Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5-year prospective study.

INTRODUCTION: Studies have shown that an impaired bone condition, represented by osteoporosis and increased fracture risk, may potentially aggravate periodontal disease and, consequently, the risk of tooth loss. This 5-year prospective study aimed to investigate whether systemic bone condition represents risk factor for tooth loss due to periodontal disease amongst elderly women. MATERIAL AND METHODS: Seventy-four participants, aged ≥ 65 years, who attended the 5-years recall for periodontal evaluation were involved. Baseline exposures were osteoporosis and fracture risk probabilities (FRAX). Women were grouped according to bone mineral density (BMD) and years of bone treatment for osteoporosis. The primary outcome at a 5-year follow-up was the number of tooth loss due to periodontal disease. Periodontitis staging and grading, and causes of tooth loss were recorded. RESULTS: The multivariate Poisson regression models showed that women with untreated/shortly treated osteoporosis were 4 times more likely to present higher number of tooth loss due to periodontal disease than those with normal BMD or treated for ≥ 3 years (risk ratio (RR) = 4.00, 95% CI 1.40-11.27). Higher FRAX was also linked to tooth loss (RR = 1.25, 95% CI 1.02-1.53). Receiver-operating characteristic (ROC) curve suggested that women with history of ≥ 1 tooth losses have higher chances of worse major FRAX (sensitivity = 72.2%; specificity = 72.2%). CONCLUSION: In this 5-year study, higher FRAX and untreated osteoporosis were risk factors for tooth loss. Women with normal BMD or treated for osteoporosis for ≥ 3 years did not show increased risk. Management of skeletal conditions should be emphasized with periodontal care for the prevention of tooth loss in elderly women.

Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report.

Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusion: The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.

Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report

ABSTRACT Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusions: The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.

A 14-Year Follow-Up Study of Sequelae in Primary Teeth and Permanent Successors After Dental Trauma

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth.

Percepção dos egressos de odontologia em relação à formação profissional com ênfase na educação interprofissional / Perception of dentistry graduates in relation to professional training with emphasis on interprofessional education

Objetivo: conhecer a percepção de egressos de graduação em Odontologia do Rio de Janeiro sobre a qualidade da formação profissional com ênfase na educação interprofissional. Materiais e Métodos: foi aplicado questionário on-line para egressos de três cursos de Odontologia, sendo duas instituições públicas e uma privada, para alunos formados entre 2016.2 e 2019.1. O questionário estruturado utilizado continha 41 perguntas para analisar a qualidade das atividades acadêmicas oferecidas durante a formação desses profissionais. As questões envolveram quatro dimensões: (1) perfil do egresso, (2) orientação do cuidado em saúde, (3) integração ensino-serviço, e (4) abordagem pedagógica. Os resultados apresentados neste artigo envolveram 9 perguntas das quatro dimensões. Resultados: os 121 egressos participantes responderam que a qualidade e oferta das atividades relacionadas à formação do perfil generalista, humanista e capacidade de compreender a realidade social foi muito boa, assim como as atividades de promoção de saúde e o uso de cenários de prática. Já as atividades relacionadas à educação multiprofissional/interprofissional e à vivência no Sistema Único de Saúde (SUS) foram consideradas moderadas. Conclusão: os resultados mostram que egressos dos cursos de Odontologia avaliados estão satisfeitos com a qualidade da formação profissional alcançada através das atividades acadêmicas oferecidas por seus cursos. Principalmente àquelas relacionadas à formação do perfil profissional e à promoção de saúde. Entretanto, a percepção dos egressos indica que experiências multiprofissionais/ínterprofissionais e vivência no SUS ainda precisam ser melhoradas, estimulando os alunos a participarem de estágios e projetos de extensão, formando, assim, profissionais capacitados a atuarem no SUS e no contexto social existente.

Objective: to know the perception of graduates in Dentistry in Rio de Janeiro about the quality of professional training with emphasis on interprofessional education. Materials and Methods: application of an on-line questionnaire for graduates of three Dentistry courses, two public institutions and one private, for students graduated between 2016.2 and 2019.1. The questions involved four dimensions: (1) graduate profile, (2) health care orientation, (3) teaching-service integration, and (4) pedagogical approach. The structured questionnaire used contained 41 questions to analyze the quality of the academic activities offered during the training of these professionals. The results presented in this article involved 9 questions from the four dimensions. Results: a total of 121 graduates participated in the survey. Most graduates perceived that the quality and offer of activities related to the formation of a generalist, humanist profile and the ability to understand social reality were 'very good', as well as health promotion activities. Activities related to multiprofessional/interprofessional education and living in the Unified Health System (SUS) were considered 'moderate', and the use of practice scenarios was also considered 'very good'. Conclusion: the results show that graduates of the evaluated Dentistry courses were satisfied with the quality of professional training achieved through the academic activities offered by their courses. Mainly those related to the formation of the professional profile and health promotion. However, multiprofessional/interprofessional experiences and experience in the SUS still need to be improved, encouraging students to participate in internships and extension projects, thus forming professionals capable of working in SUS and in the existing social context.

Psychometric Properties of the Brazilian Version of GOHAI among Community-Dwelling Elderly People.

This study assessed the psychometric properties of the Brazilian version of the Geriatric Oral Health Assessment Index (GOHAI). A representative sample of 613 community-dwelling elderly people aged from 65 to 74 years was selected. Sociodemographic data, GOHAI and self-perceived oral health measures were collected. Dental clinical measures were obtained through oral examinations. The dimensional structure and adequacy of components were assessed using Confirmatory Factor Analysis (CFA), inter-item correlations and item-scale correlations. Reliability was evaluated by internal consistency and Intraclass Correlation Coefficients. Correlations between GOHAI scores and self-reported oral health measures were conducted to assess convergent validity. The relationship between dental clinical measures and GOHAI was tested through Poisson Regression to examine discriminant validity. The link between GOHAI items and dimensions was supported by CFA. Item 12 showed a poor factor loading. The inter-item correlations varied from 0.047 to 0.442, and item-scale correlations ranged from 0.305 to 0.612. Cronbach's alpha was 0.704. The test-retest correlation for GOHAI was 0.882. GOHAI scores were correlated by self-rated oral health measures. Poor dental clinical measures were associated with GOHAI. The Brazilian version of GOHAI showed adequate psychometric properties. However, the weak dimensional structure of GOHAI suggests the need to perform cross-cultural adaptation of GOHAI for Brazilian elderly people.

Factors Associated with Noncarious Cervical Lesions in Different Age Ranges: A Cross-sectional Study.

OBJECTIVES: Understanding the possible risk factors of noncarious cervical lesion (NCCL) is important for prevention and clinical management of the condition. The aim of this study was to investigate the factors associated with the prevalence of NCCL among adolescents, adults, and elderly people. MATERIALS AND METHODS: A cross-sectional study involving 501 participants aged 15 years or older was conducted. Participants were examined to assess the number of natural teeth and the prevalence and severity of NCCL by calibrated examiners. Data on age, gender, harmful toothbrushing habits, and acidogenic diet were collected through individual interviews. Multivariate Poisson's regression models were used to evaluate the association between the independent variables and the prevalence of NCCL according to the three age groups: 15 to 39, 40 to 64, and 65 years or older. RESULTS : The prevalence of NCCL among participants was 62.5% (95% confidence interval: 58.2-66.7). Among 15- to 39-year-old participants, the mean of NCCL was higher in males, those with lower number of teeth and acidogenic diet intake. Males aged 40 to 64 years and those with harmful brushing habits were more likely to present higher mean of NCCL. Elderly people with harmful toothbrushing habits had a greater mean of NCCL. CONCLUSION: Demographic (age and gender), clinical (number of teeth), and behavioral characteristics (harmful brushing habits and acidogenic diet) were meaningful factors associated with NCCL severity. The above-mentioned relationships varied between age groups.

Association between periodontitis and Alzheimer's disease and its impact on the self-perceived oral health status: a case-control study.

PURPOSE: To test the hypothesis that periodontitis is associated with AD and search whether periodontal and other variables would negatively impact the oral health-related quality of life (OHRQoL) perception. MATERIALS AND METHODS: Oral examinations and interview on self-perceived oral health status (Geriatric Oral Health Assessment Index (GOHAI) questionnaire (higher score corresponds to better perceived oral status)) were carried out and socio-demographic data were collected from outpatients with mild to moderate AD (cases, n = 50) and from their age- and sex-matched family caregivers (controls, n = 52). Full-mouth periodontal examination was performed. Significance of differences between groups was sought by chi-square, Student's t, or the Mann-Whitney test. The association between the variables periodontitis, probing depth (PD) ≥ 5 mm, and clinical attachment loss (CAL) ≥ 5 mm with the variable group was tested in binary logistic regression models (LRMs). LRMs were used to test the association of oral findings, demographics, and group with GOHAI. RESULTS: Cases had fewer teeth and greater CAL than controls. Cases had a superior percentage of sites with plaque, calculus, and bleeding on probing than controls. Cases had greater GOHAI scores than controls. Periodontitis was a variable most likely associated with AD (OR = 11.08, p < 0.001). None of the oral findings or demographics, but group, was associated with GOHAI (OR = 14.45, p < 0.001). CONCLUSION: Periodontitis is associated with AD, but not with patients' OHRQoL. CLINICAL RELEVANCE: Health care professionals must be aware that AD patients should have a periodic thorough oral examination and preventive intervention aiming at their welfare and maintenance of a pain-free functional dentition.

Oral status, sense of coherence, religious-spiritual coping, socio-economic characteristics, and quality of life in young patients.

BACKGROUND: Several factors can influence the oral health. AIM: To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). DESIGN: This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. RESULTS: For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (ß = 0.382, ß = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (ß=-0.201). The higher the age of the C/A, the lower the NDT (ß=-0.235), and the higher the family income the lower, the need for social benefit (ß = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. CONCLUSIONS: Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.

Oral health-related quality of life of 8-10 year-old children with traumatic dental injury

Introduction: Children presents high prevalence of traumatic dental injury (TDI). Objective: It is very important to detect the impact on oral health related to quality of life (OHRQoL) in this age group. Methods: Based on this, a cross sectional study was carried out using a convenience sample. Children from 8-10 years with TDI in permanent teeth were recruited over an 18 month period, from a public University. Data about OHRQoL using the Brazilian version of CPQ 8-10 (B-CPQ 8- 0 ) were collected. TDI were classified according to Andreasen criteria and grouped according to its severity. Variations in the scores and impact of TDI on OHRQoL according to age, gender and TDI severity were examined using nonparametric statistical tests (Kruskall-Wallis and Mann-Whitney test, p<0.05). Results: From a sample of 255 children, 41 healthy children that suffered TDI in permanent were included in the study. The mean B-CPQ 8-10 scores were 29.7 (SD 14.3). Emotional and social wellbeing domais had the highest negative score impact average 8.8 (SD 5.9) and 9.8 (SD 6.3), respectively. Gender or TDI severity did not present relation to impact on OHRQoL. In relation to age, 10-year-old children had more impact on their OHRQoL on the overall scale (p<0.05) and for the functional limitation subscale (p<0.05). Conclusion: TDI impacts negatively on OHRQoL of children aged from 8-10 years old.

Introdução: Crianças apresentam alta prevalência de traumatismo dentário (TD).Objetivo: Detectar o impacto do TD na qualidade de vida relacionada à saúde bucal (QVRSB) nessa faixa etária. Métodos: Um estudo transversal foi realizado com amostra de conveniência recrutando-se crianças de 8-10 anos com TD em dente permanente por um período de 18 meses em clínica pública. Dados sobre a QVRSB foram coletados através da versão brasileira do CPQ 8-10 (B-CPQ 8-10 ). O TD foi classificado de acordo com os critérios de Andreasen e agrupado de acordo com sua gravidade. As variações nos escores e o impacto do TD na QVRSB, de acordo com idade, gênero e gravidade do TD foram examinados por meio de testes estatísticos não paramétricos (teste de Kruskall-Wallis e Mann-Whitney, p <0,05). Resultados: De uma amostra de 255 crianças, 41 crianças saudáveis que sofreram TD em dentes permanentes foram incluídas no estudo. O escore médio do B-CPQ 8-10 foi 29,7 (DP 14,3). Os domínios bem-estar emocional e social apresentaram maior impacto negativo com média de 8,8 (DP 5,9) e 9,8 (DP 6,3), respectivamente. A diferença de gênero e a gravidade do TD não apresentaram relação de impacto na QVRSB. Em relação a idade, crianças de 10 anos tiveram maior impacto na escala global da QVRSB (p <0,05) e na subescala de limitação funcional (p <0,05). Conclusão: O TD impacta negativamente a QVRSB de crianças de 8 a 10 anos de idade.

Osteoporosis, tooth loss and functional dentition in elderly women: a cross-sectional study

Objectives: The objective of this study was to investigate whether osteoporosis is an indicator of missing teeth and lack of functional dentition in elderly women. Methods: A cross-sectional study involving women aged more than 60 years was performed at the Brazilian's Navy Dental Center (Odontoclínica Central da Marinha) , Rio de Janeiro, Brazil. Demographic data and general health status information of the group were obtained through individual interviews. In addition, the number of natural teeth was recorded in oral examination. Women presenting at least one tooth were divided in groups presenting or not osteoporosis. The number of natural teeth was compared between groups, with adjustment for smoking and diabetes mellitus. The association between functional dentition and osteoporosis was evaluated using odds ratios (ORs) and their respective 95% confidence intervals. Results: Data on oral examination were available for 256 of the 360 elderly women registered in the database. The groups were composed by 55 women with osteoporosis and 201 not presenting osteoporosis. The prevalence of chronic diseases and smoking, was similar between groups. The mean number of teeth for osteoporotic women was significantly lower than in those without this disease (14,69 ± 7,69 versus 18,19 ± 7,20, p= 0.002), remaining significant after adjustment for potential confounders. Women without osteoporosis exhibited greater chance to present functional dentition than those with osteoporosis (OR = 2.10, 95% CI [1.21 to 3.66], p =0.006). Conclusion: Osteoporosis was an indicator for tooth loss and lack of functional dentition in the studied population of elderly women.

Objetivos: O objetivo deste estudo foi investigar se a osteoporose é um indicador de perda dentária e de falta de dentição funcional em idosas. Métodos: Um estudo transversal envolvendo mulheres com mais de 60 anos foi realizado na Odontoclínica Central da Marinha, Rio de Janeiro, Brasil. Dados demográficos e médicos foram obtidos através de entrevistas individuais. Os dentes naturais foram contados no exame oral. Mulheres com um ou mais dentes foram divididas em dois grupos: com e sem osteoporose. O número de dentes naturais foi comparado entre os grupos, com controle para tabagismo e diabetes mellitus. A associação entre a dentição funcional e a osteoporose foi avaliada por meio de odds ratios (OR) e seus respectivos intervalos de confiança de 95%. Resultados: Dentre 360 idosas cadastradas no banco de dados, 256 tinham registro de exame oral. Os grupos foram compostos por 55 mulheres com osteoporose e 201, sem. A prevalência de doenças crônicas e tabagismo foi semelhante entre os grupos. O número médio de dentes para mulheres com osteoporose foi significativamente menor do que as que não tinham a doença (14,69 ± 7,69 versus 18,19 ± 7,20, p = 0,002), permanecendo significativo após o ajuste para possíveis fatores de confundimento. Mulheres sem osteoporose tiveram maior chance de apresentar dentição funcional do que as outras (OR = 2,10, IC 95% [1,21-3,66], p = 0,006). Conclusão: A osteoporose foi um indicador de perda dentária e de ausência de dentição funcional na população estudada.

Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families.

OBJECTIVE: This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. STUDY DESIGN: Healthy children aged 3-7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. RESULTS: No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p<0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). CONCLUSION: Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism.

Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: A meta-analysis.

BACKGROUND: Through a systematic literature review, the authors evaluated the use of chlorhexidine (CHX) mouthwash as an adjunct to mechanical periodontal therapy for chronic periodontitis. TYPES OF STUDIES REVIEWED: The authors performed a systematic search by using PubMed (MEDLINE), Scopus, Scientific Electronic Library Online, and Cochrane Central Register of Controlled Trials. The authors selected randomized controlled clinical trials in which the investigators evaluated the probing depth (PD) and clinical attachment level (CAL) in test groups by using CHX as an adjuvant and in control groups and subject to mechanical periodontal therapy (scaling and root planing [SRP] 4-6 visits or 24 hours). RESULTS: The literature search resulted in 8 articles, which the authors then assessed for quality. After testing for heterogeneity, the authors performed a meta-analysis only in the SRP group with 4 to 6 visits. Results were positive for both PD and CAL with use of CHX. However, the summary measure was significant (P < .05) only for PD at 40 to 60 days (0.33 millimeters; 95% confidence interval, 0.08 to 0.58 mm) and 180 days (0.24 mm; 95% confidence interval, 0.02 to 0.47 mm) of follow-up, showing positive results for the use of CHX at those times. Although those differences were statistically significant, they could be interpreted as clinically slight. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adjunctive use of CHX mouthrinse with mechanical SRP resulted in slightly greater PD reduction than did SRP alone. Clinicians must consider the small additional gain in PD reduction, negligible effect on CAL, and potential for tooth staining when using CHX as an adjunct to SRP in treating chronic periodontitis.

No association between periodontitis, preterm birth, or intrauterine growth restriction: experimental study in Wistar rats.

BACKGROUND: The biologic plausibility of the possible association between periodontitis and adverse pregnancy outcomes has been assessed with the use of different experimental models. However, most experimental studies did not induce periodontitis in the animals but promoted an acute microbial challenge with selected periodontal pathogens or their products subcutaneous or intravenous or intraamniotic. The present study was then conducted to verify the biologic plausibility of such association by experimentally inducing periodontitis in Wistar rats. OBJECTIVE: An experimental study on an animal model by the induction of periodontitis in 50% of sites and assessment of the presence of cytokines in the gingival tissue, serum, placenta, cord, and amniotic fluid was designed to test the null hypothesis that experimental periodontitis that is induced on rats does not result in adverse pregnancy outcomes. STUDY DESIGN: Forty female Wistar rats were included in 2 groups: a periodontally healthy (without ligatures) and an experimentally induced periodontitis group (test, with ligatures). Forty-five days after the induction, the mating was initiated. Males were placed with females in the ratio of 1:2 for a period of 12 hours. The bodyweight of the female, from then on, was recorded daily. When the pregnancy was confirmed on day 20, laparotomy was performed. The amniotic fluid, placenta, umbilical cord, blood (serum) and maternal and gingival tissue samples were subjected to quantitative analysis for interleukin 1α, -6, -10, -4, -12p70, and -17a, tumor necrosis factor-α, and interferon-γ by multiplex methods. Mean scores, standard deviations, and standard errors for estimated measures were calculated. For cytokines analyses, the Mann-Whitney test was conducted to compare the concentration of the analytes from control and test groups in the different tissues samples. For comparison of cytokines reduction from gingival tissue to serum and from serum to placenta, the Wilcoxon Test was performed. Spearman's correlation was conducted among cytokines in the 5 different tissues that were evaluated. RESULTS: The induced periodontitis in Wistar rats did not result in adverse outcomes of pregnancy. There were no statistically significant differences between groups in relation to prematurity, fetal, or birth weight. Regarding cytokines, there were no statistically significant differences in concentrations that were measured in each tissue between the groups with periodontitis and controls. Furthermore, all cytokine levels in the placenta, except interleukin-6, were diminished compared with the amniotic fluid or maternal serum, which suggested that the cytokines cannot easily be transferred via this tissue in maternal-fetal or fetomaternal direction. The fertility rate was reduced significantly in the group with periodontitis. CONCLUSION: Periodontitis that is induced in rats is not a risk factor for preterm birth or low birthweight.

Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis.

OBJECTIVES: The aims of this study were to investigate the caries experience, periodontal status, oral hygiene habits, and salivary parameters of children and adolescents undergoing hemodialysis (HD) and to compare them with their healthy counterparts. METHODS: Fifty-two HD patients were matched for age, sex, ethnicity, and social class with 52 healthy subjects for analysis of the number of decayed, missing and filled teeth, plaque and gingival index, dental calculus accumulation, measurements of pocket depth, clinical attachment level, gingival recession, and bleeding on probing. Stimulated saliva samples were collected to assess salivary flow rate, pH and buffer capacity, and salivary concentrations of calcium, phosphate, and urea by colorimetric method. RESULTS: HD patients had lower dental caries (p = 0.004), greater plaque and calculus accumulation (p = 0.001), and reported flossing less often than the controls (p = 0.013). Regarding salivary analysis, HD patients showed significantly higher values of pH, buffer capacity, and salivary urea concentration when compared to the controls (p = 0.001). CONCLUSION: HD patients had lower caries experience, higher accumulation of dental plaque, and calculus deposition than their healthy counterparts, probably due to the differences found in their salivary biochemical parameters. CLINICAL SIGNIFICANCE: A significant number of children and adolescents undergoing hemodialysis are candidates for kidney transplantation and should receive complete pre-transplant dental exams and dental treatment. Our results open the way for the development of an individualized dental protocol for these patients with preventive measures and treatment of the poor oral health in HD patients.

Aspectos sociodemograficos e clinicos da qualidade de vida relacionada a saude bucal em adolescentes / Aspectos sociodemogragicos y clinicos de la calidad de vida relacionada con la salud bucal en adolescentes / Sociodemographic and clinical aspects of quality of life related to oral health in adolescents

OBJETIVO: Estimar a prevalência e identificar fatores sociodemográficos e parâmetros bucais associados ao impacto negativo da condição bucal na qualidade de vida de adolescentes. MÉTODOS: Foram analisados dados de 5.445 adolescentes entre 15 e 19 anos que participaram do inquérito nacional de saúde bucal (SBBrasil 2010), considerando a complexidade do desenho amostral. O desfecho foi a qualidade de vida relacionada à saúde bucal, avaliada por meio do questionário Oral Impacts on Daily Performance e analisada de forma discreta. As variáveis de exposição foram sexo, cor da pele, escolaridade, renda familiar, idade, cárie não tratada, perda dentária, dor de dente, oclusopatias, sangramento gengival, cálculo dentário e bolsa periodontal. Foram conduzidas análises de regressão de Poisson e apresentadas as razões de médias (RM), com respectivos intervalos de 95% de confiança (IC95%). RESULTADOS: Dos pesquisados, 39,4% relataram pelo menos um impacto negativo na qualidade de vida. Após o ajuste, a média do impacto negativo foi de 1,52 (IC95%1,16;2,00) vez maior no sexo feminino e 1,42 (IC95% 1,01;1,99), 2,66 (IC95% 1,40;5,07) e 3,32 (IC95% 1,68;6,56) vezes maior nos pardos, amarelos e indígenas, respectivamente, em relação aos brancos. Quanto menor a escolaridade, maior a média de impacto negativo (RM 2,11, IC95% 1,30;3,41), assim como em indivíduos com renda familiar até R$ 500,00 (RM 1,84, IC95% 1,06;3,17) comparados aos de maior renda. Encontrou-se maior impacto na qualidade de vida entre adolescentes com quatro ou mais lesões de cáries não tratadas (RM 1,53, IC95% 1,12;2,10), uma ou mais perdas dentárias (RM 1,44, IC95%1,16;1,80), com dor de dente (RM 3,62, IC95% 2,93;4,46) e com oclusopatia grave (RM 1,52, IC95% 1,04;2,23) e muito grave (RM 1,32, IC95% 1,01;1,72). ...

OBJETIVO: Estimar la prevalencia e identificar factores sociodemográgicos y parámetros bucales asociados con el impacto negativo de la condición bucal en la calidad de vida de adolescentes. MÉTODOS: Se analizaron datos de 5.445 adolescentes entre 15 y 19 años que participaron de la pesquisa nacional de salud bucal (SBBrasil 2010), considerando la complejidad del diseño de muestreo. El resultado fue la calidad de vida relacionada con la salud bucal, evaluada por medio de cuestionario Oral Impacts on Daily Performance y analizada de forma discreta. Las variables de exposición fueron sexo, color de la piel, escolaridad, renta familiar, edad, caries no tratada, pérdida dentaria, dolor de diente, maloclusiones, sangramiento de encías, cálculo dentario y bolsa periodontal. Se efectuaron análisis de regresión de Poisson y se presentaron los cocientes de promedios (RM), con sus respectivos intervalos de 95% de confianza (IC95%), RESULTADOS: Entre los investigados, 39,4% relataron por lo menos un impacto negativo en la calidad de vida. Posterior al ajuste, el promedio del impacto negativo fue de 1,52 (IC95% 1,16;2,00) veces mayor en el sexo femenino y 1,42 (IC95% 1,01;1,99), 2,66 (IC95%1,40;5,07) y 3,32 (IC95%1,68;6,56) veces mayor en los pardos, amarillos e indígenas, respectivamente, con relación a los blancos. En la medida que disminuye la escolaridad, mayor el promedio del impacto negativo (RM 2,11, IC95%1,30;3,41), así como en individuos con renta familiar hasta R$ 500,00 (RM 1,84, IC95%1,06;3,17) en comparación con los de mayor renta. Se encontró mayor impacto en la calidad de vida entre adolescentes con cuatro o más lesiones de caries no tratadas (RM1,53, IC95%1,12;2,10), una o más pérdidas dentarias (RM1,44, IC95%1,16;1,80), con dolor de diente (RM3,62, IC95%2,93;4,46), y con maloclusión grave (RM1,52, IC95%1,04;2,23) y muy grave ...

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken ...

Systematic review: change in the quality of life of children and adolescents younger than 14 years old after oral health interventions: a systematic review.

PURPOSE: The purpose of this study was to perform a systematic review that evaluated changes in the quality of life (QoL) of children and adolescents younger than 14 years old after oral health interventions. METHODS: The search strategy was based on OVID, PubMed, VHL, Cochrane, and Google Scholar databases and was completed by a manual cross-reference search. The keywords used for the search were "child" and "oral health" and "quality of life"; for Google Scholar, "before and after treatment" were also used. Articles that met the inclusion criteria were classified considering methodological quality and risk of bias. RESULTS: A total of 1,044 articles were initially retrieved; after excluding duplicate abstracts, 13 articles remained from the electronic search, and the manual search of their references detected 14 new articles. The exclusion criteria eliminated 16 of these 27 articles, leaving 11 for quality assessment. Of these, 2 were classified as high, 7 as moderate, and 2 as low methodological quality, and the majority of them had moderate risk of bias. Thus, our final selection was reduced to 9 articles for final analysis. CONCLUSION: The level of evidence was moderate and detected changes in the impact on the quality of life of children and adolescents younger than 14 years old after interventions related to oral health.

[Sociodemographic and clinical aspects of quality of life related to oral health in adolescents]. / Aspectos sociodemográficos e clínicos da qualidade de vida relacionada à saúde bucal em adolescentes.

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken into account when planning preventive, monitoring and treatment strategies for oral health problems in groups with the highest impact on their quality of life.