The impact of nonsyndromic cleft lip with or without cleft palate on oral health-related quality of life

Abstract Nonsyndromic cleft lip with or without cleft palate (NSCL±P) compromises oral health, leading to missing or malformed teeth, and hampering oral hygiene. Apart from anatomic damages, NSCL±P also culminates in an impact on the routine quality of life with social privation and psychological embarrassment. Objective To evaluate the impact of NSCL±P on oral health-related quality of life. Material and Methods The study was classified as exploratory and descriptive, with quantitative approach. Patients with NSCL±P treated between August 2013 and September 2014 at the Cleft Lip and Palate Integral Care Center (CAIF), Curitiba, Brazil, were invited to participate. Age and sex-related data were collected, as well as level of education, financial income, type of orofacial cleft, use of orthodontic and prosthetic appliances, and number of previous orofacial surgeries. Selected patients were asked to answer the Oral Impact on Daily Performance (OIDP) questionnaire designed to measure the impact of oral health on daily performances. Results The sample was composed of 103 (44.59%) women and 128 (55.41%) men, with mean age of 19.74 ± 10.20 (7-65) years. The OIDP values ranged from 1 to 175 in 114 (49.35%) patients (mean: 22.38), whereas 117 patients (50.65%) presented total OIDP value equal to zero. High negative impact of NSCL±P on daily performances was detected when associated with the female sex (p=0.037). Daily performances related to phonetics (OIDP2; 2.63) and aesthetics (OIDP5; 2.48) presented the highest average values when compared to other daily performances, except OIDP6. The main symptoms and reported oral problems comprised the aesthetic dissatisfaction. Conclusions Almost half of the patients evaluated in this study showed negative impact of NSCL±P in the performance of daily activities.

Marcadores salivares são suficientes para correlacionar estresse psicológico e doença periodontal? Revisão narrativa da literatura / Are salivary markers sufficient to correlate psychological stress and periodontal disease? Narrative review of literature

Psychological stress is related to Periodontology as one of the factors involved with the pathogenesis of the periodontal disease (PD), by means of its interaction with immunological neuroendocrine system. Biological markers measuring stress levels are cortisol, α-amylase and chromogranin A (CgA). The question of this literature review was: are salivary markers sufficient to correlate psychological stress and PD?. The literature search strategy used was the combination of the uniterms: "salivary psychological stress marker" with "periodontal disease" and "psychological stress markers" with "periodontal disease" using into four database (PudMed, Scielo, LILACS, MEDLINE). Sixteen articles were recovered and 6 were included according to the analysis of salivary markers in patients whose profile varied from healthy, with gingivitis, chronic periodontitis (CP), CP located and aggressive periodontitits (AP). The article that correlated CP with AP obtained two times higher levels of CgA in patients with AP in compared to CP, and the cortisol level was higher in AP. In another study, only in patients with CP the cortisol level was related significantly to periodontal parameters such as probing depth 5-7 mm, clinical attachment level (CAL) 5-7 mm, CAL>7mm. Another showed significant correlation of CgA, α-amylase and cortisol to tooth loss. It can be concluded that there is not sufficient evidence that salivary markers are correlated with periodontal disease due the limited number of studies with reliable methodology and to the lack of agreement to confirm this information. (AU)

O estresse psicológico está relacionado com a Periodontia como um dos fatores da etiopatogenia da doença periodontal (DP) através da interação com o sistema neuroendócrino imunológico. Entre os marcadores biológicos que medem níveis de estresse encontram-se cortisol, α-amilase e cromogranina A (CgA). Esta revisão de literatura baseou-se na pergunta: marcadores salivares são suficientes para correlacionar estresse psicológico e DP?. A estratégia de busca empregou o cruzamento das palavras-chave: "marcadores salivares no estresse psicológico" com "doença periodontal" e "marcadores do estresse psicológico" com "doença periodontal" em 4 bases de dados (PubMed, Scielo, LILACS, MEDLINE). Dezesseis artigos foram recuperados e 6 foram incluídos de acordo por abordarem análise de marcadores salivares em pacientes cujo perfil variou de saudável, com gengivite, periodontite crônica (PC), PC localizada e periodontite agressiva (PA). O artigo que correlacionou PC com PA, obteve resultado de PA duas vezes maior em nível de CgA em comparação com PC. Já o nível de cortisol mostrou-se maior em PA. A medida do cortisol em outro estudo somente em pacientes com PC relacionou-se significativamente com parâmetros clínicos periodontais como, profundidade de sondagem 5-7mm, nível de inserção clínica (NIC) 5-7 mm, NIC > 7 mm. Em outro estudo que avaliou CgA, α-amilase e cortisol, houve correlação significante com perda dentária. Pode-se concluir que não há suficiente evidência de que marcadores salivares estão correlacionados com DP devido ao limitado número de estudos com metodologia confiável e falta de concordância de resultados para confirmação dessa informação (AU)