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ABSTRACT Objective: Gestational diabetes mellitus (GDM) causes maternal and infant morbidity. Periodontitis is associated with adverse pregnancy outcomes. The aim of this study was to evaluate periodontal status, prematurity and associated factors in pregnant women with and without GDM. Subjects and methods: This observational cross-sectional study included 80 pregnant women with GDM (G1 = 40) and without GDM (G2 = 40). Demographic and socioeconomic status, systemic and periodontal health condition, prematurity and newborns' birth weight were analyzed. For bivariate analysis, Mann-Whitney U-test, t test and Chi-squared test were used. Binary logistic regression analyzed independent variables for periodontitis and prematurity (p < 0.05). Results: Patients from G1 presented lower socioeconomic status, higher weight and body mass index (BMI). Prematurity (G1 = 27.5%; G2 = 2.5%; p < 0.05) and severe periodontitis percentages (G1 = 22.5%; G2 = 0; p = 0.001) were higher in G1 than in G2. Logistic regression analysis showed that household monthly income (OR = 0.65; 95% CI 0.48-0.86; p = 0.003) and maternal BMI (adjusted OR = 1.12; 95% CI 1.01-1.25; p = 0.028) were significant predictors of periodontitis during the third trimester of pregnancy. Presence of GDM remained in the final logistic model related to prematurity (adjusted OR = 14.79; 95% CI 1.80-121.13; p = 0.012). Conclusions: Pregnant women with GDM presented higher severity of periodontitis, lower socioeconomic status, higher overweight/obesity and a 10-fold higher risk of prematurity. Socioeconomic-cultural status and BMI were significant predictors for periodontitis, and GDM was a predictor to prematurity.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Periodontitis/complications , Periodontitis/epidemiology , Diabetes, Gestational/epidemiology , Birth Weight , Body Mass Index , Cross-Sectional Studies , Risk FactorsABSTRACT
Abstract Objectives To analyze the effect of 5 toothpastes containing different percentages of S-PRG fillers compared to NaF toothpaste and NaF varnish on the dentin hydraulic conductance (Lp). Methodology Dentin disks (1.0±0.2 mm thickness) were cut from third molars, and their Lp values were evaluated using Flodec. The specimens were allocated into 7 groups (n=8). The minimum (smear layer) and the maximum (after acid etching) Lp values were recorded. Lp was also assessed after treatment with either a 0wt.%, 1wt.%, 5wt.%, 20wt.%, or 30wt.% S-PRG toothpaste, a NaF toothpaste, or a NaF varnish. Toothpastes were applied by brushing for 15 s, allowing it to settle for 1 min, and rinsing with deionized water. The NaF varnish was applied for 4 min and was removed with a probe. Specimens were exposed to citric acid (6%, pH 2.1, 1 min) and their final Lp was recorded. The pH of all products was recorded (n=3) and specimens from each group were analyzed by Laser Scanning Confocal Microscopy (LSCM). Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (a=0.05). Results The highest Lp reduction was noticed for the 5wt.% S-PRG toothpaste, NaF toothpaste, and NaF varnish. However, the toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG were similar to all toothpastes but differed from the NaF varnish. After erosion, all groups retrieved their maximum Lp values, except for the NaF varnish. The LSCM evidenced deposits on the surface of specimens treated with 5%, 20%, and 30% S-PRG-based toothpastes and NaF toothpaste. Even more deposits were observed for the NaF varnish. After the erosive challenge, the deposits were diminished in all groups. Conclusion Toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG fillers behaved similarly to a conventional NaF toothpaste, even after an erosive challenge. The NaF varnish promoted better reduction of the Lp, but its effect was also diminished after erosion.
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Abstract Objectives: this study systematically reviewed the literature in order to better understand the association among COVID-19, pregnancy and neonates. Methods: MEDLINE, EMBASE, Web of Science, BVS and SCOPUS were assessed, considering the terms: (covid 19 OR covid-19 OR novel coronavirus OR 2019 novel coronavirus OR 2019-nCoV OR sarscov 2 OR sars-cov-2 OR sarscov2 OR sars cov-2) AND (pregnancy OR pregnant OR pregnant women OR gestation OR gestational) AND (infant OR fetal OR neonatal). Thirty full-text were included (408 pregnant women, 11 non-pregnant women and 279 neonates). Results: fever (45.83%) and cough (31.61%) were the main symptoms of COVID-19 during the pregnancy. Low levels of lymphocytes (32.10%), elevated levels of C-reactive protein (32.35%); leukocytosis (29.41%); neutrophil (5.88%); and radiographic alterations on chest CT, x-ray or ultrasound (45.84%) were the main laboratorial findings. Cesarean delivery and preterm were registered in 239 and 49 cases, respectively. Ten neonates tested positive for SARS-CoV-2. Conclusion: when COVID-19 pneumonia affects women during pregnancy, the symptoms are similar to those experienced by non-pregnant women. In addition, there is still no plausible evidence suggesting vertical transmission of SARS-CoV-2 virus from mother to child.
Resumo Objetivos: este estudo revisou sistematicamente a literatura para melhor compreender a associação entre COVID-19, gravidez e neonatos. Métodos: MEDLINE, EMBASE, Web of Science, BVS e SCOPUS foram acessadas, considerando os termos: (covid 19 OR covid-19 OR novel coronavirus OR 2019 novel coronavirus OR 2019-nCoV OR sarscov 2 OR sars-cov-2 OR sarscov2 OR sars cov-2) AND (pregnancy OR pregnant OR pregnant women OR gestation OR gestational) AND (infant OR fetal OR neonatal). Trinta textos completos foram incluídos (408 gestantes, 11 mulheres nãogestantes e 279 recém-nascidos). Resultados: febre (45,83%) e tosse (31,61%) foram os principais sintomas da COVID-19 durante a gestação. Baixos níveis de linfócitos (32,10%), elevados níveis de proteínas Creativa (32,35%); leucocitose (29,41%); neutrófilo (5,88%); e alterações radiográficas sob tomografia computadorizada de tórax, radiografia ou ultrasom (45,84%) foram os principais achados laboratoriais. Parto por cesárea e prematuridade foram registrados em 239 e 49 casos, respectivamente. Dez recém-nascidos testaram positivo para o virus SARS-CoV-2. Conclusão: quando a pneumonia COVID-19 afeta mulheres durante a gravidez, os sintomas são semelhantes aos experimentados por mulheres não grávidas. Além disso, ainda não há evidências plausíveis que sugiram a transmissão vertical do vírus SARS-CoV-2 de mãe para filho.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant, Premature , Pregnancy , Risk Factors , COVID-19/diagnosis , COVID-19/epidemiology , Cesarean Section/statistics & numerical data , Risk Index , Parturition , COVID-19 Serological TestingABSTRACT
ABSTRACT Background: Obesity and bariatric surgery may be related with mental and oral disorders. Aim: To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients. Methods: Eighty-nine patients were divided in two groups: Control Group (CG) - obese patients and Experimental Group (EG) - patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered. Results: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG. Conclusion: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.
RESUMO Racional: A obesidade e a cirurgia bariátrica podem estar relacionadas a desordens mentais e bucais. Objetivo: Avaliar o impacto da cirurgia bariátrica na ansiedade, lesões iniciais de cárie dentária e sangramento gengival em pacientes obesos. Método: Oitenta e nove pacientes foram divididos em dois grupos: Grupo Controle (GC) - obesos e Grupo Experimental (GE) - pacientes submetidos à cirurgia bariátrica. O GE foi analisado antes e 12 meses após a cirurgia bariátrica; para o GC, foi respeitado um intervalo de 12 meses entre as avaliações. Foram utilizados o Sistema Internacional de Detecção e Avaliação de Cárie, Índice de Sangramento Gengival e Inventário de Ansiedade do Traço-Estado. Resultados: Não houve diferenças estatisticamente significantes entre os grupos nos dois momentos de avaliação em relação à lesão inicial de cárie dentária e ansiedade. No entanto, o número de dentes com lesão inicial de cárie dentária (p=0,0033) e sangramento gengival (p<0,0001) aumentou significativamente após a cirurgia bariátrica no GE. Conclusão: É necessário acompanhamento de equipe multiprofissional, incluindo atendimento odontológico, tanto para pacientes obesos quanto para bariátricos.
Subject(s)
Humans , Dental Caries , Bariatric Surgery , Anxiety , Prospective Studies , ObesityABSTRACT
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.
Subject(s)
Humans , Female , Pregnancy , Adult , Periodontitis/physiopathology , Pregnancy Trimester, Third/physiology , Birth Weight/physiology , Infant, Low Birth Weight/physiology , Obesity, Maternal/physiopathology , Socioeconomic Factors , Pregnancy Outcome , Body Mass Index , Logistic Models , Cross-Sectional Studies , Diabetes, Gestational/physiopathology , Statistics, NonparametricABSTRACT
Introdução: o consumo irregular de alimentos calóricos e pouco nutritivos elevou a prevalência da obesidade e a procura pela cirurgia bariátrica. Entretanto, tais condições podem causar consequências negativas na cavidade bucal. Objetivo: o objetivo deste estudo foi revisar a literatura acerca da relação entre obesidade, cirurgia bariátrica e alterações bucais. Métodos: foi realizada consulta ao PubMED e ao BVS utilizando os termos "cirurgia bariátrica", "periodontite", "síndrome x metabólica", "obesidade", "força de mordida", "cardiopatias", "qualidade de vida", "desgaste dos dentes" e "eliminação salivar" entre 2000-2017. Documentos do Ministério da Saúde brasileiro e da Organização Mundial da Saúde com dados epidemiológicos foram incluídos. Resultados: observou-se que cárie dentária é frequente e o estado crônico de inflamação do obeso contribui para o desenvolvimento da doença periodontal. Além disso, o obeso possui maior risco de desordens cardiovasculares, que pode ser potencializada por bactérias da doença periodontal. Contudo, a cirurgia bariátrica, ao contrário do esperado, pode agravar ainda mais a doença periodontal e, devido a frequentes episódios de vômito, também pode levar ao desgaste dentário. Conclusão: a literatura evidencia a importância do cirurgião-dentista no controle de riscos, na prevenção e no tratamento dos pacientes obesos e bariátricos.
Introduction: irregular intake of caloric and low-nutrient foods has raised the prevalence of obesity and the demand for bariatric surgery. However, such conditions may have negative consequences on the oral cavity. Objective: the aim of this study was to review the literature on the relationship between obesity, bariatric surgery and oral disorders. Methods: PubMED and BVS were consulted using the terms "bariatric surgery", "periodontitis", "metabolic syndrome", "obesity", "bite force", "heart disease", "quality of life", "tooth wear" and "salivary elimination"between 2000-2017. Documents from the Brazilian Ministry of Health and the World Health Organization with epidemiological data were included. Results: it was observed that dental caries is frequent, and the chronic inflammatory state of the obese patient contributes to the development of periodontal disease. In addition, the obese is at increased risk for cardiovascular disorders, which may be worsened by bacteria from periodontal disease. Yet, bariatric surgery, contrary to expectations, may further aggravate periodontal disease and, due to frequent vomiting episodes, can also lead to tooth wear. Conclusion: it can be concluded that literature highlights the importance of the dentist in the control of risks, in the prevention and treatment of obese and bariatric patients.
Subject(s)
Heart Diseases , Metabolic Syndrome , Bariatric SurgeryABSTRACT
ABSTRACT Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: "bariatric surgery" AND "dental erosion" OR "bariatric surgery" AND "dental erosion" AND "gastroesophageal reflux disease". After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.
RESUMO Introdução: Diversos problemas bucais podem ser percebidos nos indivíduos que foram submetidos à cirurgia bariátrica, frente às mudanças metabólicas e comportamentais referentes à alimentação e higienização. O desgaste dentário parece sofrer impacto após a cirurgia bariátrica, uma vez que pode ocorrer o aumento do refluxo gastresofágico após a operação. Objetivo: Analisar o impacto da cirurgia bariátrica no refluxo gastresofágico e no desgaste dentário por meio de uma revisão sistemática da literatura. Método: As seguintes bases de dados foram acessadas por dois examinadores independentes e calibrados: PubMed, Medline, Lilacs, Scielo e Cochrane usando os descritores: "bariatric surgery" AND "dental erosion" OR "bariatric surgery" AND "dental erosion" AND "gastroesophageal reflux disease". Após a exclusão dos estudos duplicados, 12 estudos foram avaliados inicialmente pelo título e resumo. Foram excluídos os sem relevância para a presente pesquisa, os de revisão da literatura e os relatos de caso. Sendo assim, foram incluídos neste estudo quatro artigos. Todos os artigos avaliados indicaram uma alta associação entre refluxo gastresofágico e desgaste dentário em pacientes submetidos à cirurgia bariátrica. A associação destes desfechos foi mais evidente após seis meses do procedimento cirúrgico. Conclusão: Pacientes submetidos à cirurgia bariátrica mostram maior prevalência de refluxo gastresofágico e desgaste dentário.
Subject(s)
Humans , Obesity, Morbid/surgery , Gastroesophageal Reflux/etiology , Bariatric Surgery/adverse effects , Tooth Wear/etiologyABSTRACT
Aim: This study aimed to evaluate oral and systemic conditions in morbidly obese patients with and without metabolic syndrome (MS) prior to bariatric surgery. Methods: One hundred patients were included and equally divided into two groups: G1 - with MS (n = 50) and G2 - without MS (n = 50). MS was diagnosed in patients presenting at least three of five signs: abdominal obesity, high triglyceride level, low high-density lipoprotein cholesterol (HDL-C) level, hypertension, and altered fasting glycemia. Variables analyzed included the patients' age, sex, body mass index (BMI), waist-to-hip ratio (WHR), and number of missing teeth. Both BMI and WHR were used to evaluate the risk of developing cardiovascular disease (RCVD). Mann-Whitney, Chi-squared, t test, hierarchical multiple linear regression and binary logistic regression models were used in statistical analyses (p<0.05). Results: There were no group-wise differences in sex (p=0.631) and BMI (p=0.200); however, the WHR (p=0.009), age (p=0.0001), and number of missing teeth (p=0.0003) were higher in G1. Obese patients with MS who were candidates for bariatric surgery presented higher RCVD than obese patients without MS (p=0.019). Binary logistic regression revealed patient age [adjusted OR=1.05, 95% CI=1.00-1.11, p=0.042] and number of missing teeth [adjusted OR=1.17, 95% CI=1.04-1.31, p=0.013] to be significant predictors of MS. Conclusion: Morbidly obese patients with MS had worse oral and systemic conditions than those without MS, regarding WHR, RCDV and number of missing teeth