Intervención educativa para la gingivitis crónica en adolescentes del Consultorio Médico de la Familia 10. Área Norte. Sancti Spíritus / Educational intervention on chronic gingivitis in adolescents at the North Area doctor´s office 10 in Sancti Spíritus

RESUMEN Fundamento: La gingivitis crónica constituye un problema de salud bucal en los adolescentes, relacionado con los escasos conocimientos y factores de riesgo presentes. Objetivo: Aplicar la intervención educativa para modificar el nivel de conocimientos de los adolescentes sobre gingivitis crónica del CMF 10 de Sancti Spíritus. Metodología: Se realizó un estudio cuasi-experimental, con diseño de antes y después en el período de septiembre 2018 a febrero del 2019, la población fueron 196 adolescentes y la muestra 61 que presentaron gingivitis crónica. Las variables utilizadas: conocimientos sobre prevención de gingivitis, higiene bucal y presencia de gravedad de la gingivitis, los métodos: del nivel teórico, empírico (encuesta, entrevista, determinación de la IHBS, Índice Gingival de Löe y Silness y de la estadística descriptiva. Resultados: Los conocimientos antes de la intervención eran insuficientes (40.8 %), la gravedad de la enfermedad el 50.8 % presentaba gingivitis moderada y el 47.5 % mala higiene bucal; después de la intervención el 90.1 % tenía conocimientos suficientes, el 73.7 % sin alteración en las encías y 83.6 % buena higiene. Conclusiones: La intervención educativa logró elevar los conocimientos, disminuir la gravedad de la gingivitis y mejorar la higiene bucal de los adolescentes.

ABSTRACT Background: Chronic gingivitis is an oral health problem in adolescents, related to poor knowledge and risk factors. Objective: To apply educational intervention to modify the adolescents' level of knowledge about chronic gingivitis at the CMF 10 in Sancti Spíritus. Methodology: A quasi-experimental study was conducted, with a before and after design from September 2018 to February 2019, the population consisted of 196, and the sample of 61 adolescents who presented chronic gingivitis. The variables used: knowledge about gingivitis prevention, oral hygiene and presence of gingivitis´ severity, methods: theoretical and empirical level (survey, interview, determination of the IHBS, Silness y Löe Gingival Index and descriptive statistics. Results: The knowledge before the intervention was insufficient (40.8 %), severity of the disease 50.8 % presented moderate gingivitis and 47.5 % bad oral hygiene; after the intervention 90.1 % had sufficient knowledge, 73.7 % without any alteration in the gums and 83.6 % good hygiene. Conclusions: The educational intervention managed to increase knowledge, decrease severity of gingivitis and improve oral hygiene of adolescents.

Aplicación del aceite de girasol ozonizado en pacientes afectados con gingivitis crónica fibroedematosa / Application of ozonated sunflower oil in patients affected with chronic fibroedematous gingivitis / Aplicação de óleo de girassol ozonizado em pacientes afetados com gengivite fibroedematosa crônica

RESUMEN Se realizó un estudio cuasi experimental de intervención terapéutica con el objetivo de evaluar la respuesta a la aplicación del Oleozón como tratamiento único en pacientes diagnosticados con gingivitis crónica fibroedematosa, que acudieron a consulta de la clínica estomatológica Docente Manuel Sánchez Silveira de Manzanillo, en el período de septiembre 2016 a mayo 2017. El universo de estudio lo constituyeron 102 pacientes afectados con esta entidad. Se registraron las variables edad, sexo, higiene bucal, frecuencia de la aplicación del tratamiento, respuesta a la terapia. El diagnóstico confirmado de gingivitis crónica fibroedematosa se realizó a partir de la clínica y el examen físico oral de la encía marginal y papilar. Se empleó una metodología para la aplicación en las regiones afectadas del preparado medicinal, se evaluó a cada paciente al 3er, 7mo y 15 días en las categorías igual, mejorado y curado. Predominó el grupo de edad de 20 a 29 años y el sexo masculino. Resaltaron los índices inadecuados de higiene bucal. La mejor respuesta al tratamiento fue entre 7 y 15 día demostrando que el Oleozón es efectivo en el tratamiento de la gingivitis crónica edematosa.

ABSTRACT A quasi-experimental therapeutic intervention study was carried out with the objective of evaluating the response to the application of Oleozón as the only treatment in patients diagnosed with chronic fibroedematous gingivitis, who came to the consultation of the Manuel Sánchez Silveira de Manzanillo Teaching Clinic, in the period from September 2016 to May 2017. The study universe consisted of 102 patients affected with this entity. The variables age, sex, oral hygiene, frequency of treatment application, response to therapy were recorded. The confirmed diagnosis of chronic fibroedematous gingivitis was made from the clinic and the oral physical examination of the marginal and papillary gums. A methodology for the application in the affected regions of the medicinal preparation was used, each patient was evaluated on the 3rd, 7th and 15 days in the equal, improved and cured categories. The age group of 20 to 29 years and the male sex predominated. They highlighted the inadequate rates of oral hygiene. The best response to treatment was between 7 and 15 days, demonstrating that Oleozon is effective in the treatment of chronic edematous gingivitis.

RESUMO Foi realizado umestudo de intervenção terapêutica quase experimental, como objetivo de avaliar a resposta à aplicação de Oleozón como único tratamento em pacientes com diagnóstico de gengivite fibroedematosa crônica, consultados na Clínica Manuel Sánchez Silveira de Manzanillo, no período de setembro de 2016 a maio de 2017. O universo do estudo foi composto por 102 pacientes acometidos por essa entidade. As variáveis ​​idade, sexo, higiene bucal, frequência de aplicação do tratamento e resposta à terapia foram registradas. O diagnóstico confirmado de gengivite fibroedematosa crônicafoi realizado na clínica e no exame físico oral das gengivas marginal e papilar. Foi aplicada uma metodologia para a aplicação nas regiões afetadas da preparação medicinal, cada paciente foi avaliado no 3º, 7º e 15 dias nas categorias igual, melhorada e curada. A faixa etária de 20 a 29 anos e o sexo masculino predominaram. Eles destacaram as taxas inadequadas de higiene bucal. A melhor resposta ao tratamento foi entre 7 e 15 dias, demonstrando que o Oleozon é eficaz no tratamento da gengivite edematosa crônica.

Eficacia del extracto de Mangifera indica L. en pacientes con gingivitis crónica edematosa y fibroedematosa / Effectiveness of the Mangifera indica L. extract in patients with edematous and fibroedematous chronic gingivitis i: en

Introducción: Las enfermedades periodontales son las afecciones más comunes del género humano y se definen como una reacción inmunoinflamatoria crónica del periodonto de protección o de inserción. Objetivo: Evaluar la eficacia del extracto acuoso tópico de Mangifera indica L. como colutorio en pacientes con gingivitis crónica edematosa y fibroedematosa. Métodos: Se realizó un estudio de intervención terapéutica en 84 pacientes con gingivitis crónica edematosa y fibroedematosa, atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde noviembre de 2014 hasta igual mes de 2015. La muestra se dividió en 2 grupos (de estudio y control) de 42 integrantes cada uno, tratados con extracto acuoso tópico de Mangifera indica L. y con solución acuosa de clorhexidina al 0,2 %, respectivamente. Los pacientes fueron evaluados al inicio, a los 7, a los 14 y a los 21 días de comenzado el tratamiento. Para la recolección de los datos se aplicó una encuesta y se emplearon las pruebas T de Student, la de homogeneidad y la de Ji al cuadrado para la diferencia de muestras, con p<0,05. Resultados: Predominaron el sexo femenino, el grupo etario de 15-19 años y la gingivitis leve. En el grupo control solo 38,0 % había curado a los 7 días de tratamiento. Conclusiones: El extracto acuoso tópico de la corteza de Mangifera indica L, fue efectivo en el tratamiento de los pacientes con gingivitis crónica edematosa y fibroedematosa y se demostró que por sus poderosas acciones ayuda a la rápida recuperación de los tejidos gingivales.

Introduction: Periodontal diseases are the most common affections of mankind and they are defined as a chronic immunoinflamatory reaction of the protection or insertion periodonto. Objective: To evaluate the effectiveness of the topic watery extract Mangifera indica L. as mouthwash in patients with edematous and fibroedematous chronic gingivitis. Methods: A study of therapeutic intervention was carried out in 84 patients with edematous and fibroedematous chronic gingivitis, assisted in Mártires del Moncada Teaching Provincial Stomatologic Clinic in Santiago de Cuba, from November, 2014 to the same month in 2015. The sample was divided in 2 groups (study and control) of 42 members each one, treated with topic watery extract of Mangifera indica L. and with watery solution of chlorhexidine at 0.2 %, respectively. The patients were evaluated at the beginning, at the 7, 14 and 21 days of having begun the treatment. A survey was applied for gathering the data and the Student T test, homogeneity test and the chi square test were used for the difference of samples, with p <0.05. Results: The female sex, 15-19 years age group and mild gingivitis prevailed. In the control group just 38.0 % got better at 7 days of treatment. Conclusions: The topic watery extract of Mangifera indica L. bark, was effective in the treatment of patients with edematous and fibroedematous chronic gingivitis and it was demonstrated that helps to the quick recovery of gingival tissues due to its powerful actions.

Effectiveness of the Mangifera indica L. extract in patients with edematous and fibroedematous chronic gingivitis

Introducción: Las enfermedades periodontales son las afecciones más comunes del género humano y se definen como una reacción inmunoinflamatoria crónica del periodonto de protección o de inserción. Objetivo: Evaluar la eficacia del extracto acuoso tópico de Mangifera indica L. como colutorio en pacientes con gingivitis crónica edematosa y fibroedematosa. Métodos: Se realizó un estudio de intervención terapéutica en 84 pacientes con gingivitis crónica edematosa y fibroedematosa, atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde noviembre de 2014 hasta igual mes de 2015. La muestra se dividió en 2 grupos (de estudio y control) de 42 integrantes cada uno, tratados con extracto acuoso tópico de Mangifera indica L. y con solución acuosa de clorhexidina al 0,2 %, respectivamente. Los pacientes fueron evaluados al inicio, a los 7, a los 14 y a los 21 días de comenzado el tratamiento. Para la recolección de los datos se aplicó una encuesta y se emplearon las pruebas T de Student, la de homogeneidad y la de Ji al cuadrado para la diferencia de muestras, con p<0,05. Resultados: Predominaron el sexo femenino, el grupo etario de 15-19 años y la gingivitis leve. En el grupo control solo 38,0 % había curado a los 7 días de tratamiento. Conclusiones: El extracto acuoso tópico de la corteza de Mangifera indica L, fue efectivo en el tratamiento de los pacientes con gingivitis crónica edematosa y fibroedematosa y se demostró que por sus poderosas acciones ayuda a la rápida recuperación de los tejidos gingivales.

Introduction: Periodontal diseases are the most common affections of mankind and they are defined as a chronic immunoinflamatory reaction of the protection or insertion periodonto. Objective: To evaluate the effectiveness of the topic watery extract Mangifera indica L. as mouthwash in patients with edematous and fibroedematous chronic gingivitis. Methods: A study of therapeutic intervention was carried out in 84 patients with edematous and fibroedematous chronic gingivitis, assisted in Mártires del Moncada Teaching Provincial Stomatologic Clinic in Santiago de Cuba, from November, 2014 to the same month in 2015. The sample was divided in 2 groups (study and control) of 42 members each one, treated with topic watery extract of Mangifera indica L. and with watery solution of chlorhexidine at 0.2 %, respectively. The patients were evaluated at the beginning, at the 7, 14 and 21 days of having begun the treatment. A survey was applied for gathering the data and the Student T test, homogeneity test and the chi square test were used for the difference of samples, with p <0.05. Results: The female sex, 15-19 years age group and mild gingivitis prevailed. In the control group just 38.0 % got better at 7 days of treatment. Conclusions: The topic watery extract of Mangifera indica L. bark, was effective in the treatment of patients with edematous and fibroedematous chronic gingivitis and it was demonstrated that helps to the quick recovery of gingival tissues due to its powerful actions.

Analysis of the clinical effect of Kangfuxin Liquid in the treatment of chronic gingivitis in orthodontic patients / 中国基层医药

Objective To study the clinical effect of Kangfuxin Liquid in the treatment of orthodontic children with chronic gingivitis.Methods From January 2014 to February 2016,a total of 100 orthodontic children with chronic gingivitis in Zhejiang Greentown Cardiovascular Hospital were selected in the research.The patients were randomly divided into the control group and observation group according to the computer numeral list method,with 50 cases in each group.The control group was treated with oral scaling,children in the observation group were treated with Kangfuxin Liquid on the basis of oral scaling.The clinical curative effect,plaque index,sulcus bleeding index,pain score,swelling score,the levels of inflammatory cytokines in gingival crevicular fluid were compared between the two groups.Results The total effective rate of the observation group was 96％,which was higher than 82％of the control group(χ2 =5.005,P<0.05).After treatment,the plaque index,gingival sulcus bleeding index,pain score,swelling scores in the two groups were significantly lower than those before treatment(all P<0.05).After treatment,the plaque index,gingival sulcus bleeding index,pain score,swelling score in the observation group were(1.14 ± 0.36)points,(1.96 ±0.64)points,(2.94 ±0.96)points,(3.32 ±0.97)points,respectively,which were significantly lower than those in the control group(t=4.862,5.041,5.513,5.041,all P<0.05).After treatment,the interleukin 1 beta(IL-1 beta),prostaglandin E2(PGE2),soluble adhesion molecule 1(sICAM-1)of gingival sulcus fluid in the two groups were significantly lower than those before treatment(all P<0.05),while after treatment,the levels of IL-1 beta,PGE2 sICAM-1 in the observation group were(10.32 ±1.19)ng/L,(246.53 ±36.29)ng/L,(135.23 ± 14.32)μg/L,respectively,which were lower than those in the control group(t=4.973,5.211,4.973,all P<0.05).Conclusion The use of Kangfuxin Liquid on chronic gingivitis after orthodontic treatment has significant clinical efficacy,can effectively reduce periodontal inflammation in patients with gingival swelling and pain,and can effectively inhibit inflammatory cytokines in gingival crevicular fluid,and improve the prognosis.

Caracterización clinicoepidemiológica de pacientes especiales con gingivitis crónica / Clinical and epidemiological characterization of special patients with chronic gingivitis

Se realizó un estudio descriptivo y transversal de 59 pacientes especiales con gingivitis crónica, atendidos en el Policlínico Docente Julián Grimau García de Santiago de Cuba, desde marzo de 2016 hasta enero de 2017, con vistas a caracterizarles según variables clínicas y epidemiológicas de interés. Entre los resultados principales prevalecieron el sexo masculino (72,9 por ciento), el grupo etario de 10-14 años (64,4 por ciento), la primaria terminada como nivel escolar (40,7 por ciento), así como la higiene bucal deficiente (81,3 por ciento) como factor de riesgo; entre estos últimos, la mayoría presentaron gingivitis crónica edematosa (79,2 por ciento) e inflamación severa (76,2 por ciento). La práctica inadecuada del cepillado dental, dada por la incapacidad intelectual de este tipo de paciente, favoreció la aparición de esta enfermedad.

A descriptive and cross-sectional study of 59 special patients with chronic gingivitis, assisted in Julián Grimau García Teaching Polyclinic was carried out in Santiago de Cuba, from March, 2016 to January, 2017, aimed at characterizing them according to clinical and epidemiologic variables of interest. Among the main results, there was a prevalence of the male sex (72.9 percen), 10-14 age group (64.4 percen), primary school level (40.7 percent), as well as the inadequate oral hygiene (81.3 percen) as risk factor; among the latter, most of them presented chronic edematous gingivitis (79.2 percen) and severe inflammation (76.2 percen). The inadequate practice of dental brushing, due to the intellectual incapacity of this type of patient, favored the emergence of this disease.

Comparision of compound radix scutellariae gargle with compound chlorhexidine gargle in the treatment of chronic gingivitis / 实用口腔医学杂志

Objective:To compare the clinical effects of gargle fluid containing scutellaria baicalensis with chlorhexidine in the treatment of chronic gingivitis and to observe TNF-α expression in gingival crevicular fluid(GCF) before and after treatment.Methods:90 cases of chronic gingivitis were divided into 3 groups (n =10) based on random number table and treated by scaling and mouth wash with normal saline(group A),chlorhexidine(group B) and scutellaria baicalensis(group C) respectively.PI and GI were measured,TNF-α level in GCF was examined after initial therapy,1 week,2 week and 1 month after treatment.Results:Comprehensive analysis of the whole treatment process showed that there was difference of PI among 3 groups(F =3.506,P =0.034).PI in group B was lower than that in group A and C (P ＜ 0.05;A vs C,P ＞ 0.05);there was difference of GI among the 3 groups (F =6.359,P =0.003).GI in group A was higher than that in group B and C(P ＜0.05;B vs C,P ＞0.05),there was difference of TNF-α concentration in GCF among the 3 groups(F =3.780,P =0.027);TNF-α in group A was higher than that in group B and C(P ＜0.05,B vs C,P ＞0.05).Conclusion:Radix scutellariae and chlorhexidine gargle fluid are equally effective in the treatment of chronic gigivitis.

Comportamiento de la gingivitis crónica en adolescentes de la Secundaria Básica “Jesús Fernández”. Santa Marta, Cárdenas / Behavior of chronic gingivitis in teenagers of “Jesus Fernández” High School. Santa Marta. Cárdenas

La gingivitis es la enfermedad periodontal más frecuente que afecta tanto a los adolescentes como a los pacientes adultos. Se realizó un estudio observacional descriptivo transversal con el objetivo de conocer la prevalencia de gingivitis en adolescentes entre 12 y 14 años de edad de la ESBU “Jesús Fernández Rodríguez”, del Consejo Popular Santa Marta, municipio Cárdenas, en el período comprendido de enero a julio de 2011. Los adolescentes fueron caracterizados según variables sociodemográficas y se identificaron los factores de riesgo presentes, así como el nivel de conocimientos sobre salud bucodental. Se encontró que los adolescentes de 14 años fueron los más afectados, dentro de ellos el sexo masculino. Entre los factores de riesgo más identificados estuvieron los contactos dentarios deficientes y el uso de aparatos ortodóncicos fijos. Al aplicarse la encuesta de conocimientos se obtuvo como resultado que el 51,1 % fue evaluado de bien.

Gingivitis is the most frequent periodontal disease affecting adolescent patients as much as adult ones. A cross-sectional, descriptive, observational study was carried out aimed to knowing gingivitis prevalence in teenagers aged 12-14 years assisting to “Jesus Fernández Rodríguez” High School of the Popular Council Santa Marta, Municipality of Cardenas, in the period from January to July 2011. Teenagers were characterized using socio-demographic variables and the existing risk factors were identified, and also the knowledge level on bucodental health. We found that teenagers aged 14 years were the most affected, and among them the male ones. Among the most commonly identified risk factors were deficient dental contacts and the use of fixed orthodontic devices. As the result of the knowledge inquiry, 51,1 % of the teenagers was evaluated as good.

Relación de la gingivitis crónica con algunas afecciones del sistema osteomioarticular según holograma del microsistema de dientes alemán / Relationship of chronic gingivitis with some conditions of the osteomyoarticular system according to hologram of the German dental microsystem

Se realizó un estudio descriptivo y transversal de 77 pacientes de ambos sexos y edades entre 20-45 años con alguna afección del sistema osteomioarticular, atendidos en la consulta estomatológica de la parroquia Leoncio Martínez de Caracas, Venezuela, desde enero hasta Junio de 2009, a fin de relacionar la gingivitis crónica con algunas afecciones de este sistema según holograma del microsistema de dientes alemán. En la casuística, el meridiano más afectado fue pulmón-intestino grueso; predominaron las dolencias del sistema osteomioarticular en el lado izquierdo y la mayoría de campos de interferencia con la gingivitis crónica estuvieron en la parte derecha de la cavidad bucal. Asimismo, se hallaron alteraciones en la columna vertebral de los afectados con gingivitis leve, moderada y avanzada

A descriptive and cross-sectional study was conducted in 77 patients of both sexes and ages between 20-45 years with some condition of the osteomyoarticular system, attended in the dental department of the parish Leoncio Martínez from Caracas, Venezuela, from January to June 2009, in order to relate chronic gingivitis to some conditions of this system according to hologram of the German dental microsystem. In the case material the most affected meridian was lung-large intestine; osteomyoarticular system conditions prevailed on the left and most of the interference fields with chronic gingivitis were on the right side of the oral cavity. Also, abnormalities in the spine of those patients with mild, moderate and severe gingivitis were found

Gingivitis crónica y la higiene bucal en adolescentes de la secundaria básica "Raúl González Diego" / Chronic gingivitis and oral hygiene in teenagers from "Raúl González Diego" high school

Introducción: las afecciones bucales constituyen un importante problema de salud por su alta prevalencia y demanda pública. Dentro de ellas encontramos la gingivitis crónica, cuyas manifestaciones clínicas aparecen desde edades tempranas, confirmándose que durante la adolescencia existe un incremento de la misma, asociado con una deficiente higiene bucal. Objetivo: por ello nos motivamos a realizar esta investigación cuyo objetivo fue determinar el comportamiento epidemiológico de la gingivitis crónica y su relación con la higiene bucal en adolescentes de la Secundaria Básica "Raúl González Diego". Material y métodos: Se realizó un estudio observacional, descriptivo, en dicha secundaria, ubicada en Calabazar, localidad del municipio Boyeros, provincia La Habana, entre enero a junio de 2010. El universo estuvo constituido por los estudiantes del centro, 336 alumnos, divididos en 190 féminas y 146 varones cuyas edades estuvieron entre 12 a 15 años. Resultados: el 57.1% de los adolescentes estaba afectado por gingivitis crónica, predominó la forma moderada - 59.4 %- en cuanto a su gravedad. El 68.2% presentó higiene bucal deficiente y existió una asociación entre la higiene bucal deficiente y la gravedad de la gingivitis crónica. Conclusiones: la mayor cantidad de adolescentes estaba afectada por gingivitis crónica, predominando la categoría de moderada en cuanto a la gravedad de la misma. Predominó la higiene bucal deficiente y existió una relación entre la higiene bucal deficiente (regular) y la gravedad de la gingivitis crónica, a peor higiene bucal mayor gravedad de la enfermedad.

Introduction: oral disease is a major health problem because of its high prevalence and public demand. Chronic gingivitis it is one of them, whose clinical manifestations appear early age, confirming that during the adolescence there is an increase of the disease, associated with deficient oral hygiene. Objective: the above exposed motivated this research whose objective is to determine the epidemiological behaviour of the chronic gingivitis and its relation to oral hygiene in adolescents of Raul Gonzalez Diego High School. Materials and methods: it was performed an observational, descriptive, transversal study in that school, situated in Calabazar, Boyeros, Havana Province, from January to June 2010. The universe consisted in all the students of the center, 336 students, divided in 190 females and 146 males. Their ages were from 12 to 15 years. Results: 57.1 per cent of the adolescents were affected by chronic gingivitis. The moderated affections prevailed, with 59.4 % of ill students. 68.2% of the sample presented a deficient oral hygiene, and it showed association between the deficient oral hygiene and the chronic gingivitis. Conclusions: were stated the prevalence of chronic gingivitis was significant in most of the adolescents, it prevailed the moderated affection in terms of severity. Most adolescents had deficient oral hygiene and there was a positive relation between the oral hygiene and the severity of chronic gingivitis: the worst oral hygiene, the disease becomes more severe.

Efficacy of a herbal extract gel in the treatment of gingivitis: A clinical study.

Background: Chronic gingivitis is the most prevalent in all dentate animals. Regular methods for controlling it have been found to be ineffective, which have paved the way for the use of herbal products as an adjunctive to mechanical therapy as they are free to untoward effects and hence can be used for a long period of time. Objective: The antigingivitis effect of a gel containing pomegranate extract was evaluated using a 21-day trial in patients with chronic gingivitis. Materials and Methods: Forty patients participated in this randomized clinical study, carried out in four phases of 7 days each over 21 days. The patients were randomly assigned to four groups: First group was treated with mechanical debridement and an experimental gel and the second group with mechanical debridement and a control gel; the third group wasn’t subjected to mechanical debridement and only experimental gel was used. The fourth group was treated with control gel only. All the groups were subjected to various clinical and microbiological parameters to evaluate the antiplaque and antigingivitis effect of the pomegranate extract. Results: The group which used the pomegranate gel along with mechanical debridement showed signifi cant improvement in all the clinical and microbiological parameters included in the study when compared with the other three groups. Conclusion: Hence it can be concluded that the pomegranate gel when used as an adjunct with mechanical debridement was effi cient in treating gingivitis.

Problemas sociales relacionados con el estado de salud periodontal de la población infantil urbano-marginal venezolana / Social problems related with the periodontal health status of the infantile urban marginal population of Venezuela

En los países subdesarrollados, donde las intervenciones comunitarias de tipo promocional o protector no han sido firmemente establecidas y en los que no existe seguimiento y control de los programas de educación y prevención para la salud, la mayoría de los individuos presentan gingivitis crónica desde edades tempranas, alcanzando esta su máxima expresión antes de los 20 años y manteniéndose igual durante toda la vida. A veces avanza a periodontitis, si no es tratada adecuadamente, lo cual tiene un impacto considerable tanto sobre la salud pública general como sobre los recursos económicos dedicados a mantenerla. En Venezuela, a pesar de que se cuenta con odontólogos especializados muy competentes, hospitales y clínicas con estructura e infraestructura adecuadas, la población más pobre carece de los servicios de salud bucal que necesitan, ya que existe un encarecimiento desmedido de los servicios médicos y estomatológicos privados. Se escribe este artículo con el objetivo de abordar los problemas sociales que más influyen en el estado de salud periodontal de la población infantil urbano marginal venezolana. La deficiente organización social, la exclusión de las clases con menos ingresos, las escasas medidas preventivo educativas sobre salud bucodental aplicadas por los servicios locales de salud, la pobre valoración de la población acerca de su salud general y bucal, la falta de motivación y por consiguiente de programas educativo-preventivos, fueron los problemas sociales más relacionados con el deterioro de la salud periodontal de esta población.

In the underdeveloped countries where the promotional or protecting communitarian intervention have not being firmly established, and where there is not follow-up and control of the health education and prevention programs, most of the individuals have Chronic Gingivitis since early ages, it reaches its maximal expression before arriving to 20 years old, and keeps the same during the whole life; sometimes it develops to periodontitis, if it is not adequately treated, having a considerable impact both on the general public health and on the economic resources used to keep it. Although there are in Venezuela very competent specialized odontologists, hospitals and clinics with the adequate structures and infrastructures, the poorest population does not have access to the oral health services they need, because there is a an excessive price raise of the private stomatologic and medical services. We write this article with the objective of dealing with the social problems striking on the periodontal health of the Venezuelan infantile urban marginal population. The deficient social organization, the exclusion of the classes with fewer incomes, the scarce preventive educative measures on oral dental health applied by the local health services, the poor evaluation the population makes on their general and oral health, the lack of motivation and therefore of educative-preventive programs, were the social problems related with the worsening of this population’s periodontal health.

Relación entre la higiene bucal y la gingivitis en jóvenes / Relation between oral hygiene and the gingivitis in the young people

INTRODUCCIÓN: la gingivitis es del tipo de enfermedad periodontal que se observa con más frecuencia en pacientes jóvenes; afecta los tejidos blandos que rodean al diente sin dañar los tejidos de soporte. OBJETIVO: determinar la relación entre higiene bucal y gingivitis en jóvenes. MÉTODOS: se realizó un estudio observacional descriptivo de corte transversal desde septiembre de 2008 a julio de 2009, para ello fue seleccionada una muestra de 300 jóvenes del sexo masculino. Se realizó una encuesta para medir los conocimientos teóricos sobre la higiene bucal. La eficiencia del cepillado se obtuvo a través del índice de Love. Con el índice gingival de Silness y L÷e se determinó el estado de salud gingival. RESULTADOS: el 45,6 por ciento los examinados obtuvo calificación de regular en conocimientos sobre higiene bucal. En la eficiencia del cepillado, 127 examinados obtuvieron regular. El 82 por ciento estaba afectado, con predominio de la inflamación gingival moderada. CONCLUSIONES: se determinó que existe una relación inversa entre la higiene bucal y la gingivitis

INTRODUCTION: the gingivitis is the more frequent periodontal disease present in young patients involving the soft tissues surrounding tooth without to damage the support tissue. OBJECTIVE: to determine the relation among the oral hygiene and gingivitis in young people. METHODS: a cross-sectional, descriptive and observational study was conducted from September, 2008 to July, 2009 including a sample of 300 young people of male sex. A survey was made to measure the theoretical knowledges on oral hygiene. The brushing effectiveness was achieved through the Love's index. Using the Silness and L÷e gingival index it was possible to determine the gingival health status. RESULTS: the 45.6 percent of examined patients had a qualification of regular in knowledge on oral hygiene. The 82 percent was affected with predominance of moderate gingival inflammation. CONCLUSIONS: it was conclude that there is an inverse relation between the oral hygiene and the gingivitis

Immunohistochemical evaluation of the inflammatory response in periodontal disease

In order to contribute to the knowledge of the pathogenesis of periodontal disease, an immunohistochemical analysis of the density of inflammatory mononucleated cells and the number of dendritic cells was performed using anti-CD4, anti-CD20, anti-CD25, anti-CD68 and anti-protein S-100 antibodies in 17 cases of chronic gingivitis (CG) and 25 of chronic periodontitis (CP). The CD4+ and CD68+ cells exhibited a diffuse distribution in the connective tissue. CD20+ cell distribution was predominantly in groups and the CD25+ cells exhibited a diffuse or focal distribution. The S-100+ cells were identified in the epithelium and the lamina propria, exhibiting distinct morphology and number. The statistical analysis showed no significant differences (p>0.05) between CG and CP regarding the density of the CD4+ and CD20+ cells and the number of S-100+ cells. However, significant differences (p<0.05) were found between the groups in the density of CD25+ and CD68+ cells . The density of macrophages was greater in CG and the level of cellular activation of the lymphocyte infiltrate was greater in CP. No differences were detected between the aforementioned conditions regarding the density of the T and B lymphocytes and to the number of the dendritic cells.

Com o objetivo de contribuir para um melhor entendimento na etiopatogenia da doença periodontal, um análise imuno-histoquímica da densidade das células inflamatórias mononucleares e da quantidade das células dendríticas foi realizada utilizando os anticorpos anti-CD4, anti-CD20, anti-CD25, anti-CD68 and anti-proteína S-100 em 17 casos de gengivite crônica (GC) e 25 casos de periodontite crônica (PC). As células CD4+ e CD68+ exibiram distribuição difusa no tecido conjuntivo, enquanto que a distribuição das células CD20+ foi predominantemente em grupos, e as CD25+ exibiram distribuição ora difusa ora focal. As células S-100+ foram identificadas no epitélio e na lamina própria, exibindo morfologia e números distintos. A análise estatística não demonstrou diferenças estatisticamente significativas em relação a densidade das células CD4+ e CD20+ e no número de células S-100+ entre os casos de CG e PC. Entretanto, houve diferenças em relação a densidade das células CD25+ e CD68+ entre os grupos (p<0,05). A densidade dos macrófagos foi maior em GC e o nível de ativação celular do infiltrado linfocítico foi maior em PC, não havendo diferenças em relação a densidade de linfócitos T e B, bem como no número de células dendríticas entre as condições anteriormente mencionadas.

Expresión inmunohistoquímica de la población celular macrofágica en la enfermedad periodontal. / Immunohistochemical expression of macrophagic cellular population in periodontal disease.

El papel de la respuesta inmunológica en la patogénesis de la enfermedad periodontal constituye tema constante de investigación por diversos autores. En el presente trabajo se propuso realizar un análisis inmunohistoquímico de la densidad y del patrón de distribución de la población celular macrofágica utilizando el anticuerpo anti-CD68 en 17 casos de gingivitis crónica y 25 de periodontitis crónica. Las células CD68+ se distribuyeron difusamente por todo el tejido conectivo. El análisis estadístico reveló diferencia significativa entre los especimenes estudiados (p < 0,05), siendo la densidad de las células macrofágicas mayor en la gingivitis crónica. Los resultados observados sugieren una mayor participación de esas células en la patogénesis de la gingivitis.

The important function of immunological reaction in periodontal disease has been studied by several reports. In order to achieve contributive information to the knowledge of the pathogeny of this disease, an immunohistochemical analysis of the density and distribution of macrophagic cells was realized using anti-CD68 antibody  in 17 cases of chronic gingivitis and 25 cases of chronic periodontitis. The CD68+ cells exhibited diffuse distribution in the connective tissue. The statistical analysis shown differences in relation to the density of this cells between the groups (p < 0,05), where the density of macrophacgic cells was higher in the chronic gingivitis. Its results can infer that the macrophagic cells has greated role in the pathogenesis of gingivitis.