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1.
Support Care Cancer ; 29(1): 135-143, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32323001

RESUMO

PURPOSE: This retrospective study investigated the effect of perioperative oral care intervention on postoperative outcomes in patients undergoing lung cancer resection, in terms of the length of postoperative hospital stay and the incidence of postoperative respiratory infections. METHODS: In total, 585 patients underwent lung resection for lung cancer, 397 received perioperative oral care intervention, whereas the remaining 188 did not. This study retrospectively investigated the demographic and clinical characteristics (including postoperative complications and postoperative hospital stay) of each group. To determine whether perioperative oral care intervention was independently associated with either postoperative hospital stay or postoperative respiratory infections, multivariate analysis, multiple regression analysis, and multivariate logistic regression analysis were conducted. RESULTS: Parameters significantly associated with a prolonged postoperative hospital stay in lung cancer surgery patients were older age, postoperative complications, increased intraoperative bleeding, more invasive operative approach (e.g., open surgery), and lack of perioperative oral care intervention (standard partial regression coefficient (ß) = 0.083, p = 0.027). Furthermore, older age and longer operative time were significant independent risk factors for the occurrence of postoperative respiratory infections. Lack of perioperative oral care intervention was a potential risk factor for the occurrence of postoperative respiratory infections, although not statistically significant (odds ratio = 2.448, 95% confidence interval = 0.966-6.204, p = 0.059). CONCLUSION: These results highlight the importance of perioperative oral care intervention prior to lung cancer surgery, in order to shorten postoperative hospital stay and reduce the risk of postoperative respiratory infections.


Assuntos
Cárie Dentária/terapia , Neoplasias Pulmonares/cirurgia , Periodontite/terapia , Assistência Perioperatória/métodos , Complicações Pós-Operatórias/prevenção & controle , Infecções Respiratórias/prevenção & controle , Adulto , Idoso , Cárie Dentária/diagnóstico , Empiema/tratamento farmacológico , Empiema/prevenção & controle , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Pulmão/patologia , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Razão de Chances , Saúde Bucal , Pacientes , Periodontite/diagnóstico , Pneumonia/tratamento farmacológico , Pneumonia/prevenção & controle , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/microbiologia , Infecções Respiratórias/tratamento farmacológico , Estudos Retrospectivos , Fatores de Risco
3.
Int J Nanomedicine ; 15: 9241-9253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33262586

RESUMO

Purpose: Reducing toxicity, immunogenicity, and costs of small interfering RNAs (siRNA) carrier materials are key goals for RNA interference (RNAi) technology transition from bench to bed. Recently, calcium ions (Ca2+) have garnered attention as a novel, alternative material for delivering siRNA to cells. However, the tolerance for Ca2+ concentration varies in different cell types, which has limited its applications in vivo. Bovine serum albumin (BSA) can bind to Ca2+ through chelation. Moreover, BSA is a favorable coating material for nanoparticles owing to its excellent biocompatibility. Therefore, we hypothesized that coating Ca2+-siRNA with BSA helps buffer Ca2+ toxicity in vivo. Methods: BSA-Ca2+-siRNA nanoparticles were prepared, and the size, shape, encapsulation, and release efficiency were characterized using atomic force microscopy, scanning electronic microcopy, and gel electrophoresis. Binding nanoparticles were evaluated using attenuated total reflection-Fourier-transform infrared spectroscopy. The cellular uptake, intracellular release, cytotoxicity, and gene knockdown of nanoparticles were evaluated in periodontal ligament stem cells (PDLSCs) using laser-scanning confocal microscope, flow cytometry, and real-time quantitative polymerase chain reaction. Results: BSA and Ca2+-siRNA could form a stable nano-scale complex (~140 nm in diameter). The nanocomplexes could maintain siRNA release for more than 1 week in neutral phosphate-buffered saline (PBS) and could induce accelerated degradation in acidic PBS (pH 5.0). The nanoparticles were taken up by the cells, primarily through macropinocytosis, and were then released intracellularly through the acidification of endosomes/lysosomes. Importantly, the BSA-Ca2+ carrier had high transfection efficiency and biocompatibility both in vitro and in vivo. To demonstrate the therapeutic potential of our BSA coating-optimized Ca2+-siRNA technology, we showed that BSA-Ca2+-siWWP1 complexes strongly enhanced the osteogenic differentiation of inflammatory PDLSCs. Conclusion: BSA-Ca2+ could potentially be used for siRNA delivery, which is not only highly efficient and cost-effective but also biocompatible to host tissues owing to the BSA coating.


Assuntos
Cálcio/metabolismo , Técnicas de Transferência de Genes , Nanopartículas/química , Periodontite/terapia , RNA Interferente Pequeno/metabolismo , Soroalbumina Bovina/química , Adulto , Animais , Morte Celular , Diferenciação Celular , Endocitose , Humanos , Camundongos Endogâmicos BALB C , Nanopartículas/ultraestrutura , Osteogênese , Ligamento Periodontal/patologia , Periodontite/patologia , Espectroscopia de Infravermelho com Transformada de Fourier , Células-Tronco/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Ubiquitina-Proteína Ligases/metabolismo , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-33143369

RESUMO

This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca+VitD) and periodontal therapy (PT) among low income Brazilian pregnant women with periodontitis (IMPROVE trial). This 2 × 2 factorial feasibility trial used a mixed-methods evaluation. In total, 69 pregnant women were randomly allocated to four groups: 1. fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2. placebo and milk plus early PT; 3. fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4. placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation, and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.


Assuntos
Alimentos Fortificados , Leite , Periodontite , Complicações na Gravidez , Vitamina D , Vitaminas , Animais , Brasil , Carbonato de Cálcio , Estudos de Viabilidade , Feminino , Humanos , Periodontite/terapia , Gravidez , Complicações na Gravidez/terapia , Gestantes , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico
5.
Artigo em Inglês | MEDLINE | ID: mdl-33092182

RESUMO

(1) Background: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factors such as stress or anxiety affecting host response. The purpose of this study is to evaluate the potential associations between psychosocial factors scores or salivary cortisol levels with clinical periodontal parameters and bacterial environment in patients with periodontitis; (2) Methods: Subgingival microbiota was collected in two pathological and one healthy sites from thirty diseased patients (before/after scaling and root planing (SRP)) and from one healthy site from thirty control patients. Usual clinical periodontal parameters were recorded, and a saliva sample was harvested. Patients completed stress and anxiety self-assessment questionnaires. Cortisol concentrations were determined by ELISA and bacteria were identified by PCR; (3) Results: No correlation between salivary cortisol and the stress-anxiety self-declared was found (p > 0.05), but high concentrations of this molecule were associated positively and linearly with periodontal pocket depth (p = 0.04). It appeared that certain psychosocial stressors are associated with a modulation of the bacterial colonization of pockets of diseased group (before/after SRP), notably concerning Tannerella forsythia (p = 0.02), Porphyromonas gingivalis (p = 0.03), Fusobacterium nucleatum (p = 0.049) and Campylobacter rectus (p = 0.01). (4) Conclusion: This study reveals associations between bacteria colonization and psychosocial parameters in periodontitis that needs to be further investigated.


Assuntos
Aggregatibacter actinomycetemcomitans , Hidrocortisona , Periodontite , Prevotella intermedia , Saliva , Adulto , Idoso , Bacteroides , Feminino , Humanos , Hidrocortisona/análise , Masculino , Pessoa de Meia-Idade , Periodontite/microbiologia , Periodontite/terapia , Estudos Prospectivos , Saliva/química , Saliva/microbiologia , Adulto Jovem
6.
Sci Rep ; 10(1): 16322, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004857

RESUMO

Nonsurgical periodontal therapy with adjunctive use of systemic antimicrobials (for 7-14 days) showed improved clinical, microbiological and immunological results over the mechanical protocol alone. Considering the increasing risk for antimicrobial resistance with longer antibiotic regimes, it is important to establish the optimal antibiotic protocol with a maximum antimicrobial benefit and minimum risk for adverse effects. The aim of the study was to evaluate the microbiological and inflammatory outcomes 12-months after a 3-/7-day systemic antibiotic protocol [amoxicillin (AMX) + metronidazole (MET)] adjunctive to subgingival debridement in severe periodontitis compared to mechanical treatment alone. From the initially treated 102 patients, 75 subjects (Placebo group: n = 26; 3-day AMX + MET group: n = 24; 7-day AMX + MET group: n = 25) completed the 12-month examination. Clinical parameters, eight periodontal pathogens and inflammatory markers were determined at baseline and 3-, 6-, 12-months after therapy using real-time PCR and ELISA respectively. After 6 months, several periodontopathogens were significantly more reduced in the two antibiotic groups compared to placebo (p < 0.05). After 1 year, both antibiotic protocols showed significant reductions and detection of the keystone pathogen P. gingivalis compared to placebo. Antibiotic protocols, smoking, disease severity, baseline-BOP, -CAL and -IL-1ß, as well as detection of T. denticola at 12-months significantly influenced the residual number of deep sites. The present data indicate that the systemic use of both short and longer antibiotic protocols (AMX + MET) adjunctive to nonsurgical periodontal therapy lead to higher microbiological improvements compared to subgingival debridement alone. The two investigated antibiotic protocols led to comparable microbiological and inflammatory results.


Assuntos
Amoxicilina/uso terapêutico , Anti-Infecciosos/uso terapêutico , Metronidazol/uso terapêutico , Periodontite/terapia , Adulto , Aggregatibacter actinomycetemcomitans , Amoxicilina/administração & dosagem , Anti-Infecciosos/administração & dosagem , Biomarcadores , Esquema de Medicação , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Metronidazol/administração & dosagem , Periodontite/tratamento farmacológico , Periodontite/microbiologia , Porphyromonas gingivalis , Reação em Cadeia da Polimerase em Tempo Real , Curetagem Subgengival/métodos
7.
Periodontol 2000 ; 84(1): 124-133, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32844410

RESUMO

Recall sessions are an integral part of supportive periodontal therapy. The aim of the current article is to review the existing evidence to support if and to what extent a predefined frequency of periodontal recall sessions ensures periodontal health and stability. Factors that potentially affect the time interval for recall are described. Moreover, original data on the relevance of residual diseased sites (ie, bleeding pockets) at patient level to predict the progression of periodontitis are presented. Overall, wide heterogeneity was found in the published literature with regards to the proposed supportive periodontal therapy recall frequency once active periodontal therapy has been completed. Available data clearly show that a primary and secondary preventive regimen based on routine supportive periodontal therapy is beneficial to preserve a periodontally healthy dentition and prevent tooth loss. However, convincing evidence regarding the appropriateness, risk-benefit, and cost-effectiveness of different recall intervals is currently scarce. In patients affected by moderate to advanced periodontitis, a supportive periodontal therapy protocol based on a 2-4 month recall interval appears reasonable. Limited data suggest that the amount/proportion of residual diseased sites (intended as pockets or bleeding pockets) and risk assessment tools may be of value in establishing the appropriate recall frequency.


Assuntos
Periodontite/terapia , Perda de Dente , Progressão da Doença , Humanos
8.
Periodontol 2000 ; 84(1): 14-34, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32844416

RESUMO

Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self-sustained feed-forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host-modulation therapies for the treatment of periodontitis. Such host-modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application.


Assuntos
Microbiota , Periodontite/terapia , Disbiose , Humanos , Inflamação
9.
J Int Acad Periodontol ; 22(3): 129-136, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32655038

RESUMO

AIMS: This case series study aimed to assess the clinical outcomes of a novel protocol for the treatment of patients with severe periodontitis. MATERIALS AND METHODS: Twenty (20) patients with severe periodontitis underwent a single session of One-Stage Full-Mouth Instrumentation (OSFMI) involving supra- and sub-gingival air-polishing with erythritol and chlorhexidine powder and ultrasonic root surface debridement and calculus removal, in association with systemic amoxicillin and metronidazole. Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Recession (REC), Bleeding on Probing (BOP) and Plaque Index (PI) were collected at baseline (T0), 6 weeks (T1), 3 months (T2) and 6 months (T3). RESULTS: At 6 months, 30% of subjects reached the primary clinical endpoint (less than or equal to4 sites with PD greater than or equal to 5 mm). The percentage of BOP decreased from 49.08 (CI95% 36.06; 62.1) at T0 to 12.97 (CI95% 7.57; 18.37) at T3. The mean number pockets with PPD≥ 5 mm and PPD greater than or equal to 7 mm decreased significantly, from 46.0 and 20.6 at T0 to 11.5 and 2.8 at T3 respectively (p less than 0.001). CONCLUSION: The OSFMI protocol led to clinical results comparable to those obtained with traditional SRP. Researchers are encouraged to test this protocol in randomized clinical trials with longer periods of observation.


Assuntos
Raspagem Dentária , Periodontite , Índice de Placa Dentária , Humanos , Metronidazol/uso terapêutico , Bolsa Periodontal/terapia , Periodontite/terapia , Resultado do Tratamento
10.
Arch Oral Biol ; 117: 104825, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32622257

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effects of Lactobacillus reuteri applied locally or systemically with scaling and root planing (SRP) to the treatment of experimental periodontitis (EP) in rats treated with 5-fluorouracil. METHODS: A cotton ligature was installed on the molars of rats. The animals (n = 54) underwent chemotherapy and were divided into groups: SRP (n = 18), scaling and root planing only; LP (n = 18), SRP and 4 sessions of local probiotic (PRO); SP, SRP and 4 sessions of systemic PRO. The molar furcation area was submitted to histopathological, histometric of alveolar bone loss (ABL) and immunolabeling analysis after euthanasia at 7, 15 and 30 days. The data were submitted to statistical analysis (α = 5%). RESULTS: At 15 days ABL was higher in LP compared to SP. At 30 days, ABL was higher in LP compared to SRP and SP. Higher immunolabeling of TGF-ß1 was observed in LP and SP at 7 days compared to SRP (p < 0.05). Lower immunolabeling of OCN and higher immunolabeling of RANKL were observed at all periods in SRP compared to SP (p < 0.05). At 30 days, SRP showed lower immunolabeling of OPG compared to SP and LP (p < 0.05). In SP, lower immunolabeling was observed at 15 days compared at 30 days (p < 0.05). CONCLUSION: The ABL was similar among the groups treated with SRP associated or not to probiotic therapeutic, although the systemic use of Lactobacillus reuteri considerably reduced inflammation and favored periodontal tissues repair.


Assuntos
Raspagem Dentária , Lactobacillus reuteri , Periodontite , Aplainamento Radicular , Animais , Fluoruracila/farmacologia , Periodontite/terapia , Ratos
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 455-460, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634883

RESUMO

Patients with malocclusions and periodontitis need to conduct the orthodontic treatment based on good periodontal treatment. Combined orthodontic-periodontal treatment can improve occlusal relationship, effectively promote inflammation control and long-term stability.


Assuntos
Má Oclusão/terapia , Periodontite/terapia , Humanos , Ortodontia Corretiva
12.
J Dent ; 99: 103417, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32592828

RESUMO

OBJECTIVES: To assess if long-term treatment costs in periodontitis patients differ between stage III vs. IV and grade B vs. C according to the 2018 classification of periodontal diseases. METHODS: A cohort of 231 periodontitis patients (followed over a mean of 18.4 years) was evaluated. Costs for active periodontal therapy (APT, including scaling and root planning, open flap debridement, root resections) and supportive periodontal therapy (SPT, including also restorative, endodontic, prosthetic and surgical treatment) were estimated from a mixed payer-perspective in Germany (in Euro 2020). Multi-dimensional staging and grading was applied. The impact of stage, grade, sex and age on total and annual costs was assessed. RESULTS: Mean (SD) total and annual treatment costs were 7154 (2554) Euro and 437 (222) Euro. Costs were generated during SPT (92 %) and by periodontal treatment (88 %) and decreased significantly with longer follow-up (p < 0.001). Total costs were 7120 (2692) Euro in stage III (n = 154) vs. 7221 (2271) Euro in stage IV (n = 77; p > 0.05), and 6256 (1605) Euro in grade B (n = 35) vs. 7314 (2660) Euro in grade C (n = 196; p < 0.001). Annual costs were 426 (219) Euro vs. 459 (228) Euro for stage III vs. stage IV (p > 0.05) and 308 (163) Euro vs. 460 (224) Euro for grade B vs. grade C (p < 0.001). Multivariable modelling found grade, but not stage, sex and age significantly associated with costs. CONCLUSIONS: Within the limitations of this study, and in patients with severe periodontitis who were systematically treated long-term, grading, but not staging was associated with costs. CLINICAL SIGNIFICANCE: Treatment costs were higher in patients with more progressive periodontitis and were found to decrease during follow-up. Dentists need to consider costs during treatment planning and communication with patients.


Assuntos
Doenças Periodontais , Periodontite , Assistência Odontológica , Alemanha , Custos de Cuidados de Saúde , Humanos , Periodontite/terapia
13.
BMC Oral Health ; 20(1): 176, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32586315

RESUMO

BACKGROUND: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. METHODS: English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence. RESULTS: Ten randomized controlled trials were included out of 1434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. CONCLUSION: When initial PPD was 4-6 mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6 mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.


Assuntos
Raspagem Dentária , Periodontite/terapia , Ultrassom , Humanos , Bolsa Periodontal , Projetos Piloto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
BMC Oral Health ; 20(1): 148, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429904

RESUMO

BACKGROUND: Periodontitis is a chronic inflammation of the tooth supporting structures that finally can lead to tooth loss. As chronic periodontitis is associated with systemic diseases multiple approaches have been followed to support regeneration of the destructed tissue. But very few materials are actually used in the clinic. A new and promising group of biomaterials with advantageous biomechanical properties that have the ability to support periodontal regeneration are self-assembling peptides (SAP). However, there is still a lack of 3D periodontal models that can evaluate the migration potential of such novel materials. METHODS: All experiments were performed with primary human periodontal ligament fibroblasts (HPLF). Migration capacity was assessed in a three-dimensional model of the human periodontal ligament by measuring the migration distance of viable cells on coated (Enamel Matrix Protein (EMP), P11-4, collagen I) or uncoated human dentin. Cellular metabolic activity on P11-4 hydrogels was assessed by a metabolic activity assay. Deposition of ECM molecules in a P11-4 hydrogel was visualized by immunostaining of collagen I and III and fibrillin I. RESULTS: The 3D periodontal model was feasible to show the positive effect of EMP for periodontal regeneration. Subsequently, self-assembling peptide P11-4 was used to evaluate its capacity to support regenerative processes in the 3D periodontal model. HPLF coverage of the dentin surface coated with P11-4 increased significantly over time, even though delayed compared to EMP. Cell viability increased and inclusion of ECM proteins into the biomaterial was shown. CONCLUSION: The presented results indicate that the 3D periodontal model is feasible to assess periodontal defect coverage and that P11-4 serves as an efficient supporter of regenerative processes in the periodontal ligament. CLINICAL RELEVANCE: The establishment of building-block synthetic polymers offers new opportunities for clinical application in dentistry. Self-assembling peptides represent a new generation of biomaterials as they are able to respond dynamically to the changing environment of the biological surrounding. Especially in the context of peri-implant disease prevention and treatment they enable the implementation of new concepts.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Ligamento Periodontal , Periodontite/terapia , Periodonto/fisiologia , Engenharia Tecidual/métodos , Materiais Biocompatíveis/química , Fibroblastos , Humanos , Regeneração
15.
Clin Oral Investig ; 24(12): 4291-4299, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32385656

RESUMO

AIM: Assessment of the effect of nonsurgical periodontal therapy on haematological parameters in patients with grades B (BP) and C periodontitis (CP). METHODS: Eight BP and 46 CP patients received full-mouth periodontal debridement within 48 h, if positive for Aggregatibacter actinomycetemcomitans with adjunctive systemic antibiotics (4 BP, 17 CP). Clinical data were collected prior and 12 weeks after periodontal therapy. Blood was sampled prior to and 1 day as well as 6 and 12 weeks after the first SD visit. Erythrocyte count, haemoglobin value, haematocrit (HCT), mean erythrocyte volume (MCV), mean corpuscular haemoglobin (MCH), MCH concentration (MCHC), platelets (PLT) and heat shock protein 27 (Hsp27) were assessed. RESULTS: Both groups showed significant clinical improvement (p < 0.05). Using univariate analysis, MCV was noticeably lower in CP than BP at all examinations, HCT only at baseline. For CP, MCHC was noticeably higher 12 weeks after SD than at baseline and 1 day (p ≤ 0.005) and Hsp27 increased noticeably at 1 day (p < 0.05). Repeated measures analysis of variance revealed African origin to be associated with lower MCV and female sex with lower MCHC. CONCLUSION: Based on multivariate analysis, periodontal diagnosis (BP/CP) was not associated with haematological parameters measured in this study or serum Hsp27. In CP, nonsurgical periodontal therapy improved MCHC 12 weeks after SD. Also in CP Hsp27 was increased 1 day after SD.


Assuntos
Índices de Eritrócitos , Periodontite , Aggregatibacter actinomycetemcomitans , Contagem de Eritrócitos , Feminino , Hematócrito , Humanos , Periodontite/terapia
16.
J Appl Oral Sci ; 28: e20190694, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428060

RESUMO

Objective Obesity is a chronic disease that negatively affects an individual's general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy. Methodology This clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of Tannerella forsythia , Porphyromonas gingivalis , Treponema Denticola , and Aggregatibacter actinomycetemcomitans was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used. Results In both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p<0.05). Obese and non-obese patients equally responded to non-surgical periodontal therapy (p>0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy. Conclusions Obesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.


Assuntos
Obesidade/microbiologia , Periodontite/microbiologia , Periodontite/terapia , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Análise de Variância , Antropometria , Índice de Placa Dentária , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Índice Periodontal , Porphyromonas gingivalis/isolamento & purificação , Estudos Prospectivos , Fatores de Risco , Estatísticas não Paramétricas , Tannerella forsythia/isolamento & purificação , Fatores de Tempo , Resultado do Tratamento , Treponema denticola/isolamento & purificação
17.
Wiad Lek ; 73(5): 841-845, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32386355

RESUMO

OBJECTIVE: The aim: To study clinical efficiency of using the diode laser in the treatment of chronic catarrhal and hypertrophic gingivitis. PATIENTS AND METHODS: Materials and methods: Treatment of 32 patients with chronic catarrhal gingivitis and 30 patients with hypertrophic gingivitis by basic therapy according to the protocols of dental care was carried out. The patients of the main groups were additionally subjected to laser irradiation of the affected areas of the gums with a diode laser. RESULTS: Results: The use of laser therapy in the treatment of chronic catarrhal gingivitis contributed to the pain relief, reducing of bleeding and edema of the gums in 68.8% of patients on the 3rd day of observation. On the 7th day, 93.8% of the examined patients had no inflammation in periodontal tissues. During treatment of hypertrophic gingivitis, anti-inflammatory and decongestant effects, improvements in the aesthetic appearance of the gums were revealed in 33.3% patients on the 3rd day of the examination; absence of inflammation, gingival bleeding and gum hypertrophy was diagnosed in 53.3% on the 7th day and in 80.0% patients on 14th day of follow-up. In the control group, similar changes were revealed only in 68.8% patients with catarrhal gingivitis and in 46.7% patients with hypertrophic gingivitis after complete course of drug treatment in 14 days of observation. CONCLUSION: Conclusions: The use of a diode laser in patients with chronic gingivitis has provided a reduction in the term required for the complete elimination of the inflammatory process and suspended its further progression.


Assuntos
Gengivite , Terapia com Luz de Baixa Intensidade , Periodontite/terapia , Índice de Placa Dentária , Humanos , Lasers Semicondutores , Periodonto
18.
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
19.
Braz Oral Res ; 34(supp1 1): e027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294680

RESUMO

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


Assuntos
Conferências de Consenso como Assunto , Doenças Periodontais/terapia , Feminino , Gengivite/diagnóstico , Gengivite/epidemiologia , Gengivite/terapia , Carga Global da Doença , Humanos , América Latina/epidemiologia , Masculino , Saúde Bucal , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Periodontite/diagnóstico , Periodontite/epidemiologia , Periodontite/terapia , Qualidade de Vida
20.
Trials ; 21(1): 291, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32293522

RESUMO

BACKGROUND: We report the first protocol for a multicenter, randomized comparison study to compare the efficacies of periodontal scaling and root-planing treatment against that of tooth-brushing treatment for nonalcoholic fatty liver disease (NAFLD) (PERION: PERIOdontal treatment for NAFLD). Nonalcoholic steatohepatitis (NASH) is an advanced form of NAFLD, which can progress to cirrhosis and hepatocellular carcinoma. Increased endotoxemia is associated with the progression of NAFLD. Periodontal bacteria possess endotoxins; Porphyromonas gingivalis is well-known as a major pathogenic bacterium in periodontitis, and serum antibody levels for P. gingivalis are high in patients with periodontitis. Several reports have indicated that P. gingivalis is related to NAFLD. This study aims to investigate the effect of periodontal treatment for liver damage, P. gingivalis infection, and endotoxemia on patients with NAFLD. METHODS: We will include adult patients (20-85 years old) with NAFLD, alanine aminotransferase (ALT) ≥ 40 IU/L, and equivalent steatosis grade ≥ 1 (target sample size, n = 40 patients; planned number of patients with outcome data, n = 32). Participants will be randomly assigned to one of two groups: a scaling and root-planing group or tooth-brushing as the usual group. The primary outcome will be the change in ALT levels from baseline to 12 weeks; the key secondary outcome will be the change in the serum immunoglobulin G (IgG) antibody titer for P. gingivalis at 12 weeks. DISCUSSION: This study should determine whether periodontal treatment decreases liver damage, P. gingivalis infection, and endotoxemia in patients with NAFLD. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN) Clinical Trials Registry, ID: UMIN000022079.


Assuntos
Infecções por Bacteroidaceae/complicações , Hepatopatia Gordurosa não Alcoólica/sangue , Periodontite/etiologia , Periodontite/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alanina Transaminase/análise , Infecções por Bacteroidaceae/microbiologia , Carcinoma Hepatocelular/prevenção & controle , Raspagem Dentária/métodos , Progressão da Doença , Endotoxemia/complicações , Endotoxemia/prevenção & controle , Feminino , Humanos , Imunoglobulina G/sangue , Cirrose Hepática/prevenção & controle , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Porphyromonas gingivalis/imunologia , Porphyromonas gingivalis/patogenicidade , Aplainamento Radicular/métodos , Segurança , Resultado do Tratamento
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