. The association between predictor variables and gingivitis prevalence was assessed using Poisson regression models. Unadjusted and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated. RESULTS: Gingivitis prevalence was 48.7% (95% IC = 33.8-63.6) and, on average, schoolchildren presented 51.8% (95% IC = 46.2-57.5) of bleeding sites. Obese individuals had 13% higher prevalence for presenting gingivitis than did normal-weight ones (PR = 1.13, 95% CI = 1.09-1.18, P < .001). The stratified analysis showed that this association was sex-specific: Obese girls presented a greater chance of having gingivitis (adjusted PR = 1.21, 95% CI = 1.09-1.34, P < .001), but such association was not observed among boys (PR = 1.07, 95% CI = 0.95-1.20, P = .29). CONCLUSION: This study showed sex differences in the association between obesity and gingivitis among 12-year-old South Brazilian schoolchildren.


Asunto(s)
Gingivitis , Obesidad , Índice de Masa Corporal , Brasil/epidemiología , Niño , Estudios Transversales , Femenino , Gingivitis/complicaciones , Gingivitis/epidemiología , Humanos , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Prevalencia
4.
J Clin Med ; 9(2)2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32054122

RESUMEN

When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper™, Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque.

5.
Eur J Dent Educ ; 24(1): 79-87, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31574582

RESUMEN

BACKGROUND: The introduction of innovative nanotechnologies in medicine and dentistry may initiate a need for curriculum revision at the universities. The aim of this study was to assess dental students' knowledge and attitudes related to nanotechnology. Covariates of students' intention to use nanomaterials in their future dental practice were evaluated using the theory of planned behaviour (TPB). METHODS: Dental students at Norwegian and Romanian Universities were invited to participate. A self-administered structured questionnaire including socio-demographics and Ajzen's TPB components was used. FINDINGS: A total of 212 out of 732 dental students participated in the survey: 52 Norwegian and 160 Romanian. Most students reported to have little knowledge about nanotechnology (Norwegians = 44.2% vs Romanians = 46.9%, P < .05). More than 90% of the students in both countries reported that they wanted to get more information about nanotechnology. Mean knowledge score was similar for Norwegian and Romanian students (4.4 ± 1.7 vs 4.2 ± 1.4, P > .05). Romanian students had more positive attitude, stronger subjective norms and stronger perceived behavioural control towards nanotechnology compared to their Norwegian counterparts. Intention to use nanomaterials in the total sample was most strongly influenced by attitude towards the use of dental nanomaterials (beta = 0.42, P < .001). CONCLUSION: Dental students in Norway and Romania demonstrated limited knowledge about nanotechnology. Intention to use nanomaterials was primarily influenced by attitudes. A clear desire for more information about the application of nanotechnology in dentistry was expressed by the respondents indicating a need for curriculum modification.


Asunto(s)
Intención , Estudiantes de Odontología , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Nanotecnología , Noruega , Rumanía , Encuestas y Cuestionarios
6.
Braz Oral Res ; 33(suppl 1): e074, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576958

RESUMEN

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.


Asunto(s)
Interfase Hueso-Implante , Implantes Dentales/efectos adversos , Periimplantitis/prevención & control , Periodontitis/prevención & control , Estomatitis/prevención & control , Interfase Hueso-Implante/diagnóstico por imagen , Placa Dental/prevención & control , Humanos , Higiene Bucal , Periimplantitis/etiología , Índice Periodontal , Periodontitis/etiología , Radiografía Dental , Factores de Riesgo , Estomatitis/etiología
7.
Oral Dis ; 25(8): 2020-2029, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31541516

RESUMEN

OBJECTIVE: To compare the myeloid and plasmacytoid DC counts and maturation status among subjects with/without generalized periodontitis (GP) and type 2 diabetes mellitus (T2DM). METHODS: The frequency and maturation status of myeloid and plasmacytoid blood DCs were analyzed by flow cytometry in four groups of 15 subjects: healthy controls, T2DM with generalized CP (T2DM + GP), prediabetes with GP (PD + GP), and normoglycemics with GP (NG + GP). RT-PCR was used to determine levels of Porphyromonas gingivalis in the oral biofilms and within panDCs. The role of exogenous glucose effects on differentiation and apoptosis of healthy human MoDCs was explored in vitro. RESULTS: Relative to controls and to NG + GP, T2DM + GP showed significantly lower CD1c + and CD303 + DC counts, while CD141 + DCs were lower in T2DM + GP relative to controls. Blood DC maturation required for mobilization and immune responsiveness was not observed. A statistically significant trend was observed for P. gingivalis levels in the biofilms of groups as follows: controls 

Asunto(s)
Células Dendríticas/inmunología , Diabetes Mellitus Tipo 2 , Periodontitis , Estado Prediabético , Adulto , Anciano , Brasil , Humanos , Persona de Mediana Edad , Porphyromonas gingivalis
8.
Braz Oral Res ; 33: e056, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31271568

RESUMEN

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.


Asunto(s)
Caries Dental/epidemiología , Caries Dental/etiología , Obesidad/complicaciones , Obesidad/epidemiología , Índice de Masa Corporal , Brasil/epidemiología , Niño , Índice CPO , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Factores Socioeconómicos
9.
J Immunol ; 202(9): 2690-2699, 2019 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-30944162

RESUMEN

Periodontitis (PD) is a common dysbiotic inflammatory disease that leads to local bone deterioration and tooth loss. PD patients experience low-grade bacteremias with oral microbes implicated in the risk of heart disease, cancer, and kidney failure. Although Th17 effectors are vital to fighting infection, functional imbalance of Th17 effectors and regulatory T cells (Tregs) promote inflammatory diseases. In this study, we investigated, in a small pilot randomized clinical trial, whether expansion of inflammatory blood myeloid dendritic cells (DCs) and conversion of Tregs to Th17 cells could be modulated with antibiotics (AB) as part of initial therapy in PD patients. PD patients were randomly assigned to either 7 d of peroral metronidazole/amoxicillin AB treatment or no AB, along with standard care debridement and chlorhexidine mouthwash. 16s ribosomal RNA analysis of keystone pathogen Porphyromonas gingivalis and its consortium members Fusobacterium nucleatum and Streptococcus gordonii confirmed the presence of all three species in the reservoirs (subgingival pockets and blood DCs) of PD patients before treatment. Of the three species, P. gingivalis was reduced in both reservoirs 4-6 wk after therapy. Further, the frequency of CD1C+CCR6+ myeloid DCs and IL-1R1 expression on IL-17A+FOXP3+CD4+ T cells in PD patients were reduced to healthy control levels. The latter led to decreased IL-1ß-stimulated Treg plasticity in PD patients and improvement in clinical measures of PD. Overall, we identified an important, albeit short-term, beneficial role of AB therapy in reducing inflammatory DCs and Treg-Th17 plasticity in humans with PD.


Asunto(s)
Amoxicilina/administración & dosificación , Bacterias , Infecciones Bacterianas , Células Dendríticas , Metronidazol/administración & dosificación , Periodontitis , Linfocitos T Reguladores , Células Th17 , Bacterias/inmunología , Bacterias/metabolismo , Infecciones Bacterianas/sangre , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/inmunología , Infecciones Bacterianas/patología , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Células Dendríticas/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodontitis/sangre , Periodontitis/tratamiento farmacológico , Periodontitis/inmunología , Periodontitis/patología , Linfocitos T Reguladores/metabolismo , Linfocitos T Reguladores/parasitología , Linfocitos T Reguladores/patología , Células Th17/inmunología , Células Th17/metabolismo , Células Th17/patología
10.
J Dent Educ ; 83(6): 663-668, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30910932

RESUMEN

Social media have become a major part of an interconnected society, impacting personal and professional lives. This Point/Counterpoint presents two opposing viewpoints on the question of whether social media should be used in dental education as a learning and communication tool for dental students. Viewpoint 1 argues that social media benefit student learning and should be used as a tool in dental education. This argument is based on evidence concerning use of social media and improved learning across health professions, improved peer-peer communication in clinical education, improved engagement in interprofessional education (IPE), and provision of a mechanism for safe and improved communication between practitioners and patients, as well as faculty and students. Viewpoint 2 argues that potential problems and risks in using social media outweigh any benefits found in learning and therefore social media should not be used as a tool in dental education. This viewpoint is supported by evidence of negative effects on learning, the establishment of a negative digital footprint in the public's view, risk of privacy violations when using social media, and the new phenomenon of Internet addiction with its negative physiological effects on social media users.


Asunto(s)
Medios de Comunicación Sociales , Estudiantes de Odontología/estadística & datos numéricos , Comunicación , Educación en Odontología/métodos , Humanos , Aprendizaje , Profesionalismo , Medios de Comunicación Sociales/estadística & datos numéricos , Estudiantes de Odontología/psicología
11.
Artículo en Inglés | MEDLINE | ID: mdl-30911403

RESUMEN

Years of human microbiome research have confirmed that microbes rarely live or function alone, favoring diverse communities. Yet most experimental host-pathogen studies employ single species models of infection. Here, the influence of three-species oral microbial consortium on growth, virulence, invasion and persistence in dendritic cells (DCs) was examined experimentally in human monocyte-derived dendritic cells (DCs) and in patients with periodontitis (PD). Cooperative biofilm formation by Streptococcus gordonii, Fusobacterium nucleatum and Porphyromonas gingivalis was documented in vitro using growth models and scanning electron microscopy. Analysis of growth rates by species-specific 16s rRNA probes revealed distinct, early advantages to consortium growth for S. gordonii and F. nucleatum with P. gingivalis, while P. gingivalis upregulated its short mfa1 fimbriae, leading to increased invasion of DCs. F. nucleatum was only taken up by DCs when in consortium with P. gingivalis. Mature consortium regressed DC maturation upon uptake, as determined by flow cytometry. Analysis of dental plaques of PD and healthy subjects by 16s rRNA confirmed oral colonization with consortium members, but DC hematogenous spread was limited to P. gingivalis and F. nucleatum. Expression of P. gingivalis mfa1 fimbriae was increased in dental plaques and hematogenous DCs of PD patients. P. gingivalis in the consortium correlated with an adverse clinical response in the gingiva of PD subjects. In conclusion, we have identified polymicrobial synergy in a three-species oral consortium that may have negative consequences for the host, including microbial dissemination and adverse peripheral inflammatory responses.

12.
Clin Implant Dent Relat Res ; 21 Suppl 1: 44-54, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30860675

RESUMEN

BACKGROUND: A newly developed dental implant system combining advancements in surface chemistry, topography, nanostructure, color, and surface energy aims to address biological challenges and expand clinical applications. PURPOSE: To assess the short- and long-term safety and efficacy of a novel, gradually anodized dental implant surface/anodized abutment. MATERIALS AND METHODS: Twenty-four Yucatan mini pigs (20-24 months old) received two dental implants in each jaw quadrant. Each site was randomized to receive either a commercially available anodized implant/machined abutment or a gradually anodized implant/anodized abutment with a protective layer. Animals were euthanized at 3, 6, and 13 weeks. Microcomputed tomography and histological analyses were performed. RESULTS: No significant histological differences in inflammation scores, epithelium length, bone-to-implant contact, or bone density were observed between groups for any healing time. Mucosal height was significantly higher at 3 weeks for controls (Δ = 0.2 mm); no differences were observed at 6 and 13 weeks. No significant differences in radiographic bone volume, bone-to-implant contact, trabecular thickness, and crestal bone levels were observed, irrespective of healing time. Trabecular spacing was borderline significant at 3 weeks in favor of the test implant sites; no differences were observed at 6 weeks. No significant differences were observed between experimental groups at 13 weeks. CONCLUSIONS: The new implant system yielded results comparable to a commercially available predicate device.


Asunto(s)
Implantes Dentales , Diseño de Prótesis Dental , Oseointegración , Animales , Implantación Dental Endoósea , Propiedades de Superficie , Porcinos , Porcinos Enanos , Titanio , Microtomografía por Rayos X
13.
Clin Implant Dent Relat Res ; 21 Suppl 1: 34-43, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30859699

RESUMEN

BACKGROUND: It is well established that electrochemical anodization of implant surfaces contributes to osseointegration and long-term implant survival. Few studies have investigated its effect on soft tissue healing. PURPOSE: To evaluate the safety and efficacy of a novel abutment surface prepared by electrochemical oxidation compared to commercially available machined titanium abutments. MATERIALS AND METHODS: Twelve 16-19 months-old, Yucatan mini-pigs received three dental implants in each mandibular jaw quadrant. Each side was randomized to receive either an anodized or a machined titanium abutment. Titanium healing caps were placed on both abutments. Animals were euthanized at 6 and 13 weeks. Radiographic and histological analyses were performed. RESULTS: No significant differences were observed histologically between groups in regard to inflammation, epithelium length, mucosal height, bone-to-implant contact, or bone density for any time point. Radiographically, crestal bone level change from baseline to 6 weeks was significantly lower for anodized than machined abutments (P = 0.046); no significant differences were observed at 13 weeks (P = 0.12). CONCLUSIONS: The novel anodized abutment showed a comparable effect on soft and hard tissue healing/remodeling and inflammation reaction to standard titanium abutments. Clinical studies should confirm these findings and explore the positive radiographic results observed at the early time point.


Asunto(s)
Pilares Dentales , Implantes Dentales , Animales , Implantación Dental Endoósea , Oseointegración , Distribución Aleatoria , Propiedades de Superficie , Porcinos , Porcinos Enanos , Titanio
14.
Braz. oral res. (Online) ; 33(supl.1): e074, 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1039314

RESUMEN

Abstract Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

15.
Braz. oral res. (Online) ; 33: e056, 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1011655

RESUMEN

Abstract The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.

16.
Sci Rep ; 8(1): 16607, 2018 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-30413788

RESUMEN

Chronic periodontitis (CP) is a microbial dysbiotic disease linked to increased risk of oral squamous cell carcinomas (OSCCs). To address the underlying mechanisms, mouse and human cell infection models and human biopsy samples were employed. We show that the 'keystone' pathogen Porphyromonas gingivalis, disrupts immune surveillance by generating myeloid-derived dendritic suppressor cells (MDDSCs) from monocytes. MDDSCs inhibit CTLs and induce FOXP3 + Tregs through an anti-apoptotic pathway. This pathway, involving pAKT1, pFOXO1, FOXP3, IDO1 and BIM, is activated in humans with CP and in mice orally infected with Mfa1 expressing P. gingivalis strains. Mechanistically, activation of this pathway, demonstrating FOXP3 as a direct FOXO1-target gene, was demonstrated by ChIP-assay in human CP gingiva. Expression of oncogenic but not tumor suppressor markers is consistent with tumor cell proliferation demonstrated in OSCC-P. gingivalis cocultures. Importantly, FimA + P. gingivalis strain MFI invades OSCCs, inducing inflammatory/angiogenic/oncogenic proteins stimulating OSCCs proliferation through CXCR4. Inhibition of CXCR4 abolished Pg-MFI-induced OSCCs proliferation and reduced expression of oncogenic proteins SDF-1/CXCR4, plus pAKT1-pFOXO1. Conclusively, P. gingivalis, through Mfa1 and FimA fimbriae, promotes immunosuppression and oncogenic cell proliferation, respectively, through a two-hit receptor-ligand process involving DC-SIGN+hi/CXCR4+hi, activating a pAKT+hipFOXO1+hiBIM-lowFOXP3+hi and IDO+hi- driven pathway, likely to impact the prognosis of oral cancers in patients with periodontitis.


Asunto(s)
Apoptosis , Infecciones por Bacteroidaceae/inmunología , Carcinogénesis/patología , Células Dendríticas/inmunología , Inmunosupresión , Monocitos/inmunología , Periodontitis/inmunología , Animales , Infecciones por Bacteroidaceae/microbiología , Infecciones por Bacteroidaceae/patología , Carcinogénesis/inmunología , Estudios de Casos y Controles , Proliferación Celular , Células Dendríticas/microbiología , Células Dendríticas/patología , Encía/inmunología , Encía/microbiología , Encía/patología , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Monocitos/microbiología , Monocitos/patología , Periodontitis/microbiología , Periodontitis/patología , Porphyromonas gingivalis/inmunología
17.
J Clin Periodontol ; 45 Suppl 20: S171-S189, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29926486

RESUMEN

OBJECTIVES: This review proposes case definitions and diagnostic considerations of systemic disorders and conditions that affect the periodontal attachment apparatus. IMPORTANCE: Periodontal diseases and certain systemic disorders share similar genetic and/or environmental etiological factors, and affected patients may show manifestations of both diseases. Characterizing these diseases and the nature of the association between them could have important diagnostic value and therapeutic implications for patients. FINDINGS: Numerous systemic disorders and certain medications can affect the periodontal attachment apparatus and cause loss of periodontal attachment and alveolar bone. Although many of these disorders are rare or uncommon, they often cause significant loss of periodontal tissue by influencing periodontal inflammation or through mechanisms distinct from periodontitis. Most of these disorders are due to innate mechanisms and some are acquired via environmental factors or lifestyle. Several disorders affect periodontal inflammation through alterations in the host immune response to periodontal infection; others cause defects in the gingiva or periodontal connective tissue, instigate metabolic changes in the host that affect various tissues of the periodontal apparatus, or operate by other mechanisms. For some systemic disorders that are more common, their contribution to the loss of periodontal tissue is modest, while for others, contribution is not supported by clear evidence. Few systemic medications are associated with increased loss of periodontal tissue, and these are typically medications used in the treatment of malignancies. CONCLUSIONS: This review identifies systemic diseases and conditions that can affect the periodontal attachment apparatus and cause loss of periodontal supporting tissues and, where possible, presents case definitions for these. Many of these diseases are associated with a profound loss of periodontal attachment and alveolar bone, and for some of these disorders the periodontal manifestations may be among the first signs of the disease. These case definitions may be useful in the early diagnosis of these diseases and may contribute to an improvement in the management of periodontal manifestations and improve the quality of life for these patients.


Asunto(s)
Enfermedades Periodontales , Periodontitis , Encía , Humanos , Inflamación , Pérdida de la Inserción Periodontal , Calidad de Vida
18.
J Clin Periodontol ; 45 Suppl 20: S219-S229, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29926500

RESUMEN

BACKGROUND: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. METHODS: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. RESULTS: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking - now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues - is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. CONCLUSION: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.


Asunto(s)
Placa Dental , Gingivitis , Enfermedades Periodontales , Periodontitis , Consenso , Estética Dental , Humanos
19.
J Periodontol ; 89 Suppl 1: S183-S203, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29926941

RESUMEN

OBJECTIVES: This review proposes case definitions and diagnostic considerations of systemic disorders and conditions that affect the periodontal attachment apparatus. IMPORTANCE: Periodontal diseases and certain systemic disorders share similar genetic and/or environmental etiological factors, and affected patients may show manifestations of both diseases. Characterizing these diseases and the nature of the association between them could have important diagnostic value and therapeutic implications for patients. FINDINGS: Numerous systemic disorders and certain medications can affect the periodontal attachment apparatus and cause loss of periodontal attachment and alveolar bone. Although many of these disorders are rare or uncommon, they often cause significant loss of periodontal tissue by influencing periodontal inflammation or through mechanisms distinct from periodontitis. Most of these disorders are due to innate mechanisms and some are acquired via environmental factors or lifestyle. Several disorders affect periodontal inflammation through alterations in the host immune response to periodontal infection; others cause defects in the gingiva or periodontal connective tissue, instigate metabolic changes in the host that affect various tissues of the periodontal apparatus, or operate by other mechanisms. For some systemic disorders that are more common, their contribution to the loss of periodontal tissue is modest, while for others, contribution is not supported by clear evidence. Few systemic medications are associated with increased loss of periodontal tissue, and these are typically medications used in the treatment of malignancies. CONCLUSIONS: This review identifies systemic diseases and conditions that can affect the periodontal attachment apparatus and cause loss of periodontal supporting tissues and, where possible, presents case definitions for these. Many of these diseases are associated with a profound loss of periodontal attachment and alveolar bone, and for some of these disorders the periodontal manifestations may be among the first signs of the disease. These case definitions may be useful in the early diagnosis of these diseases and may contribute to an improvement in the management of periodontal manifestations and improve the quality of life for these patients.


Asunto(s)
Enfermedades Periodontales , Periodontitis , Encía , Humanos , Inflamación , Pérdida de la Inserción Periodontal , Calidad de Vida
20.
J Periodontol ; 89 Suppl 1: S237-S248, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29926943

RESUMEN

BACKGROUND: A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non-carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations. METHODS: Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants. RESULTS: Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon-Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation (such as neoplastic diseases); 2) diabetes-associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking - now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues - is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. CONCLUSION: An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.


Asunto(s)
Gingivitis , Periimplantitis , Enfermedades Periodontales , Periodontitis , Consenso , Estética Dental , Humanos
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