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1.
Evid Based Dent ; 21(4): 120-121, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33339967

RESUMO

Data sources MEDLINE (PubMed), Web of Science and Cochrane Library in September 2019.Study selection Cross-sectional and cohort studies that explored the relationship between smoking cessation and tooth loss.Data extraction and synthesis The reviewers extracted data and contacted authors if relevant data were missing. Risk of bias was assessed using modified versions of the Newcastle-Ottawa scale (NOS) for both cohort and cross-sectional studies. For cross-sectional studies, random-effects model was used to assess the outcome (tooth loss). Estimates were presented as odds ratios (with 95% confidence interval). For cohort studies, random-effects model was also used to compare former and current smokers to never smokers. The estimates were presented as risk ratio (with 95% confidence interval). Heterogeneity was tested for both types of studies.Results Twenty-one studies were included in the review (14 cross-sectional and seven cohort). Of the cross-sectional studies, five studies were of low risk of bias while seven and two studies were of moderate and high risk of bias respectively. Former vs current smokers showed no significant difference in all levels of tooth loss. Of the cohort studies, the risk of tooth loss was twice as much for current smokers compared to former smokers.Conclusions There was not a significant difference in tooth loss between former smokers and never smokers. Current smokers are at a higher risk for tooth loss than former smokers.


Assuntos
Abandono do Hábito de Fumar , Perda de Dente , Estudos de Coortes , Estudos Transversais , Humanos , Fumar/efeitos adversos , Perda de Dente/prevenção & controle
3.
Menopause ; 26(11): 1277-1283, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31688575

RESUMO

OBJECTIVE: This randomized, clinical trial investigated whether zoledronic acid combined with oral health maintenance can improve periodontal disease associated with osteoporosis, thus reducing the risk of tooth loss. METHODS: Participants were those of the ZONE (ZOledroNate treatment in efficacy to osteoporosis) study. None of the participants had symptomatic periodontal disease at baseline. Participants received either zoledronic acid (5 mg; n = 333 [male 21, female 312]) or placebo (n = 332 [male 19, female 313]) once yearly for 2 years, and their age was 74.0 ±â€Š5.3 (65-88) and 74.3 ±â€Š5.4 (65-87) years, respectively. Participants were instructed to maintain good oral hygiene at baseline and every 3 months. Participants with signs or symptoms involving their oral cavity at the monthly visit with their physician were referred to dentists for examination of oral disease. All cases were included to analyze adverse events in this study. Testing for significance was conducted using Fisher exact test (P < 0.05). RESULTS: The incidence of oral adverse events was significantly higher in the control group (67 cases, 20.2%) than in the zoledronic acid group (47 cases, 14.1%; P = 0.04). The frequency of symptomatic periodontal disease observed during the study was significantly higher in the control group (40 cases, 12.0%) than in the zoledronic acid group (18 cases, 5.4%; P = 0.002). Loss of teeth was more frequent in the control group (36 cases, 10.8%) than in the zoledronic acid group (24 cases, 7.2%), although the difference was not significant. CONCLUSIONS: Zoledronic acid effectively prevented symptomatic periodontal disease in patients with osteoporosis who maintained good oral hygiene. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A438.


Assuntos
Conservadores da Densidade Óssea/administração & dosagem , Osteoporose/tratamento farmacológico , Doenças Periodontais/prevenção & controle , Perda de Dente/prevenção & controle , Ácido Zoledrônico/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Esquema de Medicação , Feminino , Humanos , Masculino , Osteoporose/complicações , Doenças Periodontais/etiologia , Perda de Dente/etiologia , Resultado do Tratamento
4.
Tohoku J Exp Med ; 247(4): 251-257, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30996210

RESUMO

Tooth loss is a risk factor for pneumonia mortality, but it is unclear whether oral care negates excess mortality due to pneumonia among community-dwelling elderly with tooth loss. The purpose of this study was to examine the influence of oral care on the association between the number of remaining teeth and the risk of pneumonia death. We analyzed for 18,098 individuals (aged ≥ 65 years) participating in a prospective cohort study. In a 2006 baseline survey, the following data were collected: the number of remaining teeth, oral care, history of disease, smoking, alcohol drinking, education level and so forth. We also obtained data on dates and causes of death between 2006 and 2014. The primary outcome was mortality due to pneumonia. Compared with those having ≥ 20 teeth, the risk of pneumonia mortality was increased among participants having 10-19 or 0-9 teeth; the multivariate hazard ratios (HRs) (95% confidence intervals [CI]) were 1.45 (1.03-2.04) and 1.38 (1.01-1.87), respectively. Among those having 0-9 teeth, a significantly increased risk of mortality due to pneumonia was disappeared for those who brushed their teeth ≥ 2 times per day, for those with visiting a dentist, and for those with use of denture, whereas the risk persisted among those who brushed their teeth ≤ 2 times per day, for those without visiting a dentist, and for those without use of denture. Tooth-brushing, visiting a dentist or use of denture may negate the increased risk of pneumonia death among the elderly with tooth loss.


Assuntos
Saúde Bucal , Pneumonia/mortalidade , Pneumonia/prevenção & controle , Autocuidado , Perda de Dente/complicações , Perda de Dente/prevenção & controle , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pneumonia/complicações
5.
Acta Odontol Scand ; 77(5): 364-370, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30777469

RESUMO

OBJECTIVES: To describe the oral health and oral health-related quality of life among social vulnerable adults enrolled in a special oral care program, and to evaluate the effect of oral care on their oral health-related quality of life. METHOD: Social workers identified social vulnerable persons in social centres and referred them to the program. Dental clinics were arranged including a well-motivated staff to be special responsive to these clients. The participants, (n = 235, mean age 43.5 years) with drug abuse, being homeless, permanently unemployed, or with mental problems were offered low-cost treatment services. Data collection was made by clinical registration and questionnaires. Oral health-related quality of life was measured by means of the Oral Health Impact Profile-14 index (OHIP-14). RESULTS: 94% of the participants had actual decayed teeth (mean 9.5). Forty-four per cent had not visited a dentist within 5 years and less than one-third reported tooth brushing twice a day, 17% even less frequent. One hundred and forty-six completed the dental program within the program period. Mean OHIP-14 score was 28.6 at baseline. Among those who fulfilled the program, the OHIP-14 score was reduced to 9.9 (p < .001). CONCLUSION: Oral health among the study population was very poor. However, oral problems in this group can be solved, and their oral health-related quality of life can be increased although it requires special arrangements and special clinical environment.


Assuntos
Odontologia Comunitária/organização & administração , Serviços de Saúde Comunitária/organização & administração , Cárie Dentária/prevenção & controle , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas em Situação de Rua/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Adulto , Dinamarca , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal/estatística & dados numéricos , Qualidade de Vida , Perda de Dente/prevenção & controle , Odontalgia/prevenção & controle
6.
Int J Dent Hyg ; 17(1): 64-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30381874

RESUMO

OBJECTIVE: To explore the association between long-term pattern of dental attendance and tooth retention among British adults. METHODS: This study analysed data from 2970 dentate adults who participated in the Adult Dental Health Survey. Data were collected through home interviews and clinical examinations. Individuals were categorized into four trajectories according to their responses to three questions on dental attendance over their life span. The four trajectories were always, current, former and never regular attenders. Tooth retention was measured as the number of natural teeth retained and having a functional dentition (20 or more teeth). Associations were examined in regression models adjusted for demographic (sex, age and country of residence), socioeconomic (education, equivalized household income and social class) and clinical factors (untreated caries and periodontal disease). RESULTS: Never and former regular attenders had fewer teeth retained (rate ratios with 95% confidence interval: 0.93 [0.89-0.97] and 0.97 [0.96-0.99], respectively) and lower odds of having functional dentition (odds ratios with 95% CI: 0.36 [0.22-0.60] and 0.53 [0.34-0.83], respectively) than always regular attenders after adjusting for demographic, socioeconomic and clinical characteristics. However, no differences in number of teeth retained or having a functional dentition were found between always and current regular attenders. CONCLUSION: Long-term regular dental attendance was associated with greater tooth retention. Never and former regular attenders had fewer teeth retained than always regular attenders. No difference in tooth retention was found between always and current regular attenders.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controle , Adolescente , Adulto , Idoso , Estudos Transversais , Inquéritos de Saúde Bucal , Dentição Permanente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores Socioeconômicos , Fatores de Tempo , Reino Unido/epidemiologia , Adulto Jovem
7.
Cochrane Database Syst Rev ; 1: CD009376, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29291254

RESUMO

BACKGROUND: Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re-infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases.According to the American Academy of Periodontology, SPT should include all components of a typical dental recall examination, and importantly should also include periodontal re-evaluation and risk assessment, supragingival and subgingival removal of bacterial plaque and calculus, and re-treatment of any sites showing recurrent or persistent disease. While the first four points might be expected to form part of the routine examination appointment for periodontally healthy patients, the inclusion of thorough periodontal evaluation, risk assessment and subsequent treatment - normally including mechanical debridement of any plaque or calculus deposits - differentiates SPT from routine care.Success of SPT has been reported in a number of long-term, retrospective studies. This review aimed to assess the evidence available from randomised controlled trials (RCTs). OBJECTIVES: To determine the effects of supportive periodontal therapy (SPT) in the maintenance of the dentition of adults treated for periodontitis. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 5), MEDLINE Ovid (1946 to 8 May 2017), and Embase Ovid (1980 to 8 May 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials (RCTs) evaluating SPT versus monitoring only or alternative approaches to mechanical debridement; SPT alone versus SPT with adjunctive interventions; different approaches to or providers of SPT; and different time intervals for SPT delivery.We excluded split-mouth studies where we considered there could be a risk of contamination.Participants must have completed active periodontal therapy at least six months prior to randomisation and be enrolled in an SPT programme. Trials must have had a minimum follow-up period of 12 months. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results to identify studies for inclusion, assessed the risk of bias in included studies and extracted study data. When possible, we calculated mean differences (MDs) and 95% confidence intervals (CIs) for continuous variables. Two review authors assessed the quality of evidence for each comparison and outcome using GRADE criteria. MAIN RESULTS: We included four trials involving 307 participants aged 31 to 85 years, who had been previously treated for moderate to severe chronic periodontitis. Three studies compared adjuncts to mechanical debridement in SPT versus debridement only. The adjuncts were local antibiotics in two studies (one at high risk of bias and one at low risk) and photodynamic therapy in one study (at unclear risk of bias). One study at high risk of bias compared provision of SPT by a specialist versus general practitioner. We did not identify any RCTs evaluating the effects of SPT versus monitoring only, or of providing SPT at different time intervals, or that compared the effects of mechanical debridement using different approaches or technologies.No included trials measured our primary outcome 'tooth loss'; however, studies evaluated signs of inflammation and potential periodontal disease progression, including bleeding on probing (BoP), clinical attachment level (CAL) and probing pocket depth (PPD).There was no evidence of a difference between SPT delivered by a specialist versus a general practitioner for BoP or PPD at 12 months (very low-quality evidence). This study did not measure CAL or adverse events.Due to heterogeneous outcome reporting, it was not possible to combine data from the two studies comparing mechanical debridement with or without the use of adjunctive local antibiotics. Both studies found no evidence of a difference between groups at 12 months (low to very low-quality evidence). There were no adverse events in either study.The use of adjunctive photodynamic therapy did not demonstrate evidence of benefit compared to mechanical debridement only (very low-quality evidence). Adverse events were not measured.The quality of the evidence is low to very low for these comparisons. Future research is likely to change the findings, therefore the results should be interpreted with caution. AUTHORS' CONCLUSIONS: Overall, there is insufficient evidence to determine the superiority of different protocols or adjunctive strategies to improve tooth maintenance during SPT. No trials evaluated SPT versus monitoring only. The evidence available for the comparisons evaluated is of low to very low quality, and hampered by dissimilarities in outcome reporting. More trials using uniform definitions and outcomes are required to address the objectives of this review.


Assuntos
Antibacterianos/uso terapêutico , Periodontite Crônica/terapia , Desbridamento Periodontal/métodos , Periodontia/métodos , Fotoquimioterapia/métodos , Perda de Dente/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Periodontite Crônica/complicações , Placa Dentária/terapia , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Periodontol 2000 ; 76(1): 150-163, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29193404

RESUMO

The ultimate goal of periodontal therapy is to prevent further disease progression in order to reduce the risk of tooth loss. This objective can be achieved through a number of therapeutic modalities comprising both the nonsurgical and surgical phases of periodontal therapy. Nonsurgical periodontal treatment has been shown to control periodontal infection and to arrest progression of the disease in a significant number of cases. However, despite completion of nonsurgical treatment, a number of periodontal pockets, defined as 'residual', often remain. The presence of residual pockets may jeopardize tooth survival and be a risk factor of further disease progression, and ultimately tooth loss. Therefore, the aim of this review is to analyze the knowledge available on the indications for and the performance of periodontal surgical treatment of residual pockets in terms of 'traditional' (clinical, microbiological), patient-based and systemic health outcomes.


Assuntos
Procedimentos Cirúrgicos Bucais/métodos , Bolsa Periodontal/cirurgia , Bolsa Periodontal/terapia , Custos e Análise de Custo , Progressão da Doença , Humanos , Microbiota , Procedimentos Cirúrgicos Bucais/efeitos adversos , Procedimentos Cirúrgicos Bucais/economia , Doenças Periodontais/cirurgia , Doenças Periodontais/terapia , Periodontite/cirurgia , Periodontite/terapia , Fatores de Risco , Fumar , Perda de Dente/prevenção & controle , Resultado do Tratamento
9.
Prev Chronic Dis ; 14: E115, 2017 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-29144892

RESUMO

INTRODUCTION: Tooth preservation in adults and children is one of the Healthy People 2020 goals for oral health. Although the overall prevalence of tooth loss has been declining in the United States, substantial racial/ethnic differences in preventable tooth loss persist as a public health problem. We examined the strength of the association of health risk factors and tooth loss in Hawai'i. METHODS: We used data from the Hawai'i Behavioral Risk Factor Surveillance System survey collected from 2011 through 2014. Participant responses were included if they self-identified as Native Hawaiian, white, Japanese, or Filipino. Differences in excess tooth loss (6 or more teeth) and known risk factors (demographics, diabetes, and dental visits) were analyzed by using univariate analyses and adjusted stepwise, logistic regression models. RESULTS: We identified oral health inequity among the 4 ethnic groups studied; among the groups, Native Hawaiians had the largest proportion of excess tooth loss. The univariate analyses found differences in the strength of these associations among the 4 racial/ethnic groups. The stepwise analyses found that the associations of excess tooth loss and race/ethnicity were not significant after adjusting for demographics, diabetes status, and dental visits. CONCLUSION: Findings suggest a need for programs and policies that improve access to oral health care in Hawai'i for those with low levels of income and education and those with diabetes.


Assuntos
Assistência Odontológica , Complicações do Diabetes , Fatores Socioeconômicos , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controle , Hawaii/epidemiologia , Humanos , Fatores de Risco
10.
Int Dent J ; 67 Suppl 2: 19-25, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29023745

RESUMO

Population ageing is a global phenomenon and is predicted to become one of the most significant social transformations of the 21st century. The anticipated demographic shift provides governments the opportunity to proactively align policies with the estimated demands for housing, transportation, social protection, and health and well-being. Oral health is a fundamental component of health and physical and mental well-being, and is influenced by the individual's changing experience, perceptions, expectations and ability to adapt to circumstances. As such, prevention of oral disease and maintenance of oral health contributes to the systemic health, well-being, and quality of life of older adults. Dental caries, periodontal disease, and tooth loss in older adults are global health concerns because they are highly prevalent worldwide, socio-economic inequalities contribute to these diseases, many of the risk factors are modifiable, and these diseases result in compromised oral health-related quality of life. Oral care must be tailored to the needs and level of dependency of older adults through the use of evidence-based approaches and inter-professional collaboration. The persistence of between countries and within countries oral health disparities indicate that population-based policies are also needed to address the underlying social, environmental, and economic causes of oral diseases.


Assuntos
Perda de Dente/prevenção & controle , Odontalgia/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Cárie Dentária/prevenção & controle , Humanos , Periodontite
11.
Niger J Clin Pract ; 20(8): 1010-1019, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28891547

RESUMO

OBJECTIVE: The defective diagnosis of alveolar structures is one of most serious handicaps when assessing available periodontal treatment options for the prevention of tooth loss. The aim of this research was to classify alveolar bone defects in the maxillary molar region which is a challenging area for dental implant applications. To our knowledge, this is the first study of periodontal bone defect prevalence by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In this study, the remaining alveolar bone patterns of 669 maxillary molars of 243 patients with periodontal bone loss were investigated on four aspects and the furcation areas of teeth, and then they were classified into six main groups. Combined periodontal-endodontic lesions (CPELs) were also reported in another category. RESULTS: Following exclusion of 39 (5.8%) teeth with CPEL, the most common group was horizontal bone defects (71.4%) and the least seen group was three-walled vertical bone defects (1.9%) in all alveolar bone sides of teeth. Osseous crater was found at the rate of 6.7% on interdental alveolar bone. Dehiscence and fenestration were detected at rates of 2.7% and 3.3%, respectively. In the assessment of furcation areas, there was no furcation involvement in 61.4% of all teeth and the rate of Grade-II involvements was 26.2%. CONCLUSIONS: The most appropriate treatment option may be decided through accurate imaging of periodontal defect morphology. CBCT can provide comprehensive information about the remaining alveolar bone structures. In this way, the need for dental implant can be prevented in many cases and be replaced with a more conservative approach on the maxillary molar region.


Assuntos
Perda do Osso Alveolar/classificação , Perda do Osso Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Doenças Maxilares/diagnóstico por imagem , Adulto , Tomada de Decisão Clínica , Feminino , Defeitos da Furca/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar , Perda de Dente/prevenção & controle , Adulto Jovem
12.
J Dent Educ ; 81(8): eS110-eS119, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28765462

RESUMO

Since the mid-20th century, there has been a remarkable decline in dental caries in the United States. The effects of that caries decline have now been demonstrated well into the adult population. These improvements in oral health are resulting in substantial declines in the reparative and restorative dental services being provided to the affected individuals, who comprise a growing part of the population. Because of fewer compromised teeth, extractions and their sequelae also are declining. Much of the recall and periodontal maintenance care can be provided by allied dental personnel. As the older age cohorts, who were children before the caries decline occurred, become an ever-smaller part of the population, the number of patients an individual dentist can treat in a year is likely to increase. This article was written as part of the project "Advancing Dental Education in the 21st Century."


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Saúde Bucal/tendências , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Humanos , Lactente , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controle , Estados Unidos/epidemiologia , Adulto Jovem
13.
Periodontol 2000 ; 75(1): 152-188, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28758300

RESUMO

Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.


Assuntos
Periodontia/métodos , Periodontite/terapia , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Terapia Combinada , Placa Dentária/prevenção & controle , Dieta , Progressão da Doença , Humanos , Higiene Bucal , Perda da Inserção Periodontal/prevenção & controle , Abandono do Hábito de Fumar , Perda de Dente/prevenção & controle
14.
J Clin Periodontol ; 44(12): 1182-1191, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28733997

RESUMO

OBJECTIVES: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. MATERIAL AND METHODS: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. RESULTS: PTL over 40 years varied between 0 and 28 teeth (mean 13.1). Four subjects presented with no PTL, while 12 were edentulous. Logistic regression revealed attachment loss as a statistically significant covariate for PTL (p < .004). Markov chain analysis showed that smoking and calculus were associated with disease initiation and that calculus, plaque, and gingivitis were associated with loss of attachment and progression to advanced disease. Mean attachment loss <1.81 mm at the age of 30 yielded highest sensitivity and specificity (0.71) to allocate subjects into a cohort with a dentition of at least 20 teeth at 60 years of age. CONCLUSIONS: These results highlight the importance of treating early periodontitis along with smoking cessation, in those under 30 years of age. They further show that calculus removal, plaque control, and the control of gingivitis are essential in preventing disease progression, further loss of attachment and ultimately tooth loss.


Assuntos
Progressão da Doença , Periodontite/complicações , Periodontite/epidemiologia , Perda de Dente/epidemiologia , Perda de Dente/etiologia , Adolescente , Adulto , Areca , Periodontite Crônica/complicações , Periodontite Crônica/epidemiologia , Cálculos Dentários/complicações , Cálculos Dentários/epidemiologia , Cálculos Dentários/prevenção & controle , Placa Dentária/complicações , Placa Dentária/epidemiologia , Placa Dentária/prevenção & controle , Gengivite/complicações , Gengivite/epidemiologia , Gengivite/prevenção & controle , Hábitos , Hong Kong , Humanos , Arcada Parcialmente Edêntula/epidemiologia , Arcada Parcialmente Edêntula/etiologia , Modelos Logísticos , Estudos Longitudinais , Masculino , Cadeias de Markov , Boca Edêntula/etiologia , Perda da Inserção Periodontal/complicações , Perda da Inserção Periodontal/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Índice Periodontal , Periodontite/prevenção & controle , Fatores de Risco , Sensibilidade e Especificidade , Fumar , Abandono do Hábito de Fumar , Fatores de Tempo , Perda de Dente/prevenção & controle , Adulto Jovem
16.
J Clin Periodontol ; 44(1): 51-57, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27801940

RESUMO

AIM: To evaluate the association between risk scores generated with a simplified method for periodontal risk assessment (Perio Risk), and tooth loss as well as bone loss during supportive periodontal therapy (SPT). MATERIALS & METHODS: Data related to 109 patients (42 males; mean age: 42.2 ± 10.2 years, range 22-62) enrolled in a SPT programme for a mean period of 5.6 years were retrospectively obtained at two specialist periodontal clinics. Patients were stratified according to Perio Risk score (on a scale from 1 - low risk to 5 - high risk) as calculated at the end of active periodontal therapy. Risk groups were compared for tooth loss as well as the changes in radiographic bone levels occurred during SPT. RESULTS: The mean number of teeth lost per patient during SPT varied from 0 to 1.8 ± 2.5 for patients with a risk score of 1 and 5 respectively (p = 0.041). Mean radiographic bone loss during SPT was ≤0.5 mm in all risk groups, without significant inter-group differences. CONCLUSIONS: Periodontal risk assessment according to Perio Risk may help to identify patients at risk for tooth loss during SPT.


Assuntos
Índice Periodontal , Periodontite/complicações , Periodontite/terapia , Perda de Dente/diagnóstico , Perda de Dente/etiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Perda de Dente/prevenção & controle , Adulto Jovem
17.
J Clin Periodontol ; 44(2): 169-177, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28028838

RESUMO

AIM: The longitudinal study assessed the risk of tooth loss under a non-regenerative treatment regimen and aimed to identify prognostic factors for tooth loss. METHODS: Three hundred and fifteen patients (8009 teeth) were examined before (T0) and after active periodontal therapy (APT, T1) as well as after (mean ± SD) 18 ± 6 years of supportive periodontal therapy (SPT, T2). Descriptive statistics and a Cox proportional hazards shared-frailty model were applied. RESULTS: Overall, 351 and 816 teeth were lost during APT and SPT, respectively, with 0.15 ± 0.17 teeth being lost per patient and year. Seventy-two percentage patients lost 0-3, 24% 4-9 and 4% ≥10 teeth. The proportion of teeth with probing-pocket depths (PPD) >6 mm was 17.2% (T0), 1.6% (T1) and remained stable at 1.7% up to T2. Tooth loss during SPT was significantly increased in older patients [HR (95% CI): 1.04 (1.01-1.07) per year] and smokers [2.62 (1.34-5.14)], with each mm of PPD [1.35 (1.17-1.56)], in multirooted compared with single-rooted teeth [1.86 (1.36-2.56)] and teeth with bone loss [BL; HR up to 23.6 (12.1-45.6) for BL > 70%]. CONCLUSION: The risk of tooth loss was generally low under the provided non-regenerative treatment regimen; a minority of patients were responsible for the majority of teeth lost during SPT.


Assuntos
Periodontite Crônica/terapia , Tratamento Conservador , Perda de Dente/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Periodontite Crônica/complicações , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Perda de Dente/epidemiologia , Perda de Dente/etiologia , Universidades
18.
Claves odontol ; 23(75): 13-25, 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-972622

RESUMO

El objetivo de este estudio fue conocer el estado dental de piezas endodonciadas en correlación conlas variables de restauración coronaria, nivel de estudio, condición laboral y acceso a servicios odontológicos. Para ello, se analizó una población de individuos, compuesta por sujetos concurrentes a los cursos de posgrado de Endodoncia del Círculo Odontológico de Córdoba y al servicio de la Cátedra“B” de Endodoncia de la Facultad de Odontología de la Universidad Nacional de Córdoba. Se hicieron tratamientos controlados durante dieciocho meses. La muestra total la conformaron 144 pacientes y se trataron 174 casos. Sólo asistieron a control el 48,6 por ciento de los pacientes, de los cuales se evaluaron 89 dientes. El estudio mostró 37 casos con restauración coronaria definitiva sin fracturas, 52 dientes sinrestauración, 21 con fracturas y 1 se perdió. Se observó un incremento de fracturas en control a los 18 meses. La tasa de fracturas evidenció un mayor porcentaje en pacientes con nivel de estudio alto, menor en pacientes sin trabajo, y mayor en pacientes con trabajo estable y precario. El tipo de atención no se diferenció, pero los porcentajes observados sugieren que los atendidos en asistencia pública tendrían más probabilidad de fracturas. Se observó un mayor porcentaje de restauraciones definitivas enatención privada y menor en consultorios públicos. El elevado porcentaje de inasistencia a controlesmotivó un análisis específico, del cual se pudo concluir que a mayor estabilidad laboral, de estudios yde asistencia privada, mayor fue la asistencia a controles. Estos datos revelan información importantepara establecer políticas públicas de la atención posendodoncia.


The aim of this study was to know the dental state of endodontic pieces in correlation with different variables such as coronary restoration, level of study, employment status and access to dental services.To do so, we analyzed a population composed of subjects who participated in two different graduate courses at the Círculo Odontológico de Córdoba and the “Chair B” of Endodontics of the Faculty ofDentistry, National University of Córdoba. Treatments were clinically and radiographically controlled for eighteen months. The total sample included 144 patients and 174 treatments. Only 48.6% patients attended the control, 89 teeth of whom were evaluated. The study showed 37 cases with definitivecoronary restoration without fractures, 52 teeth without restoration, 21 with fractures, and 1 was lost.The fracture rate showed an increase in patients with high level of study, a decrease in unemployed patients, and an increase in both patients with stable and precarious work. The kind of attention didnot differ, but the observed percentages suggest that patients treated in public services would be morelikely to suffer from fractures. There was a higher percentage of definitive restorations in private services,and lower in public ones. The high percentage of non-attendance to controls motivated a specific analysis, from which it is possible to conclude that the more job stability, studies and private access todental services, the more the attendance to controls. These data reveal important evidence in order to establish public policies of post-endodontic services.


Assuntos
Masculino , Feminino , Humanos , Tratamento do Canal Radicular/estatística & dados numéricos , Técnica para Retentor Intrarradicular/estatística & dados numéricos , Coroas , Fatores Socioeconômicos , Restauração Dentária Permanente/estatística & dados numéricos , Perda de Dente/prevenção & controle , Argentina , Acesso aos Serviços de Saúde/estatística & dados numéricos , Faculdades de Odontologia , Análise Estatística , Estudos Longitudinais , Epidemiologia Descritiva , Estudos Prospectivos , Dente não Vital/diagnóstico por imagem
19.
Claves odontol ; 23(75): 27-41, 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-972623

RESUMO

El objetivo de este estudio fue conocer el estado dental de piezas endodonciadas en correlación conlas variables de restauración coronaria, estado periodontal, nivel de estudio, condición laboral y acceso a servicios odontológicos. Para ello, se analizó una población de individuos compuesta por sujetos concurrentes a los cursos de posgrado de Endodoncia, del Círculo Odontológico de Córdoba, y al servicio de la Cátedra “B” de Endodoncia de la Facultad de Odontología, Universidad Nacional de Córdoba. Se hicieron tratamientos controlados durante dieciocho meses. La muestra total la conformaron 144 pacientes y se trataron 174 casos. El estudio mostró 37 casos con restauración coronaria definitiva sin fracturas, 52 dientes sin restauración, 21 con fracturas y 1 se perdió. De los dientes restaurados, el55,6 por ciento mostraron periodonto normal; 22,2 por ciento gingivitis, y 22 por ciento periodontitis leve. De los dientes sin restauración, el 3,9 por ciento mostraron periodonto normal; 7,8 por ciento gingivitis; 31,4 por ciento periodontitis leve; 35,3 por ciento periodontitis grave y 21,6 por ciento periodontitis complicada. De los dientes fracturados, el 16,7 por ciento mostraron periodonto normal o gingivitis; 35,3 por ciento periodontitis leve y grave, y un 72,7 por ciento periodontitis complicada. No se demostró asociación entre nivel de estudios, condición laboral y tipo de atención con fracturas de los pacientes, pero los porcentajes sugieren más probabilidad de sufrir fractura en los pacientes de la asistencia pública. El elevado porcentaje de inasistencia a control motivó un análisis específico, del cual se pudo concluir que cuanto más grave la patología periodontal, mayor el porcentaje de inasistencia. El estudio permitió observar desigualdad en el acceso a los servicios odontológicos, dientes no rehabilitados y con compromiso periodontal.


The aim of this study was to know the dental state of endodontic pieces in correlation with different variables such as coronary restoration, periodontic condition, level of study, employment status and access to dental services. A population composed of patients treated in two different postgraduate courses at the Círculo Odontológico de Córdoba and Chair “B” of Endodontics, Faculty of Dentistry,National University of Córdoba were analyzed. Treatments were clinically and radiographicallycontrolled for eighteen months. The total sample included 144 patients and 174 treatments. The studyshowed 37 cases with definitive coronary restoration without fractures, 52 teeth without restoration,21 with fractures, and 1 was lost. From restored teeth, 55.6% showed normal periodontium, 22.2%gingivitis, and 22% mild periodontitis. From teeth without restoration, 3.9% showed normalperiodontitis, 7.8% gingivitis, 31.4% mild periodontitis, 35.3% severe periodontitis and 21.6%complicated periodontitis. From fractured teeth, 16.7% showed normal periodontitis or gingivitis, 35.3% had mild and severe periodontitis, and 72.7% had complicated periodontitis. There has beenno correlation between level of education, work status, and kind of service on patient with fractures,but the percentage suggest that patients in public assistance are more likely to suffer fracture. The highpercentage of non-attendance to control led to a specific analysis, from which it is possible to concludedthat the more severe the periodontal disease, the greater the percentage of non-attendance. The study showed inequality in access to dental services, un rehabilitated teeth and with periodontal compromise.


Assuntos
Masculino , Feminino , Humanos , Adulto , Tratamento do Canal Radicular/estatística & dados numéricos , Restauração Dentária Permanente/estatística & dados numéricos , Fatores Socioeconômicos , Doenças Periodontais/epidemiologia , Fraturas dos Dentes/prevenção & controle , Perda de Dente/prevenção & controle , Argentina , Faculdades de Odontologia , Coroas , Prognóstico , Estudos Longitudinais , Epidemiologia Descritiva , Estudos Prospectivos , Análise Estatística , Qualidade da Assistência à Saúde , Periodontite/epidemiologia
20.
Belo Horizonte; s.n; 2017. 142 p. ilus.
Tese em Português | LILACS, BBO - Odontologia | ID: biblio-908571

RESUMO

Esta Tese reporta dois estudos distintos relacionados à terapia de manutenção periodontal (TMP): achados microbiológicos longitudinais de 6 anos relacionados à cooperação dos indivíduos e efeito do tabagismo na perda dental. A justificativa para estes estudos é baseada em dois aspectos pontuais: (1) Embora a associação do tabagismo como fator de risco para a periodontite e pior resposta à TMP tenha sido demonstrada em muitos estudos, o efeito isolado deste sobre a perda dental em indivíduos submetidos a TMP ainda não foi reportado em revisões sistemáticas; (2) Poucos estudos têm sido conduzidos avaliando mudanças longitudinais na microbiota subgengival de indivíduos em TMP e, até o momento, nenhum estudo relacionou níveis de bactérias associadas à periodontite com o grau de cooperação dos indivíduos em TMP. Neste sentido, os objetivos deste estudo são apresentados em dois artigos científicos: (1) realizar uma revisão sistemática e meta-análise do efeito do tabagismo na perda dental em indivíduos em TMP, com a seguinte questão focal: ¿Qual é o efeito do tabagismo na perda dental em indivíduos em terapia de manutenção periodontal?¿; (2) avaliar longitudinalmente, durante 6 anos, o efeito da cooperação em TMP na frequência das bactérias Actinomyces naeslundii, Porphyromonas gingivalis, Tanerella forsythia e Treponema dentícola. Na revisão sistemática as bases de dados MEDLINE, WEB OF SCIENCE, COCHRANE LIBRARY e SCOPUS foram pesquisadas, incluindo artigos até fevereiro de 2017. A estratégia de busca identificou 728 referências. Após a remoção das duplicatas, restaram 591 para a seleção baseada nos títulos e resumos, e desses, foram selecionados 36 para leitura completa do texto. Após a leitura, foram incluídos 10 artigos para revisão sistemática e 3 artigos para meta-análise. A qualidade da evidência científica foi moderada para indivíduos tabagistas em TMP apresentarem maior chance de perda dental que indivíduos não tabagistas. A metodologia do estudo microbiológico englobou um total de 56 indivíduos, todos recrutados de um coorte prospectivo com 212 participantes de um programa de TMP. Estes indivíduos foram acompanhados durante 6 anos, em 5 tempos de avaliações: T1 (anterior à terapia periodontal ativa), T2 (após a terapia periodontal ativa), T3 (última visita à TMP em 2 anos), T4 (última visita à TMP em 4 anos) e T5 (última visita à TMP em 6 anos). Assim, 28 indivíduos cooperadores regulares (CR) foram randomizados e pareados, pelo gênero e idade, a 28 indivíduos cooperadores irregulares (CI). Durante a TMP, os exames periodontais avaliaram os parâmetros clínicos: índice de placa (IP), profundidade de sondagem (PS), nível clínico de inserção (NCI) e sangramento à sondagem (SS). A quantificação de bactérias em carga total e dos níveis de A. naeslundii, P. gingivalis, T. forsythia e T. dentícola foi executada pela reação em cadeia da polimerase quantitativa (qPCR). Este estudo concluiu que CI apresentaram piores parâmetros clínicos periodontais e maiores níveis de carga bacteriana total que CR, refletindo o papel benéfico da cooperação na TMP em manter a estabilidade da condição periodontal


This Thesis report two distinct issues related to periodontal maintenance therapy (PMT): microbiological findings of 6 years related to compliance of individuas and effect of smoking on tooth loss. The rattionale for these studies is based on two specific aspects: (1) Although the association of smoking as a risk factor for periodontitis and worse response to PMT has been demonstrated in many studies, the isolated effect of smoking on tooth loss in patients undergiong PMT has not been reported in systematic reviews; (2) Few studies have been conducted on longitudinal changes in the subgingival microbiota of individuals in PMT and to date, no study related levels of bacteria to the degree of cooperation of individuls in PMT...


Assuntos
Humanos , Masculino , Feminino , Doenças Periapicais/terapia , Doenças Periodontais/microbiologia , Tabagismo/fisiopatologia , Perda de Dente/prevenção & controle , Bactérias , Microbiota/efeitos dos fármacos , Periodontite/prevenção & controle , Fatores de Risco
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