Self-reported questionnaire on periodontal condition validated for use in Brazil.

There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

The Impact of Omega-3 Supplements on Non-Surgical Periodontal Therapy: A Systematic Review.

AIM: This systematic review examined the additional effect of taking omega-3 supplements on periodontal therapy. METHODS: The focused question was "What is the possible effect of omega-3 supplementation concomitant to non-surgical periodontal therapy on clinical periodontal parameters?" Databases Cochrane, Embase, Google Scholar, PubMed, and Web of Science (January-July 2021) were searched to identify appropriate studies. Randomized clinical trials (RCT) about non-surgical therapy with omega-3 supplementation, with at least 3 months of supplementation period were included. Cochrane risk of bias tool version 2 and Grading of Recommendations Assessment, Development, and Evaluation were used. RESULTS: A total of 1556 studies were found, of which eight studies met the inclusion criteria. All eight studies evaluated periodontal probing depth and clinical attachment loss; plaque and gingival inflammation were evaluated in seven studies. High variety of omega-3 dosage, different study lengths, questionable results from periodontal therapy (including test and control groups), high risk of bias and moderate quality of evidence prevented a satisfactory conclusion regarding the benefits of omega-3 supplementation. The studies' high heterogeneity avoided meta-analysis. CONCLUSION: Notwithstanding all limitations, the promising effects of omega-3 supplementation presented in two six-month studies encourage performing RCT with better-defined treatment protocols and greater methodological rigor.

Self-reported questionnaire on periodontal condition validated for use in Brazil

Abstract: There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

New tendencies in non-surgical periodontal therapy.

The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.

Dental biofilm of symptomatic COVID-19 patients harbours SARS-CoV-2.

AIMS: SARS-CoV-2 RNA has been recovered from different sites in the human body, including the mouth. The present study aimed to investigate the presence of SARS-CoV-2 RNA in the dental biofilm of symptomatic patients who tested positive in nasopharyngeal and oropharyngeal (NASO/ORO) samples. MATERIALS & METHODS: An observational clinical study of individuals with flu-like symptoms was conducted between July and September 2020. Dental biofilm (BIO) samples were collected and analysed using real-time quantitative polymerase chain reaction (RT-qPCR) to determine the virus's presence. RESULTS: Seventy participants (40 ± 9.8 years of age, 71.4% female) tested positive for SARS-CoV-2 RNA in NASO/ORO samples and were included in the study. Among them, 13 tested positive in BIO samples (18.6%; 95% CI: [9.5, 27.7]). The median and interquartile range of cycle quantification (Cq) for NASO/ORO and BIO samples were 15.9 [6.9] and 35.9 [4.0] (p = .001), respectively. BIO-positive participants showed a higher virus load in NASO/ORO samples (p = .012) than those testing negative (Cq = 20.4 [6.1]). CONCLUSIONS: Dental biofilms from symptomatic COVID-19 patients harbour SARS-CoV-2 RNA and might be a potential reservoir with an essential role in COVID-19 transmission.

Oral health-related quality of life during supportive periodontal therapy: results from a randomized clinical trial.

AIM: Assessment of Oral Health Impact Profile (OHIP-14) during a randomized controlled trial of supportive periodontal therapy (SPT) consisting of oral prophylaxis with oral hygiene instructions only (test) or in conjunction with subgingival instrumentation (control). METHODS: OHIP-14 was assessed at baseline, 6, 12, 18 and 24 months. Data from 62 participants (50.97 ± 9.26 years, 24 smokers) were analysed by GEE and Logistic regression. OHIP-14 means, effect size, floor and ceiling effect and minimal important difference were calculated. Sum of OHIP-14 (severity), numbers of responses (extent) "fairly often" (FO) or "very often" (VO) and percentage of people (prevalence) reporting FO or VO were computed. RESULTS: At baseline, low scores of OHIP-14 were observed for test (7.67 ± 9.27) and control (6.51 ± 7.47) with a decreasing trend during SPT, without differences between or intra-groups over time. At 6 months, a difference was observed in the OHIP-14 prevalence (p = .03), without differences in severity and extent. Smoking status and plaque >15% (moderate oral hygiene) at 24 months were associated with higher OHIP-14 prevalence scores at that point of time (p = .038 and p = .034, respectively). CONCLUSION: Patients submitted to two different modalities of SPT maintained low OHIP-14 scores over 2 years of care.

Periodontal condition and treatment in a patient with rare systemic condition: A case report for acid sphingomyelinase deficiency.

BACKGROUND: Acid sphingomyelinase deficiency (ASMD) is a rare group of autosomal recessive disorders. This report provides the first detailed description of the periodontal condition and treatment response in a patient with chronic visceral ASMD. CASE DESCRIPTION: A 49-year-old white woman with ASMD showed elevated visible plaque index (VPI), gingival bleeding index (GBI), and bleeding on probing (BOP) at 100% of sites. Periodontal pocket depths (PPD) were mostly shallow to moderate (at 96% of sites), whereas the loss of clinical attachment (CAL) was moderate to severe (54% and 46% of sites, respectively, at 4-6 mm and ≥7 mm categories). Periapical radiographs revealed the presence of furcation involvement and intra-bony defects. The periodontal diagnosis was periodontitis stage IV, generalized, grade C. Ninety days after the end of the supra and subgingival control (e.g., cause-related therapy), marked reduction was observed for all periodontal indicators: VPI (-83%), GBI (-79%), BOP (-85%), elimination of sites PPD ≥7 mm, 27% increase in sites PPD 1-3 mm (from 64% to 91%), and gain of clinical attachment (gain of 11% CAL 1-3 mm and 25% CAL 4-6 mm; and a reduction of 36% CAL ≥7 mm). PRACTICAL IMPLICATIONS: Despite the severity of the initial periodontal condition, the patient with chronic visceral ASMD responded well to the non-surgical periodontal treatment.

New tendencies in non-surgical periodontal therapy

Abstract The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.

Gingival crevicular fluid response to protocols of non-surgical periodontal therapy: A longitudinal evaluation.

CONTEXT AND AIM: Gingival crevicular fluid (GCF) volume reflects the level of periodontal inflammation. This secondary analysis aimed to evaluate the GCF volume in patients submitted to non-surgical periodontal therapies under a split-mouth design. MATERIALS AND METHODS: GCF volume of 25 participants (47.24 ± 6.47 years) with moderate-to-severe chronic periodontitis was collected at Days 0, 30, 60, 90, 120, 270, and 450. The participants were submitted to three different non-surgical therapies randomly assigned per quadrant [GI: supragingival control (Supra) as only intervention (one quadrant); GII: Supra plus scaling and root planing (SRP) on Day 0 (two quadrants); GIII: Supra on Day 0 and SRP 30 days later (one quadrant)]. During treatment (0-60 days) and maintenance (90-450 days) participants were submitted to supragingival plaque control reinforcements. GCF volumes were analyzed after logarithmic transformation (log10) and linear models were used for intra- and inter-group comparisons, considering the data dependence. RESULTS: Baseline GCF volumes were similar between groups (GI: 0.39 ± 0.22 µl; GII: 0.42 ± 0.26 µl; GIII: 0.41 ± 0.14 µl;P > 0.05). At Day 60, GCF volumes were significantly reduced (GI: 0.20 ± 0.13 µl; GII: 0.18 ± 0.11 µl; GIII: 0.22 ± 0.13 µl; P < 0.001), without inter-groups differences. These results were maintained along maintenance period (P > 0.05). Even in sites bleeding on probing (BOP) + the means of GCF volume did not differ between groups (P > 0.05). CONCLUSIONS: All therapies determined reductions on the GCF volume along time. Supragingival plaque control modulated the subgingival area during the study, reinforcing the importance of this control over the subgingival inflammatory response.

Impact of smoking on gingival inflammation in representative samples of three South American cities.

The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

Supportive periodontal therapy in moderate-to-severe periodontitis patients: A two-year randomized clinical trial.

AIM: Evaluate supportive periodontal therapy (SPT) consisting of oral prophylaxis with oral hygiene instructions as sole intervention (test) or combined with subgingival instrumentation removing/disrupting the subgingival biofilm (control). MATERIAL AND METHODS: Sixty-two treated periodontitis patients (50.97 ± 9.26 years, 24 smokers) were randomly assigned to receive, every 3 months during 2 years, either test or control treatment. Examination included periodontal probing depth (PPD), bleeding on probing (BOP) and clinical attachment loss (CAL). Generalized estimating equations were used for analyses. RESULTS: Baseline demographics and smoking were similar between groups. However, at baseline, mean PPD was greater in test group than in control group (2.32 mm vs. 2.17 mm, p = .03), but similar after 2 years (2.23 mm vs. 2.15 mm, respectively). With time, significant PPD and BOP decrease and CAL increase were observed although without significant differences between groups. At sites ≥ 5 mm, PPD decrease was greater in test group than in control group irrespective of sex and smoking habit (p = .034). The distribution of sites gaining or losing attachment ±2 mm was similar between groups. CONCLUSION: Oral prophylaxis with oral hygiene instructions alone or in combination with subgingival instrumentation was able to maintain the previously obtained periodontal condition to a comparable extent during 2 years of SPT.

Impact of smoking on gingival inflammation in representative samples of three South American cities

Abstract The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

A multicenter study of oral health behavior among adult subjects from three South American cities.

The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.

Body fat rather than body mass index is associated with gingivitis - A southern Brazilian cross-sectional study.

BACKGROUND: This cross-sectional study aimed to evaluate the association between body mass index (BMI) and body fat with gingivitis in 613 adults of Porto Alegre, Brazil. METHODS: Individuals with at least four teeth were included in this study. They were identified through a multi-stage probability sampling, considering the city distribution of sex and age. Structured interviews were conducted by trained researchers in order to collect sociodemographic characteristics, behavioral habits, and systemic impaired conditions. Visible plaque and modified gingival index were assessed by a trained and calibrated examiner. Additionally, weight, height, and body fat percentage were measured. Body fat percentage was determined by bioelectrical-impedance analysis using a portable electrical micro-current monitor. The median sites with marginal bleeding was 20%, and used as a cutoff point for gingivitis. Crude and adjusted prevalence ratio by mean Poisson regression with robust variance were calculated. Two multivariable models were performed in order to associate both independent and dependent variables. RESULTS: In the multivariable analysis that included BMI, no significant association with gingivitis was detected. On the other hand, the multivariable model that included body fat showed that very high body fat category (PR 1.22; 95% CI: 1.01 to 1.49) was significantly associated with higher marginal gingival bleeding. CONCLUSION: Very high body fat category rather than BMI was significantly associated with higher positive marginal gingival bleeding in adults.

A multicenter study of oral health behavior among adult subjects from three South American cities

Abstract The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study.

The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.

Self-perception of patients after periodontal treatment: A longitudinal study.

AIMS: To investigate the perceptions of subjects regarding nonsurgical periodontal treatment over a period of 1 year. SETTINGS AND DESIGN: This is a secondary analysis of a randomized clinical trial, in a longitudinal observational design. METHODS: Nineteen subjects (47.24 ± 6.47 years) with moderate to severe periodontitis completed a questionnaire at two different times after a nonsurgical periodontal treatment: 30 (T1) and 390 days (T2). The questionnaire with 40 items was divided into three domains: 1-perception of changes in clinical signs of periodontal disease, 2-psychological aspects of the subject regarding their oral health status, and 3-satisfaction with the treatment. STATISTICAL ANALYSIS: Each response on the Likert scale initially showed scores ranging from 1 to 5 points. The results for each question were dichotomized into 1 or 0, respectively, showing if the subject was favorable or unfavorable to treatment. A descriptive data analysis was performed, assessing the agreement of the results in T1 and T2 (Kappa). RESULTS: The results generally showed a favorable perception related to the treatment and continued satisfaction over time. The exceptions were in regards to gingival recession, persistent bleeding and bad breath, and difficulty in performing the mechanical control imposed by the professional. CONCLUSION: It was concluded that the therapy used was satisfactory to the subjects and that a favorable perception was maintained after 1 year of follow-up.

Tooth Loss in Patients under Periodontal Maintenance in a Private Practice: A Retrospective Study

Abstract The aim of the present study was to evaluate the incidence and causes of tooth loss in periodontal subjects from a private practice in Brazil. Two trained examiners extracted data from the records of subjects who sought periodontal treatment from 1980 to 2013. Only records of patients who completed the non-surgical periodontal treatment and had at least one visit for maintenance were included. Data were analyzed by chi-square test, Student's t-test, Kaplan-Meier survival curve and Cox regression. A total of 3,319 records were reviewed and 737 records included (58.6% women, mean age of 46.6±13.0 years at the beginning of the treatment). Maintenance period ranged from 1 to 33 years (7.4±6 years). During this period, 202 individuals (27.4%) lost 360 teeth, 47.5% of losses within the first five years (n=171). Non-compliers lost more teeth than compliers (p<0.001), respectively 211 and 149 teeth. Regarding reasons of tooth loss, 84 individuals lost 38% of the teeth from periodontal disease progression (n=137). Survival analysis showed that most patients lost only one tooth from periodontal disease, and differences in the survival rates between compliers and non-compliers were observed following the second tooth loss. Approximately one-third of tooth losses was related to periodontal disease progression, and there was stability in time of the proportion of losses from disease progression and other reasons. Therefore, it is possible to conclude that compliant patients in a private practice lose fewer teeth than do non-compliers. Among compliers, periodontal disease progression was not the main cause of tooth loss.

Resumo O objetivo do presente estudo foi avaliar a incidência e causas de perda dentária em pacientes em manutenção periódica preventiva (MPP) de uma clínica privada. Dois examinadores extraíram os dados de registros de pacientes que procuraram tratamento periodontal entre 1980 a 2013. Os registros de pacientes que completaram o tratamento periodontal não cirúrgico e tiveram ao menos uma visita de MPP foram incluídos. Os dados foram avaliados utilizando os testes chi-quadrado, T de Student, curva de sobrevida de Kaplan-Meier e regressão de Cox. Dos 3.319 prontuários, 737 foram incluídos (58,6% mulheres, 46,6±13,0 anos). O período de MPP variou de 1 a 33 anos (7,4±6 anos). Durante este período, 202 indivíduos (27,4%) perderam 360 dentes, 47,5% das perdas durante os primeiros 5 anos de manutenção (n=171). Indivíduos irregulares nas consultas de MPP perderam mais dentes (p<0.001) do que indivíduos com regularidade, 211 e 149 dentes respectivamente. Oitenta e quatro indivíduos perderam 38% de dentes por progressão de doença periodontal (n=137). A maioria dos indivíduos perdeu 1 dente por doença periodontal, e foram observadas diferenças na sobrevida a partir da segunda perda dentária quando comparados indivíduos regulares e irregulares na MPP. Aproximadamente um terço dos dentes perdidos estava relacionado à progressão de doença periodontal. Foi observada uma estabilidade na proporção de perdas por progressão de doença e outras razões ao longo do tempo. Desta forma, conclui-se que indivíduos com uma frequência regular de MPP perdem menos dentes e a progressão de doença nesses indivíduos não é a principal razão para perda dentária.

Microbiological outcomes from different periodontal maintenance interventions: a systematic review.

This study aimed to investigate the differences in the subgingival microbiological outcomes between periodontal patients submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the periodontal maintenance period (PMP). A systematic literature search using electronic databases (MEDLINE and EMBASE) was conducted looking for articles published up to August 2016 and independent of language. Two independent reviewers performed the study selection, quality assessment and data collection. Only human randomized or non-randomized clinical trials with at least 6-months-follow-up after periodontal treatment and presenting subgingival microbiological outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically. The results showed that both SPG and SPG+SBG protocols of PMP determined stability in the microbiological results along time. Nevertheless, new studies comparing these interventions in PMP are needed, especially if the limitations herein discussed could be better controlled.

Microbiological outcomes from different periodontal maintenance interventions: a systematic review

Abstract This study aimed to investigate the differences in the subgingival microbiological outcomes between periodontal patients submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the periodontal maintenance period (PMP). A systematic literature search using electronic databases (MEDLINE and EMBASE) was conducted looking for articles published up to August 2016 and independent of language. Two independent reviewers performed the study selection, quality assessment and data collection. Only human randomized or non-randomized clinical trials with at least 6-months-follow-up after periodontal treatment and presenting subgingival microbiological outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically. The results showed that both SPG and SPG+SBG protocols of PMP determined stability in the microbiological results along time. Nevertheless, new studies comparing these interventions in PMP are needed, especially if the limitations herein discussed could be better controlled.