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1.
Oral Dis ; 26(2): 447-456, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31742816

RESUMO

OBJECTIVE: The aim of this cross-sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients. MATERIALS AND METHODS: Demographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full-mouth six-sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m2 ) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS: Patients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25-6.62) and 3.4 (95% CI: 1.27-9.09) times higher risk of being in stages 4 and 5 of CKD, respectively. Having ≥ 2 teeth with clinical attachment loss (CAL) ≥6 mm increased 3.9 times the risk of being in stage 5 of CKD. Patients with severe periodontitis and ≥2 teeth with CAL ≥ 6 mm had 4.4 ml/min/1.732 and 5.2 ml/min/1.732 lower eGFR (p-values < .05), respectively. CONCLUSION: Severe periodontitis was associated with poor renal conditions in predialytic CKD patients, strengthening the importance of periodontal evaluation in such patient population.

2.
J Periodontol ; 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31799694

RESUMO

BACKGROUND: The combination of probiotics and prebiotics might be useful to treat oral halitosis. The aim of this study was to assess the effect of Lactobacillus salivarius G60 (LS) and inulin on oral halitosis and tongue coating. METHODS: In this double-masked, randomized, phase II clinical trial, 45 patients (aged 35 ± 15 years, 66% female) with oral halitosis and tongue coating were allocated to three treatment groups (n = 15) using gums of oral dissolution (one gum every 12 hours) for 10 days. Each gum contained LS (1 billion colony forming units [CFUs]) + inulin (1 g), LS (1 billion CFU) or placebo. Primary outcomes were organoleptic test, Halimeter, and tongue coating, whereas secondary outcomes were quality of life (QOL) and treatment safety. Generalized linear models were used, adjusting for age and sex. In vitro tests were performed to verify whether LS interacts with inulin and whether LS inhibits the growth of Porphyromonas gingivalis and Prevotella intermedia. RESULTS: Forty-four patients (97%) completed the study. Patients treated with LS + inulin showed greater reduction in halitosis measured by Halimeter compared with placebo (adjusted post-intervention average: 96.7 versus 142.5 ppb; P = 0.003), whereas LS and placebo did not differ (115.7 versus 142.5 ppb; P = 0.097). Organoleptic measurements and coating index showed a similar decrease for all groups. QOL improved in patients treated with LS + inulin compared with placebo (P = 0.029). Side effects were mild and transient in all groups. LS did not metabolize inulin but inhibited the growth of P. gingivalis and P. intermedia after 72 hours. CONCLUSIONS: Treatment with L. salivarius G60 combined or not with inulin showed significant decrease in the outcomes organoleptic test, Halimeter, and coating index, improving oral halitosis. However, no significant difference was obtained between the groups.

3.
Braz Oral Res ; 33(suppl 1): e074, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576958

RESUMO

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.


Assuntos
Interface Osso-Implante , Implantes Dentários/efeitos adversos , Peri-Implantite/prevenção & controle , Periodontite/prevenção & controle , Estomatite/prevenção & controle , Interface Osso-Implante/diagnóstico por imagem , Placa Dentária/prevenção & controle , Humanos , Higiene Bucal , Peri-Implantite/etiologia , Índice Periodontal , Periodontite/etiologia , Radiografia Dentária , Fatores de Risco , Estomatite/etiologia
4.
Braz Oral Res ; 33: e090, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31531553

RESUMO

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


Assuntos
Gengivite/epidemiologia , Gengivite/etiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Índice de Placa Dentária , Feminino , Hemorragia Gengival/epidemiologia , Hemorragia Gengival/etiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Prevalência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , América do Sul/epidemiologia , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
5.
Oxid Med Cell Longev ; 2019: 9187978, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428231

RESUMO

This systematic review with meta-analysis aimed to evaluate the effect of antioxidants as an adjuvant in periodontitis treatment. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane, Lilacs, OpenGrey, and Google Scholar. Based on the PICO strategy, the inclusion criteria comprised interventional studies including periodontitis patients (participants) treated with conventional therapy and antioxidants (intervention) compared to patients treated only with conventional therapy (control) where the periodontal response (outcome) was evaluated. The risk of bias was evaluated using the Cochrane RoB tool (for randomized studies) and ROBINS-I tool (for nonrandomized studies). Quantitative data were analyzed in five random effects meta-analyses considering the following periodontal parameters: clinical attachment loss (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing depth (PD). After all, the level of certainty was measured with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool. Among the 1884 studies identified, only 15 interventional studies were according to the eligibility criteria and they were included in our review. From them, 4 articles presented a high risk of bias. The meta-analysis showed a statistically significant difference for CAL (SMD 0.29 (0.04, 0.55), p = 0.03, I 2 = 13%), PI (SMD 0.41 (0.18, 0.64), p = 0.0005, I 2 = 47%), and BOP (SMD 0.55 (0.27, 0.83), p = 0.0001, I 2 = 0%). The GRADE tool showed a moderate to high certainty in the quality of evidence depending on the clinical parameter and antioxidants used. These results suggest that the use of antioxidants is an adjunct approach to nonsurgical periodontal therapy which may be helpful in controlling the periodontal status.


Assuntos
Antioxidantes/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Catequina/análogos & derivados , Catequina/uso terapêutico , Periodontite Crônica/patologia , Bases de Dados Factuais , Hemorragia , Humanos , Índice Periodontal , Espécies Reativas de Oxigênio/metabolismo
6.
J Forensic Sci ; 64(6): 1693-1697, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31237698

RESUMO

The purpose of expert reports is to support the judge in his decisions, by providing technical information. However, it remains uncertain as to what extent the content of these reports is used, and if they are effectively associated with judicial decisions. The aim of this study was to perform a qualitative analysis of case reports in relation to the judicial decisions rendered in association with these reports, by determining the connection between causal nexus and aspects of fault. The case reports included lawsuits against dentists, issued by the Medical Justice Department of the State Court of Appeals of Rio Grande do Sul, Brazil, between 2010 and 2013. Comparing the percentage of agreement between case report and judicial decision, causal nexus was 79.9% and fault was 86.7%. The high percentages of agreement found in relation to fault and causal nexus highlight the relevance of expert reports in weighing the judge's decision.


Assuntos
Odontólogos , Responsabilidade Legal , Imperícia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Brasil , Humanos
7.
Front Physiol ; 10: 234, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949062

RESUMO

Background: Regular physical activity boosts several physical capacities and reduces many inflammatory markers of several diseases. In this sense, periodontal disease is a multifactorial inflammatory disease of tooth supporting tissues that has been claimed to trigger processes of systemic alterations. The aim of this systematic review and meta-analysis was to assess the effects of physical activity on periodontal disease. Methods: Observational studies published until August 2018 were searched in online databases (PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar) after developing a PECO statement that focused on the comparison between adults that followed a routine of exercises or presented a sedentary lifestyle and its effects on periodontal disease. Searching and data extraction were conducted by following PRISMA guidelines. Registration protocol: CRD42016049661. Quality assessment and risk of bias were analyzed by following Fowkes and Fulton protocol. Results: A total of 512 references were retrieved, while only seven were considered eligible. Two meta-analysis involving the prevalence of periodontal disease and unadjusted/adjusted Odds ratio were performed. One of studies did not find association between clinical periodontal parameters and physical activity. Six articles suggested an association between periodontal disease and regular practice of physical activity since a reduction of periodontal prevalence was observed. Moderate level of evidence was demonstrated on GRADE analysis. Conclusion: Physical activity was associated as a potential tool for reduction of periodontal disease prevalence. The frequency of physical activity is directly related to a low occurrence of periodontitis. However, it is important that further investigations evaluate the effects of other exercise variables, such as volume and intensity, on the periodontal disease prevalence.

8.
Braz Dent J ; 30(1): 12-21, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30864641

RESUMO

This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Heparina de Baixo Peso Molecular/farmacologia , Adipócitos/citologia , Animais , Relação Dose-Resposta a Droga , Heparina de Baixo Peso Molecular/administração & dosagem , Masculino , Megacariócitos/citologia , Ratos , Ratos Wistar
9.
Braz. dent. j ; 30(1): 12-21, Jan.-Feb. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-989433

RESUMO

Abstract This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.


Resumo O presente estudo objetivou verificar o efeito da heparina de baixo peso molecular (HBPM) sob a perda óssea alveolar (POA), contagem de células sanguíneas, megacariócitos e adipócitos em ratos Wistar machos. Quarenta ratos Wistar de 60 dias foram randomicamente divididos em quatro grupo: Controle (C), Doença Periodontal (DP), Heparina (Hp) e Heparina + Doença Periodontal (Hp+DP). HBPM foi aplicada durante 60 dias em doses de 1 mL/kg/dia. Coletas sanguíneas foram realizadas nos dias 0, 30 e 60. No dia 49, os grupos DP e Hp+DP receberam indução de doença periodontal por ligadura ao redor do segundo molar superior direito. No lado esquerdo, verificou-se perda óssea alveolar espontânea. A média de POA no lado com ligadura mostrou-se estatisticamente diferente entre os grupos C (0,35±0,07 mm) e Hp+PD (0,49±0,09 mm) (p<0,001), entre os grupos DP (0,55±0,11 mm) e Hp (0,32±0,06 mm) (p<0,001) e entre os grupos Hp e Hp+DP (p<0,001). Nenhuma diferente significativa foi observada entre os grupos no lado sem ligadura. Peso dos animais, consumo de ração e ingestão de água não mostraram diferenças significativas entre os grupos. Megacariócitos e adipócitos foram contados por microscopia óptica e nenhuma diferença significativa foi encontrada. Dentro dos grupos, houve um aumento e uma diminuição, respectivamente, na contagem de linfócitos (p=0,005 no grupo C e p=0,009 no grupo Hp+DP somente) e leucócitos (p=0,003 no grupo C, p=0.001 no grupo DP e p=0,002 no grupo Hp e Hp+DP). Não houve diminuição no número de plaquetas nos três períodos de coleta. HBPM não foi capaz de modificar a POA, porém modificou a contagem de células sanguíneas, especialmente aumentando o número de linfócitos.

11.
Int Dent J ; 69(3): 171-182, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30152076

RESUMO

BACKGROUND: Toothbrushing might be associated with the development of soft tissue lesions. This systemic review aimed to examine soft tissue lesions caused by different bristle stiffnesses and bristle end-shapes in manual toothbrushes in adult individuals. MATERIALS AND METHODS: Scopus, EMBASE and PubMed databases were searched to find controlled trials that evaluated manual toothbrush bristle stiffness and/or end-shape in regard to soft tissue safety. The grey literature was also included in the search strategy. Two reviewers independently performed the screening, final selection and data extraction. To be included, studies had to have been performed using at least two manual toothbrushes differing in bristle stiffness and/or end-shape, and had to report any adverse effects on oral soft tissues after at least 7 days of follow-up. A meta-ethnography strategy was used for qualitative data synthesis. The Cochrane Collaboration tool was assessed to evaluate the risk of bias. RESULTS: Thirteen studies were included from the 1,945 initially retrieved. Toothbrush bristle end-shape was investigated in six studies, bristle stiffness in two, and both features were investigated in five studies. Hard-bristle toothbrushes produced more gingival lesions than medium- and soft-bristle brushes. A slight gingival recession width increase was identified in the end-rounded group, compared with the tapered group. Only four studies presented adverse effects as the primary outcome. CONCLUSION: Soft and extra-soft toothbrushes tend to be safer. Oral soft tissue injuries are similar for both tapered and end-rounded bristles. Further studies investigating adverse effects as a primary outcome are recommended.


Assuntos
Retração Gengival , Escovação Dentária , Adulto , Ensaios Clínicos Controlados como Assunto , Desenho de Equipamento , Gengiva , Dureza , Humanos
12.
Clin Oral Investig ; 23(6): 2659-2666, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30327951

RESUMO

OBJECTIVE: The aim of the study was to perform a systematic review of the literature regarding the adjuvant effects of metformin on the results of mechanical periodontal treatment. METHODS: First, a search on the PubMed, EMBASE, and Scopus databases was performed up to March 2018. Randomized clinical trials with at least 3 months of follow-up and using metformin associated with mechanical periodontal treatment were included in the review. As comparison group, mechanical or periodontal therapy alone or in combination with placebo. The studies should involve adults with at least 30 years of age diagnosed with chronic periodontitis. For the evaluation of the risk of bias of the articles, the Cochrane Collaboration tool was used. RESULTS: Studies (1912) were retrieved and 4 were included in the review. The articles are all from the same research center and used metformin in gel at concentrations of 0.5%, 1%, or 1.5%. The majority of included studies presented low risk of bias. A linear meta-analysis was conducted for probing depth and clinical attachment loss outcomes. The results showed a weighted mean difference of 2.12 mm (95% CI 1.83-2.42) and 2.29 mm (95% CI 1.72-2.86) for probing depth and clinical attachment level, respectively, favoring the group exposed to 1% adjunct metformin. CONCLUSION: The adjuvant use of metformin may promote an additional benefit to the results of mechanical periodontal therapy. CLINICAL SIGNIFICANCE: The metformin as an adjuvant on periodontal treatment shows potential to reduce needs of additional interventions and also reduces the inflammatory burden in patients.


Assuntos
Periodontite Crônica/terapia , Raspagem Dentária , Metformina/uso terapêutico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Braz. oral res. (Online) ; 33: e090, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1039308

RESUMO

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

14.
Braz. oral res. (Online) ; 33(supl.1): e074, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1039314

RESUMO

Abstract Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

15.
J Clin Periodontol ; 45(10): 1222-1237, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30076616

RESUMO

AIM: To systematically review the literature about the effect of periodontal treatment on oxidative stress (OxS) biomarkers. MATERIAL AND METHODS: Three databases (PubMed, EMBASE, and Scopus) were searched up to February 2018. Clinical trials with a follow-up of at least 6 weeks after mechanical periodontal treatment were included. Due to the high heterogeneity among the units and indices of measurements used in the studies, a meta-analysis was not performed. RESULTS: Overall, 3,199 studies were retrieved, of which 20 were included. Four studies were randomized clinical trials (RCT), and 16 studies were non-RCTs. The most common OxS biomarkers used were 8-hydroxydeoxiguanosine (8-OHdG), total oxidant status (TOS), and total antioxidant status (TAS). After treatment, most of the studies reported a decrease in 8-OHdG concentration in the gingival crevicular fluid (GCF) and saliva. In addition, the salivary concentration of this biomarker was similar to periodontally healthy patients. Periodontal therapy was effective in reducing TOS in GCF, saliva, and serum in most studies. TAS, however, responded inconsistently to the periodontal intervention. CONCLUSION: Periodontal therapy reduces the levels of OxS biomarkers, even to values similar to those found in periodontally healthy individuals. Additional RCTs are warranted, as the information is mainly based on nonrandomized studies.


Assuntos
Periodontite Crônica , Biomarcadores , Líquido do Sulco Gengival , Humanos , Estresse Oxidativo , Perda da Inserção Periodontal , Índice Periodontal , Saliva
16.
BrJP ; 1(3): 223-230, July-Sept. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1038951

RESUMO

ABSTRACT BACKGROUND AND OBJECTIVES: To assess the prevalence of temporomandibular dysfunction symptoms and the associated factors in the elderly of a city in southern Brazil. METHODS: A cross-sectional observational study performed in residential homes, with probabilistic cluster sample, interviewed and examined 287 seniors aged from 65 to 74 years in the city of Cruz Alta, state of Rio Grande do Sul, Brazil. The Fonseca Anamnestic Index was used for temporomandibular dysfunction analysis, as well as a structured questionnaire for socioeconomic conditions and an oral health clinical examination. Either Chi-square or Mann-Whitney tests assessed associations between the dependent and independent variables and presented by frequency distribution. Uni- and multivariate analyses were performed to verify the association between temporomandibular dysfunction risk and explanatory variables. For all statistical analyses, a 5% significance level was adopted. RESULTS: The prevalence of temporomandibular dysfunction symptoms was 55.1%. In the final multivariate model, age ≥70 years (RP=0.674; 95% CI: 0.516 - 0.881) showed as a protection factor against temporomandibular dysfunction, and the average of tooth loss (RP=1.022; 95% CI: 1.004 - 1.039) showed as a risk factor for temporomandibular dysfunction in relation to their respective controls. CONCLUSION: The findings of the present study showed a high prevalence of temporomandibular dysfunction symptoms. Age and tooth loss were associated with higher risk of temporomandibular dysfunction. The results suggested the need for improvement in oral health conditions of the elderly and the importance of further epidemiological studies about temporomandibular dysfunction in this population.


RESUMO JUSTIFICATIVA E OBJETIVOS: Avaliar a gravidade dos sintomas de disfunção temporomandibular e seus fatores em idosos de uma cidade do sul do Brasil. MÉTODOS: Estudo observacional transversal de domicílios residenciais, com amostra probabilística por conglomerado, entrevistou e examinou 287 idosos, com idade entre 65 e 74 anos da cidade Cruz Alta, estado do Rio Grande do Sul, Brasil. O Índice Anamnésico de Fonseca foi utilizado para avaliação da disfunção temporomandibular, além de um questionário estruturado para condições socioeconômicas e um exame clínico de saúde bucal. As associações entre a variável dependente e a independente foram avaliadas pelos testes de Qui-quadrado ou Mann-Whitney, apresentadas por meio da distribuição de frequências. As análises uni e multivariada foram realizadas para verificar a associação entre a disfunção temporomandibular e as variáveis exploratórias. Para todas as análises, o nível de significância foi de 5%. RESULTADOS: A prevalência de sintomas de disfunção temporomandibular foi de 55,1%. No modelo multivariado final, a idade ≥70 anos (RP=0,674; 95% IC: 0,516 - 0,881) apresentou-se como fator de proteção para disfunção temporomandibular e a média de perda dentária (RP=1,022; 95% IC: 1,004 - 1,039) apresentou-se como fator de risco para disfunção temporomandibular em relação a seus respectivos controles. CONCLUSÃO: Os resultados demonstraram alta prevalência de sintomas de disfunção temporomandibular. A idade e a média de perda dentária foram associadas à disfunção temporomandibular. Os resultados sugerem melhorias nas condições de saúde bucal dos idosos e a importância de estudos epidemiológicos sobre disfunção temporomandibular nessa população.

17.
J Evid Based Dent Pract ; 18(2): 110-118, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29747791

RESUMO

OBJECTIVE: This study aimed to describe the trends in dentistry article reviews as well as to compare citation patterns between systematic and narrative reviews. METHODS: A search strategy was developed, in Scopus database, in order to identify all narrative and systematic reviews published between 2000 and 2015. Original research studies, letters to the editor, editorials, book chapters, and case reports were excluded. From the list of studies available, 30 reviews per year were randomly chosen. The review type, year of publication, number of authors, country of the first author, open access, language, main topic of interest, journal's H index, number of references, and number of citations were extracted by 2 researchers. The number of citations was extracted from the Scopus database. Multivariable regression analysis was used in order to detect the association between citation rate and the independent variables. RESULTS: Overall, 118 and 362 systematic and narrative reviews were included in this study. Throughout the years, the number of systematic reviews has increased from 5.8% to 53.3%. However, the mean number of citations has significantly decreased, and this is affected by the review's year of publication. A trend for lower citation in systematic reviews (Relative risk [RR]: 0.79; 95% confidence interval: 0.75-0.84) has been demonstrated; however, the number of citations of narrative reviews has been increasing over the years (RR: 1.14; 95% confidence interval: 1.08-1.21). CONCLUSION: From 2000 to 2015, the number of systematic reviews increased substantially. On the other hand, a trend for lower citations of these studies has been observed that is affected over time.


Assuntos
Bibliometria , Odontologia , Humanos , Revisão Sistemática como Assunto
18.
Braz Oral Res ; 32: e22, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29723334

RESUMO

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


Assuntos
Inquéritos de Saúde Bucal/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Saúde Bucal/estatística & dados numéricos , Higiene Bucal/estatística & dados numéricos , Autorrelato , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Argentina/epidemiologia , Brasil/epidemiologia , Chile/epidemiologia , Cidades/epidemiologia , Estudos Transversais , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores Sexuais , Escovação Dentária/estatística & dados numéricos , Adulto Jovem
19.
J Periodontol ; 89(4): 388-396, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29603230

RESUMO

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


Assuntos
Gengivite , Tecido Adiposo , Adulto , Índice de Massa Corporal , Brasil , Estudos Transversais , Humanos
20.
Clin Oral Investig ; 22(2): 671-687, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29396642

RESUMO

OBJECTIVE: This study aimed to systematically review clinical trials about the effect of statins as adjunct to mechanical periodontal therapy, on probing pocket depth, clinical attachment level, and intrabony defects, in comparison to mechanical periodontal therapy alone or in association with placebo. MATERIAL AND METHODS: Three databases were searched for controlled clinical trials that used any locally delivered or systemically statin as a sole adjunctive therapy to mechanical periodontal treatment. Weighted mean differences between baseline and 6 months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD), and intrabony defect (IBD) were calculated. A high heterogeneity was detected. Therefore, a meta-regression adjusted for type of statin and year of publication was performed. RESULTS: Fifteen studies were included in the systematic review, and ten studies were included in the meta-analysis. In the meta-regression, the adjunct use of simvastatin, rosuvastatin, and atorvastatin additionally reduced PPD in comparison to mechanical periodontal therapy and a placebo gel (2.90 ± 0.35, 3.90 ± 0.77, 3.06 ± 0.71 mm, respectively; p < 0.05). Regarding the resolution of IBD, simvastatin and rosuvastatin significantly improved in comparison to control group (0.89 ± 0.35 and 1.93 ± 0.77 mm, respectively; p < 0.05). No statistically significant difference was found between the statins for both PPD and IBD (p < 0.05). Regarding CAL gain, simvastatin provided a statistically significant improvement as compared to the control group (2.02 ± 0.79 mm; p = 0.043). CONCLUSIONS: The use of statins, used as sole adjuncts to mechanical periodontal treatment, improved the periodontal parameters. In the quantitative analyses, simvastatin was the only drug that showed additional benefits in all evaluated parameters. CLINICAL RELEVANCE: Statins promote significantly clinical periodontal improvements when administered in association with non-surgical scaling and root planning (SRP), when compared to SRP alone or in association with a placebo.


Assuntos
Doenças Periodontais/tratamento farmacológico , Raspagem Dentária , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases , Perda da Inserção Periodontal/tratamento farmacológico , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Aplainamento Radicular
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