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1.
Prim Dent J ; 9(4): 45-51, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33225855

RESUMO

Dentists are likely to encounter lesions that have both periodontal and endodontic aetiological components; the so called 'perio-endo lesions'. A thorough examination with appropriate investigations remains pivotal to diagnosing a perio-endo lesion. Correct diagnosis of such lesions is therefore important as it enables the most suitable clinical management to be treatment planned. It is still recommended that for the treatment of perio-endo lesions, initial endodontic therapy is completed.


Assuntos
Doenças Periodontais , Humanos , Doenças Periodontais/diagnóstico , Doenças Periodontais/terapia
2.
Artigo em Inglês | MEDLINE | ID: mdl-32872648

RESUMO

The study aimed to determine if oral hygiene influences not only oral health but also potentially metabolic disorders such as overweight or obesity. Participants were 94 patients: 40 with increased body mass and 54 with normal body mass. The methods included dental examination, a questionnaire concerning hygienic habits and an assessment of selected salivary inflammatory markers. The new parameter named "cleaning index" (describing the interaction between average time of tooth brushing in minutes and its frequency per day) significantly correlated with Body Mass Index (RSpearman = 0.300). The multivariate regression model incorporating cleaning index, approximal plaque index, receptor 1 for tumor necrosis factor-alpha (TNFα-R1) and interleukin-15 (IL-15) had a high power to predict overweight or obesity (AUC = 0.894). Patients with poor oral hygiene (approximal plaque index >40%) were more than eight times more likely to suffer from obesity than patients with good oral hygiene. Cleaning index higher than 4 decreased the odds by about 85%. Oral hygiene habits, adjusted by salivary concentrations of selected inflammatory markers may allow predicting effectively overweight or obesity risk. Early proper dental prophylaxis and treatment could lead to the better prevention of metabolic disorders.


Assuntos
Higiene Bucal , Sobrepeso , Saliva , Adulto , Índice de Massa Corporal , Quimiocina CCL2/análise , Citocinas/análise , Índice de Placa Dentária , Feminino , Humanos , Interleucina-15/análise , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/imunologia , Saúde Bucal , Índice de Higiene Oral , Sobrepeso/epidemiologia , Sobrepeso/imunologia , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Doenças Periodontais/imunologia , Valor Preditivo dos Testes , Saliva/química , Adulto Jovem
3.
Acta Odontol Scand ; 78(7): 553-559, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32552160

RESUMO

Background: Periodontitis has been associated with several systemic diseases and medical conditions, including oral cancer (OC). However, most studies reporting an association between OC and periodontal disease have used different clinical and radiographic criteria to define periodontal disease. This review aimed to evaluate the currently available evidence to determine an association between periodontal disease (extension and severity), OC, and oral potentially malignant disorders (OPMDs).Material and methods: A systematic search of studies published up to August 2018 was performed following the PRISMA guidelines in the electronic databases MEDLINE (PubMed) and COCHRANE (OVID). A methodological evaluation was made using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist.Results: Eight studies (case-control, cross-sectional and cohort) were included. An increased clinical attachment loss, plaque index, bleeding on probing, and radiographic bone loss was found in patients with OC and OPMDs. Differences in the methodological characteristics, case definition used for periodontal diseases, and OC location did not allow estimating the odds ratio required to conduct a meta-analysis.Conclusion: Some studies suggest a positive relationship between periodontal disease, OC, and OPMDs; however, the currently available evidence is insufficient to draw solid conclusions.


Assuntos
Neoplasias Bucais , Doenças Periodontais , Periodontite , Estudos de Casos e Controles , Estudos Transversais , Humanos , Neoplasias Bucais/complicações , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Periodontite/complicações , Periodontite/diagnóstico , Periodontite/epidemiologia
4.
J Periodontol ; 91 Suppl 1: S50-S55, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32432812

RESUMO

Medicine and dentistry need to treat the individual not the "average patient." This personalized or precision approach to health care involves correctly diagnosing and properly classifying people to effectively customize prevention, diagnosis, and treatment. This is not a trivial undertaking. Achieving precision health requires making sense of big data, both at the population level and at the molecular level. The latter can include genetic, epigenetic, transcriptomic, proteomic, metabolomic data, and microbiome data. This biological information can augment established clinical measurements and supplement data on socioeconomic status, lifestyle, behaviors, and environmental conditions. Here, the central thesis is that, with sufficient data and appropriate methods, it is possible to segregate symptom-based and phenotypically based categories of patients into clinically and biologically similar groups. These groups are likely to have different clinical trajectories and benefit from different treatments. Additionally, such groups are optimal for investigations seeking to unveil the genomic basis of periodontal disease susceptibility. Analysis of these complex data to produce actionable and replicable health and disease categories requires appropriately sophisticated bioinformatics approaches and thorough validation in diverse patient samples and populations. Successful research programs will need to consider both population-level and well-controlled deep phenotyping approaches. Biologically informed stratification of periodontal disease is both feasible and desirable. Ultimately, this approach can accelerate the development of precision health through improvements in research and clinical applications.


Assuntos
Microbiota , Doenças Periodontais , Genômica , Humanos , Microbiota/genética , Saúde Bucal , Doenças Periodontais/diagnóstico , Doenças Periodontais/genética , Doenças Periodontais/prevenção & controle , Proteômica
5.
BMC Health Serv Res ; 20(1): 412, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393349

RESUMO

BACKGROUND: In many low- and middle-income countries, insufficient human resources limit access to oral health services. Shifting clinical tasks to less specialized health professionals, such as community health workers, has been used as a strategy to expand the health workforce, especially in remote or underserved locations. The objective of this study was to evaluate the validity of periodontal examinations conducted by auxiliary nurse midwives in a rural home setting in Nepal. METHODS: Twenty-one pregnant women < 26 weeks gestation from Sarlahi District, Nepal, underwent full mouth periodontal examinations measuring probing depth (PD) and bleeding on probing (BOP) on 6 sites per tooth by one of five auxiliary nurse midwives, who were trained for this study but had no previous training in dentistry. After a 15-min break, each participant was examined again by an experienced dentist. Measures of validity for PD and BOP were calculated comparing the pooled and individual auxiliary nurse midwives to the dentist. A multivariable GEE model estimated the effect of periodontal characteristics on agreement between the auxiliary nurse midwives and the dentist. RESULTS: Participant mean age was 22 years (SD: ±3 years), mean PD was 1.4 mm (SD: 03 mm), and 86% of women had BOP (according to the dentist). Percent agreement, weighted kappa scores, and intraclass correlation coefficients for PD, with an allowance of ±1 mm, exceeded 99%, 0.7, and 0.9, respectively, indicating an acceptable level of agreement. Auxiliary nurse midwives tended to report higher PD scores relative to the dentist, although this over-estimation was small and unlikely to impact population-based estimates of important indicators of oral health status. GEE regression modeling indicated similar agreement for mandible vs. maxilla, left vs. right side, and PD (≤2 mm, > 2 mm), and lower agreement for posterior teeth and lingual and proximal sites. CONCLUSION: Auxiliary nurse midwives were able to accurately conduct periodontal examinations in a rural home setting, suggesting the potential to shift tasks away from highly trained dentists and periodontal examiners in low-resource communities. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study); registered on August 6th, 2010.


Assuntos
Agentes Comunitários de Saúde/educação , Enfermeiras Obstétricas/educação , Doenças Periodontais/diagnóstico , Adulto , Odontólogos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Nepal , Índice Periodontal , Gravidez , Gestantes , População Rural , Adulto Jovem
6.
Braz Oral Res ; 34(supp1 1): e022, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294675

RESUMO

The art of diagnosis is of great importance in the management of any disease. This includes preventive and therapeutic strategies. To make an accurate and effective diagnosis, knowledge about the health-disease process is fundamental. This paper reviews the important aspects for periodontal diagnosis in a contemporary approach, and endeavors to establish challenges for improving periodontal diagnosis, especially in Latin America. Considering that contemporary periodontal diagnosis should be based on knowledge of the etiopathogenesis of periodontal diseases, this paper highlights that the recently proposed classification system for periodontal diseases and conditions was based on the best available evidence. This system was conceived for individual diagnosis, therefore, its use in research and epidemiological settings might be limited. The system leads to a practical implication that stresses the importance of interviewing the patient, thorough periodontal charting, and requesting any imaging and other complementary tests necessary. An important observation is that partial periodontal data recordings usable for screening are not diagnostic methods and might underestimate disease. The goals of utmost importance for Latin America are to increase the awareness of both the population and the profession and to prioritize correct periodontal diagnosis. In addition, learning how to use the new classification system will help with diagnosing periodontal diseases.


Assuntos
Doenças Periodontais/diagnóstico , Humanos , América Latina , Doenças Periodontais/classificação , Índice Periodontal , Guias de Prática Clínica como Assunto
7.
Braz Oral Res ; 34(supp1 1): e027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294680

RESUMO

Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.


Assuntos
Conferências de Consenso como Assunto , Doenças Periodontais/terapia , Feminino , Gengivite/diagnóstico , Gengivite/epidemiologia , Gengivite/terapia , Carga Global da Doença , Humanos , América Latina/epidemiologia , Masculino , Saúde Bucal , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Periodontite/diagnóstico , Periodontite/epidemiologia , Periodontite/terapia , Qualidade de Vida
8.
Postgrad Med ; 132(6): 521-525, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32298158

RESUMO

Objectives: To evaluate the risk of periodontal disease (PD) in gout patients. Methods: This retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2000. The gout cohort included 31,759 patients newly diagnosed with gout from 2000 to 2012, and the comparison (nongout) cohort included 63,517 patients. Univariate and multivariable adjusted hazard ratios (aHRs), with corresponding 95% confidence intervals (CIs), were estimated using the Cox proportional hazard model for determining the occurrence of PD in both cohorts. We also measured the cumulative incidence of PD in these two cohorts using the Kaplan-Meier method and assessed the curve difference using the log-rank test. Results: The mean follow-up time was more than 6 years for both cohorts. The overall incidence rate of PD was significantly higher in the gout cohort than in the comparison cohort (5.04 vs 4.16 per 10,000 person-years; aHR = 1.13, 95% CI = 1.10-1.16). Only patients using colchicine had a significantly lower risk of PD (aHR = 0.85, 95% CI = 0.79-0.91). Conclusion: In our study, patients with gout showed an increased risk of PD, and treatment with colchicine could decrease the risk. Abbreviations: PD: periodontal disease; LHID: Longitudinal Health Insurance Research Database; NHIRD, National Health Insurance Research Database; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; CI: confidence interval; HR: hazard ratio.


Assuntos
Colchicina/uso terapêutico , Gota , Doenças Periodontais , Estudos de Coortes , Feminino , Gota/diagnóstico , Gota/tratamento farmacológico , Gota/epidemiologia , Supressores da Gota/uso terapêutico , Humanos , Incidência , Revisão da Utilização de Seguros , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Taiwan/epidemiologia
9.
Rev. cuba. estomatol ; 57(1): e2053, ene.-mar. 2020. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126490

RESUMO

RESUMEN Introducción: El edentulismo es la pérdida total o parcial de dientes, ocasionado principalmente por la caries y la enfermedad periodontal; es un proceso gradual que está comúnmente asociado al aumento de edad. Actualmente es considerado una discapacidad debido a la limitación funcional que ocasiona en quien lo presenta. Objetivo: Exponer el tratamiento rehabilitador multidisciplinario, funcional y estético en un paciente con desarmonías oclusales. Presentación del caso: Paciente masculino de 74 años, diagnosticado con edentulismo parcial bimaxilar, mediante examen clínico y radiológico. Se sometió a terapia periodontal generalizada, cirugía preprotésica, restauración de plano oclusal de forma directa e indirecta y rehabilitación bucal con prótesis removibles total superior y parcial inferior; lo cual le permitió recuperar funcionalidad, estética y autoestima. Conclusiones: El edentulismo desencadena alteración en el estado funcional y emocional del paciente. Un diagnóstico integral y plan de tratamiento multidisciplinario y ordenado desencadenó éxito en el presente caso(AU)


ABSTRACT Introduction: Edentulism is total or partial tooth loss mainly caused by dental caries and periodontal disease. It is a gradual process often associated to aging. At present edentulism is considered to be a disability, due to the functional limitations undergone by sufferers. Objective: Describe the multidisciplinary, functional and esthetic rehabilitation treatment provided to a patient with occlusal disharmony. Case presentation: A 74-year-old male patient was diagnosed with bimaxillary partial edentulism based on clinical and radiographic examination. The patient underwent generalized periodontal therapy, pre-prosthetic surgery, direct and indirect occlusal plane restoration, and oral rehabilitation with total upper and partial lower removable prostheses, as a result of which he recovered his functionality, esthetic appearance and self-esteem. Conclusions: Edentulism triggers changes in the functional and emotional state of patients. Comprehensive diagnosis and orderly multidisciplinary treatment led to success in the case herein presented(AU)


Assuntos
Humanos , Masculino , Idoso , Doenças Periodontais/diagnóstico , Cárie Dentária/terapia , Reabilitação Bucal/métodos , Dimensão Vertical , Prótese Dentária/métodos , Estética
10.
N Z Vet J ; 68(3): 178-186, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32028869

RESUMO

Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.


Assuntos
Odontologia/veterinária , Doenças dos Cavalos , Doenças Dentárias/veterinária , Animais , Cárie Dentária/veterinária , Odontologia/métodos , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/prevenção & controle , Doenças dos Cavalos/terapia , Cavalos , Doenças Periodontais/diagnóstico , Doenças Periodontais/prevenção & controle , Doenças Periodontais/terapia , Doenças Periodontais/veterinária , Doenças Dentárias/diagnóstico , Doenças Dentárias/prevenção & controle , Doenças Dentárias/terapia
11.
PLoS One ; 15(2): e0229485, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32109938

RESUMO

Periodontal disease, the most prevalent infectious disease in the world, is caused by biofilms formed in periodontal pockets. No specific bacterial species that can cause periodontitis alone has been found in any study to date. Several periodontopathic bacteria are associated with the progress of periodontal disease. Consequently, it is hypothesized that dysbiosis of subgingival microbiota may be a cause of periodontal disease. This study aimed to investigate the relationship between the subgingival microbiota and the clinical status of periodontal pockets in a quantitative and clinically applicable way with the newly developed Oral Care Chip. The Oral Care Chip is a DNA microarray tool with improved quantitative performance, that can be used in combination with competitive PCR to quantitatively detect 17 species of subgingival bacteria. Cluster analysis based on the similarity of each bacterial quantity was performed on 204 subgingival plaque samples collected from periodontitis patients and healthy volunteers. A significant difference in the number of total bacteria, Treponema denticola, Campylobacter rectus, Fusobacterium nucleatum, and Streptococcus intermedia bacteria in any combination of the three clusters indicated that these bacteria gradually increased in number from the stage before the pocket depth deepened. Conversely, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, and Streptococcus constellatus, which had significant differences only in limited clusters, were thought to increase in number as the pocket depth deepened, after periodontal pocket formation. Furthermore, in clusters where healthy or mild periodontal disease sites were classified, there was no statistically significant difference in pocket depth, but the number of bacteria gradually increased from the stage before the pocket depth increased. This means that quantitative changes in these bacteria can be a predictor of the progress of periodontal tissue destruction, and this novel microbiological test using the Oral Care Chip could be effective at detecting dysbiosis.


Assuntos
Bactérias/isolamento & purificação , DNA Bacteriano/análise , Microbiota , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Doenças Periodontais/microbiologia , Bolsa Periodontal/microbiologia , Adulto , Campylobacter rectus/isolamento & purificação , Feminino , Fusobacterium nucleatum/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/diagnóstico , Índice Periodontal , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificação , Streptococcus constellatus/isolamento & purificação , Tannerella forsythia/isolamento & purificação , Treponema denticola/isolamento & purificação , Adulto Jovem
12.
Clin Oral Investig ; 24(9): 3085-3091, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31897707

RESUMO

OBJECTIVE: This study aimed to examine saliva flow rates and prevalence of dental and periodontal diseases of patients with newly diagnosed severe haematological diseases and compare these findings with age-matched controls of normal population. METHODS: A total of 149 patients diagnosed with haematological diseases aimed to be treated with haematological stem cell transplantation between 2008 and 2018 and 154 controls were included in the study. A dental examination was performed for patients within a maximum of 6 months after diagnosis. Differences were compared in terms of the stimulated salivary flow rate (SSFR); decayed, missing and filled teeth (DMFT) index; number of teeth; caries prevalence; presence of periodontitis and acute infections. RESULTS: The mean SSFR of the patient group was significantly lower (1.1 ml/min ± 0.7 ml/min) than the mean SSFR of the controls (1.3 ml/min ± 0.5 ml/min; p = 0.004). The number of caries lesions was significantly higher in the patient group (mean ± SD, 1.1 ± 1.9) than in the control group (mean ± SD, 0.4 ± 1.2; p < 0.001). There were fewer teeth and a higher DMFT index in the patient group compared to the control group, but the differences were not significant. Acute symptomatic infections were observed in eight (5.4%) patients and in none of the controls (p < 0.01). CONCLUSIONS AND CLINICAL RELEVANCE: Oral examinations in patients with newly diagnosed severe haematological disease demonstrated a higher prevalence of caries, acute infections and lower mean SSFR compared with the controls. These findings support the recommendations for early dental examination at the time of diagnosis.


Assuntos
Cárie Dentária , Doenças Hematológicas , Doenças da Boca , Doenças Periodontais , Índice CPO , Cárie Dentária/complicações , Doenças Hematológicas/complicações , Humanos , Doenças da Boca/complicações , Doenças da Boca/diagnóstico , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico , Prevalência
13.
PLoS One ; 15(1): e0227386, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923271

RESUMO

Canine Chronic Ulcerative Stomatitis is a spontaneously occurring inflammatory disease of the oral mucosa. An immune-mediated pathogenesis is suspected though not yet proven. We have recently reported on the clinical and histologic features, and identification of select leukocyte cell populations within the lesion. A clinical and histologic similarity to oral lichen planus of people was proposed. In the present study, these initial observations are extended by examining lesions from 24 dogs with clinical evidence of chronic ulcerative stomatitis. Because dogs with chronic ulcerative stomatitis often have concurrent periodontal disease, we wondered if dental plaque/biofilm may be a common instigator of inflammation in both lesions. We hypothesized that dogs with chronic ulcerative stomatitis would exhibit a spectrum of pathologic changes and phenotype of infiltrating leukocytes that would inform lesion pathogenesis and that these changes would differ from inflammatory phenotypes in periodontitis. Previously we identified chronic ulcerative stomatitis lesions to be rich in FoxP3+ and IL17+ cells. As such, we suspect that these leukocytes play an important role in lesion pathogenesis. The current study confirms the presence of moderate to large numbers of FoxP3+ T cells and IL17+ cells in all ulcerative stomatitis lesions using confocal immunofluorescence. Interestingly, the majority of IL17+ cells were determined to be non-T cells and IL17+ cell frequencies were negatively correlated with severity on the clinical scoring system. Three histologic subtypes of ulcerative stomatitis were determined; lichenoid, deep stomatitis and granulomatous. Periodontitis lesions, like stomatitis lesions, were B cell and plasma cell rich, but otherwise differed from the stomatitis lesions. Direct immunofluorescence results did not support an autoantibody-mediated autoimmune disease process. This investigation contributes to the body of literature regarding leukocyte involvement in canine idiopathic inflammatory disease pathogenesis.


Assuntos
Doenças do Cão/imunologia , Gengivite Ulcerativa Necrosante/imunologia , Animais , Doença Crônica , Diagnóstico Diferencial , Doenças do Cão/patologia , Cães , Técnica Direta de Fluorescência para Anticorpo , Gengivite Ulcerativa Necrosante/diagnóstico , Gengivite Ulcerativa Necrosante/patologia , Gengivite Ulcerativa Necrosante/veterinária , Inflamação/etiologia , Leucócitos/patologia , Mucosa Bucal/patologia , Doenças Periodontais/diagnóstico
14.
Support Care Cancer ; 28(1): 177-184, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31001696

RESUMO

PURPOSE: Crevicular fluid was used to assess interleukin-17 (IL-17) and vascular endothelial growth factor (VEGF) in cancer patients receiving zoledronic acid and/or bevacizumab. The markers were also assessed in the serum. METHODS: Twenty-five patients were included and comprised three groups: patients who received zoledronic acid (n = 9), patients who received bevacizumab (n = 9), and patients who received zoledronic acid combined with bevacizumab (n = 5). One patient received zoledronic acid and everolimus and another received zoledronic acid, bevacizumab, and temsirolimus. IL-17 and VEGF were measured by standard quantitative ELISA kits and assessed in two study points. RESULTS: Twenty-four patients maintained good periodontal health; one had asymptomatic osteonecrosis of the jaw. First assessment: 44 samples were collected; 21 from serum and 23 from crevicular fluid. Second assessment, 6 months later: 11 samples were collected; 6 from serum and 5 from crevicular fluid. IL-17 was detected in all samples, in serum and crevicular fluid, and remained unchanged at both time points. Serum VEGF in patients with bevacizumab alone or combined with zoledronic acid was significantly lower compared with that of patients who received zoledronic acid alone. VEGF was not detected in the crevicular fluid. CONCLUSIONS: Crevicular fluid might be an easy, non-invasive means to assess IL-17. The stable values of IL-17 in crevicular fluid and serum and the lack of VEGF in the crevicular fluid could be related to the good periodontal health of our patients. Further studies are needed to assess IL-17 and VEGF in the crevicular fluid in patients with and without periodontal disease.


Assuntos
Bevacizumab/administração & dosagem , Líquido do Sulco Gengival/química , Interleucina-17/análise , Neoplasias/tratamento farmacológico , Doenças Periodontais/diagnóstico , Fator A de Crescimento do Endotélio Vascular/análise , Ácido Zoledrônico/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Bevacizumab/efeitos adversos , Biomarcadores/análise , Biomarcadores/metabolismo , Quimioterapia Combinada/efeitos adversos , Feminino , Líquido do Sulco Gengival/metabolismo , Humanos , Inflamação/diagnóstico , Inflamação/metabolismo , Interleucina-17/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias/irrigação sanguínea , Neoplasias/metabolismo , Neoplasias/patologia , Neovascularização Patológica/diagnóstico , Neovascularização Patológica/metabolismo , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico , Osteonecrose/metabolismo , Doenças Periodontais/induzido quimicamente , Doenças Periodontais/etiologia , Bolsa Periodontal/induzido quimicamente , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/metabolismo , Valor Preditivo dos Testes , Fator A de Crescimento do Endotélio Vascular/metabolismo , Ácido Zoledrônico/efeitos adversos
15.
Acta Odontol Scand ; 78(3): 196-202, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31686553

RESUMO

Objective: The aim was to evaluate the association of behavioural and socioeconomic factors with the occurrence of periodontal disease and dental caries, paying special attention to the simultaneous occurrence of these diseases.Materials and methods: The study population consisted of 5255 dentate persons aged ≥30 years from a nationally representative survey. Caries and probing pocket depth were recorded by tooth and calculated in relation to the number of existing teeth. The groups were: non-affected (A), the two most affected quintiles for periodontal disease with little or no dental caries (B), the two most affected quintiles for dental caries with little or no periodontal disease (C) and the two most affected quintiles for both periodontal disease and dental caries (D). Presence of dental plaque was determined, and behavioural and socioeconomic factors were established.Results: Dental plaque, smoking, lack of regular dental check-ups, older age and a basic level of education were strongly associated with the simultaneous occurrence of periodontal disease and dental caries.Conclusions: There are many behavioural and socioeconomic factors that associate with the occurrence of both periodontal disease and dental caries. These factors also increase the risk of individuals having these diseases simultaneously.


Assuntos
Cárie Dentária/epidemiologia , Placa Dentária , Comportamentos Relacionados com a Saúde , Higiene Bucal , Doenças Periodontais/epidemiologia , Fumar/efeitos adversos , Adulto , Idoso , Estudos Transversais , Cárie Dentária/diagnóstico , Inquéritos de Saúde Bucal , Finlândia/epidemiologia , Humanos , Pessoa de Meia-Idade , Saúde Bucal , Doenças Periodontais/diagnóstico , Prevalência , Fatores de Risco , Fumar/epidemiologia , Fatores Socioeconômicos
16.
J Clin Periodontol ; 47(3): 289-308, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31701554

RESUMO

OBJECTIVE: To systematically assess the diagnostic value of host-derived salivary biomarkers based on their reported sensitivity and specificity in relation to clinical parameters of periodontal disease diagnosis in adults. MATERIALS AND METHODS: Comprehensive search of PubMed, Nature, Cochrane and OVID (Embase, MEDLINE [R] and PsycINFO) was conducted up to 1 August 2018, using key terms relevant to the research questions and Cochrane methodology, supplemented by a grey literature search. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS- 2) tool was used to assess the methodological quality of all included studies. RESULTS: Seven studies were included in the review. Macrophage inflammatory protein-1αlpha (MIP-1α), interleukin-1beta (IL-1ß), interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8) were identified as diagnostically acceptable biomarkers for periodontal disease. Overall, the combination of IL-6 and MMP-8 showed best diagnostic performance. Also, a combination of the four key biomarkers (IL-1ß, IL-6, MMP-8 and MIP-1α) showed promising results for distinction between gingivitis and periodontitis, as well as for periodontitis compared with gingival health. Results are interpreted with caution due to limitations in the number of studies included and their quality. CONCLUSION: Certain salivary biomarkers can potentially be useful in combination and singularly for the diagnosis of periodontal disease. However, further methodically robust research is required to validate these biomarkers.


Assuntos
Gengivite , Doenças Periodontais/diagnóstico , Periodontite , Adulto , Biomarcadores , Humanos , Saliva , Sensibilidade e Especificidade
17.
Int Endod J ; 53(2): 186-199, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31162683

RESUMO

AIM: To reach a consensus on a consistent strategy to adopt when screening patients for dental/periodontal infections and on the feasibility of providing dental treatment before cardiothoracic surgery, cardiovascular surgery or other cardiovascular invasive procedures. METHODOLOGY: A panel of experts from six Italian scientific societies was created. The deliberations of the panel were based on the RAND method. From an initial systematic literature review, it became clear that a consensually validated protocol for the reproducible dental screening of patients awaiting cardiac interventions was considered mandatory by professionals with expertise in the dental, cardiologic and cardiac surgery areas. However, a systematic review also concluded that the treatment options to be provided, their prognosis and timing in relation to the physical condition of patients, had never been defined. Following the systematic review, several fundamental questions were generated. The panel was divided into two working groups each of which produced documents that addressed the topic and which were subsequently used to generate a questionnaire. Each member of the panel completed the questionnaire independently, and then, a panel discussion was held to reach a consensus on how best to manage patients with dental/periodontal infections who were awaiting invasive cardiac procedures. RESULTS: A high level of agreement was reached regarding all the items on the questionnaire, and each of the clinical questions formulated were answered. Three tables were created which can be used to generate a useful tool to provide standardized dental/periodontal screening of patients undergoing elective cardiovascular interventions and to summarize both the possible oral and cardiovascular conditions of the patient and the timing available for the procedures considered. CONCLUSIONS: Upon publication of this consensus document, the dissemination of the information to a wide dental and cardiac audience should commence. The authors hope that this consensus will become a model for the development of a dedicated protocol, ideally usable by heart and dental teams in the pre-interventional preparation phase.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Doenças Periodontais , Doenças Estomatognáticas , Procedimentos Cirúrgicos Torácicos , Consenso , Humanos , Infecções , Doenças Periodontais/diagnóstico , Cuidados Pré-Operatórios , Doenças Estomatognáticas/diagnóstico
19.
PLoS One ; 14(11): e0225036, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31756178

RESUMO

OBJECTIVE: To investigate the repercussion of periodontal disease (PD) in the pregnant woman health and the complications during pregnancy and delivery, as well as negative outcomes for the newborn (as infections, prematurity, low birth weight and fetal growth restriction). METHOD: Retrospective cohort study, based on medical records of 142 pregnant women assisted at a prenatal service of usual risk between 2012-2014, with a dental evaluation for PD. Maternal variables, along with labor and newborn variables, were analyzed. The newborns were stratified into two groups: offspring of mothers with PD (subdivided into Severe Periodontal Disease-SPD) and offspring of mothers without PD. Each outcome was adjusted by a multiple logistic regression model, with significance for p-value <0.05, considering all potential confounding factors. RESULTS: Among women diagnosed with SPD, the odds ratio for vulvovaginitis was 3.45 times greater (OR = 3.45, p-value = 0.050) and 5.59 times higher for premature rupture of membranes (OR = 5.59; p-value = 0.017). For neonates, the chance of fetal growth restriction was 11.53 times higher for pregnant women with SPD (OR = 11.53, p = 0.041). CONCLUSION: The periodontal disease increased the chance of neonatal and maternal negative outcomes, being the fetal growth restriction, vulvovaginitis and premature rupture of the membrane (PROM) the main results driven by the presence of Severe Periodontal Disease.


Assuntos
Saúde do Lactente , Doenças Periodontais/epidemiologia , Adulto , Estudos de Coortes , Escolaridade , Feminino , Humanos , Recém-Nascido , Trabalho de Parto , Exposição Materna , Parto , Doenças Periodontais/diagnóstico , Gravidez , Resultado da Gravidez , Adulto Jovem
20.
Int J Rheum Dis ; 22(11): 1990-2000, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31659869

RESUMO

OBJECTIVE: To evaluate the adipokine levels in early rheumatoid arthritis (eRA) and first-degree relatives (FDR) of patients with RA and establish their association with rheumatic disease activity and periodontal variables. METHOD: A cross-sectional study with eRA patients, FDR and a healthy population. Adipokine levels, clinical, joint radiological indexes and periodontal variables were evaluated. A descriptive, bivariate analysis was performed based on the adipokine levels by χ2 , Fisher's test and Mann-Whitney U test. A logistic regression was made for associations. RESULTS: High leptin levels were associated with the diagnosis of eRA (odds ratio [OR] = 2.79; 95% CI 1.54-5.07). Early rheumatoid arthritis with high adiponectin levels was less likely to have Multidimensional Health Assessment Questionnaire score >3, body mass index (BMI) >25 and Routine Assessment of Patient Index Data 3 score >12 (OR = 0.16; 95% CI 0.03-0.72). Early rheumatoid arthritis was more likely to present high leptin and interleukin (IL)6 levels with low adiponectin simultaneously (OR = 5.03; 95% CI 1.05-24.0). High leptin levels were associated with the FDR adjusted for IgG2 Porphyromonas gingivalis, swollen joints, P gingivalis and low IL6 (OR = 2.57; 95% CI 1.14-5.95). CONCLUSION: High adipokine levels in eRA may modulate the disease activity. Having more than 1 adipokine at high serum levels is associated with increased disability, disease activity and BMI, indicating that RA is controlled by adiponectin levels in the early stages of the disease. High leptin levels, presence of P gingivalis and swollen joints may be the factors associated with the development of RA in FDR.


Assuntos
Adipocinas/sangue , Artrite Reumatoide/sangue , Família , Doenças Periodontais/sangue , Adulto , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/genética , Biomarcadores/sangue , Estudos Transversais , Diagnóstico Precoce , Feminino , Hereditariedade , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Doenças Periodontais/diagnóstico , Doenças Periodontais/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Medição de Risco , Fatores de Risco , Regulação para Cima
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