Periodontal disease and its relationship with preterm labor and/or newborns with low birth weight / A doença periodontal e sua relação com o parto prematuro e/ou recém-nascidos com baixo peso ao nascer

Objective - To establish a relationship between the periodontal disease and premature birth babies and/or low birth weight babies, to determine that the periodontal disease may be an independent risk factor for these conditions. Methods - Forty-two pregnant women who attended the prenatal visits at Cruz de Malta Assistance Center (Brazil) were enrolled in this study. Each woman was submitted to a questionnaire and to a comprehensive periodontal exam. From the periodontal exam the pregnant women were assigned into two groups. Results - The first group was composed by periodontal disease (n=18) with an average pregnancy period of 36 weeks and newborns with weight average values of 3.210 Kg ± 0.490 Kg. The second group was composed by women without periodontal disease (n=24) who presented an average pregnancy period of 35 weeks and 5 days ± 3 days and newborns with weight average values of 2.920 Kg ± 0.510 Kg. The other risk factors cited above were also evaluated. Conclusion - It was possible to conclude through this present study that the periodontal disease did not interfere in a negative way neither on the pregnancy time nor on the newborn weight. Thus it cannot be classified as an independent risk factor for preterm labors and/or newborns with low birth weight babies.

Objetivo - Estabelecer uma relação entre a doença periodontal e bebês prematuros ao nascimento e/ou bebês de baixo peso, para determinar que a doença periodontal pode ser um fator de risco independente para essas condições. Métodos - Quarenta e duas mulheres grávidas que participaram das consultas pré-natais no Centro Assistencial Cruz de Malta (Brasil) foram incluídos neste estudo. Cada mulher foi submetida a um questionário e de um exame abrangente periodontal. A partir do exame periodontal as gestantes foram divididas em dois grupos. Resultados - O primeiro grupo foi composto por doença periodontal (n=18) com um período de gestação média de 36 semanas e recém-nascidos com peso valores médios de 3,210 kg ± 0,490 kg. O segundo grupo foi composto por mulheres sem doença periodontal (n=24), que apresentou um período de gestação média de 35 semanas e 5 dias ± 3 dias e recém-nascidos com peso valores médios de 2,920 kg ± 0,510 kg. Os outros fatores de risco citados acima também foram avaliados. Conclusão - Foi possível concluir através deste estudo que a doença periodontal não interferiu de forma negativa nem sobre o tempo de gravidez, nem no peso ao nascer. Assim, não pode ser classificado como um fator de risco independente para partos pré-termo e/ou recém-nascidos com baixo peso ao nascer.

Incidence of Entamoeba gingivalis and Trichomonas tenax in samples of dental biofilm and saliva from patients with periodontal disease / Incidência de Entamoeba gingivalis e Trichomonas tenax em amostras de biofilme e saliva de pacientes com doença periodontal

OBJECTIVE: This study analyzed the incidence of Entamoeba gingivalis and Trichomonas tenax in samples of dental biofilm and saliva from patients with gingivitis / periodontitis and in healthy subjects. METHODS: Biofilm and saliva samples were taken from 20 patients with gingivitis, 22 with periodontitis and 9 healthy individuals. They were spread on sterile Petri dishes, diluted with saline and examined with a light microscope. Salivary pH was determined by universal pH indicators trips. The chi-square test was used to determine significance (p<0.05). RESULTS: Almost one-third (31.37 percent) (50 percent from gingivitis and 50 percent from periodontitis) of the biofilm samples and 35.29 percent (39 percent from gingivitis and 61 percent from periodontitis) of the saliva samples were positive for Entamoeba gingivalis. Trichomonas tenax was found in 22.53 percent of the biofilm samples (16.66 percent from gingivitis, 41.67 percent from periodontitis and 41.67 percent from healthy patients) and 9.81 percent of the saliva samples (20 percent from gingivitis, 40 percent from periodontitis and 40 percent from healthy patients).The presence of these microorganisms was related to the type of periodontal disease (p=0.001), but not with age (p=0.178) or risk factors (p=0.194). CONCLUSION: These findings suggest that Entamoeba gingivalis more common in the early stages of periodontitis, while Trichomonas tenax is considered a protozoan of the gingival sulcus. However, further studies are needed to determine the relationship between these species and periodontitis.

OBJETIVO: Analisar a incidência de Entamoeba gingivalis e Trichomonas tenax em amostras de biofilme dental e saliva de pacientes com gengivite/periodontite e de indivíduos saudáveis. MÉTODOS: Amostras de saliva e biofilme foram obtidas de 20 pacientes com gengivite, 22 com periodontite e 9 indivíduos saudáveis. O material foi depositado em placas de Petri e diluído em soro fisiológico para posterior observação. O pH das amostras de saliva foi determinado com fitas indicadoras de pH. Os dados foram tratados por teste qui-quadrado (p<0,05). RESULTADOS: Foi observada positividade para Entamoeba gingivalis em 31,37 por cento das amostras de biofilme (50,00 por cento com gengivite e 50,00 por cento com periodontite) e 35,29 por cento de saliva (39,00 por cento gengivite e 61,00 por cento periodontite). Foi observado o Trichomonas tenax em 22,53 por cento das amostras de biofilme (16,66 por cento gengivite, 41,67 por cento periodontite, e 41,67 por cento saudáveis) e 9,81 por cento de saliva (20,00 por cento gengivite, 40,00 por cento periodontite, e 40,00 por cento saudáveis). A presença de parasitas esteve relacionada ao tipo de doença periodontal (p=0,001), mas não a idade (p=0,178) e a fatores de risco (p=0,194). CONCLUSÃO: Estes achados sugerem que a Entamoeba gingivalis aparece mais em estágios iniciais da periodontite, enquanto que o Trichomonas tenax é considerado um protozoário do sulco gengival. Contudo, outros estudos são necessários para determinar a relação entre essas espécies e a periodontite.

Prevalence of oral Entamoeba gingivalis and Trichomonas tenax in patients with periodontal disease and healthy population in Shiraz, southern Iran.

Background: It was shown that two parasites of Entamoeba gingivalis (E. gingivalis) and Trichomonas tenax (T. tenax) may be responsible for oral parasitic infection. This study was designed to evaluate the prevalence of these parasites in oral cavity of patients with periodontal disease and in healthy population in Shiraz, Southern Iran. Materials and Methods: A total of 50 patients with periodontal disease (case group) and 50 subjects with healthy gingiva (control group) entered in the present study. A questionnaire recorded general health, smoking habits, and any history of antibiotic consumption during the last six months for each patient. In the case group, saliva was collected by sterile swab and the gingival crevicular fluid by the paper point. The plaque and calculi were collected by sterile curette and scaler. In the control group, saliva and gingival crevicular fluid were collected and sent to laboratory for further studies. Results: In the case group, nine patients were infected, six with E. gingivalis and three with T. tenax. Seven patients had mobility of the teeth, one patient was smoker and five had previous history of antibiotic consumption. In the control group, only one subject was infected with E. gingivalis without any history of smoking and antibiotic consumption. Conclusion: Parasitic infections are relatively common in patients with periodontal disease. It seems that follow-up of instructions are essential in control of parasitic infection in Southern Iran.

Estudos de freqüência, morfologia e diagnóstico de Entamoeba gingivalis, Gros, 1849 / Frequency, morphology and diagnosis studies of Entamoeba gingivalis, Gros, 1849

Entamoeba gingivalis is found only in its trophozoite form and it is postulated that its main transmission mechanism is through the kiss. E. gingivalis is considered pathogenic by some authors and commensal to others. It does not have a defined role in the installation of disease. To address some of this questions we studied a 100 patients who were seen through the Odontological Hospital from the Universidade Federal de Uberlândia in order to determine its frequency in the buccal cavity. The material were collected using swabs from four different buccal sites and the smears were stained by a modified Papanicolaou technique. The results revealed positivity index of 62 per cent. The affinity of the dye to the food vacuole contents and to the ingested bacterias prevents clear visualisation of the central and peripherical chromatin constituents of the parasite's nucleus. Mouth washes with 3ml of saline from 10 patients, were used to evaluate which parasitological method of diagnosis (fresh, iron-haematoxylin stained, Giemsa and Papanicolaou) gives better visualisation of the parasite. The mouth washes sediment from fresh material revealed 100 per cent of positivity and clear visualisation of the free form and locomotion of the trophozoites. No stained technique of the smear showed adequate visualisation, presenting the nucleus partially covered by the food vacuoles. In stained preparations by toluidine blue ultrastructure analysis of the morphology of parasite can be observed.