Subgingival microbial profile of women with breast cancer: a cross-sectional study

Background: Some prospective studies have observed associations between periodontal disease and breast cancer. Therefore, the aim of the present study was to investigate the composition of the subgingival biofilm of women diagnosed with breast cancer, who also presented with chronic periodontitis. Methods: All subjects underwent clinical and microbiological assessment. Subgingival biofilm samples were taken from at least three sites of 44 women who had breast cancer. The mean levels and proportions of 40 bacterial species were determined by checkerboard DNA-DNA hybridization. Spearman correlation was used to assess possible associations between the mean levels of bacterial species and clinical conditions. Results: The five species found at the highest levels were Prevotella nigrescens, Actinomyces gerencseriae, Neisseria mucosa, Porphyromonas gingivalis and Tannerella forsythia. The species detected in the lowest counts were Propionibacterium acnes, Streptococcus constellatus, Streptococcus intermedius, Eubacterium saburreum and Streptococcus anginosus. No significant association between levels and proportion of bacterial species and clinical parameters were found. Conclusion: In conclusion, the results of the present study found no direct association between the subgingival microbiota and breast cancer and an indirect pathway should be addressed in further studies.

Condição bucal e qualidade de vida em pacientes alcoolistas e não alcoolistas ­ estudo caso-controle / Buccal condition and quality of life in alcoholic and non-alcoholic patients ­ case-control study

Objetivo: estudar as concepções dos pacientes alcoolistas, alcoolistas cirróticos e cirróticos não alcoolistas quanto à percepção de qualidade de vida, condição periodontal, perda dentária e uso ou não de prótese dentária. Material e métodos: estudo caso-controle com 194 pacientes, com idades entre 25 e 73 anos, atendidos no Serviço de Gastroenterologia do Hospital Universitário Cassiano Antônio de Moraes (Hucam/Ufes), quanto aos parâmetros: profundidade de sondagem, nível de inserção clínica, índice de placa visível, sangramento gengival, sangramento a sondagem, supuração, mobilidade dentária, lesões de furca e questionário OHIP-14. Resultados: a condição clínica dos pacientes mostrou predomínio de má qualidade de vida marcada por perda dentária extrema. Foram observadas perdas de inserção periodontais, predominância de placa dentária (p=0,002) e bolsas periodontais profundas (< 6 mm) no grupo-caso (p=0,035). Alguns parâmetros do OHIP-14 com significância (p < 0,001) foram observados com a condição clínica médica, especialmente nas categorias dos problemas ao falar, sentimento de constrangimento social e mastigação. Uma comparação foi realizada para avaliar a percepção dos pacientes alcoolistas e desdentados em relação ao OHIP-14, utilizando apenas as primeiras (nunca) e as últimas (sempre) respostas. A resposta "nunca" apresentou maiores percentuais nas questões 1 (91,8%); 2 (82,7%); 6 (69,4%); 7 (70,7%); 8 (88,3%); 9 (80,0%); 12 (90,4%); 13 (69,2%); e 14 (89,8%). A pergunta 5 obteve a resposta "sempre" como a maior porcentagem (73,3%) para o mesmo grupo. Conclusão: a condição clínica dos pacientes mostra efeitos significativos ao se correlacionar os parâmetros do OHIP-14 com a condição periodontal deteriorada e ausência considerável de próteses dentárias.

Objective: in the present study we studied the conceptions of alcoholic, cirrhotic alcoholic and non-alcoholic cirrhotic patients regarding perception of quality of life, periodontal condition, tooth loss and use of dental prosthesis. Material and methods: we evaluated 194 patients aged 25-73 years, attending the Gastroenterology Department of the University Hospital Cassiano Antônio de Moraes (Hucam/Ufes), regarding the parameters: probing pocket depth, clinical attachment loss, visible plaque, marginal gingival bleeding, bleeding on probing, suppuration, dental mobility, furcation lesions, and OHIP-14 questionnaire. Results: the clinical condition of the patients showed a predominance of poor quality of life marked by extreme dental loss. Periodontal attachment losses, predominance of dental plaque (p=0.002) and signifi cant deep pockets ( 6 mm) were observed in the case group (p=0.035). Some OHIP-14 parameters with signifi cance (p < 0.001) were also observed with the medical clinical condition, especially in the categories of speech problems, feeling of social embarrassment and chewing. A comparison was made to evaluate the perception of alcoholic and edentulous patients in relation to OHIP-14 using the fi rst (never) and the last (always) answers. The answer "never" presented higher percentages in questions 1 (91.8%); 2 (82.7%); 6 (69.4%); 7 (70.7%); 8 (88.3%); 9 (80.0%); 12 (90.4%); 13 (69.2%); and 14 (89.8%). Question 5 obtained the answer "always" as the highest percentage (73.3%) for the same group. Conclusion: the clinical condition of patients shows signifi cant effects when correlating with OHIP-14 parameters with the medical clinical condition, deteriorated periodontal condition and considerable absence of dental prostheses.

Radiographic Bone Evaluation after Periodontal Full Mouth Disinfection Treatment in Women Undergoing Chemotherapy or Hormone Therapy with Tamoxifen

Objective: To radiographically evaluate the alveolar bone level after periodontal full mouth disinfection (FMD) treatment in women during chemotherapy (CHE) and hormone therapy with Tamoxifen (TAM). Material and Methods: This is an uncontrolled clinical trial with a convenience sample of women in antineoplastic treatment (CHE and TAM) and non-surgical periodontal FMD treatment. The Radiographic examination consisted of four bitewing radiographs and six periapical radiographs of the upper and lower anterior teeth, acquired according to the parallelling standard technique at three times: before (T0), 3 (T3) and 6 (T6) months after periodontal treatment. The alveolar crest level in the interproximal area of each tooth was measured by two calibrated observer using magnifying glass and digital caliper. Statistical analysis was performed for evaluation of the three times in each experimental group using the Friedman test (p < 0.05) and between groups, the Mann Whitney test (p <0.05). Results: Overall, 14 women undergoing treatment for breast cancer participated in this study. A follow-up loss of five (35.71%) women occurred during the study and the final sample size was composed of nine women divided into two groups: CHE (n = 4) and TAM (n = 5). A total of 330 sites were evaluated: 126 (CHE) and 204 (TAM). The alveolar bone level showed statistically significant reduction after 6 months of FMD therapy (p <0.05), but there was no difference between antineoplastic treatment type (p> 0.05). Conclusion: Patients undergoing chemotherapy and hormone therapy with Tamoxifen showed better alveolar bone levels after six months of periodontal FMD treatment. The current antineoplasic therapy did not influence the results obtained with periodontal treatment.

Periodontopatógenos e riscos de complicações na gravidez / Periodontopathogens and risks of pregnancy complications. A review of the literature

A doença periodontal é um processo inflamatório crônico dos tecidos periodontais, causada por bactérias gram-negativas anaeróbicas presentes no biofilme dentário. Esse foco infeccioso pode manifestar-se em sítios corporais distantes ou sistêmicos, quando essas bactérias alcançam a corrente sanguínea. Os objetivos desse estudo de revisão são: demonstrar a relação entre doença periodontal e prematuridade, o efeito do tratamento periodontal sobre o nascimento de prematuros, e se microrganismos periodontopatogênicos são capazes de induzir efeitos adversos na gravidez quando os mesmos são encontrados na placenta. Esse estudo constituiu-se de uma revisão da literatura com artigos científicos selecionados através de bancos de dados Scielo, Bireme, Medline e Lilacs, publicados nos anos de 1980 a 2013. Entre os estudos selecionados, todos relacionaram a doença periodontal como sendo um fator de risco importante a ser considerado na gravidez, pois a presença de patógenos orais associou-se à prematuridade, baixo peso fetal ao nascer e infecções perinatais. Portanto, segundo a literatura consultada, a infecção periodontal em mulheres grávidas não deve ser negligenciada pois, se essa doença favorece complicações gestacionais, a atenção à saúde periodontal das gestantes deve estar incluída nas ações de cuidados do pré-natal.

Periodontal disease is a chronic inflammatory process of periodontal tissues caused by gram- negative anaerobic bacteria present in the biofilm. This infection may occur in distant or systemic body sites, when these bacteria reach the bloodstream. The aims of this review study are to demonstrate the relationship between periodontal disease and preterm birth, the effect of the periodontal treatment on preterm birth, and whether periodontopathogenic microorganisms can induce adverse effects on pregnancy when they are found in the placenta. This study is a literature review with scientific papers selected through Scielo Bireme, Medline and Lilacs databases and published between 1980 and 2013. All selected studies considered the periodontal disease as an important risk factor for the pregnancy, since the presence of oral pathogens was associated with premature birth, low birth weight and perinatal infections. Therefore, according to the literature, periodontal infection in pregnant women should not be underestimated, because it favors pregnancy complications, and periodontal health care to pregnant women should be included in the prenatal care.