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1.
Artigo em Inglês | MEDLINE | ID: mdl-33528456

RESUMO

The aim of the present study was to retrospectively evaluate the longevity of teeth and implants during a long-term period in a cohort of periodontally compromised patients, treated and maintained in a private specialist periodontal practice, and to analyze the associated risk factors. Fifty-eight patients (30 men, 28 women) who had received active periodontal therapy (APT) and regular periodontal maintenance (PM) ≥ 10 years were included and evaluated. The following were evaluated: (1) statistically significant differences of clinical parameters assessed at six tooth or implant sites (plaque scores, bleeding score, periodontal probing depth, bleeding on probing, and gingival recession) and radiographic parameters (mesial and distal bone crest loss) between patients with and without tooth/implant loss during PM; and (2) associations between the number of teeth and implants lost and potential risk factors. During PM, the overall average tooth loss was 0.07 teeth/patient/year (0.04 teeth/patient/year for periodontal reasons), while the overall average implant loss was 0.4 implants/patient/year. The overall implant failure was 10.08%, and the rate of implant failure due to biologic reasons was 9.8%. Incidence of implant failures in patients with vs without recurrent periodontal disease was 83.3% vs 16.7% (P < .05). Results showed that in chronic periodontitis patients, ATP followed by long-term PM is successful in keeping the majority of periodontally compromised teeth. In the same patients, a higher tendency for implant loss than tooth loss was found.


Assuntos
Perda do Osso Alveolar , Periodontite Crônica , Implantes Dentários , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Manutenção , Masculino , Estudos Retrospectivos
2.
Niger J Clin Pract ; 23(10): 1345-1355, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047690

RESUMO

Background: Several studies have demonstrated an association between obesity, periodontitis, and exercise. Aims: This study aimed to investigate the effects of regular exercise on obese women with periodontal disease, using serum, saliva, and gingival crevicular fluid (GCF) samples. A before-after study design was adopted to evaluate the effects of 12 weeks of regular exercise on obese women grouped according to periodontal status, without a control group (no exercise). The study sample comprised of 15 patients without periodontitis (NP group) and 10 patients with chronic periodontitis (CP group), from whom periodontal parameters were measured and serum, saliva, and GCF samples were collected. Body mass index (BMI), anthropometric measurements, somatotype-motoric tests, and maximal oxygen consumption (VO2max) were recorded at baseline and after exercise. Subjects and Methods: Med Calc was used for statistical analysis. Results: After exercise, a significant decrease in BMI and a significant increase in VO2max were observed in both groups. A significant decrease in probing depth and clinical attachment loss, serum leptin, GCF tumor necrosis factor-α(TNF-α) and leptin, and a significant increase in GCF resistin were observed in the CP group. A significant decrease in serum TNF-α and leptin levels and a significant increase in serum resistin and GCF TNF-α, leptin, resistin, and adiponectin levels were observed in the NP group. Significant correlations between bleeding on probing and levels of interleukin-1ß and leptin in GCF were observed in the CP group. Conclusions: This study showed that regular exercise exerts different impacts with respect to clinical and biochemical aspects of periodontal and systemic conditions in obese women.


Assuntos
Adipocinas/metabolismo , Periodontite Crônica/complicações , Periodontite Crônica/metabolismo , Exercício Físico/fisiologia , Líquido do Sulco Gengival/química , Obesidade/complicações , Saliva/química , Adipocinas/sangue , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Periodontite Crônica/sangue , Feminino , Humanos , Interleucina-1beta/sangue , Interleucina-1beta/metabolismo , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/metabolismo , Bolsa Periodontal/metabolismo , Resistina/sangue , Resistina/metabolismo , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/metabolismo
3.
Chin J Dent Res ; 23(3): 191-197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32974619

RESUMO

OBJECTIVES: To investigate whether the levels of serum C-reactive protein (CRP), salivary interleukin (IL)-6 and IL-lß in metabolic syndrome (MS) patients can be potential monitors for inflammation in MS patients with severe periodontitis. METHODS: A total of 114 MS patients and 49 systemically healthy subjects were enrolled. CRP in serum and IL-1ß and IL-6 in non-stimulated whole saliva were collected from these patients and subjects and analysed by enzyme-linked immunosorbent assay (ELISA). Dental examinations were performed and the participants completed a questionnaire. RESULTS: The serum CRP level of MS patients was higher than that of systemically healthy subjects, and increased as the number of components increased (P < 0.05). No difference was observed in the salivary level of IL-6 and IL-1ß between MS patients and controls or between MS patients with different components. The level of salivary IL-6 in MS patients with moderate/severe periodontitis was significantly higher than in MS patients with good periodontal health/mild periodontitis (P < 0.05). After adjustment for age, sex and smoking habits, multivariate analysis showed that the corresponding odds ratio (OR) for MS combined with moderate/severe periodontitis was 1.21 (95% confidence interval [CI] 1.04-1.39, P = 0.012) for subjects with high serum CRP and salivary IL-6 and IL-1ß were not risk indicators for MS combined with moderate/severe periodontitis. CONCLUSIONS: MS patients might be burdened by high levels of serum CRP. Serum CRP could be a potentially valuable biomarker to detect inflammation in MS patients with severe periodontal disease.


Assuntos
Periodontite Crônica/complicações , Síndrome Metabólica , Biomarcadores , Proteína C-Reativa , Humanos , Saliva
4.
Med Oral Patol Oral Cir Bucal ; 25(6): e745-e751, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32701927

RESUMO

BACKGROUND: The objective of this cross-sectional clinical study was to analyze the differences in the microbiome in gingival sulci of adult patients in the presence or absence of chronic periodontitis. MATERIAL AND METHODS: Patients with or without periodontal disease were included in this cross-sectional study. Subgingival biofilm samples were collected and analyzed by 16S massive pyrosequencing. Functional analyses were also performed. RESULTS: A total of 15 phyla, 154 genera and 351 species were detected globally. Differences between disease and non-disease samples were observed in all taxonomical levels which suggest functional profile changes in the community. It was found that the main species associated with non-disease samples were reduced in disease but not completely suppressed. Analysis of the functional potential of the biofilms revealed a significantly higher activity related to endocytosis and phosphatidylinositol signaling in the disease group but lower cell adhesion molecules. CONCLUSIONS: Specific differences between health and disease suggest functional profile changes in the community, although bacteria associated with periodontal disease are also increased in health. Transcriptome studies should be conducted to confirm and deepen metabolic dysfunctions.


Assuntos
Periodontite Crônica , Microbiota , Adulto , Bactérias , Biofilmes , Periodontite Crônica/complicações , Estudos Transversais , Gengiva , Humanos
5.
Artigo em Inglês | MEDLINE | ID: mdl-32429260

RESUMO

Bipolar disorder (BD) is a psychiatric mood disturbance manifested by manic, hypomanic, or major depressive periods. Chronic inflammation was evidenced as an important etiologic factor of BD. Chronic periodontitis (CP) is an inflammatory disease triggered by bacterial products, leading to the destruction of periodontium. The relationship between BD and CP is of interest to investigate. Therefore, a nationwide population-based cohort study was used to investigate the risk of BD and CP exposure from 2001 to 2012. We identified 61,608 patients with CP from the Taiwanese National Health Insurance Research Database (NHIRD). The 123,216 controls were randomly captured and matched by age, sex, index year, and co-morbidities. The association between CP exposure and BD risk was examined by Cox proportional hazards regression models. In this study, 61,608 CP patients and 123,216 controls were followed up for 7.45 and 7.36 years, respectively. In total, 138 BD patients were identified in the CP cohort and 187 BD cases were found in the non-CP cohort. The incidence rate of BD was significantly higher in the CP cohort than in the non-CP cohort (adjusted HR: 1.46, 95% CI: 1.17-1.81) according to the multivariate Cox regression analysis. Females had a 1.47-fold increased risk (95% CI: 1.16-1.86) for BD compared to males. Taken together, CP may be associated with an increased risk of subsequent BD in Taiwan.


Assuntos
Transtorno Bipolar , Periodontite Crônica , Transtorno Depressivo Maior , Adulto , Idoso , Transtorno Bipolar/epidemiologia , Estudos de Casos e Controles , Periodontite Crônica/complicações , Periodontite Crônica/epidemiologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
6.
J Periodontal Res ; 55(4): 574-580, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32232983

RESUMO

BACKGROUND AND OBJECTIVE: Evidence suggests that periodontitis has a negative effect on the quality of life of an individual, with increased impacts by greater disease severity. The aim of this study was to assess the association between quality of life and the presence of different severity and forms of periodontitis (aggressive and chronic), compared to a disease-free control group. MATERIALS AND METHODS: Four hundred and seventy one study participants were classified according to periodontal diagnosis using the 1999 Consensus Classification into chronic periodontitis (CP), aggressive periodontitis (AgP) and periodontally healthy. Oral health-related quality of life was assessed using the OHIP-14 questionnaire. Outcomes consisted of the prevalence of oral impacts reported occasionally, fairly often or very often (OFOVO) as well as fairly often or very often (FOVO), OHIP-14 total and domain scores. Logistic and linear regression analyses were carried out to test associations between periodontal diagnosis and quality of life outcomes, adjusted for smoking, age, ethnicity and body mass index. RESULTS: Over 90% of periodontitis patients reported at least one oral impact experienced occasionally, fairly often or very often (OFOVO) compared with 53.8% of periodontally healthy controls (P < .001). After adjustment for covariates, significant differences were found between the periodontitis groups and healthy controls for OHIP-14 outcome scores (P < .001) and across all of the OHIP-14 domains (P < .005). These differences were clinically meaningful as they were higher than the measurement errors. No significant differences were identified between AgP and CP in adjusted analysis when comparing OHIP-14 scores. CONCLUSION: Patients with periodontitis have worse quality of life than periodontally healthy individuals, with differences being clinically meaningful. AgP patients reported worse OHRQoL overall compared to CP patients, but these moderate and meaningful differences were explained through the adjustment process.


Assuntos
Periodontite Agressiva , Periodontite Crônica , Saúde Bucal , Qualidade de Vida , Periodontite Agressiva/complicações , Periodontite Crônica/complicações , Humanos , Inquéritos e Questionários
7.
Medicine (Baltimore) ; 99(15): e19698, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282725

RESUMO

BACKGROUND: Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in cancer is controversial. The aim of this study was to evaluate the effect of periodontal bacteria infection on incidence and prognosis of cancer. METHODS: A systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library databases was performed to obtain 39 studies comprising 7184 participants. The incidence of cancer was evaluated as odd ratios (OR) with a 95% confidence interval (95% CI) using Review Manager 5.2 software. Overall survival, cancer-specific survival and disease-free survival, which were measured as hazard ratios (HR) with a 95% CI using Review Manager 5.2 software. RESULTS: Our results indicated that periodontal bacteria infection increased the incidence of cancer (OR = 1.25; 95%CI: 1.03-1.52) and was associated with poor overall survival (HR = 1.75; 95% CI: 1.40-2.20), disease-free survival (HR = 2.18; 95%CI: 1.24-3.84) and cancer-specific survival (HR = 1.85, 95%CI: 1.44-2.39). Subgroup analysis indicted that the risk of cancer was associated with Porphyromonas gingivalis (Pg) infection (OR = 2.16; 95%CI: 1.34-3.47) and Prevotella intermedia (Pi) infection (OR = 1.28; 95%CI: 1.01-1.63) but not Tannerella forsythia (Tf) (OR = 1.06; 95%CI: 0.8-1.41), Treponema denticola (Td) (OR = 1.30; 95%CI: 0.99-1.72), Aggregatibacter actinomycetemcomitans (Aa) (OR = 1.00; 95%CI: 0.48-2.08) and Fusobacterium nucleatum (Fn) (OR = 0.61; 95%CI: 0.32-1.16). CONCLUSION: This meta-analysis revealed periodontal bacteria infection increased the incidence of cancer and predicted poor prognosis of cancer.


Assuntos
Infecções Bacterianas/microbiologia , Periodontite Crônica/microbiologia , Boca/microbiologia , Neoplasias/epidemiologia , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Infecções Bacterianas/complicações , Periodontite Crônica/complicações , Intervalo Livre de Doença , Fusobacterium nucleatum/isolamento & purificação , Humanos , Incidência , Neoplasias/mortalidade , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificação , Prognóstico , Medição de Risco , Treponema denticola/isolamento & purificação
8.
BMC Oral Health ; 20(1): 52, 2020 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-32059714

RESUMO

BACKGROUND: Non-surgical periodontal therapy (NSPT) known as gold standard treatment in managing periodontitis. The aim of this study was to investigate the response of NSPT in periodontitis subjects who were obese. Clinical parameters of periodontitis, changes in serum resistin and periodontal pathogens in subgingival plaque were compared before and after NSPT in periodontitis subjects who were obese and with normal weight. METHODS: A total of 48 periodontitis subjects (obese, n = 18; normal weight, n = 30) were recruited (hereafter will be referred as participants) to participate into a prospective, before and after clinical trial. Obesity status is defined by body mass index (BMI) criteria (obese: ≥30 kg/ m2; normal weight < 25 kg/m2). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD) and Clinical Attachment Loss (CAL) were recorded; and serum and plaque were collected at baseline and following 12 weeks post-NSPT. Serum resistin level was analyzed using enzyme-linked immune-sorbant assay (ELISA), while detection of periodontal pathogens in dental plaque were carried out using real time PCR (qPCR). RESULTS: Following NSPT, means VPI and GBI showed significant improvement between obese and normal weight groups (p <  0.05), but no difference in means PPD and CAL was observed between groups. Obesity remained as a predictor for VPI and GBI after adjusting for smoking habit. No significant difference was observed in serum resistin level and mean counts for P. gingivalis, T. forsythia, and P. intermedia between obese and normal weight groups following NSPT. CONCLUSIONS: Regardless of obesity status, NSPT has a significant impact on VPI and GBI in periodontitis subjects. However, the impact of NSPT towards serum resistin and periodontal pathogens was non-significant in those with periodontitis. TRIAL REGISTRATION: This study followed the Consolidation Standards of Reporting Trials Statement and retrospectively registered on 26/11/2015 at clinicaltrials.gov (No. NCT02618486).


Assuntos
Periodontite Crônica/terapia , Obesidade/complicações , Resistina/sangue , Periodontite Crônica/complicações , Periodontite Crônica/epidemiologia , Índice de Placa Dentária , Feminino , Humanos , Masculino , Perda da Inserção Periodontal , Estudos Prospectivos
9.
PLoS One ; 15(2): e0228921, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053656

RESUMO

OBJECTIVE: Interleukin (IL)-17A and IL-18 have been proposed to play important roles in periodontitis and type 2 diabetes mellitus (DM), but human data are conflicting. The present study aimed to investigate the roles of IL-17A and IL-18 in periodontitis and DM by measuring salivary and serum levels, respectively. MATERIALS AND METHODS: A total of 49 participants with type 2 DM and 25 control subjects without type 2 DM were recruited. A periodontal screening and recording (PSR) index (0, 1-2, 3, and 4) was used to classify whether these subjects had periodontitis. Salivary and serum IL-17A and IL-18 levels were measured by enzyme-linked immunosorbent assay. Multiple linear regression analyses were used to evaluate the associations between these cytokines and clinical parameters. RESULTS: Salivary IL-17A levels were not significantly different between patients with DM and controls, however, the levels were significantly higher in controls with periodontitis than those without periodontitis (p = 0.031). Salivary IL-17A levels were significantly associated with the PSR index (ß = 0.369, p = 0.011). Multiple linear regression analyses revealed the association of salivary IL-18 levels and fasting plasma glucose (ß = 0.270, p = 0.022) whereas serum IL-18 levels were associated with HbA1C (ß = 0.293, p = 0.017). No correlation between salivary and serum levels of IL-17A and IL-18 was found. CONCLUSION: Salivary IL-17A was strongly associated with periodontitis, whereas salivary IL-18 was associated with FPG and serum IL-18 was associated with HbA1C. These results suggest the role of these cytokines in periodontal inflammation and DM.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Interleucina-17/análise , Interleucina-18/análise , Adulto , Estudos de Casos e Controles , Periodontite Crônica/complicações , Citocinas/análise , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/imunologia , Feminino , Líquido do Sulco Gengival/química , Hemoglobina A Glicada/análise , Humanos , Interleucina-17/sangue , Interleucina-18/sangue , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Periodontite/sangue , Periodontite/metabolismo , Saliva/química
10.
Exp Neurol ; 326: 113176, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31926167

RESUMO

Epidemiological studies suggest that chronic periodontitis (CP) is closely associated with the incidence and progression of cognitive impairment. The present study investigated the causal relationship between CP and cognitive decline and the underlying mechanism in mice. Long-term ligature around the left second maxillary molar tooth was used to induce CP in mice. Severe alveolar bone loss and inflammatory changes were observed in gingival tissues, accompanied by progressive cognitive deficits during a 12-month period. We also observed cerebral neuronal and synaptic injury and glial activation in this mouse model of CP. Furthermore, CP mice exhibited significant dysbiosis of the oral and gut microbiota, disruption of the intestinal barrier and blood-brain barrier, increases in the serum contents of proinflammatory cytokines and lipopolysaccharide (LPS), and increases in brain LPS levels, Toll-like receptor 4 (TLR4) expression, nuclear factor-κB (NF-κB) nuclear translocation and proinflammatory cytokine mRNA levels. These results indicate that CP may directly induce progressive cognitive decline and its mechanism is probably related to microbiota-gut-brain axis disorders, LPS/TLR4/NF-κB signaling activation and neuroinflammatory responses in mice. Therefore, the microbiota-gut-brain axis may provide the potential strategy for the prevention and treatment of CP-associated cognitive impairment.


Assuntos
Encefalopatias/etiologia , Periodontite Crônica/complicações , Transtornos Cognitivos/etiologia , Microbioma Gastrointestinal , Processo Alveolar/patologia , Animais , Barreira Hematoencefálica , Encefalopatias/psicologia , Doença Crônica , Periodontite Crônica/psicologia , Transtornos Cognitivos/psicologia , Citocinas/sangue , Lipopolissacarídeos/sangue , Masculino , Camundongos , NF-kappa B , Neuroglia/patologia , Neurônios/patologia , Transdução de Sinais , Sinapses/patologia , Receptor 4 Toll-Like
11.
PLoS One ; 15(1): e0227757, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31986169

RESUMO

AIM: Alveolar resorption is one of the most important events in periodontitis. Osteoclast activity is regulated by the ratio between receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG). The aim of this study was to evaluate changes in the RANKL/OPG ratio in crevicular fluid after periodontal treatment. MATERIAL AND METHODS: A total of 15 patients with periodontitis were included in the study group. Samples were collected from an area with active periodontitis and a healthy area. The RANKL and OPG levels were measured before and after periodontal scaling and root planing (SRP) treatment. The study group was compared to the control group, which included 10 patients without periodontitis. ID Clinicaltrial.gov: NCT03787875. RESULTS: A decrease in the RANKL level was found in areas with active periodontitis after periodontal treatment, but no change in the OPG level was observed. Therefore, the treatment induced a decrease in the RANKL/OPG ratio in sites with destructive periodontal activity. CONCLUSIONS: Periodontal treatment acts on the RANKL/OPG ratio by decreasing osteoclastogenesis. These results encourage the use of these molecules for periodontal diagnosis, monitoring and treatment. ID CLINICALTRIAL.GOV: NCT03787875.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Periodontite Crônica/terapia , Raspagem Dentária , Líquido do Sulco Gengival/química , Osteoprotegerina/análise , Idoso , Perda do Osso Alveolar/diagnóstico , Perda do Osso Alveolar/etiologia , Estudos de Casos e Controles , Periodontite Crônica/complicações , Periodontite Crônica/diagnóstico , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Osteoclastos/metabolismo , Osteoprotegerina/metabolismo , Índice Periodontal , Estudos Prospectivos , Ligante RANK , Resultado do Tratamento
12.
J Periodontal Res ; 55(2): 315-323, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31912903

RESUMO

BACKGROUND: Inflammation increases diabetes mellitus type 2 (T2DM) progression and severity. T2DM patients are at high risk of the rapid development of chronic periodontitis (CP). Topical presence, high numbers, and bactericidal effects of immune cells are challenged by augmented antigen-induced inflammation, which promotes both diseases. OBJECTIVES: To investigate gingival cellular inflammatory responses in individuals with previously undiagnosed T2DM with CP or CP alone and in systemically and periodontally healthy controls (H) in vivo and to establish an ex vivo technique permitting quantitative and qualitative assessments of gingival crevicular immune cells. MATERIALS AND METHODS: T2DM + CP, CP, and H individuals (n = 10, each) received a 2-week oral hygiene regimen (OHR). Afterwards, a noninvasive sampling technique was performed to evaluate gingival inflammation induced under standardized conditions in vivo, that is, in the absence of severe periodontal destruction and inflammation at clinically healthy sites. Stimuli (casein/test or phosphate-buffered saline w/o. Ca2+ or Mg2+ , PBS(-/-) /control) were randomly applied contralaterally in the gingival sulci of participants' upper dentes canini. One day after completion of the OHR, gingival crevicular fluid (GCF) was kinetically assayed between the time of the baseline (BL) measurement and 55 minutes. Polymorphonuclear leukocyte (PMN) content (PMNGCF ) was quantitated at an optimum time of 35 minutes. PMNGCF counts reflect local inflammation. Ex vivo samples were fluorimetrically labeled, gated according to the donor's peripheral blood polymorphonuclear neutrophils (PMNPB ), and then counted, employing flow cytometry. RESULTS: PMNGCF counts in unstimulated gingival crevices (at BL) in the T2DM + CP group were higher than those in the CP and H groups. PMNGCF counts were elevated in casein vs PBS(-/-) -stimulated gingival crevices in all groups. Patients with T2DM + CP showed increased PMNGCF counts compared to those with CP (P = .035) according to scatter plots. CD45+ counts in the stimulated sites in T2DM + CP patients were higher than those in CP and H patients (P = .041). Under stimulation conditions, the CD45+ counts differed from those under placebo conditions (P = .019), indicating augmented, inducible inflammatory leukocyte infiltrate in T2DM + CP patients. CONCLUSIONS: This noninvasive technique permits quantitative assessment of (experimental) gingival inflammation in vivo, revealing an influence of T2DM + CP on the number of primary immune cells in the gingival crevice. Patients who are challenged with (local) leukocytosis are likely at risk of collateral damage to the gingival crevice neighboring tissues, favoring the severity and progression of CP and consequently T2DM (www.clinicaltrials.gov NCT01848379).


Assuntos
Periodontite Crônica/complicações , Diabetes Mellitus Tipo 2/complicações , Ativação de Neutrófilo , Periodontite Crônica/imunologia , Diabetes Mellitus Tipo 2/imunologia , Líquido do Sulco Gengival/citologia , Humanos , Índice Periodontal
13.
J Appl Oral Sci ; 28: e20190025, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31778442

RESUMO

INTRODUCTION: Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. OBJECTIVE: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. METHODOLOGY: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. RESULTS: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. CONCLUSION: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.


Assuntos
Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Raspagem Dentária/efeitos adversos , Géis/administração & dosagem , Dor/prevenção & controle , Aplainamento Radicular/efeitos adversos , Adulto , Idoso , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Método Duplo-Cego , Feminino , Humanos , Lidocaína/administração & dosagem , Combinação Lidocaína e Prilocaína , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Bolsa Periodontal , Placebos , Prilocaína/administração & dosagem , Adulto Jovem
14.
Oral Dis ; 26(4): 822-829, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31834660

RESUMO

AIM: The present study aimed to monitor the clinical outcomes and the metabolic response of periodontal therapy (non-surgical) in patients with periodontitis (chronic) and uncontrolled diabetes (type 2). METHODS: Eighty-eight subjects with periodontitis (chronic) and uncontrolled diabetes (type 2) were enrolled in this controlled trial and allocated randomly to the test group (44 patients were received immediate periodontal therapy) or the control group (44 patients were received delayed periodontal therapy). The metabolic and clinical evaluations were conducted at baseline and 3 months. This included clinical attachment level, glycated hemoglobin (HbA1c), bleeding on probing, visible plaque, and pocket depth. The periodontal therapy in this study consists of one-stage scaling and root planning, a combination of systemic antibiotics (amoxicillin 500 mg and metronidazole 400 mg), and oral hygiene instructions. RESULTS: Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at 3-month follow-up period the patients within the test group demonstrated significantly better clinical and metabolic outcomes than patients in the control group. CONCLUSION: The non-surgical periodontal treatment using a combination of metronidazole and amoxicillin significantly improved the metabolic outcome in addition to periodontal health in diabetic subjects with chronic periodontitis.


Assuntos
Glicemia , Periodontite Crônica/terapia , Raspagem Dentária , Diabetes Mellitus Tipo 2/terapia , Aplainamento Radicular , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Periodontite Crônica/complicações , Diabetes Mellitus Tipo 2/complicações , Hemoglobina A Glicada/análise , Humanos , Metronidazol/uso terapêutico
15.
J. appl. oral sci ; 28: e20190025, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1056588

RESUMO

Abstract Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. Objective: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. Methodology: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. Results: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. Conclusion: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Dor/prevenção & controle , Raspagem Dentária/efeitos adversos , Aplainamento Radicular/efeitos adversos , Géis/administração & dosagem , Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Bolsa Periodontal , Placebos , Prilocaína/administração & dosagem , Medição da Dor/métodos , Método Duplo-Cego , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Combinação Lidocaína e Prilocaína , Lidocaína/administração & dosagem
16.
J. appl. oral sci ; 28: e20190025, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090776

RESUMO

Abstract Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. Objective: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. Methodology: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. Results: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. Conclusion: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Dor/prevenção & controle , Raspagem Dentária/efeitos adversos , Aplainamento Radicular/efeitos adversos , Géis/administração & dosagem , Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Bolsa Periodontal , Placebos , Prilocaína/administração & dosagem , Medição da Dor , Método Duplo-Cego , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Combinação Lidocaína e Prilocaína , Lidocaína/administração & dosagem
17.
Wiad Lek ; 73(12 cz 1): 2607-2611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33577476

RESUMO

OBJECTIVE: The aim: To evaluate the clinical efficacy of treatment-and-prophylactic complex in patients addicted to tobacco with chronic generalized periodontitis with chronic hyperacid gastritis. PATIENTS AND METHODS: Materials and methods: 68 patients (men and women) aged 25-44 years were examined. They were distributed into two groups: the main group - 48 patients addicted to tobacco with chronic generalized 1 degree periodontitis and chronic hyperacid gastritis, associated with Helicobacter pylori, the control group - 20 healthy individuals without bad habits. Patients of the main group were distributed at random into 2 subgroups (1.1, 1.2) depending on the chosen therapy. The patients of the subgroup 1.1 received the basic therapy and the developed treatment and prophylactic complex, the subgroup 1.2 received the basic therapy and the ultraphonophoresis procedures with placebo. Assessment of the effectiveness of therapy was carried out by determining hygienic index OHI-S and periodontal indices (PI, PMA index and Muhlemann bleeding index (MBI)). RESULTS: Results: The usage of the treatment-and-prophylactic complex resulted in improvement of the hygienic index OHI-S and periodontal indices (PI, PMA index and MBI) at the immediate and late observation period. CONCLUSION: Conclusions: Results of the study confirmed the effectiveness of the proposed treatment-and-prophylactic complex in therapy of chronic generalized 1 degree periodontitis in patients addicted to tobacco smoking with chronic hyperacid gastritis.


Assuntos
Periodontite Crônica , Gastrite , Helicobacter pylori , Adulto , Periodontite Crônica/complicações , Periodontite Crônica/prevenção & controle , Feminino , Gastrite/complicações , Gastrite/tratamento farmacológico , Humanos , Masculino , Índice Periodontal , Tabaco
18.
Cochrane Database Syst Rev ; 12: CD009197, 2019 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-31887786

RESUMO

BACKGROUND: There may be an association between periodontitis and cardiovascular disease (CVD); however, the evidence so far has been uncertain about whether periodontal therapy can help prevent CVD in people diagnosed with chronic periodontitis. This is the second update of a review originally published in 2014, and first updated in 2017. Although there is a new multidimensional staging and grading system for periodontitis, we have retained the label 'chronic periodontitis' in this version of the review since available studies are based on the previous classification system. OBJECTIVES: To investigate the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase, and CINAHL, two trials registries, and the grey literature to September 2019. We placed no restrictions on the language or date of publication. We also searched the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure, the VIP database, and Sciencepaper Online to August 2019. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared active periodontal therapy to no periodontal treatment or a different periodontal treatment. We included studies of participants with a diagnosis of chronic periodontitis, either with CVD (secondary prevention studies) or without CVD (primary prevention studies). DATA COLLECTION AND ANALYSIS: Two review authors carried out the study identification, data extraction, and 'Risk of bias' assessment independently and in duplicate. They resolved any discrepancies by discussion, or with a third review author. We adopted a formal pilot-tested data extraction form, and used the Cochrane tool to assess the risk of bias in the studies. We used GRADE criteria to assess the certainty of the evidence. MAIN RESULTS: We included two RCTs in the review. One study focused on the primary prevention of CVD, and the other addressed secondary prevention. We evaluated both as being at high risk of bias. Our primary outcomes of interest were death (all-cause and CVD-related) and all cardiovascular events, measured at one-year follow-up or longer. For primary prevention of CVD in participants with periodontitis and metabolic syndrome, one study (165 participants) provided very low-certainty evidence. There was only one death in the study; we were unable to determine whether scaling and root planning plus amoxicillin and metronidazole could reduce incidence of all-cause death (Peto odds ratio (OR) 7.48, 95% confidence interval (CI) 0.15 to 376.98), or all CVD-related death (Peto OR 7.48, 95% CI 0.15 to 376.98). We could not exclude the possibility that scaling and root planning plus amoxicillin and metronidazole could increase cardiovascular events (Peto OR 7.77, 95% CI 1.07 to 56.1) compared with supragingival scaling measured at 12-month follow-up. For secondary prevention of CVD, one pilot study randomised 303 participants to receive scaling and root planning plus oral hygiene instruction (periodontal treatment) or oral hygiene instruction plus a copy of radiographs and recommendation to follow-up with a dentist (community care). As cardiovascular events had been measured for different time periods of between 6 and 25 months, and only 37 participants were available with at least one-year follow-up, we did not consider the data to be sufficiently robust for inclusion in this review. The study did not evaluate all-cause death and all CVD-related death. We are unable to draw any conclusions about the effects of periodontal therapy on secondary prevention of CVD. AUTHORS' CONCLUSIONS: For primary prevention of cardiovascular disease (CVD) in people diagnosed with periodontitis and metabolic syndrome, very low-certainty evidence was inconclusive about the effects of scaling and root planning plus antibiotics compared to supragingival scaling. There is no reliable evidence available regarding secondary prevention of CVD in people diagnosed with chronic periodontitis and CVD. Further trials are needed to reach conclusions about whether treatment for periodontal disease can help prevent occurrence or recurrence of CVD.


Assuntos
Antibacterianos/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Periodontite Crônica/complicações , Prevenção Secundária/métodos , Doenças Cardiovasculares/etiologia , Periodontite Crônica/classificação , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Saúde Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
Rev Med Chil ; 147(6): 762-775, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859830

RESUMO

Rheumatoid arthritis (RA) and chronic periodontitis (CP) may be related due to a bidirectional etiology. The evidence shows that CP could alter the clinical course of RA. We performed a systematic search to determine if CP alters the morbidity of RA, analyzing its clinical and molecular aspects. Of 552 initial articles found, 16 were selected for a thorough review. There is a greater prevalence of CP in patients with RA. Patients with RA have significantly higher values of periodontal clinical parameters than healthy controls. Arthritis activity is significantly greater in patients who suffer from CP and decreases with nonsurgical periodontal treatment. There is a significant relationship between the severity of CP and RA activity.


Assuntos
Artrite Reumatoide/complicações , Periodontite Crônica/complicações , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/terapia , Biomarcadores , Estudos de Casos e Controles , Periodontite Crônica/fisiopatologia , Periodontite Crônica/terapia , Feminino , Humanos , Masculino , Fatores de Risco
20.
Nutr Hosp ; 36(5): 1095-1100, 2019 Oct 17.
Artigo em Espanhol | MEDLINE | ID: mdl-31516010

RESUMO

Introduction: Introduction: in Mexico the main problem in public health is obesity and other diseases that are associated whit this condition, including oral health. Objective: to evaluate the effect of metformin treatment in patients with class I obese on the activity of metalloproteinases present in periodontium with chronic periodontitis. Methods: a clinical study was conducted in 68 patients with class I obesity and periodontal disease. They were divided into 4 groups. 2 of them, in addition to the periodontal treatment, were administered metformin 850 mg per day for six weeks; 2 samples were taken per patient of periodontal tissue before and after each treatment, body mass index, plaque index and inflammation were measured. Acrylamide gel zymography was used to measure the activity of metalloproteinases in the sample of tissue collected. The data obtained were analyzed by descriptive statistics, student t for related samples and one-way ANOVA was performed considering p < 0.01 as statistically significant. Results: in the group of patients who were administered metformin at the end of the treatment, there was a decrease in the body mass index, the degree of inflammation and lower metalloproteinase activity, compared with the control group (65% vs 25%; < 0.01). Conclusions: treatment with metformin in patients with obesity class I and periodontal disease decreases BMI, improves the symptoms of chronic periodontitis and decreases the activity of metalloproteinases 1, 3, 8, V present in periodontium of these patients.


Assuntos
Periodontite Crônica/complicações , Periodontite Crônica/enzimologia , Hipoglicemiantes/uso terapêutico , Metaloproteases/efeitos dos fármacos , Metaloproteases/metabolismo , Metformina/uso terapêutico , Obesidade/complicações , Obesidade/tratamento farmacológico , Adulto , Feminino , Humanos , Hipoglicemiantes/farmacologia , Metformina/farmacologia , Obesidade/classificação
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