RESUMO
Traumatic dental injuries (TDIs) are a public health concern that requires special attention in primary dentition due to the sequel that can be originated in permanent dentition. This paper aims to report a dental trauma injury highlighting the importance of follow-up the traumatized primary tooth until the eruption of its permanent successor. A 3-year-old female patient referred to a Dental Trauma Care Program (DTCP) in a Brazilian Public University after falling from her own height with the involvement of the deciduous maxillary left central incisor. The child's mother did not seek immediate care. The patient did not have any complaint and the tooth presented an enamel fracture during the clinical examination without radiographic alterations. The procedure performed was occlusal wear and insertion of the patient into the DTCP. After a 6-months clinical and radiographic follow-up, the primary maxillary left central incisor presented crown discoloration and periapical bone rarefaction. The treatment was pulpectomy followed by restoration of the tooth. In the 3-year follow-up, prolonged retention occurred and tooth extraction was the treatment of choice. After a 6-year follow-up, the permanent teeth erupted without any sequelae. TDIs are frequent in the primary dentition and, in some circumstances may interfere with the normal development of the permanent tooth causing irreversible sequelae. This case report reinforces the importance of seeking immediate care whenever dental traumas occur. Besides, a long-term follow-up of the traumatized tooth is essential for successful outcomes. Clinical and radiographic monitoring is fundamental to help dental professionals to decide the best treatment and to minimize potential complications.
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Pulp canal obliteration (PCO) presents itself as a frequent pulp complication in traumatized primary teeth, characterized as a progressive deposition of hard tissue in the root canal. In this context, this study aimed to evaluate the association between PCO due to the occurrence of traumatic dental injuries (TDI) in deciduous teeth and specific factors. For this, a retrospective study was carried out through 210 medical records selected from the Dental Trauma Care Program from 2012 to 2019. After applying the eligibility criteria, 371 deciduous teeth were included. Statistical analysis was performed using chi-square and Fischer's exact test. The occurrence of PCO was observed in 4.9%. Associated factors such as age (P=0.63), sex (P=0.47) and search for care (P=0.87) did not influence the occurrence of PCO. Concerning the type of TDI and development of PCO, the injury of subluxation showed a statistically significant association (P=0.01). There was an association of PCO with other TDI complications such as crown discoloration (P<0.01) and acceleration of physiological root resorption (P=0.01). No statistically significant association was found regarding the development of sequelae in permanent successors and PCO (P>0.05). Based on this study, PCO was not a frequent complication of TDI in deciduous teeth in the population evaluated. PCO was associated with subluxation, crown discoloration, and acceleration of physiological root resorption. However, it did not show association with any related factor (age, sex, and seeking care) and the development of clinical or radio graphical sequelae in permanent successors.
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The aim of this study was to evaluate how the oral hygiene condition can influence the Oral Health-Related Quality of Life (OHRQoL) of preschoolers and their families. A cross-sectional study was conducted involving 446 children aged 2 to 6 years from public schools located in Rio de Janeiro, Brazil. The groups were dichotomized: regular/poor oral hygiene condition (RPOH) or good oral hygiene condition (GOH). The caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The average score in the RPOH group was 6.36 (6.35 DP) and GOH was 4.43 (5.35 SD) (P < .01). In the child subscale, the average of the RPOH and GOH group were, respectively, 4.12 (4.14 DP) and 3.13 (3.66 DP) (P = .01). In the family subscale, RPOH and GOH group were, respectively, 2.24 (3.12 DP) and 1.29 (2.52 DP) (P = .01). RPOH group had the greatest impact on OHRQoL.
RESUMO
Traumatic dental injury (TDI) in deciduous teeth can affect itself and subsequent dentition due to its close anatomical relationship with the permanent germ. Besides, it can have psychologically undesirable effects on children and their parents and impact their Oral Health-Related Quality of Life (OHRQoL). In this case report, we aimed to describe a TDI in primary dentition that presented sequel on primary and on permanent dentition as well to describe the impact on OHRQoL after 4 years of follow-up. A 4-year-old boy was referred to the Dental Trauma Care Program (DTCP) six months after an accident at school that resulted in TDI. In deciduous dentition, the tooth 51 presented periapical lesion due to lateral luxation and tooth 61 presented pulp canal obliteration due to a concussion. The teeth received appropriate treatment. After 4 years of follow-up, in the permanent dentition, tooth 11 presented mild disturbance (demarcated opacity) as sequel of TDI in deciduous dentition. The patient's OHRQoL was evaluated throughout this process until the eruption of the permanent tooth. TDI and the sequelae on permanent tooth had a negative impact on the patient's OHRQoL. TDI treatment improved the patient's OHRQoL. This case report reinforces the importance of regular follow-up of traumatized teeth as it can affect both dentitions with a negative impact on OHRQoL.
RESUMO
Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium. OBJECTIVES: The aim of this study was to identify 5 types of fimA genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. MATERIAL AND METHODS: Thirty-one patients with periodontitis harboring P. gingivalis were selected: 16 nonsmokers (NS) and 15 smokers (SM). Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment, namely: plaque index, bleeding on probe, probing depth, gingival recession and clinical attachment level. The frequency of P. gingivalis and fimA genotype strains were determined by polymerase chain reaction. RESULTS: Type I fimA was detected in the majority of SM and NS at baseline, and the frequency did not diminish after 3 months of treatment. The frequency of type II genotype was higher in SM than NS at baseline. After 3 months, statistical reduction was observed only for types II and V fimA genotypes in SM. The highest association was found between types I and II at baseline for NS (37.5%) and SM (53.3%). CONCLUSION: The most prevalent P. gingivalis fimA genotypes detected in periodontal and smoker patients were genotypes I and II. However, the presence of fimA genotype II was higher in SM. Periodontal treatment was effective in controlling periodontal disease and reducing type II and V P. gingivalis fimA.
Assuntos
Proteínas de Fímbrias/isolamento & purificação , Periodontite/microbiologia , Periodontite/terapia , Porphyromonas gingivalis/isolamento & purificação , Fumar/efeitos adversos , Adulto , Idoso , DNA Bacteriano , Feminino , Proteínas de Fímbrias/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Periodontite/patologia , Reação em Cadeia da Polimerase , Porphyromonas gingivalis/genética , Estatísticas não Paramétricas , Fatores de TempoRESUMO
Abstract Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium. Objectives The aim of this study was to identify 5 types of fimA genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. Material and Methods Thirty-one patients with periodontitis harboring P. gingivalis were selected: 16 nonsmokers (NS) and 15 smokers (SM). Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment, namely: plaque index, bleeding on probe, probing depth, gingival recession and clinical attachment level. The frequency of P. gingivalis and fimA genotype strains were determined by polymerase chain reaction. Results Type I fimA was detected in the majority of SM and NS at baseline, and the frequency did not diminish after 3 months of treatment. The frequency of type II genotype was higher in SM than NS at baseline. After 3 months, statistical reduction was observed only for types II and V fimA genotypes in SM. The highest association was found between types I and II at baseline for NS (37.5%) and SM (53.3%). Conclusion The most prevalent P. gingivalis fimA genotypes detected in periodontal and smoker patients were genotypes I and II. However, the presence of fimA genotype II was higher in SM. Periodontal treatment was effective in controlling periodontal disease and reducing type II and V P. gingivalis fimA.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Periodontite/microbiologia , Periodontite/terapia , Fumar/efeitos adversos , Porphyromonas gingivalis/isolamento & purificação , Proteínas de Fímbrias/isolamento & purificação , Periodontite/patologia , Fatores de Tempo , DNA Bacteriano , Índice Periodontal , Reação em Cadeia da Polimerase , Porphyromonas gingivalis/genética , Estatísticas não Paramétricas , Proteínas de Fímbrias/genética , Genótipo , Pessoa de Meia-IdadeRESUMO
Objetivo: o propósito deste estudo foi avaliar, através da revisão de literatura, os aspectos clínicos (índice de placa, índice gengival, profundidade de sondagem, recessão gengival e nível clínico de inserção) e microbiológicos (presença qualitativa e quantitativa de periodontopatógenos) e a resposta de pacientes tabagistas à terapia periodontal. Material e Métodos: foram selecionados artigos científicos publicados entre os anos de 1978 a 2014, através dos bancos de dados MEDLINE, PUBMED e LILACS. Resultados: existem divergências em relação à influência do tabagismo nos parâmetros clínicos e microbiológicos. Conclusão: baseado nos estudos avaliados pode-se concluir que há diferenças clínicas e microbiológicas significativas no paciente tabagista e comprometimento da resposta à terapia periodontal.
Objective: the aim of this study was to evaluate, through literature review, clinical aspects (plaque index, gingival index, probing depth, gingival recession and clinical attachment level) and microbiological (qualitative and quantitative presence of periodontal pathogens) in smokers patients and the response to periodontal therapy. Material and Methods: it was selected scientific articles published between the years 1978 and 2014. We were selected scientific articles from MEDLINE, PUBMED and LILACS databases. Results: there are controversies between tobacco and clinical and microbiological parameters. Conclusion: based on the evaluated studies we can conclude that there are significant clinical and microbiological differences in smoking patients and impaired response to periodontal therapy.
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This pilot study aimed to evaluate the influence of smoking on clinical and microbiological parameters after nonsurgical periodontal therapy. Forty-eight subjects were grouped into smokers (SM, n = 24) and nonsmokers (NS, n = 24) and paired according to gender, age, ethnicity, and periodontal status. Both groups received oral hygiene education and scaling and root planing. Clinical evaluation was performed using plaque index (PI), bleeding on probing (BOP), pocket probing depth (PPD), gingival recession (GR), and clinical attachment level (CAL) before instrumentation (baseline) and at 3 and 6 months. The prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Candida albicans, Candida glabrata, Candida tropicalis, and Candida dubliniensis in subgingival biofilm was determined by polymerase chain reaction. The data were statistically analyzed considering p < 0.05. Clinical conditions improved between baseline and 3 months after periodontal treatment. However, NS had a better clinical response, presenting greater PPD reduction and CAL increase in comparison to SM. Periodontal treatment reduced the levels of P. gingivalis, A. actinomycetemcomitans, and T. forsythia individually after 3 months for the NS group and after 6 months for both groups. The prevalence of Candida species was markedly higher in SM than in NS at all time points evaluated. Periodontopathogens associated or not with C. albicans or C. dubliniensis were more prevalent in SM than in NS at baseline and after 3 months. It was concluded that smoking impairs clinical and microbiological responses to periodontal therapy. Periodontopathogens combined or not with some Candida species are resistant to short-term periodontal therapy in SM.
Assuntos
Bactérias/isolamento & purificação , Candida/isolamento & purificação , Doenças Periodontais/microbiologia , Doenças Periodontais/terapia , Periodonto/microbiologia , Fumar/efeitos adversos , Adulto , Idoso , Índice de Placa Dentária , Raspagem Dentária/métodos , Feminino , Retração Gengival , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Projetos Piloto , Reação em Cadeia da Polimerase , Valores de Referência , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract This pilot study aimed to evaluate the influence of smoking on clinical and microbiological parameters after nonsurgical periodontal therapy. Forty-eight subjects were grouped into smokers (SM, n = 24) and nonsmokers (NS, n = 24) and paired according to gender, age, ethnicity, and periodontal status. Both groups received oral hygiene education and scaling and root planing. Clinical evaluation was performed using plaque index (PI), bleeding on probing (BOP), pocket probing depth (PPD), gingival recession (GR), and clinical attachment level (CAL) before instrumentation (baseline) and at 3 and 6 months. The prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Candida albicans, Candida glabrata, Candida tropicalis, and Candida dubliniensis in subgingival biofilm was determined by polymerase chain reaction. The data were statistically analyzed considering p < 0.05. Clinical conditions improved between baseline and 3 months after periodontal treatment. However, NS had a better clinical response, presenting greater PPD reduction and CAL increase in comparison to SM. Periodontal treatment reduced the levels of P. gingivalis, A. actinomycetemcomitans, and T. forsythia individually after 3 months for the NS group and after 6 months for both groups. The prevalence of Candida species was markedly higher in SM than in NS at all time points evaluated. Periodontopathogens associated or not with C. albicans or C. dubliniensis were more prevalent in SM than in NS at baseline and after 3 months. It was concluded that smoking impairs clinical and microbiological responses to periodontal therapy. Periodontopathogens combined or not with some Candida species are resistant to short-term periodontal therapy in SM.