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1.
BMC Oral Health ; 20(1): 116, 2020 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-32299404

RESUMEN

BACKGROUND: The biologic width is defined as the coronal dimension to the alveolar bone that is occupied by healthy gingival tissue. The objective of the present study was to correlate radiographic findings of biologic width invasion with the periodontium status. METHODS: It were included 14 patients with restored teeth with biological width invasion, on the proximal sites, observed clinically and radiographically. 122 proximal sites were evaluated, 61 in the test group (biological width invasion) and 61 in the control group (adequate biological width). Smokers and patients presenting periodontal disease or restorations with contact in eccentric movements, horizontal over-contour or secondary caries were excluded from the sample. The invasion of the biologic width was diagnosed when the distance from the gingival margin of restoration to the bony crest was less than 3 mm. Intrabony defect and bone crest level, as well as, their vertical and horizontal components were radiographically evaluated when present. Plaque index, bleeding on probing, probing depth, gingival recession height, keratinized gingival height and thickness, and clinical attachment level were clinically evaluated. Data were subjected to Spearman's Correlation and Wilcoxon's test. RESULT: The most prevalent tooth with biological width invasion was the first molar. There was a statistically significant correlation between the bone crest (p < 0.001), vertical (p < 0.001) and horizontal (p = 0.001) components. In the test group, there was a statistically significant correlation between bleeding on probing (p < 0.001; r = 0.618) and width of gingival recession (p = 0.030; r = - 0.602) with the intraosseous component; and between keratinized gingival height and bone level (p = 0.037; r = - 0.267). In the control group, there was a correlation between plaque index (p = 0.027; r = - 0.283) with bone level and correlation between keratinized gingival thickness and bone level (p = 0.034; r = - 0.273) and intrabony component (p = 0.042; r = 0.226). CONCLUSION: A statistically significant relationship was found between bleeding on probing and gingival recession in patients who presented intrabony defects due to the invasion of biological width, which may be also related to the thickness of the keratinized gingiva.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Productos Biológicos , Recesión Gingival/diagnóstico por imagen , Periodoncio/patología , Adulto , Pérdida de Hueso Alveolar/etiología , Estudios de Casos y Controles , Índice de Placa Dental , Femenino , Estudios de Seguimiento , Encía/diagnóstico por imagen , Encía/patología , Recesión Gingival/etiología , Recesión Gingival/patología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/diagnóstico por imagen , Pérdida de la Inserción Periodontal/etiología , Periodontitis/diagnóstico por imagen , Periodontitis/etiología , Prevalencia , Radiografía
2.
Implant Dent ; 27(5): 575-581, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30113343

RESUMEN

PURPOSE: The aim of this study was to assess if there is an association between buccal mucosa thickness and periimplant attachment loss after 1 year of function. MATERIALS AND METHODS: A total of 28 patients (14 periimplantitis implants and 14 healthy implants) were included. The buccal mucosal thickness was assessed using K-files at 3 mm apical to the soft tissue margin of the implant. Probing depth, recession (REC), clinical attachment level (CAL), bleeding on probing, and radiographic bone loss on mesial and distal sites of the implant were recorded. RESULTS: The data showed that there was a statistically significant difference in midfacial REC between thin and thick buccal mucosa groups. However, the CAL was not statistically significant different between both groups. In addition, there was no statistically significant difference in mesial and distal bone loss between implants with thin and thick mucosa. CONCLUSION: When the midfacial soft tissue thickness was thin, the midfacial REC was greater and the CAL also tended to be higher. There was no association between buccal mucosa thickness and periimplant bone loss on mesial and distal sites of the implant after 1 year of function.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea , Mucosa Bucal/patología , Pérdida de la Inserción Periodontal/etiología , Anciano , Estudios Transversales , Implantación Dental Endoósea/efectos adversos , Femenino , Recesión Gingival/etiología , Recesión Gingival/patología , Humanos , Masculino , Periimplantitis/complicaciones , Periimplantitis/patología , Pérdida de la Inserción Periodontal/patología , Índice Periodontal , Radiografía Dental
3.
Dental Press J Orthod ; 23(1): 79-86, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29791688

RESUMEN

INTRODUCTION: The surgically assisted rapid maxillary expansion is a procedure that reduces the resistance of the sutures correcting the posterior crossbite in adults. OBJECTIVE: The aim of this study was to evaluate the periodontal status of 17 adults submitted to this procedure. METHODS: The clinical attachment level (CAL), gingival recession, attached gingiva and bleeding were evaluated in maxillary first premolars and molars, central and lateral incisors of right and left sides before surgery, 5 days and 6 months after. Means, standard deviation, medians, minimum and maximum values were compared among the evaluations using the Friedman and McNemar tests. RESULTS: There was a statistically significant increase in CAL in the right central incisor, right and left premolars and right and left molars. There was a statistically significant increase in gingival recession in the right and left premolars and molars. The amount of attached gingiva significantly decreased in right premolars and right and left molars. There was increase in bleeding in most of the teeth. CONCLUSION: Results indicated that the surgically assisted rapid maxillary expansion might cause alterations in periodontal tissue.


Asunto(s)
Recesión Gingival/etiología , Maxilar/cirugía , Técnica de Expansión Palatina/efectos adversos , Pérdida de la Inserción Periodontal/etiología , Adulto , Femenino , Hemorragia/etiología , Humanos , Masculino , Persona de Mediana Edad , Técnica de Expansión Palatina/instrumentación
4.
J Contemp Dent Pract ; 19(3): 324-330, 2018 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-29603707

RESUMEN

AIM: Periodontitis, a chronic infectious disease, affects most of the population at one time or the other and its expression is a combination of hosts, microbial agents, and environmental factors. Extensive literature exists for the relationship between periodontal disease and diabetes mellitus, cardiovascular diseases, and adverse pregnancy outcomes. Only a few studies performed in a limited number of patients have reported peri-odontal health status in chronic renal failure patients. Hence, the aim of the present study is to assess and compare the periodontal status of patients with chronic renal failure undergoing dialysis, predialysis with systemically healthy individuals. MATERIALS AND METHODS: A total of 90 patients were divided into three groups. Group I: 30 renal dialysis patients. Group II: 30 predialysis patients. Control group comprised 30 systemically healthy patients who formed group III. Periodontal examination was carried out using oral hygiene index-simplified (OHI-S), plaque index (PI), gingival index (GI), probing depth, and clinical attachment loss. RESULTS: The results of the study showed that the periodontal status of patients with chronic renal failure undergoing dialysis (dialysis group) and patients with chronic renal failure not undergoing renal dialysis (predialysis) when compared with systemically healthy subjects showed significantly higher mean scores of OHI-S, PI, and clinical attachment loss. CONCLUSION: Thus, patients with chronic renal failure showed poor oral hygiene and higher prevalence of periodontal disease. CLINICAL SIGNIFICANCE: The dental community's awareness of implications of poor health within chronic renal failure patients should be elevated.


Asunto(s)
Fallo Renal Crónico/complicaciones , Periodontitis/etiología , Adulto , Anciano , Estudios de Casos y Controles , Índice de Placa Dental , Humanos , Masculino , Persona de Mediana Edad , Índice de Higiene Oral , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal , Bolsa Periodontal/etiología , Diálisis Renal , Adulto Joven
5.
Eur J Orthod ; 40(2): 176-194, 2018 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-29106513

RESUMEN

Background: Insertion of orthodontic fixed appliances has been known to induce a mostly transient qualitative and quantitative alteration of the intraoral microbiota. However, the extent to which treatment with fixed appliances might have a lasting adverse effect on the periodontal attachment of the teeth has not yet been investigated in an evidence-based manner. Objectives: Aim of this systematic review was to assess the effect of comprehensive treatment with fixed orthodontic appliances on clinical attachment levels of adolescent and adult periodontally healthy patients. Search methods: Seven databases were searched from inception to February 2017. Selection criteria: Prospective non-randomized longitudinal clinical studies. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, Paule-Mandel random-effects meta-analyses of the clinical attachment loss and its 95 per cent confidence intervals (CIs) were calculated. Results: A total of 9 trials were identified that included 335 treated patients (at least 34 per cent male / 66 per cent female) with an average age of 22.6 years. The average pooled clinical attachment loss was 0.11 mm (9 studies; 335 patients; 95 per cent CI = 0.12 mm gain to 0.34 mm loss; P = 0.338) with high heterogeneity. Furthermore, one study hinted that a small amount of clinical attachment might be gained by intrusion of upper incisors. Additional analyses indicated that the results were robust to addition of untreated patient groups, while patient age and timing of outcome measurement might play an important role. Conclusions: According to existing evidence from longitudinal clinical studies orthodontic treatment with fixed appliances has little to no clinically relevant effect on periodontal clinical attachment levels. Registration: PROSPERO (CRD42017057042). Funding: None.


Asunto(s)
Aparatos Ortodóncicos Fijos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Pérdida de la Inserción Periodontal/etiología , Odontología Basada en la Evidencia/métodos , Humanos , Estudios Longitudinales , Ortodoncia Correctiva/instrumentación , Estudios Prospectivos
6.
J Periodontol ; 88(12): 1271-1280, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28753103

RESUMEN

BACKGROUND: The aim of this study is to investigate the impact of alcohol consumption on clinical attachment loss (AL) progression over a period of 5 years. METHODS: A multistage probability sampling strategy was used to draw a representative sample of the metropolitan area of Porto Alegre, Brazil. Five hundred thirty-two individuals (209 males and 293 females) aged 18 to 65 years at baseline with no medical history of diabetes and at least six teeth were included in this analysis. Full-mouth periodontal examinations with six sites per tooth were conducted at baseline and after 5 years. Alcohol consumption was assessed at baseline by asking participants about the usual number of drinks consumed in a week. Four categories of alcohol consumption were defined: 1) non-drinker; 2) ≤1 glass/week; 3) >1 glass/week and ≤1 glass/day; and 4) >1 glass/day. Individuals showing at least two teeth with proximal (clinical AL) progression ≥3 mm over 5 years were classified as having disease progression. Multiple Poisson regression models adjusted for age, sex, smoking, socioeconomic status, and body mass index were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: Overall, individuals who consumed >1 glass/day had 30% higher risk for clinical AL progression (RR = 1.30; 95% CI: 1.07 to 1.58) than non-drinkers. Among males, risk of clinical AL progression for individuals drinking >1 glass/day was 34% higher than non-drinkers (RR = 1.34; 95% CI: 1.09 to 1.64). Never-smoker males drinking ≤1 glass/week had significantly lower risk for clinical AL progression than non-drinkers (RR = 0.52; 95% CI: 0.30 to 0.89), whereas those drinking >1 glass/day had significantly higher risk (RR = 1.50; 95% CI: 1.08 to 1.99). Among females, no association between alcohol consumption and clinical AL progression was observed. CONCLUSIONS: Alcohol consumption increased the risk of clinical AL progression, and this effect was more pronounced in males. Low dosages (≤1.37 g of alcohol/day) of alcohol consumption may be beneficial to prevent periodontal disease progression in males. The impact of alcohol cessation initiatives on periodontal health should be evaluated.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Pérdida de la Inserción Periodontal/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas/epidemiología , Índice de Masa Corporal , Brasil/epidemiología , Progresión de la Enfermedad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etiología , Distribución de Poisson , Riesgo , Factores de Riesgo , Factores Sexuales , Fumar/efectos adversos , Factores Socioeconómicos , Población Urbana/estadística & datos numéricos , Adulto Joven
7.
Periodontol 2000 ; 74(1): 140-157, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28429487

RESUMEN

Reduced periodontal support is a challenge that clinicians often face during rehabilitation of compromised dentition. The close and intricate relationship between the periodontal tissues and the processes of tooth movement suggest that adjunct orthodontic therapy may play an important role in overcoming these problems. On the other hand, excessive movement of teeth beyond the anatomic boundaries of the alveolar process is commonly believed to contribute to further destruction of the periodontal tissues. This review evaluates the clinical effects of various orthodontic tooth movements on the surrounding periodontal soft tissues and alveolar bone. Another objective was to identify possible patient and treatment-related factors that may influence the response of periodontal tissue to specific orthodontic treatments. Particular emphasis is placed on specific tooth movements, such as extrusion, intrusion, space closure and arch expansion. Limitations of current research are also highlighted and discussed.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Proceso Alveolar/fisiología , Pérdida de la Inserción Periodontal/etiología , Periodoncio/fisiología , Técnicas de Movimiento Dental , Humanos
8.
Orthod Fr ; 88(1): 95-103, 2017 Mar.
Artículo en Francés | MEDLINE | ID: mdl-28229856

RESUMEN

INTRODUCTION: The periodontal morphotype is a leading feature to be born in mind during surgical, implant, prosthetic, restorative as well as orthodontic treatment. A fragile morphotype will rapidly trigger severe and worrying clinical repercussions for the patient. MATERIALS AND METHODS: In order to minimize the risks involved, sound knowledge of the different morphotypes and of the techniques for clinically evaluating them is a major requirement. These factors need to be regularly reassessed since morphotypes can vary throughout the course of treatment. RESULTS: Detecting and controlling mucogingival risk factors will enable an appropriate clinical approach designed to avoid the onset of secondary recessions or other gingival pathologies.


Asunto(s)
Encía/patología , Recesión Gingival/prevención & control , Pérdida de la Inserción Periodontal/prevención & control , Recesión Gingival/patología , Humanos , Ortodoncistas/normas , Pérdida de la Inserción Periodontal/etiología , Pérdida de la Inserción Periodontal/patología , Examen Físico , Rol del Médico , Pautas de la Práctica en Medicina/normas , Pronóstico , Factores de Riesgo
9.
J Dent Res ; 96(3): 261-269, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28048966

RESUMEN

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20-0.49], P < 0.001; osteopenia = 0.07 mm [95% CI, 0.01-0.13], P = 0.02). Only studies with lower risk of bias were available for the analysis of CAL severity. Women with low BMD presented more severe attachment loss, represented as mean percentage of sites with CAL ≥4 mm (osteoporosis = 3.04 [95% CI, 1.23-4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36-3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74-7.40], P < 0.001). This systematic review and meta-analysis indicates that postmenopausal women with osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.


Asunto(s)
Densidad Ósea , Enfermedades Óseas Metabólicas/complicaciones , Osteoporosis Posmenopáusica/complicaciones , Pérdida de la Inserción Periodontal/etiología , Femenino , Humanos , Factores de Riesgo
10.
Clin Oral Investig ; 21(2): 675-683, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27604232

RESUMEN

OBJECTIVES: The aim of the present study was to evaluate the association of metabolic syndrome (MS) with periodontitis (PE) and tooth loss (TL). MATERIALS AND METHODS: A cross-sectional study was conducted with 363 individuals who underwent full-mouth periodontal examination, and the association between MS and PE was evaluated considering three outcomes: severe periodontitis, mean probing depth ≥2.4 mm, and mean clinical attachment loss ≥2.0 mm. The prevalence ratio (PR) between MS and PE was calculated using a model adjusted for gender, age, smoking, years of education, and socioeconomic status. RESULTS: The adjusted model showed a PR for severe periodontitis of 1.17 (95 % CI 0.83-1.65). There was no significant association between MS and PE defined as mean probing depth ≥2.4 mm. MS was significantly associated with PE defined as mean attachment loss ≥2 mm in individuals aged 41-60 years (PR 1.47, 95 % CI 1.05-2.06). In addition, MS was associated with TL (>6 teeth) (PR 1.23, 95 % CI 1.02-1.49) for all ages, both in crude and adjusted analyses. CONCLUSIONS: We concluded that there is a weak association of MS with both attachment loss and TL. CLINICAL RELEVANCE: Patients with MS seem to have a higher risk of attachment loss and tooth loss and should be screened for periodontal disease.


Asunto(s)
Síndrome Metabólico/complicaciones , Enfermedades Periodontales/etiología , Pérdida de Diente/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal
11.
Bull Tokyo Dent Coll ; 57(2): 97-104, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27320299

RESUMEN

We report a case of generalized chronic periodontitis and type 2 diabetes mellitus requiring periodontal treatment including regenerative therapy. The patient was a 66-year-old man who presented with the chief complaint of gingival inflammation and mobile teeth in the molar region. He had been being treated for type 2 diabetes mellitus since 1999. His glycated hemoglobin (HbA1c) level was 7.8%. An initial examination revealed sites with a probing depth of ≥7 mm in the molar region, and radiography revealed angular bone defects in this area. Based on a clinical diagnosis of generalized chronic periodontitis, the patient underwent initial periodontal therapy. An improvement was observed in periodontal conditions on reevaluation, and his HbA1c level showed a reduction to 6.9%. Periodontal regenerative therapy with enamel matrix derivative was then performed on #16, 26, and 27. Following another reevaluation, a removable partial denture was fabricated for #47 and the patient placed on supportive periodontal therapy (SPT). To date, periodontal conditions have remained stable and the patient's HbA1c level has increased to 7.5% during SPT. The results show the importance of collaboration between dentist and physician in managing periodontal and diabetic conditions in such patients.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/trasplante , Trasplante Óseo/métodos , Periodontitis Crónica/complicaciones , Periodontitis Crónica/terapia , Proteínas del Esmalte Dental/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Hemoglobina A Glucada/metabolismo , Regeneración Tisular Guiada Periodontal/métodos , Planificación de Atención al Paciente , Pérdida de la Inserción Periodontal/terapia , Bolsa Periodontal/cirugía , Movilidad Dentaria/terapia , Anciano , Pérdida de Hueso Alveolar/etiología , Glucemia/metabolismo , Comorbilidad , Índice de Placa Dental , Raspado Dental , Diabetes Mellitus Tipo 2/terapia , Gingivitis/etiología , Gingivitis/terapia , Hemoglobina A Glucada/química , Educación en Salud Dental , Hepatitis B , Humanos , Masculino , Maloclusión de Angle Clase I/terapia , Diente Molar/patología , Diente Molar/cirugía , Higiene Bucal/educación , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal , Calidad de Vida , Aplanamiento de la Raíz , Extracción Dental , Movilidad Dentaria/etiología , Diente Impactado/cirugía , Resultado del Tratamiento
12.
Am J Orthod Dentofacial Orthop ; 149(4): 473-80, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27021451

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate the efficiency of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction. METHODS: The sample consisted of 20 patients (15-25 years old) with Class II Division 1 malocclusions. The suggested treatment plan was extraction of the maxillary first premolars with subsequent canine retraction. The sample was divided into 2 equal groups. In the first group, 1 side of the maxillary arch was randomly chosen for treatment with corticotomy, and in the second group, piezocision treatment was used. The contralateral sides of both groups served as the controls. Cuts and perforations were performed with a piezotome, and canine retraction was initiated bilaterally in both groups with closed-coil nickel-titanium springs that applied 150 g of force on each side. The following variables were examined over a 3-month follow-up period: rate of canine crown tip, molar anchorage loss, canine rotation, canine inclination, canine root resorption, plaque index, gingival index, probing depth, attachment level, and gingival recession. The rate of canine crown tip was assessed every 2 weeks after the start of canine retraction at 6 time points. RESULTS: The rates of canine crown tip were greater in the experimental sides than in the control sides in both groups. Corticotomies produced greater rates of canine movement than did piezocision at 4 time points. Canine root resorption was greater in the control sides. The remaining studied variables exhibited no differences between the control and the experimental sides. CONCLUSIONS: Corticotomy-facilitated orthodontics and piezocision are efficient treatment modalities for accelerating canine retraction.


Asunto(s)
Diente Canino/patología , Maxilar/cirugía , Osteotomía/métodos , Piezocirugía/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Diente Premolar/cirugía , Aleaciones Dentales/química , Índice de Placa Dental , Estudios de Seguimiento , Recesión Gingival/etiología , Humanos , Maloclusión de Angle Clase II/terapia , Diente Molar/patología , Níquel/química , Métodos de Anclaje en Ortodoncia/métodos , Alambres para Ortodoncia , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal , Bolsa Periodontal/etiología , Resorción Radicular/etiología , Titanio/química , Corona del Diente/patología , Extracción Dental/métodos , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento , Adulto Joven
13.
Am J Orthod Dentofacial Orthop ; 149(2): 277-86, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26827985

RESUMEN

Fixed retainers are effective in maintaining the alignment of the anterior teeth more than 90% of the time, but they can produce inadvertent tooth movement that in the most severe instances requires orthodontic retreatment managed with a periodontist. This is different from relapse into crowding when a fixed retainer is lost. These problems arise when the retainer breaks but remains bonded to some or all teeth, or when an intact retainer is distorted by function or was not passive when bonded. In both instances, torque of the affected teeth is the predominant outcome. A fixed retainer made with dead soft wire is the least likely to create torque problems but is the most likely to break. Highly flexible twist wires bonded to all the teeth appear to be the most likely to produce inadvertent tooth movement, but this also can occur with stiffer wires bonded only to the canines. Orthodontists, general dentists, and patients should be aware of possible problems with fixed retainers, especially those with all teeth bonded, because the patient might not notice partial debonding. Regular observations of patients wearing fixed retainers by orthodontists in the short term and family dentists in the long term are needed.


Asunto(s)
Retenedores Ortodóncicos/efectos adversos , Alambres para Ortodoncia/efectos adversos , Adulto , Pérdida de Hueso Alveolar/etiología , Aleaciones Dentales/química , Recubrimiento Dental Adhesivo/efectos adversos , Recubrimiento Dental Adhesivo/métodos , Falla de Equipo , Femenino , Recesión Gingival/etiología , Humanos , Diseño de Aparato Ortodóncico , Pérdida de la Inserción Periodontal/etiología , Docilidad , Retratamiento , Acero Inoxidable/química , Acero/química , Estrés Mecánico , Técnicas de Movimiento Dental/efectos adversos , Torque
14.
Clin Oral Investig ; 20(9): 2575-2580, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26888220

RESUMEN

OBJECTIVE: A study is made of the main oral manifestations of patients with rheumatoid arthritis (RA), particularly salivary flow, and of its possible association to periodontal disease. MATERIAL AND METHODS: A prospective comparative study was made of 146 patients (73 with RA and 73 controls), recording pocket depth, clinical attachment loss, bleeding index, plaque index, and the DMFT index to assess periodontal and dental alterations. Sialometric measurements were also made to determine resting, stimulated, and parotid salivary flow. RESULTS: The patients with RA had greater periodontal pocket depths (with moderate depths in most cases), as well as greater attachment loss and more bacterial plaque. The resting whole saliva and stimulated parotid saliva rates were also clearly decreased in the RA group compared with the controls. CONCLUSIONS: Patients with RA are more likely to present periodontal disease, poorer oral hygiene manifesting as an increased accumulation of bacterial plaque, and decreased salivary flow rates. CLINICAL RELEVANCE: Vulnerability to periodontitis is confirmed in one of the largest samples ever studied of patients with rheumatoid arthritis (RA). Also, there is evidence of hyposialia (decrease in salivary rate) in RA patients without Sjögren's syndrome.


Asunto(s)
Artritis Reumatoide/complicaciones , Enfermedades de la Boca/etiología , Adulto , Anciano , Estudios de Casos y Controles , Estudios Transversales , Índice CPO , Placa Dental/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/etiología , Bolsa Periodontal/etiología , Estudios Prospectivos , Xerostomía/etiología
15.
J Oral Rehabil ; 43(1): 31-8, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26332936

RESUMEN

It has earlier been reported that individuals with poorly controlled diabetes have severe periodontal disease (PD) compared to well-controlled diabetes. This longitudinal interventional study compared periodontal treatment outcomes with HbA1c level changes in four groups of diabetic and non-diabetic patients with or without PD, respectively. HbA1c, bleeding on probing (BOP), plaque index and periodontal pocket depth (PPD) 4 < 6 mm and ≥6 mm were recorded at baseline to 3 months after non-surgical treatment and 3-6 months for surgical treatment in subjects with or without T2D, and with or without PD. A total of 129 patients were followed from baseline to 6 months. Diabetics with PD and without PD showed reductions in HbA1c levels with a mean value of 0·3% after 3 months and mean values of 1% and 0·8%, respectively, after 6 months. Diabetics with PD showed higher levels of BOP versus non-diabetics without PD (P < 0·01) and versus diabetics without PD (P < 0·05) at baseline. After 6 months, diabetics with PD showed higher number of PPD 4 < 6 mm versus diabetics without PD (P < 0·01) and non-diabetics with PD (P < 0·01). Diabetics without PD showed higher levels of PPD 4 < 6 mm versus non-diabetics without PD (P < 0·01). Surgical and non-surgical periodontal treatment in all groups improved periodontal inflammatory conditions with a decrease in HbA1c levels in a period of three and 6 months. No change was seen in the number of pockets PPD 4 < 6 mm in diabetic subjects with PD after non-surgical and surgical treatment.


Asunto(s)
Periodontitis Crónica/etiología , Diabetes Mellitus Tipo 2/complicaciones , Hemoglobina A Glucada/metabolismo , Pérdida de la Inserción Periodontal/etiología , Bolsa Periodontal/fisiopatología , Periodontitis Crónica/metabolismo , Periodontitis Crónica/fisiopatología , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Pérdida de la Inserción Periodontal/metabolismo , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Bolsa Periodontal/metabolismo , Autocuidado , Resultado del Tratamiento
16.
J Clin Periodontol ; 42(9): 832-842, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26250060

RESUMEN

AIM: We investigated the long-term impact of adjunctive systemic antibiotics on periodontal disease progression. Periodontal therapy is frequently supplemented by systemic antibiotics, although its impact on the course of disease is still unclear. MATERIAL & METHODS: This prospective, randomized, double-blind, placebo-controlled multi-centre trial comprising patients suffering from moderate to severe periodontitis evaluated the impact of rational adjunctive use of systemic amoxicillin 500 mg plus metronidazole 400 mg (3x/day, 7 days) on attachment loss. The primary outcome was the percentage of sites showing further attachment loss (PSAL) ≥1.3 mm after the 27.5 months observation period. Standardized therapy comprised mechanical debridement in conjunction with antibiotics or placebo administration, and maintenance therapy at 3 months intervals. RESULTS: From 506 participating patients, 406 were included in the intention to treat analysis. Median PSAL observed in placebo group was 7.8% compared to 5.3% in antibiotics group (Q25 4.7%/Q75 14.1%; Q25 3.1%/Q75 9.9%; p < 0.001 respectively). CONCLUSIONS: Both treatments were effective in preventing disease progression. Compared to placebo, the prescription of empiric adjunctive systemic antibiotics showed a small absolute, although statistically significant, additional reduction in further attachment loss. Therapists should consider the patient's overall risk for periodontal disease when deciding for or against adjunctive antibiotics prescription.


Asunto(s)
Antibacterianos/efectos adversos , Pérdida de la Inserción Periodontal/etiología , Periodontitis/diagnóstico , Periodontitis/tratamiento farmacológico , Amoxicilina/efectos adversos , Progresión de la Enfermedad , Método Doble Ciego , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Alemania/epidemiología , Humanos , Masculino , Metronidazol/efectos adversos , Persona de Mediana Edad , Prevalencia , Pronóstico , Estudios Prospectivos
17.
BMC Oral Health ; 15: 84, 2015 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-26208714

RESUMEN

BACKGROUND: The purpose of this clinical study was to assess the prevalence of acidic oral mucosal lesions and periodontal conditions in patients suffering from erosive esophageal reflux disease (ERD) compared with non erosive esophageal reflux disease (NERD) patients, both treated with long term proton pump inhibitors (PPI). METHODS: Seventy-one patients with diagnosed GERD were studied: i.e. 29 ERD and 42 NERD patients. Thorough visual examination of the oral mucosa and a periodontal evaluation was performed. The primary outcome was defined as a statistically significant difference, between the two groups, in the presence of acidic lesions of the oral mucosa and specific periodontal parameters. RESULTS: This study failed to demonstrate statistically significant differences between ERD and NERD patients with respect to the prevalence of oral mucosal lesions. However, significantly more ERD patients suffered from severe periodontitis (CAL ≥ 5 mm) as compared to NERD patients. Accordingly, it may be assumed that PPI-use had no adverse effects on the prevalence of acidic oral mucosal lesions and on periodontal destruction. CONCLUSIONS: Within the limitations of this study it may be concluded that ERD and NERD patients need separate evaluation with respect to periodontal destruction. Moreover, long term PPI medication had no adverse clinical impact on acidic oral mucosal lesions and periodontal destruction. Further studies are necessary to elucidate the role of reflux in the periodontal destruction of ERD individuals.


Asunto(s)
Reflujo Gastroesofágico/complicaciones , Enfermedades de la Boca/etiología , Enfermedades Periodontales/etiología , Adulto , Anciano , Anciano de 80 o más Años , Antiulcerosos/uso terapéutico , Índice de Placa Dental , Eritema/etiología , Femenino , Ácido Gástrico , Reflujo Gastroesofágico/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Úlceras Bucales/etiología , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal , Bolsa Periodontal/etiología , Periodontitis/etiología , Fotografía Dental/métodos , Inhibidores de la Bomba de Protones/uso terapéutico , Estomatitis/etiología , Enfermedades de la Lengua/etiología , Adulto Joven
18.
Dental Press J Orthod ; 20(2): 35-41, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25992985

RESUMEN

OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored.


Asunto(s)
Placa Dental/etiología , Gingivitis/etiología , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Adolescente , Niño , Recubrimiento Dental Adhesivo/métodos , Dispositivos para el Autocuidado Bucal , Índice de Placa Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Higiene Bucal/educación , Pérdida de la Inserción Periodontal/etiología , Índice Periodontal , Propiedades de Superficie , Cepillado Dental/instrumentación , Pastas de Dientes/uso terapéutico
19.
BMC Oral Health ; 15: 59, 2015 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-25971786

RESUMEN

BACKGROUND: Plasminogen deficiency is a rare autosomal recessive disease, which is associated with aggressive periodontitis and gingival enlargement. Previously described treatments of plasminogen deficiency associated periodontitis have shown limited success. This is the first case report indicating a successful therapy approach consisting of a non-surgical supra- and subgingival debridement in combination with an adjunctive systemic antibiotic therapy and a strict supportive periodontal regimen over an observation period of 4 years. CASE PRESENTATION: The intraoral examination of a 17-year-old Turkish female with severe plasminogen deficiency revealed generalized increased pocket probing depths ranging from 6 to 9 mm, bleeding on probing over 30%, generalized tooth mobility, and gingival hyperplasia. Alveolar bone loss ranged from 30% to 50%. Clinical attachment loss corresponded to pocket probing depths. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Prevotella nigrescens and Eikenella corrodens have been detected by realtime polymerase chain reaction. Periodontal treatment consisted of full mouth disinfection and adjunctive systemic administration of amoxicillin (500 mg tid) and metronidazole (400 mg tid). A strict supportive periodontal therapy regimen every three month in terms of supra- and subgingival debridement was rendered. The reported therapy has significantly improved periodontal health and arrested disease progression. Intraoral examination at the end of the observation period 3.5 years after non-surgical periodontal therapy showed generalized decreased pocket probing depths ranging from 1 to 6 mm, bleeding on probing lower 30%, and tooth mobility class I and II. Furthermore, microbiological analysis shows the absence of Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola after therapy. CONCLUSION: Adjunctive antibiotic treatment may alter the oral microbiome and thus, the inflammatory response of periodontal disease associated to plasminogen deficiency and diminishes the risk of pseudomembrane formation and progressive attachment loss. This case report indicates that patients with plasminogen deficiency may benefit from non-surgical periodontal treatment in combination with an adjunctive antibiotic therapy and a strict supportive periodontal therapy regimen.


Asunto(s)
Conjuntivitis/complicaciones , Periodontitis/etiología , Plasminógeno/deficiencia , Enfermedades Cutáneas Genéticas/complicaciones , Adolescente , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/terapia , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Terapia Combinada/métodos , Femenino , Estudios de Seguimiento , Hemorragia Gingival/etiología , Hemorragia Gingival/terapia , Hiperplasia Gingival/etiología , Hiperplasia Gingival/terapia , Humanos , Metronidazol/uso terapéutico , Pérdida de la Inserción Periodontal/etiología , Pérdida de la Inserción Periodontal/terapia , Desbridamiento Periodontal/métodos , Bolsa Periodontal/etiología , Bolsa Periodontal/terapia , Periodontitis/terapia , Movilidad Dentaria/etiología , Movilidad Dentaria/terapia
20.
J Int Acad Periodontol ; 17(4): 116-22, 2015 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-26727150

RESUMEN

AIM: The aim of this study was to correlate radiographic examination with the clinical periodontal condition in cases of biologic width invasion by overextending restoration margins in restored premolars and molars. MATERIALS AND METHODS: The present pilot study involved nine people (mean age 32 years) with biologic width invasion by 21 surfaces overextending restoration margins in restored premolars and molars. Radiographs were made in a standardized unit using the interproximal technique and were evaluated by a single calibrated investigator. The clinical periodontal parameters were analyzed with the use of a computerized periodontal probe. Exploratory analysis and Spearman's correlation were used to perform statistical analyses (SPSS, p < 0.05). RESULTS: The most prevalent teeth with biologic width invasion were second premolars and first molars. Mean plaque index was 30.76%, and bleeding on probing was 27.0%. The mesial surface was invaded in 47.6% of cases and the distal surface in 52.4%. The 21 sites with biologic width invasion were found in patients with the following periodontal status: periodontal health (11 sites), gingivitis (2 sites), mild periodontitis (7 sites) and moderate periodontitis (1 site). There was a correlation between plaque index and bleeding on probing with the horizontal component of the bone level. CONCLUSIONS: There was correlation between the radiographic parameters of biologic width invasion and clinical conditions. The measure of the bone crest level correlated with the gingival recession. The horizontal component of bone defect correlated with plaque index and bleeding on probing.


Asunto(s)
Diente Premolar/patología , Restauración Dental Permanente/efectos adversos , Diente Molar/patología , Enfermedades Periodontales/etiología , Periodoncio/patología , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Proceso Alveolar/diagnóstico por imagen , Índice de Placa Dental , Femenino , Encía/patología , Recesión Gingival/diagnóstico por imagen , Recesión Gingival/etiología , Gingivitis/diagnóstico por imagen , Gingivitis/etiología , Humanos , Queratinas , Masculino , Pérdida de la Inserción Periodontal/diagnóstico por imagen , Pérdida de la Inserción Periodontal/etiología , Enfermedades Periodontales/diagnóstico por imagen , Índice Periodontal , Periodontitis/diagnóstico por imagen , Periodontitis/etiología , Proyectos Piloto , Radiografía , Propiedades de Superficie
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