Analysis of oral risk factors for ventilator-associated pneumonia in critically ill patients.

OBJECTIVE: This a cross-sectional study to evaluate the association between oral health findings and ventilator-associated pneumonia (VAP) among critically ill patients in intensive care units (ICU). MATERIAL AND METHODS: Data were collected from medical records, and a detailed oral physical examination was performed on 663 critically ill patients on mechanical ventilation. Data were statistically analysed using univariate and logistic regression models relating the development of VAP with the oral findings. RESULTS: At oral physical examination, the most frequent findings were tooth loss (568-85.67%), coated tongue (422-63.65%) and oral bleeding (192-28.96%). Patients with a coated tongue or oral bleeding on the first day of ICU hospitalization developed more VAP than did patients without these conditions (20.14 vs 13.69%, p = 0.02; 23.44 vs 15.50%, p = 0.01, respectively). In the logistic regression, a coated tongue and oral bleeding were considered independent risk factors for VAP development (OR = 1.61 (1.03-2.51) and OR = 1.69 (1.08-2.66), respectively). CONCLUSIONS: The presence of a coated tongue and oral bleeding in ICU admission could be considered markers for the development of VAP. CLINICAL RELEVANCE: The results of this paper reinforce the importance of proper maintenance of oral hygiene before intubation, which may lead to a decrease in the incidence of VAP in the ICU.

A comparison between visual, intraoral scanner, and spectrophotometer shade matching: A clinical study.

STATEMENT OF PROBLEM: Visual shade matching is subjective and a cause of concern for clinicians. Different measurement devices have been developed to assist in tooth color selection and to achieve better esthetic results. However, consensus is lacking as to which method of tooth shade selection provides more predictable results. PURPOSE: The purpose of this clinical study was to compare the reliability of different visual and instrumental methods for dental shade matching. MATERIAL AND METHODS: Visual shade matching was performed by 3 experienced clinicians using 2 different shade guides (VITA Classical A1-D4 and VITA Toothguide 3D-MASTER with 29 tabs; VITA Zahnfabrik) with and without the aid of a light-correcting device (Smile Lite; Smile Line). An intraoral scanner (TRIOS; 3Shape A/S) and a spectrophotometer (VITA Easyshade Advance 4.0; VITA Zahnfabrik) were also used for color shade matching. The instrumental methods were repeated 3 times to determine repeatability. Shade-matching sessions for each method were performed under controlled lighting on the middle third of the maxillary right central incisor of 28 participants. The Fleiss' kappa statistical test was used to assess the reliability of each method. The weighted kappa statistical test was used to assess the agreement between the shades matched by different methods (α=.05). RESULTS: Instrumental methods were more accurate than visual methods. The best performance was found for the intraoral scanner configured for the 3D-MASTER scale (Fleiss' kappa value of .874) and for the spectrophotometer configured for the VITA Classical scale (Fleiss' kappa value of .805). The best visual shade-matching method was the VITA Classical scale associated with the light-correcting device (Fleiss' kappa value of .322). The Classical scale without the light-correcting device showed the poorest reliability (Fleiss' kappa value of .177) (P<.05). CONCLUSIONS: Instrumental methods for color shade matching were more reliable than the visual methods tested.

Prevalence of dental trauma in disabled persons seen at the dental clinic for special-needs patients of the Catholic University of Brasília (UCB) / Prevalência de traumatismo dentário em pacientes com deficiência atendidos na clínica de pacientes especiais da Universidade Católica de Brasília (UCB)

Introduction: In Brazil, dental trauma (DT) is considered a public health problem. However, few studies in the literature report the prevalence of DT in disabled persons (DP). Objective: The aim of this study was to assess the prevalence of DT among DP seen at the Dental Clinic for Special-Needs Patients (COPE) of the Catholic University of Brasília. Material and method: A retrospective, descriptive study analyzing 73 medical charts of DP seen at the COPE between 2014 and 2016 was conducted. Clinical and sociodemographic data were collected. The t-test was used to check for significant differences between the categories of the variables analyzed. The Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses (p < 0.05). Result: A DT prevalence of 33/73 (45.2%) was found among DP. The predominant type of fracture was crown fracture (26/33-78.8%). The majority of patients were over 20 years old (63/73 - 86.3%), at a proportion significantly higher than those for the other age categories (p < 0.008). The patients in the sample had a variety of diseases, predominantly in the following categories: mental (22/73- 30.1%), multiple (19/73-26%), and systemic (14/73-19.2%). Conclusion: A high prevalence of DT was found in DP, with the majority of cases being related to mental and multiple diseases. Further research is needed to assess the prevalence of DT in this patient group throughout the Federal District.

Introdução: No Brasil, o traumatismo dentário (TD) é considerado um problema de saúde pública. No entanto, poucos estudos na literatura relatam a prevalência de TD em pessoas com deficiência (PD). Objetivo: O objetivo deste trabalho foi avaliar a prevalência de TD em PD atendidas na Clínica de Pacientes Especiais da Universidade Católica de Brasília (COPE). Material e método: Este estudo seguiu um delineamento descritivo e retrospectivo, e foi realizado por meio da análise de 73 prontuários de PD atendidas na COPE entre 2014 e 2016. Foram coletados dados sociodemográficos e clínicos. O teste t foi utilizado entre as proporções para determinar se houve diferenças significativas entre as categorias das variáveis analisadas. O programa "Statistical Package for Social Sciences" (SPSS), versão 23.0 (IBM Corporation, Armonk, NY, EUA) foi utilizado nas análises (p<0,05). Resultado: Encontrou-se uma prevalência de TD de 33/73 (45,2%) entre os PD. A fratura predominante foi a do tipo coronária, com uma frequência de 26/33 (78,8%). A maioria dos pacientes tinha acima de 20 anos, com uma frequência de 63/73 (86,3%), significativamente maior do que as frequências das outras categorias (p < 0,008). Os pacientes da amostra apresentavam doenças variadas, sendo as mais prevalentes as das categorias mental, com frequência de 22/73 (30,1%), múltipla com 19/73 (26%), e sistêmica com 14/73 (19,2%). Conclusão: Foi encontrada uma alta prevalência de TD em PD, sendo a maioria dos casos relacionados a doenças mentais e múltiplas. Futuras pesquisas são necessárias para avaliar a prevalência de TD nesse grupo de pacientes em todo o Distrito Federal.

Strain transfer behavior of different planning options for mandibular single-molar replacement.

STATEMENT OF PROBLEM: The loss of the first molar and second premolar could lead to mesial movement of the second molar, thus limiting the restoration space for the 2 missing teeth. Placement of a larger first molar is a common choice, but the best implant number and position option remain controversial. PURPOSE: The purpose of this in vitro study was to test different planning options for replacing the mandibular first molar. MATERIAL AND METHODS: Two polyoxymethylene models simulated first molar edentulous spaces of 11 mm (conventional size first molar: control group) and 14 mm (enlarged first molar: all remaining groups other than control). Models included acrylic resin replicas of a first and second premolar, a second molar, and the first molar edentulous space. The following groups were established: control (CO), ø3.5-mm center implant; center implant (CI), ø3.5 mm; mesial implant (MI), ø3.5 mm; distal implant (DI), ø3.5 mm; center implant (WI), ø5.0; 2 implants (2I), 2 ø3.5-mm implants. Three Co-Cr molar crowns were fabricated for each group by using a computer-aided design and computer-aided manufacturing (CAD-CAM) technique. Model surface strains under a 250-N first molar load were calculated by 3-dimensional digital image correlation. Three regions of interest below the first molar were selected for comparison among groups. A test for unequal variances and a follow-up Welch ANOVA were used for statistical analysis (α=.05). RESULTS: The highest strains were found when the first molar was restored by using a 5.0-mm-wide implant (P<.05). Region of interest 1 showed that two 3.5-mm implants replacing the lost molar showed strain distribution similar to that of only one 3.5-mm implant (P>.05). Mesial and distal placement of the implant showed more neutral strain results than other restoration options (P<.05). CONCLUSIONS: Two small-diameter implants in an increased edentulous space show more optimized surface strain behavior than a single wide-diameter implant. However, a single 3.5-mm implant also showed reduced strains in the restoration of the same edentulous space.

Oral care practices for patients in Intensive Care Units: A pilot survey.

OBJECTIVE: To assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in Intensive Care Units (ICUs). STUDY POPULATION AND METHODS: A cross-sectional survey was conducted among 71 health professionals working in the ICU. A self-administered questionnaire was used to determine the methods used, frequency, and attitude toward oral care provided to patients in Brazilian ICUs. The variables were analyzed using descriptive statistics (percentages). A one-sample t-test between proportions was used to assess significant differences between percentages. t-statistics were considered statistically significant for P < 0.05. Bonferroni correction was applied to account for multiple testing. RESULTS: Most participants were nursing professionals (80.3%) working 12-h shifts in the ICU (70.4%); about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia, respectively (P < 0.05). Most reported using spatulas, gauze, and toothbrushes (49.3%) or only toothbrushes (28.2%) with 0.12% chlorhexidine (49.3%) to sanitize the oral cavity of ICU patients (P < 0.01). Most professionals felt that adequate time was available to provide oral care to ICU patients and that oral care was a priority for mechanically ventilated patients (80.3% and 83.1%, respectively, P < 0.05). However, most professionals (56.4%) reported feeling that the oral cavity was difficult to clean (P < 0.05). CONCLUSION: The survey results suggest that additional education is necessary to increase awareness among ICU professionals of the association between dental plaque and systemic conditions of patients, to standardize oral care protocols, and to promote the oral health of patients in ICUs.

Root Coverage in Smokers with Acellular Dermal Matrix Graft and Enamel Matrix Derivative: A 12-Month Randomized Clinical Trial.

This study investigated whether enamel matrix derivative (EMD) contributes to root coverage of gingival recessions performed with acellular dermal matrix graft (ADMG) in smokers during a 12-month follow-up. A sample of 19 smokers presenting bilateral Miller Class I or II gingival recessions were included. Selected sites randomly received both ADMG and EMD (test) or ADMG alone (control). Probing depth, clinical attachment level, gingival recession height, keratinized tissue, and root coverage were evaluated. Mean gain in recession height (P < .05), sites with complete root coverage (P < .05), and percentage of root coverage (59.7% and 52.8%, respectively) favored the test group compared with the control group.

Buscando previsibilidade no planejamento estético com uso de tecnologia tridimensional e digital ­ relato de caso / Seeking predictability in the aesthetic planning using 3d and digital technology ­ case report

A estética do sorriso é influenciada pela cor, forma, textura, medidas de comprimento e largura e alinhamento dos dentes, contorno gengival, a relação desses fatores com as características faciais, posicionamento da linha média, linha do sorriso, posicionamento do bordo incisal, dentre outros. Esses elementos possibilitam um sorriso esteticamente harmonioso, o que muitas vezes pode ser a queixa dos pacientes. Neste artigo será apresentado um relato de caso, no qual se utilizou tomografia computadorizada Cone Beam e planejamento digital do sorriso para auxiliar tanto no planejamento e previsibilidade, quanto na execução da cirurgia periodontal para aumento de coroa clínica estético. foi executado ainda, após a cicatrização dos tecidos periodontais, clareamento dental de consultório, associado ao caseiro, a fim de se alcançar resultados estéticos satisfatórios e suprir a expectativa da paciente. Após a finalização do caso, a paciente mostrou-se satisfeita com o resultado obtido e com os procedimentos realizados. Pode-se concluir que ambas as ferramentas, tomografia e planejamento digital do sorriso, facilitaram o diagnóstico e o planejamento do caso, proporcionando melhor comunicação entre profissionais e paciente e obtenção de resultados favoráveis e previsíveis.

Smile aesthetics is influenced by color, texture, shape, length, width and alignment of teeth, gingival contour, and the relation of these factors with the facial features, midline position, smile line, incisal edge positioning, among others. Such elements allow a harmoni-ous smile that may be frequently a patient complaint. This paper reports a case where cone beam computed tomography and digital smile design were used to assist the planning and predictability of a periodontal surgery to increase aesthetic clinical crown. After healing of periodontal tissues, in-office bleaching associated with at-home bleaching were conducted to achieve satisfactory aesthetic results and meet patient's expectations. After the case con-clusion, the patient was satisfied with the treatment outcome. It can be concluded that both tomography and digital smile design, facilitated the diagnosis and planning of the case, providing a better communication between professionals and patient achieving a favorable and predictable outcome.

Oral health promotion in patients with chronic renal failure admitted in the Intensive Care Unit.

Oral hygiene deficiency is common in patients treated in ICUs and it enables biofilm colonization by microorganisms that lead to respiratory infections. A 30-year-old female patient with chronic renal failure was hospitalized. Dental procedures were performed in the ICU and contributed to the patient's health after a few days.

Predictable Outcomes with Porcelain Laminate Veneers: A Clinical Report.

This clinical report describes how to achieve predictable outcomes for anterior teeth esthetic restorations with porcelain laminate veneers by associating the digital planning and design of the restoration with interim restorations. The previous digital smile design of the restoration eliminates the communication barrier with the patient and assists the clinician throughout patient treatment. Interim restorations (diagnostic mock-ups) further enhance communication with the patient and prevent unnecessary tooth reduction for conservative tooth preparation. Adequate communication between patient and clinician contributes to successful definitive restorations and patient satisfaction with the final esthetic outcome.

Comparação entre enxerto gengival livre e retalho reposicionado apical modificado para ganho de mucosa ceratinizada ­ relato de caso / Comparison between free gingival graft and modified apically repositioned flap to gain keratinized mucosa ­ case report

A quantidade adequada de gengiva inserida ao redor dos dentes é de extrema importância para a proteção e manutenção da saúde gengival. Na ausência de largura adequada de gengiva inserida, o enxerto gengival livre (EGL) é a técnica padrão ouro para este fim. Entretanto, o EGL necessita de duas áreas cirúrgicas, o que ocasiona maior incômodo ao paciente no pós-operatório. Uma alternativa, quando há uma faixa mínima de gengiva inserida, é o retalho reposicionado apical modificado (MARF), que apresenta apenas uma área cirúrgica e é uma técnica fácil, o que acelera o tempo transcirúrgico e diminui o desconforto pós-cirúrgico do paciente. Este artigo relata um caso clínico, no qual em um lado foi empregada a técnica de enxerto gengival livre no dente 45 e, no lado contralateral, a técnica de MARF no dente 34 a fim de aumentar a faixa de gengiva inserida. Após dez meses de controle pós-operatório, observou-se aumento satisfatório de mucosa ceratinizada em ambos os lados, 4 mm no dente 45 e 4 mm no dente 34, e aparência estética aceitável, o que favorecerá a higienização bucal e a saúde periodontal, já que são áreas adjacentes à prótese parcial removível. Concluiu-se que o MARF é uma alternativa satisfatória ao EGL, entretanto, esta técnica necessita de 1 mm de gengiva inserida e não aumenta a espessura gengival. Na ausência completa de gengiva inserida, o EGL é ainda a técnica de eleição para obter melhores resultados (AU).

Adequate amount of attached gingiva around the teeth is needed for protection and maintenance of gingival health. In the absence of suitable width of attached gingiva, gingival free graft (EGL) is the gold standard technique for such purpose. However, EGL requires two surgical areas, leading to greater postoperative discomfort to the patient. Alternatively, when there is a minimum range of attached gingiva is the flap modified apically repositioned (MARF) having only one surgical area and is an easy technique, which accelerates the cross-surgical time and reduces postoperative patient discomfort. The objective of this study is to report a case in which the free gingival graft technique was used in one side (tooth #45), and the MARF technique was used in the contralateral side (tooth #34) in order to increase the range of the attached gingiva. After ten months of postoperative control, it was observed satisfactory increase of keratinized mucosa on both sides, 4 mm on tooth #45 and 4 mm on tooth #34, and acceptable aesthetic appearance, thus promoting oral hygiene and periodontal health since they were areas adjacent to a removable partial denture. It can be concluded that the MARF is a satisfactory alternative to EGL. However, this technique requires 1 mm of attached gingiva and it does not increase gingiva thickness. In the complete absence of gingiva, EGL is still the technique of choice for best results (AU).

Diferenças técnicas de aumento estético de coroa clínica / Different techniques of aesthetic clinical crown lengthening: cases report

A crescente demanda de pacientes que procuram tratamento dentário por razões estéticas vem crescendo, tendo como queixa principal o sorriso gengival e a aparência de dentes curtos. O aumento estético de coroa clínica é de suma importância para se alcançar um sorriso harmônico, principalmente quando a etiologia é a erupção passiva alterada. Tradicionalmente, o procedimento é realizado com a elevação de um retalho para a exposição da crista óssea e subsequente osteotomia/osteoplastia. Entretanto, a osteotomia via sulco gengival sem levantamento de retalho, utilizando microcinzéis, tem sido uma opção para casos de biotipos periodontais intermediários ou finos. Os benefícios da técnica incluem a finalização do procedimento sem a necessidade de suturas, a diminuição do desconforto pós-operatório e a otimização da reparação tecidual. O presente trabalho teve como objetivo exemplificar as diferentes técnicas de osteotomia em aumento estético de coroa clínica, por meio do relato de dois casos clínicos, nos quais os pacientes foram diagnosticados com sorriso gengival devido à erupção passiva alterada. No primeiro caso clínico, a osteotomia foi realizada com elevação de retalho e, no segundo, sem retalho. Ambos os casos obtiveram resultados esteticamente favoráveis, sem intercorrências no pós-operatório.

The growing demand of patients seeking dental treatment for aesthetic reasons has been growing, with the main complaint the gummy smile and appearance of short teeth. The aesthetic clinical crown lengthening is of paramount importance to achieve a harmonious smile, especially when the cause is altered passive eruption. Traditionally, this procedure is performed using flap elevation to fully expose the underlying bone and allow subsequent osteotomy/osteoplasty. However, the osteotomy through gingival sulcus, without flap elevation, using microchisels, has been an option for cases of intermediate or thin periodontal biotypes. The benefits of the technique include the ability to finalize the procedure without the need for sutures, less postoperative discomfort and improved tissue repair. This paper aims to illustrate the different techniques of osteotomy in aesthetic clinical crown lengthening by the report of two clinical cases in which patients were diagnosed with gummy smile due to altered passive eruption. In the first clinical case, osteotomy was performed with elevation flap and in the second case, it was performed without elevation flap. Both cases achieved aesthetically favorable and results without complications postoperatively.

Enxerto gengival livre e retalho posicionado coronariamente para recobrimento radicular / Free gingival grafts and coronally positioned flap for root coverage

O sucesso do tratamento das retrações gengivais baseia-se no conhecimentode sua etiologia e na avaliação da previsibilidade do recobrimentoradicular. Diversas técnicas têm sido propostas para o tratamento das retraçõesgengivais, a fim de promover possíveis melhorias na estética dosorriso. Este artigo relata um caso clínico de recobrimento radicular deretrações Classe I de Miller por meio do reposicionamento coronal do retalhoapós a colocação do enxerto gengival livre, tendo como resultado osucesso clínico do procedimento, tanto do ponto de vista do recobrimentoradicular como da satisfação da paciente.

Matriz dérmica acelular e matriz derivada do esmalte para recobrimento radicular em fumantes / Acellular dermal matrix grafts and enamel matrix protein for root coverage in smokers

O fumo apresenta uma influência negativa na previsibilidade dos procedimentos de cirurgias plásticas periodontais, principalmente, por meio da deficiência na função de fibroblastos periodontais. A literatura relata bons resultados clínicos de recobrimento radicular com o uso da matriz dérmica celular (MDA) e que a proteína derivada da matriz do esmalte (PDME) contribui para a melhora na atividade fibroblástica. O objetivo desse estudo foi avaliar a MDA associada ou não à PDME para recobrimento radicular em fumantes. Foram selecionados 20 pacientes com retrações gengivais bilaterais Classe I ou II de Miller, > 3 mm. Um grupo foi tratado com MDA e o outro com MDA associada à PDME. Os parâmetros clínicos - profundidade de bolsa a sondagem (PBS), nível clínico de inserção relativo (NCIR), altura da retração gengival (ARG), largura da retração gengival (LRC), quantidade de gengiva queratinizada (QCQ) e espessura da gengiva queratinizada (EGQ) - foram avaliados duas semanas após a terapia períodontal básica (exame inicial) e três meses após os procedimentos cirúrgicos. Par análise estatística, foram usados os testes de Wilcoxon, com nível de significância de 5%. Os dois procedimentos apresentaram resultados favoráveis, com diferenças estatisticamente significantes em todos os parâmetros clínicos após três meses. Não houve diferenças estatisticamente significantes entre os grupos. Concluiu-se que a MDA associada ou não à PMDE pode ser uma alternativa para o recobrimento radicular de retrações gengivais Classe I e II de Miller. Contudo, em pacientes fumantes, a associação da PMDE à MDA parece não mostrar benefícios clínicos adicionais no recobrimento radicular três meses após a cirurgia.

Cirurgia minimamente invasiva em casos de hiperplasia de papilas - descrição de técnica / Minimally invasive surgery in cases of papilla hyperplasia - technique description

A utilização da microscopia operatória é baseada nos conhecimentos e nas técnicas de cirurgia minimamente invasiva (CMI), onde os recursos de amplificação de imagem são fundamentais para uma melhor visualização, permitindo uma modificação e um refinamento da técnica cirúrgica, que é um dos fatores que influencia os resultados da cirurgia periodontal. Dentro deste contexto, os benefícios da CMI e da utilização do microscópio operatório estão relacionados a aumento da acuidade visual, melhor magnificação e iluminação do campo cirúrgico e, consequentemente, a maior precisão da técnica cirúrgica. A utilização desse recurso para a correção de hiperplasia de papilas é plausível, uma vez que promove mínimo traumatismo tecidual e a preservação da altura das papilas interdentárias. Dessa forma, o objetivo desse trabalho foi mostrar o recurso da CMI para correção de hiperplasia de papilas, onde são propostas algumas alterações na técnica clássica de gengivoplastia.

The influence of restorations and prosthetic crowns finishing lines on inflammatory levels after non-surgical periodontal therapy.

OBJECTIVE: The aim of the present study was to evaluate the inflammatory response in sites where crowns were placed supragingivally, at the level of the gingival margin and subgingivally. These were measured clinically and through the levels of interleukin-1 3 and matrix metalloproteinase-2, inflammatory mediators, before and after periodontal therapy. METHODS: From 68 patients analyzed, 10 were selected for this study. The gingival crevicular fluid of the patients was collected and analyzed using standard enzyme-linked immunosorbent assay (ELISA). The clinical parameters were measured and correlated with interleukin-1beta and matrix metalloproteinase-2. Both analyses were realized before (baseline) and 2 months after non-surgical periodontal therapy. The two-way variance analysis (two-way ANOVA), Tukey-Kramer multiple comparisons test (post hoc) and Pearson parametric correlation test were performed in statistical analysis. RESULTS: There were statistically significant differences before and after nonsurgical periodontal therapy when comparing supra- and subgingival margins for the plaque and bleeding indexes (p < 0.05). There was a tendency toward correlation between the reduction of plaque index and the reduction of interleukin-1beta levels, both for supragingival (r = 0.694, p = 0.026) and subgingival margins (r = 0.715, p = 0.020) post non-surgical periodontal therapy. The levels of matrix metalloproteinase-2 were not detectable by ELISA because they were below the detection threshold of the assay. CONCLUSION: Supragingival restorations appeared to be more adequate in promoting periodontal health when compared with the other possible marginal finish lines. They also presented a better response to basic periodontal treatment, according to clinical and inflammatory findings.

Inflammation markers in healthy and periodontitis patients: a preliminary data screening.

Advances in diagnostic research are moving towards methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. The purpose of this study was to evaluate whether differences in the serum levels of inflammatory biomarkers are differentially expressed in healthy and periodontitis patients. Twenty-five patients (8 healthy patients and 17 chronic periodontitis patients) were enrolled in the study. A 15 mL blood sample was used for identification of the inflammatory markers, with a human inflammatory flow cytometry multiplex assay. Among 24 assessed cytokines, only 3 (RANTES, MIG and Eotaxin) were statistically different between groups (p<0.05). In conclusion, some of the selected markers of inflammation are differentially expressed in healthy and periodontitis patients. Cytokine profile analysis may be further explored to distinguish the periodontitis patients from the ones free of disease and also to be used as a measure of risk. The present data, however, are limited and larger sample size studies are required to validate the findings of the specific biomarkers.

Inflammation markers in healthy and periodontitis patients: a preliminary data screening

Advances in diagnostic research are moving towards methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. The purpose of this study was to evaluate whether differences in the serum levels of inflammatory biomarkers are differentially expressed in healthy and periodontitis patients. Twenty-five patients (8 healthy patients and 17 chronic periodontitis patients) were enrolled in the study. A 15 mL blood sample was used for identification of the inflammatory markers, with a human inflammatory flow cytometry multiplex assay. Among 24 assessed cytokines, only 3 (RANTES, MIG and Eotaxin) were statistically different between groups (p<0.05). In conclusion, some of the selected markers of inflammation are differentially expressed in healthy and periodontitis patients. Cytokine profile analysis may be further explored to distinguish the periodontitis patients from the ones free of disease and also to be used as a measure of risk. The present data, however, are limited and larger sample size studies are required to validate the findings of the specific biomarkers.

Avanços no diagnóstico da doença periodontal levam a métodos nos quais o risco e atividade da doença periodontal podem ser identificados e quantificados por biomarcadores. Pacientes com periodontite podem apresentar elevados níveis circulatórios de marcadores inflamatórios específicos que podem ser correlacionados com a severidade da doença. Portanto, o objetivo desse estudo foi avaliar as diferenças nos níveis séricos de biomarcadores inflamatórios em pacientes saudáveis e com doença periodontal. Foram incluídos no estudo 25 pacientes (8 saudáveis e 17 com periodontite crônica). Uma amostra de 15 mL de sangue foi obtida para identificar os marcadores inflamatórios simultaneamente utilizando Array de proteínas através de citometria de fluxo. De 24 citocinas inflamatórias analisadas, apenas 3 (RANTES, MIG e Eotaxina) apresentaram diferenças estatisticamente significantes (p<0,05) entre os dois grupos. Conclui-se que alguns marcadores inflamatórios selecionados apresentam diferença de concentração em pacientes com periodontite e saudáveis. A análise do perfil de citocinas pode ser utilizada tanto para distinguir pacientes periodontais de pacientes saudáveis, como para medir o risco à doença. Contudo, mais estudos com número maior de amostras são necessários para validar os achados sobre os biomarcadores específicos.