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1.
Rev. cuba. estomatol ; 57(3): e2976, jul.-set. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126523

RESUMO

RESUMEN Introducción: La periodontitis se caracteriza por ser una inflamación mediada por el huésped y asociada a microbios que producen la pérdida de la adherencia periodontal. Una infección focal localizada como la enfermedad periodontal podría conducir a una inflamación sistémica. La disfunción endotelial vascular se ha asociado con una variedad de enfermedades y factores de riesgo para la aterosclerosis, que incluyen la edad, hipertensión arterial, dislipidemias, diabetes, tabaquismo, enfermedades cardiovasculares específicas como arteriopatía coronaria, cerebral y procesos infecciosos e inflamatorios como enfermedad periodontal. Objetivo: Evaluar los efectos del tratamiento periodontal no quirúrgico sobre la función endotelial de los pacientes con periodontitis crónica mediante una revisión de ensayos clínicos aleatorizados. Métodos: Se utilizó una estrategia de búsqueda primaria en combinación de vocabulario controlado y términos de texto libre para la elaboración de una estrategia de búsqueda en MEDLINE a través de PubMed, mediante el PubMed Advanced Search Builder el 5 de julio de 2019. Análisis e integración de la información: Fueron seleccionados 29 artículos de 2214. Para la elección se tuvo en cuenta que fueran estudios en humanos donde estuvieran relacionadas las variables de estudio. Del 100 por ciento de los artículos seleccionados se encontró que el 37,9 por ciento pertenecían a estudios de casos y controles, el 31 por ciento pertenecían a estudios transversales, el 10,34 por ciento a estudios de cohorte y solo 20,6 por ciento fueros estudios de ensayos clínicos, de los cuales solo 3 artículos (10 por ciento) fueron seleccionados para esta revisión. Conclusiones: La terapia periodontal no presenta un efecto sobre la función endotelial en un periodo de 3 meses, sin embargo, a los 6 meses se reporta una mejoría en la función endotelial(AU)


ABSTRACT Introduction: Periodontitis is characterized by being an inflammation mediated by the host and associated with microbes that produce, the loss of periodontal adhesion. A localized focal infection such as periodontal disease could lead to systemic inflammation. Vascular endothelial dysfunction has been associated with a variety of pathologies and risk factors for atherosclerosis, including age, hypertension, dyslipidemias, diabetes, smoking, specific cardiovascular pathologies such as coronary artery disease, cerebral, inflammatory, and infectious processes such as periodontal disease. Objective: Assess the effects of non-surgical periodontal treatment on the endothelial function of patients with chronic periodontitis through a review of randomized clinical trials. Methods: We used a primary search strategy using a combination of controlled vocabulary and free text terms based on the MEDLINE search strategy through PubMed using the PubMed Advanced Search Builder on July 05, 2019. Analysis and integration of the information: 29 articles of 2214 were selected because they are human studies where the study variables are related. 100 percent of the selected articles found that 37.9 percent belonged to case-control studies, 31 percent belonged to cross-sectional studies, 10.34 percent to cohort studies and only 20.6 percent were clinical trial studies, of which only 3 articles (10 percent) were selected for this review. Conclusions: Periodontal therapy does not have an effect on endothelial function in a period of 3 months, however at 6 months an improvement in endothelial function was reported(AU)


Assuntos
Humanos , Periodontite/fisiopatologia , Literatura de Revisão como Assunto , Doenças Cardiovasculares/etiologia , Fatores de Risco , Aterosclerose/etiologia , Estudos de Casos e Controles , Estudos Transversais , Estudos de Coortes , Bases de Dados Bibliográficas
2.
Life Sci ; 260: 118309, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32841664

RESUMO

AIMS: Oral cavity pathogens play an important systemic role, modulating the development of several diseases. Periodontitis is a very common oral disease associated with dental biofilm. It is characterized by gum inflammation, periodontal ligament degeneration, dental cementum and alveolar bone loss. Studies point to the association between maternal periodontitis and adverse outcomes during pregnancy. However, they did not evaluate the impact of maternal periodontitis in the offspring. Thus, our objective was to investigate the effects of maternal periodontitis in the immune system of offspring. MATERIAL AND METHODS: For this evaluation we induced acute lung injury in rat pups. Pregnant rats were submitted or not to periodontitis by ligature technique. Thirty days after the birth, offspring was submitted to acute lung inflammation by administration of lipopolysaccharide (LPS, Salmonella abortus equi, 5 mg/kg, ip). KEY FINDINGS: Our results showed that maternal periodontitis increased myeloperoxidase activity, the levels of TNF-alpha and IL-17A in the bronchoalveolar fluid, the gene expression of TNF-alpha, IL-17A, and cyclooxygenases 1 and 2. In addition, maternal periodontitis did not alter the number of leukocytes migrated into the lung, tracheal responsiveness, expression of TLR4 and NF-KB translocation. SIGNIFICANCE: This study showed prenatal programming of the immune response induced by maternal periodontitis, and reinforces the importance of oral health care during pregnancy.


Assuntos
Lesão Pulmonar Aguda/imunologia , Reprogramação Celular , Periodontite/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/imunologia , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/patologia , Animais , Animais Recém-Nascidos , Feminino , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Lipopolissacarídeos/toxicidade , Masculino , NF-kappa B/metabolismo , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Efeitos Tardios da Exposição Pré-Natal/patologia , Ratos , Fator de Necrose Tumoral alfa/metabolismo
3.
PLoS One ; 15(7): e0234659, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614834

RESUMO

BACKGROUND: The relationship between poor oral health conditions and cognitive decline is unclear. OBJECTIVE: To examine the association between oral health and cognition in humans and rats. METHODS: In humans: a cross-sectional study was conducted. Cognitive levels were evaluated by the Mini Mental State Examination (MMSE); oral conditions were reflected by the number of missing index teeth, bleeding on probing, and probing pocket depth (PD). In rats: a ligature-induced (Lig) periodontitis model and Aß25-35-induced model of Alzheimer's disease (AD) were established; tumor necrosis factor-α (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), and C-reactive protein levels in the hippocampus and cerebral cortex were detected. RESULTS: MMSE scores for the number of missing index teeth ≥ 7 group were significantly lower than those in the ≤ 6 group. A negative relationship (correlation coefficient ρ = -0.310, P = 0.002) was observed between MMSE scores and number of missing index teeth. More missing index teeth and lower education levels were independent risk factors for cognitive decline. A negative relationship (correlation coefficient ρ = -0.214, P = 0.031) was observed between MMSE scores and average PD. TNF-α and IL-6 levels in the hippocampus of the Lig+AD group were significantly higher than those of the AD group. IL-1 and IL-6 levels in the cerebral cortex of the Lig+AD group were significantly higher than those of the AD group. CONCLUSION: Poor oral health conditions including more missing index teeth and higher average PD may be risk factors for cognitive decline. Periodontitis may increase inflammatory cytokines in rat models of AD.


Assuntos
Transtornos Cognitivos/etiologia , Saúde Bucal , Periodontite/complicações , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/etiologia , Peptídeos beta-Amiloides/toxicidade , Animais , Proteína C-Reativa/análise , Causalidade , Córtex Cerebral/química , China/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Estudos Transversais , Índice CPO , Modelos Animais de Doenças , Feminino , Hipocampo/química , Humanos , Interleucina-1/análise , Masculino , Aprendizagem em Labirinto , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Fragmentos de Peptídeos/toxicidade , Índice Periodontal , Periodontite/epidemiologia , Periodontite/etiologia , Periodontite/fisiopatologia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fatores de Risco , Fator de Necrose Tumoral alfa/análise
4.
Artigo em Inglês | MEDLINE | ID: mdl-32235665

RESUMO

OBJECTIVES: To assess and compare dietpractices, body mass index (BMI), and oral health-related quality of life (OHRQoL) in adults with and without periodontitis. METHODS: Demographics, health-related behaviors, BMI, dental and periodontal parameters, diet practices, and Oral Health Impact Profile-14 (OHIP-14) were collected from 62periodontitis patients and 100 controls without periodontitis. RESULTS: Havingperiodontitis was positively associated with male sex (p=0.004), older age (p<0.001), smoking pack-years (p = 0.006), weight (p = 0.008), BMI (p = 0.003), number of meals per day (p<0.001) and had a negative associationwithdecayed teeth (p = 0.013), alcohol (p = 0.006), and sweets (p = 0.007) consumption.Periodontitis patients were more likely to avoid carbonated beverages (p = 0.028), hot (p = 0.003), and cold drinks (p = 0.013), cold (p = 0.028), hardtextured (p = 0.002), and fibrous foods (p = 0.02) thanthe controls, and exhibited higher global OHIP-14 (p<0.001) andmost domain scores. Age (p<0.001), BMI (p =0.045), number of meals per day (p = 0.024), and global OHIP-14 score (p<0.001) remained positivelyassociated with periodontitis in the multivariate analysis. CONCLUSIONS: Periodontitis patients exhibitedhigher BMI and altered dietpracticesand OHRQoL as compared to controls. Assessment of diet practices, BMI,and OHRQoLshould bepart of periodontal work-up. Dentists and dietitians shouldcollaborate to design strategies to addressthese challenges.


Assuntos
Índice de Massa Corporal , Dieta , Saúde Bucal , Periodontite/fisiopatologia , Qualidade de Vida , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
5.
J Appl Oral Sci ; 28: e20190351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236354

RESUMO

INTRODUCTION: Excessive weight is associated with periodontitis because of inflammatory mediators secreted by the adipose tissue. Periodontal impairments can occur during pregnancy due to association between high hormonal levels and inadequate oral hygiene. Moreover, periodontitis and excessive weight during pregnancy can negatively affect an infant's weight at birth. OBJECTIVE: This observational, cross-sectional study aimed to evaluate the association between pre-pregnancy overweight/obesity, periodontitis during the third trimester of pregnancy, and the infants' birth weight. METHODOLOGY: The sample set was divided into 2 groups according to the preconception body mass index: obesity/overweight (G1=50) and normal weight (G2=50). Educational level, monthly household income, and systemic impairments during pregnancy were assessed. Pocket probing depth (PPD) and clinical attachment level (CAL) were obtained to analyze periodontitis. The children's birth weight was classified as low (<2.5 kg), insufficient (2.5-2.999 kg), normal (3-3.999 kg), or excessive (≥4 kg). Bivariate analysis (Mann-Whitney U test, t-test, chi-squared test) and logistic regression (stepwise backward likelihood ratio) were performed (p<0.05). RESULTS: G1 showed lower socioeconomic levels and higher prevalence of arterial hypertension and gestational diabetes mellitus during pregnancy than G2 (p=0.002). G1 showed higher means of PPD and CAL (p=0.041 and p=0.039, respectively) and therefore a higher prevalence of periodontitis than G2 (p=0.0003). G1 showed lower infants' birth weight than G2 (p=0.0004). Excessive maternal weight and educational levels were independent variables associated with periodontitis during the third trimester of pregnancy (X2[2]=23.21; p<0.0001). Maternal overweight/obesity was also associated with low/insufficient birth weight (X2[1]=7.01; p=0.008). CONCLUSION: The present findings suggest an association between excessive pre-pregnancy weight, maternal periodontitis, and low/insufficient birth weight.


Assuntos
Peso ao Nascer/fisiologia , Recém-Nascido de Baixo Peso/fisiologia , Obesidade Materna/fisiopatologia , Periodontite/fisiopatologia , Terceiro Trimestre da Gravidez/fisiologia , Adulto , Índice de Massa Corporal , Estudos Transversais , Diabetes Gestacional/fisiopatologia , Feminino , Humanos , Modelos Logísticos , Gravidez , Resultado da Gravidez , Fatores Socioeconômicos , Estatísticas não Paramétricas , Adulto Jovem
6.
Braz Oral Res ; 34(supp1 1): e026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294679

RESUMO

Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review.


Assuntos
Periodontite/fisiopatologia , Periodontite/terapia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , América Latina , Saúde Bucal , Periodontia/tendências , Qualidade de Vida
7.
Sci Rep ; 10(1): 6891, 2020 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-32327711

RESUMO

The present study examined the hemodynamics [arterial pressure (AP), AP variability (APV), heart rate (HR), and heart rate variability (HRV)], cardiac function (echocardiographycally), and myocardial inflammation in Balb/c mice submitted to Periodontitis, through the ligation of the left first molar, or Sham surgical procedure. The first protocol indicated that the AP was similar (136 ± 2 vs. 132 ± 3 mmHg in Sham), while the HR was higher in mice with Periodontitis (475 ± 20 vs. 412 ± 18 bpm in Sham), compared to their Sham counterparts. The APV was higher in mice with Periodontitis when evaluated in the time domain (4.5 ± 0.3 vs. 3.4 ± 0.2 mmHg in Sham), frequency domain (power of the LF band of systolic AP), or through symbolic analysis (patterns 0V + 1V), indicating a sympathetic overactivity. The HRV was similar in the mice with Periodontitis, as compared to their Sham counterparts. In the second protocol, the mice with Periodontitis showed decreased cardiac output (10 ± 0.8 vs. 15 ± 1.4 mL/min in Sham) and ejection fraction (37 ± 3 vs. 47 ± 2% in Sham) associated with increased myocardial cytokines (Interleukin-17, Interleukin-6, and Interleukin-4). This study shows that experimental Periodontitis caused cardiac dysfunction, increased heart cytokines, and sympathetic overactivity, in line with epidemiological studies indicating an increased risk of cardiovascular events in clinical Periodontitis.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Periodontite/complicações , Periodontite/fisiopatologia , Perda do Osso Alveolar/complicações , Perda do Osso Alveolar/fisiopatologia , Animais , Pressão Sanguínea , Citocinas/metabolismo , Testes de Função Cardíaca , Frequência Cardíaca , Ligadura , Masculino , Camundongos Endogâmicos BALB C , Miocárdio/metabolismo , Pulso Arterial , Sístole
8.
J Vis Exp ; (155)2020 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-32065119

RESUMO

The main advantages of studying the pathophysiology of periodontal disease utilizing murine models are the reduced cost of animals, array of genetically modified strains, the vast number of analyses that can be performed on harvested soft and hard tissues. However, many of these systems are subject to procedural criticisms. As an alternative, the ligature-induced model of periodontal disease, driven by the localized development and retention of a dysbiotic oral microbiome, can be employed, which is rapidly induced and relatively reliable. Unfortunately, the variants of ligature-induced murine periodontitis protocol are isolated to focal regions of the periodontium and subject to premature avulsion of the installed ligature. This minimizes the amount of tissue available for subsequent analyses and increases the number of animals required for study. This protocol describes the precise manipulations required to place extended molar ligatures with improved retention and usage of a novel rinse technique to recover oral neutrophils in mice with an alternative approach that mitigates the aforementioned technical challenges.


Assuntos
Neutrófilos/metabolismo , Periodontite/sangue , Animais , Modelos Animais de Doenças , Camundongos , Periodontite/fisiopatologia
9.
J Appl Oral Sci ; 28: e20190248, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939522

RESUMO

OBJECTIVE: The evidence is inconclusive regarding the effect of periodontal treatment on glycemic control and systemic inflammation in patients with type 2 diabetes (T2D) and periodontitis. To evaluate the effect of scaling and root planing (SRP) on the metabolic control and systemic inflammation of patients with type 2 diabetes (T2D). METHODOLOGY: A literature search was conducted using the MEDLINE database via PubMed and the Cochrane Central Register of Controlled Trials, from their oldest records up to July 2018. Only randomized clinical trials (RCT) were considered eligible for evaluating the effect of periodontal treatment on markers of metabolic control [glycated hemoglobin (HbA1C)] and systemic inflammation [C-reactive protein (CRP)] in patients with T2D. The quality of the studies was evaluated using the Cochrane Collaboration risk assessment tool. Meta-analyses were performed for HbA1c and CRP using random effects models. The size of the overall intervention effect was estimated by calculating the weighted average of the differences in means (DM) between the groups in each study. Heterogeneity was assessed using the Q-statistic method (x2 and I²). The level of significance was established at p<0.05. RESULTS: Nine RCT were included. SRP was effective in reducing HbA1c [DM=0.56 (0.36-0.75); p<0.01] and CRP [DM=1.89 (1.70-2.08); p<0.01]. No heterogeneity was detected (I2=0%, p>0.05). CONCLUSIONS: SRP has an impact on metabolic control and reduction of systemic inflammation of patients with T2D.


Assuntos
Raspagem Dentária/métodos , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/fisiopatologia , Periodontite/fisiopatologia , Periodontite/terapia , Aplainamento Radicular/métodos , Proteína C-Reativa/análise , Hemoglobina A Glicada/análise , Humanos , Viés de Publicação , Resultado do Tratamento
10.
Sci Rep ; 10(1): 1402, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996751

RESUMO

The aim of this prospective cohort study was to investigate the association between intrauterine fetal growth patterns and periodontal status in pregnant women. Fifty-three pregnant women were recruited. Periodontitis was diagnosed based on probing pocket depth and clinical attachment level. Maternal urinary 8-hydroxy-2'-deoxyguanosine levels and body mass index were recorded. Ultrasonographic measurements of the biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) were recorded, and estimated fetal weight (EFW) was calculated. In addition, approximation spline curves of BPD, AC, FL, and EFW were obtained throughout the gestation period. Recorded delivery outcomes were gestational age (GA), birth weight and length, sex, placental weight, and umbilical cord length. Forty-four participants (34.1 ± 4.9 years) were analyzed. Mean neonatal birth weight was 2906.0 ± 544.4 g. On multiple regression analysis, birth weight was related with periodontitis (standardized ß = -0.21, P = 0.001). For EFW and BPD, the curves of the periodontitis group were located lower than those of the non-periodontitis group, with significant differences after 32 weeks and 20 weeks of GA, respectively. In conclusion, periodontal treatment before conception may be recommended and a good periodontal condition in the early stage of pregnancy at the latest is desirable for infant growth.


Assuntos
Desenvolvimento Fetal/fisiologia , Saúde Materna , Periodontite/fisiopatologia , Complicações na Gravidez/fisiopatologia , Adulto , Peso ao Nascer/fisiologia , Feminino , Feto/diagnóstico por imagem , Feto/fisiologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Estudos Longitudinais , Índice Periodontal , Periodontite/diagnóstico , Gravidez , Complicações na Gravidez/diagnóstico , Estudos Prospectivos , Ultrassonografia Pré-Natal
11.
Arch Oral Biol ; 109: 104553, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31563004

RESUMO

This study evaluated the effects of replacing a saturated fat diet by n-3 polyunsaturated fatty acids (n-3PUFA), on alveolar bone loss in hypercholesterolemic rats with experimental periodontitis (PD). METHODS: Eight week old Wistar rats were assigned according to dietary intake. Control group (C, n = 15) fed a commercial diet throughout the experiment. Atherogenic group (AT, n = 30) fed AT diet for 3 weeks; thereafter, AT was randomized to receive either a n-3PUFA (n = 15) or to continue with AT (n = 15) diet. Subsequently, PD was induced in all groups by unilateral ligature (L) of the first molar (M1) of the left mandible, non-ligated contralateral molars served as controls. After every week of PD induction, 5 rats per group were euthanized. Serum was collected for lipids assays and hemi-mandibles were subjected to histomorphometric (% upper and lower interradicular bone volume and periodontal ligament height, hPDL) and radiographic analyses (periodontal bone support, PBS, in ligated teeth, between M1-M2). RESULTS: Rats fed n-3PUFA diet rapidly induced a significant reduction in the serum lipids (p < 0.001). In all rats the ligated teeth showed a greater bone loss as compared with the unligated molars. At the end of the experiment the AT + L was the worst in % lower bone volume (p < 0.01), hPDL and PBS (p < 0.05). In contrast, rats fed n-3PUFA + L was similar to those rats fed C diet (p > 0.05). CONCLUSION: Alveolar bone and dyslipidemia improved by substituting saturated fat intake for a n-3PUFA rich diet, in hypercholesterolemic rats with PD.


Assuntos
Perda do Osso Alveolar/terapia , Dieta , Ácidos Graxos Ômega-3/administração & dosagem , Óleos de Peixe/administração & dosagem , Hipercolesterolemia/fisiopatologia , Periodontite/fisiopatologia , Animais , Dislipidemias/terapia , Distribuição Aleatória , Ratos , Ratos Wistar
12.
J Periodontal Res ; 55(3): 392-399, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31854460

RESUMO

OBJECTIVE: Smoking causes pathological changes in all tissues, including gingiva and alveolar bone. The aim of present study was to evaluate apoptotic tissue alterations and tissue destruction in smoker and non-smoker periodontitis patients and healthy individuals. METHODS: Gingival biopsy samples from 15 systemically and orally healthy individuals (Group 1), 15 systemically healthy periodontitis patients (Group 2), 15 systemically and orally healthy smokers (Group 3), and 15 systemically healthy smoker periodontitis patients (Group 4) were enrolled in the present study. Clinical periodontal measurements as plaque index (PI), gingival index (GI), and clinical attachment levels (CAL) were recorded, and gingival biopsies were obtained. Biopsy samples were fixed in formalin solution and embedded in paraffin. Fibroblast and inflammatory cell counts were determined via histomorphometrically. Hypoxia-inducible factor alpha (HIF-1α), vascular endothelial growth factor(VEGF), tissue inhibitor of matrix metalloproteinase-1(TIMP-1), matrix metalloproteinases-8(MMP-8) expressions, Bax, Bcl-2, and caspase-3 expressions were evaluated via immunohistochemistry. RESULTS: Demographic data of the study groups were similar. Smoking levels of the smokers were also similar. The highest fibroblast cell counts were observed in healthy controls and the counts were similar in other groups. The highest inflammatory cell counts were found in smoker periodontitis group, and the lowest counts were found in healthy control groups. The differences were statistically significant. HIF-1α and Bax expressions were elevated and Bcl-2 decreased in smoker periodontitis patients compared with healthy individuals. However, there were no differences in VEGF, MMP-8, and TIMP-1 expressions. CONCLUSION: Within limits of present study, it can be suggested that both smoking and periodontitis caused similar decrease in fibroblast counts while causing a dramatic increase in inflammatory cell counts. Increased apoptosis and hypoxia also accompanied to the increased inflammation.


Assuntos
Apoptose , Gengiva/patologia , Hipóxia , não Fumantes , Periodontite/fisiopatologia , Fumantes , Fatores de Transcrição Hélice-Alça-Hélice Básicos , Estudos de Casos e Controles , Caspase 3 , Fibroblastos , Líquido do Sulco Gengival , Humanos , Metaloproteinase 8 da Matriz , Proteínas Proto-Oncogênicas c-bcl-2 , Inibidor Tecidual de Metaloproteinase-1 , Fator A de Crescimento do Endotélio Vascular , Proteína X Associada a bcl-2
13.
J. appl. oral sci ; 28: e20190248, 2020. graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1056591

RESUMO

Abstract The evidence is inconclusive regarding the effect of periodontal treatment on glycemic control and systemic inflammation in patients with type 2 diabetes (T2D) and periodontitis Objective: To evaluate the effect of scaling and root planing (SRP) on the metabolic control and systemic inflammation of patients with type 2 diabetes (T2D). Methodology: A literature search was conducted using the MEDLINE database via PubMed and the Cochrane Central Register of Controlled Trials, from their oldest records up to July 2018. Only randomized clinical trials (RCT) were considered eligible for evaluating the effect of periodontal treatment on markers of metabolic control [glycated hemoglobin (HbA1C)] and systemic inflammation [C-reactive protein (CRP)] in patients with T2D. The quality of the studies was evaluated using the Cochrane Collaboration risk assessment tool. Meta-analyses were performed for HbA1c and CRP using random effects models. The size of the overall intervention effect was estimated by calculating the weighted average of the differences in means (DM) between the groups in each study. Heterogeneity was assessed using the Q-statistic method (x2 and I²). The level of significance was established at p<0.05. Results: Nine RCT were included. SRP was effective in reducing HbA1c [DM=0.56 (0.36-0.75); p<0.01] and CRP [DM=1.89 (1.70-2.08); p<0.01]. No heterogeneity was detected (I2=0%, p>0.05). Conclusions: SRP has an impact on metabolic control and reduction of systemic inflammation of patients with T2D.


Assuntos
Humanos , Periodontite/fisiopatologia , Periodontite/terapia , Raspagem Dentária/métodos , Aplainamento Radicular/métodos , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/prevenção & controle , Proteína C-Reativa/análise , Hemoglobina A Glicada/análise , Resultado do Tratamento , Viés de Publicação
14.
J. appl. oral sci ; 28: e20190351, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090778

RESUMO

Abstract Excessive weight is associated with periodontitis because of inflammatory mediators secreted by the adipose tissue. Periodontal impairments can occur during pregnancy due to association between high hormonal levels and inadequate oral hygiene. Moreover, periodontitis and excessive weight during pregnancy can negatively affect an infant's weight at birth. Objective This observational, cross-sectional study aimed to evaluate the association between pre-pregnancy overweight/obesity, periodontitis during the third trimester of pregnancy, and the infants' birth weight. Methodology The sample set was divided into 2 groups according to the preconception body mass index: obesity/overweight (G1=50) and normal weight (G2=50). Educational level, monthly household income, and systemic impairments during pregnancy were assessed. Pocket probing depth (PPD) and clinical attachment level (CAL) were obtained to analyze periodontitis. The children's birth weight was classified as low (<2.5 kg), insufficient (2.5-2.999 kg), normal (3-3.999 kg), or excessive (≥4 kg). Bivariate analysis (Mann-Whitney U test, t-test, chi-squared test) and logistic regression (stepwise backward likelihood ratio) were performed (p<0.05). Results G1 showed lower socioeconomic levels and higher prevalence of arterial hypertension and gestational diabetes mellitus during pregnancy than G2 (p=0.002). G1 showed higher means of PPD and CAL (p=0.041 and p=0.039, respectively) and therefore a higher prevalence of periodontitis than G2 (p=0.0003). G1 showed lower infants' birth weight than G2 (p=0.0004). Excessive maternal weight and educational levels were independent variables associated with periodontitis during the third trimester of pregnancy (X2[2]=23.21; p<0.0001). Maternal overweight/obesity was also associated with low/insufficient birth weight (X2[1]=7.01; p=0.008). Conclusion The present findings suggest an association between excessive pre-pregnancy weight, maternal periodontitis, and low/insufficient birth weight.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Periodontite/fisiopatologia , Terceiro Trimestre da Gravidez/fisiologia , Peso ao Nascer/fisiologia , Recém-Nascido de Baixo Peso/fisiologia , Obesidade Materna/fisiopatologia , Fatores Socioeconômicos , Resultado da Gravidez , Índice de Massa Corporal , Modelos Logísticos , Estudos Transversais , Diabetes Gestacional/fisiopatologia , Estatísticas não Paramétricas
15.
J. appl. oral sci ; 28: e20190248, 2020. graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090780

RESUMO

Abstract The evidence is inconclusive regarding the effect of periodontal treatment on glycemic control and systemic inflammation in patients with type 2 diabetes (T2D) and periodontitis Objective: To evaluate the effect of scaling and root planing (SRP) on the metabolic control and systemic inflammation of patients with type 2 diabetes (T2D). Methodology: A literature search was conducted using the MEDLINE database via PubMed and the Cochrane Central Register of Controlled Trials, from their oldest records up to July 2018. Only randomized clinical trials (RCT) were considered eligible for evaluating the effect of periodontal treatment on markers of metabolic control [glycated hemoglobin (HbA1C)] and systemic inflammation [C-reactive protein (CRP)] in patients with T2D. The quality of the studies was evaluated using the Cochrane Collaboration risk assessment tool. Meta-analyses were performed for HbA1c and CRP using random effects models. The size of the overall intervention effect was estimated by calculating the weighted average of the differences in means (DM) between the groups in each study. Heterogeneity was assessed using the Q-statistic method (x2 and I²). The level of significance was established at p<0.05. Results: Nine RCT were included. SRP was effective in reducing HbA1c [DM=0.56 (0.36-0.75); p<0.01] and CRP [DM=1.89 (1.70-2.08); p<0.01]. No heterogeneity was detected (I2=0%, p>0.05). Conclusions: SRP has an impact on metabolic control and reduction of systemic inflammation of patients with T2D.


Assuntos
Humanos , Periodontite/fisiopatologia , Periodontite/terapia , Raspagem Dentária/métodos , Aplainamento Radicular/métodos , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/prevenção & controle , Proteína C-Reativa/análise , Hemoglobina A Glicada/análise , Resultado do Tratamento , Viés de Publicação
16.
Adv Exp Med Biol ; 1197: 107-117, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31732938

RESUMO

T helper 17 (Th17) cells were first described as a T helper subset involved in the pathogenesis of experimental autoimmune inflammation. Since then, these cells have been described as orchestrators of immunopathology in several human inflammatory conditions including psoriasis, rheumatoid arthritis, and inflammatory bowel disease. More recently, the crucial role of Th17 cells in the regulation of immunity and protection of barrier sites has been unveiled. In the present work, we review the available evidence regarding Th17 cells in health and disease with a focus on the oral mucosa and their role in periodontitis pathogenesis. Recent mechanistic studies in animal models have demonstrated that interleukin-17A (IL-17A) and Th17 cells are critical mediators for alveolar bone destruction during periodontal inflammation. Observations in a cohort of patients with naturally occurring impaired Th17 cell differentiation supported these findings. However, interventional studies are needed to conclusively implicate Th17 cells in the immunopathogenesis of human alveolar bone and tissue destruction that characterize periodontitis.


Assuntos
Periodontite , Células Th17 , Animais , Diferenciação Celular , Modelos Animais de Doenças , Humanos , Inflamação , Interleucina-17/imunologia , Periodontite/fisiopatologia , Células Th17/citologia , Células Th17/imunologia
17.
J Immunol Res ; 2019: 8672604, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637266

RESUMO

The ligand of the receptor activator of NF-κB (RANKL) is a key molecule in the formation of osteoclasts, the key cells that cause the disease-associated alveolar bone resorption in periodontitis. We hypothesized that polymorphonuclear leukocytes (PMNs), found as the most prominent cells of inflamed periodontal tissues, could play an important role in providing signals to trigger osteoclastogenesis and thus activating pathological bone resorption in periodontitis. RANKL expression was investigated on circulatory PMNs (cPMNs) and oral PMNs (oPMNs) taken from both controls and periodontitis patients. On average, 2.3% and 2.4% RANKL expression was detected on the cPMNs and oPMNs from periodontitis patients, which did not differ significantly from healthy controls. Since cPMNs may acquire a more osteoclastogenesis-facilitating phenotype while migrating into the inflamed periodontium, we next investigated whether stimulated (with LPS, TNF-α, or IL-6) cPMNs have the capacity to contribute to osteoclastogenesis. Enduring surface expression of RANKL for short-lived cells as cPMNs was achieved by fixating stimulated cPMNs. RANKL expression on stimulated cPMNs, as assessed by flow cytometry and immunohistochemistry, was limited (6.48 ± 0.72%, mean expression ± SEM) after 24 and 48 hours of stimulation with LPS. Likewise, stimulation with TNF-α and IL-6 resulted in limited RANKL expression levels. These limited levels of expression did not induce osteoclastogenesis when cocultured with preosteoclasts for 10 days. We report that, under the aforementioned experimental conditions, neither cPMNs nor oPMNs directly induced osteoclastogenesis. Further elucidation of the key cellular players and immune mediators that stimulate alveolar bone resorption in periodontitis will help to unravel its pathogenesis.


Assuntos
Neutrófilos/metabolismo , Osteogênese/imunologia , Ligante RANK/metabolismo , Adulto , Idoso , Perda do Osso Alveolar/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/imunologia , Periodontite/fisiopatologia
18.
Sci Rep ; 9(1): 14663, 2019 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-31605018

RESUMO

Periodontitis is an inflammatory disease caused by pathogenic oral microorganisms that induce the destruction of periodontal tissue. We sought to identify the relevant differentially expressed genes (DEGs) and clarify the mechanism underlying the rapid alveolar bone loss by using ligature-induced periodontitis in mice. A silk ligature was tied around the maxillary left second molar in 9-week-old C57BL/6 J male mice. In-vivo micro-CT analysis revealed that ligation induced severe bone loss. RNA-sequencing analysis, to examine host responses at 3 days post-ligation, detected 12,853 genes with fragments per kilobase of exon per million mapped reads ≥ 1, and 78 DEGs. Gene ontology term enrichment analysis revealed the expression profiles related to neutrophil chemotaxis and inflammatory responses were significantly enriched in the ligated gingiva. The expression levels of innate immune response-related genes, including S100a8 and S100a9, were significantly higher in the ligated side. S100A8 was strongly detected by immunohistochemistry at the attached epithelium in ligated sites. Inhibition of S100A8 and S100A9 expression revealed that they regulated IL1B and CTSK expression in Ca9-22 cells. Thus, innate immune response-related molecules might be associated with the burst-destruction of periodontal tissue in ligature-induced periodontitis. Especially, S100A8 and S100A9 may play an important role in alveolar bone resorption.


Assuntos
Calgranulina A/genética , Calgranulina B/genética , Doenças Periodontais/genética , Periodontite/genética , Animais , Catepsina K/genética , Modelos Animais de Doenças , Regulação da Expressão Gênica/genética , Humanos , Interleucina-1beta/genética , Camundongos , Camundongos Endogâmicos C57BL , Doenças Periodontais/fisiopatologia , Periodontite/fisiopatologia , Periodonto/metabolismo , Periodonto/fisiopatologia , RNA-Seq/métodos
19.
Artigo em Inglês | MEDLINE | ID: mdl-31380305

RESUMO

Periodontitis is a common intraoral infection and is inextricably linked to systemic diseases. Recently, the regulation between host immunologic response and periodontal pathogens has become a hotspot to explain the mechanism of periodontitis and related systemic diseases. Since Porphyromonas gingivalis (P. gingivalis) was proved as critical periodontal pathogen above all, researches focusing on the mechanism of its virulence factors have received extensive attention. Studies have shown that in the development of periodontitis, in addition to the direct release of virulent factors by periodontal pathogens to destroy periodontal tissues, over-low or over-high intrinsic immune and inflammatory response mediated by Toll-like receptors (TLRs) can lead to more lasting destruction of periodontal tissues. It is very necessary to sort out how various cytopathic factors of P. gingivalis mediate inflammation and immune responses between the host through TLRs so as to help precisely prevent, diagnose, and treat periodontitis in clinic. This review summarizes the role of three most widely studied pathogenic factors produced by P. gingivalis (lipopolysaccharide, gingipains, pili) and their interactions with TLRs at the cellular and molecular level in the progress of periodontitis.


Assuntos
Fímbrias Bacterianas/metabolismo , Cisteína Endopeptidases Gingipaínas/metabolismo , Interações Hospedeiro-Patógeno , Lipopolissacarídeos/metabolismo , Porphyromonas gingivalis/patogenicidade , Receptores Toll-Like/metabolismo , Fatores de Virulência/metabolismo , Animais , Infecções por Bacteroidaceae/microbiologia , Infecções por Bacteroidaceae/patologia , Infecções por Bacteroidaceae/fisiopatologia , Modelos Animais de Doenças , Humanos , Periodontite/microbiologia , Periodontite/patologia , Periodontite/fisiopatologia
20.
Arch Osteoporos ; 14(1): 94, 2019 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-31444638

RESUMO

This study investigated whether periodontitis affects systemic bone status and whether FRAX® is a screening tool for periodontal disease in elderly women. The findings showed that bone density was not influenced by periodontitis and highlighted that women with FRAX® score above the intervention threshold had greater chance to present severe periodontitis. PURPOSE: This study investigated whether periodontal disease is a predictor for systemic bone loss among elderly women. The utilization of FRAX® as a screening tool for severe periodontitis was also evaluated in this population. METHODS: Current bone mineral density (BMD) for lumbar spine and proximal femur was used as an indicator of "bone status." Number of interdental sites with severe clinical attachment loss, frequency of bleeding on probing, and percentage of tooth loss due to periodontitis represented "periodontal disease" that was tested as a predictor of bone loss in a structural equation modeling analysis involving 110 participants. The intake of antiosteoporosis medication was considered in the analysis. Four other different criteria for periodontitis classification were also tested. FRAX® for major fracture was calculated without BMD, and with intervention threshold set by age. Longitudinally, BMD changes up to 10 years were also obtained and checked for possible association with periodontitis. RESULTS: Periodontal disease was not a predictor for worse systemic bone status according to the different periodontal disease classifications, and was not associated with BMD changes. Antiosteoporosis medication directly predicted periodontal disease and systemic bone status. Women with FRAX® score above the intervention threshold had higher chance for periodontitis in more advanced stages: III/IV (OR = 1.13, 95% CI [1.04 to 1.22], p = 0.03). CONCLUSION: Periodontal disease did not constitute a predictor for reduced systemic bone density in the studied population of elderly women. On the other hand, FRAX® demonstrated to be a useful tool to suggest periodontal evaluation. Antiresorptive medication showed benefits on periodontal and bone status.


Assuntos
Densidade Óssea/fisiologia , Osteoporose Pós-Menopausa/complicações , Periodontite/complicações , Absorciometria de Fóton , Idoso , Conservadores da Densidade Óssea/uso terapêutico , Estudos Transversais , Feminino , Fêmur/fisiologia , Humanos , Vértebras Lombares/fisiologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/fisiopatologia , Fraturas por Osteoporose/complicações , Fraturas por Osteoporose/fisiopatologia , Periodontite/fisiopatologia , Estudos Retrospectivos , Perda de Dente/complicações , Perda de Dente/fisiopatologia
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