Oral conditions and the impact on quality of life of morbidly obese and bariatric patients / Condições bucais e o impacto na qualidade de vida de pacientes obesos mórbidos e bariátricos

ABSTRACT Objective The aim was to evaluate the prevalence of dental caries, periodontal disease and edentulism in morbidly obese and bariatric patients, and to verify the oral health impact on quality of life. Methods We evaluated 33 morbidly obese patients (G1) and 50 patients submitted to bariatric surgery (G2). The DMFT, CPI, prosthetic status and prosthetic need for edentulism were used to analyze oral conditions. The impact of oral health on quality of life was assessed using the OIDP questionnaire. Results CPOD were G1: 9.0±7.0 and G2: 13.3±8.0 (p= 0.020). The dental calculus was the worst periodontal condition G1: 72.7% and G2: 80.0% (p= 0.752). The majority of G1 and G2 patients did not use (p = 0.878) and did not need (p= 0.132) dental prosthesis. The mean of OIDP was G1: 11.2±23.8 and G2: 14.16±23.8 (p= 0.089). Conclusion It concluded that bariatric patients have a higher prevalence of dental caries and the need for dental prostheses is related to the impact of oral health on the quality of life of obese patients.

RESUMO Objetivo Objetivou-se avaliar prevalência de cárie, doença periodontal e edentulismo em pacientes obesos mórbidos e bariátricos e verificar o impacto da saúde bucal na qualidade de vida. Métodos Avaliou-se 33 pacientes obesos mórbidos (G1) e 50 pacientes submetidos à cirurgia bariátrica (G2). Os índices CPOD, IPC, uso e necessidade de prótese foram utilizados para analisar as condições bucais. O impacto da saúde bucal na qualidade de vida foi avaliado através do questionário OIDP. Resultados CPOD foi G1:9,0±7,0 e G2:13,3±8,0 (p=0,020). O cálculo dentário foi a pior condição periodontal G1:72,7% e G2:80.,0% (p=0,752). A maioria dos pacientes do G1 e G2 não usavam (p=0,878) e não necessitavam (p=0,132) de prótese dentária. A média do OIDP foi G1:11,2±23,8 e G2:14,16±23,8 (p=0,089). Conclusão Conclui-se que os pacientes bariátricos apresentam maior prevalência de cárie dentária e a necessidade de prótese dentária está relacionada com impacto da saúde bucal na qualidade de vida dos pacientes obesos.

Dental caries among preschool children: effects of social inequality and the impact of a university extension project / Cárie-dentária em pré-escolares: efeitos das desigualdades sociais e impactos de projeto de extensão universitária

ABSTRACT Objective The aims of this study were to assess the prevalence of dental caries among preschoolers at public and private schools and to evaluate the associations among the prevalence of the disease, socioeconomic factors, and the impact of a university extension project. Methods Five-year-old preschool children were examined and were divided into three groups: children from private schools who were not receiving regular preventive care (group 1), children from public schools who were not receiving regular preventive care (group 2), children from public schools who were receiving preventive care through a university extension project (group 3). The children were examined for decay-missing-filled index, and their caregivers were interviewed to collect data on socioeconomic factors. Fisher's and Chi-squared tests were used to analyze the data. Results Group 1 showed better socioeconomic and oral conditions compared with groups 2 and 3. Parents'/guardians' level of education was associated with the presence of disease in their children; however, income showed no association. Conclusion Dental caries were more prevalent in the group with worse socioeconomic indicators, and although the university extension project had been implemented in one of the groups, it was not able to overcome health inequalities.

RESUMO Objetivo O objetivo deste estudo foi verificar a prevalência da cárie dentária em pré-escolares de escola pública e privada, avaliando sua associação a fatores socioeconômicos e impactos projeto de extensão universitária. Métodos Foram examinados pré-escolares de 5 anos, alocados em 3 grupos: G1 - crianças de colégio privado, sem projeto preventivo em saúde bucal; G2 - crianças de ensino público também sem cuidados preventivos regulares; G3 - pré-escolares de ensino público que recebem cuidados preventivos através de projeto de extensão universitária. As crianças foram examinadas para aferição do índice ceo-d e seus responsáveis foram entrevistados para verificação de fatores socioeconômicos. Para análise dos dados foi utilizado o teste de Fisher e o teste Qui-quadrado Resultados A escola referente ao G1 mostrou melhores condições socioeconômicas e bucais, comparada com os grupos G2 e G3. A escolaridade dos pais esteve associada à presença de doença nos filhos, porém, a renda não demonstrou associação. Conclusão A cárie dentária foi mais prevalente no grupo com piores indicadores socioeconômicos, e apesar do projeto de extensão universitária em saúde bucal estar presente em uma das situações ele não foi capaz de superar as desigualdades em saúde.

Profundidade do sulco gengival em pacientes de faixa etária de 18-25 anos / Depth of gingival sulcus in patients aged between 18 to 25 years

Gingival probing performed in periodontal normal condition brings important results for the definition of health and diseases of the periodontal tissues. The aim was to evaluate the depth probing of the gingival sulcus in permanent dentition of young adults. It was carried out a transversal study with 120 volunteers aged 18 to 25 years and with healthy gum. It was used a manual periodontal probe Williams model. The evaluation was performed on all four sides, with a total of four measurements per tooth. The collected data were first tabulated and submitted to Kruskal-Wallis test with Dunn's post test.The mean and standard deviation of the upper teeth were: incisor (1.1343 ± 0.33665); canine (1.1819 ± 0.369); premolar ratio (1.3677 ± 0.3752); molar(1.8030 ± 0.4116). The mean of the lower teeth was: incisor (1.1260 ± 0.3272); canine (1.2106 ± 0.3390); premolar ratio (1.4580 ± 0.3778); molar (1.9068 ± 0.4497).It concludes that the average depth of the gingival sulcus, between the group of teeth was higher in the lower arch relative to the upper; except for faces: incisive distal, buccal molar and the lingual incisor and canine; in which the result related to the average depth is less than the upper arch. (AU)

A sondagem gengival realizada em condições periodontais normais traz importantes resultados para a definição de saúde e doenças dos tecidos periodontais. O objetivo deste estudo foi avaliar a profundidade clínica do sulco gengival em uma dentição jovem. Um estudo transversal foi realizado com 120 voluntários entre 18 e 25 anos com gengiva saudável. Um modelo de Williams de sonda periodontal manual foi utilizado. A avaliação foi realizada nos quatro lados, com um total de quatro medidas por dente. Os dados coletados foram tabulados e submetidos ao teste de KruskalWallis com pós-teste de Dunn. A média e o desvio padrão dos dentes superiores foram: incisivo (1,1343 ± 0,33665); canino (1,1819 ± 0,369); pré molar (1,3677 ± 0,3752); molar (1,8030 ± 0,4116). A média dos dentes inferiores foi: incisivo (1,1260 ± 0,3272); canino (1,2106 ± 0,3390); pré-molar (1,4580 ± 0,3778); molar (1,9068 ± 0,4497). Concluise que a profundidade média do sulco gengival, entre o grupo de dentes, foi maior no arco inferior em relação ao superior; exceto por faces: incisiva distal, molar vestibular e incisivo lingual e canino; em que o resultado relacionado à profundidade média é menor que o arco superior (AU)

Avaliação da síndrome de Burnout em professores universitários / Assessment of Burnout syndrome in university teachers

A profissão docente é considerada pela Organização Internacional do Trabalho como uma das mais estressantes, por ser uma atividade que envolve intenso contato entre pessoas. Com isso, a incidência de elementos que conduzem à síndrome de Burnout está cada vez mais evidente nestes indivíduos. O objetivo desse estudo foi avaliar a síndrome de Burnout entre os professores da graduação dos cursos da área da saúde. Foram convidados a participar da pesquisa docentes dos cursos da área da saúde da Universidade do Oeste Paulista, em Presidente Prudente. Após a assinatura do termo de consentimento livre e esclarecido, foram aplicados dois instrumentos para coleta de dados. Os dados foram tabulados e analisados com o auxílio de programas estatísticos e foi utilizado o teste de correlação de Pearson ao nível de significância de 5%. Foram entrevistados 72 docentes, sendo quedestes, 48 (66,7%) são do sexo masculino e 24 (33,3%) são do sexo feminino. De acordo com as dimensões da síndrome de Burnout, a que mais se destacou foi a exaustão emocional. As variáveis que demostraram significância na correlação de Pearson foram: a quantidade de cursos que o docente leciona (p=0,0012) e a quantidade de alunos com quem tem contato diariamente (p=0,0463) dentro da dimensão de exaustão emocional; e a idade (p=0,0319) e tempo de trabalho (p=0,0082) dentro da dimensão da eficácia profissional. Os resultados identificaram um baixo índice em todas as dimensões, porém houve associação significativa entre as dimensões de exaustão emocional e eficácia profissional com as variáveis sociodemográficas (AU).

The teaching profession is considered by the International Labour Organization (ILO) as one of the most stressful as it is an activity that involves intense contact between people. Thus, an incidence of elements that lead to burnout syndrome is increasingly evident in these professionals. The aim of this study was to evaluate the burnout syndrome among professors of undergraduate health courses. The teachers at health courses at University of Western Sao Paulo were invited to enroll the research. After they given the written informed consent, it was applied two instruments to data collect. The data were analyzed on a statistical software with Pearson's correlation at 5% significance level. It was interviewed 72 professors, of whom 48 (66,7%) were male, and 24 (33,3%) were female. According to the dimensions of Burnout Syndrome, the most outstanding was Emotional Exhaustion. The variables that showed significance in the Pearson's correlation were: the number of courses the professors teach (p = 0.0012) and the number of students with whom they have daily contact (p = 0.0463) within the emotional exhaustion dimension; and age (p = 0.0319) and working time (p = 0.0082) within the dimension of Professional Effectiveness. Results identified a low index in all dimensions, but there was a statistical association between the dimensions of emotional exhaustion and professional efficacy with the sociodemographic variables (AU).

Obesity and periodontitis: systematic review and meta-analysis.

The scope of this study was to conduct a systematic review of the studies on the association between obesity and periodontitis. The methods applied included a literature search strategy and selection of studies using inclusion and exclusion in accordance with the criteria for characteristics of the studies and meta-analysis. The research was conducted in the PubMed, Embase and Lilacs databases through 2010. Selected papers were on studies on humans investigating whether or not obesity is a risk factor for periodontitis. Of the 822 studies identified, 31 studies met the inclusion criteria and were included in this meta-analysis. The risk of periodontitis was associated with obesity (or had a tendency for this) in 25 studies, though it was not associated in 6 studies. The meta-analysis showed a significant association with obesity and periodontitis (OR = 1.30 [95% Confidence Interval (CI), 1.25 - 1.35]) and with mean Body Mass Index (BMI) and periodontal disease (mean difference = 2.75). Obesity was associated with periodontitis, however the risk factors that aggravate these diseases should be better clarified to elucidate the direction of this association. Working with paired samples and avoiding confusion factors may contribute to homogeneity between the studies.

Obesity and periodontitis: systematic review and meta-analysis / Obesidade e periodontite: revisão sistemática e meta-análise

The scope of this study was to conduct a systematic review of the studies on the association between obesity and periodontitis. The methods applied included a literature search strategy and selection of studies using inclusion and exclusion in accordance with the criteria for characteristics of the studies and meta-analysis. The research was conducted in the PubMed, Embase and Lilacs databases through 2010. Selected papers were on studies on humans investigating whether or not obesity is a risk factor for periodontitis. Of the 822 studies identified, 31 studies met the inclusion criteria and were included in this meta-analysis. The risk of periodontitis was associated with obesity (or had a tendency for this) in 25 studies, though it was not associated in 6 studies. The meta-analysis showed a significant association with obesity and periodontitis (OR = 1.30 [95% Confidence Interval (CI), 1.25 - 1.35]) and with mean Body Mass Index (BMI) and periodontal disease (mean difference = 2.75). Obesity was associated with periodontitis, however the risk factors that aggravate these diseases should be better clarified to elucidate the direction of this association. Working with paired samples and avoiding confusion factors may contribute to homogeneity between the studies.

O objetivo deste estudo foi realizar uma revisão sistemática sobre a associação entre obesidade e periodontite. Os métodos aplicados incluíram uma estratégia de busca na literatura, seleção dos estudos por meio dos critérios de inclusão e exclusão de acordo com as características dos estudos e meta-análise. A busca foi realizada nas bases de dados PubMed, EMBASE e LILACS até 2010. Os artigos selecionados foram sobre estudos em humanos, investigando se a obesidade é um fator de risco para periodontite. Dos 822 estudos identificados inicialmente, 31 atendiam aos critérios de inclusão e foram incluídos na metanálise. O risco da periodontite esteve associado com obesidade (ou teve uma tendência para isso) em 25 estudos, sendo que 6 não encontraram esta associação. A meta-análise mostrou uma associação significativa entre obesidade e periodontite. (OR = 1,30 [95% Intervalo de Confiança (IC); 1,25 - 1,35]) e entre o Índice de Massa Corporal (IMC) médio e doença periodontal (diferença nas médias = 2,75). Obesidade esteve associada à periodontite, entretanto os fatores de risco que agravam essas doenças devem ser melhor esclarecidos para elucidar a direção dessa associação. Trabalhar com amostras pareadas e evitar fatores de confusão podem contribuir para a homogeneidade entre os estudos.

Impact of bariatric surgery on oral health conditions: 6-months cohort study.

OBJECTIVES: We evaluate oral health conditions before and after bariatric surgery. METHODS: The sample was composed of 59 patients who had undergone Roux-en-Y gastric bypass (RYGB). Salivary flow, periodontal pocket depth and dental wear were evaluated before and after 6 months of surgery. Body mass index (BMI), C-reactive protein (CRP) and glucose levels were obtained from the patient's medical files. A t-test was used for dependent samples. RESULTS: The mean BMI decreased from 49.31 ± 8.76 to 35.52 ± 8.12 kg/m(2) in 6 months after surgery (P < 0.000). Before surgery, 67% of patients had high levels of CRP and 38% higher blood glucose levels and after surgery there were significant reductions in these levels (P < 0.001). Salivary flow ranged from 0.84 to 0.95 ml/min. There was increased prevalence of periodontal pockets (P = 0.022) and mean pocket depth increased to about 0.5 mm (P < 0.001). The percentage of surfaces with dental wear in dentine was significantly higher after bariatric surgery (P = 0.002), while dental wear in enamel decreased (P = 0.019). CONCLUSIONS: Bariatric surgery may improve systemic conditions. However, it had a negative impact on oral health conditions because of an increase in periodontal disease and dental wear.

Effect of natural gel product on bovine dentin erosion in vitro

Objective: To evaluate the efficacy of Neem (Azadirachta indica) experimental gel for the prevention of erosive wear on bovine dentin, in vitro. Material and Methods: One hundred dentin blocks were allocated into 5 experimental groups (20 samples each): C (control group, without gel); CG (control group, only base gel); F (fluoride gel, 1.23% NaF; pH 4.1, Dentsply; Brazil); N (Neem gel, 10% neem extract; pH 4.1, manipulation); NF (Neem+fluoride gel, 10% Neem extract and 1.23% NaF; pH 4.1, manipulation). The blocks were stored in artificial saliva for 24 hours. After this, they were submitted to six alternating re- and demineralization cycles. The blocks were analyzed for wear (profilometry). The results were submitted to statistical analysis by ANOVA and Tukey tests (P<0.05). Results: The mean wear (±SD, µm) was shown as follows in groups: C (13.09±0.99), CG (10.60±1.99), F (10.90±1.44), N (12.68±1.13) and NF (10.84±1.65). All gels showed some preventive action when compared with control group. However, significant differences were found only between Neem+fluoride gel and fluoride gel. Conclusion: A single application of a neem-containing fluoride gel reduced dentin erosion, thus it is a possible alternative in reducing dental wear. Further research should investigate the action mechanism and the synergism between them. .

Impacto da obesidade na saúde bucal: revisão de literatura / Impact of obesity on oral health: a literature review

As taxas de prevalência e de incidência referentes à obesidade têm se tornado alarmantes, tanto em adultos como em crianças. O acúmulo excessivo de gordura no organismo pode acarretar prejuízos à saúde dos indivíduos. Objetivo: o presente estudo tem como objetivo apresentar uma revisão de literatura sobre a interação da obesidade com a saúde bucal por meio de um estudo ordenado em periódicos de circulação nacional e internacional. Materiais e método: foram encontrados 514 estudos, dentre os quais, foram selecionados 18 artigos, com base nos seguintes critérios: época de publicação, tema adequado ao proposto neste trabalho, ideias claras, objetivas e condizentes com o título do estudo. Resultados: os estudos selecionados mostraram associações entre doença periodontal e obesidade. Já em relação aos trabalhos que associavam cárie dental e obesidade, houve algumas divergências, estando estas em minoria. Conclusão: conclui-se que os pacientes obesos necessitam de atenção em saúde bucal, especialmente em relação à prevenção da doença periodontal e cárie dentária.

Prevalence and incidence rates regarding obesity have become alarming in both adults and children. The excessive fat buildup in the body may lead to health problems of individuals. Objective: this study aims to present a literature review on the interaction between obesity and oral health from a study ordered in journals of national and international circulation. Materials and method: five hundred and fourteen (514) studies were found, among which 18 were selected based on the following criteria: time of publication, proper subject to the proposal of this work, clear, objective and consistent ideas for the title of the study. Results: the selected studies have shown associations between periodontal disease and obesity. There were differences regarding the work that linked obesity to dental caries, but those were the minority. Conclusion: it is concluded that obese patients require oral health care, especially concerning prevention of periodontal disease and dental caries.

Effect of natural gel product on bovine dentin erosion in vitro.

OBJECTIVE: To evaluate the efficacy of Neem (Azadirachta indica) experimental gel for the prevention of erosive wear on bovine dentin, in vitro. MATERIAL AND METHODS: One hundred dentin blocks were allocated into 5 experimental groups (20 samples each): C (control group, without gel); CG (control group, only base gel); F (fluoride gel, 1.23% NaF; pH 4.1, Dentsply; Brazil); N (Neem gel, 10% neem extract; pH 4.1, manipulation); NF (Neem+fluoride gel, 10% Neem extract and 1.23% NaF; pH 4.1, manipulation). The blocks were stored in artificial saliva for 24 hours. After this, they were submitted to six alternating re- and demineralization cycles. The blocks were analyzed for wear (profilometry). The results were submitted to statistical analysis by ANOVA and Tukey tests (P<0.05). RESULTS: The mean wear (±SD, µm) was shown as follows in groups: C (13.09±0.99), CG (10.60±1.99), F (10.90±1.44), N (12.68±1.13) and NF (10.84±1.65). All gels showed some preventive action when compared with control group. However, significant differences were found only between Neem+fluoride gel and fluoride gel. CONCLUSION: A single application of a neem-containing fluoride gel reduced dentin erosion, thus it is a possible alternative in reducing dental wear. Further research should investigate the action mechanism and the synergism between them.

Estudo longitudinal prospectivo sobre problemas bucais em pacientes bariátricos / Prospective longitudinal study of oral problems in bariatric surgery

Esta pesquisa objetivou avaliar as alterações bucais, como cárie dentária, doença periodontal, desgaste dentário e fluxo salivar em pacientes bariátricos. A amostra foi constituída por 21 pacientes obesos submetidos à cirurgia bariátrica e acompanhados após 3 (3M), 6 (6M) e 12 (12M) meses, e por 16 pacientes não obesos submetidos à colecistectomia (GC). As condições bucais avaliadas foram: cárie (CPOD e ICDAS II), doença periodontal (IPC), desgaste dentário (IDD) e o fluxo salivar. Os questionários BAROS e OIDP foram utilizados para verificar a qualidade de vida e o impacto da saúde bucal. Os testes de Mann-Whitney, Friedman, Wilcoxon e Coeficiente de Correlação de Spearman foram aplicados (p<0,05). O CPOD médio foi de 18,0±3,4; 18,7±3,4; 18,9±4,6; 19,0±4,5 e 14,8±7,2 para PRÉ, 3M, 6M, 12M e GC, respectivamente (p>0,05). Após a cirurgia bariátrica os pacientes apresentaram aumento significativo na incidência de lesões cariosas iniciais (PRÉ= 28,6%; 3M= 4,8%; 6M=42,8%; 12M= 71,4%; e GC=75,0%). A condição periodontal não se alterou após a cirurgia bariátrica (bolsa periodontal- PRÉ= 57,1%, 3M= 52,4%; 6M= 38,1%; 12M= 76,2%; GC= 31,2%) (p>0,05). Todos os pacientes apresentaram algum grau de desgaste dentário, sendo que os valores IDD foram PRÉ=1,3±0,2; 3M=1,3±0,3; 6M=1,4±0,3; 12M=1,4±0,3 e GC=1,5±0,3. Incidência e severidade de desgaste dentário aumentaram após a cirurgia bariátrica (p= 0,000). A média do fluxo salivar não sofreu alteração após a cirurgia bariátrica e foi maior quando comparada ao GC (p>0,05). Houve correlação apenas entre redução do fluxo salivar e desgaste dentário no 12M (r= -0,458; p<0,05). De acordo com o protocolo BAROS, os pacientes submetidos à cirurgia bariátrica relataram que sua qualidade de vida melhorou após procedimento cirúrgico, verificou diferença significativa apenas entre os períodos 3M e 12M (p=0,003). Verificou-se que impacto da saúde bucal na qualidade de vida dos pacientes após a cirurgia bariátrica é menor...

The aim of this study was to evaluate oral health changes such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. The sample consisted on 21 obese patients who had been submitted to bariatric surgery and followed up for 3 (3M), 6 (6M) and 12 (12M) months and also on 16 patients not obese submitted to cholecystectomy (CG). Oral conditions evaluated: dental caries (DMFT and ICDAS II), periodontal disease (CPI), dental wear (DWI) and salivary flow. Such BAROS as OIDP surveys were utilized to verify quality of life and oral health impact. Mann-Whitney, Friedman, Wilcoxon and Spearman`s Correlation Coefficient tests were applied (p<0.05). The mean of DMFT was 18.0±3.4; 18.7±3.4; 18.9±4.6; 19.0±4.5; and 14.8±7.2 to PRE, 3M, 6M, 12M and GC respectively (p>0.05). After bariatric surgery, patients presented significant increase in the incidence of initial carious lesions (PRE= 28.6%; 3M= 4.8%; 6M=42.8%; 12M= 71.4%; and GC=75.0%). Periodontal condition did not change after bariatric surgery (periodontal pocket PRE= 57.1%, 3M= 52.4%; 6M= 38.1%; 12M= 76.2%; GC= 31.2%) (p>0.05). All patients presented certain degree of dental wear, considering that the DWI values were PRE=1.3±0.2; 3M=1.3±0.3; 6M=1.4±0.3; 12M=1.4±0.3 and GC=1.5±0.3. Incidence and severity of dental wear have increased after bariatric surgery (p= 0.000). The mean of salivary flow did not change after bariatric surgery and was the same when compared to GC (p>0.05). There was correlation only between salivary flow and dental wear in 12M (r= -0.458; p<0.05). According to BAROS protocol, patients submitted to bariatric surgery reported that quality of life has improved after surgical procedure and significant difference was verified only among 3M and 12M periods (p=0.003). It was verified that oral health impact on patients quality of life after bariatric surgery is minor (PRE= 19.4±31.4; 3M= 5.6±9.1; 6M= 5.4±11.3; 12M= 11.8±23.2) (p>0.05)...

Estudo longitudinal prospectivo sobre problemas bucais em pacientes bariátricos / Prospective longitudinal study of oral problems in bariatric surgery

Esta pesquisa objetivou avaliar as alterações bucais, como cárie dentária, doença periodontal, desgaste dentário e fluxo salivar em pacientes bariátricos. A amostra foi constituída por 21 pacientes obesos submetidos à cirurgia bariátrica e acompanhados após 3 (3M), 6 (6M) e 12 (12M) meses, e por 16 pacientes não obesos submetidos à colecistectomia (GC). As condições bucais avaliadas foram: cárie (CPOD e ICDAS II), doença periodontal (IPC), desgaste dentário (IDD) e o fluxo salivar. Os questionários BAROS e OIDP foram utilizados para verificar a qualidade de vida e o impacto da saúde bucal. Os testes de Mann-Whitney, Friedman, Wilcoxon e Coeficiente de Correlação de Spearman foram aplicados (p<0,05). O CPOD médio foi de 18,0±3,4; 18,7±3,4; 18,9±4,6; 19,0±4,5 e 14,8±7,2 para PRÉ, 3M, 6M, 12M e GC, respectivamente (p>0,05). Após a cirurgia bariátrica os pacientes apresentaram aumento significativo na incidência de lesões cariosas iniciais (PRÉ= 28,6%; 3M= 4,8%; 6M=42,8%; 12M= 71,4%; e GC=75,0%). A condição periodontal não se alterou após a cirurgia bariátrica (bolsa periodontal- PRÉ= 57,1%, 3M= 52,4%; 6M= 38,1%; 12M= 76,2%; GC= 31,2%) (p>0,05). Todos os pacientes apresentaram algum grau de desgaste dentário, sendo que os valores IDD foram PRÉ=1,3±0,2; 3M=1,3±0,3; 6M=1,4±0,3; 12M=1,4±0,3 e GC=1,5±0,3. Incidência e severidade de desgaste dentário aumentaram após a cirurgia bariátrica (p= 0,000). A média do fluxo salivar não sofreu alteração após a cirurgia bariátrica e foi maior quando comparada ao GC (p>0,05). Houve correlação apenas entre redução do fluxo salivar e desgaste dentário no 12M (r= -0,458; p<0,05). De acordo com o protocolo BAROS, os pacientes submetidos à cirurgia bariátrica relataram que sua qualidade de vida melhorou após procedimento cirúrgico, verificou diferença significativa apenas entre os períodos 3M e 12M (p=0,003). Verificou-se que impacto da saúde bucal na qualidade de vida dos pacientes após a cirurgia bariátrica é menor...

The aim of this study was to evaluate oral health changes such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. The sample consisted on 21 obese patients who had been submitted to bariatric surgery and followed up for 3 (3M), 6 (6M) and 12 (12M) months and also on 16 patients not obese submitted to cholecystectomy (CG). Oral conditions evaluated: dental caries (DMFT and ICDAS II), periodontal disease (CPI), dental wear (DWI) and salivary flow. Such BAROS as OIDP surveys were utilized to verify quality of life and oral health impact. Mann-Whitney, Friedman, Wilcoxon and Spearman`s Correlation Coefficient tests were applied (p<0.05). The mean of DMFT was 18.0±3.4; 18.7±3.4; 18.9±4.6; 19.0±4.5; and 14.8±7.2 to PRE, 3M, 6M, 12M and GC respectively (p>0.05). After bariatric surgery, patients presented significant increase in the incidence of initial carious lesions (PRE= 28.6%; 3M= 4.8%; 6M=42.8%; 12M= 71.4%; and GC=75.0%). Periodontal condition did not change after bariatric surgery (periodontal pocket PRE= 57.1%, 3M= 52.4%; 6M= 38.1%; 12M= 76.2%; GC= 31.2%) (p>0.05). All patients presented certain degree of dental wear, considering that the DWI values were PRE=1.3±0.2; 3M=1.3±0.3; 6M=1.4±0.3; 12M=1.4±0.3 and GC=1.5±0.3. Incidence and severity of dental wear have increased after bariatric surgery (p= 0.000). The mean of salivary flow did not change after bariatric surgery and was the same when compared to GC (p>0.05). There was correlation only between salivary flow and dental wear in 12M (r= -0.458; p<0.05). According to BAROS protocol, patients submitted to bariatric surgery reported that quality of life has improved after surgical procedure and significant difference was verified only among 3M and 12M periods (p=0.003). It was verified that oral health impact on patients quality of life after bariatric surgery is minor (PRE= 19.4±31.4; 3M= 5.6±9.1; 6M= 5.4±11.3; 12M= 11.8±23.2) (p>0.05)...

Evaluation of an Experimental Gel Containing Euclea natalensis: An In Vitro Study.

Objective. To evaluate the effect of an experimental gel containing Euclea natalensis extract on dentin permeability. Methods. Thirty-six dentin discs, 1-mm-thick. The discs were prepared from the coronal dentin of extracted human third molars that were divided into 3 groups (n = 10). The dentin discs in each group were treated with the groups following experimental materials: (FG): 1.23% fluoride gel, pH 4.1; (EG): Euclea natalensis extract gel, pH 4.1; (CG): control gel, pH 4.1. The gels were applied to the occlusal slide of the dentin under the following conditions: after 37% phosphoric acid and before 6% citric acid. The hydraulic conductance (HC) of each condition was determined four times using a fluid flow apparatus (Flodec). The data were analyzed using Two-way ANOVA and Tukey's test (P < 0.05). Results. The greatest mean reduction in HC was produced in group EG dentin discs (61.2%; P < 0.05). Even after acid challenge with 6% citric acid the great reduction occurred in group EG (66.0%; P < 0.05) than other groups (CG-77.1%, FG-90.8%). Conclusion. E. natalensis gel not only reduced dentin permeability, but also resisted posttreatment citric acid challenge without changing its permeability. Further research has to confirm this promising result in the clinical situation.

Alveolar bone loss and periodontal status in a bariatric patient: a brief review and case report.

To review the effects of obesity surgery on oral health and to present a case report of the periodontal condition of an obese woman who underwent bariatric surgery. A search of studies related to bariatric surgery and oral health was made in PubMed. For case report, BMI, salivary flow, and periodontal condition were evaluated during three different periods. The oral health problems found were dental wear, periodontal diseases, xerostomia, and dental caries. The patient who was evaluated before bariatric surgery and was followed up for 2 years, lost 40.4 kg, presented normal blood glucose levels and controlled hypertension without medication. Salivary flow remained of equal value in the first year, there was an increase in mean probing depth and there existed low bone density in these sites. Patients who have undergone bariatric surgery need to be closely monitored after surgery to prevent the development of oral complications, especially periodontal conditions.

Interfaces between bariatric surgery and oral health: a longitudinal survey.

PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54), up after 3 months (n=24) and 6 months (n=16). METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p<0.05). RESULTS: DMFT was 17.6 ± 5.7, 18.4 ± 4.1 and 18.3 ± 5.5 (P>0.05), presence of periodontal pockets in 50%, 58% and 50% of patients (p>0.05), tooth wear in dentin present in 81.5%, 87.5% and 87.5% before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012). Salivary flow was 0.8 ± 0.5 ml/min before surgery, 0.9 ± 0.5 ml/min for 3 months and 1.1 ± 0.5m/min for 6 months (p>0.05). The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029). CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.

Effect of propolis gel on the in vitro reduction of dentin permeability.

OBJECTIVE: The aim of this study was to evaluate the capacity of potassium oxalate, fluoride gel and two kinds of propolis gel to reduce the hydraulic conductance of dentin, in vitro. MATERIAL AND METHODS: The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on a model proposed in literature. Thirty-six 1-mm-thick dentin discs, obtained from extracted human third molars were divided into 4 groups (n=9). The groups corresponded to the following experimental materials: GI-10% propolis gel, pH 4.1; GII-30% propolis gel; GIII-3% potassium oxalate gel, pH 4,1; and GIV-1.23% fluoride gel, pH 4.1, applied to the dentin under the following surface conditions: after 37% phosphoric acid and before 6% citric acid application. The occluding capacity of the dentin tubules was evaluated using scanning electron microscopy (SEM) at ×500, ×1,000 and ×2,000 magnifications. Data were analyzed statistically by two-way ANOVA and Tukey's test at 5% significance level. RESULTS: Groups I, II, III, IV did not differ significantly from the others in any conditions by reducing in hydraulic conductance. The active agents reduced dentin permeability; however they produced the smallest reduction in hydraulic conductance when compared to the presence of smear layer (P<0.05). The effectiveness in reducing dentin permeability did not differ significantly from 10% or 30% propolis gels. SEM micrographs revealed that dentin tubules were partially occluded after treatment with propolis. CONCLUSIONS: Under the conditions of this study, the application of 10% and 30% propolis gels did not seem to reduce the hydraulic conductance of dentin in vitro, but it showed capacity of partially obliterating the dentin tubules. Propolis is used in the treatment of different oral problems without causing significant great collateral effects, and can be a good option in the treatment of patients with dentin sensitivity.

Effect of iron gel on dentin permeability.

This study evaluated in vitro the effect of an experimental gel containing iron on the reduction of hydraulic conductance of dentin. Thirty-six 1-mm-thick dentin discs obtained from extracted human third molars were divided into 3 groups of 10 specimens each. The groups corresponded to the following experimental materials: 1.23% acidulated phosphate fluoride gel, pH 4.1; 3% potassium oxalate gel, pH 4.1 (Oxa-Gel®); and iron sulfate gel (10 mmol/L FeSO4), pH 4.1. The gels were applied to dentin under the following conditions: after 37% phosphoric acid and before 6% citric acid. Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. There was no significant differences (p<0.05) among the groups in any of the conditions for hydraulic conductance reduction, except for smear layer presence. The active agents reduced dentin permeability, but they produced significantly lower (p<0.05) reduction in hydraulic conductance when compared to presence of smear layer. The effectiveness in reducing dentin permeability was not significantly different (p>0.05) among the gels. This study suggests that the iron gel promoted reduction in dentin permeability comparable to that of the other agents and thus may be considered a good clinical alternative for the treatment of dentin hypersensitivity.

Effect of propolis gel on the in vitro reduction of dentin permeability

OBJECTIVE: The aim of this study was to evaluate the capacity of potassium oxalate, fluoride gel and two kinds of propolis gel to reduce the hydraulic conductance of dentin, in vitro. MATERIAL AND METHODS: The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on a model proposed in literature. Thirty-six 1-mm-thick dentin discs, obtained from extracted human third molars were divided into 4 groups (n=9). The groups corresponded to the following experimental materials: GI-10 percent propolis gel, pH 4.1; GII-30 percent propolis gel; GIII-3 percent potassium oxalate gel, pH 4,1; and GIV-1.23 percent fluoride gel, pH 4.1, applied to the dentin under the following surface conditions: after 37 percent phosphoric acid and before 6 percent citric acid application. The occluding capacity of the dentin tubules was evaluated using scanning electron microscopy (SEM) at ×500, ×1,000 and ×2,000 magnifications. Data were analyzed statistically by two-way ANOVA and Tukey's test at 5 percent significance level. RESULTS: Groups I, II, III, IV did not differ significantly from the others in any conditions by reducing in hydraulic conductance. The active agents reduced dentin permeability; however they produced the smallest reduction in hydraulic conductance when compared to the presence of smear layer (P<0.05). The effectiveness in reducing dentin permeability did not differ significantly from 10 percent or 30 percent propolis gels. SEM micrographs revealed that dentin tubules were partially occluded after treatment with propolis. CONCLUSIONS: Under the conditions of this study, the application of 10 percent and 30 percent propolis gels did not seem to reduce the hydraulic conductance of dentin in vitro, but it showed capacity of partially obliterating the dentin tubules. Propolis is used in the treatment of different oral problems without causing significant great collateral effects, and can be a good option in the treatment of patients with dentin sensitivity.

Interfaces between bariatric surgery and oral health: a longitudinal survey / Interface entre cirurgia bariátrica e saúde bucal: estudo longitudinal

PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54), up after 3 months (n=24) and 6 months (n=16). METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p<0.05). RESULTS: DMFT was 17.6±5.7, 18.4±4.1 and 18.3±5.5 (P>0.05), presence of periodontal pockets in 50 percent, 58 percent and 50 percent of patients (p>0.05), tooth wear in dentin present in 81.5 percent, 87.5 percent and 87.5 percent before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012). Salivary flow was 0.8±0.5 ml/min before surgery, 0.9±0.5 ml/min for 3 months and 1.1±0.5m/min for 6 months (p>0.05). The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029). CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.

OBJETIVO: Avaliar alterações bucais, como cárie dentária, doença periodontal, desgaste dentário e fluxo salivar, em pacientes bariátricos. MÉTODOS: Cinquenta e quatro pacientes obesos, submetidos à cirurgia bariátrica, tiveram suas condições bucais avaliadas antes (n=54), aos 3 meses (n=24) e aos 6 meses (n=16) após a cirurgia bariátrica. Os índices para avaliação das condições bucais foram: CPOD, IPC, IDD e o volume de fluxo salivar. O questionário OIDP foi utilizado para verificar o impacto da saúde bucal na qualidade de vida. ANOVA e correlação de Spearman foram utilizados para análise estatística (p<0,05). RESULTADOS: CPOD foi 17,6±5,7, 18,4±4,1 e 18,3±5,5 (p>0,05), bolsa periodontal foi encontrada em 50 por cento, 58 por cento e 50 por cento dos pacientes (p>0,05) e o desgaste dentário em dentina em 81,5 por cento, 87,5 por cento e 87,5 por cento dos pacientes, respectivamente antes, 3 meses e 6 meses após a cirurgia bariátrica. Houve diferença significativa entre os três períodos estudados, quanto à prevalência e à severidade do desgaste dentário (p=0,012). O fluxo salivar foi 0,8±0,5 ml/min antes, 0,9±0,5 ml/min aos 3 e 1,1±0,5 ml/min aos 6 meses após cirurgia (p>0,05). O impacto da saúde bucal na qualidade de vida diminuiu com o tempo decorrido após cirurgia bariátrica (p=0,029). CONCLUSÕES: As mudanças no estilo de vida após a cirurgia bariátrica podem aumentar a gravidade de problemas bucais pré-existentes. Entretanto, esta alteração na condição bucal pode não influenciar a qualidade de vida.

Effect of iron gel on dentin permeability

This study evaluated in vitro the effect of an experimental gel containing iron on the reduction of hydraulic conductance of dentin. Thirty-six 1-mm-thick dentin discs obtained from extracted human third molars were divided into 3 groups of 10 specimens each. The groups corresponded to the following experimental materials: 1.23 percent acidulated phosphate fluoride gel, pH 4.1; 3 percent potassium oxalate gel, pH 4.1 (Oxa-Gel®); and iron sulfate gel (10 mmol/L FeSO4), pH 4.1. The gels were applied to dentin under the following conditions: after 37 percent phosphoric acid and before 6 percent citric acid. Data were analyzed statistically by ANOVA and Tukey's test at 5 percent significance level. There was no significant differences (p<0.05) among the groups in any of the conditions for hydraulic conductance reduction, except for smear layer presence. The active agents reduced dentin permeability, but they produced significantly lower (p<0.05) reduction in hydraulic conductance when compared to presence of smear layer. The effectiveness in reducing dentin permeability was not significantly different (p>0.05) among the gels. This study suggests that the iron gel promoted reduction in dentin permeability comparable to that of the other agents and thus may be considered a good clinical alternative for the treatment of dentin hypersensitivity.

Este estudo objetivou avaliar in vitro o efeito do gel experimental contendo ferro na redução da condutividade hidráulica na dentina. Trinta e seis discos de dentina humana de 1 mm de espessura, foram obtidos de terceiros molares extraídos divididos em 3 grupos de 10 espécimes cada. Os grupos foram divididos nos seguintes grupos experimentais: F- flúor gel a 1,23 por cento, pH 4,1; O- gel de oxalato de potássio a 3 por cento, pH 4,1; I- gel de sulfato ferroso FeSO4 a 10 mmol/L, pH 4,1. Os géis foram aplicados na dentina sob as diferentes condições: após o ácido fosfórico a 37 por cento a antes do ácido cítrico a 6 por cento. Os resultados foram analisados por ANOVA e teste de Tukey, com nível de significância de 5 por cento. Todos os grupos (gel de flúor, oxalato de potássio e gel de ferro) não apresentaram diferenças significativas entre si para todas as condições testadas, exceto na presença da smear layer (p<0,05). Os produtos utilizados reduziram a permeabilidade dentinária, entretanto apresentaram baixa redução quando comparados à smear layer (p<0,05). Não houve diferença significativa na efetividade dos géis testados para reduzir a permeabilidade dentinária (p<0,05). Este estudo sugere que o gel de ferro promoveu redução na permeabilidade dentinária comparável à dos outros agentes e, portanto, pode ser considerada uma boa alternativa clínica para o tratamento da hipersensibilidade dentinária.