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1.
Braz Oral Res ; 35(Supp 2): e100, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34586214

RESUMO

Randomized clinical trials (RCTs) are human studies carried out to compare different treatments or interventions, and their results are used to support clinical decision-making and improve patient care. Herein, the aim of this study was to review the selection process of study outcomes in periodontology. Primary outcomes should draw the main conclusions of the study, whereas secondary outcomes should only be used to help explain the main findings and generate future research hypothesis. Outcomes are classified as clinically relevant (CROs) or surrogate outcomes. CROs - the first option for primary outcome variables - should convey not only substantial health benefits, but also be deemed important by patients. In periodontology, tooth loss/retention and oral health-related quality of life (OHRQoL) are examples of CROs. While tooth loss has main limitations as a primary outcome, emerging evidence suggest that patient-reported outcome measures (PROMs) can accurately detect OHRQoL following periodontal therapy. When CROs cannot be assessed, validated surrogate outcomes can be used as proxies. Primary outcome variables should reflect a treatment endpoint at the patient level that can be easily used to inform decision-making in daily practice. These outcomes should allow the implementation of a treat-to-target concept in which the intervention can be clearly judged against a prespecified treatment target. Recently, the presence of at most 4 sites with periodontal probing depth ≥5 mm post-treatment was suggested as an effective endpoint for periodontal trials. In perspective, a combination of validated clinical parameters and PROMs will provide a more comprehensive assessment of periodontal treatments.


Assuntos
Periodontia , Perda de Dente , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
J Clin Periodontol ; 48(10): 1333-1343, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34296465

RESUMO

AIM: To determine the association between periodontitis stage and grade with oral-health-related quality of life (OHRQoL). MATERIALS AND METHODS: This cohort was derived from the Porto Alegre study. The original sample was representative of more than 3 million inhabitants of a Brazilian urban area. Full-mouth periodontal examinations at six sites per tooth were performed at baseline and 5 years later. Periodontitis grade was determined by direct evidence of progression of attachment loss over the follow-up. Stage of periodontitis and OHRQoL, determined by the oral health impact profile version 14 (OHIP-14), were recorded at the follow-up examination. Mean ratios (MRs) and 95% confidence intervals (95% CIs) were estimated adjusting for age, sex, smoking, systemic diseases, tooth loss, and baseline periodontitis diagnosis. RESULTS: Five-hundred and ninety-nine individuals were analysed. Individuals with periodontitis grade C + stage II (MR = 1.49; 95% CI = 1.08-2.04) and stages III/IV (MR = 1.83; 95% CI = 1.25-2.66) had significantly higher OHIP scores than those without periodontitis or with periodontitis stage I/grade B. Individuals with periodontitis stages II and III/IV + grade B did not differ from those without periodontitis or with periodontitis stage I/grade B. CONCLUSION: Severity and progression rate of periodontitis are associated with poor OHRQoL.


Assuntos
Periodontite , Qualidade de Vida , Estudos de Coortes , Humanos , Saúde Bucal , Periodontite/epidemiologia , Inquéritos e Questionários
3.
J Clin Periodontol ; 48(1): 14-23, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33010056

RESUMO

AIM: To assess obesity as a risk factor for tooth loss over 5 years in an urban sample of Brazilian adults. MATERIALS AND METHODS: A total of 1586 individuals were surveyed using a multistage probabilistic approach. Five years later, 635 individuals 14-64 years old were re-examined. An incident case of tooth loss was determined for a participant that had lost at least one tooth over time. Obesity was evaluated by calculating body mass index at baseline and by the change in obesity status over time. RESULTS: Incident cases of tooth loss were significantly more frequent among obese (47.1%) than normal-weight individuals (32.4%) (p = .004). Obese individuals had 31% higher risk [relative risk (RR) =1.31; 95% confidence interval (95%CI) 1.04-1.65] for tooth loss than normal-weight individuals adjusting for age, socio-economic status, smoking, dental care and periodontitis. This association was significant for females (RR=1.47, 95%CI 1.08-2.01), but not for males. The risk for tooth loss was also modified by presence of periodontitis at baseline and lifetime smoking exposure. There was an increased risk for tooth loss for those that remained obese than those that remained normal weight. CONCLUSION: Obesity is associated with higher risk for tooth loss. This association was modified by sex, periodontal status and smoking.


Assuntos
Perda de Dente , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Perda de Dente/complicações , Perda de Dente/epidemiologia , Adulto Jovem
4.
Cytokine ; 138: 155360, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33221157

RESUMO

BACKGROUND: The effect of non-surgical periodontal treatment on oral and systemic inflammatory mediators in subjects with periodontitis and hyperglycemia remains largely unknown. Therefore, the aim of this clinical study was to compare the short-term effect of non-surgical periodontal treatment on serum, saliva and GCF inflammatory markers levels in GP subjects with or without hyperglycemia. METHODS: Sixty subjects divided into four groups of equal size were selected to participate: type 2 diabetics with generalized periodontitis (T2DM + GP), pre-diabetics with GP (PD + GP), normoglycemic subjects with GP (NG + GP), and healthy controls. GCF, serum, and saliva samples were obtained at baseline and 30 days after scaling and root planning (SRP) and the levels of interleukin-1ß (IL-1 ß), IL-8, IL-6, IL-2, IL-5, IL-4, IL-10, Interferon gamma (IFN-γ), Granulocyte macrophage colony-stimulating factor (GM-CSF) and Tumor necrosis factor-alpha (TNF-α) were determined by ultrasensitive multiplex assay. Clinical periodontal measurements were recorded. RESULTS: SRP yielded significant improvement of all periodontal parameters for all GP groups (p < 0.01). A significant reduction in GCF levels of several cytokines were observed; however, only IL-1B and IFN-γ were consistently reduced post-treatment across all GP groups. Salivary levels of IL-1ß were significantly reduced in all GP groups following treatment. No significant differences were observed for serum levels after SRP. CONCLUSIONS: Periodontal treatment reduced local inflammatory markers, specifically IL-1B and IFN-γ, irrespective of the diabetes status. Periodontal treatment had no significant effect on serum levels of the inflammatory markers evaluated in this study.

5.
Braz. oral res. (Online) ; 35(supl.2): e100, 2021. tab
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1339468

RESUMO

Abstract Randomized clinical trials (RCTs) are human studies carried out to compare different treatments or interventions, and their results are used to support clinical decision-making and improve patient care. Herein, the aim of this study was to review the selection process of study outcomes in periodontology. Primary outcomes should draw the main conclusions of the study, whereas secondary outcomes should only be used to help explain the main findings and generate future research hypothesis. Outcomes are classified as clinically relevant (CROs) or surrogate outcomes. CROs - the first option for primary outcome variables - should convey not only substantial health benefits, but also be deemed important by patients. In periodontology, tooth loss/retention and oral health-related quality of life (OHRQoL) are examples of CROs. While tooth loss has main limitations as a primary outcome, emerging evidence suggest that patient-reported outcome measures (PROMs) can accurately detect OHRQoL following periodontal therapy. When CROs cannot be assessed, validated surrogate outcomes can be used as proxies. Primary outcome variables should reflect a treatment endpoint at the patient level that can be easily used to inform decision-making in daily practice. These outcomes should allow the implementation of a treat-to-target concept in which the intervention can be clearly judged against a prespecified treatment target. Recently, the presence of at most 4 sites with periodontal probing depth ≥5 mm post-treatment was suggested as an effective endpoint for periodontal trials. In perspective, a combination of validated clinical parameters and PROMs will provide a more comprehensive assessment of periodontal treatments.

6.
Rev. odontol. UNESP (Online) ; 50: e20210015, 2021. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1289856

RESUMO

Abstract Introduction The investigation of peri-implant diseases risk indicators helps to prevent and target treatment techniques. Objective The aim of this cross-sectional study was to determine the occurrence of peri-implantitis and its potential risk indicator factors, besides to assess the long-term success and survival rates of dental implants after 8 to 10 years of function. Material and method For this, fifty individuals who had received their implant-supported rehabilitation between 2003 and 2005 were included. Data regarding demographics, medical and dental history were collected and a complete clinical examination was performed. Multivariate analysis was used to identify potential risk indicator factors related to the occurrence of peri-implantitis. Overall, 211 implants had been placed; 197 were in function, 9 were still submerged, and 5 had been lost. Result Success and survival rates were 81.5% and 97.6%, respectively. Peri-implant mucositis affected 77.1% of subjects and 52.3% of implants. Peri-implantitis was diagnosed in 14 individuals (29.2%) and 25 implants (12.7%). Subjects with osteoporosis (OR = 2.84) and generalized bleeding on probing (OR = 8.03) were significantly associated with higher odds of peri-implantitis. At the implant level, visible plaque (OR = 4.45) and deep probing depths (OR = 4.47) were significantly associated with peri-implantitis. Conclusion Through these results, our study suggests that osteoporosis and generalized periodontal/peri-implant mucosa inflammation increase the likelihood of peri-implantitis.


Resumo Introdução A investigação dos fatores indicadores de risco para as doenças peri-implantares auxilia na prevenção e direcionamento das técnicas de tratamento Objetivo O objetivo deste estudo transversal foi determinar a ocorrência de peri-implantite e seus potenciais fatores indicadores de risco, além de avaliar as taxas de sucesso e sobrevida em longo prazo dos implantes dentários após 8 a 10 anos de função Material e método Foram incluídos cinquenta indivíduos que receberam sua reabilitação implanto-suportada entre 2003 e 2005. Dados demográficos, história médica e odontológica foram coletados e um exame clínico completo foi realizado. A análise multivariada foi utilizada para identificar potenciais fatores indicadores de risco relacionados à ocorrência de peri-implantite. Ao todo, 211 implantes foram colocados; 197 estavam em função, 9 ainda estavam submersos e 5 haviam sido perdidos. Resultado As taxas de sucesso e sobrevivência foram de 81,5% e 97,6%, respectivamente. A mucosite peri-implantar afetou 77,1% dos indivíduos e 52,3% dos implantes. A peri-implantite foi diagnosticada em 14 indivíduos (29,2%) e 25 implantes (12,7%). Indivíduos com osteoporose (OR = 2,84) e sangramento generalizado à sondagem (OR = 8,03) foram significativamente associados a uma maior chance de peri-implantite. Ao nível do implante, a placa visível (OR = 4,45) e as maiores profundidades de sondagem (OR = 4,47) foram significativamente associadas à peri-implantite. Conclusão Por meio desses resultados, nosso estudo sugere que a osteoporose e a inflamação generalizada da mucosa periodontal / peri-implantar aumentam a probabilidade de peri-implantite.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Implantes Dentários , Taxa de Sobrevida , Fatores de Risco , Peri-Implantite , Prevalência , Indicadores (Estatística) , Prevenção de Doenças
7.
J Periodontal Res ; 55(4): 559-566, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32167175

RESUMO

OBJECTIVE: To assess the association between weight status and gingivitis in a representative sample of 12-year-old schoolchildren from South Brazil. BACKGROUND: An association between obesity and gingivitis in children and adolescents has been observed; however, the present evidence has major limitations. METHODS: A cross-sectional study was conducted in Porto Alegre, South Brazil, from September 2009 to December 2010 and included a representative sample of 1528 12-year-old schoolchildren attending public and private schools. Data collection included the application of a questionnaire, recording of anthropometric measures (weight and height), and clinical examination (gingival bleeding index, recorded in four sites per tooth). The outcome of the study was the prevalence of gingivitis, defined as the proportion of schoolchildren presenting ≥52% of bleeding sites (based on the median). Weight status was categorized according to body mass index into normal, overweight, or obese. The association between predictor variables and gingivitis prevalence was assessed using Poisson regression models. Unadjusted and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated. RESULTS: Gingivitis prevalence was 48.7% (95% IC = 33.8-63.6) and, on average, schoolchildren presented 51.8% (95% IC = 46.2-57.5) of bleeding sites. Obese individuals had 13% higher prevalence for presenting gingivitis than did normal-weight ones (PR = 1.13, 95% CI = 1.09-1.18, P < .001). The stratified analysis showed that this association was sex-specific: Obese girls presented a greater chance of having gingivitis (adjusted PR = 1.21, 95% CI = 1.09-1.34, P < .001), but such association was not observed among boys (PR = 1.07, 95% CI = 0.95-1.20, P = .29). CONCLUSION: This study showed sex differences in the association between obesity and gingivitis among 12-year-old South Brazilian schoolchildren.


Assuntos
Gengivite , Obesidade , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Gengivite/complicações , Gengivite/epidemiologia , Humanos , Masculino , Obesidade/complicações , Obesidade/epidemiologia , Prevalência
8.
J Clin Med ; 9(2)2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32054122

RESUMO

When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper™, Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque.

9.
Eur J Dent Educ ; 24(1): 79-87, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31574582

RESUMO

BACKGROUND: The introduction of innovative nanotechnologies in medicine and dentistry may initiate a need for curriculum revision at the universities. The aim of this study was to assess dental students' knowledge and attitudes related to nanotechnology. Covariates of students' intention to use nanomaterials in their future dental practice were evaluated using the theory of planned behaviour (TPB). METHODS: Dental students at Norwegian and Romanian Universities were invited to participate. A self-administered structured questionnaire including socio-demographics and Ajzen's TPB components was used. FINDINGS: A total of 212 out of 732 dental students participated in the survey: 52 Norwegian and 160 Romanian. Most students reported to have little knowledge about nanotechnology (Norwegians = 44.2% vs Romanians = 46.9%, P < .05). More than 90% of the students in both countries reported that they wanted to get more information about nanotechnology. Mean knowledge score was similar for Norwegian and Romanian students (4.4 ± 1.7 vs 4.2 ± 1.4, P > .05). Romanian students had more positive attitude, stronger subjective norms and stronger perceived behavioural control towards nanotechnology compared to their Norwegian counterparts. Intention to use nanomaterials in the total sample was most strongly influenced by attitude towards the use of dental nanomaterials (beta = 0.42, P < .001). CONCLUSION: Dental students in Norway and Romania demonstrated limited knowledge about nanotechnology. Intention to use nanomaterials was primarily influenced by attitudes. A clear desire for more information about the application of nanotechnology in dentistry was expressed by the respondents indicating a need for curriculum modification.


Assuntos
Intenção , Estudantes de Odontologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Nanotecnologia , Noruega , Romênia , Inquéritos e Questionários
10.
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
11.
Oral Dis ; 25(8): 2020-2029, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31541516

RESUMO

OBJECTIVE: To compare the myeloid and plasmacytoid DC counts and maturation status among subjects with/without generalized periodontitis (GP) and type 2 diabetes mellitus (T2DM). METHODS: The frequency and maturation status of myeloid and plasmacytoid blood DCs were analyzed by flow cytometry in four groups of 15 subjects: healthy controls, T2DM with generalized CP (T2DM + GP), prediabetes with GP (PD + GP), and normoglycemics with GP (NG + GP). RT-PCR was used to determine levels of Porphyromonas gingivalis in the oral biofilms and within panDCs. The role of exogenous glucose effects on differentiation and apoptosis of healthy human MoDCs was explored in vitro. RESULTS: Relative to controls and to NG + GP, T2DM + GP showed significantly lower CD1c + and CD303 + DC counts, while CD141 + DCs were lower in T2DM + GP relative to controls. Blood DC maturation required for mobilization and immune responsiveness was not observed. A statistically significant trend was observed for P. gingivalis levels in the biofilms of groups as follows: controls 

Assuntos
Células Dendríticas/imunologia , Diabetes Mellitus Tipo 2 , Periodontite , Estado Pré-Diabético , Adulto , Idoso , Brasil , Humanos , Pessoa de Meia-Idade , Porphyromonas gingivalis
12.
Braz Oral Res ; 33: e056, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31271568

RESUMO

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.


Assuntos
Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Obesidade/complicações , Obesidade/epidemiologia , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Índice CPO , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Sobrepeso/complicações , Sobrepeso/epidemiologia , Fatores Socioeconômicos
13.
J Immunol ; 202(9): 2690-2699, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30944162

RESUMO

Periodontitis (PD) is a common dysbiotic inflammatory disease that leads to local bone deterioration and tooth loss. PD patients experience low-grade bacteremias with oral microbes implicated in the risk of heart disease, cancer, and kidney failure. Although Th17 effectors are vital to fighting infection, functional imbalance of Th17 effectors and regulatory T cells (Tregs) promote inflammatory diseases. In this study, we investigated, in a small pilot randomized clinical trial, whether expansion of inflammatory blood myeloid dendritic cells (DCs) and conversion of Tregs to Th17 cells could be modulated with antibiotics (AB) as part of initial therapy in PD patients. PD patients were randomly assigned to either 7 d of peroral metronidazole/amoxicillin AB treatment or no AB, along with standard care debridement and chlorhexidine mouthwash. 16s ribosomal RNA analysis of keystone pathogen Porphyromonas gingivalis and its consortium members Fusobacterium nucleatum and Streptococcus gordonii confirmed the presence of all three species in the reservoirs (subgingival pockets and blood DCs) of PD patients before treatment. Of the three species, P. gingivalis was reduced in both reservoirs 4-6 wk after therapy. Further, the frequency of CD1C+CCR6+ myeloid DCs and IL-1R1 expression on IL-17A+FOXP3+CD4+ T cells in PD patients were reduced to healthy control levels. The latter led to decreased IL-1ß-stimulated Treg plasticity in PD patients and improvement in clinical measures of PD. Overall, we identified an important, albeit short-term, beneficial role of AB therapy in reducing inflammatory DCs and Treg-Th17 plasticity in humans with PD.


Assuntos
Amoxicilina/administração & dosagem , Bactérias , Infecções Bacterianas , Células Dendríticas , Metronidazol/administração & dosagem , Periodontite , Linfócitos T Reguladores , Células Th17 , Bactérias/imunologia , Bactérias/metabolismo , Infecções Bacterianas/sangue , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/imunologia , Infecções Bacterianas/patologia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Células Dendríticas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/sangue , Periodontite/tratamento farmacológico , Periodontite/imunologia , Periodontite/patologia , Linfócitos T Reguladores/metabolismo , Linfócitos T Reguladores/parasitologia , Linfócitos T Reguladores/patologia , Células Th17/imunologia , Células Th17/metabolismo , Células Th17/patologia
14.
J Dent Educ ; 83(6): 663-668, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30910932

RESUMO

Social media have become a major part of an interconnected society, impacting personal and professional lives. This Point/Counterpoint presents two opposing viewpoints on the question of whether social media should be used in dental education as a learning and communication tool for dental students. Viewpoint 1 argues that social media benefit student learning and should be used as a tool in dental education. This argument is based on evidence concerning use of social media and improved learning across health professions, improved peer-peer communication in clinical education, improved engagement in interprofessional education (IPE), and provision of a mechanism for safe and improved communication between practitioners and patients, as well as faculty and students. Viewpoint 2 argues that potential problems and risks in using social media outweigh any benefits found in learning and therefore social media should not be used as a tool in dental education. This viewpoint is supported by evidence of negative effects on learning, the establishment of a negative digital footprint in the public's view, risk of privacy violations when using social media, and the new phenomenon of Internet addiction with its negative physiological effects on social media users.


Assuntos
Mídias Sociais , Estudantes de Odontologia/estatística & dados numéricos , Comunicação , Educação em Odontologia/métodos , Humanos , Aprendizagem , Profissionalismo , Mídias Sociais/estatística & dados numéricos , Estudantes de Odontologia/psicologia
15.
Clin Implant Dent Relat Res ; 21 Suppl 1: 34-43, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30859699

RESUMO

BACKGROUND: It is well established that electrochemical anodization of implant surfaces contributes to osseointegration and long-term implant survival. Few studies have investigated its effect on soft tissue healing. PURPOSE: To evaluate the safety and efficacy of a novel abutment surface prepared by electrochemical oxidation compared to commercially available machined titanium abutments. MATERIALS AND METHODS: Twelve 16-19 months-old, Yucatan mini-pigs received three dental implants in each mandibular jaw quadrant. Each side was randomized to receive either an anodized or a machined titanium abutment. Titanium healing caps were placed on both abutments. Animals were euthanized at 6 and 13 weeks. Radiographic and histological analyses were performed. RESULTS: No significant differences were observed histologically between groups in regard to inflammation, epithelium length, mucosal height, bone-to-implant contact, or bone density for any time point. Radiographically, crestal bone level change from baseline to 6 weeks was significantly lower for anodized than machined abutments (P = 0.046); no significant differences were observed at 13 weeks (P = 0.12). CONCLUSIONS: The novel anodized abutment showed a comparable effect on soft and hard tissue healing/remodeling and inflammation reaction to standard titanium abutments. Clinical studies should confirm these findings and explore the positive radiographic results observed at the early time point.


Assuntos
Dente Suporte , Implantes Dentários , Animais , Implantação Dentária Endo-Óssea , Osseointegração , Distribuição Aleatória , Propriedades de Superfície , Suínos , Porco Miniatura , Titânio
16.
Clin Implant Dent Relat Res ; 21 Suppl 1: 44-54, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30860675

RESUMO

BACKGROUND: A newly developed dental implant system combining advancements in surface chemistry, topography, nanostructure, color, and surface energy aims to address biological challenges and expand clinical applications. PURPOSE: To assess the short- and long-term safety and efficacy of a novel, gradually anodized dental implant surface/anodized abutment. MATERIALS AND METHODS: Twenty-four Yucatan mini pigs (20-24 months old) received two dental implants in each jaw quadrant. Each site was randomized to receive either a commercially available anodized implant/machined abutment or a gradually anodized implant/anodized abutment with a protective layer. Animals were euthanized at 3, 6, and 13 weeks. Microcomputed tomography and histological analyses were performed. RESULTS: No significant histological differences in inflammation scores, epithelium length, bone-to-implant contact, or bone density were observed between groups for any healing time. Mucosal height was significantly higher at 3 weeks for controls (Δ = 0.2 mm); no differences were observed at 6 and 13 weeks. No significant differences in radiographic bone volume, bone-to-implant contact, trabecular thickness, and crestal bone levels were observed, irrespective of healing time. Trabecular spacing was borderline significant at 3 weeks in favor of the test implant sites; no differences were observed at 6 weeks. No significant differences were observed between experimental groups at 13 weeks. CONCLUSIONS: The new implant system yielded results comparable to a commercially available predicate device.


Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Osseointegração , Animais , Implantação Dentária Endo-Óssea , Propriedades de Superfície , Suínos , Porco Miniatura , Titânio , Microtomografia por Raio-X
17.
NPJ Biofilms Microbiomes ; 5(1): 11, 2019 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32179736

RESUMO

Years of human microbiome research have confirmed that microbes rarely live or function alone, favoring diverse communities. Yet most experimental host-pathogen studies employ single species models of infection. Here, the influence of three-species oral microbial consortium on growth, virulence, invasion and persistence in dendritic cells (DCs) was examined experimentally in human monocyte-derived dendritic cells (DCs) and in patients with periodontitis (PD). Cooperative biofilm formation by Streptococcus gordonii, Fusobacterium nucleatum and Porphyromonas gingivalis was documented in vitro using growth models and scanning electron microscopy. Analysis of growth rates by species-specific 16s rRNA probes revealed distinct, early advantages to consortium growth for S. gordonii and F. nucleatum with P. gingivalis, while P. gingivalis upregulated its short mfa1 fimbriae, leading to increased invasion of DCs. F. nucleatum was only taken up by DCs when in consortium with P. gingivalis. Mature consortium regressed DC maturation upon uptake, as determined by flow cytometry. Analysis of dental plaques of PD and healthy subjects by 16s rRNA confirmed oral colonization with consortium members, but DC hematogenous spread was limited to P. gingivalis and F. nucleatum. Expression of P. gingivalis mfa1 fimbriae was increased in dental plaques and hematogenous DCs of PD patients. P. gingivalis in the consortium correlated with an adverse clinical response in the gingiva of PD subjects. In conclusion, we have identified polymicrobial synergy in a three-species oral consortium that may have negative consequences for the host, including microbial dissemination and adverse peripheral inflammatory responses.


Assuntos
Biofilmes/crescimento & desenvolvimento , Coinfecção/microbiologia , Células Dendríticas/microbiologia , Gengiva/microbiologia , Consórcios Microbianos , Periodontite/microbiologia , Fímbrias Bacterianas/genética , Fusobacterium nucleatum/genética , Fusobacterium nucleatum/fisiologia , Humanos , Inflamação , Microbiota , Porphyromonas gingivalis/genética , Porphyromonas gingivalis/fisiologia , RNA Ribossômico 16S/genética , Streptococcus gordonii/genética , Streptococcus gordonii/fisiologia
18.
Braz. oral res. (Online) ; 33: e056, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1011655

RESUMO

Abstract The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.


Assuntos
Humanos , Masculino , Feminino , Criança , Cárie Dentária/etiologia , Cárie Dentária/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Fatores Socioeconômicos , Brasil/epidemiologia , Índice de Massa Corporal , Índice CPO , Métodos Epidemiológicos , Sobrepeso/complicações , Sobrepeso/epidemiologia
19.
Braz. oral res. (Online) ; 33(supl.1): e074, 2019. tab, graf
Artigo em Inglês | LILACS | 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.


Assuntos
Humanos , Periodontite/prevenção & controle , Estomatite/prevenção & controle , Implantes Dentários/efeitos adversos , Peri-Implantite/prevenção & controle , Interface Osso-Implante/diagnóstico por imagem , Higiene Bucal , Periodontite/etiologia , Estomatite/etiologia , Radiografia Dentária , Índice Periodontal , Fatores de Risco , Placa Dentária/prevenção & controle , Peri-Implantite/etiologia
20.
Sci Rep ; 8(1): 16607, 2018 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-30413788

RESUMO

Chronic periodontitis (CP) is a microbial dysbiotic disease linked to increased risk of oral squamous cell carcinomas (OSCCs). To address the underlying mechanisms, mouse and human cell infection models and human biopsy samples were employed. We show that the 'keystone' pathogen Porphyromonas gingivalis, disrupts immune surveillance by generating myeloid-derived dendritic suppressor cells (MDDSCs) from monocytes. MDDSCs inhibit CTLs and induce FOXP3 + Tregs through an anti-apoptotic pathway. This pathway, involving pAKT1, pFOXO1, FOXP3, IDO1 and BIM, is activated in humans with CP and in mice orally infected with Mfa1 expressing P. gingivalis strains. Mechanistically, activation of this pathway, demonstrating FOXP3 as a direct FOXO1-target gene, was demonstrated by ChIP-assay in human CP gingiva. Expression of oncogenic but not tumor suppressor markers is consistent with tumor cell proliferation demonstrated in OSCC-P. gingivalis cocultures. Importantly, FimA + P. gingivalis strain MFI invades OSCCs, inducing inflammatory/angiogenic/oncogenic proteins stimulating OSCCs proliferation through CXCR4. Inhibition of CXCR4 abolished Pg-MFI-induced OSCCs proliferation and reduced expression of oncogenic proteins SDF-1/CXCR4, plus pAKT1-pFOXO1. Conclusively, P. gingivalis, through Mfa1 and FimA fimbriae, promotes immunosuppression and oncogenic cell proliferation, respectively, through a two-hit receptor-ligand process involving DC-SIGN+hi/CXCR4+hi, activating a pAKT+hipFOXO1+hiBIM-lowFOXP3+hi and IDO+hi- driven pathway, likely to impact the prognosis of oral cancers in patients with periodontitis.


Assuntos
Apoptose , Infecções por Bacteroidaceae/imunologia , Carcinogênese/patologia , Células Dendríticas/imunologia , Imunossupressão , Monócitos/imunologia , Periodontite/imunologia , Animais , Infecções por Bacteroidaceae/microbiologia , Infecções por Bacteroidaceae/patologia , Carcinogênese/imunologia , Estudos de Casos e Controles , Proliferação de Células , Células Dendríticas/microbiologia , Células Dendríticas/patologia , Gengiva/imunologia , Gengiva/microbiologia , Gengiva/patologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Monócitos/microbiologia , Monócitos/patologia , Periodontite/microbiologia , Periodontite/patologia , Porphyromonas gingivalis/imunologia
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