Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5-year prospective study.

INTRODUCTION: Studies have shown that an impaired bone condition, represented by osteoporosis and increased fracture risk, may potentially aggravate periodontal disease and, consequently, the risk of tooth loss. This 5-year prospective study aimed to investigate whether systemic bone condition represents risk factor for tooth loss due to periodontal disease amongst elderly women. MATERIAL AND METHODS: Seventy-four participants, aged ≥ 65 years, who attended the 5-years recall for periodontal evaluation were involved. Baseline exposures were osteoporosis and fracture risk probabilities (FRAX). Women were grouped according to bone mineral density (BMD) and years of bone treatment for osteoporosis. The primary outcome at a 5-year follow-up was the number of tooth loss due to periodontal disease. Periodontitis staging and grading, and causes of tooth loss were recorded. RESULTS: The multivariate Poisson regression models showed that women with untreated/shortly treated osteoporosis were 4 times more likely to present higher number of tooth loss due to periodontal disease than those with normal BMD or treated for ≥ 3 years (risk ratio (RR) = 4.00, 95% CI 1.40-11.27). Higher FRAX was also linked to tooth loss (RR = 1.25, 95% CI 1.02-1.53). Receiver-operating characteristic (ROC) curve suggested that women with history of ≥ 1 tooth losses have higher chances of worse major FRAX (sensitivity = 72.2%; specificity = 72.2%). CONCLUSION: In this 5-year study, higher FRAX and untreated osteoporosis were risk factors for tooth loss. Women with normal BMD or treated for osteoporosis for ≥ 3 years did not show increased risk. Management of skeletal conditions should be emphasized with periodontal care for the prevention of tooth loss in elderly women.

Association between periodontitis and Alzheimer's disease and its impact on the self-perceived oral health status: a case-control study.

PURPOSE: To test the hypothesis that periodontitis is associated with AD and search whether periodontal and other variables would negatively impact the oral health-related quality of life (OHRQoL) perception. MATERIALS AND METHODS: Oral examinations and interview on self-perceived oral health status (Geriatric Oral Health Assessment Index (GOHAI) questionnaire (higher score corresponds to better perceived oral status)) were carried out and socio-demographic data were collected from outpatients with mild to moderate AD (cases, n = 50) and from their age- and sex-matched family caregivers (controls, n = 52). Full-mouth periodontal examination was performed. Significance of differences between groups was sought by chi-square, Student's t, or the Mann-Whitney test. The association between the variables periodontitis, probing depth (PD) ≥ 5 mm, and clinical attachment loss (CAL) ≥ 5 mm with the variable group was tested in binary logistic regression models (LRMs). LRMs were used to test the association of oral findings, demographics, and group with GOHAI. RESULTS: Cases had fewer teeth and greater CAL than controls. Cases had a superior percentage of sites with plaque, calculus, and bleeding on probing than controls. Cases had greater GOHAI scores than controls. Periodontitis was a variable most likely associated with AD (OR = 11.08, p < 0.001). None of the oral findings or demographics, but group, was associated with GOHAI (OR = 14.45, p < 0.001). CONCLUSION: Periodontitis is associated with AD, but not with patients' OHRQoL. CLINICAL RELEVANCE: Health care professionals must be aware that AD patients should have a periodic thorough oral examination and preventive intervention aiming at their welfare and maintenance of a pain-free functional dentition.

Oral status, sense of coherence, religious-spiritual coping, socio-economic characteristics, and quality of life in young patients.

BACKGROUND: Several factors can influence the oral health. AIM: To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). DESIGN: This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. RESULTS: For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (ß = 0.382, ß = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (ß=-0.201). The higher the age of the C/A, the lower the NDT (ß=-0.235), and the higher the family income the lower, the need for social benefit (ß = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. CONCLUSIONS: Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.

Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families.

OBJECTIVE: This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. STUDY DESIGN: Healthy children aged 3-7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. RESULTS: No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p<0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). CONCLUSION: Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism.

No association between periodontitis, preterm birth, or intrauterine growth restriction: experimental study in Wistar rats.

BACKGROUND: The biologic plausibility of the possible association between periodontitis and adverse pregnancy outcomes has been assessed with the use of different experimental models. However, most experimental studies did not induce periodontitis in the animals but promoted an acute microbial challenge with selected periodontal pathogens or their products subcutaneous or intravenous or intraamniotic. The present study was then conducted to verify the biologic plausibility of such association by experimentally inducing periodontitis in Wistar rats. OBJECTIVE: An experimental study on an animal model by the induction of periodontitis in 50% of sites and assessment of the presence of cytokines in the gingival tissue, serum, placenta, cord, and amniotic fluid was designed to test the null hypothesis that experimental periodontitis that is induced on rats does not result in adverse pregnancy outcomes. STUDY DESIGN: Forty female Wistar rats were included in 2 groups: a periodontally healthy (without ligatures) and an experimentally induced periodontitis group (test, with ligatures). Forty-five days after the induction, the mating was initiated. Males were placed with females in the ratio of 1:2 for a period of 12 hours. The bodyweight of the female, from then on, was recorded daily. When the pregnancy was confirmed on day 20, laparotomy was performed. The amniotic fluid, placenta, umbilical cord, blood (serum) and maternal and gingival tissue samples were subjected to quantitative analysis for interleukin 1α, -6, -10, -4, -12p70, and -17a, tumor necrosis factor-α, and interferon-γ by multiplex methods. Mean scores, standard deviations, and standard errors for estimated measures were calculated. For cytokines analyses, the Mann-Whitney test was conducted to compare the concentration of the analytes from control and test groups in the different tissues samples. For comparison of cytokines reduction from gingival tissue to serum and from serum to placenta, the Wilcoxon Test was performed. Spearman's correlation was conducted among cytokines in the 5 different tissues that were evaluated. RESULTS: The induced periodontitis in Wistar rats did not result in adverse outcomes of pregnancy. There were no statistically significant differences between groups in relation to prematurity, fetal, or birth weight. Regarding cytokines, there were no statistically significant differences in concentrations that were measured in each tissue between the groups with periodontitis and controls. Furthermore, all cytokine levels in the placenta, except interleukin-6, were diminished compared with the amniotic fluid or maternal serum, which suggested that the cytokines cannot easily be transferred via this tissue in maternal-fetal or fetomaternal direction. The fertility rate was reduced significantly in the group with periodontitis. CONCLUSION: Periodontitis that is induced in rats is not a risk factor for preterm birth or low birthweight.

Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis.

OBJECTIVES: The aims of this study were to investigate the caries experience, periodontal status, oral hygiene habits, and salivary parameters of children and adolescents undergoing hemodialysis (HD) and to compare them with their healthy counterparts. METHODS: Fifty-two HD patients were matched for age, sex, ethnicity, and social class with 52 healthy subjects for analysis of the number of decayed, missing and filled teeth, plaque and gingival index, dental calculus accumulation, measurements of pocket depth, clinical attachment level, gingival recession, and bleeding on probing. Stimulated saliva samples were collected to assess salivary flow rate, pH and buffer capacity, and salivary concentrations of calcium, phosphate, and urea by colorimetric method. RESULTS: HD patients had lower dental caries (p = 0.004), greater plaque and calculus accumulation (p = 0.001), and reported flossing less often than the controls (p = 0.013). Regarding salivary analysis, HD patients showed significantly higher values of pH, buffer capacity, and salivary urea concentration when compared to the controls (p = 0.001). CONCLUSION: HD patients had lower caries experience, higher accumulation of dental plaque, and calculus deposition than their healthy counterparts, probably due to the differences found in their salivary biochemical parameters. CLINICAL SIGNIFICANCE: A significant number of children and adolescents undergoing hemodialysis are candidates for kidney transplantation and should receive complete pre-transplant dental exams and dental treatment. Our results open the way for the development of an individualized dental protocol for these patients with preventive measures and treatment of the poor oral health in HD patients.

Lower dental caries prevalence associated to chronic kidney disease: a systematic review.

BACKGROUND: The aim of this systematic review was to determine whether there is any evidence in the literature referring to a lower prevalence of dental caries in children and adolescents with chronic kidney disease (CKD) compared to healthy individuals. METHODS: A search of the PubMed Medline, Ovid Medline and Cochrane Library databases was performed using the MeSH terms "dental caries" and "chronic renal failure". To be eligible for entry in our study, controlled observational studies had to present a decayed, missing and filled index for primary teeth (dmft) and/or for permanent teeth (DMFT) in children and adolescents with CKD. RESULTS: After evaluation of title, keywords and abstracts of the articles selected, six articles met the inclusion criteria. Three of these six articles included studies which showed susceptibility to bias and possible confounding factors. A subsequent assessment of the six studies revealed that the mean caries indices in both primary (dmf) and permanent (DMF) teeth were lower in the children and adolescents with CKD compared with healthy individuals. CONCLUSION: Data in the literature weakly support a lower prevalence of caries in children and adolescents with CKD than in their healthy counterparts. There is still a lack of well-designed studies that provide better scientific evidence in support of this conclusion.

Response to the letter to the editor:Osteonecrosis of the jaws in patients under osteoporosis treatment:nine-year experience report.

None.

Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report.

Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusion: The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks.

BACKGROUND: Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. METHODS: A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group--employed women with paid work, and, 2. home-based social network group--women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. RESULTS: There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥ 4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥ 4 [OR 1.73 (95% CI: 1.23-2.42)]. CONCLUSIONS: Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.

Initial assessment of responsiveness of the P-CPQ (Brazilian Version) to describe the changes in quality of life after treatment for traumatic dental injury.

This study aimed to assess the responsiveness of the Brazilian version of the Parental-Caregiver Perception Questionnaire (B-P-CPQ) to describe changes in quality of life (QoL) after treatment for traumatic dental injury (TDI). After eligibility criteria were applied, 42 of 255 patients who went to a dental trauma center for TDI treatment were included. QoL was evaluated in two different appointments: A1 (after TDI) and A2 (after TDI treatment). The B-P-CPQ scores were calculated using the additive method. Psychometric properties like internal consistency (Cronbach's Alpha), test-retest reliability, intraclass correlation coefficient (ICC), and construct validity (Spearman's correlations) were assessed, and, mainly, the responsiveness was analyzed by standardized response means (SRM). Mean B-P-CPQ scores were 30.05 (1.74 SD) and 2.67 (4.05 SD), while the median scores were 17.39 and 2.00 (P < 0.01), respectively in A1 and A2. Cronbach's Alpha was 0.87 in A1 and 0.66 in A2. ICC was 0.90. B-P-CPQ scores were correlated with overall well-being (P < 0.01; rho: 0.71). The B-P-CPQ responsiveness scores declined 27.38 points, and a perfect SRM of 1.76 was achieved. The B-P-CPQ scores indicated changes in QoL following TDI. The change was observed as an impact decrease after TDI treatment, demonstrating positive reduction and improvement on QoL. The responsiveness of the P-CPQ (Brazilian version) in detecting change on QoL after TDI treatment was confirmed by SRM assessment. The findings represent an evidence of the importance of professional care and treatment of TDI.

Psychometric Properties of the Brazilian Version of GOHAI among Community-Dwelling Elderly People.

This study assessed the psychometric properties of the Brazilian version of the Geriatric Oral Health Assessment Index (GOHAI). A representative sample of 613 community-dwelling elderly people aged from 65 to 74 years was selected. Sociodemographic data, GOHAI and self-perceived oral health measures were collected. Dental clinical measures were obtained through oral examinations. The dimensional structure and adequacy of components were assessed using Confirmatory Factor Analysis (CFA), inter-item correlations and item-scale correlations. Reliability was evaluated by internal consistency and Intraclass Correlation Coefficients. Correlations between GOHAI scores and self-reported oral health measures were conducted to assess convergent validity. The relationship between dental clinical measures and GOHAI was tested through Poisson Regression to examine discriminant validity. The link between GOHAI items and dimensions was supported by CFA. Item 12 showed a poor factor loading. The inter-item correlations varied from 0.047 to 0.442, and item-scale correlations ranged from 0.305 to 0.612. Cronbach's alpha was 0.704. The test-retest correlation for GOHAI was 0.882. GOHAI scores were correlated by self-rated oral health measures. Poor dental clinical measures were associated with GOHAI. The Brazilian version of GOHAI showed adequate psychometric properties. However, the weak dimensional structure of GOHAI suggests the need to perform cross-cultural adaptation of GOHAI for Brazilian elderly people.

Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS).

BACKGROUND: Oral disorders can have a negative impact on the functional, social and psychological wellbeing of young children and their families and cause pain/discomfort for the child. Oral health-related quality of life (OHRQoL) has emerged as an important health outcome in clinical trials and healthcare research. The Early Childhood Oral Health Impact Scale (ECOHIS) is a proxy measure of children's OHRQoL designed to assess the negative impact of oral disorders on the quality of life of preschool children. The objective of this study was to evaluate the psychometric properties of the Brazilian version of the ECOHIS (B-ECOHIS). METHODS: This investigation was carried out in preliminary and field studies. The preliminary study comprised a cross-sectional study carried out in the city of Petropolis, Brazil. A sample of 150 children from two to five years of age was recruited at a public hospital. In the field study, an epidemiological survey was carried out in public and private preschools of Belo Horizonte, Brazil. The B-ECOHIS was answered by 1643 parents/caregivers of five-year-old male and female preschool children. In both phases, oral examinations were performed by a single previously calibrated dentist. Reliability was determined through test-retest reliability and internal consistency. Validity was determined through convergent and discriminant validities. The correlation between the scores obtained on the child and family impact sections was assessed. RESULTS: In the preliminary (P) and field (F) study, test-retest reliability correlation values were 0.98 and 0.99 for the child impact section and 0.97 and 0.99 for the family impact section, respectively. The B-ECOHIS demonstrated internal consistency: child impact section (P: α = 0.74; F: α = 0.80) and family impact section (P: α = 0.59; F: α = 0.76). The correlation between the scores obtained on the child and family impact sections was statistically significant (P: rs = 0.54; F: rs = 0.62; p ≤ 0.001). In both phases of the study, B-ECOHIS scores were significantly associated with the decayed, missing and filled teeth index, decayed teeth and discolored upper anterior teeth (p < 0.05). CONCLUSION: The B-ECOHIS proved reliable and valid for assessing the negative impact of oral disorders on the quality of life of preschool children.

Factors Associated with Noncarious Cervical Lesions in Different Age Ranges: A Cross-sectional Study.

OBJECTIVES: Understanding the possible risk factors of noncarious cervical lesion (NCCL) is important for prevention and clinical management of the condition. The aim of this study was to investigate the factors associated with the prevalence of NCCL among adolescents, adults, and elderly people. MATERIALS AND METHODS: A cross-sectional study involving 501 participants aged 15 years or older was conducted. Participants were examined to assess the number of natural teeth and the prevalence and severity of NCCL by calibrated examiners. Data on age, gender, harmful toothbrushing habits, and acidogenic diet were collected through individual interviews. Multivariate Poisson's regression models were used to evaluate the association between the independent variables and the prevalence of NCCL according to the three age groups: 15 to 39, 40 to 64, and 65 years or older. RESULTS : The prevalence of NCCL among participants was 62.5% (95% confidence interval: 58.2-66.7). Among 15- to 39-year-old participants, the mean of NCCL was higher in males, those with lower number of teeth and acidogenic diet intake. Males aged 40 to 64 years and those with harmful brushing habits were more likely to present higher mean of NCCL. Elderly people with harmful toothbrushing habits had a greater mean of NCCL. CONCLUSION: Demographic (age and gender), clinical (number of teeth), and behavioral characteristics (harmful brushing habits and acidogenic diet) were meaningful factors associated with NCCL severity. The above-mentioned relationships varied between age groups.

Periodontal bacterial load: a proposed new epidemiological method for periodontal disease assessment.

AIM: The purpose of this study was to identify a periodontal clinical measure that correlates with red complex bacteria usually associated with periodontal disease. METHODS AND MATERIALS: Periodontal clinical parameters were recorded in 116 postpartum women at six sites per tooth for all teeth excluding third molars. Two subgingival plaque samples per subject were collected and analyzed for 39 bacterial species using the Checkerboard DNA-DNA hybridization technique. Periodontal Bacterial Load (PBL) was calculated as the sum of all pocket depth measurements of 4 mm at sites with a Clinical Attachment Level (CAL) of 4 mm. The association of clinical and bacterial scores was analyzed using the Spearman correlation coefficient and the Kruskal-Wallis test. RESULTS: The PBL was correlated with microorganisms from the red complex that included Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, individually or grouped (p<0.05). The PBL was not associated with periodontally beneficial species from the yellow, green, purple, and blue complexes (p>0.05). The proportions and mean counts of the red complex were increased according to the quartile groups of distribution of the PBL. CONCLUSION: PBL appears to be a reliable measure of periodontal status in postpartum women. CLINICAL SIGNIFICANCE: PBL avoids bias in the assessment of periodontal status in studies of periodontal disease.

Avaliação da percepção dos professores sobre educação interprofissional em saúde por meio de grupos focais / Evaluación de la percepción de los profesores sobre educación interprofesional en salud por medio de grupos focales / Assessment of professors' perception about the interprofessional education in health using focus groups

Este estudo avalia a percepção de docentes de uma universidade pública brasileira sobre educação interprofissional (EIP). Professores de Medicina, Odontologia e Enfermagem participaram de grupos focais on-line síncronos refletindo sobre os seguintes tópicos: (1) disciplinas em comum; (2) projetos interprofissionais de pesquisa e extensão; (3) atenção aos determinantes sociais nos planos de tratamento aos usuários; e (4) práticas colaborativas durante a pandemia de Covid-19. Foi usada análise interpretativa descritiva para avaliar quatro grupos focais (n = 10) utilizando instrumento estruturado com 17 itens acerca dos quatro tópicos mencionados. Segundo os docentes, não existem disciplinas comuns entre os cursos da Saúde. Projetos de extensão e de pesquisa com abordagem interprofissional acontecem somente por poucas iniciativas individuais de professores. Segundo os participantes, os alunos consideram os determinantes sociais nos planos de tratamento. Ocorreram poucas práticas colaborativas durante a pandemia. Observou-se a necessidade de orientações sobre EIP para graduação.(AU)

Este estudio evalúa la percepción de docentes de una universidad pública brasileña sobre educación interprofesional (EIP). Profesores de Medicina, Odontología y Enfermería participaron en grupos focales on-line síncronos reflexionando sobre tópicos: (1) asignaturas en común, (2) proyectos interprofesionales de investigación y extensión, (3) atención a los factores determinantes sociales en los planes de tratamiento a los usuarios, y (4) prácticas colaborativas durante la pandemia de Covid-19. Se utilizó el análisis interpretativo descriptivo para evaluar cuatro grupos focales (n=10) utilizando instrumento estructurado con 17 ítems sobre los 4 tópicos mencionados. Según los docentes, no existen asignaturas comunes entre los cursos de la salud. Los proyectos de extensión y de investigación con abordaje interprofesional constituyen unas pocas iniciativas individuales de profesores. Según los participantes, los alumnos consideran los factores determinantes sociales en los planes de tratamiento. Hubo pocas prácticas colaborativas durante la pandemia. Se observó la necesidad de orientaciones sobre EIP para graduación.(AU)

This study evaluates the perception of professors on interprofessional education (IPE) from a public university in Brazil. Professors of Medicine, Dentistry and Nursing participated in synchronous online focus groups reflecting on topics: (1) common disciplines, (2) interprofessional research and extension projects, (3) attention to social determinants in user treatment plans, and (4) collaborative practices during the Covid-19 pandemic. An accurate focus group transcription and interpretative descriptive analysis were used to assess four focus groups (n=10) using a structured instrument with 17 items about the 4 topics mentioned. According to professors, there are no common disciplines among health courses. Extension and research projects with an interprofessional approach are only individual initiatives by professors. According to participants, students consider social determinants in treatment plans. There were few collaborative practices during the pandemic. There was a need for IPE guidelines for graduation.(AU)

Child-OIDP index in Brazil: cross-cultural adaptation and validation.

BACKGROUND: Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen. METHODS: For cross-cultural adaptation, a translation/back-translation method integrated with expert panel reviews was applied. A total of 342 students from four public schools took part of the study. RESULTS: Overall, 80.7% of the sample reported at least one oral impact in the last three months. Cronbach's alpha was 0.63, the weighted kappa 0.76, and the intraclass correlation coefficient (ICC) 0.79. The index had a significant association with self-reported health measurements (self-rated oral health, satisfaction with oral health, perceived dental treatment needs, self-rated general health; all p < 0.01). CONCLUSION: It was concluded that the Child-OIDP index is a measure of oral health-related quality of life that can be applied to Brazilian children.

The relationship between alcohol dependence and periodontal disease.

BACKGROUND: The aim of this study was to evaluate the relationship between alcohol dependence and periodontal disease. METHODS: A cross-sectional study of 49 alcoholic and 49 non-alcoholic men was conducted at Philippe Pinel Institute, Rio de Janeiro, Brazil. Subjects were screened for alcohol dependence using the CAGE (cut-down, annoyed, guilty, eye-opener) questionnaire and the criteria of the International Statistical Classification of Diseases, 10th Revision. Sociodemographic data and periodontal clinical parameters, such as visible plaque, bleeding on probing, probing depth (PD), and clinical attachment level (CAL), were collected. Groups were controlled for smoking. Intergroup comparisons of sociodemographic data and mean percentage of clinical parameters were analyzed by the chi(2) and Mann-Whitney tests. The independent effect of alcohol dependence on CAL and PD was assessed by multiple linear regression analysis, adjusting for the effects of plaque, age, income, education, and living conditions. RESULTS: A significant linear relationship was found between alcohol dependence and mean CAL (P < or =0.013) and mean PD (P < or =0.001). CONCLUSION: Alcohol dependence may be associated with an increased severity of CAL and PD.

Subgingival microbial profile of obese women with periodontal disease.

BACKGROUND: This study compared the composition of subgingival microbiota between obese and non-obese women with or without periodontal disease. METHODS: Full-mouth periodontal clinical assessments were carried out in 76 obese women (17 periodontally healthy and 59 with periodontal disease), and 34 non-obese women (12 periodontally healthy, 22 with periodontal disease). Subgingival biofilm samples were individually obtained from seven sites of each individual, and the prevalence and counts of 40 bacterial taxa were determined by the checkerboard method. The frequency and counts of each species were computed for each individual and across the groups. Differences among and between groups were sought by the Kruskal-Wallis and Mann-Whitney tests, respectively. Possible correlations between obesity and clinical and microbiologic parameters were tested with Spearman correlation coefficient. RESULTS: Streptococcus sanguinis, Streptococcus oralis, and Capnocytophaga ochracea were found in significantly higher levels in obese compared with non-obese women (P < 0.01). In patients with periodontal health, Porphyromonas gingivalis and Leptotrichia buccalis were detected in higher mean frequency and/or counts in obese women than in non-obese women, whereas in patients with periodontal disease, obese women harbored greater levels of C. ochracea than non-obese women (P < 0.01). Moreover, obese women with periodontal disease presented significantly greater mean counts of P. gingivalis and Tannerella forsythia than non-obese women with periodontal health (P < 0.01). When the conditions obesity and periodontal disease are present at the same time, significant positive correlations were detected with C. ocharcea, P. gingivalis, S. sanguinis, and T. forsythia. CONCLUSION: Few differences in the composition of the subgingival microbiota of obese and non-obese women with periodontal health or disease were found. However, a high prevalence of P. gingivalis in obese women with periodontal health was observed.

Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report

ABSTRACT Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusions: The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.